ANNUAL REPORTS

This page provides details of all projects and overview of expenditure between 2009 and 2023 in our Annual Reports.

Programs this year continue to be mainly preoccupied with emergency responses due to the resurgence of cholera. To combat this epidemic, we acknowledge with gratitude the financial support from Action Contre la Faim through funding from our major donor BHA (USAID), who with 74% of our total budget is our main funder, as well as UNICEF (11%) and SKAT (1%). We also welcome again through ACF new funding from SIDA, constituting of 12.4% of our total budget. In addition we received 1.6% Oak Foundation, which was the first organisation to support Zimbabwe AHEAD in 1996 and has this year returned to us, asking to build capacity of their other partners to use our approach.

The team at Africa AHEAD have held their own again in 2023, with a staff of 41, of which 40% are women. As an organisation, we are committed to ensuring our staff grow professionally, and I was therefore impressed that 19 staff members seized the opportunity to study on top of their demanding jobs, taking short courses in aspects of community development that will further enhance the organisation’s professionalism.

New acronyms now dominate our work, including CATI (Case Area Targeted Intervention), a strategy to identify new cholera cases and prioritize all households within 50 meters with Non-Food Item (NFI) kits. Social Marketing is taking over our health promotion budget, with half a million radio listeners receiving health information to control the epidemic. However, our core business is long-term sustainable development, and to this end, we have trained 8,275 beneficiaries in 52 new CHCs and 7 new School Health Clubs.

Regionally, we continue to influence the WASH Sector, training a local CBO, Development Technology Training Center in Malawi, supported by Transform International, who as a result successfully started CHCs through online training, which was then enhanced practically by a visit to our programme this year on a Look & Learn tour. Online training has now proved to be a viable way to replicate our CHC approach regionally at low cost.

My deep respect to Regis Matimati for steering the organisation through another challenging year for the country with not only the cholera epidemic, rampant inflation, but now a national emergency due to drought. Admiration also goes to our patient mother in the organisation, Patience Muserepwa, now promoted to Head of Finance, for another year in which we were rated ‘low risk’, not only by UNICEF but also by USAID auditors.

Sincere thanks also to our vibrant Board of Trustees, who continue to provide moral support to the organisation. Special thanks to Mrs. Jacquie Anderson, outgoing Trustee after four years on the Board, and welcome to Ms. Nyarai Kurebgwaseka, our new Trustee, who is to strengthen our expertise on women’s empowerment through home enterprises.

Dr. Juliet Waterkeyn

Co-founder and Chairperson

 

A little over five years since Africa AHEAD relocated from the United Kingdom back to our roots in Zimbabwe, the organisation is sustaining the phenomenal growth achieved in 2021, for the second year running. This is all the more admirable  given an environment where many local NGOs are finding it difficult to survive. I am proud to report that our organisation has become the ‘go to’ organisation for international organisations seeking to support a reliable development programme which can guarantee community-led development using our signature Community Health Clubs.

Since its formation the focus of Africa A.H.E.A D has been on Applied Health Education (A.H.E.) through behaviour change in hygiene within water and sanitation programmes, solidly within the WASH Sector. In 2022 the Board agreed to change the ‘A.D’ in the acronym to signify Agriculture for Development to capture our work on the empowerment of women (SDG 5) through income generation (SGD 8) in agricultural projects. With international concern over global warming (SG 7), we are extending the scope of Community Health Clubs to ensure community resilience to climate change through food sustainability (STD 2) which together with SDG 6 will ensure Good Health (SDG 3) and Poverty Reduction (SDG 1). The holistic design of our projects in 2022 can be appreciated at a glance by the SDG colour coding along the side of each page in this Annual Report.

The good governance of the organisation has been further strengthened in the past year by welcoming Dr. Victor Nyamandi as a Trustee, an appropriate addition since he was the District Health Office when the first CHCs were started in Makoni District in 1994. He replaces our loyal Trustee Sally Kuiper who has been of great support over the past few years as signatory for the Board. Africa AHEAD is a truly home-grown NGO, managed by Zimbabweans for Zimbabweans striving for a level of excellence which more often associated with international organisations. Once again, we have been given a clean bill of health by our auditors for 2022.

