Authored by Evans A.K. Miriti

The Health of People and the Environment in the Lake Victoria Basin (HoPE-LVB) project used stakeholder engagement, education and a series of community meetings to allow communities to identify the issues most important to them and identify potential solutions. From there, the communities were able to work with local officials to draft and amend a set of by-laws around these issues that everyone in the community could agree upon. This empowered the community to take action, allowed for ownership and buy-in surrounding these new by-laws and has demonstrated improvements in public health and livelihoods.


Communities in and around the Lake Victoria Basin experience a number of interconnected challenges, including dependence on diminishing natural resources, widespread poverty, food insecurity, poor sexual and reproductive health outcomes and inaccessible health services. At the same time, the ecosystem itself faces overuse and resulting degradation. To address these intertwined challenges and foster healthy, engaged communities, Pathfinder International is currently advancing an integrated population, health and environment (PHE) initiative called Health of People and Environment–Lake Victoria Basin (HoPE–LVB) in partnership with several environmental and health sector partners in Uganda, Kenya and the United States. (1)

Helping Communities Improve Their Lives

HoPE-LVB has always placed their focus on holistically meeting the needs of communities. On Bussi and Jaguzi Islands, the HoPE-LVB team worked with project communities, other stakeholders and baseline survey results to identify the interrelated challenges affecting the islands' communities. These ranged from rapid population growth with poor access to health services to unplanned land management, deforestation and overfishing. All of these factors contributed to the loss of natural resources and an uncertain future for the next generation. Meetings and discussions showed the communities’ willingness to change and embrace appropriate practices that would improve their lives. However, communities felt they lacked the needed technical skills and institutionalized guidance to sustain whatever measures were adopted. To assist with this, the HoPE-LVB project team helped the communities identify locally-driven solutions and adhere to self-established decrees.

Community Dialogues

In order to begin the process of empowering communities to set and then adopt local regulations, the project team engaged community members in discussions to identirfy the issues they felt most affected their lives in the areas of health, environmental conservation and livelihoods. Community members were asked to freely share ideas, ask questions and suggest solutions to issues. Meetings brought together community members, community leaders and District officials. Discussions allowed the project team to identify issues around which to begin intervention strategies with community buy-in.

Building Capacity

In order to empower communities to improve their quality of life while maintaining the natural resources they depend on, the project team worked to build the capacity of community members. This was done through a focus on understanding population dynamics, promoting public health and encouraging the means for environmental conservation. Training sessions specifically focused on sexual and reproductive health, includling family planning and environmental conservation practices. By linking these two areas, community members were able to identify the relationships between health and the environment and suggest strategies that would allow them to improve their quality of life while sustaining their natural resources.

Both men and women were brought together in these discussions, in contrast to many maternal and child health discussions that were primarily attended by women. This created an increased presence of women in community meetings and allowed women to speak to their challenges and share their ideas for ways to create an improved standard of life.

As strategies were implemented, communities saw increases in crop yields, livestock and fish catch while also noticing improved health.

Creating By-laws

During the community meetings, it was noted that while community governance structures are in place, there are either no local by-laws or the ones that exist are weak and need revision. HoPE-LVB staff worked with District officials, community members and leaders to draft localized by-laws which could be uniquely designed for the areas in which the project is implemented. By-laws were drafted by representatives of various interest groups and were vetted by community members. In continuing meetings, community leaders discussed what the by-laws mean to everyone in the community and community members committed themselves to observing the by-laws and promoting them among their social groups. This helped ensure ownership of the by-laws amongst the whole community.


1. Pathfinder International. Sustaining Health, Rights, and the Environment in the Lake Victoria Basin. Watertown, MA:Pathfinder International, 2015.