COMMUNITY BASED ENVIRONMENTAL HEALTH PROMOTION PROGRAMME

(CBEHPP) IN RWANDAMUKAMUNANA Alphonsine

Ministry of Health TEL: 0788673500

Email: munana01@yahoo.fr1

What is CBEHPP

Community Based Environmental Health Promotion Program uses a Community Health Clubs (CHC) Approach/Strategy to reach all communities and empower them to identify their personal, domestic hygiene, nutrition and environmental health related problems (including drinking water, appropriate utilization of latrines, handwashing, food safety etc.)

Community Health Club during a CHC dialogue session (RUSIZI)

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The Government of Rwanda launched CBEHPP in December 2009 with an objective of reducing significantly by 2017 the debilitating national disease burden (Diarrhea, Intestinal Parasites and Respiratory infections) and therefore contributing to poverty reduction through sustainable hygiene behaviour change through the following strategic interventions.

1. Establishment of Community Hygiene Clubs (CHCs) in all villages2. Increase use of hygienic latrines in homes, schools and health

facilities3. Increase hand washing with soap at critical times in homes, schools

and health facilities

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SPECIFIC STRATEGIES

3. Increase drinking of safe water in homes, schools and health facilities

5. Achieve Zero Open Defecation in all villages through construction and use of improved toilets.

6. Improve safe disposal of children’s faeces in all households

7. Increase households with bath shelters, rubbish pits, pot-drying racks and clean yards

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SPECIFIC STRATEGIES

• Aims to reach all 15,000 villages in Rwanda• Establish a Community Hygiene Club (CHC) in every village• All households in each village will be CHC members• One member represents the household in a Club session•CHC Members required to meet every week for 2 hoursInformed decision making through good information• Creating a common unity/goal through activities• Action oriented with weekly hygiene improvements (e.g. making existing toilets hygienic).

CBEHPP APPROACH

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CBEHPP PARTNERSHIP

MINECOFINMINEDUC

MINAGRI

MININFRA

WASAC

MoH Environmental Health

MIGEPROF

CBEHPP(CHCs)

MINALOC/DISTRICT

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PARTNERS

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CBEHPP IMPLEMENTATION STRUCTUREMinistry of Health

(Environmental Health Desk)

District(District Health Unit)

District Hospital (EHO)

Sector (Social Affairs) Health Center (EHO)

Cell (Social Economic Development Officer)

Village (Head of village)Village ASOC (CHC

Facilitator)CHC

MINALOC, MINIFRA, MINEDUC, MINAGRI, MIGEPRO, MINECOFIN

CHC MEMBERS:1-President2- Vice President3- Secretary4- Vice Secretary5- Treasurer6- Vice Treasurer7- HH Representatives

CHC Committee

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ROADMAP FOR IMPLEMENTATION OF CBEHPPMilestone Events

2009 2010 2011 2012Q4 Q 1 Q2 Q3 Q4 Q1 Q2 Q3 Q4 Q1 Q2 Q3 Q4

Program Launch

Program design & advocacy.

Development of road map  

Phase I Start-up

Start-up in5 Districts /Province  

Phase II Consolidate

Consolidate & add 5 new

DistrictsLaunch of

HSPI 

Phase III Scale-Up

Roll-out to all remaining 22 Districts 

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CBEHPP TRAINING OF NATIONAL CORE TRAINERS

In November 2010 the core team was trained in order to scale up training

Roll out of EHO Training in 5 Districts in December 2010, and 4 other districts in 2011.

CHC Approach: Key Implementation aspects

o 6 Months Community Health education - 20 Dialogue sessions.o Target groupo Inclusive o Structuredo Participatoryo Group consensuso Homeworko ReinforcementoCertification o Quantifying behavior change

The Community Health Club Methodology is facilitated by Village Social Affairs who in turn are supported and mentored by Environmental Health Officers located at Administrative District and Health Facility level.

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1 Introduction Bring friends and family2 Common Diseases Know common diseases3 Personal Hygiene Family wash shelter4 Hand washing Handwash facility/ soap5 Skin diseases Children no skin diseases6 Diarrhoea Knowledge of SSS/ORS7 Infant Care Correct Immunization8 Intestinal Parasites/Worms Children no Worms9 Food Hygiene Clean Drying Rack10 Nutrition Good Road to Health11 Food Security/Safety Kitchen Garden12 Water Sources Clean Water Source13 Safe Drinking Water Safe Storage and Usage14 Adequate Sanitation ZOD/Clean Safe Toilets15 The Model Home Waste Management and Greening16 Good Parenting Clean Children17 Respiratory Diseases Good Ventilation18 Malaria Use of Treated Bed Nets19 Bilharzia Treatment for Bilharzia20 HIV/AIDS VCT and PMTCT

KEY LESSONS LEARNED DURING CHC DIALOGUE SESSIONS AND HOMEWORK

CHC Committee election

CHC MEMBERS IN INTERACTIVE CLUB ACTIVITIES

CHC Members during a village mapping session

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CHC MEMBERS IN INTERACTIVE CLUB ACTIVITIES

Village WASH Mapping during a CHC session Sanitation and hygiene Promotion Songs13

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CHC APPROACH FACILITATING LIVE DISCUSSIONS

Reinforcement: Peer pressure /home visitsHomework: Recommended PracticesMeasurable: Specific Targets Each Week

HOMEWORK IMPLEMENTATION AT HOUSEHOLD AND VILLAGE LEVEL

Maintaining their water source and cleaning up the solid waste to preserve a clean environment

Construction of a pot/plate rack

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FAVORABLE ENVIRONMENT FOR CBEHPP

oAvailability of political will - all levelsoSupportive DPsoAvailability of qualified personnel to implement CBEHPPoCBEHPP Roadmap though a review is neededoExistence of Health Clubs in all VillagesoPositive involvement of the Media.

CONCLUSION

We are inviting all our partners to actively support the programme (CBEHPP). While the Village Social Affairs and Environmental Health Officers are already available, their capacity to achieve positive results through CHCs requires technical support and motivation.

Appropriate training materials and financial resources for this noble cause are critical towards achieving effective implementation.

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THANK YOU FOR YOU ATTENTION

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