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COMMUNITY HEALTH CLUB PROJECTS

1. CARE International (funded by Gates Foundation)

In 2003, Africa AHEAD provided training for 23 facilitators from HIDO, a local NGO and a PHAST Toolkit was developed specifically for the IDP Camps. Trainers were then posted into 15 Internally Displaced People’s camps in Gulu District. Within a month over 116 Community Health Clubs with over 15,000 members, had been registered and weekly sessions were held for six months. By this time over 11,256 latrines, as well as 11,709 pot racks, and 2127 hand washing facilities had been constructed. This record breaking number of latrines highlights the power of the CHC Approach to create a strong demand for sanitation even crowded IDP camps, in an emergency setting within a short period of time.

2. Malaria Consortium – HIDO (funded by Unicef):

The approach was then taken to Pader District, also a refugee area in Norther Uganda, by HIDO (in partnership with Malaria Consortium). Another 35 health clubs were established with 2,599 members in 8 IDP camps and within 5 months 51% (1,318 members) had built latrines as well constructed 400 rubbish pits, 1,644 pot racks and 810 bathrooms.

3. Lutheran World Federation:

Based on recommendations in an evaluation (by Cranfield University), Community Health Clubs were started in Katakwi by Lutheran World Federation. In October 2006, a local EHD trainer who had co-facilitated with Africa AHEAD in the Gulu Trainer successfuly trained LWF field staff in PHAST and the CHC approach. By March 2007 there was a 40% uptake of sanitation. This was important as it shows how replication does not depend solely on Africa AHEAD, and points the way forward as to how Uganda can scale up CHCs without external consultancy.

4. WaterAid and partner NGOs pilot CHCs:

In May 2008, Africa AHEAD provided training for WaterAid local partners to enable them to start up Community Health Clubs in various areas of Uganda: Busoga Trust in Southern Uganda, whilst SSWARS and AEE operate mainly in Kampala. WEDA, another highly successful implementing partner is currently conducting a successful program in Katakwi using Clusters rather than health clubs and will be integrating some of the CHC ideas into their home grown health promotion methodology.We await an update on how these organisation have adapted the CHC Approach to their own contexts.

Accredited CHC Trainer: Justin Otai (MoH); Victor Kwame (HIDO)

Africa AHEAD Consultant: Dr. Juliet Waterkeyn

PRACTISING ORGANISATIONS:

CARE International; HealthIntegrated Organisation for Development (HIDO); Malaria Consortium, Unicef; WaterAid; UWASNET, Lutheran World Federation; WEDA; SSWARS; AEE; Busoga Trust

TRAINING MATERIAL: MoH PHAST Training Manual (available in country from EHD-MoH)

REPORTS: Waterkeyn. J. (2008) Africa AHEAD Scoping Study: Community Health Clubs in Uganda. Part 1. WaterAid Uganda.

PUBLICATIONS

UWASNET: Uganda Water and Sanitation NGO Network, Members Directory 2007-8

UWASNET. Group Performance Report for 2007.

Okot, P., Kwame, V., and Waterkeyn, J. (2005). Rapid Sanitation Uptake in the Internally Displaced People Camps of Northern Uganda through Community Health Clubs. Kampala. 31st WEDC Conference

Mpalanyi.J. and Mukama.D. (2007) Documentation of best practices (BOP) in hygiene and sanitation in districts of Uganda. WSP – AF.

Hygiene & Sanitation Strategies in Uganda: How to Achieve Sustainable Behavior Change?

Waterkeyn, A. (2005). Hygiene & sanitation strategies in Uganda: How to achieve sustainable behaviour change? Kampala, 31st WEDC Conference.

Abstract: Breaking the faecal:oral disease transmission route is a vital first step towards overcoming preventable disease and, ultimately, poverty. Simple knowledge transfer, whatever methodology is employed, does not automatically result in changed or improved behaviour. There is growing consensus that to achieve behaviour change in hygiene and sanitation practices communities, both rural and high-density peri-urban, need to be supported in ways that will stimulate social cohesion and result in group decisions being taken. Such cohesion and the building of social capital can ensure that peer pressure comes to bear and poor hygiene practices can thus be challenged. This paper considers several approaches to Hygiene Promotion and Sanitation that are currently receiving attention. It attempts to tease out some of the common threads that appear to be stimulating social cohesion and peer pressure towards achieving behaviour change that will be sustained and also considers the current hopeful situation in Uganda.

