aihd annual report 2010

AFRICAN INSTITUTE FOR HEALTH & DEVELOPMENT. 2nd Floor Wood Avenue Court, Wood Avenue, P.O. Box 4525900100, Nairobi. Tel: +25420387 3385, Fax: +25420 3873385.

Website: www.aihdint.org, Email: [email protected] AFRICAN INSTITUTE FOR HEALTH & DEVELOPMENT

‘Working with communities for better lives through evidence-based programming”

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2010

Better health for all people

Our commitment

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ACRONYMS AND ABBREVIATIONS

AGM Annual General MeetingAIDS Acquired Immuno-Deficiency SyndromeAIHD African Institute for Health & DevelopmentAPOC African Programme for Onchocerciasis Control ARVs Anti-RetroviralsCAP Community Action ProjectCBMS Community Based Monitoring SystemsCDC Centres for Disease Control and PreventionCNCD-Africa Consortium for Non-Communicable Diseases Prevention and Control in Sub-Saharan AfricaCRS Community Social ResponsibilityCSOs Civil Society OrganizationsDHP Division of Health Promotion DNCD Division of NCDs ED Executive DirectorEPRI Economic Policy Research Institute GFC Global Financial CrisisGoK Government of KenyaHIV Human Immuno-Deficiency VirusHSS Health Systems Strengthening projectICC Intersectoral Consultation Committees IUHPE International Union for Health Promotion and Education KEMRI Kenya Medical Research Institute KIDEP Kimilili Integrated Development Education Programme KNBS Kenyan National Bureau of Statistics KRC Korogocho Resident CommitteeLPMS Local Poverty Monitoring SystemM&E Monitoring and Evaluation

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MDGs Millennium Development GoalsMoPHS Ministry of Public Health and SanitationMPHIL Masters Degree in Health Promotion MSPNDV 2030 Ministry of State for Planning, National Development and Vision 2030MTCBO Mitumba Trust Community Based organization NCDs Non-Communicable DiseasesNEMA National Environment Management AuthorityPEP Poverty and Economic PolicyPHASE Personal Hygiene and Sanitation EducationPMTCT Prevention of Mother to Child TransmissionSCB Standard Chartered BankT2TK Trash to Treasures KenyaToT Training of Trainers TWG Technical Working Group UNDP United Nations Development Programme UoN University of NairobiVSL Voluntary Savings and LoanWHO World Health Organization

AIHD MISSION STATEMENTEmpowering communities for better lives

OUR VISIONTo be a lead agency dedicated to the improvement of people’s health and

social well-being

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TABLE OF CONTENTS

ACRONYMS AND ABBREVIATIONS 3

TABLE OF CONTENTS 5

CHAIRMAN’S MESSAGE 6

EXECUTIVE DIRECTOR’S MESSAGE 8

BACKGROUND 11

Objectives 11

PROGRAMMES AND ACTIVITIES 15

1. Community-Based Monitoring System (CBMS) 15

a) Local Poverty Monitoring System (LPMS) Tana River 16

b) CBMS for Local Authorities 18

2. Non-Communicable Diseases (NCDs) Programme 20

The Rising Threat of NCDs 20

Formation of the NCD Expert, Partner Groups and the Consortium 20

CNCD-Africa Website and Pre-launch Highlights 22

Participation in NCD Meetings 23

CNCD-Africa Official Launch in Geneva 23

Documentation 24

3. Working with the Urban Poor in Mitumba Informal Settlement 24

4. The Community Action Project (CAP) 25

5. Trash to Treasures Kenya (T2TK) 26

6. Women and Children’s Health and Livelihood Project 29

Seed Funding 29

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7. Prevention of Crime and Violence 30

