Opal Health
Blog
Team reflections
Opal Health is officially launched!
June 2026
Our program is up and running! May was our first month of delivery, and communities really turned out. 890 people, 124% of our target, joined our village-based maternal and newborn health dialogues guided by government #CHEWs, to talk about why mothers and babies die and what they can do about it.

Those stats are encouraging early signals we'll continue to monitor. But what stayed with me most: CHEWs used the gatherings to conduct general wellness checks on participants: measuring blood pressure, following up on children feeling unwell, assessing arm circumference to advise on nutrition. Nobody asked them to; I had actually forgotten to include it in the trainings.
A Community Health Extention Worker (CHEW) measures the blood pressure of PLA participants in Atoot Sub-County, Ngora District, Uganda. May 2026
Participants gather for PLA meetings in Atoot Sub-county, Ngora District, Uganda. May 2026.
There's a lot written about how the #PLA method strengthens health systems beyond its primary outcomes. It was really great watching that integrated delivery happen on its own.

Curious about our work or interested in community health? We'd love to chat. Please reach out.
What is PLA-MNH?
May 2026
Participatory Learning and Action is what happens when academics get their hands on a very simple concept.
Helpful, thanks. So what is PLA-MNH? Participatory Learning and Action for Maternal and Newborn Health (PLA-MNH) is a community dialogue method that brings people together to find and fix the real reasons mothers and babies don't get care in time. It sounds complicated, but it's really just problem-solving that starts with asking communities about their lived experiences.
How does it work? Community health talks are often didact. They consist of Community Health Workers (CHW) telling communities what they need to know, or should do, for their health with the goal of shifting behaviors. PLA has the same goal but starts from the believe that communities are best positioned to identify their barriers to care, and the strategies to solve them. A trained facilitator, in our case a government CHW, guides community members through a cycle of meetings — identifying local barriers to care, designing solutions, and taking action. No outside prescriptions. The community owns the problem and the answer. Under Opal Health's program, the facilitator is a government Community Health Extension Worker (CHEW) that our team has trained in the PLA method.
An Opal Health PLA meeting, guided by a Community Health Extention Workers (CHEW) in Atoot Sub-county. May 2026
Why use PLA? Most maternal and newborn deaths are preventable. Women often know care is available but don't reach it in time. Information campaigns alone don't change that. Collective action does. Across multiple RCTs, PLA-MNH has reduced maternal and neonatal mortality by up to 49%.
What are we here to find out? PLA-MNH has strong global evidence. What's less tested is whether it can fully integrate into government health systems — and what happens when it does. We're asking: does it strengthen community health delivery beyond maternal health? Does it clear the cost-effectiveness bar of at least 8x a direct cash transfer? And can it become a standard part of how Uganda's Community Health Extension Workers serve their communities — with lessons for other countries?
Opal Health Feasibility Analysis: Assessing PLA's potential for impact in Eastern Uganda
December 2025
A focus group with mothers in Ngora District
Meeting Dr Deogratias, the Senior Medical Officer for Reproductive and Child Health in the Ministry of Health
On the way to visit a health facility with Dr Anne Kabona, Deputy Director for Public Health at the Jinja Referral Hospital
December 2025 - Our visit to Uganda
𝗥𝗲𝗳𝗹𝗲𝗰𝘁𝗶𝗼𝗻𝘀 𝗳𝗿𝗼𝗺 𝗼𝘂𝗿 𝘀𝗰𝗼𝗽𝗶𝗻𝗴 𝘃𝗶𝘀𝗶𝘁: Matthew Beer and I have just returned from a trip to Eastern Uganda where we assessed the feasibility of an Opal Health pilot. With major programmes winding down, we wanted to understand whether a new NGO could add sustainable value. Across 7 districts, we met mothers, community health workers, clinicians, and district leaders who welcomed us with openness and candour. Here’s what stood out:

𝟭. 𝗖𝗼𝗺𝗺𝘂𝗻𝗶𝘁𝗶𝗲𝘀 𝗮𝗿𝗲 𝗿𝗲𝗮𝗱𝘆 𝘁𝗼 𝗹𝗲𝗮𝗱: We saw strong appetite for local problem-solving. As one FGD participant put it, “𝘸𝘦 𝘩𝘢𝘷𝘦 𝘢 𝘨𝘳𝘰𝘶𝘱 𝘳𝘪𝘨𝘩𝘵 𝘩𝘦𝘳𝘦, 𝘭𝘦𝘵’𝘴 𝘴𝘵𝘢𝘳𝘵!” This reinforced the value in initiatives that support existing momentum by providing the structure and tools for collective action.

