Small Health Initiatives and Infrastructure Upgrading

Deliverables:

A community resource centre building, part of which was to be utilised as a clinic. The clinic is still functional with support from a State registered nurse who is also a Federation member. There are no doctor’s services at the moment because the doctor who was supporting the Federation is now employed full time elsewhere and so cannot make adequate time to support the Federation on the clinic initiative. The City of Harare planning department has advised the Federation on the availability of a clinic site in Crowborough and also on the possibility for the Federation to partner with the City around the establishment of a clinic at this site and make use of the Federation’s experience with the Crowborough initative. Another local doctor who is also supporting the Federation from his private Clinic has expressed willingness to technically support the Federation in terms of reflecting on the Crowborough Clinic initiative and finding possible options of scaling up.

Community capacity:

The fund is growing and has a current balance of US$44,000. Contributing members are able to access cash for treatment fees. At their annual forum in January 2015, the Harare Federation resolved to pursue the idea of using their Health fund to kick start the establishment a medical aid scheme for poor communities after doing a research around this idea.

Exchanges around health issues have also been strengthened through this project resulting in increased contact and interaction on health issues between Federation groups in different areas and regions resulting in the creation of platforms for cross pollination of ideas.

Scale:

The project has helped to strengthen HIV/AIDS awareness and education initiatives in all the regions. The Health component is now taken as one of the key vetting criteria by the Federation. This pushes all members to participate in health programmes and activities thereby benefiting through the improvement of their health status. All Federation groups have to save for health, which is also another positive outcome as Federation members get to prioritise their healthcare. All Federation groups also have a health representative who is responsible for making sure that health issues are taken on board starting at group level. This component is also found at all the levels of the Health structure and recently the Federation introduced it at the National level where they now have a National Health structure that is responsible for strategising on health issues at a national level. The project has also helped strengthen all these initiatives. There has been a noticeable improvement in the health status of the Federation, which includes a reduction in HIV/AIDS prevalence. Herbal therapy is also another initiative that has been strengthened through this project resulting in the provision of an alternative to costly health medication for the Federation and other poor communities.

The project helped to trigger the training of the Federation and other poor communities on different health aspects and issues thereby improving their capacity to manage and deal with health challenges at the local level. This training has also resulted in the creation of linkages with other organisations.

With respect to the project's impact at a national level, the Kariba Federation in Mashonaland West launched its own community herbal clinic in September 2011 after learning from the Crowborough initiative. As of June 2014 a number of off-shoots had been established. These include: 

Harare Health Fund: The fund is growing. Contributing members are able to access cash for treatment fees. There are challenges however around issues of making sure that all contributing members are able to equitably access support from the fund. There is need for more technical skills around issues of assessing requests for financial support from the fund. There are suggestions to engage some health insurance companies to find out if they can assist the Federation on the issue of a health insurance. This option could help the Federation get around the issues of managing the health fund and ensuring equitable access by all contributing members.The Harare Federation has so far made a repayment of US$1,800.00 towards their UPFI loan of US$20,000.00. This was passed on to the Kariba Federation to help them kick start their community herbal clinic.

Replication of Health Initiative:There are some other federation areas that are replicating the Harare Health Initiative and have made progress on some activities. These areas are: 

(i) Gwanda: The Gwanda town Federation areas have started health savings with the aim of establishing a Network Health Fund. Currently the total health savings for all the areas is US$ 8,000.00 in total. A maximum of US$50.00 is given per member for treatment fees.

(ii) Kariba: Kariba has established an area health fund, which is accessible to all the contributing members from savings schemes around Kariba town. The fund has a total of US$6,950.00 of which US$5,750.00 has been used for assisting beneficiaries with treatment fees and US$1,200.00 is cash in the bank account.  

The Kariba Federation has started a community herbal clinic, which is serving both Federation and non-Federation members in the town. The clinic is manned by Federation members who have been trained in herbal medicine by various organisations such as River of Life in Harare, Eden Herbal Clinic as well as the Federation members who are managing the Crowborough Clinic. The Harare Federation managed to give Kariba US$1,800.00, which has been used to establish the Kariba clinic as part of its UPFI loan repayment. They used some of the money to renovate their resource centre so that they can use part of it as their herbal clinic. The rest of the money was used to purchase equipment for the clinic, which includes furniture and a fridge. The Kariba Federation has a thriving herbal garden from which they get herbs for the herbal medicine used to treat patients.

Impact:

The Federation has given input to the ongoing review of the Public Health Act, pointing out how the Act might better address issues of public health, housing, water & sanitation amongst the urban poor. Their input emphasized the role played by poor communities and how they can be included as equal partners and not just passive beneficiaries of services. 

The Federation has been able to register its herbal medicine operations with the Ministry of Health and Child Welfare. The next step is obtaining an operating license for the mobile clinic from the City of Harare which should take place by mid July 2011, after completion of the refurbishment of the mobile clinic vehicle. The home based care programme is expected to encourage further interactions with local authority clinics for the provision of efficient service at community level. Negotiations with local authorities for land to establish herbal gardens in Harare have also begun as a result of this project.

SDI Contributions:

SDI contributed US$20,000.00

Resources Leveraged:

The medical doctor who is working with the Federation was giving a subsidised service to the Federation and the community at large in the form of her medical expertise and training services. River of Life Church is also giving subsidised training in home-based care to the community and the Eden Village Clinic in Mhangura is assisting the Federation with the establishment and management of community herbal clinics.