Namajjuzzi Community Led Climate Smart Health Networks.

Our solution integrates Climate Smart Actions Literacy into our outreaches for Voluntary Male Medical Circumcision, Sexual and Reproductive Health Rights to accelerate Health living outcomes in Namajjuzzi wetland (Masaka) region.

The Namajjuzi wetland region covers about 35,000 square kilometres stretching through Bukomansimbi, Kalungu, Kyotera, Lwengo, Lyantonde, Masaka, Rakai and Ssembabule districts with large swaths of wetlands and natural forest reserves. In Uganda, wetlands have suffered encroachment, degradation, and reclamation for agriculture, settlement, and mining reducing its coverage from 15.6% in 1994 to 8.9% in 2019. In this region, a mixed land tenure system including public, mailo, freehold, and customary which was modified to grant legal standing to squatters (Bibanja owners) are used. Inhabitants of the Namajjuzi region engage in commercial and subsistent agriculture raising an average monthly household income of about 210,000 Uganda shillings (US $56) that is caters for an average of between 5 and 7 members. The high level of poverty in the region has curtailed utilization of alternative energy sources maintaining biomass which accounts for 94% of energy consumption in Uganda as the main source of energy. Apart from pollution, biomass use has led to deforestation consequently degrading and, in some instances, eliminating entire natural forest covers.

The decline in both wetlands and forest covers set in motion numerous climate related issues including floods; droughts; soil degradation; destruction of eco, waste management and road systems; increased cost of filtration of water for domestic use; increase in drug, alcohol and substance abuse; extreme weather-related diseases (water born/based and malnutrition-related diseases); gender-based violence; and mortality due to direct and subsequent effects of climate change. These conditions worsen the already dire issues of accessibility, affordability, and acceptability of both primary and secondary health care services consequential to the fight against HIV, TB, and Malaria. It also interferes with accessibility and affordability of education services which diminishes prospects of attaining skills and awareness to fight against poverty; mitigate problems related to climate change; and increase acceptability and adoption of health care services.

These problems disproportionately impact Adolescent Girls and Young Women, persons living with HIV, persons with disability and TB survivors. For instance, many girls and women the region lack access to and awareness of the need for primary and secondary health care services including sexual and reproductive health rights in a region where HIV prevalence is 11.7% compared to the national average of 5.8% (ages 15-49 years). Despite the above challenges, Climate Smart Actions Plans are either out of the domain of the local population discourse or are political buzz words used to gain political advantage. Through partnership with Rakai Health Science Program (RHSP), MOD public health foundation conducts between 80-100 outreaches focusing on Voluntary Male Medical Circumcision (VMMC) for males aged 15 and above and Sexual and Reproductive Health Rights (SRHR) service for their female partners as a combination HIV prevention strategy. MOD intends to integrate Climate Smart Actions Literacy into her (VMMC) and (SRHR) outreaches to accelerate Healthy living outcomes in Namajjuzzi wetland (Greater Masaka) region. MOD will use the VMMC/SRHR outreaches as avenues to integrate Climate Smart Actions Plans literacy and form Climate Smart Champions Networks in the districts along Namajjuzi Wetland.

Our solution is to integrate Climate Smart Actions Literacy into our routine VMMC and SRHR outreaches in all the districts along Namajjuzi wetland in greater Masaka region. MOD will integrate Service delivery (ISD) to accelerate healthy living outcomes for vulnerable populations while raising awareness to the conservation needs in the region during outreaches. MOD shall develop and implement Innovative Climate Smart Actions Minimum Viable Products including; Stakeholders and Geo-spatial Characterization Tools; Climate Smart health Champions and Network; Local metrological centers; Phone Apps; Hygiene Kits; Knowledge and waste disposal spaces. These will leverage linkage, engagement, and ownership of solutions such as subject matter health workforce with the capacity to respond to climate-induced health risks in the region. Project activities such as: tree planting, regenerative agriculture, household waste management skills will be implemented to restore and improve already degraded natural systems.  