Whilst we have always strived to give ‘Value for Money’ at less than US$5 per person, this year we achieved an all-time record: with an income of US$3.1 million we were able to reach over 5 million people which makes the average ‘cost per beneficiary’ only US$1.30 per person. This is of course a rough measure since some project participants have received more investment than others: with 85 CHCs, over 2,000 people were provided with Health Education whilst many also benefitted from solarised piped water schemes in  villages in Gokwe North & South, Kariba, Makoni, and Chimanimani. Through our Covid outreach programme the public health campaigns with messaging through SMS and over the radio reached a vast audience. Over 100,000 people received vaccinations, a quick but lifesaving intervention.  The following pages give so much detail it is hard to believe this was all achieved in the past year or two by our Executive Director and his 56 dedicated staff.

Dr. Juliet Waterkeyn

Co-founder and Chairperson

2021 Annual Report 

Executive Director’s Summary: Regis Matimati

Our interventions reached over 2.2 million beneficiaries over the two years with a revenue of  US$ 2,113,108 in 2021 and US$1,490,352 in 2020 with a total revenue of US$ 3,603,460 over the two years.

Our staff grew to 50 staff members comprising of public health experts, public health engineers, accountants  and logisticians. I am humbled to have held the torch charting the course for this group of dedicated and selfless experts.

The two years went like a song. I could not falter given the liberal support I got from my four pillars in Programs, Finance and Administration, Logistics and Supply as well as Monitoring, Evaluation, Accountability and Learning leads.

Across the country the organization achieved amazing targets as articulated in this report.   I respect the efforts of the team and the coordination and technical support they got from the development partners in the field, the stakeholders and program participants across the country.

We continued to enjoy support and capacity building from our international partners namely ACF, Oxfam, Care International, SKAT Foundation and UNICEF. We will continually engage others so that we are always available to serve the communities of Zimbabwe.

The organization continues to sit in national and regional think-tanks to chart the way for Zimbabwe. National WASH has appointed Africa AHEAD the Lead Focal Agency in Bulawayo and Matebeland North Province, the only organisation in the country to be given this responsibility of co-ordinating other non-governmental organisations in two provinces.

Resultantly the National WASH also saw it fit to appoint Africa AHEAD as

1. i) Co-Chair with Oxfam of the WASH Technical Working Group
2. ii) Local NGO representatives for the Sanitation and Water For All (SWA)

iii) Local NGO representative for the WASH in Schools Strategy Team.

I pay tribute to the support I got from the Board of Trustees throughout the year and wish to thank them for entrusting me with the task to lead the organization as we serve the people of Zimbabwe.

We will continue to deploy our diligence in the country’s development goals. The organization is a growing concern. We will keep focused.

2020 Annual Report

Despite the obvious challenges caused by the global pandemic, 2020 actually turned out to be one of the most successful years ever for Africa AHEAD.  With an annual budget of almost USD 3 million, approximately one million beneficiaries were supported by AA-Z at an average per-capita cost of just USD 3.00

Clearly this past year has been a remarkable success by any measure but especially when one takes into account the difficulty of operating under severe lock-down restrictions combined with critical fuel shortages and the over-arching challenges being faced by the failing economy and infrastructure.  But despite these many vicissitudes AA-Z, under the very capable leadership of Regis Matimati our Executive Director, was able to expand total compliment of staff by some 50% to 42 staff which is the highest it has been for the past two decades!