8. Social Protection Programme 30

9. Maiuni Water and Sanitation Project 30

The Process 31

10. Social Benefits of Onchocerciasis Study 32

11. Health Systems Strengthening Study 33

12. Internship Programme 33

OUR PARTNERS 37

OTHER ACTIVITIES 39

Strategic Plan Launch 39

AIHD’s Website Launch 39

Technical Assistance 39

Staff Development 40

AIHD in the Media and Other News 40

FINANCIAL REPORT 42

Financial Statements for the Year 2010 42

Annual Expenditure by Activity 2009/2010 44

Regions of Expenditure 2009/2010 44

Annual Expenditure 2004 - 2010 44

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CHAIRMAN’S MESSAGE

The African Institute for Health & Development (AIHD) is a learning organization with a constant quest for new knowledge and the development of viable partnerships and networks to promote its mission. The lessons of yesterday and the opportunities of today are constantly channelled into new programme ideas intended to improve lives of vulnerable communities in Africa.

The development of this Annual Report, the first in the organization’s history, is a clear testimony of its ambition to actively document and learn from the lessons of the past. In 2004 when AIHD was initiated, many doubted it would become the large and vibrant organization that it has become. In its infancy, AIHD leadership and the Board promoted partnerships and research as practical approaches to learning, growth and positioning itself in the highly competitive development environment it operated in. AIHD has weathered the storms of harsh operating environments and emerged as one of the most effective development organizations, implementing cutting-edge work that has truly transformed communities in Eastern Africa.

Today AIHD is supporting development programmes in health, poverty reduction,

Dr. Samson Radeny

policy development and governance. At the same time, the organization continues to invest in knowledge management through research and utilization of new knowledge to support change processes. The work of AIHD has not only transformed communities, but more importantly changed individuals and households. AIHD is changing health conditions and creating livelihoods for communities in Eastern Africa through simple and innovative technologies. Whether it is training on hygiene & sanitation, addressing non-communicable diseases (NCDs), supporting policy reform or creating livelihoods, the reverberating effects of AIHD’s work is empowering individuals and communities to use their skills and talents to improve their conditions. The plastic recycling initiative uses simple but appropriate technology to preserve the environment while creating and sustaining livelihoods for hundreds of vulnerable families. Neighbourhoods that were once littered with plastic bags dumped carelessly from homes have become cleaner and members more conscious of sanitation hygiene in their environment. Mothers that once locked up their young children in homes while they went to search for work no longer have to live with the dread of coming home to find their children missing, starved, defiled or burned to death.

Dr. Samson Radeny

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In 2010, AIHD continued to partner with various local and international organizations to promote health of most vulnerable communities. The work with and through the Government of Kenya is a clear example of how partnership with the government can quickly transform lives of communities. AIHD’s vision in the next coming years is to broaden this partnership to include other areas of need in the country. Collaboration with other development as well as bilateral agencies such as the International Union for Health Promotion and Education (IUHPE), World Health Organization (WHO) and the World Bank, among others, has placed AIHD at the centre stage of international development. Through these existing partnerships new initiatives and networks were established to bolster the organization’s work. Many of these new initiatives will continue into the next

fiscal year as AIHD leadership endeavours to broaden its scope while developing integrated programmes with local communities.

The leadership and Board of AIHD greatly acknowledge the support of development partners and communities that have contributed to its success in the past seven years. Though this is a 2010 Report, it manifests the successes of the previous years and confirms that the achievements of 2010 would not have been possible without the active engagement of our development partners. The guidance of the AIHD Board and the relentless efforts of the staff have combined to create an amazing renewable source of energy that will continue to fuel the engine of this organization for years to come. Thank you for your priceless contributions.

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It gives me great pleasure to be part of the production of this 2010 Annual Report. This is the first report for the Institute since it was established in June 2004. Its production confirms that the Institute has come a long way in delivering on the promises of the Founder members. When Dr. Kaendi Munguti, Dr. Lynet Okeng’o, Prof. Isaac Nyamongo and I sat together one evening in April 2004, to conceive the idea of establishing a non-governmental organization, little did we know that we would see so much growth within such a short time. Stories abound of institutions that start with so much promise but fizzle out due to real challenges of financing and staffing.

