Cost Effective Health Promotion: Community Health Clubs.
The new strategy of using Community Health Clubs as a vehicle for rural health promotion was first used in Zimbabwe, in 1994 in Makoni District, in a field trial initiated by the author. As the demand for expansion increased, an NGO, Zimbabwe A.H.E.A.D. (Applied Health Education and Development) was founded in 1997 to support Ministry of Health implement this new approach, in the three districts of Makoni, Gutu and Tsholotsho. The training of community takes place once a week for six months, with at least 20 sessions being conducted on different topics. The methodology used in the AHEAD Approach recognised that Health Promotion is the ideal entry point for development. It maintains that if this is used as a process to develop a real ‘common unity’ of understanding and a ‘culture of health’ within a community, subsequent W & S programmes will be effective, easier to implement, and sustainable.
The objective of this paper is to demonstrate the low costs of effective health promotion (using the AHEAD Approach) to the donor, in an effort to encourage greater investment in this essential component of a Water and Sanitation programme. Costs of the field staff conducting the Health Promotion are calculated to give a cost per beneficiary. Additional Costs not included are US$ 47,709 (40%) for Sanitation (3128 VIP latrines in two years); US$ 36,878 (30%) for establishing over 500 income generating projects, as well as US$ 10,242 (10%) on Administration. The Total Project cost for 2000 was US$120,000, of which only 20% was spent on Health Promotion.
In the second year, cost per beneficiary dropped from 0.91 in Year 1, to only 0.35c. This token amount can improve health knowledge of the mother, which can result in upgrading of family hygiene and the prevention of many diseases. When this budget is recalculated as a cost per trainer, (including training, equipment, motorbike and running costs), this amounts to only US$3,144 for two years.