Joseph Katabarwa and Fausca Uwingabire (Africa AHEAD Country Directors) report on a CBEHHP training in Rwanda in December 2018
The Sustainable Development Goal 6.2 focuses on safely managed equitable sanitation, hygiene for all and end open defecation focuses on the need for increasing the proportion of population using safely managed sanitation services, including a hand-washing facility with soap and water.
The Government of Rwanda, through the Ministry of Health, launched the Community Based Environmental Health Promotion Programme (CBEHPP) on December 17th 2009 with the objective of improving personal, domestic and community hygiene practices towards reducing the national disease burden and alleviating poverty among the Rwandan population.
The CBEHPP empowers communities to identify and solve their personal and domestic hygiene and environmental health related problems (including safe drinking water and improved sanitation) and have used the holistic Community Health Club (CHC) approach, as a means of rapidly attaining hygiene behavior changes that are both sustainable and cost effective.
The Programme prioritized Improved household and institutional hygiene practices and sanitation, food safety and improved nutrition, minimizing indoor air pollution to reduce Acute Respiratory Infections (e.g. promote fuel-efficient stoves with chimneys) and Improved Vector Control.
The national Community Health Worker (CHW) programme was subject to an extensive external evaluation in 2016 and the recommendations need to be implemented to ensure that these key health workers are used optimally.
The evaluation found that there is a high turnover of CHWs (10 per cent on average) and the others are usually overloaded and being asked to work on a range of interventions.
As a response to the issue, the government of Rwanda planned to support the Community Health Workers better through training, development of business case for sustainability of the program in order to improve health services (Resolution 11 from 15th Leadership Retreat 2018).
The supervisors of Community Health Workers at Health Center level were not trained therefore MoH/RBC planned to train them with a community health package in order to build their capacity so that they could better accomplish their responsibilities as well as be able to train community health workers themselves.
In the first phase the staff from the 13 Districts implementing Stunting Prevention and Reduction Project SPRP (supported by World Bank) will be trained.
The overall objective of this training is to equip the supervisors of CHWs at Health Center level with knowledge, skills and attitudes so that they are able to deliver and supervise the implementation of the Community based on Environmental Health Promotion Program.
- Build the capacity of TOT on Community based on Environmental Health Promotion Program (CBEHPP) and Health Care West Management (HCWM) to be capable to train in Charge of CHWs
- Build the capacity of in charge of CHWs in establishment of integrated community health package with CBEHPP and (HCWM) in their package.
- Improve monitoring systems to track implementation of integrated community health Environmental Health Promotion Program and Health Care West Management