Association for Applied Health Education And Development

August 2010

Africa AHEAD Project Manager Nancy Maksimoski conducted a 3-day workshop on the CHC Methodology for EWS staff 17-19 August 2010 in Durban. The training covered Modules 1 (Feasibility: Rationale for the Community Health Club Approach) and 2 (Planning: How to Start a Community Health Club Project) of Africa AHEAD’s CHC Manual.  For this project, 8 EWS Health Promoters will each be responsible for forming and facilitating 5 CHCs, to be implemented in a combination of informal settlement and rural communities.

Health Promoters discuss Siyathuthuka's Challenges

After an introduction to the AHEAD methodology on the first day, the group discussed the challenges facing informal settlements, and the HPs feared there was little that could be done to convince community members to take ownership of the communal facilities – a problem that is seen as the core issue behind many of the challenges the HPs identified.

On the second day of the training, Africa AHEAD led the HPs on a transect walk and mapping exercise of Siyathuthuka, with the assistance of community leader Nhlanhla and resident Innocent.  As Khethokuhle (Siyathuthuka’s CHC) has only just begun its CHC sessions, its current state is very similar to that at baseline. The group noted that while the container toilets provided by EWS are very well maintained by its caretaker, grey water, illegal dumping, and illegal taps are problematic in the community.  Participants engaged Nhlanhla and Innocent in discussion about many of the issues they highlighted earlier in the workshop, in order to understand these matters from the perspective of a community leader/resident.

Impiloyethu has started a glass recycling project which will help to keep the community free of glass litter and serve as an income generating project for the club members involved

To illustrate the difference CHCs can have on communities, the HPs were then taken next door to Boxwood Place, where Impiloyethu has been active for the past year. Not only could the group visibly see the differences between the two communities and view Impiloyethu’s projects, but they were able to talk with CHC members and hear their stories about how health clubs have improved their lives.

After the site visits, the attitudes of the Health Promoters towards the concept of ownership had noticeably changed. Although still thought to be a challenge, they agreed that it was something the health clubs could achieve and their enthusiasm became very tangible.

In order to better understand the dynamics of a CHC, the group formed their own mock CHC, Vukuz’ thatha (Get up and do it for yourself), which they will continue to be members of for the remainder of the upcoming trainings.

In addition to the site visits and presentations, Africa AHEAD facilitated discussions on the roles and responsibilities of the project’s stakeholders, mobilisation, and other important topics. Participants also acted in several helpful role-playing exercises, such as how one engages with community leaders, which can be problematic as these people often act as gatekeepers to the community.

By the end of the three day training, the group had a clear understanding of the CHC methodology, plans to begin engagement of Councillors and Community Leaders, and were enthusiastic to start the project.

Africa AHEAD left the group with the homework of choosing the communities they wish to implement the project in, engaging the relevant project stakeholders for each community, as well as to begin the mobilisation and registration process for the health clubs.  Africa AHEAD is very pleased with the results of the workshop and is looking forward to seeing what the group is able to achieve in the upcoming weeks before September’s workshop.

August 31st, 2010 | Tags: Community Health, Durban, Health Clubs, Informal Settlements, KwaZulu-Natal, Solid Waste Disposal, SOUTH AFRICA, Water And Sanitation, Women | Category: KwaZulu-Natal, SOUTH AFRICA, Training/Consulting | Leave a comment

Bountiful gardens at Johanna Road show that CHC members are ready for the next phase

In response to the results of the Johanna Road Pilot Project, eThekwini Water Services (EWS) has decided to extend the project by 6 months so that Impiloyethu can continue onto the next phase in the Applied Health Education and Development (AHEAD) methodology, where graduates are invited to participate in weekly Food Security, Agriculture, and Nutrition (FAN) modules.  These sessions stress the importance of proper nutrition – information which is much needed in informal settlements. In addition to weekly meetings, EWS’ Agriculture Management Unit (AMU) will be assisting the club with building a large communal garden across the street from the Johanna Road settlement.