 We shall establish strategic public health plans to engage communities in addressing climate-related disruptions such as flash floods, drought, unreliable seasons, storms, soil erosion and depletion, eco-biological destruction, lowering of water tables (aquifers), and reduction in flora and fauna; raising awareness and consciousness to health related issues such as family planning, HIV/TB prevention, abortion care, gender based violence, basic hygiene; and advocating for access to equitable education for the marginalized. MOD will establish community led climate smart health champions networks for girls, young women and their male partners including TB survivors and persons living with HIV and disability. We will leverage on already existing community structures such as: Villages Health Teams (VHTs), Communities of Practice (LC1s), Male Action Groups (MAGs), Girl Empowerment Forums (GEFs) to advance literacy on climate Smart Action Plans. Our Solution will engage and promote healthy living among 2500 households, aid in mitigating impacts of climate change as a post COVID-19 response, recovery and resilience innovation. 

The project will both restore and improve the dignity, agency, autonomy and self-determination of marginalized members of the community including TB survivors, persons living with HIV, persons with disability, adolescent girls and women by recruiting and training them in Climate smart action planning and deploying them as Climate smart health champions. It will improve access to education of the underserved members of the community by raising consciousness about the importance of equitable access to education. The project will increase household income of 2500 households subsequently improving household hygiene, nutrition, health, and educational outcomes. The project will improve treatment outcomes for people living with TB and HIV by involving them in Climate smart health Champions networks for social support and engagement. It will generate employment opportunities for both MOD staff and other members of the community such as tree nursery operators. It will generate awareness and consciousness about Smart climate actions which will positively influence cultural norm change hence improving the lives of marginalized members of the society. 

Other beneficiaries will include Civil Society Organizations (CSOs), educational institutions, religious Institutions and Local Governments. These will be involved in climate smart action trainings, activity planning, implementation and evaluation. They will form and participate in viable climate smart support groups out of which we shall form the Greater Masaka Climate Smart Champions Network.   Indirect beneficiaries will include entities that provide support facilitation and networks e.g., provide permits, political support, and policy guidance (National Forestry Authority (NFA) and Environmental Management Authority (NEMA), Uganda Prisons, Police and Peoples Defense Forces, and Buganda Kingdom).

About MOD Public Health Foundation

MOD Public Health Foundation also known as “MOD” is a registered Non-profit Organization (NGO) (INDR155354614NB) located on Plot 79 Bukoba Road, Near Gaz, Masaka City Uganda. MOD was founded as a Community-Based Organisation (CBO) by a team of young public Health Professions in August 2016. The Organisation is positioned as a local, low cost but efficient public health solutions and implementing Organisations. We have 30 years’ combined experience in designing and implementing innovative people centered public health programs in the areas of:  HIV/AIDS, Maternal and Child health, Social Economic Strengthening and climate Smart Action Plans. From providing innovative public health solutions, the organization’s consulting portfolio has steadily grown into other areas including Program Evaluations, Organizational Development, Strategic Plan Development, Project Management, and Capacity Building.  “We envision healthier communities accessing low-cost emerging public health innovations and solutions”. Our mission is “To achieve universal health care coverage in under-served communities and sub-populations through accelerating optimal translation, uptake, and impact of new public health knowledge and practices” . The Organization’s business and program approach is built on the culture of.

1. Passion and Innovation
2. Flawless execution and
3. Team building to sustain our innovations and impact.

 MOD Public Health Foundation  5-Year Strategic Plan II 2020/21-2024/25 defines our product and services as namely:  

1. Community Engagement for Health Promotion and Behavior Change programming.
2. Health and Organizational Systems Strengthening
3. Knowledge Thesis, Research, and Translation
4. Community Health Insurance Scheme
5. Public Health Workforce and Leadership Development

 MOD’s five-year successful experience in implementing complex projects such as DREAMS (Determined, Resilience, Empowered, AIDS free, Mentored and Safe Girl) program for 35,000 AGYW in Mubende region, funded by Center for Disease Control and Prevention (CDC) gives the Organisation a credible advantage to deliver this urgently needed Namajjuzzi Community Led Climate Smart Health Networks. This project is aligned to our strategic area one “Community Engagement for Health Promotion and Behavior Change programming.

