This page provides details of all projects and overview of expenditure between 2009 and 2017 in our Annual Reports.
This past year we surpassed the target for reaching 2 million people through our efforts since 1997 having established 3,466 CHCs across 11 countries in Africa and beyond. This does not include the countless other CHCs that have been implemented through other organisations. The success in Rwanda where CHCs have been taken to scale nationally has inspired us to continue our efforts to spread the CHCs to other countries. The past two years have been spent assessing the community response in Rwanda in one district where we provided the intervention for a Randomised Control Trial. This has provided much opportunity for learning and our own monitoring capacity has increased with the use of an App which we have developed to monitor hygiene behaviour change in Community Health Clubs linked to our online registry.
For a small NGO to challenge the findings of any RCT, was a David and Goliath experience, especially when funded by the influential Gates Foundation, but we could not accept the counter-intuitive finds which were so at odds with our experience on the ground. With the intervention coming to an end in Rwanda in mid 2017, we have had to close up in Rwanda. However, in Zimbabwe we maintain an exceptionally dedicated staff who continue to demonstrate practically how to achieve sustainable Hygiene Behaviour Change at under US$ 5 per person while at same time increasing the scope of the CHC approach to address a whole raft of the new Sustainable Development goals (SDGs) in an holistic and integrated manner. Within these two years, the Zimbabwe team of 15 reached a total of 148,000 people in 264 Community Health Clubs, in 6 Districts, whilst rehabilitating over 140 boreholes, starting 13 communal nutrition gardens and setting a high bar for model kitchens (as can be seen from the front cover). As we go forward into 2018 we intend to maintain our dynamic and innovative edge to disseminate an expanded CHC-SDG approach.
2015 Annual Report
With the international endorsement of the Sustainable Development Goals in 2015, we expect that the holistic CHC development model used by Africa AHEAD may become one of the most practical ways of meeting a range of development objectives.
We now have two active hubs in Rwanda and Zimbabwe managed by Country Directors, Mr. Joseph Katabarwa in Rwanda and Mr. Regis Matimati in Zimbabwe. Both Directors have long experience with the CHC approach and have shown a strong commitment to community development. Amans Ntakarutimana is awarded Africa AHEAD Award for an outstanding project in the DRC which achieved some of the highest community response in terms of hygiene improvements despite the volatility of the project area.
This year has been one of consolidation of the organisation under the UK registered Charity and ensuring international standards with an online accounting system which is being controlled by our new Finance Manager in the UK.
By the end of 2015 our new monitoring website was operating as a CHC registry with a standardized tool for assessing behavior change using cell phones to collect household data. This promises to be a useful tool in the future to attract partners.
ZIMBABWE: Country Director, Regis Matimati receives the Annual Africa AHEAD Award in recognition his outstanding Advocacy efforts this year which has resulted in nearly US$ 150,000 worth of consultancy training for Zim AHEAD with 6 NGOs. And through them we have assisted in the start up of 826 CHCs / SHCs with over half a million beneficiaries. We thought last year was good (when we were implementing our own projects) which resulted in 177,445 beneficiaries, but training other NGOs is more cost-effective at under US$0.50 p.p. Despite the challenges of finding funding for project implementation in Zimbabwe, 40% of our target of one million beneficiaries has already been met in the past two years, and Africa AHEAD at least in this country is well on target to meet our ‘5×5’ challenge.
RWANDA: We are delighted as the national Community Based Environmental Health Promotion Programme (CBEHPP) is making great gains in the country. There are registered CHCs in almost every one of the 14,860 villages in the country and 40% have now been trained. At a workshop hosted jointly by Unicef, USAID and Africa AHEAD, we were acknowledged as the driving force in the start up and roll out of the CHCs in Rwanda. It is now gratifying to see that Unicef and USAID will be supporting implementing partners to ensure the remaining 60% of the country benefits from CBEHPP. We are also expecting a positive outcome from the Randomised Control Trial in Rusizi District where preliminary results are showing that the CHCs are causing a strong community response and the District is already begging for scale up. We await the results of the impact evaluation being conducted by IPA due to be published next year. Meanwhile Gates Foundation is extending the Rwanda project until the end of 2016, to ensure all 150 villages have the same Classic CHC treatment.