Grey water is a large problem at Siyathuthuka

The project extension will also see the creation of an another CHC in the neighbouring settlement of Siyathuthuka, also located along Johanna Road on the way to the Northern Treatment Works.  Siyathuthuka, home to approximately 600 households, is in need of health and hygiene training, as well as better maintenance of their communal facilities.  Despite being more than twice the size of Johanna Road, the community only has one container ablution block and four chemical toilets. The combination of a shortage of facilities and poor communal management has left the container toilets in a very unhygienic state. Grey water, illegal dumping, and open defecation are also problems within the community that the CHC will work to address.

Impiloyethu members Nokuthula Mathetha and Nthabeleng Molusi, who have shown to be outstanding club members by their participation in CHC activities and acting as role models in the community, will be trained to be community facilitators for the new clubs.

August 10th, 2010 | Tags: Durban, Health Clubs, Informal Settlements, Nutrition, Pilot Projects, Water And Sanitation | Category: Community Health Clubs, Countries, KwaZulu-Natal, SOUTH AFRICA | Leave a comment

Africa AHEAD is excited to report that 31 members of Impiloyethu Community Health Club graduated 10 April 2010.  In recognition of their efforts, a morning ceremony was held at the Education Centre at the Northern Treatment Works in Durban.

Impiloyethu members sing about the importance of health and hygiene

The events began with a public viewing of the CHC’s agri-tubes, tyre-step project and communal improvements attributed to the CHC at Johanna Road/Boxwood Place.  After which, the attendees gathered at the Education Centre for a Welcome Address by eThekwini Water Services Education Trainer Lucky Sibiya, who has been part and parcel of the project.  Master of Ceremonies, Africa AHEAD project officer Ndyebo Mgangqizana then introduced Impiloyethu who treated guests to song and dance, centered around the importance of health and hygiene.

An EWS senior official delivered the keynote address of the morning. He stressed the importance of health and sanitation in our communities, noting the important improvements that Impiloyethu has been the driving force of at Johanna Road. He encouraged them to continue on their mission of making their community a better place for all of its residents.

A mother takes her baby suffering from diarrhea and dehydration to the clinic in Impiloyethu's drama

Africa AHEAD Project Manager Nancy Maksimoski followed with a powerpoint presentation which visually highlighted the changes that have occurred at Johanna Road since the formation of the CHC on both a household and communal level.

The highlight of the afternoon was most certainly Impiloyethu’s educational drama involving the importance of hygiene and proper treatment of diarrhea in children, which they wrote themselves. Impiloyethu hopes to show other communities and groups their drama to raise awareness about these issues.

The ceremony concluded with a presentation of certificates to all graduates and closing remarks from Africa AHEAD Dr. Juliet Waterkeyn.

CHC member Mpanza receives his certificate from Lucky Sibiya, while Africa AHEAD facilitator Ndyebo Mgangqizana looks on

Africa AHEAD and EWS are both very proud of the work done by Impiloyethu in the past few months and look forward to their upcoming projects at Johanna Road.

“Community means strength that joins our strength to do the work that needs to be done. Arms to hold us when we falter. A circle of healing. A circle of friends.” -Starhawk, Human Rights & Eco-Activist

August 10th, 2010 | Tags: Diarrhoeal Diseases, Durban, Health Clubs, Informal Settlements, Pilot Projects, Women | Category: Countries, KwaZulu-Natal, SOUTH AFRICA | Leave a comment

March 2010

After 6 months of health promotion modules, impressive improvements have occurred at the Johanna Road Informal Settlement in the eThekwini Municipality, as measured by our Household Observations Survey, and as observed through communal changes and activities.

Research

From the baseline surveys, it was identified that the most problematic areas were low practice of zero open defecation (ZOD) (7%) and pour-to-waste method (16.3%), and a high presence of ringworm infection (18.6%).  After 6 months of health promotion sessions, 100% of CHC member households have ZOD and no visible ringworm, while pour-to-waste method has increasd to 88.5% of CHC households.  In addition to ZOD and no ringworm, 100% of CHC households now use a ladle, safely store their water and food, have a pot rack, and know how to make salt-sugar-solution to treat dehydration from diarrhea.

