By Dr. Schola Matovu | Nursing Professor | Nurse Scientist | Director of Global Learning and EngagementJune 9, 2026
When we talk about caregiving, we often imagine parents raising children. But across the world—from rural Uganda to communities here in the United States—grandparents are stepping in as primary caregivers in growing numbers.
This is not a temporary trend. It is a global reality.
In my previous work, I introduced grandparent caregiving as a widespread and deeply important phenomenon. This week, I want to go further—to talk about what it truly means to meet grandparent caregivers where they are.
Because “where they are” is not just physical.
It is mental. Emotional. Financial. Social. Structural.
And wherever that “place” may be, one truth remains constant:
their priorities matter.
Seeing Caregiving Beyond the Surface
Across my research in both Utah and rural Uganda, I’ve encountered grandparents navigating remarkably similar challenges despite very different settings.
They are managing:
- Financial strain
- Health limitations
- Emotional stress
- Limited access to support systems
But what often gets overlooked is the urgency of their needs in the present moment.
It may take more than 10 years to regulate a new and innovative health device. While systems evolve slowly, caregivers cannot afford to wait.
A grandmother in rural Uganda who cares for a 16-year-old grandchild with a disability may walk miles to reach a clinic once a week—carrying that child on their back.
What she needs today is not a future innovation. She needs reliable transportation.
At the same time, in Utah, resources may exist—transport programs, healthcare services, financial support systems—but many grandparent-caregivers do not know how to access them.
These insights fundamentally shift how we should design support systems.
Moving From Solutions For to Solutions With
Historically, many caregiving interventions have been designed from the top down.
But this approach often misses the mark.
That is why my work adopts human-centered design (HCD).
Human-centered design starts with a simple but powerful principle:
The people closest to the problem must be part of designing the solution.
What This Looks Like in Uganda & Utah:
In Uganda, this approach has informed the current development and refinement of our BAJJAJJA intervention.
We engaged:
- Grandparent caregivers
- Local council leaders
- Nurses
- Income generating activity experts
- Women empowerment experts
Together, we have identified three priorities:
- Financial stability
- Social support
- Health and wellbeing
In Utah, this approach is informing the development of The Grand Experience, our community-informed podcast intervention designed to elevate the voices of grandparent-caregivers and improve access to resources, research and support systems.
We have engaged:
- Grandparent-caregivers
- Community service providers
- Program leaders
- Legal experts working in kinship care
- Researchers
- Individuals raised by grandparents
Together, these community partners are contributing to shaping the focus and design of the intervention, with an emphasis on:
- Increasing the visibility of grandparent-caregiving experiences
- Improving awareness and access to available resources and research
- Strengthening connection between caregivers and systems of support
A Critical Insight: Access vs. Availability
Across both contexts, one of the most important insights from this work is this:
The challenge is not always availability. It is access.
- In Uganda, critical services or innovations may not yet be fully scaled or regulated—and even when they are, they may remain out of reach.
- In Utah, services exist—but navigating them can be overwhelming and unclear.
In both cases, grandparent-caregivers experience the same outcome:
they cannot reach what they need. Today.
This is why our work is now focused on:
- Increasing the visibility of existing resources
- Simplifying pathways to access
- Reducing barriers that prevent caregivers from using available support
Because a resource that cannot be accessed is not a solution.
Why This Matters
Grandparent-caregivers are:
- Anchors of family stability
- Providers of continuity
- Drivers of community resilience
Meeting Them Where They Are
There is no single starting point.
There is only where they are.
And if we truly meet them there, we must respond to both realities:
- The immediacy of their daily needs
- And the systems that shape their ability to access support
Because dignity is not built in future systems alone—
it is built in whether grandparent-caregivers can meet their needs, today.