AIHD has benefitted a lot from the support of partners who have stood by it since the very beginning. It remains indepted to many development partners including the IUHPE, Centers for Disease Control and Prevention (CDC) Atlanta, World Bank, Community-Based Monitoring System (CBMS) Network, WHO among others. Specific individuals have also walked with AIHD hand in hand. I would like to make a special mention of Marie-Claude Lamarre, Richard Bayles and Paul Francis for their encouragement over the years.

EXECUTIVE DIRECTOR’S MESSAGE

The Board of Directors has provided strategic leadership to the Institute and continues to do so despite their busy schedules. Our collaborators in the scientific world have continued to partner with us in ideas and proposal writing. Without these individuals who have volunteered their time and resources, AIHD would not have survived this far.

The communities we work with in Kenya, including Mitumba, Korogocho, Maiuni, Tana River, Murang’a, Kilifi, Kisumu, Bungoma, Kakamega and Busia, have been great partners. I extend a special gratitude to all of them for their continued support and contribution to making better lives a reality. AIHD will remain committed to working with communities for better health through evidence-based programming. It will continue to nurture current and new partnerships towards the fulfilment of its objectives. The Strategic Plan 2010-2015 will provide the framework for our activities in the next four years and we hope to provide feedback to you, our partners, on our activities as they evolve.

Our collaboration with the Government of Kenya (GoK) through the Ministry of State for

Dr. Mary Amuyunzu-Nyamongo

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Planning, National Development and Vision 2030 (MSPNDV 2030) and the Ministry of Public Health and Sanitation (MoPHS) confirms our commitment to sustainable interventions. We do hope to expand our collaboration with governments in the region, in the areas of technical assistance and programme implementation.

This report, although focused on the activities of 2010, is a culmination of work, the efforts and commitment of dedicated staff since 2004.

The social determinants activities, community-based monitoring systems, NCD interventions, social protection, crime and violence prevention - are but a few examples of our progressive engagement with communities.

I hope you will find this report insightful and that you will create time and space to support our activities with the aim of improving the lives and well-being of communities in Kenya and beyond.

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AIHD is a Non-Governmental Organization (NGO), established and registered with the NGOs Board in June 2004 in Nairobi, Kenya, by a group of African researchers and academicians. The Institute’s main focus is to work with communities for better lives through evidence-based programming, conducting research, training and advocacy on health and development issues that are contextually relevant to Kenya and to other African countries. The Institute is involved in policy dialogue and formulation on key development issues including HIV/AIDS, poverty alleviation, gender, child health, nutrition, malaria, non-communicable diseases (NCDs), social protection and health promotion. The Institute implements its activities in partnership with local, national, regional and international partners.

The institute’s 2010-2015 Strategic Plan was launched in Nairobi, Kenya in August 2010. It lays out the blueprint for programming for the Institute.

ObjectivesAs an institution, we seek to meet the following objectives through our various programme areas:

• Empowercommunitiestodevelopsustainable home-grown solutions to their health and development;

• Bridgethegapbetweenresearchandprogramming;

• Buildthecapacityofyoungpeopletoengage in community development; and

• Engageintheformulationandimplementation of health and development policies.

The AIHD is guided by the following core values and principles:• Excellence and Professionalism:

Committed to do all we can in the best way possible while maintaining the highest standards.

• Integrity: Committed to working with honesty and trust as the pillars of integrity.

• Commitment: Deliberate about serving the community with passion and diligence.

• Respect: Committed to being respectful of others and to resources available to us, being prudent with all we have.

• Team spirit: Committed to fostering team spirit within AIHD and with all our stakeholders.

• Service: Committed to serve others in humility, exuding friendliness, courtesy,

BACKGROUND

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sensitivity to diversity, open-mindedness and love.