None of the CHC members have a handwashing facility, which Africa AHEAD believes is due to the majority of club members being located near a standpipe or ablution block.  Therefore, they use these facilities to wash their hands, to limit the amount of grey water they need to dispose of near their house.

CHC Activities

Demonstration grey water agri-tube garden at Johanna Road

Gardening

As documented in previous reports, the Johanna Road CHC communal and personal gardens have flourished.  In recognition of the CHC’s talent and hard work, the eThekwini Department of Water provided 15 grey water agri-tube gardens designed by Khanyisa Projects to club members on 2 February, with seedlings delivered 3 March.  Another round of approximately 20 agri-tubes will be delivered in the middle of March, to the remaining graduating club members.  One or two “Coke Bottle” grey water gardens will also be piloted in the settlement to determine which system better fits the environment.

Projects

The CHCs have plans for a very exciting community wide project – a tyre-step pathway to link Boxwood Place to Johanna Road.  As the settlement is located along the side of a steep hill, it can be very difficult and dangerous to traverse the settlement, especially in rainy weather.  The tyre-step pathway will help to make this task easier, as the current dirt trail will be replaced with steps.  Africa AHEAD has contacted companies to supply the tyres, and the DWS has agreed to provide tools (10 spades, 10 hoes, 10 forks, and 30 pairs of gloves) for the project.  The CHC has communicated with the community leaders and other residents, as they envision this to be a community-wide project.  They hope to commence work on the project second Saturday in March.

CHC members are also continuing to collect glass bottles as part of their new recycling project.  Africa AHEAD has approached the Municipality about the possibility of organizing transport for CHC members to Pinetown in order for them to learn more first hand about recycling.

In recognition that only so much improvement can be made to the grey water and drainage issues with education, the DWS is rehabilitating the bottom ablution block.  In addition to fixing the bottom ablution block, the DWS has agreed to put in a channeling system at the standpipe on Boxwood Place, so excess water from the tap can be diverted to the vegetable gardens located behind the standpipe.  The DWS began the project 4 March, with plans to complete it by 10 March.

Graduation

In recognition of the completion of the health promotion sessions, a graduation for the CHC members successfully completing the modules, will be held 11 April at the Northern Water Treatment Works.  The festivities will commence at 8h30 am, with a short walking tour through the settlement, where the new tyre-step pathway will be utilized.

Next Steps

As the CHCs have reached a point of transition. Africa AHEAD will assist Impiloyethu and Sakhimpiloyethu with their merge into one club.  After this is complete, the club will elect an executive board, draft and ratify a constitution, register as a CBO, and open a bank account.  Africa AHEAD plans to help the executive board ease into facilitation of the sessions so the transition goes smoothly.  The CHCs have told Africa AHEAD that they plan to continue to meet on a regular basis to discuss community issues and to plan community activities.  They have also expressed interest in Africa AHEAD’s module on nutrition.

March 8th, 2010 | Tags: Baseline Data, Behaviour Change, Community Health, Diarrhoeal Diseases, Durban, Health Clubs, Health Promotion, Hygiene Behaviour & Practices, Informal Settlements, KwaZulu-Natal, Pilot Projects, SOUTH AFRICA, Vegetable Gardens, Water And Sanitation, Women | Category: Community Health Clubs, Countries, KwaZulu-Natal, SOUTH AFRICA | Leave a comment

June, 2010

The City of Cape Town requested that Africa AHEAD to provide another Community Health Club (CHC) training for the City’s Environmental Health Practitioners (EHPs) and Community Workers (CWs).

Africa AHEAD providde training in the AHEAD methodology for 20 CWs and 16 EHPs over the course of 7 days in April 2010. Upon completion of the sessions, each CW is to  start a new health club in the informal settlements of Cape Town, bringing the total number of CHCs in the city to over 150.

The training was  held at Look Out Hill in Khayelitsha, facilitated by Dr. Juliet Waterkeyn (Africa AHEAD Director), Jason Rosenfeld (Africa AHEAD Project Manager), and Nancy Maksimoski (Africa AHEAD Project Manager), assisted by Charlotte Adams and Joyce Cwayi from Imbasa.

