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- 1994 – ongoing Zimbabwe
- 2002 – ongoing Sierra Leone
- 2003 – 2004 Albania
- 2005 – ongoing Uganda
- 2005 – 2010 South Africa
- 2007 – 2010 Guinea Bissau
- 2008 – ongoing Rwanda
- 2009 – 2010 Vietnam
- 2011- 1ongoing Namibia
1994 – ongoing: Zimbabwe:
The country where the Community Health Club approach was first pioneered in 1995 (supported by Unicef and Oak Foundation). After a field trial of one year, the project was taken to scale in Makoni District (funded by Danida), and Tsholotsho and Gulu Districts (funded by DFID). Although the economy collapsed in 2001 and the organisation had to downsize for a few years, the Community Health Clubs in Makoni District continued their activities and actually prospered in a time of extreme recession. A new project started in 2006 in Chipinge and Buhera District in partnership with Mercy Corps. Since 2009 OXFAM became a partner with a CHC project in Chipinge District and Chiredzi, which was completed in August 2010. ACF is currently partnering with Zim AHEAD in Masvingo, and numerous training is being done for other organisations wanting to start CHCs through the Protracted Relief Programme 11 funded by DFID. The Ministry of Health is now firmly supporting the AHEAD Approach in Zimbabwe and CHC is in the process of becoming institutionalised as an National Programme. In 2012 Zimbabwe AHEAD has started 480 CHCs in Mberengwa and Gutu districts in partnership with ACF and is about to start up a major programme in five districts in Manicaland and Masvingo funded directly by USAID/OFDA which will entail another 450 CHCs operational by early 2013. In addition Zim AHEAD is starting up small urban CHC projects in the towns of Bindura (GAA) and Chipinge (ACF) funded by the Unicef Urban WASH fund.
2005 – 2010: South Africa
Based in South Africa there are a number of smaller training initiatives but the main project has with government helping to establish CHCs in tin Kwa Zulu Natal where health clubs started in 10 wards of Umzimkhulu. In the urban areas of Durban Africa AHEAD initiated a pilot project in two informal settlements for the eThekwinini Municipality in 2009 -10. DWAF hae lost interest in these projects and there has been no change since 2010. However in Cape Town where over 400 CHC has been started in the 200 informal settlements, due to training by Africa AHEAD from 2004-2008, but we are no longer involved as this has been driven by the City Health Department and we have had no updates recenty. There is currently interest by Councillors and leading NGOs to start CHCs in Masiphumelele near Fish Hoek, Cape Town but it is small scale and again there has been a slow response.
2009 – onging: Rwanda
The Ministry of Health is taking the lead in Rwanda and the CHC Approach has been launched at the highest level,in the Community Based Environmental health promotion Programme (CBEHPP). This has been facilitated by the production of a substantial Tool kit of visual aids and manuals to be used as the training material completed by Dr Juliet Waterkeyn, in November 2010. Training has been done in 5 Pilot districts. As of 2011, a Presidential initiative decreed that all 15, 000 villages in Rwanda should start CHCs within the next year. This means training all 45,000 community health workers in the country. By Feb 2013, 98% of all villages had registered CHCs and a comprehensive structure of CBEHPP committees from Provincial to Village level has been set up to monitor the progress in each village . There are 14 NGOs assisting MoH to conduct training but this is proving a challenge at this scale. Water Aid and Wrold Vision have registered considerable improvements and are excited about he programme. Africa AHEAD, supported by Gates Foundation is assisting the MoH in Rwanda to ensuring standards are maintained despite the massive scale up. In one district of Rusizi, a Randomised Control Trial is being started involving 150 villages to ascertain the effect of the CHC approach in Rwanda on disesae reduction.This external evaluation is being conducted by IPA, Innovations for Poverty Action, a consortium of research professionals from highly reputed universities based out of Washington DC. The AHEAD project in Rusizi is due to start in July 2013, once the base line for the RCT has been completed and the control and intervention villages selected.
2009- ongoing: Vietnam
Vietnam is the first Asian Countiry to adopt the CHC Approach, with a pilot project in four Provinces which started in November 2009, after the first workshop by Africa AHEAD. By July 2010 the Tool Kit and Manual was finalised with our assistance from Africa AHEAD (funded by Danida) and a start up workshop held for trainers. This will enable the roll on training to take place in all areas where 40 CHCs have already been formed up and registered. However there is no recent information on whether this scaling up is taking place.
2005 – ongoing: Uganda
The introduction of CHCs into Uganda was also facilitated by CARE International who requested Dr. J. Waterkeyn to assist in an emergency project in Gulu District in 15 IDP Camps. The ambitious target was to build 10,000 latrine within six months as well as to reach 120,000 people with health promotion. This proved to be possible using the CHC Approach and all targets were not only met but exceeded, with 11,500 latrine built within 8 months. CHC’s continue to be used in Northern Uganda and other organisations are now taking this route. WaterAid supporting a training in 2007 for local partner NGOs with a view to scaling up the methodology. Information is needed to ascertain to what extent this has been implemented by the NGOs.
This year (2013) a small programme in 20 communities aims to support the provision of safe drinking water is being considered by a consortium involving International Lifeline Fund, Blue Planet and ReachScale who have invited Africa AHEAD to conduct training for these communities with a view to scaling up at a future stage.
2007: Guinea Bissau
Effective Interventions requested Africa AHEAD to train facilitators and in 2007 started up CHCs in the Southern Districts of Timbali and Quinara. By 2010 the post intervention data was completed and result on levels of hygiene behaviour change and reduction of child mortality have been published.
2002-2003: Sierra Leone:
A consultancy for CARE International for the Directors Juliet and Anthony Waterkeyn in 2002-3 provided an opportunity to introduce this methodolgy in Sierra Leone. The pilot project in Bo and Moyamba Districts comprised of 50 CHCs in 25 villages. CHCs are now a common strategy in Sierra Leone and a training manual for the country has been produced, enabling the scaling up of this approach to take place. In January 2013, the directors undertook and evaluation to assess ongoing health promotion programmes by all NGOs in Sierra Leone with a view to evolving CLTS which is the main policy in the country to include more aspects of the CHC approach. the report has just been completed and we await future developments.
2011: Namibia
Africa AHEAD is currently assisting Cuve Water supported by ISOE, a German Research Insitute, to implement a small pilot project in Outapi town, in four peri urban settlements where they are setting up a sewrage system. CHCs are being started to assit in the managment of the communal facilities.