UGANDA & DRC: We have two pilot projects, one in Uganda in partnership with ILF, almost complete and the other in Democratic Republic of the Congo in partnership with Tearfund which has just started in March 2015 and runs to the end of 2015. The DRC project may lead to more exposure for the CHC Model as the programme is being seriously monitored by ODI who are measuring achievements and impact and making a comparative analysis of the different approaches, including CLTS and ‘Village Assaini’. Already the response from the community has told us CHCs are working as well as ever even in the DRC.
2013 Africa AHEAD Annual Report
Our Annual Budget was the highest it has ever been at close to a million USD. The USAID project was particularly important as we were directly funded for the first time since 2002 and this has given us the ability to approach donors directly. ACF was particularly generous and supported our finance and non finance staff and in-house grant management. It is only a pity that USAID / OFDA completed their short emergency funding and were are unable to expand in these projects, as without exception the local authorities have been delighted with our outputs. The target in the ACF Programme were ambitious by any standards with 100% coverage of all villages but we achieved outstanding results which were highlighted internationally at the Water & Health Conference in North Carolina, where Africa AHEAD presented Papers in October 2013. This project has generated much interest internationally and we feel that in the field we have made an impact out of all proportion to our size as a NGO.
2013 saw an all time high for the number of beneficiaries we reached this past year thanks to proper funding at scale. With a small staff of only 12 Project Officers we started up a total of 883 Community Health Clubs and 73 School Health Clubs in 12 months. This amounts to 44,444 CHC members which equates to 171,445 direct beneficiaries. With our target to meet one million beneficiaries in 5 years we have achieved 17% in one year.
Zim AHEAD became more visible nationally as we made sure we were well represented at all national level WASH, Nutrition, Urban Rehabilitation, Education and Agriculture Networking Technical Working Groups.
In Rwanda the long awaited start up of CHCs (funded by the Gates Foundation) got going after the villages which had been selected by our partner, IPA who was conducting the Randomised Control Trial. The Training of Trainers workshop took place in November 2013, and the stage is now set for the training of the community in 2014.
In Uganda a small project was started in partnership with International Lifeline Fund to compliment their borehole rehabilitation programme in Apac District. Africa AHEAD will have two staff training ILF and MoH staff to run the 60 CHCs that will start up in 2014.
2012 Africa AHEAD Annual Report
During this year Africa AHEAD started the process of amalgamating the various wings of AHEAD into one registered Charity based out of the UK. The year was mainly focused on advocacy and partner development. Programmes include the start up of the GAtes funded Monitoring of CHCs in Rwanda and an evaluation of Health promotion in Sierra Leone.
2012 was an exceptionally productive year for Zim AHEAD with projects in Manicaland Province, Masvingo, Midlands and Mashonaland Central with a total number of 204,709 beneficiaries. With only 30 full time staff Zim AHEAD has positively enhanced the lives of 201,709 people in just one year in the rural and urban areas of Zimbabwe at an average cost of US$6.11 per person per annum, enabling an estimated 45,000 thousand households to manage their own health and hygiene through Community Health Clubs and so preventing disease and improve their living standards enabling them to live in dignity as a functional Community. Two major projects were the Cholera Mitigation through CHC Programme funded by USAID and Rural WASH in Schools through ACF funded by EC, as well as the Small Towns Hygiene Promotion and Capacity Building in Bindura through with GAA and Chipinge through ACF through Unicef .
2011 Africa AHEAD Annual Report
The year started out with great promise. Zimbabwe AHEAD had consolidated its reputation with government as an innovative leader in the sector, contributing to the national effort in WASH and SAG networks, as well as spear-heading the development of new Health Promoting Schools Curriculum. We were also considered a strategic local partner by many international NGOs wanting to use the CHC methodology as it spread throughout the country thanks largely to our role in Protracted Relief Programme (PRP II), where we had trained 22 NGOs in our methodology. Through our sister Association, Africa AHEAD, we were invited to provide community mobilization in massive engineering contracts by prestigious UK firms, who were bidding for rehabilitation of sanitation in 5 towns in Zimbabwe. By the end of 2010, eight international partners had submitted joint proposals with us for EC Funding and in early 2011 we were delighted to hear the ACF bid was successful. Our team was gearing up to begin this ambitious programme starting 450 CHCs in Gutu and Mberengwa districts. Although we expected to start in May, delays ensued while ACF worked through their own bureaucratic demands from the EU, and ZimAHEAD was left hanging. As our project with OXFAM wound up in mid year, and the ACF programme still showed no signs of start up in July, many field staff were laid off , while others were on half salaries for the rest of the year.
