This is the first generation of AMREF case studies. It is a first attempt aimed at documenting evidence of success, challenges and lessons learnt arising from AMREF’s interventions in health development in Africa. We have embarked on a journey to create tools to inform policy and practice by generating credible evidence aimed at providing solutions to community health policy and systems problems.
These case studies provide an empirical inquiry that investigates AMREF’s attempts to generate rigorously vetted knowledge that will support intended changes to policy and practice.They chronicle AMREF’s efforts in working closely with local populations to bridge the gap between health systems and the communities. For example, the case study on traditional health practitioners in South Africa illustrates how the capacity of the healers is harnessed and built to respond to and better manage patients with HIV/AIDS and TB. Their integration is important and vital in preventing and mitigating the impact of these diseases in the community. The use of mother co-ordinators in the fight against malaria in Ethiopia underpins the importance of capacity building for human resources for health. That it is vital for communities to be the centre of health interventions is further evidenced in the implementation of water and sanitation programmes in northern Uganda. The case study on fighting HIV/AIDS through community-based organisations in Kenya proves that working constructively with partners can be effective in bringing about changes in health care policy and service delivery.
With these case studies, AMREF is demonstrating its commitment to establishing effective and sustainable community participation modules where communities have a decisive say in their health solutions. Since this is our maiden attempt in documenting our interventions, the quality in terms of
content, context and analysis is expected to be enhanced in subsequent editions.
Involving Communities in the Fight Against Malaria in Ethiopia
Malaria is still one of the leading causes of morbidity and mortality in developing countries. AMREF has been implementing a malaria prevention and control programme in Afar region since 2005. The main activities include training health care service providers, equipping health centres, training mother co-ordinators, distributing insecticide treated nets and sensitizing local leaders on malaria prevention and control.
As a result of this programme, the skills of over 200 health care service providers on diagnosis and treatment improved. There was a 34% increase in knowledge about transmission of malaria, 62.5% increase in ITN possession, and 48% increase in treatment seeking behaviour at community level. At
present, about 300 mother co-ordinators are in place at community level. There has also been a significant decrease in epidemic occurrences of malaria. The programme has demonstrated a reasonable and replicable model of malaria prevention and control by strengthening and linking the
different segments of health systems in pastoralist communities. View Case Study
Strengthening the Capacity of Traditional Health Practitioners to Respond to HIV/AIDS and TB in KwaZulu Natal, South Africa
South Africa is currently experiencing explosive twin pandemics of HIV/AIDS and tuberculosis (TB), with over 16% of the population infected with HIV/AIDS. Two-thirds of those with HIV/AIDS also suffer from TB due to their weakened immune systems. AMREF has been implementing a traditional health practitioners’ project whose aim is to contribute towards effective and efficient management, and integration of HIV/AIDS, STIs and TB services by traditional healers in Umkhanyakude district, KwaZulu Natal, South Africa.
This paper presents the experiences, impact and lessons of the innovative approach of working with traditional healers in HIV and TB prevention and control programmes, especially at the primary health care level. View Case Study
The CASHE Model: An Innovative Way of Implementing Decentralised Water and Sanitation Services in Uganda
Although deaths and illnesses related to poor sanitation are entirely preventable, millions of people in developing countries continue to lose their lives every year. It is estimated that 80% of the disease burden in Uganda is associated with poor sanitation while diarrhoea alone accounts for 19% of all
infant deaths. Despite the explicit commitments expressed by Uganda’s decentralisation policies, the bulk of the water and sanitation activities are still implemented directly by district authorities.
The CASHE model promotes capacity building of communities to implement their own water and sanitation services with emphasis on generating demand for sanitation and hygiene through social mobilisation by community resource persons. The result of the project activities has been cost-effective and equitable investment in sanitation and hygiene which optimizes utilisation of available community resources. It proved that community health workers when equipped with the necessary skills and knowledge can be effective in delivery of water and sanitation programmes. View Case Study
Building Community Capacity in HIV/AIDS Response: The Case of Maanisha Project in Kenya
This case study documents the experiences drawn from AMREF’s Maanisha programme in Kenya which works with various stakeholders for a co-ordinated and participatory HIV/AIDS response. The programme applies a twin approach of provision of capacity building and grant making. The study highlights the lessons learnt in contributing to a co-ordinated, harmonised, participatory and vibrant response to HIV/AIDS in Kenya. It draws a number of recommendations for future policy and practices based on the programme’s experience. View Case Study