1. MUKAMUNANA Alphonsine
COMMUNITY BASED ENVIRONMENTAL HEALTH PROMOTION PROGRAMME (CBEHPP) IN RWANDA
MUKAMUNANA Alphonsine
Ministry of Health
TEL:

2. 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)

3. 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.
Establishment of Community Hygiene Clubs (CHCs) in all villages
Increase use of hygienic latrines in homes, schools and health facilities
Increase hand washing with soap at critical times in homes, schools and health facilities

4. SPECIFIC STRATEGIES
Increase drinking of safe water in homes, schools and health facilities
Achieve Zero Open Defecation in all villages through construction and use of improved toilets.
Improve safe disposal of children’s faeces in all households
Increase households with bath shelters, rubbish pits, pot-drying racks and clean yards

5. 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).

6. CBEHPP PARTNERSHIP CBEHPP PARTNERS MoH MIGEPROF MINECOFIN MINEDUC
Environmental Health
MINECOFIN
MIGEPROF
CBEHPP
(CHCs)
MINALOC/DISTRICT
MINEDUC
MINAGRI
PARTNERS
MININFRA
WASAC

7. 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)
CHC MEMBERS:
1-President
2- Vice President
3- Secretary
4- Vice Secretary
5- Treasurer
6- Vice Treasurer
7- HH Representatives
Cell (Social Economic Development Officer)
CHC Committee
Village (Head of village)
Village ASOC (CHC Facilitator)
CHC

8. ROADMAP FOR IMPLEMENTATION OF CBEHPP
Milestone Events
2009
2010
2011
2012 Q4
Q 1 Q2 Q3 Q1
Program Launch
Program design & advocacy.
Development of road map
Phase I Start-up
Start-up in
5 Districts /Province
Phase II Consolidate
Consolidate & add 5 new Districts
Launch of HSPI
Phase III Scale-Up
Roll-out to all remaining 22 Districts

9. CBEHPP TRAINING OF NATIONAL CORE TRAINERS
Roll out of EHO Training in 5 Districts in December 2010, and 4 other districts in 2011.
In November 2010 the core team was trained in order to scale up training

10. 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 Dialogue sessions.
Target group
Inclusive
Structured
Participatory
Group consensus
Homework
Reinforcement
Certification
Quantifying behavior change

11. KEY LESSONS LEARNED DURING CHC DIALOGUE SESSIONS AND HOMEWORK1
Introduction
Bring friends and family 2
Common Diseases
Know common diseases 3
Personal Hygiene
Family wash shelter 4
Hand washing
Handwash facility/ soap 5
Skin diseases
Children no skin diseases 6
Diarrhoea
Knowledge of SSS/ORS 7
Infant Care
Correct Immunization 8
Intestinal Parasites/Worms
Children no Worms 9
Food Hygiene
Clean Drying Rack 10
Nutrition
Good Road to Health 11
Food Security/Safety
Kitchen Garden 12
Water Sources
Clean Water Source 13
Safe Drinking Water
Safe Storage and Usage 14
Adequate Sanitation
ZOD/Clean Safe Toilets 15
The Model Home
Waste Management and Greening 16
Good Parenting
Clean Children 17
Respiratory Diseases
Good Ventilation 18
Malaria
Use of Treated Bed Nets 19
Bilharzia
Treatment for Bilharzia 20
HIV/AIDS
VCT and PMTCT

12. CHC MEMBERS IN INTERACTIVE CLUB ACTIVITIES
CHC Committee election
CHC Members during a village mapping session

13. CHC MEMBERS IN INTERACTIVE CLUB ACTIVITIES
Village WASH Mapping during a CHC session
Sanitation and hygiene Promotion Songs

14. CHC APPROACH FACILITATING LIVE DISCUSSIONS
Reinforcement: Peer pressure /home visits
Homework: Recommended Practices
Measurable: Specific Targets Each Week

15. 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

16. FAVORABLE ENVIRONMENT FOR CBEHPP
Availability of political will - all levels
Supportive DPs
Availability of qualified personnel to implement CBEHPP
CBEHPP Roadmap though a review is needed
Existence of Health Clubs in all Villages
Positive involvement of the Media.

17. 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.

18. THANK YOU FOR YOU ATTENTION