COMMUNITY BASED
ENVIRONMENTAL HEALTH
PROMOTION PROGRAMME (CBEHPP)
IN RWANDA
MUKAMUNANA Alphonsine
Ministry of Health
TEL: 0788673500
Email: munana01@yahoo.fr
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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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SPECIFIC STRATEGIES
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 villages
2. Increase use of hygienic latrines in homes, schools and health
facilities
3. 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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CBEHPP APPROACH
• 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).
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CBEHPP PARTNERSHIP
MoH
Environmental Health
MINEDUC
MIGEPROF
CBEHPP
MINAGRI
MINECOFIN
PARTNERS
(CHCs)
MINALOC/DISTRICT
MININFRA
WASAC
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CBEHPP IMPLEMENTATION STRUCTURE
Ministry of Health
(Environmental Health Desk)
MINALOC, MINIFRA, MINEDUC,
MINAGRI, MIGEPRO, MINECOFIN
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
CHC MEMBERS:
1-President
2- Vice President
CHC
3- Secretary
Committee
4- Vice Secretary
5- Treasurer
6- Vice Treasurer
7- HH Representatives
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ROADMAP FOR IMPLEMENTATION OF CBEHPP
Milestone
Events
2009
Q4
Q1
Q2
2011
Q3
Q4
Q1
Q2
Q3
2012
Q4
Q1
Q2
Q3
Q4
 Program design &
advocacy.
 Development of
road map
Program
Launch
Phase I
up
2010
Start-
Phase II
Consolidate
Phase III ScaleUp
Start-up in
5 Districts
/Province
Consolidate &
add 5 new
Districts
Launch of HSPI
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.
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CHC Approach: Key Implementation aspects
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.
6 Months Community Health education 20 Dialogue sessions.
o Target group
o Inclusive
o Structured
o Participatory
o Group consensus
o Homework
o Reinforcement
oCertification
o Quantifying behavior change
o
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KEY LESSONS LEARNED DURING CHC DIALOGUE
SESSIONS AND HOMEWORK
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Introduction
Common Diseases
Personal Hygiene
Hand washing
Skin diseases
Diarrhoea
Infant Care
Intestinal Parasites/Worms
Food Hygiene
Nutrition
Food Security/Safety
Water Sources
Safe Drinking Water
Adequate Sanitation
The Model Home
Good Parenting
Respiratory Diseases
Malaria
Bilharzia
HIV/AIDS
Bring friends and family
Know common diseases
Family wash shelter
Handwash facility/ soap
Children no skin diseases
Knowledge of SSS/ORS
Correct Immunization
Children no Worms
Clean Drying Rack
Good Road to Health
Kitchen Garden
Clean Water Source
Safe Storage and Usage
ZOD/Clean Safe Toilets
Waste Management and Greening
Clean Children
Good Ventilation
Use of Treated Bed Nets
Treatment for Bilharzia
VCT and PMTCT
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CHC MEMBERS IN INTERACTIVE CLUB ACTIVITIES
CHC Committee election
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 Songs
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CHC APPROACH FACILITATING LIVE DISCUSSIONS
Reinforcement: Peer pressure /home visits
Homework: Recommended Practices
Measurable: Specific Targets Each Week
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HOMEWORK IMPLEMENTATION AT HOUSEHOLD AND
VILLAGE LEVEL
Construction of a pot/plate
rack
Maintaining their water source and cleaning up
the solid waste to preserve a clean environment
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FAVORABLE ENVIRONMENT FOR CBEHPP
oAvailability of political will - all levels
oSupportive DPs
oAvailability of qualified personnel to implement CBEHPP
oCBEHPP Roadmap though a review is needed
oExistence of Health Clubs in all Villages
oPositive involvement of the Media.
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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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