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.