• Accountability: Prudence in the use of institutional resources.

Looking Ahead

Over the next five years, AIHD will focus on three main programme areas:

1. Facilitate health improvement through health promotion interventions - the Institute intends to use the health promotion approach to address factors that determine health with a focus on NCDs, water and sanitation and some key

communicable diseases, including HIV/AIDS, malaria and tuberculosis;

2. Social empowerment of communities through evidence-based programming - to meet the health needs and influence stakeholders’ input at the community level with a focus on CBMS, crime and violence prevention, social protection and income generation (recycling); and

3. Strengthen capacity building at programmatic levels - ensuring the availability of human capacity through offering internships for young professionals, exchange visits and conducting strategic training seminars and workshops.

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Over the last seven years, AIHD has implemented a range of programmes that have helped shape its current focus. This being the first Annual Report, we have attempted to provide background information on the projects/programmes and their current status for better understanding.

1. Community-Based Monitoring System (CBMS)

Community-Based Monitoring System (CBMS) is a tool that provides policy makers and programme implementers with a sound

PROGRAMMES AND ACTIVITIES

The CBMS Network in particular supports the development and institutionalization of systems for monitoring poverty at the local level while empowering communities to participate in the development process.

www.pep-net.org

information base for tracking the impacts of macroeconomic reforms and various policy shocks. It is an organized way of collecting information at the local level for use by local government units, national government agencies, non-governmental organizations (NGOs), civil society organizations (CSOs) and development partners for planning, programme implementation and monitoring.

CBMS builds and strengthens the capacity of planners and programme implementers at the national and local levels for an improved and transparent system of resource allocation and governance.

AIHD has been implementing CBMS activities since 2007 with the technical and financial support of the CBMS Network and the Ministry of State for Planning, National Development and Vision 2030 (MSPNDV 2030). CBMS is implemented in Tana River County, Murang’a, Kisumu and Kilifi Local Authorities. The main aim of CBMS is to empower communities to plan, implement, monitor and evaluate poverty alleviation initiatives. In so doing, there are other corollary benefits including building the capacities of local government units, increasing gender equity, and eliciting early warning signs of crises.

Ms. Alice Sereti Ms. Alice Sereti

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a) Local Poverty Monitoring System (LPMS) Tana River

In Tana River county, factors such as drought, changes in climatic conditions, changing livelihoods and ethnic conflicts have contributed to high poverty levels. Ethnic conflicts in the county can be traced back to pre-independence days, and continue to contribute to low socio-economic

Figure 1: The CBMS Process. Source: www.pep-net.org

development. Health indicators, trends and data are hard to collect, let alone monitor. It is against this background that LPMS was piloted in selected sub-locations in Tana River county. The GoK ranked the county 40 out of the 45 poorest counties in Kenya in 2005. Almost four-fifths (72%) of the total population live below the poverty line according to the district’s strategic plan 2005-2010.

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Figure 1: Map of Tana River District. Source: GoK

Sights of Tana River District- Source: AIHD

Locals of Tarasaa sub location are without water after River Tana changed its course.

Most children in Walesorea do not go school.

Locals taking part during seasonal calendar in Laini.

The locals of Tarassa trying stop the River from changing its course.

Figure 1: Map of Tana River District. Source: GoK

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Through the LPMS, AIHD has collected two data sets that have highlighted the major constraints to socio-economic development in Tana River. These include historical marginalization of the region, frequent droughts and ethnic conflict.

b) CBMS for Local AuthoritiesIn collaboration with the Ministry of State for Planning, National Development and Vision 2030, AIHD initiated several CBMS activities in the country:• Piloted CBMS in three Local Authorities

(Las) namelythe pilot study covered 7925 households distributed in the three Las as follows:• Murang’a–2286• Kisumu–2990and• Kilifi–2649.Thefullreportisavailablein

the AIHD website (www.aihdint.org).