A graduation ceremony arranged by the Health Department was subsequently held on the 3rd June 2010 for all those who had been trained.

March 5th, 2010 | Tags: Community Health, Health Clubs, Informal Settlements, SOUTH AFRICA, Training Materials | Category: Community Health Clubs, Countries, SOUTH AFRICA, Western Cape | Leave a comment

The Metro Health Club: Grassroots Action for Improved Community Health in the Western Cape

For the past four years Africa AHEAD has been trying to introduce the concept of the Community Health Club Methodology into the informal settlements of the Western Cape. This has presented quite a challenge and it was open to debate whether the CHC approach, so effective in the rural areas, could really have the same appeal in the squatter camps of the Mother City, where there is little community cohesion, and where alienation of marginalized communities and political infighting by gate keepers has undermined so much development.

In 2005 the CHC idea was introduced into Khayelitsha through the University of Western Cape who sponsored a workshop facilitated by Africa AHEAD, where the first 25 facilitators were trained. The training was poorly received by existing stakeholders, and only one facilitator managed to establish a CHC the first time round which did at least demonstrate that a health club could work with the right facilitator.

Later that year working with Africa AHEAD, Hygiene Promotion Partnership, a research wing of BYU University adopted many of the concepts of the Community Health Club approach to start over 75 health clusters (groups of ten families) in the informal settlements of Du Noon, Phillippi Sweet Home and Kwa Five.

In 2007, the City Health Department  sponsored Africa AHEAD in the development of training materials to scale up the CHC training, and with the new Tool kit of visual aids and the manual,  two workshops have been held in the past two years, with another 50 participants trained in the CHC Approach. City Health Department has been working hard to integrate all development in the informal settlements through CHCs but with over 240 informal settlements this is a real challenge. Ngcwele Dyani was appointed as liason between the CHCs and Health Department and in June 2009, a large graduation ceremony was held for the CHCs in Phillipi. Mr. Armien Petersen of Environmental Health in City of Cape Town Health Department  was amazed by the response, as it has shown that Health Clubs are as attractive to women in town, who just like their counterparts in the villages love to come together for self improvement. It is also clear that although the CHCs are well received in informal settlements, to make any impact on preventing diseases like diarrhea there has to be a thicker diffusion of health clubs throughout every informal settlement.

There are now 120 active Community Health Clubs in the Western Cape and in July 2009, they formed an umbrella group to coordinate their activities. The Metro Health Club is the ideal mechanism for replication as it has been started by CHC leaders themselves, and is a genuine bottom up initiative. The executive board gave us a vision  with great enthusiasm of how  MHC plans to expand the activities of the health clubs through an holistic approach. Currently drafting their constitution in order to get registered, the MHC will focus on coordinating all CHCs in five different fields: Water and Sanitation, Health, Special Projects, Education, Recruitment, Finance. Each health club will have a representative for each field and these will meet regularly to facilitate development initiatives throughout the informal settlements, acting as grass roots instruments for change within their community. The MHC is encouraging those living in the informal settlements to take ownership of their problems and like the ethos of the CHCs the main focus is to stimulate self-help. The Metro Health Club is the best proof yet of the viability of the Community Health Club approach, as a vehicle of change in informal settlements, to uplift communities using health promotion to galvanise the energy of women.

Since the creation of Metro Health Club, the City of Cape Town and the Health Clubs have embarked on a truly special and beneficial relationship.  The City has created a database of all the CHC members, to use for employment for city projects involving water, health, sanitation, and hygiene.  As all CHC members have a basic training in these subjects, this allows the City a quick and easy way to find knowledgable and reliable employees, while offering much needed employment opportunities for CHC members.

Metro Health Club held its first event on National Hand Washing Day, 15 October 2009, where the health clubs gathered to promote hand washing with soap in the informal settlements of Cape Town.

Africa AHEAD has pledged to support the Metro Health Club, to enable more training and skills development in the 120 CHCs of the Western Cape.

