CHASE Africa’s Programme and Partnership Manager, Jo McClellan and Sexual and Reproductive Health and Rights (SRHR) Manager, Francis Kadiri recently visited the Nakivale Refugee Settlement in Uganda to catch up with our partner the Rwenzori Centre for Research and Advocacy (RCRA) on their pilot SRHR health and environment programme in the settlement. We have supported RCRA to launch the programme, providing SRHR services, outreach provision and dialogue to people living in Nakivale.
Outreach Services for the Nakivale Refugee Settlement
The Nakivale Refugee Settlement is the oldest in Uganda. Established in the 1960s the settlement has been running continuously for over 60 years and has a huge footprint of over 180 square kilometres. Currently, over 160,000 people live within the settlement, with this number set to grow significantly as it is now the only refugee settlement in Uganda accepting new refugees. 2024 has also seen an increase in pressure on Nakivale as international funding for refugee settlements in Uganda has been cut, due to refugee pressure in other parts of the world.
We support and fund RCRA to provide SRHR and family planning outreach services in two zones within Nakivale (overall there are five zones). RCRA work alongside the Office of the Prime Minister (OPM), the Ministry of Health (MOH) and Medical Teams International (MTI) and other groups operating within the site but are the only organisation offering SRHR and family planning outreach services.
Outreach Clinic in the Nakivale settlement
RCRAs Outreach services have become essential in the Nakivale settlement for a number of reasons:
- RCRA operate in the ‘intake’ zone where new residents are housed in temporary shelters with no security, meaning there is little opportunity (or willingness) to travel, to access healthcare services.
- Many people have arrived from countries with little knowledge of SRHR or family planning, so there is often further reticence to travel to access these services.
- The footprint of the settlement can be extremely restrictive for those that are willing to travel due to the distance and time required to reach static clinics.

Community Outreach Health Workers

Community Dialogue
Typical Outreach services that RCRA provide include;
Community Health Workers (CHWs) & Village Health Teams (VHTs), visiting people at their homes providing information, advice and family planning services and serving as the point of contact for various health-related issues.
Outreach Clinics, which provide temporary clinics in certain hard-to-reach areas, so residents don’t need to travel to access healthcare and services.
Dialogues, that provide a forum for information to be shared and offered in different settings. These gatherings are designed to disseminate information into the community and also move information upwards towards higher parts of government.
Backpack Nurse Clinics: These are facilitated by RCRA’s Backpack Nurse Grace Twinomuhangi, who visits two allocated zones of the settlement. Grace, is a full-time member of the RCRA team and splits her time between the Rubondo facility and the Ruhoko satellite clinic. She is currently the only staff member at either of the facilities with a sole focus on SRHR and Family Planning and reaches around 50 mothers each day. Grace provides Health education and family planning services as well as immunisation, antenatal support and sometimes assists deliveries.
“As well as providing immunization, vaccines and family planning methods I also offer health education information so that people can make their own informed decisions. I always perform many tests and at times help mothers who have birthing complications such as pre-eclampsia.”
– Grace Twinomuhangi, Outreach nurse, Nakivale refugee settlement.

Grace Twinonmuhangi - Outreach Nurse
Despite the extended challenges that RCRA have faced, they are looking ahead with plans to develop their offering in the Nakivale Settlement (including plans to employ a second full-time midwife and extend community dialogues). The Ministry of Health and Medical Teams International have been particularly positive about the role RCRA are playing in supporting people in relation to SRHR and family planning.
Moving forward the work that RCRA are doing will be key in supporting the people they serve, especially with the ongoing cuts to central funding and swelling population of the Nakivale settlement.