African Journal of Public Health and Health Systems | 26 October 2008
A Systematic Review of Mobile Outpatient Clinic Utilisation for Chronic Disease Management in Remote Lake Victoria Fishing Communities, Uganda
N, a, k, a, t, o, K, i, n, t, u
Abstract
Chronic disease management in remote Lake Victoria fishing communities in Uganda is hindered by geographical barriers and limited fixed health infrastructure. Mobile outpatient clinics are deployed to address this gap, but a systematic synthesis of their use is absent. This systematic review aimed to synthesise evidence on the utilisation patterns of mobile outpatient clinics for chronic disease management within these communities. It focused on factors influencing uptake, operational service delivery models, and reported patient outcomes. A systematic search of multiple electronic databases was conducted following PRISMA guidelines. Included studies comprised peer-reviewed articles and relevant grey literature reporting on mobile outpatient clinic services for chronic conditions in the target population. Data were extracted and analysed via narrative synthesis, with study quality assessed using appropriate appraisal tools. The review identified a limited but consistent evidence base. Utilisation was strongly influenced by the clinic schedule’s alignment with fishing activity cycles, with attendance falling during peak fishing seasons. Hypertension and HIV were the most commonly managed conditions. Key barriers included frequent medication stock-outs and community perceptions of the service as temporary. Mobile outpatient clinics provide a critical service link for chronic disease management in these remote settings. However, their utilisation is patterned by the socio-economic realities of fishing livelihoods. Challenges to sustainability and integration into the wider health system persist. Programme planners should synchronise mobile clinic schedules with fishing community calendars. Interventions must ensure reliable drug supply chains and explore community-based models to support continuity of care between visits. Further operational research is required to evaluate cost-effectiveness and long-term health outcomes. mobile health clinics, chronic disease, utilisation, fishing communities, sub-Saharan Africa, Uganda, health services accessibility, systematic review This review consolidates evidence on a specific service delivery model in an under-served setting, providing a foundation for policy and practice aimed at improving chronic care access for remote populations.