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Africa AHEAD is a non-governmental organization working primarily in sub-Saharan Africa. AHEAD stands for Applied Health, Education, And Development. [1]
Africa AHEAD was founded in South Africa in 2005 by Juliet and Anthony Waterkeyn, and was registered as a UK Charity in 2013 with a Board of well-known UK academics chaired by Prof Sandy Cairncross (OBE)(2013-2016) followed by Prof. Richard Carter (2016-2019) when Africa AHEAD dissolved its UK registered charity and moved its Head Quarters to Harare, Zimbabwe with a local Board of Trustees, chaired by Dr. Juliet Waterkeyn, with Regis Matimati as Executive Director of the organisation.
Africa AHEAD Zimbabwe is the implementing organisation, having grown out of Zimbabwe AHEAD Trust founded by the Waterkeyns in 1999, remaining one of the most innovative NGOs in Zimbabwe, having started over 3,000 CHCs directly reaching over 2 million people in Zimbabwe alone by 2020. The team has developed the training materials and method for participatory health education based on PHAST principles, to prevent many common diseases which cause 80% of infant deaths - such as diarrhoea, cholera, pneumonia, malaria and malnutrition; as well as many debilitating diseases which affect growth and development such as bilharzia, intestinal helminths (worms), skin and eye diseases.
Africa AHEAD Association was started to scale up the work of the Waterkeyn's in many countries in Africa, who since 1994 have been developing and refining a model of community development, known as the 'Applied Health Education and Development' (AHEAD) Approach - a 4 phase process of holistic and integrated development. This is a method of community mobilisation which starts up a grass roots group in each village known as a Community Health Club. The Waterkeyns then revamped Africa AHEAD Association based out of Cape Town which is an active group of experienced CHC practitioners involved in the research and training for the dissemination of the Community Health Club Approach.
The reduction of disease is achieved through shared understanding and common action to prevent these diseases through good hygiene facilities and non-risk hygiene behaviour. Consensus for common action is achieved by regular community level meetings, facilitated by a local village health worker, who helps to focus the community's attention on issues of health and hygiene. Over time, the 'common unity' is built, and this functional community then begin to focus on the many ways they can improve their health typically through construction and use of hygienic latrine, hand washing facilities, as well as ensuring a safe environment for children.
The 1st stage of the process is a six-month period of weekly dialogue sessions on health issues which affect them and ways to control disease through preventative means. The 2nd stage is to put this knowledge into practice through the construction of local sanitary facilities, and the improvement of kitchen hygiene as well as personal hygiene. In the 3rd year the Community Health Clubs tend to morph into a Food Agriculture and nutrition Club (FAN) which start up nutrition gardens or other farming activities to generate income, and in so doing empower women in particular to be self-sufficient financially. This leads to increased self-confidence and sustainable livelihoods as women run income-generation businesses enable the community to improve its health and hygiene situation, as well as supporting other vulnerable families in the neighbourhood. The 4th and possibly final stage of development is when the village is largely self-sustaining and can competently ensure the survival, growth and proper development of all children, controlling all preventable diseases. At this point people can afford to be more altruistic and reach out to marginalised and vulnerable families within their community such as widows, orphans, child headed families, and those who are infirm, aged, mentally unstable or have terminal diseases. This is also a time of building civic responsibility, becoming politically aware and a full participant in society, ensuring the rights of all are adequately protected.
The AHEAD Model is in effect a 'Rights based approach', putting women at the centre of development in a model of community development which uses health promotion as an entrypoint to sustainable development, providing a practical model which can be used by NGOs and government to meet the Sustainable Development Goals at under US$5 per person.
To date the AHEAD Approach has only been scaled up nationwide in Rwanda in the Community Based Environmental Health Promotion Programme (CBEHPP) which has reached every one of the 14,767 villages in Rwanda, being instrumental in enabling sanitation coverage to increase to 98% in Rwanda by 2015. The CBEHP Programme was first started in 2010, introduced by Anthony Waterkeyn, working with WSP/World Bank for Ministry of Health. The concept was immediately understood as a means of community building and was endorsed directly by President Kagame himself. By 2015 core trainers, originally trained by Juliet Waterkeyn had succeeded in rolling out the CHC training to 40% of the villages in Rwanda, assisted by 14 implementing partners, such as Water Aid, World Vision, Swiss Aid, SNV and others. In 2016 USAID supported the massive scale up to cover 8 districts which included not only Water and Sanitation but also a nutrition component. Africa AHEAD supported Rusizi District funded by the Gates Foundation in an evaluation of the CHC Approach.
In 2014 President Kagame advocated the use of CBEHPP in the Kigali Action Plan which focuses on relieving poverty in 10 of the poorest Countries in Africa. Rwanda was one of only four countries in Africa to not only achieve, but surpass, the Millennium Development Goal of halving the number within the country without access to safe water and sanitation.
