A.H.E.A.D: The Community Health Club Approach to Sustainable Development
‘The individual is helpless socially, if left to himself… if he comes into contact with his neighbour, and they with other neighbours, there will be an accumulation of social capital which may immediately satisfy his social needs and which may bear a social potentiality sufficient to the substantial improvement of living conditions in the whole community.’ - Hanifan, L.J. (1916)
Holistic and Sustainable Community Development
The Community Health Club Approach promotes long-term, broad development, trying to discourage shallow development that addresses only one particular problem within a community. The basic assumption of the ‘Community Development’ approach is that lack of development is due to lack of ‘common unity’ in communities. Until the ‘social capital’ within communities is increased by sound knowledge, solid organisation and increased capacity, no amount of external assistance will produce sustainable improvement. The promotion of self-efficacy is the key objective in the process of empowerment and this can be developed by health education and hygiene promotion, which provides an entry point for a process of capacity building. Therefore the CHC approach advocates that before implementation of development projects such as water sanitation or food security, a Community Health Club should be established to provide a vehicle for all development.
AFRICA AHEAD Association was founded to provide a resource for development Organisations, Agencies, and Government wishing to implement public health programmes through Community Health Clubs (CHCs). For the past 15 years case studies of CHC projects have repeatedly demonstrated how training in hygiene is an effective entry point which not only improves health and living conditions but provides a structure within a community that enables the members to become self reliant.
Community Health Clubs have helped to improve the living conditions of the poorest of the poor in diverse situations: rural Christian communities in Zimbabwe, post conflict resettlements in Sierra Leone, refugee camps in Uganda, remote Moslem villages in Guinea Bissau and informal settlements in urban South Africa.
The AHEAD Model is a process of development which uses Health Promotion as an entry point into the communities based on the assumption that health is a universal issue which attracts all mothers. The discussion of health issues promoted a ‘common unity’ making it a functional community. After six months, the community start to make positive changes to their hygiene, sanitation and water facilities, which enable most preventable diseases (such a diarrhoea) to be reduced. Creating a demand for sanitation is one of the main challenges of the Millenium Development Goals, which is to halve the number of those without safe water and sanitation worldwide by 2015.
Applied Health Education leads on to skills training and income generation. Once there is reliable income, communities can afford to be altruistic, and take responsibility and care of their vulnerable families. With world recession, high unemployment and the pandemic of HIV/AIDS, the AHEAD Model, if properly implemented, can predictably ensure that communities become self-reliant and self motivated and escape the poverty trap.
MISSION
To provide support to NGOs, Agencies and Government Ministries in developing countries to use a community-driven holistic approach to development using Community Health Clubs as a vehicle for change.
VISION
To create an international association of partners dedicated to implementing and promoting the CHC approach, to sharing of lessons learned and the promotion of best practices based on empirical evidence so as to enhance the overall cost-effectiveness of development in the Third World.
SERVICE
Africa AHEAD is dedicated to assisting those interested in using the CHC approach to health and development, and provide the following services:
- Technical advice for water and sanitation programmes
- Design of projects using Community Health Clubs
- Training workshops for effective health promotion
- Research and evaluation of Health Promotion programmes
- Provision of information on the CHC Approach
COMMUNITY HEALTH CLUBS are really appropriate for most communities because they …
- Reduce communicable diseases through good home hygiene
- Modify habitual, detrimental hygiene behaviour through group consensus
- Build a ‘common unity’ of purpose within community
- Initiate a Community Based Organisation useful for all development
- Are sustainable by communities after exit of donors
- Promote creative problem-solving with participatory activities
- Ensure informed decision making through participation
- Break the ‘Cycle of Poverty’ and promote local industry
- Use positive traditional values of consensus to effect change
- Empower women in particular to become confident
- Meet the need created by intellectual starvation
- Provide support for disadvantaged and terminally ill
- Attract other donors looking for well organised communities
The AHEAD MODEL is attractive to funding agencies because it…
- Stimulates a demand for sanitation to meet United Nations Millennium Development Goals
- Provides quantifiable outputs in hygiene behaviour change
- Proven to be a Health Promotion Cost-Effective Model over past decade
- Guarantees high levels of hygiene improvement
- Replicable in all Developing Countries
- Can be scaled up to national level
- Leads to development initiatives in other sectors
- Most effective with the poorest of the poor
- Appropriate in peri-urban or rural areas
- Appropriate in for long term development or quick emergency programmes
- Provides a clear exit strategy once communities are functional
CONFERENCES :
In 2008 CHC Approach was recognised as a key methdology for Behaviour Change in the following International Conferences:
- AFRICASAN (South Africa, February 2008). The 8-point “eThekwini Declaration” that was signed up to by 32 Ministers from across the continent, highlighted the importance of the CHC Approach as one of the recommended methodologies for Behaviour Change in Africa;
- WORLD WATER WEEK (Stockholm, August 2008). Africa AHEAD presents a paper on CHCs with a focus on Urban Areas: two case studies (Zimbabwe and Uganda)
PUBLICATIONS:
The Joint Agency Document (signed up to by 18 development agencies: WHO, World Bank, UNDP, WaterAid, DFID, DANIDA, SIDA etc.etc.) entitled:-“Poverty, Health, and Environment” recognised the following CHC Case Study as one of the best results internationally for ‘hygiene behaviour change::
‘DFID funded the Community Health Clubs in rural Tsholotsho District, Zimbabwe. The project increased the proportion of households using a ladle to draw water from 3% to 93% and the proportion with an improved pit latrine from 40% to 80%, as well as improving other aspects of hygiene behaviour , at a cost of only $3.33 per household….. as Zimbabwe example shows it can be cost-effective to invest in changing behaviour.’
RESEARCH:
The AHEAD Model is based on the PhD research of the founder of Zimbabwe AHEAD and Africa AHEAD: Waterkeyn J (2006) Cost-Effective Health Promotion and Hygiene Behaviour Change through Community Health Clubs. PhD thesis submitted to London School of Hygiene and Tropical Medicine.
Waterkeyn, J. & Cairncross, S. (2005). Creating demand for sanitation and hygiene through Community Health Clubs: a cost-effective intervention in two districts of Zimbabwe. 61. Social Science & Medicine. p.1958-1970
Copyright: Creative Commons. Whilst this information has been made available and put into the public domain by this website the author would appreciate due accreditation and warmly welcomes any contributions in terms of adaptations of the AHEAD Model that may be posted on this website, in the interest of improving best practice to the communities of the Developing World