For more information, please contact info@africaahead.com

March 5th, 2010 | Tags: Community Health, Health Clubs, Hygiene Promotion, Informal Settlements, SOUTH AFRICA, Water And Sanitation | Category: Community Health Clubs, Countries, SOUTH AFRICA, Western Cape | Leave a comment

January 2010

In 2005 the CHC idea was introduced into Khayelitsha through the University of Western Cape who sponsored a workshop facilitated by Africa AHEAD, where the first 25 facilitators were trained. Later that year working with Africa AHEAD, Hygiene Promotion Partnership, a research wing of BYU University adopted many of the concepts of the Community Health Club approach to start over 75 health clusters (groups of ten families) in the informal settlements of Du Noon, Phillippi Sweet Home and Kwa Five. The main trainers in this project were Charlotte Adams and Joyce Ntombomzi , who have been leading lights since then working voluntarily to support Community Health Clubs in their own areas.

Charlotte Adams, head of mobilisation for Imbasa Community Resources

In late 2009, Adams and Ntombomzi joined forces with two other women (Nokwezi and Nozuko Nxasana) previously trained in the AHEAD Methodology to form the non-profit organisation, Imbasa Community Resources. Like Africa AHEAD, Imbasa has a vision of holistic, sustainable community development through health promotion and encouraging an ethos of self-help amongst the community.  They hope to achieve this vision by working with existing Community Health Clubs, as well as creating new clubs in interested areas. The organisation has four areas of focus: mobilisation (Charlotte), education and training (Joyce), water and sanitation (Nokwezi) and skills development (Nozuko). Imbasa has a variety of projects planned for 2010, including creche work in Du Noon, meeting with vendors to educate on proper food hygiene practices, and linking community health clubs with their local health inspectors to address water.  They also hope to open dialogue between South Africans and their neighbours from other African countries, to begin to create better relations between the different nationalities, in light of 2009’s xenophobic attacks.

Joyce, a tireless Community Worker, is now helping to promote hygiene education and training through Imbasa Community Resources

Africa AHEAD is excited to announce that they will be partnering with Imbasa Community Resources to implement a new Community Health Club project in the Western Cape, starting in February 2010.  This project will see the creation of health clubs in informal settlements new to the AHEAD methodology (Vrygrond, Masiphumelele, and Redhills), as well as expansion in areas with existing health clubs (Philippi and Mitchell’s Plain) (read more).

For more information on Imbasa Community Resources, please contact Joyce from Imbasa or info@africaahead.com

January 25th, 2010 | Tags: Cape Town, Community Cohesion, Community Health, Gate Keepers, Health Clubs, Health Promotion, Hygiene Promotion, Imbasa Community Resources, Informal Settlements, Khayelitsha, Marginalized Communities, Political Infighting, Social Capital, SOUTH AFRICA, Squatter Camps, Sustainable Community Development, University Of Western Cape, Water And Sanitation, Women | Category: Associates, Countries, SOUTH AFRICA, Western Cape | Leave a comment

Community Health Clubs were started in Mutare, Zimbabwe in an effort to combat the rapid spread of Cholera in Zimbabwe in 2009. This is an inspiring account of how well mobilised women were able to role back this deadly threat and prevent any daths from cholera in this high risk area. The paper presented at IWA Conference in Mexico 2009, also includes an example from Uganda where overcrowding and poor sanitation in IDP Camps was similarly addressed through Community Health Clubs.

Cholera Mitigation in Zimbabwe and Uganda Case Study

January 20th, 2010 | Tags: Case Study, Cholera, Community Health, Diarrhoeal Diseases, Hand Washing, Health Clubs, Health Promotion, Hygiene Behaviour & Practices, Informal Settlements, Mexico, Participatory Activities, Solid Waste Disposal, UGANDA, Water And Sanitation, Women, ZIMBABWE | Category: Download PDFs, HIDO, Health Promotion, Hygiene, UGANDA, ZIMBABWE, ZIMBABWE AHEAD | Leave a comment

READ THE LATEST NEWS FROM SOUTH AFRICA – (click here)

