The Budondo Malaria Control Project was implemented in Budondo Sub-County, in the Northern Division of Jinja City, Uganda, from September 2025 to February 2026. The Community Impact Grant project was led by the Rotaract Club of Jinja in partnership with Budondo Health Centre IV, Smart FM and NBS FM, the Jinja City District Health Management Team, and the Jinja City District Health Office, and supported by Malaria Partners International.
The integrated campaign reached ten villages, combining community awareness, women's savings groups that produced and sold mosquito-repellent products, malaria testing at drug outlets, bed net distribution, and environmental clean-ups. 87 Rotarians and Rotaractors took part in the project activities.
Project Need & Rationale
Budondo Sub-County sits within Uganda's Busoga Sub-Region, one of the hardest-hit parts of the country, where a malaria prevalence of 21% ranks it the third most affected sub-region nationally.
Within that high-burden region, Budondo stands out as a local hotspot, accounting for over 40% of the confirmed malaria cases recorded across Jinja City's Northern Division. Baseline assessment showed why the burden persisted. About 69% of households attributed severe malaria, especially in children, to witchcraft or spiritual causes rather than to mosquitoes, and only 42% could correctly name the mosquito as the cause.
As a result, many families delayed formal care for two to three days after fever began and turned first to drug shops or traditional healers. Consistent nightly use of insecticide-treated nets stood at just 34%, and fewer than 30% of households kept up basic environmental hygiene. For many families, the cost of prevention tools was itself a barrier.
The treatment system reinforced the problem. Around 88% of drug outlets sold antimalarials without first testing for malaria, largely because rapid test kits were not available to them. The Village Health Team network, the volunteers meant to connect households to the health system, was under-resourced, and Budondo Health Centre IV, the referral point for all ten villages, was repeatedly overstretched, with severe cases sometimes sent on to Jinja Regional Referral Hospital 45 to 90 minutes away.
These gaps were closely linked, each one feeding the others, so the project was designed to address them together rather than one at a time.
Project Objectives
- Raise malaria knowledge and early treatment-seeking through radio, community meetings, and elder-led dialogue
- Form 10 Village Savings and Loan Associations producing and selling mosquito-repellent jelly and candles for women's economic empowerment
- Distribute MRDT kits to drug outlets and train operators in test-before-treat dispensing
- Distribute insecticide-treated nets to the most vulnerable households and reduce breeding sites through clean-up drives
- Strengthen Village Health Teams for community-based surveillance and referral.
- Track progress through a three-phase MEAL cycle and document lessons learned
Implementation - Approach & Activities
The project was implemented across ten villages of Budondo Sub-County: Namizi, Nsuube, Ibungu, Buwagi, Kyomya East, Kyabirwa, Bususwa, Kazinga, Buyala, and Nakanyonyi. Activities ran from September 2025 to February 2026, led by the Rotaract Club of Jinja with Budondo Health Centre IV and the Jinja City health authorities.
Community Engagement and Awareness
Five malaria-prevention messages aired daily on Smart FM and NBS FM from late September 2025 through February 2026, in English, Lusoga, and Luganda, reaching cumulative listener impressions above 500,000. The messages covered mosquito biology, net use, testing before treatment, compound cleanliness, and dispelling the belief that malaria is caused by witchcraft.
Because that belief was deeply held, the project also asked respected community elders, led by Hajji Ibrahim Mulondo, to lead face-to-face dialogue sessions in Nakanyonyi, Buwagi, Kyomya East, and Namizi, where they challenged the witchcraft explanation directly and paired traditional plant knowledge with the biomedical facts.
Community mobilization meetings were held in all ten villages, and in the low-signal villages of Ibungu and Kazinga, printed materials, picture-based guides, and megaphone announcements were used to fill the gap left by potential weak radio reception. The Rotaract Club of Jinja designed the message content and co-facilitated; Budondo Health Centre IV provided technical support.
Women's Economic Empowerment through Savings Groups
Village Savings and Loan Associations are community-run groups, made up mostly of women, in which members pool small regular savings, lend to one another, and run a shared business together. In this project, that shared business was making and selling mosquito-repellent jelly and candles, which supported the malaria effort in three ways at once: the income gave women the means to invest in prevention their households could not previously afford, the products put a low-cost local repellent within reach of the wider community, and the groups' regular meetings gave the project a reliable place to deliver education, organize net distribution, and refer people for testing.
Ten of these groups formed across the ten villages between September and October 2025. Against a target of 75 women, 113 participants enrolled (102 women and 11 men). Members were trained to make the repellent jelly and candles from locally sourced ingredients, including lemongrass, rosemary, lemon eucalyptus, and cloves, and 84 completed the full training. Groups also learned to manage their savings and record-keeping, and several built market links: the Nakanyonyi group secured a supply agreement with a vendor in Jinja City, the Nsuube group created its own product brand, Nsuube Shield, sold through a network of seven motorcycle-taxi (boda-boda) riders, and the Buwagi group negotiated a 22% cut in the cost of its ingredients. Together the groups produced 1,790 units of repellent jelly and 3,160 candles, earning about UGX 5,595,500 (roughly USD 1,500).
Test-Before-Treat at Drug Outlets
For many people in Budondo, a private drug shop is the first and only stop when a fever strikes. At the start of the project, about 88% of these outlets sold antimalarial medicine on the basis of fever alone, without first confirming that the illness was actually malaria. This meant people whose fevers had another cause were treated for the wrong illness, while the real problem went undiagnosed, and households spent scarce money on medicine they may not have needed. The outlets were not equipped to do otherwise, as they had no testing tools on hand.
