Community health club approach as a strategy to empower community action to improve hygiene and sanitation

The Community Health Club approach relies entirely on community empowerment for health and development issues. There are four major components being implemented in phases. The first component is the Knowledge Base focussing on (i) mobilising and sensitizing the community on hygiene and sanitation through participatory approaches - PHAST, (ii) organising communities into the 'club' arrangements based on voluntary basis, creating common unity and purpose of community health clubs (CHCs), (iii) conducting health/hygiene education through a card system and identifying practicable hygiene and sanitation interventions. The second component is Practical Skills Application focussing on construction of hygiene and sanitation facilities identified through the knowledge base phase and improvement of existing infrastructure and behavioural change practices. The third component is Economic Empowerment which focuses on promoting identified simple income generating activities, skills training in simple income generating activities, skills in improvement of financial management and environmental management skills / initiatives. The fourth component is the Social Activities / Initiatives which looks at literacy training, care of HIV/AIDS victims/orphans and other relevant social community identified development activities promotion. The main achievements include increased latrine coverage from 44 to 55%, well organized non-government structures (CHC), ownership of the initiatives, increase in related hygiene infrastructure, increased collaboration between district and the NGOs. Some of the lessons learnt are that (i) membership cards are powerful incentives, (ii) CHCs provide a unity of purpose, (iii) the approach encourages members to be more analytical in linking poor hygiene to poverty and try to apply acquired knowledge, (iv) strong exemplary leadership in CHC members is crucial, (v) use of demos raises a lot of interest, and (vi) by-laws cement the groups and encourage slow takers.