RIVER Africa, seeks to use the provision of health services and improvement of livelihoods as tools for social change and economic development. RIVER Africa was formed in direct response to the ever expanding poverty gap and the perpetual erosion of livelihoods in Southern Africa, paying special attention to the situation in Zimbabwe, Zambia, Malawi, Namibia and Tanzania. 

The Districts that River Africa is working in and has links in are classed as Hard-to-Reach areas, due to a multiplicity of barriers to accessing both primary and secondary health care, education, paid work and other social goods. 

These areas have some of the lowest literacy rates, the worst geographical terrains; the poorest rates for malnutrition; water and sanitation; access to health and education.

They have high proportions of Hard-to-Reach populations; are considered the least developed and poorest Districts in their respective countries. Zimbabwe (Mbiri district), Malawi (Mulanje and Zomba).