𝟮. 𝗧𝗵𝗲 𝗶𝗻𝘃𝗲𝘀𝘁𝗺𝗲𝗻𝘁 𝗰𝗮𝘀𝗲 𝗳𝗼𝗿 𝗰𝗼𝗺𝗺𝘂𝗻𝗶𝘁𝘆 𝗵𝗲𝗮𝗹𝘁𝗵 𝗶𝘀 𝘀𝘁𝗿𝗼𝗻𝗴, 𝗮𝗻𝗱 𝘁𝗶𝗺𝗲𝗹𝘆: Uganda’s earlier gains on maternal mortality show what’s possible when facility improvements and community engagement move together. As progress stalls, due in part to the changing funding landscape, the government’s CHEW model provides the right framework to move it forward. However, their outreach capacity remains limited. A district leader put it plainly: “𝘰𝘶𝘳 𝘤𝘩𝘳𝘰𝘯𝘪𝘤 𝘱𝘳𝘰𝘣𝘭𝘦𝘮 𝘪𝘴 𝘵𝘩𝘦 2 𝘥𝘦𝘭𝘢𝘺𝘴: 𝘞𝘦 𝘯𝘦𝘦𝘥 𝘱𝘢𝘳𝘵𝘯𝘦𝘳𝘴 𝘵𝘰 𝘩𝘦𝘭𝘱 𝘶𝘴 𝘦𝘯𝘤𝘰𝘶𝘳𝘢𝘨𝘦 𝘸𝘰𝘮𝘦𝘯 𝘵𝘰 𝘴𝘦𝘦𝘬 𝘢𝘯𝘥 𝘢𝘤𝘤𝘦𝘴𝘴 𝘤𝘢𝘳𝘦 𝘰𝘯 𝘵𝘪𝘮𝘦.” This points to the need for solutions that can layer on to existing community structures, supporting their reach and effectiveness.

𝟯. 𝗖𝗼𝗺𝗺𝘂𝗻𝗶𝗰𝗮𝘁𝗶𝗼𝗻 𝗶𝘀 𝗯𝗼𝘁𝗵 𝗮 𝗿𝗼𝗼𝘁 𝗰𝗮𝘂𝘀𝗲 𝗮𝗻𝗱 𝗮 𝗽𝗮𝘁𝗵𝘄𝗮𝘆 𝘁𝗼 𝘀𝗼𝗹𝘂𝘁𝗶𝗼𝗻𝘀: Delays in care often stem from misinformation, fear, and distrust. Communities and service providers alike asked for platforms that enable dialogue, strengthen accountability, and help them solve problems collectively.

𝟰. 𝗧𝗵𝗲 𝗲𝘅𝗽𝗲𝗿𝘁𝗶𝘀𝗲 𝗶𝘀 𝗮𝗹𝗿𝗲𝗮𝗱𝘆 𝘁𝗵𝗲𝗿𝗲. 𝗢𝘂𝗿 𝗿𝗼𝗹𝗲 𝗶𝘀 𝘁𝗼 𝗰𝗼𝗻𝗻𝗲𝗰𝘁 𝗮𝗻𝗱 𝗮𝗰𝗰𝗲𝗹𝗲𝗿𝗮𝘁𝗲 𝗶𝘁: We found strong talent across the system. With large programmes closing, there is space for actors who can reconnect the system; using seed capital to activate existing capacity and create opportunities for national experts to lead.

𝗪𝗲 𝗰𝗼𝗻𝗰𝗹𝘂𝗱𝗲 𝘁𝗵𝗶𝘀 𝘀𝗰𝗼𝗽𝗶𝗻𝗴 𝗺𝗶𝘀𝘀𝗶𝗼𝗻 𝗰𝗼𝗻𝗳𝗶𝗱𝗲𝗻𝘁 𝘁𝗵𝗮𝘁 𝘁𝗵𝗶𝘀 𝗶𝘀 𝗮 “𝘆𝗲𝘀, 𝗮𝗻𝗱” 𝗺𝗼𝗺𝗲𝗻𝘁: 𝘺𝘦𝘴, Opal Health can add value, 𝘢𝘯𝘥 this can be done by strengthening systems and amplifying community voices. We aim to begin working in communities by March 2026 and will share updates as we progress.

Thanks to our advisors—Benson Odong, azizi buyinza, Edmund Emulu, Yatin Nana, Emmanuel George Okurut, Nicolas Laing — who made our trip a success and all those who took the time to meet then and since.
Opal Health Feasibility Analysis: Assessing PLA's potential for impact in Eastern Uganda
December 2025
A focus group with mothers in Ngora District
Meeting Dr Deogratias, the Senior Medical Officer for Reproductive and Child Health in the Ministry of Health
On the way to visit a health facility with Dr Anne Kabona, Deputy Director for Public Health at the Jinja Referral Hospital
December 2025 - Our visit to Uganda
𝗥𝗲𝗳𝗹𝗲𝗰𝘁𝗶𝗼𝗻𝘀 𝗳𝗿𝗼𝗺 𝗼𝘂𝗿 𝘀𝗰𝗼𝗽𝗶𝗻𝗴 𝘃𝗶𝘀𝗶𝘁: Matthew Beer and I have just returned from a trip to Eastern Uganda where we assessed the feasibility of an Opal Health pilot. With major programmes winding down, we wanted to understand whether a new NGO could add sustainable value. Across 7 districts, we met mothers, community health workers, clinicians, and district leaders who welcomed us with openness and candour. Here’s what stood out:

𝟭. 𝗖𝗼𝗺𝗺𝘂𝗻𝗶𝘁𝗶𝗲𝘀 𝗮𝗿𝗲 𝗿𝗲𝗮𝗱𝘆 𝘁𝗼 𝗹𝗲𝗮𝗱: We saw strong appetite for local problem-solving. As one FGD participant put it, “𝘸𝘦 𝘩𝘢𝘷𝘦 𝘢 𝘨𝘳𝘰𝘶𝘱 𝘳𝘪𝘨𝘩𝘵 𝘩𝘦𝘳𝘦, 𝘭𝘦𝘵’𝘴 𝘴𝘵𝘢𝘳𝘵!” This reinforced the value in initiatives that support existing momentum by providing the structure and tools for collective action.

