7. Recommendations

Recommendations are derived directly from the conclusions and are categorised by stakeholder. Each is intended to be specific, actionable and proportionate to the evidence.

7.1 Donor (Basque Government)

1. Fund a structured transition/exit phase. Given that sustainability is the intervention’s principal exposure, prioritise bridge or follow-on financing explicitly designed to transition financing-dependent components (mobile outreach, referral coordination, the medical hostel, specialised survivor support) toward government and partner ownership, rather than abrupt closure. (Links to: Sustainability, Connectivity.)
2. Support multi-year, nexus-oriented financing. Favour funding modalities that sustain the humanitarian–development nexus the project demonstrated, enabling system strengthening to consolidate beyond single project cycles. (Effectiveness, Sustainability.)
3. Require and resource outcome-level measurement. In future calls, support stronger outcome and cost-effectiveness measurement (including unit costing and disability-disaggregated data) to enable firmer attribution and value-for-money analysis. (Impact, Efficiency.)

7.2 Farmamundi (lead / coordinating partner)

1. Develop an explicit sustainability and handover strategy at design stage for any successor intervention, with defined responsibilities, timelines and resourcing for each component’s transition to local systems. (Sustainability.)
2. Redesign the urban health package for chronic and non-communicable disease, moving beyond an essential-medicines specification toward referral, cost-mitigation and chronic-care models suited to Kampala. (Relevance, Coverage.)
3. Formalize and extend the partnership with Makerere University. Move from project-based collaboration to a multi-year MoU covering (i) joint research on refugee protection and SGBV, (ii) student placements/internships within Farmamundi field operations, (iii) co-authored policy briefs, and (iv) shared participation in future calls. This would consolidate the technical capacity built during this project and provide an institutional anchor for evidence generation and outcome-level measurement.
4. Strengthen the results framework, adding outcome-level indicators, disability- and age-disaggregation, and indicators capturing men’s and boys’ engagement and environmental measures. (Effectiveness, Cross-cutting.)
5. Institutionalise environmental and Do No Harm screening, including medical-waste management and expectation-management for service continuity. (Cross-cutting, Connectivity.)

7.3 Implementing partners (AHA and EMESCO)

1. Address staff turnover and skills retention through institutionalised refresher training, mentorship, and the embedding of competencies in facility routines and SOPs rather than in individuals. (Effectiveness, Sustainability.)
2. Strengthen the referral feedback loop by standardising referral documentation, designating referral focal points at receiving hospitals, and tracking loop closure to resolve the paperwork and rotation disruptions identified. (Coordination, Efficiency.)
3. Deepen the integration of community committees and VHTs into settlement and district structures so that community-level functions continue with light-touch facilitation. (Sustainability, Ownership.)
4. Expand deliberate targeting of under-reached groups — men and adolescent boys in protection/MHPSS, persons with disabilities, older persons, and the most remote settlement populations. (Coverage, Cross-cutting.)

7.4 Government of Uganda (MoH, OPM, KCCA, District Health Offices)

1. Absorb and sustain harmonised referral protocols, SOPs and accountability practices into routine district and facility systems, and formally recognise project-strengthened VHT and committee structures. (Sustainability, Coordination.)
2. Prioritise specialist and diagnostic capacity for refugee-serving facilities and reinforce the referral architecture, including for urban refugees, within district health planning. (Effectiveness, Coverage.)
3. Integrate MHPSS into routine primary care, given the scale of demonstrated unmet mental-health need, including continued investment in screening and de-stigmatisation. (Impact, Sustainability.)
4. Sustain coordination platforms with humanitarian partners to maintain the dense, functional coordination fabric the project supported. (Coordination.)

7.5 Community level (community committees, leaders, VHTs, rights-holders)

1. Maintain and rotate community committee and leader functions, ensuring continuity of identification, referral, awareness and feedback roles and renewal of trained personnel. (Ownership, Sustainability.)
2. Sustain awareness and de-stigmatisation activity, with intensified outreach to men and boys to support transformative change in gender and help-seeking norms. (Effectiveness, Cross-cutting.)
3. Continue using AAP feedback mechanisms and hold local institutions accountable through the established dialogue and complaint channels. (Ownership, Participation.).

The consultations with beneficiaries and key informants generated a wide range of practical recommendations aimed at strengthening the effectiveness, sustainability and inclusiveness of future programming. Across Result Area 1, participants emphasized the need to expand access to chronic disease medications, strengthen referral systems through dedicated focal persons and digital tracking, institutionalize continuous mentorship for health workers, improve community visibility of outreach services, and enhance mental health programming through stronger links to livelihoods and peer-support structures. Stakeholders also called for greater localization of tools and protocols through translation into refugee languages, improved communication on medicine availability, and stronger follow-up mechanisms for patients receiving specialized care. Under Result Areas 2, 3 and 4, beneficiaries and key informants highlighted the importance of deepening community ownership, participation and accountability. Recommendations included engaging men and boys more deliberately in SGBV prevention, providing modest support to community protection structures, integrating economic empowerment opportunities for survivors, and strengthening legal aid services. Participants further proposed expanding community-centered advocacy through refugee-led media initiatives, podcasts, community correspondents and simplified research feedback products. In relation to accountability, stakeholders emphasized the need for more accessible feedback channels, particularly face-to-face mechanisms in settlement settings, stronger confidentiality safeguards for sensitive complaints, multilingual information materials, and regular “You Said – We Did” feedback updates to demonstrate how community concerns influence program decisions.