However, the various funding expectations did not all materialise as hoped. The second half of 2011 taxed our small NGO to near breaking point. As the political situation in Zimbabwe remained locked in stale-mate, we, like many other NGOs this year, found direct funding elusive. To minimize core costs, Regis Matimati, our Director of Programmes has stood in for me as Acting Director most of the year and continued valiantly to keep up morale despite the many challenges, whilst Innocent Marivo, our Admin and Finance Manager patiently kept us in business, with sale of training materials and consultancy training workshops for Medair and PRP II. I would like to recognize the loyalty of our staff, who have all come back to the Zim AHEAD family ready to work again now the ACF project is finally going ahead. We are happy to announce that in January 2012 we are taking on 9 new staff for the ACF Programme, and another 8 new staff for the emergency USAID-OFDA that we expect to start up soon. This will enable Zim AHEAD to go back to our old project areas of Makoni District, Chiredzi and Masvingo, training 240 CHCs with 216,000 beneficiaries in one year. 2012 should be a record breaking year for us as we continue to scale up CHCs throughout Zimbabwe. May this happen as planned!
2010 Zimbabwe AHEAD Annual Report
ZimAHEAD team was at it again in 2010 scoring major public health goals with outstanding achievements in all our programming areas. The EC funded project in partnership with Mercy Corps drew to an end in October 2010 after three years of building community capacity to address health and nutrition in Buhera, Chipinge and Chiredzi. All project targets were exceeded at no extra cost. (See Annual Report, page 9) In partnership with Oxfam on an OFDA funded project, we burst into national limelight which resulted into phenomenal hardware outputs, thanks to our Programme Manager, Andrew Muringaniza. After only six months of software promotion, the Chiredzi community, constructed over 235 top of the range latrines and thousands other health and hygiene enabling facilities with zero subsidies. Two Directors from Ministry of Health, from the Department of Environmental Health, and the Department of Infrastructure Development, toured the area and were spell bound by what they saw. Even the National Coordination Unit’s Coordinator was surprised by what the communities did with stimulation from ZimAHEAD in Chiredzi and Masvingo urban. Communities took control, showing accountability, ownership and responsibility over their own health and development spurred by the motivation in the health club sessions. (See Annual Report, page 10) In particular the Garikai community attracted attention. Once they were the black spot of Masvingo town looked down upon by other residents of Masvingo. Their place is now a symbol of health after they joined the clubs and cleaned their area, they are now proud of their homes and walk with heads held high, a big difference from the past. (See page 11). ADRA and ACF contracted us to offer them training and backstopping support and this was done to satisfaction, training their teams in Gokwe North and Matabeleland South.
2009 Zimbabwe AHEAD Annual Report
In 2009, the head office was brought back to Harare after 7 years based in Rusape, and as a result Zimbabwe AHEAD’s visibility and capacity in the WASH sector has increased. The robustness of the CHC approach has thus been proven throughout this challenging ten-year period and is now considered as being best practice for Hygiene Promotion in Zimbabwe by the MoH and WASH sector.
During this same decade while Zimbabwe AHEAD was fighting for survival against all odds, the ‘CHC approach’ was quickly gaining a reputation across the rest of the continent. In recent years since 2000 it has been taken up in countries across Africa including Rwanda and Uganda in East Africa, Sierra Leone and Guinea Bissau in West Africa and also South Africa. In addition, Vietnam in SE Asia is also now introducing CHCs within their national programme of preventative health. So, while Zimbabwe has been floundering, CHCs have been thriving! In fact an important document signed up to by no less than 19 major Development Agencies (including World Bank, UNDP, WHO, DFID, DANIDA, etc) actually singled out the CHC approach as being particularly effective for achieving hygiene behaviour change. This global document sited the Tsholotsho project (as implemented by Zimbabwe AHEAD and researched at the LSHTM), as being clear evidence of this.
So, after the challenges of this decade now past, we enter the next decade full of hope and optimism that Zimbabwe AHEAD will once again rise to new heights and quickly surpass the successful position it had reached by 1999. The fact that CHCs have become internationally recognised will likely lead to increasing interest and opportunities for Zimbabwe AHEAD to positively influence this exciting development sector at large. The fact that an inspiring country like Rwanda has recently taken up the challenge to train 45,000 Community Health Workers in the CHC methodology is likely to be taken up by any number of additional countries in the near future. To meet such challenges, Zimbabwe AHEAD must aim to strengthen further its already high standards of excellence in training, research and programme implementation so that it can positively influence the achievement of the MDGs in Africa and beyond.