HEALTH
At ROM, we believe that delivering quality health outcomes requires a comprehensive package of activities addressing prevention, treatment, care, and support.
Services are tailored to meet the needs of women, children, adolescents, youth, men, and key populations, ensuring that no one is left behind.
HIV Care and Treatment Program: Transforming HIV Care in Uganda
For more than two decades, Reach Out Mbuya Community Health Initiative has been at the forefront of Uganda’s HIV response, delivering compassionate, comprehensive, and community-driven services. Today, ROM supports over 116,000 clients on treatment, achieving viral load suppression rates above 97 percent, far surpassing national and global targets. The HIV program offers a full continuum of care from testing and counselling, linkage, lifelong treatment, and adherence support to medication-assisted therapy (MAT) for individuals with substance use disorders.
Continuum of Care for All
Integration with maternal and child health services has strengthened prevention of mother-to-child transmission. Adolescents and young people benefit from peer-led adherence support through the Young Adolescent Peer Supporters (YAPS) initiative, while adolescent girls and young women receive a comprehensive package of HIV prevention, sexual and reproductive health services, psychosocial support, life skills, and economic empowerment. ROM also expands prevention options through pre-exposure prophylaxis, HIV self-testing, and community outreach for high-risk populations including sex workers, fisherfolk, truck drivers, and uniformed personnel.
Integrated HIV, TB, and Reproductive Health Services
Recognizing the close link between HIV, tuberculosis, and reproductive health, ROM provides fully integrated screening, treatment, and prevention services. The program includes TB preventive therapy, cervical cancer screening and treatment, sexual and reproductive health education, and laboratory diagnostics such as viral load monitoring and TB/HIV testing. Through drop-in centers, mobile clinics, and household outreach, ROM reaches those living in remote or informal settlements, bringing quality health care closer to people’s homes.
Health Systems Strengthening
For over two decades, Reach Out Mbuya Community Health Initiative has been a trusted leader in strengthening Uganda’s health system. From its beginnings as a community-based HIV service provider, ROM has evolved into a nationally and regionally recognized institution advancing governance, monitoring and evaluation, digital health, laboratory systems, supply chain management, epidemic preparedness, and community health systems.
ROM anchors accountability and transparency through strong governance and active engagement in Ministry of Health and Kampala Capital City Authority technical working groups, the Kampala HIV Project steering committee, and national policy consultations. At the community level, it builds the capacity of civil society and grassroots organizations to deliver quality care, advocate for their communities, and participate in decision-making. Monitoring and evaluation systems are aligned with national and global frameworks, ensuring timely, accurate, and complete reporting.
Continuous quality improvement (CQI) is embedded across all supported facilities, with real-time analytics and data reviews driving adaptive programming.
Laboratory & Supply Chain Systems
Despite national fulfillment challenges, ROM ensures continuity of care through redistribution mechanisms and community-based innovations such as pharmacy distribution points and Boda Boda drug delivery services for marginalized populations.
ROM has strengthened laboratory systems through accreditation support, quality management, and optimized diagnostics. GeneXpert utilization has surpassed 120 percent with reduced turnaround times, while external quality assurance pass rates remain above 90 percent across HIV, TB, CD4, and CrAg testing. Laboratory infrastructure and mentorship programs have improved diagnostic accuracy, resulting in timely results for improved clinical outcomes.
Supply chains are reinforced through robust forecasting, ordering, and electronic stock monitoring using Rx Solution and eAFYA platforms.
Digital Health Transformation
Digital health transformation is a hallmark of ROM’s work. The organization pioneered the rollout of the paperless UgandaEMR Plus across ART, maternal and child health, and TB clinics in Kampala. Facilities now use biometric registration, mobile drug delivery applications, and health information exchange platforms that integrate with national systems, reducing duplication and improving client retention. ROM’s innovation extends to mobile health, where community health workers use handheld devices to register clients, capture data, and follow up in real time.
This digital linkage between community and facility levels ensures no client is left behind, while electronic dashboards enable data-driven decision-making and improve accountability.
Community Health Systems
Community health systems lie at the heart of ROM’s model. Village Health Teams, peer educators, safe spaces for adolescent girls and young women, grandmother networks, and youth ambassadors extend access, build trust, and reinforce accountability. Differentiated service delivery models bring care closer to households, while savings groups, revolving funds, and livelihood initiatives strengthen family resilience.
Epidemic Preparedness and Global Health Security
ROM is a key partner in global health security and epidemic preparedness. During the Mpox outbreak, more than 13,000 individuals were screened, suspected cases safely isolated, and thousands reached through risk communication and community awareness campaigns. Infection Prevention and control mentorships, PPE distribution, and epidemic surveillance embedded within EMR and community systems have enhanced early detection and rapid response capacities.
Health Economics, Workforce, and Governance
Health economics underpins ROM’s approach to efficient, sustainable healthcare delivery. Multimonth ART dispensing has reached 93 percent for three-month refills and 40 percent for six-month refills, improving retention while reducing costs. Financial stewardship follows international best practices, with over two decades of clean audits and transparent management of multi-donor funds.
