When Systems Are Strained, Communities Still Matter: How Amref Uganda Sustains Care amid Challenging Times.

Wednesday, 11 February, 2026

The year 2025 tested health systems across Africa in unprecedented ways. Declining donor funding, shifting global priorities, and the withdrawal of key partners placed immense pressure on frontline services. Yet, in many communities, care did not stop. It adapted. It endured. It continued, because of strong local institutions and committed health workers.

In Uganda’s West Nile region, within the Rhino Camp refugee settlement, this resilience is visible every day at Ofua Health Centre II.

A Lifeline for Refugee and Host Communities

Ofua Health Centre II serves both refugee and host communities in Ofua 6 and surrounding villages, reaching an estimated population of more than 9,500 people. Following the exit of several USAID-supported partners, the facility has become the primary source of healthcare for many neighboring communities. What was once a facility serving about 60 patients per day now receives close to 100. Patients walk long distances-sometimes over 15 kilometers-to access basic services. For many, Ofua is the only remaining option.

Despite these growing demands, Amref Health Africa in Uganda continues to support the facility with a small but dedicated team: a clinical officer, nurse, laboratory assistant, and midwife. Together, they deliver lifesaving care under increasingly difficult conditions.

Doing More with Less

The withdrawal of partners providing maternal health, nutrition, referrals, WASH, and ambulance services has left major gaps. Drug supplies are stretched. Essential medicines are consumed faster than planned. Complementary services such as ultrasound scans and emergency referrals have disappeared.

Community outreach programs and support for Village Health Teams (VHTs) have also been affected. Without facilitation, many VHTs struggle to continue providing household-level care and health education. This weakens early detection, prevention, and follow-up-especially for children, women, and persons with disabilities.

Yet, Amref Uganda has remained present. Through integrated outreach services supported by Amref Health Africa in Netherlands, the organisation continued to bring immunisation, antenatal care, nutrition screening, family planning, and ICCM services closer to vulnerable households. Even in these limitations, the commitment to community-centred healthcare remains unwavering.

Infrastructure Challenges, Human Commitment

Beyond staffing and supplies, infrastructure poses another challenge. Water shortages compromise infection prevention. Power outages following the breakdown of a solar inverter affect security and service delivery. Facility structures require urgent renovation.

Still, health workers report for duty. Mothers continue to bring their children. Pregnant women seek antenatal care. Communities trust that help will be found. This trust is built on years of consistent engagement and presence.

Staying Relevant Through Local Leadership

The experience at Ofua reflects a broader reality across Uganda following the difficult year of 2025. As external funding fluctuated, Amref Uganda strengthened its focus on:

Deepening community engagement
Working closely with district health systems
Supporting frontline workers
Expanding digital and media visibility
Building diversified partnerships

These efforts have helped ensure that essential services continue, even when traditional funding streams decline.

Like our colleagues in Ethiopia, who recently reflected on resilience in the face of uncertainty, Amref Uganda’s experience shows that strong local roots matter. When systems are strained, community-based institutions become the backbone of survival and recovery.

A Call for Renewed Partnership

The situation at Ofua Health Centre II highlights both the fragility and strength of humanitarian health systems. Without renewed investment and coordinated support, hard-won gains risk being reversed. But with strategic partnerships, targeted funding, and community leadership, recovery is possible.

Amref Health Africa in Uganda remains committed to standing with refugee and host communities, advocating for sustainable solutions, strengthening primary healthcare, and ensuring that no one is left behind. Because even when the lights flicker, strong roots can still hold.