Expanding Access to Healthcare in Uganda’s Coffee Communities

This Article at a Glance: 

• Together with our partners, we’re implementing a project to expand access to affordable healthcare for 2,700 coffee farming households in Uganda. 
• Insights from Phase 1 are shaping a digital platform that combines subsidized healthcare services and flexible savings tools. 
• The initiative is strengthening resilience and wellbeing in coffee communities and lays the foundation for more secure livelihoods. 

In Uganda, Sucafina is working with JDE Peet’s, Elucid and the Netherlands Enterprise Agency (RVO) on the Resilience through Enhanced Access to Community Health (REACH) Project. Together, we aim to boost healthcare access for 2,700 coffee farming households in Bukomansimbi, Lwengo, Sembabule and Kalungu districts. 

Most coffee farmers in Greater Masaka cultivate small plots of just 1 to 3 acres. Limited access to land and seasonal income from coffee leaves them vulnerable to climate shocks and market fluctuations. Women carry out much of the workload on farms, yet too often have little influence on household financial decisions. 

On top of this, many farmers must make long, costly journeys for treatment and healthcare. As one farmer from Lwengo recalls: “I had to walk an hour at night with a sick child… no boda [motorbike taxi] would ride.” With fewer than 2% of Ugandans covered by health insurance, most rely on out-of-pocket payments that strain already fragile budgets. 

Phase 1 of the REACH Project gathered valuable data on household income levels, healthcare access, labor practices and gender dynamics. These insights are now shaping the design of a digital health financing platform aligned to coffee communities’ needs. The platform brings together subsidized healthcare services (such as malaria treatment, maternal care and child health) and digital tools to strengthen transparency, access and inclusion across farming communities. 

Understanding the challenges: “We sell goats or part of the harvest early.” 

To better understand the day-to-day realities of farming families, we carried out a comprehensive assessment in spring 2025, including surveys with 220 households and 48 children, focus group discussions and interviews with community stakeholders.  

The responses highlighted four main interconnected challenges: income vulnerability, limited access to affordable, quality healthcare, labor practices and occupational health, and gender inequality. Farmers across the four districts shared their experiences of the challenges around healthcare and household decision-making during focus groups: 

"We sell goats or part of the harvest early, even before it’s ready. That’s how we raise money when sick.” – Male farmer in Lwengo. 

“You can walk for two hours to the health center, and by the time you arrive, your energy is gone.” – Female farmer in Bukomansimbi.  

“Sometimes the decision is delayed because the husband is not around or there is no money.” – Female farmer in Lwengo. 

These statements clearly illustrate why healthcare access must go hand in hand with supporting livelihoods and more inclusive household decision-making. 

What’s next: piloting a digital health financing platform 

To meet this need, we are developing a digital healthcare platform that will reduce out-of-pocket expenses and improve service quality, while supporting farmers to build more secure livelihoods. Key features include: 

• Subsidized essential healthcare for farming households. 
• Digital savings tools linked to local farmer groups.  
• Gender-responsive design to ensure women can access and influence health decisions. 
• Easy-to-navigate dashboards to track outcomes and strengthen supply chain accountability. 

We will pilot the approach in Kalungu and Bukomansimbi, before expanding to other districts. Over time, this scalable model could serve as a blueprint for rural health financing in Uganda and beyond. 

Accessible healthcare strengthens wellbeing and livelihoods 

More accessible healthcare means families can seek treatment sooner, keep their children in school, maintain farm productivity and plan for the future with greater confidence. By building healthcare financing into existing community structures and supply chains, the project supports more stable and prosperous livelihoods – and a brighter future for Uganda’s coffee sector. 

“Most coffee programs focus on the health and productivity of the coffee trees. But this assumes, often incorrectly, that farmers themselves are healthy and able to carry out the labor their farms require. The REACH Project is teaching us that every farm support program should begin with an assessment of household nutrition and health. Truly sustainable farming is only possible when farmers’ basic needs are addressed first,” says Suzanne Uittenbogaard, Group Sustainability Program Manager at Sucafina.