Reaching the Last Mile: Amref Health Africa and Partners Improve Access To Healthcare For Island Communities in Mityana District.

By Daphine Ayebare

The Saving Lives and Livelihoods (SLL) project, implemented by Amref Health Africa in Uganda in partnership with Africa CDC, African Union, and Ministry of health in Uganda & funded by the MasterCard Foundation, has been a game-changer for communities in hard-to-reach areas of Mityana District. On August 13, 2025, the project provided life jackets to health workers from 3 health facilities which support the island communities in Katiko, Bagwe and Mabo Islands along Lake Wamala, ensuring their safety as they deliver essential health services to the last mile.

Kawooya Vincent, the District Health Officer (DHO) for Mityana, says this support has been a huge relief. “We can only be productive if we are alive and improve the livelihood of our communities,” he said. “One of the biggest challenges has been accessing these islands with health services. This is the issue that Amref has solved today through provision of life jackets to supervisors and vaccination teams to ensure last mile coverage.” This sentiment is echoed by Ronald Kateregga, a project officer, who explained that a key priority for the project is to extend services to hard-to-reach communities, of which Islands qualify, as well as people living with comorbidities and the elderly. “People here have to move long distances including crossing the lake, which is a huge barrier to the health facility to access services. Maanyi Health Center III which is a sub-county health facility has a catchment of 25,000 including residents of Mabo Island.

Kakule Henry, the In-Charge, highlighted the challenges faced by the facility, including understaffing, lack of transport, and safety equipment for health workers.

“If a health worker is to move from facility to island, it’s expensive for the facility in terms of fuel for the boat hire, so we stop at the landing sites and request the communities to cross for services, which is also financially constraining for them.” Kakule Henry, Incharge Maanyi Health Center III

Henry added that “without partners like Amref to support, we would not be able to reach the islands with integrated services through outreaches.”

The project’s impact is evident in the stories of beneficiaries like Nakato Florence, a 32-year-old resident of Mabo Island who came for the first integrated outreach conducted by SLL on the Island. “I brought my baby to get the malaria and polio vaccines. The services were provided fast, and were easy to access,” she said, beaming with joy. “I also got an antenatal check-up as I am one and a half months pregnant with my second child.” Nakato got her Td1 (tetanus-diphtheria) shot to prevent tetanus and tested for HIV/AIDs as well. She elaborated that it would have cost up to UGX 40,000 exclusive of treatment to and from Maanyi Health Centre III to get these services, which is quite expensive.

Joseph Tibakanya, 62, also benefited from the outreach. “The Village health team members did door-to-door mobilization to let us know of the nurses’ coming, and that is how I was able to attend,” he said, grateful for the support.

Between January and August 2025, the Saving Lives and Livelihoods project has supported the Ministry of Health to vaccinate 3,090 young girls and women against HPV, 2,718 men and women against Hepatitis B and 11,158 against yellow fever which is 63.8% of the intended target. Additionally, 10,019 non-pregnant women received the tetanus-diphtheria vaccine (Td1), and 17,129 pregnant women received the Td vaccine, which accounts for 84.3% of the intended target in Mityana district.

Integrated Community Outreaches

Integrated Community Outreaches provide a range of essential health services, including immunization, antenatal care, postnatal care, HIV testing and counseling, and screening for chronic diseases like hypertension and diabetes. By bringing these services to the community level, the project is increasing access to healthcare and reducing the burden on individuals who would otherwise have to travel long distances to receive care.

The SLL project has also strengthened the capacity of Village Health Teams and health workers to deliver quality vaccination services and other health interventions, provided logistical support for transportation of vaccines and essential supplies to hard-to-reach areas and improved data capture and quality in 7 other districts in the Mubende region (Mubende, Kiboga, Kasanda, Nakasongola, Kyankwanzi, Luweero and Nakaseke)

The project’s partnerships with the Ministry of Health, District Health Offices, and other stakeholders are critical to sustaining its outcomes. These collaborations will ensure that the project gains are institutionalized and can be maintained beyond the project’s lifespan, driving progress towards Universal Health Coverage.

Amref Health Africa

Amref Health Africa teams up with African communities to create lasting health change.