The Bududa District

The Bududa District (Bududa) in eastern Uganda is a world apart. Located in the foothills of Mt. Elgon, it is a misty, remote area known for its Arabica coffee. Despite its beauty, Bududa is one of Uganda’s poorest regions and health services are desperately needed.

In 2010, the worst mudslide in Uganda’s history swept away the  health facility serving the Bukobero community and surrounding areas in Bududa. The health facility was never rebuilt and now people must walk miles for health care or use their meager resources for transport. During the rainy seasons, when rivers are swollen and bridges washed out, transport is often impossible.

Imagine being a women in labor having to walk miles through hills with elevations up to 5,900 feet and torrential rains to reach a health facility. The lack of health care in this area has resulted in one of the lowest rates of deliveries in medical facilities in the country.

Now there is a chance to bring much needed health services to the people of this beautiful region.

The Bududa District

The Bukobero Community Health Centre

This new health facility will be a Health Center III, which can provide maternity care and deliveries. It will be located in Buwali Sub County and accessible to the five surrounding sub counties. In this area, there are only three other health facilities serving 80,000 people and only one of those can provide maternity and delivery services.[1] 

Besides maternity services, the facility will provide comprehensive medical care, including primary care, HIV/AIDS testing, counseling, and treatment, vaccination programs, family planning, youth friendly services, and treatment for illnesses such as malaria, respiratory infections, and diarrheal diseases.

Health promotion and education will be a major focus – helping people remain healthy.

Land has been purchased safely out of the slide zone and additional land has been donated for a road and future clinic expansion. The Community Based Organization (CBO) owns the land and will operate the clinic. The CBO management team is comprised of elders, activists, and leaders, both men and women. Mobilizers are spreading the word to surrounding villages.

Much is already going on! The land has been cleared and graded. A water system installed which will supply clean water to the facility and the surrounding community, and plans completed. Once construction starts, the community will continue to contribute through in-kind donations. The CBO is also working with additional partners, such as Kilowatts for Humanity, which is  designing a solar system to operate the facility, and the Elgon Wildlife Conservation Organization, which teaches about the important connection between health, population, and the environment.

The CBO also knows the importance of sustainability and has started a cooperative to develop income-generating activities to help support the clinic in the future. These will potentially include bee keeping, brick making, and a coffee cooperative. And the Ugandan team is learning about health financing with the hope of starting a health insurance program for the community.

The Need

Accessible health services are critically needed in Bududa. The health of women and children have been particularly affected.

  • 49% of children under five years of age are stunted, almost twice the national average [2]. Poverty is not the only reason for stunting. Frequent infections early in life are also a risk factor [3] .
  • Only 24% of deliveries are in health facilities, risking the health of the mother and child [4].
  • Lack of access to family planning has resulted in a fertility rate of approximately 7.2 births per woman compared with 5.4 nationally [2]. Women with five or more pregnancies are at much higher risk for maternal and neonatal complications.
  • 43% of the population lives in extreme poverty, or below the equivalent $1.90 a day.
  • The high birth rate has put excessive pressure on the land, leading to deforestation and slides as population pressure pushes cultivation higher and higher.

The importance of youth friendly services

According to the USAID, the average Ugandan is a fourteen-year-old girl who has a one-in-four risk of becoming pregnant during adolescence. She will likely drop out of school before reaching secondary level [5]. 48% of the population is under age 15 [6].

Youth friendly services are critically needed. These services are tailored to the specific emotional, physical, and health needs of youth. The Bukobero Community Health Centre will provide them.

Even before the health center is built, the CBO is already leading the way by developing a soccer club, for both boys and girls.

The Kuushu Rising Stars Football Club was started in 2018 with gifts from friends in the UK, two American sisters, and from community donations. It is providing positive activities for youth helping to keep them in school and focused on their futures. (And it is winning tournaments!)

Girls of the Kuushu Rising Stars Football Club
Boys of the Kuushu Rising Stars Football Club


[1] Health Facilities Inventory, Uganda Ministry of Health, 2012.

[2] Uganda Demographic and Health Survey, 2016.

[3] Dewey, et al. Long-term consequences of stunting in early life. Maternal and Child Nutrition, 2011.

[4] Bududa District Local Government Statistical Abstract, 2012.

[5] USAID Uganda Country Development Cooperation Strategy, 2016-2021.

[6] World Population Prospects: The 2017 Revision, United Nations.