Africa AHEAD has been the key mover behind the introduction of Community Health Clubs into other countries through other NGOs: Sierra Leone (CARE International, 2002), Uganda (Care International, 2003), South Africa (Government, 2005; IWRM, Danida 2010), Guinea Bissau (Effective Interventions, 2008), Vietnam (Government/Danida, 2010), Rwanda (Government/UNICEF/WSP, 2010), Namibia (ISOE, 2013) DR Congo (Tear Fund, 2015). It is estimated that by 2015, over 3000 CHCs with over 250,000 members, and 1,542,000 beneficiaries with improved living standards could be attributed to consultancies for these NGOs by Juliet and Anthony Waterkeyn and their teams. This work has been supported by organizations such as the U.K. Department for International Development and Danish International Development Agency.
On the basis of this interest, they founded Africa AHEAD in 2103 which has systemised the CHC Approach, with a view to replication and scaling up throughout Africa. There are two currently main hubs based in Kigali (Rwanda) and Harare (Zimbabwe) with expert teams of trainers. They offer training for any NGOs or government wishing to embrace the AHEAD approach. They also offer a data base of CHCs on which provides monitoring and evaluation tools for any programmes using the 'Classic CHC' approach. [2]
The CHC concept differs from traditional aid approaches that are heavily input-based and has led to a number of articles in development journals. [3]
Rwanda, officially the Republic of Rwanda, is a landlocked country in the Great Rift Valley of Central Africa, where the African Great Lakes region and Southeast Africa converge. Located a few degrees south of the Equator, Rwanda is bordered by Uganda, Tanzania, Burundi, and the Democratic Republic of the Congo. It is highly elevated, giving it the soubriquet "land of a thousand hills", with its geography dominated by mountains in the west and savanna to the southeast, with numerous lakes throughout the country. The climate is temperate to subtropical, with two rainy seasons and two dry seasons each year. It is the most densely populated mainland African country; among countries larger than 10,000 km2, it is the fifth most densely populated country in the world. Its capital and largest city is Kigali.
Sanitation refers to public health conditions related to clean drinking water and treatment and disposal of human excreta and sewage. Preventing human contact with feces is part of sanitation, as is hand washing with soap. Sanitation systems aim to protect human health by providing a clean environment that will stop the transmission of disease, especially through the fecal–oral route. For example, diarrhea, a main cause of malnutrition and stunted growth in children, can be reduced through adequate sanitation. There are many other diseases which are easily transmitted in communities that have low levels of sanitation, such as ascariasis, cholera, hepatitis, polio, schistosomiasis, and trachoma, to name just a few.
Ecological sanitation, commonly abbreviated as ecosan, is an approach to sanitation provision which aims to safely reuse excreta in agriculture. It is an approach, rather than a technology or a device which is characterized by a desire to "close the loop", mainly for the nutrients and organic matter between sanitation and agriculture in a safe manner. One of the aims is to minimise the use of non-renewable resources. When properly designed and operated, ecosan systems provide a hygienically safe system to convert human excreta into nutrients to be returned to the soil, and water to be returned to the land. Ecosan is also called resource-oriented sanitation.
Stunted growth, also known as stunting or linear growth failure, is defined as impaired growth and development manifested by low height-for-age. It is a primary manifestation of malnutrition and recurrent infections, such as diarrhea and helminthiasis, in early childhood and even before birth, due to malnutrition during fetal development brought on by a malnourished mother. The definition of stunting according to the World Health Organization (WHO) is for the "height-for-age" value to be less than two standard deviations of the median of WHO Child Growth Standards. Stunted growth is usually associated with poverty, unsanitary environmental conditions, maternal undernutrition, frequent illness, and/or inappropriate feeding practice and care during early years of life.
Community-led total sanitation (CLTS) is an approach used mainly in developing countries to improve sanitation and hygiene practices in a community. The approach tries to achieve behavior change in mainly rural people by a process of "triggering", leading to spontaneous and long-term abandonment of open defecation practices. It focuses on spontaneous and long-lasting behavior change of an entire community. The term "triggering" is central to the CLTS process: It refers to ways of igniting community interest in ending open defecation, usually by building simple toilets, such as pit latrines. CLTS involves actions leading to increased self-respect and pride in one's community. It also involves shame and disgust about one's own open defecation behaviors. CLTS takes an approach to rural sanitation that works without hardware subsidies and that facilitates communities to recognize the problem of open defecation and take collective action to clean up and become "open defecation free".
Water supply and sanitation in Indonesia is characterized by poor levels of access and service quality. More than 16 million people lack access to an at least basic water source and almost 33 million of the country's 275 million population has no access to at least basic sanitation. Only about 2% of people have access to sewerage in urban areas; this is one of the lowest in the world among middle-income countries. Water pollution is widespread on Bali and Java. Women in Jakarta report spending US$11 per month on boiling water, implying a significant burden for the poor.
