Community-based health insights from rural Uganda: challenges and resilience in healthcare access

The Ugandan healthcare system is a multilevel, decentralised network comprised of both government and privately funded institutions. Disparities in healthcare access between urban and rural settings remain an issue in Uganda. A mix of ethnographic fieldwork and informal interviews was conducted within a rural community north of Kampala. These aimed to explore determinants of community health behaviours, healthcare challenges faced by residents and existing healthcare strategies and resources. Four key themes emerged from the discussions: healthcare access and utilisation, community culture and health-seeking behaviour, role of voluntary health teams and resource use and community-led solutions. Interviews with community leads highlighted several potential community-designed strategies to address these issues. These community reflections echo wider literature on rural healthcare access. Critically, the importance of health outreach, integration of traditional medicine and cultural sensitivity cannot be understated. Co-design and community collaboration is essential to ensure sustainable, asset-based approaches to rural healthcare problem solving.