For full article in pdf, click here: Hygiene and Sanitation Strategies in Uganda: How to Achieve Sustainable Behavior Change

January 18th, 2010 | Tags: Health Clubs, HIDO, Hygiene Behaviour & Practices, IDP Camps, Latrines, Malaria, PHAST, Training Materials | Category: Countries, UGANDA | Leave a comment

Okot, P., Kwame, V., & Waterkeyn, J. (2005). Rapid Sanitation Uptake in the Internally Displaced People Camps of Northern Uganda through Community Health Clubs. Kampala. 31st WEDC Conference.

Abstract: When thousands of people are forced to live in poor living conditions in a closely confined area the immediate health risk is the lack of sanitation and the likelihood of cholera outbreaks as well as diarrhea resulting in high levels of mortality and morbidity especially amongst the children. In Uganda an insurgency by the Lords Resistance Army, has for the past 18 years been responsible for the displacement of over 1.6 million people in the North. In Gulu District, where this intervention is based, 89% of the population have moved from their rural homes into 33 Internally Displaced People’s (IDP) Camps, each with an average of over 15,000 per camp. IDPs live in temporary housing in squalid conditions, with open defecation, no solid waste disposal, and low levels of home hygiene. The few boreholes provided at these vast camps cannot meet the demand and serve between 1,000 to 2,000 people each. In the largest settlement of Pabbo Camp with 68,000 people there was an outbreak of cholera and investigation pointed to contamination of boreholes as a primary cause. There is also 31% acute malnutrition in the camps, and malaria is endemic.

A local NGO, Health Integrated Development Organization (HIDO), has recently been formed, supported by CARE International, to tackle this issue. Their field officers, mainly clinicians, live full time in 15 IDPs camps and have started 116 Community Health Clubs with 15,522 regular members who meet weekly for hygiene sessions. Although this programme has only been going since January 2005, it has been readily received by the IDPs themselves and despite the failure of many previous efforts to involve the community this strategy has met with little resistance. Within three months health club members have constructed 3,504 latrines, as well as 3,372 drying racks and 1,472 bath shelters. A base line survey was done before the project start up showing less than 5% sanitation and extremely poor hygiene practices. Judging from the acceptance of recommended practices within the health clubs to-date, it will be possible by September 2005, to see some significant improvements. In addition new technologies such as the Poly sanplat, (which has been designed specifically for this programme), and the Tipppy Tap for handwashing, (a method recommended by Ministry of Health for some time), are proving appropriate for the massive task of improving hygiene and sanitation in IDP camps. The strategy has been based on the AHEAD methodology using participatory PHAST training tools, and this adaptation to suit local conditions may provide a future model for other agencies working in these areas. The target is to involve 120,000 people in health promotion and provide 10,000 latrines by the end of the programme. If this is achieved, preventable diseases should decrease and given that people from the same village tend to cluster together in the same IDP camps, their Health Club should continue to manage community health when they are eventually able to return to their home areas, so helping to rebuild their lives on hygienic principles.

For full article in pdf, click here: Rapid Sanitation Uptake in the Internally Displaced People Camps of Northern Uganda through Community Health ClubsFor a copy of the presentation from the WEDC Conference in pdf, click here: Rapid Sanitation Uptake in Internally Displaced People Camps in Northern Uganda through Community Health Clubs: Presentation at 31st WEDC Conference, Kampala

January 6th, 2008 | Tags: Boreholes, CARE, Cholera, Community Health, Health Clubs, HIDO, IDP Camps, Malaria, PHAST, Solid Waste Disposal, Training Materials, UGANDA, WEDC Conference | Category: Sanitation, UGANDA | Leave a comment