Background
Uganda Development and Health Associates (UDHA) is a national non-governmental organization established to strengthen community systems for improved prevention, early detection, diagnosis, treatment, and long-term outcomes for HIV, tuberculosis (TB), and related public health priorities in Uganda. UDHA’s mandate is to bridge community and health system gaps by strengthening grassroots service delivery, improving access to diagnostics and care, enhancing accountability, and promoting people-centered approaches that reduce stigma, improve health-seeking behavior, and strengthen treatment adherence.
Since its establishment, UDHA has built a strong operational presence across nineteen districts in Eastern Uganda, including Mbale City, Mbale District, Busia, Tororo, Bugweri, Buyende, Iganga, Jinja City, Jinja District, Kaliro, Kamuli, Luuka, Mayuge, Namayingo, Namutumba, Buikwe, Buvuma, Kayunga, and Bukwo. These districts represent high-burden settings for TB and HIV, characterized by dense populations, mobile communities, fishing and border settlements, informal urban settlements, and hard-to-reach rural areas. UDHA’s geographic focus ensures targeted programming in communities with persistent barriers to healthcare access, delayed diagnosis, and suboptimal treatment outcomes.
UDHA implements integrated community-based interventions along the full TB cascade of care, including household and extended contact tracing for both drug-sensitive and drug-resistant TB, community-based screening and referral, systematic tracking of presumptive TB clients through diagnostic completion, treatment initiation follow-up, TB preventive treatment (TPT) initiation, and strengthening referral and reporting pathways between community and facility levels. These interventions are delivered through a robust network of regional TB and Leprosy supervisors, district health officers, district TB and Leprosy supervisors, facility TB focal persons, and community structures, including village health teams, and under the RSSH grant UDHA, operates with 68 community-based organisations (CBOs) supported by the Global Fund HIV/TB project. The CBOs are trained, mentored, and supervised to conduct structured outreach, social mobilisation, stigma reduction, referral tracking, and patient follow-up, ensuring continuity of care and improved diagnostic completion rates.
A core strength of UDHA lies in its long-standing investment in community systems strengthening and accountability. Within its CBO network, twelve partner organisations implement Community-Led Monitoring (CLM) activities, coordinated by a dedicated CLM Officer and supported by twenty-four trained community monitors. Through structured data collection, community feedback, and engagement with health facilities and district leadership, UDHA supports real-time identification of service delivery gaps, barriers to diagnostic access, and patient experience challenges. This approach ensures that community voices meaningfully inform service improvement, advocacy, and health system accountability processes.
