Zimbabwe, Tsholotsho

Tsholotsho was selected as an area of intervention due to lack of an Integrated Water and Sanitation Supply Programme, poor water and sanitation coverage and the high level of pump failure on boreholes (DFID, 1997). The Zimbabwe A.H.E.A.D intervention in Tsholotsho was in 3 wards out of 19, where 32 clubs were formed with 2,105 members with 12,630 beneficiaries (taking each member to have a household of six). In two years, there were a total of 832 health promotion sessions held by 3 trainers, costing an average of US$3.35 per member or 35c per beneficiary, including start-up costs (Waterkeyn 2001). All targets were met with 150 boreholes rehabilitated and 1,200 latrines built in 18 months, subsidised at US$15 each (Zimbabwe AHEAD, 2000).

In  2000 Zimbabwe AHEAD  started income generation within the Health Clubs with the production of handwashing facilities and cement blocks in all three wards of Sipepa, Jumila and Madlamombe.  A larger initiative was started in Jimila ward training 10 women in hand-made paper making, which continued for two years.

  • Country: Zimbabwe
  • Period: 1999-2000
  • Donor: DFID
  • Partner: Ministry of Health
  • Province: Matebeleand North
  • District: Tsholtosho
  • 3 Wards: 5,6, 10
  • Number of Villages: 32
  • Number of households: 2,105
  • Number of CHCs: 32
  • Number of Members: 2,105
  • Number of health education session: 832
  • Number of EHTs: 3 
  • Number of CHC facilitators: 32
  • Number of beneficiaries: 12,630
  • Cost of Project: US$ 21,265
  • Cost per beneficiary: 0.91c (US$)

In Tsholotsho, club members’ households were compared to a control group of non CHC members. The difference between the two groups showed particularly high adherence to recommended practices including:

  • ‘no open faecal disposal’ seen in 92% of  to 2% in the control
  • ‘individual cups’ (97% compared to 22%)
  • ‘ladle in use’ (95% versus 30%)
  • ‘pouring method of hand washing’ at (91% versus 3%)
  • ‘individual plates’ (86% versus 10%)
  •  ‘hand wash facility owned’ (80% versus 40%)
  • ‘pot racks’ (78% versus 41%)
  • ‘swept yard’ (73% versus 49%)
  •  ‘rubbish pit owned’ (64% versus 25%).
  • Not one person in the control group practised cat sanitation,
  •  57% of CHC without latrines buried their faeces.
  • Of the 43% who had latrines, most were built in the last year,
  •  98% were found to be used and clean.
  • Soap at hand wash facilities of 39% of CHC, versus 19%
  •  60% of the members had nutrition gardens versus  29% of control.

The mean difference between Health Clubs (70%) and Control (27%) of 21 observations was a 43% increase.

An Evaluation conducted by DFID states:

The Community Health Clubs have been the biggest achievements towards social issues especially for women and should be seen as a foundation for further and other development issues/projects. Women feel more empowered and regarded as part of the society. CHCs should be promoted to a higher level than at present and council should take advantage of the idea and make other NGOs and government aware as to increases in income generating projects.’ (Muringamza, 2002)