LOCATION OF RWANDA
Community voices from Rusizi District
The Road map for Community Based environmental Health Promotin Programme (CBEHPP) was first adopted in 2010 by Ministry of Health Rwanda, enabling the replication of Community Health Clubs into 5 Pilot districts in Rwanda.
The Kigali Action Plan is an document produced by the African Union which includes a recommendation that the 10 fragile states in Africa adopt the CBEHPP Programme as a sure way to meet the demands of the Sustainable Development goals for Water and Sanitation. See 3.4.
Evaluation of CBEHPP
The Bill & Melinda Gates Foundation, supported Innovations for Poverty Action (IPA) in one district of Rusizi, conducted a Randomised Control Trial to ascertain the effect of the CHC approach in Rwanda on disease reduction (2015 – 2016). Thier published findings were dissappointing and have been hotly contested by the monitoring team whose findings over a longer period (2013-2017) did not tally with those found by the cRCT.
Monitoring of CBEHPP:
Africa AHEAD, which assisted Ministry of Health in Rusizi completed the four year intervention in 2017 has publishing findings from the data collected over the same period as the RCT, but extends for another two years. These results demonstrate considerable hygiene behaviour change over that period.
Africa AHEAD CONTACT PERSON
The Community Based Environmental Health Promotion Programme (CBEHPP)
The Ministry of Health is taking the lead in Rwanda and the CHC Approach has been launched at the highest level, in the Community Based Environmental Health Promotion Programme (CBEHPP). This has been facilitated by the production of a substantial Tool Kit of 350 visual aids and two manuals. The Training of core trainers was completed by Dr Juliet Waterkeyn, in November 2010. Roll on Training has been done in 5 Pilot districts, and continues to be done throughout the country by Ministry of Health.
In 2011, a Presidential initiative decreed that all 14, 860 villages in Rwanda should start CHCs within the next year. This meant training approximately 45,000 community health workers in the country.
By Feb 2013, MoH had recorded that 98% of all villages had registered CHCs and a comprehensive structure of CBEHPP committees from Provincial to Village level has been set up to monitor the progress in each village . There are now 14 NGOs assisting MoH to conduct training but this is proving a challenge at this scale.
By 2015 the program was well established but there was much training to be done to complete the 56% of villages still outstanding. At the CBEHPP Workshop, the Director General of MoH confirmed that by June 2018, MoH wants total (100%) coverage of CHCs across all villages and households in Rwanda.
USAID supported SNV and CRS to add to the CBEHPP with an Integrated Nutrition and WASH programme in 8 Districts, and a baseline was completed.
Unicef scaled up CBEHPP to another 14 Districts so that CHCs cover all villages with proper training by 2020.
World Vision was implementing CHCs in 10 districts with 750 CHCs initiated, reaching 56,000 members and 300,000 beneficiaries.
WaterAid was working in Bugesera District and has conducted a study through University of Rwanda showing positive results.
This meant all of the 30 districts were covered by the programme.