What is clear from the thirteen individual project reports that were being implemented over these past twelve months; all of which are here detailed in this Annual Report, the organisation has been operating across vast swathes of Zimbabwe from Manicaland to Masvingo as well as both Bulawayo and Harare.  There is a familiar saying that ‘success builds success’ and this now clearly appears to be what is happening with AA-Z. With ever increasing confidence in AA’s capacity to respond quickly and professionally to emergency scenarios, fresh funding has been forthcoming from the likes of UNICEF as well as from major INGOs like Christian Aid, ACF, SIDA, ECHO, OFDA & SKAT Foundation.  It is also most encouraging that there is the likelihood of renewal of past partnerships with CARE and Oxfam as well. All of these important relationships with international organisations helps to disseminate the AHEAD ethos of Applied Health, Education, Agriculture and Development with the CHC model at the core as has always been our objective ever since we started AA 25 years ago.

What is also noteworthy is the way AA-Z is achieving increasing levels of sector integration of all implementation activities.  In other words, a far more comprehensive approach is being achieved that encompasses Nutrition/Agriculture, enhanced WASH as well as Education.  AA-Z is also gaining a solid reputation for being able to respond quickly, professionally and effectively in Emergency situations of which Zimbabwe has been inundated of late what with droughts, floods and cyclones as well as the ongoing Covid pandemic and frequent cholera outbreaks.

While AA-Z has been busy implementing the numerous projects across the country Regis and his team were also able to offer useful contributions to the Zoom CHC Training courses that have been organised by Africa AHEAD Associates (AAA) from Cape Town.  The CHC modules attracted around sixty participants from 18 countries and resulted in CHC projects being disseminated to various new organisations and countries around the world. This complimentary relationship between AA-Z and AAA has got off to a very good start during the course of this past year.  Dissemination of the AHEAD / CHC approach is finally beginning to happen at scale and Zimbabwe, where it all began 25 years ago, continues to provide the bed-rock experience based on first-hand engagement with communities.

2018-2019 Biennial Report

For the past six  years Africa AHEAD has been a registered UK Charity, with a UK Board of Trustees, but despite our best efforts it has been  a challenge to raise sufficient funds to cover the costs of Executive Management  in the UK. Our primary objective has always been to provide assistance to the  poor in Africa with minimal administrative overheads. After our London  Strategic Planning Meetings in March and July 2019, we are closing in the UK and will once again become a southern based NGO,   returning to our roots, where Zimbabwe AHEAD started in 1999,  with our headquarters in Harare.  As the Co-founder Anthony Waterkeyn retires this year as CEO, the future of our organisation rests with Regis Matimati who having been Country Director for the past few years, now is appointed  Executive Director  for this regional hub. Our invigorated Board of Trustees in Zimbabwe is now headed by a new Chairman Dr, Jaap Kuiper, taking over from Janette Hetherton who remains Trustee, with  Co-founder Dr. Juliet Waterkeyn as the incoming Secretary,  Trustees Smolly Moyo,  Sally Whittaker, Anthony Waterkeyn and Clarie Griffiths who joins us  replacing  Graham Cheater, who retires this year. Despite the challenges of operating in Zimbabwe there is increasing  emergency funding due to the effects of global warming, as demonstrated by the devastation caused by Cyclone Idai, this year, as well as the constant threat of cholera and cross border threat of epidemics. In this year, which sees the retirement of the original founders from the management, we have realised one of our 5×5 Challenge to reach one million people within 5 years in Zimbabwe.  This year alone our small team of 15-30 staff have improved the lives of 527,860 people in 5 Districts of Zimbabwe, providing social support to 11,625 Community Health Club members in 155 CHCs. We have contributed to the containment of  5 preventable diseases. We have played a large role in  helping to contain the cholera epidemic by providing wash hand facilities at all bus termini in Harare, thereby minimising the spread of this killer diease to the rural areas.   We also provided borehole rehabilitation and public latrines, not only at market places in Harare, but in Chipinge District where damaged water and sanitation facilities again threatened to end in a cholera outbreak. Whilst we are intent on assisting in these emergencies we are aiming to strengthen our long term development programmes using the full four-phase AHEAD approach in a holistic and integrated process of sustainable development.

2016 – 2017 Annual Report

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.

2014 Africa AHEAD  Annual Report 

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.