 Technical Capacity and Experience  

In this project MOD will be represented by a team of three health promotion staff with multi- disciplinary skills and experience. The Staff include: Nakidde Monica (Project Team Leader, Health Promotion Nurse, DOB 30th March  2001), Silver Onyango (Legal Officer, DOB: 02 July 1998), Namubiru Hadijah, Social Worker, DOB: 16th  May 2001). The three staff her part of the MOD team who have supported designing and implementing various innovative  community projects to influence behavior change for healthier living among vulnerable population in underserved communities of Masaka Region. The project team will be supported on the background by MOD’s senior public health professions to ensure effective implementation of Namajjuzzi Community Led Climate Smart Health Networks Project

• Nakidde Monica (Project Team Leader, Health Promotion Nurse and Volunteer, DOB 30th March  2001).
• Namubiru Hadijah (Social Worker, DOB: 16th  May 2001)
• Silver Onyango (Legal Officer, DOB: 02 July 1998)

Monica is our dedicated health promotion nurse and Volunteer at MOD Public Health Foundation. She has committed herself to supporting grassroots-based communities to become active actors in the HIV Epidemic control, TB, and Malaria eradication in Masaka District Uganda. Monica is part of the team that has trained several communities including health facility workers, and Village Health Teams (VHTs) from hard-to-reach rural areas as Communities of Practice (COP). Her work has supported mainstreaming HIV/TB/Malaria eradication mechanisms for UNAIDS 2030 goals and integrating COVID-19 response, recovery, and resilience plans. She has supported implementation of several HIV prevention and behavior change projects such as the PEPFAR/CDC-DREAMS program for adolescent Girls and Young Women (AGYW), Assessing Early Warning Indicators for HIV Drug Resistance, Sexual and Reproductive Health Rights (SRHR), and VMMC in Rakai, Bukomansimbi and Ssembabule districts. At MOD, Monica has supported to design and implement models and projects that focus on improving the productivity of vulnerable populations while integrating concepts of Climate Smart Action Plans. Monica has used her background in Systems and Design thinking to get stories rooted in resilience out of the grassroot communities where we work. We were able to introduce quantitative and qualitative methods whose outcomes became the seeds for Community Systems Strengthening (CSS); Communities of Practice (COP); and Public-Private Mix (PPM). Monica has supported the use of appropriately accessible tools to report on HIV/TB prevention and regularly engaged in strengthening the capacity of local and rural-based CBOs in Uganda to own knowledge and skills to keep the traction toward 2030 in focus. Therefore, with that vast experience in community engagement, Monica is the team leader of this Project.

 Hadijah is our dedicated Assistant Programmes Officer with a Social Works Education Background. As a social-Worker, Hadijah has gained experience in working with grassroots CBOs to implement projects such as WASH, DREAMS program for Adolescent Girls and Young Women (AGYW), Voluntary Male Medical Circumcision (VMMC), and Socio-Economic Strengthening Projects. She has supported CBOs to become active actors in the HIV/TB/Malaria eradication interventions in the hard-to-reach communities of Greater Masaka, Uganda.

At MOD, Hadijah has supported the introduction of language and community art to keep health promotion best practices translatable and effective among out of school but sexually active communities. These have continued to adopt and use concepts such as Resilience and Sustainable Systems for Health (RSSH); Community Systems Strengthening (CSS); Communities of Practice (COP), Integrated Service Delivery (ISD); Public-Private Mix (PPM). He has supported the use of tools, skills development, and knowledge-based sharing to promote VMMC Services, SRH/HIV Prevention and behaviour change by strengthening the capacity of local and rural-based CBOs in Uganda to engage strategically. Hadijah has experience in  conducting community needs assessment for all projects implemented at MOD. Therefore, Hadijah’s social work experience will be installed into the Namajjuzzi Community Led Climate Smart Health Networks to enhance project community participation, ownership and behavior change.

Silver Onyango is a dedicated legal officer in his final Year studying Bachelor of Laws at Islamic University in Uganda- Mbale main campus. Silver is a volunteer at MOD for the last six (years) and passionate about public health, girl education, Advocacy and Litigation. He has worked with individual girls and grassroots communities to enhance the fight against HIV, TB, and Malaria by both supporting and advocating for access to equitable and skills building education, social economic strengthening and restoration of families, and raising consciousness about the effects of discrimination and stigmatization based on gender, age, HIV and TB health status, or disability.

