CASE STUDY: Zimbabwe: Community Health Clubs deliver Hygiene + Total Sanitation @ $4.42 pp
Source: December 2012 Project Report Zimbabwe AHEAD/ACF, Cecilia Chinhengo / Juliet Waterkeyn
Blanket coverage: This Community Health Club project was implemented by Zim AHEAD, in partnership with ACF in 429 villages, within 11 wards of Gutu and Mberengwa, Masvingo Province, Zimbabwe in 2012. The ambitious aim was to achieve blanket coverage, by getting every household within each village represented in a Community Health Club, in order to achieve complete common understanding and full community participation in the management of safe hygiene and sanitation to achieve Zero Open Defecation. Within six months, this project had exceeded its target of 450 CHCs with a total of 457 Community Health Clubs (214 in Gutu and 243 in Mberengwa). By December 2012, at the end of the six month training, there were 17,578 members (7,963 in Gutu and 9,615 in Mberengwa). The membership exceeded expectations with 107% coverage meaning 7% of the households had more than one member in a CHC. 7% of the 429 villages had more than one CHC.
The hygiene training in Community Health Clubs appeals mainly to women with 13,590 female members (6,170 in Gutu and 7,420 in Mberengwa), of which 75% completed all 20 sessions. Given the gender bias in African culture, male membership it is always a challenge to attract men to the hygiene sessions. It was therefore considered an achievement to have 3,988 male members (1,793 in Gutu and 2,195 in Mberengwa), of which 31% achieved full attendance. Male involvement is demonstrated by their physical support in the construction of hygiene enabling facilities and latrines.
Of the 19 indicators of recommended practices used to assess compliance, 10 out of 19 indicators show over 80% compliance. Monitoring was conducted through the use of a household inventory kept at community level by the Community Health Club Executive Committees. It was found that by project end, there were 21,101 new tippy taps. This means that in every single household there is at least one tippy tap for hand-washing, and 4,619 households have more than one tippy tap in their compound. 12,976 (79%) households have new pot racks, and 12,666 (77%) households have dug refuse pits. Most importantly 4,559 (28%) new hygienic latrines were constructed without any subsidy at all within the six months and another 3,212 (19%) households were in the process of building latrines at time of survey. Zero Open Defecation has been achieved with 7,771 new latrines (47% of all households) making an increase of 30% within a year – the remaining households are practicing cat sanitation as a safe contingency, whilst building their sanitation facilities. All this was achieved with 12 full time field workers, who trained and supervised 154 Community Based Facilitators.
Value for Money:
This project supplied no inputs for water and sanitation, relying completely on positive peer pressure to galvanise households to upgrade at their own expense. With an estimated 82,410 beneficiaries (5 per household) and the total cost of the programme at US$ 363,961 the cost per beneficiary is estimated at US$4.42. Alternatively it can be estimated that the average cost per CHC is estimated at US$796 per annum, including all administrative and field costs. Self-supply and self-monitoring through Community Health Clubs has ensured one of the highest community responses yet seen in Zimbabwe, and it is this success that can be rolled out with very little material inputs.