ROM’s workforce of 139 blends technical expertise with lived community experience. Over 30 percent of staff are recruited through ROM’s peer model, ensuring that services are trusted,
relevant, and community-driven. Continuous training and mentorship sustain technical excellence, innovation, and alignment with global standards.
Tuberculosis
ROM’s Tuberculosis (TB) program delivers a comprehensive and holistic package of prevention, case detection, treatment, and community-based support, with particular emphasis on TB/HIV co-infection, pediatric TB, and drug-resistant TB. The program has consistently achieved treatment success rates above 88%, surpassing the national target of 85%. Early case detection remains central, combining intensified facility-based screening, household contact tracing, and innovative community interventions such as mobile
chest X-ray screening in high-burden hotspots. All suspected TB cases are investigated using modern laboratory methods including GeneXpert testing for confirmation and rifampicin resistance, along with complementary tools such as Urine LAM and CRP testing to strengthen detection among people with advanced HIV disease and children. Community-centered care is a cornerstone of the program. ROM has pioneered home-based TB care models, where newly diagnosed patients receive clinical support at home
during the critical first month of treatment. This approach prevents facility-based transmission, reduces stigma, improves adherence, and ensures treatment completion. Each patient is linked to community health workers and treatment supporters for ongoing monitoring and follow-up. Pediatric TB, often underdiagnosed nationally, receives special attention through community contact tracing, targeted screening in high-volume facilities, and collaboration with pediatric research programs to improve diagnosis and care.
Drug-resistant TB management is integrated into service delivery, with access to individualized treatment regimens and enhanced adherence support.
Holistic support for patients and families is embedded in ROM’s TB program. Patients and households benefit from nutritional support, psychosocial counseling, peer support, mental health care, and livelihood strengthening to address the socio-economic barriers that undermine TB treatment outcomes.
Education campaigns raise awareness, combat stigma, and promote health-seeking behaviors, while social protection
initiatives provide relief for households facing income loss during treatment. Laboratory and surveillance systems are strengthened to improve accuracy, timeliness, and accountability. GeneXpert services and bacteriological confirmation are scaled up, while electronic case-based surveillance (eCBSS) maps hotspots, informs outreach, and tracks outcomes. Health worker mentorship, supportive supervision, and
continuous training guarantee quality service delivery aligned with national and WHO guidelines.
Supply chain management has been reinforced to ensure uninterrupted availability of TB diagnostics and medicines. Quality improvement collaboratives drive progress across supported sites, improving case notification, TB Preventive Therapy (TPT) uptake, and treatment outcomes.
In 2024, ROM-supported facilities notified 1,229 new and relapse TB cases, with 72% bacteriologically confirmed and 99% initiated
on treatment. Treatment success rose to 90%, meeting global benchmarks. Contact tracing reached 4,866 individuals, with 97% screened and 11% confirmed positive, demonstrating the effectiveness of community-led interventions. The program is expanding mobile X-ray services, strengthening pediatric TB diagnostics, and deepening community engagement for prevention, stigma reduction, and social resilience.
Through integration of TB care with broader HIV, maternal-child health, elderly care, and livelihood programs, ROM ensures that TB interventions are not only medical but also socially responsive and familycentered.
ROM’s Tuberculosis (TB) Program delivers a comprehensive and holistic package of prevention, case detection, treatment, and community-based support with a strong focus on TB/HIV coinfection, pediatric TB, and drug-resistant TB. The program has consistently achieved treatment success rates above 88 percent, surpassing the national target of 85 percent. Early case detection remains central to ROM’s approach, combining intensified facility-based screening, household contact tracing, and innovative community interventions such as mobile chest X-ray screening in high-burden hotspots. All suspected TB cases are investigated using modern diagnostic methods including GeneXpert testing for confirmation and rifampicin resistance, along with complementary tools such as Urine LAM and CRP testing to strengthen detection among people with advanced HIV disease and children.
In 2024, 93 percent of clients in care were screened for diabetes mellitus, with over 1,200 cases diagnosed; 82 percent were screened for depression and anxiety, identifying 240 cases, most of whom were initiated on treatment.
d) Non Communicable Diseases (NCDs)
Non-communicable diseases (NCDs) such as hypertension, diabetes, cardiovascular disease, cancers, and mental health conditions are a growing health challenge in Uganda, often compounding the burden of HIV and other infectious diseases. ROM’s NCD program advances the Ministry of Health’s NCD agenda through a comprehensive approach that combines advocacy, early detection, treatment support, and community-led care models. Multi-disease screening is routinely conducted at both facility and community levels, covering nutritional disorders, hypertension, diabetes, HIV, cervical cancer, depression, and anxiety.
