SITED IN OTHER’S PUBLICATIONS:
Towards EDPRS ideals: Water access, hygiene and sanitation in Rwanda give new hopes and opportunities |
Extract from Sunday Times, Rwanda. 3rd September, 2011. Thomas Kagera |
The Government of Rwanda through the Community Based Environment Health Promotion Programme, under the Ministry of Health, has encouraged the establishment of Community Hygiene Clubs (CHCs). A Community Hygiene Club (CHC) is a discussion group of peers from the same locality, who meet, identify their sanitation, hygienic and health problems or needs, and, through dialogue and using stimulant tools, get engaged in identifying solutions—together.
The CHC approach appeals to an inate need for health knowledge which is then reinforced by peer pressure to conform to communally accepted standards of hygiene, thereby creating a ‘culture of health.’ Members can, for example, decide that after two months, all members shall have built a drying rack, or a standard latrine or a bathing shelter. The ideas and concepts originate from the members and implemented by them. The government however, always comes out to give technical support and guidance.
Discipline and mindset change are some of the tenets that the government has fervently emphasized to ensure clean hygiene and sanitation. The government emphasizes upholding the dignity of every Rwandan, and sanitation and hygiene are some of the components that the leadership of President Paul Kagame has relentlessly put to the fore and, actually, helped implement.
Sanitation and Health.
Mara D, Lane J, Scott B, Trouba D (2010) PLoS Med 7(11)
Extract from the paper: Community Health Clubs
Community Health Clubs aim to change sanitation and hygiene attitudes and behaviour through communal activities. The approach has proved effective and cost-effective in the Makoni and Tsholotsho Districts of Zimbabwe where villagers were invited to weekly sessions where one health topic was debated and then action plans formulated [55]. In one year in Makoni District, for example, 1,244 health sessions were held by 14 trainers, costing an average of US$0.21 per beneficiary and involving 11,450 club members. Club members’ hygiene in both districts was significantly different (p<0.0001) from that of a control group, and the study’s authors concluded that if a strong community structure is developed and the norms of a community are altered, sanitation and hygiene behaviour are likely to improve.
http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000363
The effectiveness and sustainability of two demand driven sanitation and hygiene approaches in Zimbabwe.
Whaley L and Webster R, 2011.
Journal of Water, Sanitation and Hygiene for Development. IWA Publishing 01.1
With the current debate of the effectiveness of different methodologies to achieve behaviour change this is the first peer reviewed paper which actually compares the two approaches of CHC and CLTS in terms of measuring levels of hygiene change using proven indicators of hand washing and self supply of latrines to break the fecal oral transmission route. With some interesting findings, the conclusion is that although the methodologies both achieve high levels of response, the approach of reinforcing positive behaviour by community support through CHCs is more acceptable culturally and achieves more holistic development than CLTS, which uses negative peer pressure to shame people into change, and focuses only on the achievement of latrine construction, with little change in hand washing practices.
http://www.africaahead.org/publications/2011_Whaley_CHC.pdf
Sanitation: Changing Behaviours
Luke Whaley (Feb, 2011)
http://thinkafricapress.com/article/sanitation-changing-behaviours
Think Africa Press explores different approaches to inculcating sustainable behavioural change in Sub-Saharan Africa.
Extract: The research conducted in Zimbabwe is interesting because it brings under the magnifying glass two approaches designed to create a desire for change in a population. This must now be seen as one of the key areas of development work if the great challenges many of Africa’s countries face are to be addressed with any real degree of success. The fact that these particular approaches are so different means a comparison of the two serves to provide valuable insights into future best practice for governments, NGOs and other health professionals.
Community Health Clubs in Uganda
Extract:
Experience has shown that Community Health Clubs are effective modes for changing knowledge, attitude and practices on environmental health issues. Sanitation and hygiene behaviour can be starting points of for all members of community health clubs, where mutual support will help to achieve outputs. This information case gives steps in establishing such Clubs as well as practical hints.
LeaPPS Community Health Clubs in Uganda 2008.pdf (326.39 kB)
Community Health Club Approach – Case study of Katakwi in Uganda
Poverty, Health, and Environment
The Joint Agency Document: 18 development agencies including WHO, World Bank, UNDP, WaterAid, DFID, DANIDA, SIDA etc)
http://http//www.unpei.org/PDF/Pov-Health-Env-CRA.pdf
Extract (p.33) quotes the following AHEAD CHC Case Study as one of the best results internationally for ‘hygiene behaviour change:
‘DFID funded the Community Health Clubs in rural Tsholotsho District, Zimbabwe. The project increased the proportion of households using a ladle to draw water from 3% to 93% and the proportion with an improved pit latrine from 40% to 80%, as well as improving other aspects of hygiene behaviour , at a cost of only $3.33 per household….. as Zimbabwe example shows it can be cost-effective to invest in changing behaviour.’
AFRICASAN CONFERENCE
South Africa, February 2008.
The 8-point “eThekwini Declaration” was signed up to by 32 Ministers from across the continent, identified one Priority area as ‘demand led / supply fed sanitation and hygiene with the current situation having behaviour change at a very limited scale.’ The Action recommended is to ‘develop national demand led programmes including the use of the CHC Approach.’ (P.7)
http://www.unwater.org/downloads/eThekwiniAfricaSan.pdf
Hygiene Promotion in Burkina Faso and Zimbabwe: New approaches to behaviour change.
Sidibe, M. & Curtis, V. (2002). Blue-Gold Field Note, Water and Sanitation Program (WSP)-Africa Region, World Bank.
Summary: After years of debate, most people working in water and sanitation now agree that hygiene promotion is vitally important. But even now, many programmes and projects either ignore it or do it badly. This Field Note describes two African hygiene promotion programmes that have successfully used new approaches: Programme Saniya in Burkina Faso, and ZimAHEAD in Zimbabwe. They both concentrated on understanding how people actually behave and hence how to change that behaviour, and they both demonstrated ideas that can be applied at a larger scale. Changing human hygiene behaviour is a long process that is difficult to measure, and both of these programmes still have obstacles to overcome. However, this work indicates that systematic and carefully managed hygiene promotion programmes can achieve improvements in hygiene behaviour and hence reduction in diarrhoeal diseases.
http://africaahead.org/wp-content/uploads/2008/01/world-bank-blue-gold.pdf
Community Health Clubs Initiative Scores Success in Cholera Fight
Afro News: April 10, 2010
Community Health clubs are the entry point to sustainable water and sanitation development by the people, with the people for the people. Matimati notes that they involve very little investment results in a very big impact and ownership and responsibility. He adds that knowledge is power and spurs people to act for common good.
http://www.theafronews.ca/2010/04/09/2692/