At MOD, Silver has been behind the design and implementation of storytelling using social back grounding. This has enabled us to link teenage mothers, teenage fathers and older concerned parents who are bitter about their children missing school due to teenage pregnancies or boys being imprisoned for defilement. The nexus of care, criminalization and health outcomes are Silver's expertise which communities in our catchment have benefitted from immensely. This engagement has enabled communities to see productivity among vulnerable persons and promoted the application of the benefits of global issues such as Communities of practice (COP), Community Systems Strengthening (CSS); and Integrated Service Delivery (ISD). An indefatigable volunteer and passionate fired to many, Silver has supported the use of tools, skills development, and knowledge-based sharing to promote better health outcomes for vulnerable people and also participated in programmes for HIV/TB/Malaria prevention.

Therefore, in the Namajjuzzi Community Led Climate Smart Health Networks Project, Silver will use his legal background to promote public health Advocacy and litigation to enhance implementation of climate smart actions in the targeted districts. 

MOD Public Health Foundation has implemented various Community Programs in Masaka for the since 2016 (Eight years (8) now). These projects include; Demand creation for Voluntary Male Medical Circumcision (VMMC) for Men aged 15 years and above, Sexual and Reproductive Health Rights (SRHR) in Mubende Region for Adolescent Girls and Young Women (AGYW) 15-24 Years, DREAMS including Gender Based Prevention Programme for AGWS 15-24 years in Seven Districts of Masaka and Mubende Region. Through those projects, MOD has profiled various community needs assessments to facilitate targeted implementation of solutions to the real people who need the services. Among the key beneficiaries served are; People Living with HIV and AIDS, People Living with Disability (PWD), AGYW particularly Single Mothers, and Orphans and Vulnerable Children.  During our VMMC and SRHR outreaches, Our project officers are constantly observing and profiling community problems that need urgent solutions. For instance, last year in November our VMMC Project officer (Peter Ssemaganda) asked a question during management meeting, “how can we integrate issues of climate change within our usual VMMC outreaches?”. He had observed poor waste disposal, people destroying the Namajjuzi Wetland for traditional agriculture and bricklaying. Both men and women were engaged during the outreaches on what can be done to preserve the so much needed wetland, Majority of them requested MOD to provide awareness on climate change.

In December last year, MOD Public Health Foundation conducted a 12-day (10th-22nd December 2022) Strategic thinking workshop which involved MOD staff, Communities of Practice (COP), District stakeholder and key service beneficiaries. The main goal was to develop MOD Programe themes from the UNAIDS 2030 Sustainable Development Goals (SDGS). We discussed how the organisation can align its programs to the global goals.  The key themes developed and aligned to the SDGS included the following;

Theme 1: Sexual Reproductive Health and Rights (SRHR)

Theme 2: Household Social economic Strengthening (HSES)

Theme 3: Community Health Insurance Scheme (CHIS)

Theme 4: Community Engagement and Advocacy

Theme 5: Organisation Systems Strengthening

(SDG 1: No Poverty, SDG 2: Zero Hunger , SDG 3: Good Health and well-being, SDG 16: Peace, Justine and Strong)

Theme 6: Girls in Science Education

Theme 7: Gender Based Violence (GBV) prevention.

(SDG 4:  Quality Education , SDG 5: Gender Equity , SDG 10: Reduced Inequalities)

SDG 4:  Quality Education

SDG 5: Gender Equity

SDG 10: Reduced Inequalities

Theme 8: Healthy Living and Climate Action Plans (HLCAP)

Theme 9: Strengthening Partnerships and community engagement.

Theme 10: Promoting Alternative Clean Energy Adoption.

(SDG 6:  Clean Water and Sanitation ,SDG 7: Affordable and Clean Energy , SDG 13: Climate

One of the main outcomes of this strategic thinking workshop was members appreciated the urgent need of integrating climate action plans into our programme design objectives. That is why we have developed this solution that is integrating Climate Smart Actions Literacy into our outreaches for Voluntary Male Medical Circumcision, Sexual and Reproductive Health Rights to accelerate Health living outcomes in Namajjuzzi wetland (Masaka) region. Such approaches will enhance integrated service delivery and improve access and utilisation of health services while protecting our environment.

Lastly, the need of the population to benefit from this project were also identified during our accountability mechanisms structures such as: Annual General Meetings that involve beneficiaries, Regular review meetings with stakeholders where we share challenges, observations and stories of impact. It is through those forums when beneficiary needs were identified. 

