Kachumbala Maternity Unit
Uganda, Africa
Kachumbala Maternity Unit
Uganda, Africa

Fast Company honors Kachumbala Maternity Unit as World Changing Idea.

Kachumbala is located in Uganda’s Bukedea District, home to 170,000 people in rural eastern Uganda. It is one of the country’s most impoverished regions. The region’s only existing maternity unit is a two-room, 1950s-era facility that turns away six out of every 10 women who seek its help, because it doesn’t have room for them.  The region suffers from a high infant mortality rate. An estimated 35-40 children out of every 100 die before their first birthday.

To improve Kachumbala’s health care facilities, HKS proposed a sustainable, passive maternity facility: The Kachumbala Maternity Unit. To build it, we partnered with Engineers for Overseas Development (EFOD), a Wales-based non-profit organization that trains young apprentices in the building trades.

Furthering the challenge of expanding the regional maternity unit, Kachumbala does not have a reliable source of electricity. To construct the new unit, we devised a fully passive building, created with vernacular construction methods.


By considering the building’s current and future impacts, HKS and EFOD gave the region a health care facility that will improve the health of its mothers and children. We did it by changing how we designed, specifically, by changing:

  1. The way we partner.  For more than a decade, EFOD has been on the ground in Kachumbala, working with village elders and community members on meaningful projects that have real impacts.  We built and maintained trust with the community.
  2. The people who build it.  We hired and trained more than 40 community members to help build the maternity unit right alongside our team.  These paid construction workers gained valuable skills for future employment. 
  3. The materials we build with.  We used only local materials on the project, and constructed the building with methods that didn’t require electricity. Handmade bricks that form the building’s structure were made on site, baked in the sun, not fired (saving trees from being cut and burned).  Using regionally made products is environmentally and socially responsible and supports the economy.  
  4. Our impact to the planet.  The sustainable, passive design will have a minimal impact on regional resources, while improving health care for its people.

The new building will accommodate up to six births each day, the average for the region. As a result, all women in the Bukedea district will have access to a maternity unit when the facility opens in early 2017. The Kachumbala Maternity Unit will change the lives of people in Uganda, and its design example can change the world, too. 

The Design 

The design objective was to create a new maternity unit able to serve its people with the materials, utilities and construction techniques available on site. The facility had to be fully self-sufficient with regard to electrical supply (because the local grid is not reliable) and water intake (because there is no city plumbing). Additionally, construction techniques could not rely on electricity or running water. If any construction required a bolted connection, it had to be pre-fabricated elsewhere and transported to the site.

HKS tested the design with the assistance of UK-based health professionals, who also provided midwife support and training for local health care providers. We analyzed the design’s circulation, flows and equipment needs for practicality. We designed patient and visitor area circulation to reduce the risk of cross-contamination. Equipment consultation was particularly insightful, because we learned that anything we specified for the building had to be able to be serviced or replaced locally. Any items that would require parts to be shipped or replaced elsewhere simply wouldn’t work for this project.

The existing two-room health facility will be repurposed and used for other medical functions. The new building will house delivery suites, prenatal and postnatal facilities and was designed to support future expansion. 

Impact Beyond Uganda

While the impact of the project on the people of Kachumbala is easy to see, the project also had a huge impact on our firm, and how we will design moving forward.

Community engagement and research into local materials and construction methods gave our designers a new perspective on what it means to design within a local context.

Our perspective on funding projects also shifted. In June 2016, HKS launched an ambitious employee fundraising campaign to help complete construction of the Kachumbala maternity unit.  We raised more than 25 percent of the total construction cost through our own employee’s donations, in addition to the design, which HKS offered pro-bono through our Citizen HKS program. 

Citizen HKS is focused on driving social change through design, fundraising, and community service, expanding our collective impact as global citizens to empower people and help lift communities anywhere in the world where we identify a need.