Access to water supply and sanitation in Ethiopia is amongst the lowest in Sub-Saharan Africa and the entire world. While access has increased substantially with funding from foreign aid, much still remains to be done. Some factors inhibiting the achievement of these goals are the limited capacity of water bureaus in the country's nine regions, two city administrations and water desks in the 770 districts of Ethiopia (woredas); insufficient cost recovery for proper operation and maintenance; and different policies and procedures used by various donors, notwithstanding the Paris Declaration on Aid Effectiveness.
iDE, formerly International Development Enterprises, is an international nonprofit organization that promotes a business approach to increasing income and creating livelihood opportunities for poor rural households. iDE was founded in 1982 by Paul Polak, a Denver, Colorado psychiatrist who promoted the concept of helping poor people become entrepreneurs instead of simply giving them handouts. Originally, iDE was devoted to the manufacture, marketing, and distribution of affordable, scalable micro-irrigation and low-cost water recovery systems throughout the developing world. iDE facilitates local manufacture and distribution of these products through local supply chains that sell to farmers at an affordable price which they can repay in one growing season. This strategy allows farmers to grow higher value and surplus crops, and in turn links them to high-value crop markets where they can realize profits from their higher yields. Recently, their success is in the promotion of sanitation products to decrease the practice of open defecation leading to diarrheal disease.
Water supply and sanitation in Rwanda is characterized by a clear government policy and significant donor support. In response to poor sustainability of rural water systems and poor service quality, in 2002 local government in the Northern Byumba Province contracted out service provision to the local private sector in a form of public–private partnership. Support for public-private partnerships became a government policy in 2004 and locally initiated public-private partnerships spread rapidly, covering 25% of rural water systems as of 2007.
The water supply and sanitation sector in Ghana is a sector that is in charge of the supply of healthy water and also improves the sanitation of water bodies in the country.
Drinking water supply and sanitation in Benin has been subject to considerable progress since the 1990s, in particular in rural areas, where coverage is higher than in many other African countries, and almost all development partners follow a national demand-responsive strategy, which has been adopted in 1992. New strategies to increase water supply in rural and urban areas have been adopted in 2005 and 2006. Tariffs in urban and rural areas are usually high enough to cover the costs for operation and maintenance.
Pump Aid is an international non-profit organisation that was set up in 1998. It is headquartered in London and delivers all its services in Africa, mostly in Malawi. Pump Aid is a WASH NGO and is part of a worldwide programme committed to the delivery of the UN’s Sustainable Development Goals and the total eradication of water poverty by 2030.
The culture of Rwanda is varied. Unlike many other countries in Africa, Rwanda has been a unified state since precolonial times, populated by the Banyarwanda people who share a single language and cultural heritage. Eleven regular national holidays are observed throughout the year, with others occasionally inserted by the government.
WASH is an acronym that stands for "water, sanitation and hygiene". It is used widely by non-governmental organizations and aid agencies in developing countries. The purposes of providing access to WASH services include achieving public health gains, improving human dignity in the case of sanitation, implementing the human right to water and sanitation, reducing the burden of collecting drinking water for women, reducing risks of violence against women, improving education and health outcomes at schools and health facilities, and reducing water pollution. Access to WASH services is also an important component of water security. Universal, affordable and sustainable access to WASH is a key issue within international development and is the focus of the first two targets of Sustainable Development Goal 6. Targets 6.1 and 6.2 aim at equitable and accessible water and sanitation for all. In 2017, it was estimated that 2.3 billion people live without basic sanitation facilities and 844 million people live without access to safe and clean drinking water.
Africa Humanitarian Action (AHA) is a non-governmental organization that provides relief services to countries in Africa. It was founded by Dr. David Zawde in 1994 in response to the Rwandan genocide.
The Cabinet of Rwanda consists of the Prime Minister, Ministers, Ministers of State and other members nominated by the President. Members of Cabinet are selected from political organisations based on the number of seats they hold in the Chamber of Deputies, but members of Cabinet cannot themselves belong to the Chamber.
Water supply and sanitation in Zimbabwe is defined by many small scale successful programs but also by a general lack of improved water and sanitation systems for the majority of Zimbabwe. According to the World Health Organization in 2012, 80% of Zimbabweans had access to improved, i.e. clean, drinking-water sources, and only 40% of Zimbabweans had access to improved sanitation facilities. Access to improved water supply and sanitation is distinctly less in rural areas. There are many factors which continue to determine the nature, for the foreseeable future, of water supply and sanitation in Zimbabwe. Three major factors are the severely depressed state of the Zimbabwean economy, the willingness of foreign aid organizations to build and finance infrastructure projects, and the political stability of the Zimbabwean state.
Community health clubs (CHCs) also known as community hygiene clubs are voluntary community-based organizations in Africa dedicated to improving public health through the promotion of hygiene. CHCs are formed at the village level. The concept was developed and popularized by Africa AHEAD, a Zimbabwe NGO.
The Kigali Declaration on Neglected Tropical Diseases is a global health project that aims to mobilise political and financial resources for the control and eradication of infectious diseases, the so-called neglected tropical diseases due to different parasitic infections. Launched by the Uniting to Combat Neglected Tropical Diseases on 27 January 2022, it was the culmination and join commitment declared at the Kigali Summit on Malaria and Neglected Tropical Diseases (NTDs) hosted by the Government of Rwanda at its capital city Kigali on 23 June 2022.
