By Dr. Schola Matovu | Nursing Professor | Nurse Scientist | Director of Global Learning and Engagement
July 7, 2026
Did you know that a maize (corn) field in Uganda could help us better understand how to support grandparent caregivers in Utah and other under-resourced communities across the United States?
At first glance, those places may seem worlds apart.
Yet the realities facing many caregivers can be surprisingly familiar: financial strain, food insecurity, social isolation, limited access to services, and the daily responsibility of caring for family members with few resources to rely on.
That is why the work unfolding in a maize field in rural Uganda is about much more than agriculture.
It is about understanding how communities build health, economic stability, and support from the ground up—and how those lessons can inform sustainable solutions in Uganda, Utah, and beyond.
In this episode, I share how a community-informed intervention, currently being implemented through my five-year research grant, is translating into action with grandparent-caregivers in Uganda and generating insights that may help strengthen interventions for vulnerable caregivers across settings.
🌱 Building with Communities, Not for Communities
This work is part of a five-year research initiative centered on the BAJJAJJA intervention—a community-driven model designed to improve both economic and health outcomes among grandparent-caregivers.
At its core, the research focuses on three aims:
- Refinement through collaboration: Working closely with community partners to shape and adapt the intervention.
- Testing in real-world settings: Implementing the intervention with 24 Ugandan grandmothers to understand feasibility, acceptability, and early impact.
- Understanding sustainability: Examining what helps—or limits—long-term success for both health behaviors and income-generating activities.
What makes this work unique is that it is not static.
It is iterative.
It evolves.
It responds to community priorities and lived realities.
Rather than delivering a predetermined solution, we are learning alongside community members and adapting as we go.
🌾 What Is Happening Now: Moving from Planning to Action
We are now in the early stages of implementing the refined BAJJAJJA intervention.
One of the first activities underway is an income-generating component centered on maize farming.
At first glance, it may seem simple.
But for many grandmother-caregivers raising grandchildren—it carries profound meaning.
Many are:
- Raising multiple children
- Managing limited household resources
- Experiencing food insecurity
- Navigating caregiving responsibilities with minimal formal support
For these families, maize farming is not just an agricultural activity.
It is a potential pathway to food security, income generation, and greater household stability.
🌫️ What Often Goes Unseen: The Starting Point
When we talk about interventions, it is easy to focus on outcomes.
What is less visible is where people begin.
This work does not start from abundance.
It begins amid:
- Limited financial resources
- Inconsistent access to food
- Physical demands associated with caregiving and labor
- Structural systems that often provide little support
Before a single maize seed was planted, land had to be cleared.
The soil had to be prepared.
Support had to be organized.
Physical challenges had to be overcome.
For many older caregivers, this work is demanding.
Yet despite those challenges, people continue showing up, contributing what they can, and investing in a future they hope will be more secure than the present.
In many ways, they are planting more than maize.
They are planting hope.
🌿 What Is Emerging: More Than Farming
As implementation unfolds, something important is becoming visible.
The most valuable outcome may not be the maize itself.
It may be what is growing around it.
Grandmothers are not working in isolation.
They are:
- Showing up together
- Encouraging one another
- Sharing caregiving experiences
- Learning from one another
- Helping carry both the physical and emotional weight of daily life
This is where another critical component of the intervention emerges:
Peer support.
While maize is the visible activity, the underlying mechanisms include:
- Social connection
- Shared accountability
- Mutual encouragement
- Collective problem-solving
At the same time, visiting nurses provide health coaching, integrating health promotion into grandmother caregivers’ daily lives.
Rather than treating health and economic well-being as separate issues, the intervention recognizes that they are deeply interconnected.
🧠A Key Early Insight: Economic Empowerment Is About More Than Income
One important lesson emerging during this early phase is that economic empowerment is not simply about generating revenue.
It is also about:
- Restoring agency
- Building confidence
- Strengthening relationships
- Expanding opportunities
- Creating pathways toward sustainability
Most importantly, it is about meeting people where they are rather than where we assume they should be.
This is what research in action looks like.
Not distant.
Not disconnected.
But responsive, adaptive, and grounded in lived experience.
🌎 Why This Matters Beyond Uganda
A question I am often asked is:
What can we learn from a community in rural Uganda that applies elsewhere?
The answer is: quite a lot.
While the specific contexts differ, many communities across rural Utah and other under-resourced areas of the United States face challenges that echo those experienced by grandmother caregivers in this study.
Caregivers may encounter:
- Financial hardship
- Geographic isolation
- Limited access to healthcare
- Social isolation
- Scarcity of community resources
Studying populations that experience sustained economic constraints and limited structural support helps us identify the core mechanisms that drive successful interventions.
Is it the income-generating activity itself?
Is it social support?
Is it accountability?
Is it community ownership?
Or is it the combination of all of these factors working together?
By understanding these mechanisms in one setting, we can better adapt and scale interventions for other communities facing similar barriers.
The goal is not to replicate programs exactly.
The goal is to identify the ingredients that make them work.
These insights will directly inform my ongoing and future efforts to support grandparent caregivers and other vulnerable populations in rural and persistently under-resourced communities in the United States and beyond.
In that sense, this work is simultaneously local and global.
The lessons move in both directions.
⚖️ What We Are Watching Moving Forward
As the study progresses, we are paying close attention to:
- Whether the intervention is feasible and acceptable
- Whether it improves economic and health outcomes
- What supports are needed to sustain progress
- Which barriers emerge over time
- How grandmother caregivers maintain engagement and behavior change
Because sustainability should never be assumed.
It must be understood.
Only then can interventions move beyond short-term success and create lasting impact.
🌍 Key Takeaway
What this phase of the BAJJAJJA intervention demonstrates is that a maize field can represent much more than agriculture.
It can represent:
- A response to food insecurity
- A pathway to economic stability
- A source of social connection
- A platform for health promotion
- A foundation for community-led change
And perhaps most importantly, it reminds us that meaningful solutions are rarely created in isolation.
They are built alongside the people they are intended to serve.
đź’¬ Closing
What we are seeing is only the beginning.
The seeds have been planted—both in the soil and within the community.
As the maize grows, so too will our understanding of what works, what doesn’t, and what it truly takes to create sustainable change.
And while the fields may be in Uganda, the lessons being cultivated there have the potential to reach far beyond them—informing how we support caregivers, families, and communities in rural Utah, across the United States, and around the world.
This is not just a project.
This is a process.
This is research in action.
Now you know.