Association for Applied Health Education And Development

COMMUNITY HEALTH CLUBS:3

Monitoring of health promotion achievements has always been considered a challenge, because individual hygiene behaviour changes are difficult to quantify.  However one the the strengths of the Community health club Approach is that it can ensure that detailed monitoring to be done, not only by project management staff, but also by the community themselves. Because the health clubs are trained to   keep accurate records of all aspects of their community, they also monitor the training and ensure the trainer is performing according to their own expectations. This provides the project planners with a self monitoring system which is cost effective because activities  do not have to be supervised continually by the line manager. The key to the monitoring system is the Membership Card.

Above: An example of a membership card used in Sierra Leone. Every session that is attended is signed and dated by the facilitator. When the card is completed the member is entitled to a certificate of full attendance. This enables us to quantify very accurately exactly how many members we have, how many are attending, how many complete the training, the number od training sessions held etc. This can also be used to compare the relative outputs of different facilitaqtors so as to monitor who are the most effective, in terms of number of members and levels of attendence at their sessions. This can be compared to their costs (petrol, allowances, etc) to ascertain their own cost effectiveness.

A membership card is issued to each member, listing the topics to be covered and recommended practices. It should be developed in conjunction with the health workers, and programme managers at the training workshop based on formative research within the community.

It has been found that when membership cards are distributed at the first health club meeting, they mobilise others to join, because people are convinced of the seriousness of the programme and want to join so that they too can have a card.

The membership card is the key to the structure of the whole project and is essential in a number of ways:

1. It provides a sense of identity

2. It encourages people to join

3. It shows the seriousness of the project

4. It gives members an overview of what they will learn

5. It provides targets in terms of recommended changes

6. It enables the facilitator to quantify community attendance

7. It allows the community to hold the facilitator accountable

8. It provides a monitoring tool for programme managers

9. It is an overt symbol of the Community Health Club

10. It prevents gatecrashers from reaping unearned benefits

In addition to the membership cards the following information is also kept by the secretary of the health club:

1. List of members in each health club
2. Inventory of every member’s hygiene facilities (eg. Latrine, hand-washing facility, pot rack etc)
3. Attendance per health session
4. Topics covered at each health session
5. Number of health sessions per trainer
6. Average attendance of members per year
7. Number of members completing course of sessions.