PROJECTS UNDERTAKEN IN SOUTH AFRICA

1. Development of generic CHC Training manual and extensive PHAST Tool Kit for Informal Settlements (City Health Department- Danida)

2. Training for City Health Department of facilitators to start CHCs in Informal Settlements near Cape Town

3. Support to Hygiene Promotion Partnership for base line survey to ascertain level of hygiene behaviour change in 4 informal settlements

4. Feasibility study for Integrated Water Resource Management (IWRM)to start CHCs in 3 water catchment areas in South Africa ( DWAF-Danida)

5. Planning and implementation of a comprehensive CHC programme in the rural areas of Kwa Zulu Natal for DWAF-IWRM (See Map: A)

6. Training of 25 Sangoco facilitators to start CHCs in North West province (Sangoco NGOs- DWAF-Danida) (See Map: B)

7. Training of Water and Sanitation Forum facilitators to start health clubs in Khayelitsha (for University of Western Cape)

8. Planning and implementation of a pilot CHC project in eThikweni (Durban) informal settlement

1.PHAST Manual and Tool Kit to enable scaling up of training

In 2008 Africa AHEAD, in conjunction with the City Health Department, developed and published a dedicated manual

Community Health Clubs in Informal Settlements: A training manual for community workers using participatory activities. Developed by J. Waterkeyn for City of Cape Town Health Department. Funded by Danida. Illustration by Itayi Njagu.

This manual comes with a comprehensive PHAST Tool Kit for informal Settlements consisting of 13 essential topics related to home hygiene.

The training comprises of three Modules:

Module 1: Feasibility: the Rationale for the Community Health Club Approach

A one day training for Managers and decision makers to enable them to visualise and understand the reason for ‘doind development’ through Community Health Clubs)

Module 2: Planning: How to start a Community Health Club Project:

A three day training for middle management and supervisors as well as the facilitators of the CHCs.

Module 3: PHAST Participatory Activities for Informal Settlements

A six day training for facilitators only to enable them to use all the PHAST toools and carry out 24 training sessions with community Health cubs

Please contact juliet@africaahead.com for more information if you are interested in this training.

2. City Health Department Pilot Community Health Clubs in the Cape Flats

2008. Belleville Cape Town: the first CHC facilitators to be trained

The first batch of trainees were passed after a six day workshop in March 2008, and are expected each to start one health club. Although the xenophobic riot of 2008 affected the start up of health clubs in many areas there is at least one success story in Phillippi. There are over 200 members in three health clubs and their training is providing an inspiration to replicate the project in other areas. In the near future all the CHCs will be assessed by Africa AHEAD with a view to learning lessons as to how the health clubs are being received in the Cape Flats. It appears that there have been several challenges including the difficulty of the members to meet during the xenophobic unrest that swept the informal settlements in South Africa last year. there are also concerns as to how the health club facilitators were supported and if there was enough supervision by Environmental health Personel to ensure that the sessions were heald as planned in the workshop.

Another training is to due to be hele in April / May supported by the Health Department , when the next intake of community members will be trained by Africa AHEAD to start Community Health Clubs in different areas.

3. Feasibility Study for Integrated Water Resource Management

In 2000, the South African Department of Water Affairs and Forestry (DWAF), with the assistance of the Royal Danish Government (DANIDA), initiated a program to pilot Integrated Water Resource and Management (IWRM) approaches in three Water Management Areas (WMA) of South Africa: the Olifants-Doorn (Western Cape Province), the Crocodile-Marico (North West Province), and the Mzimkhulu-Mvoti (Kwa-Zulu Natal Province). These WMAs were selected as they represent a cross-section of water resources conditions as well as water use conditions and user interests. Phase 2 of this project, which focuses more on direct support and partnerships at local, regional and national levels, was begun in 2006 and is set to last until 2010. For more information about IWRM activities in South Africa, please visit www.iwrm.co.za.

The CHC Approach will contribute to the goals of IWRM by building a strong foundation of knowledge, cooperation and behavior change in each of the targeted communities. This foundation will then be used to successfully implement a variety of projects such as rain water harvesting, nutrition gardening, income generation, HIV/AIDS case management, and improved management of sanitation facilities.

