LOCATION OF RWANDA
|Population (2014)||12 million|
|GNT /per capita (2013)||US$1,450|
|Under 5 mortality rate/1000 births (2014)||55|
|deaths per year (2012)||9.18|
|WASH deaths per year (2012)||2119|
|DALYs /1000 cap (13- 289 high)||183|
|WASH deaths per year (2004)||48,100|
|WASH deaths % total burden||31%|
|Diarrhoea rate/1000 (0.2 low – 107 high)||65|
|ARI rate (0.1 lowest)/1000||39|
|Malnutrition (% stunting)/1000||52%|
|Human Devlopment Index (2011)||0,429|
|Ranking in World (2011)||166|
Plot 5 – KK361, Kigali
DISTRICT COVERAGE OF COMMUNITY HEALTH CLUBS
COVERAGE OF DISTRICTS (April, 2015)
Community Health Clubs are established in ALL of the 30 Districts in Rwanda. In addition 98% of all 14,767 villages in Rwanda have registered CHCs. Of this number 5,376 villages have trained Village Health Workers (ASOC) who are running health sessions regularly. The remaining Districts are set to be trained by 2018, supported by Unicef in 18 Districts and USAID in 9 districts.
IMPLEMENTING PARTNERS OF CBEHPP
- RFHP/ USAID
- SNV / UNICEF
- Tearfund / Scottish Government
- World Vision
- STPH / SDC
- Nyamata Hospital / Various
- Africa AHEAD/Gates Foundation
Rwanda - CHC Coverage
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.
Water Aid and World Vision have registered considerable improvements and are excited about the programme.
Africa AHEAD, supported by Gates Foundation, is assisting the MoH in Rwanda to ensuring standards are maintained despite the massive scale up. In one district of Rusizi, a Randomised Control Trial is being started involving 150 villages to ascertain the effect of the CHC approach in Rwanda on disease reduction.This external evaluation is being conducted by IPA, Innovations for Poverty Action, a consortium of research professionals from highly reputed universities based out of Washington DC.
RANDOMISED CONTROL TRIAL OF THE CHC MODEL
IN RUSIZI DISTRICT
In 2009, Africa AHEAD brought the CBEHPP to the attention of the Bill & Melinda Gates Foundation (BMGF) who are now helping MoH to monitor and evaluate the efficacy of the the CHC to reduce common preventable diseases. Rusizi District in Western Province, was selected to demonstrate the ‘Classic’ CHC Model. The project Monitoring of the Community Health Club Model started in 2012 and is set to continue until end of 2016.
A Randomised Control Trial being currently being undertaken by Innovation for Poverty Action (IPA) which will determine precisely how hygiene behavior can be improved to reduce the national disease burden in Rwanda and similar countries.
THE COMMUNITY BASED ENVIRONMENTAL HEALTH PROMOTION PROGRAMME (CBEHPP)
The Community Based Environmental Health Promotion Programme (CBEHPP) is a national hygiene behaviour change program in Rwanda that has adopted the Community Health Club (CHC) methodology, which was endorsed by the president who directed that it should be extended to every village in the country. This was made policy in the Health Sector Strategic Strategy in 2009.
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.
Africa AHEAD is playing a key role in building this capacity by providing a demonstration district so assisting MoH to maintain the quality in the scale up ensuring the CHCs are replicated at the same high standard.
PROPOSALS READY FOR FUNDING
- Strengthening and Monitoring the Community-Based Environmental Health Promotion Programme (CBEHPP) in Karongi, Kirehe, Nyagatare, Nyaruguru & Rutsiro Districts (2014 – 2016).
- Increasing Rwandan Secondary School Graduation Rate (Esp. Among Girls), Teacher Effectiveness and 21st Century Employment-Relevant Skills in Rusizi District, Rwanda (one year)
- The Micro-Enterprise Model for Self Sustainability though Digital Marketing in Community Health Clubs in Rwanda (two years)
AFRICA AHEAD PROJECTS
- 2008 – 2010: Advocacy for CHC Model and Development Road Map for CBEHPP, WSP- World Bank for Ministry of Health (Anthony Waterkeyn)
- 2010-2012: Development of CBEHPP Training Materials and Manuals for CBEHPP for MoH / Unicef (Juliet Waterkeyn)
- 2013-2016: Monitoring Behaviour Change and Improved Health Outcomes through the Community Hygiene Club Methodology in Rwanda – funded by Bill & Melinda Gates Foundation
Regional Rep: Zachary Bigirmana
Country Director: Joseph Katabarwa
Programme Manager: Amans Ntakarutimana
Monitoring Officer: Andrew Ndahiro
Finance Officer: Jeanne Gasengayire
Data Officer: Etienne Havumiragira
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