The project set out to establish a simple rule at these shops: test before you treat. Operators would use a malaria rapid diagnostic test, a quick finger-prick test that gives a result in minutes, and sell antimalarial medicine only when that test came back positive.
To make that possible, the project supplied 500 test kits to participating outlets by November 2025, meeting the target, and trained 45 operators, including hands-on practice runs, to take the blood sample, read the result, record the case, and dispense medicine only on a positive test. When several outlets ran out of kits in January 2026, the team set up a restocking system that reordered kits based on how quickly each outlet was using them, and handed it to the Jinja City District Health Management Team to adopt as a standard procedure. Village Health Teams reinforced the new norm by directing people with fever to these outlets for a test before buying any medicine.
ITN Distribution, Clean-Up, and Surveillance
Nets went to the most vulnerable households, identified through a scoring system that gave priority to homes with children under five, pregnant women, recent malaria cases, and low income. Of 301 households assessed, the most vulnerable received nets in this cycle, with the village of Ibungu, ranked highest-need, receiving the largest share; the 101 remaining households were referred to the Jinja City District Health Office for the government's 2026 national bed net distribution.
Unannounced follow-up visits found 87% of recipient households had their nets correctly hung over sleeping areas, and 26 households received coaching on how to install them. Community clean-up drives targeting standing water, drainage, and waste ran in all ten villages, and elder sessions encouraged traditional deterrent practices, such as smoking homes with citronella and native herbs, alongside the modern net and repellent methods. Village Health Teams were trained to watch for and report malaria cases, triage fevers, and refer people for testing.
Project Outcomes
Figures below compare a baseline survey in September 2025 with an endline survey in February 2026, each covering 340 households and 45 drug outlets across all ten villages, unless noted otherwise.
- Direct beneficiaries: 313
- Indirect beneficiaries: 1,000+
- Rotarians and Rotaractors involved: 87
- Correct knowledge of the cause of malaria: 42% to 89% (target 80%)
- Belief that malaria is caused by witchcraft: 69% to 12%, an 88% reduction (target 80%); 93% reduction in villages with elder dialogue versus 71% without
- Recall of a radio prevention message: 88% (target 80%)
- Seeking care within 24 hours of fever: 28% to 74%
- Women enrolled in savings groups: 113 (target 75; +51%); 84 completed production training
- Repellent products made (from group sales records): 1,790 jelly units and 3,160 candles; about UGX 5,595,500 (USD 1,500) in sales
- Household income among members (from group savings records): +28.4% (target +20%); average monthly income from sales UGX 34,500, up from zero
- Drug outlets promoting testing before treatment: 12% to 91% (target 60%); all 45 trained operators still testing at the end of the project
- Self-medication with unprescribed antimalarials: 61% to 19%, a 69% reduction
- Community awareness of malaria testing: 18% to 84%
- MRDT kits supplied to drug outlets: 500
- Insecticide-treated nets distributed to vulnerable households: 200
- Consistent nightly net use: 34% to 82% (target 70%); 87% hung correctly (from household installation checks)
- Use of traditional prevention practices: 28% to 76%
- Village Health Teams trained on malaria symptoms and prevention methods: 10
Qualitative Outcomes
Women reported greater say in household health decisions once they were earning their own income from repellent sales, and locally made repellents that had been unavailable or too expensive are now sold within the community at affordable prices. In the villages where elders co-led the dialogues, residents could speak about traditional and modern prevention methods side by side. Drug outlet operators and community members described a real shift toward testing before treatment, a concern that has also drawn national attention in Uganda (Daily Monitor, https://www.monitor.co.ug/uganda/news/national/self-medication-fueling-malaria-deaths-in-uganda-experts-5256812). All ten savings groups were still active and producing on their own when the project closed.
Challenges
Geographic isolation in Ibungu, served by a single drug outlet and a distant health facility, kept its knowledge and behavior scores below the village average; weak radio reception in Ibungu and Kazinga meant the project had to rely on printed guides and megaphones there; the kit shortages at six outlets in January 2026 prompted the new restocking system; three savings groups needed extra coaching to run their meetings well, and two had lower training attendance to work around; and demand for nets outstripped supply, leaving 101 vulnerable households to be referred to the national distribution instead.
Lessons Learned
- Enrollment ran 51 percent above target on word of mouth alone, which suggests that savings groups can keep a community engaged in malaria prevention well beyond a funded project, in a way that one-off outreach cannot.
- Belief change was strongest where respected elders co-led the conversation: those villages averaged a 93 percent drop in the witchcraft belief, against 71 percent where elders were not involved.
- Members teaching one another worked as well as formal training. The Nsuube and Bususwa groups, where formal attendance was lower, reached the same product quality and group governance by having their most engaged members coach the rest, which carries clear cost-saving implications.
- Drug outlet operators who got hands-on practice runs adopted testing far more readily (34 percentage points higher) than those who only received instruction, which suggests practice runs should be a minimum standard for this kind of training.
- Isolated villages like Ibungu need dedicated community health worker support and stronger referral links, more than a savings-group model on its own can provide.
Sustainability
All ten savings groups were active and producing on their own at closure, and each village created its own action plan, keeping the simple scorecard the project provided so members can track their progress every quarter without further funding. The Buwagi and Nsuube groups had already trained neighboring households on their own, and the ten trained Village Health Teams kept their startup kits and manuals. Two gains were built into the district health system: the kit-restocking system was handed to the Jinja City District Health Management Team to adopt as standard practice, and the 101 vulnerable households not reached this cycle were referred to the Jinja City District Health Office for the government's 2026 national bed net distribution.