Community-Based NCD Support Groups
ROM has introduced an innovative model where clients with hypertension or diabetes self-organize into community support groups. Members contribute small weekly fees to pool resources, enabling bulk purchases of essential medicines during facility stockouts. This model guarantees
uninterrupted treatment, improves adherence, reduces complications, and fosters solidarity, resilience, and patient empowerment. These peer-led groups also serve as platforms for health education, psychosocial support, and collective problem-solving, making NCD care both sustainable and community-owned
Prevention, Health Education, and Behavior Change
Recognizing the social and behavioral drivers of NCDs, ROM implements community-based health education campaigns that promote prevention and healthier lifestyles. These initiatives raise awareness of risk factors, discourage tobacco and harmful alcohol use, promote physical activity, and encourage healthy diets. ROM’s integration of NCD prevention into HIV, TB, and maternalchild health programs ensures that wellness is approached holistically, addressing the full spectrum of client needs rather than focusing on a single disease
Strengthening Health Systems for NCD Care
The NCD program reinforces health systems by training health workers in integrated service delivery, strengthening supply chain management for NCD commodities, and advocating for increased access to diagnostic tools such as BP machines, glucometers, and cholesterol meters.
Electronic Medical Record (EMR) platforms are being adapted to capture NCD data, improving reporting, surveillance, and decision-making. Dedicated volunteers and triage assistants have been deployed at facilities to support screening, manage patient flow, and reduce waiting times. These
system-level improvements have enhanced efficiency, client satisfaction, and the quality of chronic disease management.
Mental Health Integration
Recognizing the intersection between mental health and physical illness, ROM integrates mental health screening and care within its NCD services. Depression, anxiety, and stress are routinely screened, and clients are referred for counselling or treatment when needed. ROM’s mental health integration model combines clinical care, peer support, and community awareness to reduce stigma and ensure that clients receive comprehensive, person-centered care.
e) Geriatric Care
The Geriatric Care Program was launched in 2014 to improve the quality of life for elderly persons aged 50 years and above affected and infected with HIV, while also supporting the orphans and vulnerable children (OVC) under their care. The program applies a holistic model that integrates economic strengthening, social protection, psychosocial support, health services, and linkages to care, ensuring that older persons live with dignity and resilience in their later years. Elderly beneficiaries receive comprehensive services that respond to the unique vulnerabilities of aging, including treatment for common geriatric conditions such as hernia, hypertension, diabetes, and cervical cancer. They also benefit from nutritional support, improved shelter, and better sanitation facilities. Psychosocial services address stigma, isolation, and trauma often associated with aging in poverty, while spiritual and community-based counseling promote dignity and emotional wellbeing. Peer-to-peer networks encourage solidarity, restoring a sense of purpose and
belonging among older adults.
The Grandmother-to-Grandmother (GM2GM) Model
At the heart of ROM’s elderly care work is the Grandmother-to-Grandmother (GM2GM) caregiving model and the Grandmother Village Committees (GVCs). These networks empower elderly women as caregivers, leaders, and decision-makers, positioning them not only as recipients
of care but also as active participants in sustaining their communities.
Elderly women provide critical unpaid care for fellow older persons, grandchildren orphaned by HIV, young mothers, and chronically ill relatives making them the backbone of Uganda’s community care systems. ROM strengthens their capacity through training, peer mentorship, and
leadership development
Home-Based Care and Economic Empowerment
ROM extends care beyond health facilities through home-based services and mobile outreach clinics, bringing medical attention directly to bedridden or immobile older persons. This approach ensures that no one is left behind, especially in rural or underserved areas.
Elderly clients participate in Village Savings and Loan Associations (VSLAs) tailored to their needs, backyard gardening, poultry rearing, and craft-making. These initiatives generate income, reduce dependency, and affirm the economic contribution of older persons to their households and communities.
Nutrition, Psychosocial Wellbeing, and Social Protection
Food insecurity and malnutrition remain pressing challenges for many elderly households. ROM responds through nutritional support packages, elderly-friendly community gardens, and linkages to palliative care and social protection services such as government grants and safety nets.
Psychosocial well-being is reinforced through elderly drama clubs, social groups, and cultural activities. Through music, dance, and creative arts, older persons express themselves, find joy, and reconnect with their communities.
f) Maternal and Child Health
Since 2006, Reach Out Mbuya Community Health Initiative (ROM) has implemented a Maternal and Child Health (MCH) Program to improve access to quality health services for pregnant women, lactating mothers, and their children. The program integrates antenatal and postnatal care, immunization, nutrition support, and safe delivery services. It also provides mama kits and strengthens community–facility linkages. Mothers receive education on family planning, nutrition, hygiene, breastfeeding, and disease prevention, helping them safeguard their health and that of
their children.
Mother-to-Mother Model
The program uses a Mother-to-Mother (M2M) peer model, where trained mothers support others through home visits and group sessions. These networks encourage antenatal attendance, safe deliveries, and adherence to child immunization. Family support groups promote learning and
emotional resilience.
Addressing Urban Health Challenges
In Kampala’s informal settlements, mothers face challenges like HIV, TB, malaria, malnutrition, and poverty. ROM addresses these through nutrition support, sanitation promotion, counseling, backyard gardening, and male partner engagement to improve food security and household
wellbeing