In May 2008, Africa AHEAD was invited to assess the feasibility of piloting Community Health Clubs (CHC) in targeted areas within the three WMAs. Between May and September 2008, stakeholders were engaged, situational analyses and site visits were conducted, and project proposals and plans were submitted.

4. Community Health Club Pilot Project in Umzimkhulu: Kwa Zulu Natal

Participants in a Health Club Training Workshop in Umzimkhulu - Jan 2009

The team: Project Officer Moses, Council Representative Tabiso and Jason Project Manager for Africa AHEAD in Umzimkhulu

Africa AHEAD has been contracted to implement a pilot project in the Mzimkhulu-Mvoti WMA, within the Umzimkhulu Municipality. Umzimkhulu which is located in the foothills of the Southern Drakensberg Mountains. Until recently Umzimkhulu was a part of the Eastern Cape Province, and as a result the levels of development in this district are far below the standards found in the rest of the Kwa Zulu Natal. According to the Municipality’s 2008 Integrated Development Plan, 40.2% of the population has access to piped water sources, with the remainder using unprotected sources such as rivers, streams and springs. In addition, while 92.9% of households reportedly have access to sanitation facilities, the majority of these facilities are neither safe nor hygienic. This low level of development is ideal territory to start a community health club programme as past research has shown.

The project in Umzimkhulu began to take shape from Septemeber 2008, as the Municipal Council approved the implementation of CHCs in all 18 Wards, a Project Steering Committee was constituted, the sites for implementation were selected and Africa AHEAD welcomed its newest team member, Mr. Moses Mncwabe, Project Officer for the Umzimkhulu project. The site selection process was a competitive one, with interested Ward Councilors submitting an application form indicating the communities they wanted to participate and the names of potential facilitators to be trained by Africa AHEAD. 10 Councilors who submitted applications, to join the programme and the Project Steering Committee selected one community and facilitators from each ward. Community Health Clubs have now formed up and facilitators have been trained in base line research. the base line survey was completed in January 2009, and the PHAST training is to be started in mid February, and continue every second week. Facilitators will then rely the training back to their ward where their health clubs will meet every week. The training will be complete with six months, by the end of August 2009.

5. Replicating through local NGOs: North West Province

Africa AHEAD is working closely with the South African National Non-Governmental Organization Coalition (SANGOCO) to start up CHCs through training the staff of existing local NGO’s in the North West Province and Gauteng. Unlike other projects which are implemented directly by Africa AHEAD, the input in this project is merely to train and mentor the staff of 3 local NGO’s, who will then manage the implementation and activities of CHCs in their catchment areas. While most of the CHCs in this WMA will be formed in communities in and around Mafikeng and Zeerust (North West Province), there is one Community Based Organization in Majaneng (Gauteng Province), near Hammanskraal, that will also be implementing CHCs.

NORTH WEST PROVINCE: Africa AHEAD will be collaborating with SANGOCO and two NGO’s based in the North West Province to implement CHCs, Tlhoafalo Advice Center and Lethabo Water and Sanitation. Each NGO will have between 7-9 staff trained in the CHC Approach by Africa AHEAD and will develop CHCs in 5-6 communities.

GAUTENG PROVINCE: Majaneng is a small rural settlement located on the border of the Gauteng and North West Provinces. In this area, Africa AHEAD will again be collaborating with SANGOCO and one local Community Based Organization, the Kekanastad Traditional Mothers Organization (KETRAMODEO). Africa AHEAD will train 5 members of this organization who will then develop CHCs in 5 sub-areas of Majaneng.

