How do CHCs work? A description from the field

How do Community Health Clubs work?

Our team in Zimbabwe were asked to describe how CHCs work. Their description is a fresh look at the whole process…

This is how Regis Matimati, Director of Programmes describes the process….

‘Here is how it goes.

About 50-100 people staying in the same locality meet once weekly on a chosen day led  by a trained Community Based Facilitator. Following a set syllabus, they discuss one health topic per week and go back home to implement the changes they want to see in their homes, environment and the community. The next week they meet and allocate a couple of minutes to testimonies of what has changed or what was easy or difficult to change back home. They proffer solutions and congratulate each other on the successes experienced. Those who would not have scored much, are urged to keep pressing on the activities to see the change. They then move on to the week’s topic and in similar fashion they take some ‘home work’ back home to implement the practical side of the issues.

After a couple of weeks the whole group or in smaller groups move house-to-house to assess the changes experienced in the community. (they love this part so much wherever we have been to). Where others are showing off their developments, the others are stimulated to emulate. Positive peer pressure and social solidarity takes root and the early adopters are revered. The late adopters are motivated to
catch up. Social capital is generated as people relate to each other more due to the weeks of meetings and socializing. The community now has common-unity. They know what they want and want what is best for themselves. Sometimes they help each other to construct health and hygiene enabling facilities (hand washing facilities, latrines, pot racks and rubbish pits). They mainstream issues of social inclusion like working with the disabled, the vulnerable like orphaned children, the chronically ill  and the elderly incapacitated. A lot of team work is  evident. A social network is created. Every club member wants to be identified with like minded community members. A development veldt fire is ignited.

Periodically during the 6 months of weekly sessions the club members hold inter-house, inter-club and inter-community health and hygiene competitions. A friendly rivalry is created to spur the others to measure up to the set minimum health and hygiene standards.

On a set date they hold a community Graduation Day where those who have finished the sessions are publicly recognized by the community. Certification is done with support   from the public health officials and the Who-is-Who of the community. (The certificate is a prized possession as for most it will be their one and only certificate of accomplishment).

CHCs in Zimbabwe have sustainably cleaned up previously dirty towns (Mutare, Masvingo, Chiredzi, Chipinge and Bindura to name a few). Communities have taken  ownership, control, increased responsibility and accountability over their own health and development in general where they are working in clubs.

The strength of the CHC is that it generates Social Capital in communities, meaning high levels of trust and interdependence. The club becomes an information highway in the community. They meet to socialize, to debrief and a host of other unexpected benefits are realized where communities are working together in groups. Livelihoods improvement projects becomes a natural follow on.

While the CHC approach was initially developed as a public health focused intervention to change hygiene behavior to achieve safe water and sanitation, our 19 years of programming has shown that we can factor in any community development topic on the syllabus according to identified community needs. The CHCs ends up as a Community Based Organization through which any development issue can
be channeled. This is holistic and sustainable development, led by the community themselves. It works!’