Zimbabwe AHEAD

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Zimbabwe AHEAD is the original organisation which was started in 1997 to replicate the Community Health Club Approach that had proved so successful in field trials during the previous 2 years. As the original pioneer in the Community Health Club approach, Zim AHEAD has the longest experience in this methodology and in the past decade has developed the CHC Model to its full extent. Zim AHEAD has played a catalytic role in pioneering a workable solution to achieve sustainable development and is the resource centre for a participatory PHAST Tool Kit of visual aids for health promotion which is provided to other NGOs with training to set up Community Health Clubs.

2009 Zimbabwe AHEAD Staff

The AHEAD approach has taken a firm root in Zimbabwe where the Ministry of Health continues to implement health promotion through Community Health Clubs. In Makoni District the programme has diversified to become a sustainable livelihoods programme, with over 5,000 nutrition gardens growing herbs and vegetables. The Health Clubs in Makoni have become famous thanks to international exposure through research findings, and Tsholotsho District remains an example world-wide of some of the most cost-effective health promotion to be accurately documented in the literature.

Andrew Muringaniza, responsible for the sucessful Tsholotsho Project 1997-2001, now Project officer in Chipinge

Morgan Haiza, starting some of the first CHCs in Zimbabwe in 1995, now Project Officer in Chipinge

THE GOLDEN YEARS (1997-2000)

During this start-up period, Zim AHEAD was well supported by funding agencies such as DFID, Danida and Oak Foundation. Two substantial health promotion, water and sanitation programmes were completed in three districts of Zimbabwe, Makoni District (Danida) and Tsholotsho and Gutu District (DFID).

Zimbabwe AHEAD was directly responsible for initiating over 265 Community Health Clubs in this area, with a total number of members trained in under three years being 11,450 with an estimated number of beneficiaries being 68,700. Through training support to other agencies a further 72 CHC started in all wards of Bikita, and seven wards in Lupane (IWSS-DFID), as well as in Zaka District with CARE International. By 2001 there was an estimated number of 17,282 members in 5 districts, with over 103,692 beneficiaries. In Makoni the cost per beneficiary for two years of health promotion amounted to US$ 0.63 per year, whilst in Tsholotsho the cost was only US$0. 35 per beneficiary. A total of 3,600 latrines had been constructed with subsidy of US$15-20 per latrine. In 1998-9 the 2400 latrines constructed in only two of the 57 districtsÂ amounted to 24% of the 8,000 latrines constructed nationwide that year. PhD Research was to show that levels of hygiene behaviour change was exceptionally high with an average of 43% in underdeveloped Tsholotsho for 21 indicators with less in Makoni of 13% average, accounted for by higher standards of hygiene due to being a more developed area . See Publications for details.

THE LEAN YEARS: 2001-2006

Mrs Josephine Mutandiro, as District Coordinator developed the Herb and Nutrition Programme in Makoni from 2002 which has become a life savour for over 5000 families.

When Zimbabwe disintegrated in 2001, donors abandoned the funding of projectsÂ and the Zim AHEAD was forced to scale down operations. The Head office was moved to the District where most activities were taking place and from 2003, the organisation has been based in Rusape. Importantly, although there was little funding during this difficult period, the Community Health Clubs kept themselves busy and many self reliance project were started with minimal outside inputs. During these lean years, some support for Zim AHEAD activities was given by LEAD, FAO and New Zealand Aid , but the organisation struggled to keep going. However, despite the economic, political and social crisis in Zimbabwe (with inflation well over 10,000% and unemployment at 70%), the Community Health Club members were not only surviving but actually prospering! Sales from over 500 income generating groups enabled women to support their families financially through the sale of produce. The income generating groups are engaged in are beekeeping (there are currently over 10,000 beekeepers in the programme), the propagation and sale of dried herbs and vegetables, carpentry, sewing, tin-smithing, and paper making. All of these activities have brought significant wealth to the area. In addition, ten health clubs built a Training Centre and Community Market as a means of developing an outlet for their produce between 2002 and 2005, but this brave effort was damaged by arson in 2007.

Importantly, although there was little funding during this difficult period, research into the achievements of CHCs in ZimAHEAD Project areas was conducted at the London School of Hygiene and Tropical Medicine which has ensured the survival of valuable lessons learnt through this approach. This has resulted in the spread of academic understanding of the power of this methodology to produce cost-effective hygiene behaviour change, and giving the parent Zim AHEAD a place at the cutting edge of good development practice.

Sustainability of Community Health Clubs

The unfortunate situation in in Zimbabwe has provided an opportunity to test the viability of the CHC Approach to sustain self reliant development in the most challenging of circumstances. Interviews in 2003 showed that of the 20 health clubs that were randomly selected in each of the 20 wards of Makoni, all were still operational after three years without external support despite the melt down ofÂ the country economically. CHC members were responsible for coordinating development initiatives such as health promotion and surveillance, water point rehabilitation, sanitation, nutrition, HIV/AIDS Care, Orphan and Widow support and sustainable livelihoods, as well as playing netball, discussions of health and hygiene, and planning income generating activities. (See: What the community says: Quotations posted on this website were collected at this time (Research and Dissemination Project funded by DFID )

NEW HOPE (2007 -2009)

: FAN Club members are given a starter kit of 30 main herbs and taught the medicinal properties of each to enable home treatment of common ailments, providing a self help solution in the face of the collapse of health services in Zimbabwe.

In Stage 3 of the programme, Zimbabwe AHEAD is now converting the Community Health Clubs into Food and Nutrition Programme (FAN) clubs, growing herbs and vegetables to ensure food security in these difficult times, supported by the EU. Since February 2007, Mercy Corps has been Zim AHEAD’s main partner, funded by British Lottery Fund and EU. Despite the political and economic turmoil of that time, and the hardships of minimal support, the unswerving commitment of the staff ensured that a successful programme was started in Chipinge District. Within six months there were 27 health clubs with over 2705 members. The following year community monitoring with household inventories showed that there was a 43% improvement of hygiene practice as measured before and after the project.

In Rusape, Zim AHEAD continues to assist play schools started in some CHCs providing much needed supplementary feeding for orphans and vulnerable children. There are currently five centres, where a midday meal is provided and children are taught games and cultural songs and dances by the volunteers. this Ambuya Asistance Programme (Grandmother support) is supported by New Zealand Aid, who also helped build the Wild Honey Sangano Centre, providing a focus for CHC activities.

A Programme implemented by Zimbabwe AHEAD, supported by OXFAM has now started in two urban high density suburbs of Mutare, where health clubs have become one of the most viable means of arresting the spread of cholera which is ravaging the country.