A three day training workshop was held from 11th-13th August 2008, on Module 2: How to start up Community Health Clubs. At this training the NGO staff were given activities to help map and analyse the areas to prioritise within their areas of operation. They were also trained to carry out a base line survey of 100 household in the selected area. This was done through the innovative method of using ordinary cells phones to capture data in the field. (See Publications, Rosenfeld and Waterken, 2008). The data is then automatically collated and preliminary result have been collected and a report issued by Africa AHEAD who are to process the data and provide on going support to enable any behaviour change to be measured effectively. The CHCs have now been formed up, the base line data collected and facilitators from the NGOs are now waiting for the next phase of the training which is being delayed by funding constraints. Local NGO are begging to start the next training as their communities have been mobilised and are loosing interest with such delay.

6. Hygiene Promotion Partnership Research

Brigham Young University, (on behalf of Rickett Benkisser) started a research programme in four informal settlements to establish whether the use of antiseptic cleaning material in home could reduce diarrhoea in low income homes. In order to conduct this research an intervention was planned to monitor 140 clusters in four informal settlements: Phillipi, Du Noon, Kwa 5, and Sweet Home. The model was that each of the 65 facilitators would hold weekly sessions in a cluster of ten homes. As the strategy was very similar to the CHC approach, Africa AHEAD was called on to help develop the training materials for the modules which were prepared by HPP. The beneficiaries of the programme were able to assist in the development of the PHAST Tool Kit and HPP supported the development of the illustrations, and HPP trainers were trained by Africa AHEAD to use the materials. Although this programme has now been completed, many clusters have become viable grass roots groups and anecdotal evidence is strong that they have improved in their home hygiene practices.

Participants learn how to make a squezzy bottle: a practical solution to handwashing outside informal shacks

New Research Findings on Behaviour Change

PUBLICATION:

Comprehensive Family Hygiene Promotion in Peri-urban Cape Town: Gastrointestinal and Skin Disease Reduction in Children Under Five. Cole, E, Hawkley, et al. Brigham Young University.

‘Community based PLA proved to be a powerful approach for reducing illness through supporting families in the adoption of new hygiene practices and in mobilising the communities for health and social change.

Achievements of facilitators and study participants included the health and hygiene situation in households and neighborhoods, setting up of hand-washing stations, teaching children and neighbors correct hand washing methods, instituting child safety practices, influencing vendors to practice hygienic food preparations, managing communal toilet and rubbish pick ups and determining how to link health to local economic development.’

Reduction in disease
Findings from this paper indicate that Skin infections were reduced by 39.1% in formal housing but interestingly not in informal housing.

Gastroinstestinal infections were reduced by 14% in formal housing and by 11% in informal housing.

7. University of the Western Cape – Khayelitsha Sanitation Forum

The concept of Community Health Clubs was first floated in South Africa in 2005, supported by the University of the Western Cape, in a pilot project in Khayelitsha, one of the most challenging informal settlements in the Cape Flats. 25 Facilitators were nominated by the Khayelitsha Sanitation Forum, and training was provided by Africa AHEAD. Due to insufficient support most of the health clubs never took off, but one determined facilitator has shown that CHCs in informal settlements can play an important role in providing support to the needy.

Saviour Maqaloti : The first facilitator to start a Community Health Club in the Cape Flats

Philisanani Community Health Club

One of the facilitators, Saviour ran with the idea and mobilised a huge following of over one hundred members. trained the group over the next six months and Africa AHEAD was delighted to be able to provide certificates for the 25 core members who had completed every session. Some of the group have become voluntary clinical assistants, while another has started a play school and yet another has a voluntary service assisting the pensioners access their pensions and ensure they are properly cared for. The group has become a registered CBO called Philisanani and has recently secured government funding for a second training in home hygiene for which Africa AHEAD is providing certification.

January 18th, 2010 | Tags: Africa Development, Baseline Data, Behaviour Change, City Health Department, Community Health, Danida, Diarrhoeal Diseases, Durban, DWAF, Feasibility Study, Home Hygiene, Hygiene Behaviour, Hygiene Promotion, Informal Settlement, Informal Settlements, Integrated Water Resource Management, KwaZulu-Natal, North West Province, Participatory Activities, Pilot Projects, Sangoco, SOUTH AFRICA, University Of Western Cape, Water And Sanitation, Water Resource Management, Women | Category: Countries, KwaZulu-Natal, SOUTH AFRICA | Leave a comment