𝟮. 𝗧𝗵𝗲 𝗶𝗻𝘃𝗲𝘀𝘁𝗺𝗲𝗻𝘁 𝗰𝗮𝘀𝗲 𝗳𝗼𝗿 𝗰𝗼𝗺𝗺𝘂𝗻𝗶𝘁𝘆 𝗵𝗲𝗮𝗹𝘁𝗵 𝗶𝘀 𝘀𝘁𝗿𝗼𝗻𝗴, 𝗮𝗻𝗱 𝘁𝗶𝗺𝗲𝗹𝘆: Uganda’s earlier gains on maternal mortality show what’s possible when facility improvements and community engagement move together. As progress stalls, due in part to the changing funding landscape, the government’s CHEW model provides the right framework to move it forward. However, their outreach capacity remains limited. A district leader put it plainly: “𝘰𝘶𝘳 𝘤𝘩𝘳𝘰𝘯𝘪𝘤 𝘱𝘳𝘰𝘣𝘭𝘦𝘮 𝘪𝘴 𝘵𝘩𝘦 2 𝘥𝘦𝘭𝘢𝘺𝘴: 𝘞𝘦 𝘯𝘦𝘦𝘥 𝘱𝘢𝘳𝘵𝘯𝘦𝘳𝘴 𝘵𝘰 𝘩𝘦𝘭𝘱 𝘶𝘴 𝘦𝘯𝘤𝘰𝘶𝘳𝘢𝘨𝘦 𝘸𝘰𝘮𝘦𝘯 𝘵𝘰 𝘴𝘦𝘦𝘬 𝘢𝘯𝘥 𝘢𝘤𝘤𝘦𝘴𝘴 𝘤𝘢𝘳𝘦 𝘰𝘯 𝘵𝘪𝘮𝘦.” This points to the need for solutions that can layer on to existing community structures, supporting their reach and effectiveness.

𝟯. 𝗖𝗼𝗺𝗺𝘂𝗻𝗶𝗰𝗮𝘁𝗶𝗼𝗻 𝗶𝘀 𝗯𝗼𝘁𝗵 𝗮 𝗿𝗼𝗼𝘁 𝗰𝗮𝘂𝘀𝗲 𝗮𝗻𝗱 𝗮 𝗽𝗮𝘁𝗵𝘄𝗮𝘆 𝘁𝗼 𝘀𝗼𝗹𝘂𝘁𝗶𝗼𝗻𝘀: Delays in care often stem from misinformation, fear, and distrust. Communities and service providers alike asked for platforms that enable dialogue, strengthen accountability, and help them solve problems collectively.

𝟰. 𝗧𝗵𝗲 𝗲𝘅𝗽𝗲𝗿𝘁𝗶𝘀𝗲 𝗶𝘀 𝗮𝗹𝗿𝗲𝗮𝗱𝘆 𝘁𝗵𝗲𝗿𝗲. 𝗢𝘂𝗿 𝗿𝗼𝗹𝗲 𝗶𝘀 𝘁𝗼 𝗰𝗼𝗻𝗻𝗲𝗰𝘁 𝗮𝗻𝗱 𝗮𝗰𝗰𝗲𝗹𝗲𝗿𝗮𝘁𝗲 𝗶𝘁: We found strong talent across the system. With large programmes closing, there is space for actors who can reconnect the system; using seed capital to activate existing capacity and create opportunities for national experts to lead.

𝗪𝗲 𝗰𝗼𝗻𝗰𝗹𝘂𝗱𝗲 𝘁𝗵𝗶𝘀 𝘀𝗰𝗼𝗽𝗶𝗻𝗴 𝗺𝗶𝘀𝘀𝗶𝗼𝗻 𝗰𝗼𝗻𝗳𝗶𝗱𝗲𝗻𝘁 𝘁𝗵𝗮𝘁 𝘁𝗵𝗶𝘀 𝗶𝘀 𝗮 “𝘆𝗲𝘀, 𝗮𝗻𝗱” 𝗺𝗼𝗺𝗲𝗻𝘁: 𝘺𝘦𝘴, Opal Health can add value, 𝘢𝘯𝘥 this can be done by strengthening systems and amplifying community voices. We aim to begin working in communities by March 2026 and will share updates as we progress.

Thanks to our advisors—Benson Odong, azizi buyinza, Edmund Emulu, Yatin Nana, Emmanuel George Okurut, Nicolas Laing — who made our trip a success and all those who took the time to meet then and since.