Our solution provides subsidized novel innovations that requires immediate popular uptake in order to motivate engagement and participation by beneficiaries in social economic transforming, Climate Smart activities. These transformative activities are provided in the form of information, education and communication (IEC) processes. This way, we pass on strategic knowledge, skills, and practices provided to empower communities in application of climate smart action plans free of charge. Our solution uses numerous technological systems such as phone Apps, messaging, data entry tools, geo locations tools for mobilization, sensitization, education and coordination of service delivery. However, the beneficiaries provide what are known as community contribution materials in form of land, resource personnel, appropriate and indigenous cultural knowledge and skills which set in place acceptance and ownership of the proposed solutions and strategies. Our solution is sure to catalyze community systems strengthening and communities of practice in the provision of integrated service delivery for optimal transformation among other service providers in the region and country. 

Our impact goal for the next one year is to create networks of community led climate smart health champions in the Namajjuzi region trained to mitigate effects of climate change on health systems. Our implementation strategy has four axes which are establishing a resource and knowledge hub, mobilizing communities, training, and rolling out (extension services) in climate smart action plans based on the following principals: connecting, inspiring and empowering.

We will establish an integrated Climate Smart and healthy living Knowledge hub. In this space champions and community members will access information, knowledge and skills vital for achieving social economic transformation through health and Climate Smart action plans. We will establish a knowledge hub (an address, a facilitation and logistical support center, and a center of excellence). Key activities are: Establish a coordination center and create MOD space (e-library, local meteorological station, advocacy spaces, and interaction center) for climate smart actions and healthy living.  

We will mobilize and train communities on climate smart action activity planning to increase involvement, create ownership and awareness of the mitigation solutions and strategies, while raising critical climate smart consciousness that enables communities to address the destructive effects and adapt, adopt, and sustain positive actions. Key activities are: Establish Climate smart literacy including: culture norms change, training of champions [household management, waste management, and critical climate smart skills, climate smart agriculture (rain water harvesting, bottle irrigation, and biogas and manure processing), cottage industry (knitting, leather craft work, baking), Afforestation and Re-afforestation (quick growing and self-regenerating trees); Use of smart climate (renewable) energy sources (biogas, improved cookstoves)]; engaging communities in climate smart consciousness raising activities (exhibitions, farmers markets); documenting, reporting and rectifying climate related abuses; support local governments and CSO to develop strategic plans on climate action plans; create a species conservation center; and form Climate smart action networks.

Our solution will be driven by and based on numerous technologies. We will establish an integrated Climate Smart and healthy living Knowledge hub creation and establishment of a coordination center and create MOD space such as physical and e-library, local meteorological station, advocacy spaces, and interaction center both in the communities and via multiple phone, social media and mass media applications for climate smart actions and healthy living. We will also help geo spatial, data entry, climate smart reporting forms and tools for mapping, evaluating and reporting climate smart health actions. We will apply other indigenous irrigation methods such as rain water harvesting and storage for irrigation and not so indigenous ones like bottle irrigation. We will also apply biogas processing and use technology which are already established technologies. We will implement cottage industry (knitting, leather craft work, baking) trainings using common technologies. 

Our solution has so far reached 500 household and we intend to reach 2500 in the next 12 months. 

The risk to look out for: Pollution; unreliable rainfall; and controlled lake or water body shore community activities. We anticipate an influx of people in the areas where we shall be working. This means that more people will need to be provided trainings to address risks to our project: Pollution; unreliable rainfall; controlled lake or water body shore community activities; water and sanitation crisis; lack of water technology or water use skills beyond sanitation and travel; centralized water-based technology experts making them inaccessible; irregular environmental regulation and coordination policies/enforcement; bureaucracy at the directorate of Water Resources Management (DWRM) making it harder to manage and develop the water resources; lack of proper channels to address grievances. According to various reports such as the Uganda Country Profile by Sustainable Water Partnerships (SWP), "urbanization and agricultural expansion are rapidly degrading extensive wetlands.

There is also a great anticipation in the communities of direct financial benefits when such engagements are organized which works to undermine acceptability and adoption of the solutions. We are already engaging communities to improve acceptability of the project in those areas. Currently, we don’t have the financial capability to roll out this solution to all the anticipated households. This award would meet the current financial challenge. 

