Health & Health Rights

Advancing equitable access to health, dignity and informed choice for underserved communities

Health is more than the treatment of illness. It is shaped by whether people can obtain reliable information, reach appropriate services, make informed decisions about their bodies, receive respectful care, live in safe environments and participate in decisions affecting their health. Rural Smiles Foundation works with rural and underserved communities to strengthen access to health information, prevention, referral, essential services and responsive health systems. Our Health & Health Rights Program brings together community health, maternal and newborn health, sexual and reproductive health and rights, HIV prevention and care, cancer prevention, mental health and psychosocial wellbeing, health-system strengthening and community accountability.

Our approach recognises that many health challenges are interconnected. A pregnant woman may live within reach of a health facility but still face unreliable electricity, transport costs or weak referral arrangements. A young person may technically have access to sexual and reproductive health services but lack accurate information, confidentiality or a safe environment in which to seek care. A person living with HIV may have treatment available but avoid services because of stigma or fear of discrimination. We therefore work not only on health services, but also on the conditions that determine whether people can actually use those services safely, confidently and with dignity.

Understanding Uganda's Health Context

Uganda continues to make important progress in health while facing persistent inequalities in access, service quality and health outcomes. The 2024 National Population and Housing Census recorded 45,905,417 people in Uganda, including more than 23.5 million females and 22.3 million males. A population of this scale, spread across urban centres, rural communities, hard-to-reach areas and refugee hosting districts, creates substantial demand on primary healthcare, community health structures and referral systems.

Progress has been made in reducing deaths among mothers and children. The 2022 Uganda Demographic and Health Survey estimated the maternal mortality ratio at 189 maternal deaths per 100,000 live births for the seven years preceding the survey. This represented an improvement from earlier surveys, but it also means pregnancy and childbirth continue to carry preventable risks for many women. Newborn survival remains another important challenge. The 2022 survey reported 22 neonatal deaths per 1,000 live births, while under-five mortality stood at 52 deaths per 1,000 live births. These figures demonstrate the continuing importance of quality antenatal care, safe delivery, immediate newborn care, postnatal follow-up and timely referral when complications occur. 

Sexual and reproductive health needs remain substantial. Among currently married women aged 15-49, use of a modern family-planning method reached 38 percent in 2022. At the same time, teenage childbearing remained high: 23.5 percent of girls aged 15-19 nationally had already had a live birth or were pregnant with their first child. In Bunyoro, where Rural Smiles Foundation has a significant operational presence, the corresponding figure was 24.2 percent. HIV also remains an important public-health and health rights issue. Uganda's Ministry of Health reported adult HIV prevalence among people aged 15 years and above at 5.3 percent in 2023. Prevalence was considerably higher among women at 6.5 percent, compared with 3.3 percent among men. These national averages also mask differences in vulnerability, access to prevention and experiences of stigma among different communities. 

Uganda simultaneously faces a growing burden from non-communicable diseases, including cancer. Global Cancer Observatory estimates for 2022 identified cervical cancer as the most frequently diagnosed cancer in Uganda, with approximately 6,938 new cases. It accounted for about one-third of estimated cancer cases among women. These statistics tell only part of the story. Health outcomes are also affected by the everyday realities of rural life: distance from health facilities, transport costs, availability of trained health workers, continuity of medicines and supplies, electricity and other infrastructure, health literacy, social norms, stigma, disability, gender inequalities, poverty and whether people trust the systems intended to serve them.

Health Is Also a Rights Issue

Our work is grounded in the understanding that access to healthcare should be accompanied by dignity, information, participation, confidentiality, informed choice and freedom from discrimination. Uganda's constitutional framework directs the State to ensure that Ugandans have access to health services and to take practical measures toward the provision of basic medical services. The Constitution also establishes protections relating to dignity, equality, participation, children, persons with disabilities and a clean and healthy environment.

Uganda's health-policy framework increasingly reflects the same principles. The Ministry of Health's patient-rights framework recognises rights to quality services, relevant health information, non-discrimination, participation, respectful treatment, informed consent and confidentiality. In March 2026, the Ministry of Health launched a new Client Charter and Service Delivery Standards, setting out what citizens should expect when accessing health services and providing mechanisms through which the public can give feedback, report service gaps and seek redress.

Our Approach

Rural Smiles Foundation uses an integrated community health and rights approach. We do not view health education, prevention, referral, infrastructure, community participation and accountability as isolated interventions. We connect them. We begin by listening to communities and understanding the barriers people experience. We then work with community structures, health workers, facilities, local government institutions and other partners to design practical responses. This approach is consistent with Uganda's National Community Health Strategy, which emphasises equitable access to community health services, increased service coverage, stronger community-to-facility referral systems, increased demand and utilisation of services and meaningful community participation.