MOD Public Health Foundation Currently has four Partners for robust project development and Implementation. These Include;

• Rakai Health Science Program (RHSP) for project funding “Demand Creation for Voluntary Male Medical Circumcision for Men aged 15 years and above in the Greater Masaka Region. MOD is mobilizing men from hard to reach communities, male action groups and organizes outreaches for VMMC services while as  as RHSP provides the necessary medical supplies and technical fees for health workers. 
• PEPFAR Small Grants Uganda for project funding “Accelerating Demand for:  Voluntary Male Medical Circumcision (VMMC) for Men aged 15 years and above, Sexual and Reproductive Health Service for AGYW aged 15-24 years and in the Greater Masaka Region. PEPFAR provided additional finding support to MOD to accelerate community mobilisation of men and young girls for VMMC and SRHR services through health promotion and behaviour change drives. 
• Mbarara University of Science and Technology are piloting Knowledge Synthesis and Research hum at MOD in the area of Indoor air pollution, supporting climate smart project development, staff mentorship and capacity building programs.  
• Action 4 Health Uganda (A4HU) for Project evaluation: Sexual and Reproductive Health Services (SRHR) among AGYW 15-24 years in Kampala and Mukono Region.

Our project business model is anchored on engaging communities of practice, established community structures and targeted beneficiaries to integrate Climate Smart Actions Literacy into our routine outreaches for Voluntary Male Medical Circumcision, Sexual and Reproductive Health Rights. This mode  will accelerate awareness on impact of climate change and to accelerate Health living outcomes for people and ecosystem along Namajjuzzi wetland (Masaka) region. Our direct target beneficiary segment will be people living with HIV (PLHIV), TB Survivors, People Living with Disability (PWD), Adolescent Girls and Young Women (AGYW), Men Aged 15 years and above under VMMC services. Other beneficiaries will include Civil Society Organizations (CSOs), educational institutions, religious Institutions and Local Governments, National Forestry Authority (NFA) and Environmental Management Authority (NEMA), Uganda Prisons, Police and Peoples Defense Forces, and Buganda Kingdom.

MOD shall develop and implement Innovative Climate Smart Actions Minimum Viable Products and services that  include:

• Stakeholders and Geo-spatial Characterization Tools
• Climate Smart health Champions and Network
• Setting up local metrological centers and Phone Apps
• Climate Smart Hygiene Kits (Sanitary pads, waste management disposal kits).
• Setting up Climate smart Knowledge hub for learning.
• Supporting implementation of activities that reduce carbon footprints (tree planting, regenerative smart agriculture, household waste management)

Our financial sustainability is already embedded into the project design. MOD will engage, work with already established community structures namely: Local government LC1, Village Health Teams (VHTs), District environmental officials and households for cost-effectiveness and efficient implementation of project products and services.

 Through the “Namajjuzzi Community Led Climate Smart Health Networks project” awareness and demand for health services such as VMMC, SRHR in the targeted communities will increase. This integration will add value and change current cultural norms among beneficiaries. More men will be mobilise for VMMC services. This likely to motivate our current project funding partners (Rakai Health Science Program (RHSP), PEPFAR Uganda) to scale up funding for greater impact in Masaka region.

 MOD will establish a climate smart Knowledge hub for learning. Beneficiaries and stakeholders will pay a subsidized fee to access learning materials. The project will also support establishment of implementation sciences research in areas of climate smart plans and alternative energy sources. Strengthening evidence based programing through documentation and research will position MOD to strategic funding partners.

 MOD’s is approach to Integrate and implement Climate Smart Actions in programme design is aimed at anchoring the Organisation’s solutions into global UNAIDS 20230 Sustainable Development Goals. Such developed programs will attract funding from potential agencies of partners who are interested in solutions that address climate changes and its impact.

 MOD shall profile, document, and share best practices arising from implementation of the Namajjuzzi Community Led Climate Smart Health Networks. Such stories of change will increase MOD’s visibility on social media platforms, support development of MOD Climate Action App for adaptation.

The “Namajjuzzi Community Led Climate Smart Health Networks project will increase household income when households carry our smart agriculture, establish tree nursery gardens from which the project can support beneficiaries grow specific tree species for planting along Namajjuzzi Wetland.