• Conducted the 1st CBMS nationalconference in 2009, through the support of the Finnish Embassy and the United Nations Development Programme (UNDP);

• Hosted the 1st Training of Trainers (ToT)from April 19 to 25, 2010 in Nairobi, Kenya as further elaborated below.

Training of Trainers (ToT) - A Key Achievement in 2010 for CBMSA total of thirty (30) participants drawn from the central government, local authorities and civil society organizations (CSOs) underwent a one-week in-house training in the following areas: the CBMS concept; qualitative and quantitative data collection processes; data management and analysis; poverty mapping; and building a CBMS database.

A group photo during the TOT Workshop in Karen, Nairobi

A group photo during the TOT Workshop in Karen, Nairobi

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In evaluating the training, the participants observed that CBMS tool could be used for planning at the different devolved levels. They however indicated the need for further training in data processing, analysis, presentation and poverty mapping. Following this training, a CBMS ToT manual has been developed.

Global Financial Crisis (GFC) StudyAs part of our CBMS activities, AIHD participated in a seven-country study to assess the impacts

A group photo during the (PEP) Research Network Conference Pullman Hotel, Dakar, Senegal (June 2010)

of the GFC on local communities. The survey was conducted in four sites: Tana River; Murang’a; Kilifi; and Kisumu. The channels explored for the impact of GFC included export market, remittance and local employment. The results of this study were presented by the project team during the 8th Poverty and Economic Policy (PEP) Network conference in Dakar, Senegal in June 2010. The preliminary report is available at www.pep-net.org.

A group photo during the (PEP) Research Network Conference Pullman Hotel, Dakar, Senegal (June 2010)

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2. Non-Communicable Diseases (NCDs) Programme

The face of CNCD-Africa: A future filled with optimism and hope

The Rising Threat of NCDs NCDs are diseases that are not contagious. Majority of these diseases are as a result of lifestyle choices such as lack of exercise, lack of a proper diet, smoking, excessive consumption of alcohol and substance abuse. Exposure to some environmental chemicals from industrial wastes, agricultural chemicals (such as heavy metals, persistent organic pollutants, expired or unused chemicals) can also lead to NCDs. This programme area has been the focus for AIHD since 2006. Recognizing the increasing importance of lifestyle-related NCDs in sub-Saharan Africa including heart disease, stroke, cancer, diabetes, and chronic respiratory diseases, the Department of Health, UK, and CDC-Atlanta, funded the International Union for Health Promotion and Education (IUHPE) and the African Institute for Health & Development (AIHD) to initiate and facilitate a process of supporting countries in the region to help advocate and maximize their efforts for NCD prevention and control. As part of

The face of CNCD-Africa: A future filled with optimism and hope

this process, an NCD Prevention and Health Promotion Advocacy Meeting was held in Bagamoyo, Tanzania in August 2008.

Formation of the NCD Expert, Partner Groups and the ConsortiumThe Bagamoyo meeting was followed by the establishment of NCD Expert and Partner Groups, which met in July 2009 in Entebbe, Uganda to ratify the need for a platform for engaging different actors on the NCD agenda. The Entebbe meeting led to the establishment of the Consortium for NCD Prevention and Control in sub-Saharan Africa (CNCD-Africa) in 2009. The Consortium is hosted by AIHD.

In 2010, the Consortium’s activities included the: recruitment of the secretary, Mr. Jared O. Owuor (pictured); setting up the office; purchase of equipment and general administration. One of the key mandates of the Secretariat was the recruitment of members, awareness creation and coordination of member activities through

Mr. Jared O. Owuor

Mr. Jared O. Owuor

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the CNCD-Africa platform. This involved consultations with potential partners on membership issues and by end of 2010, 23 members from across the continent had joined the Consortium.

Promotion of CNCD-Africa among potential members became a central mechanism for recruiting members. Priority was given to organizations and institutions working with NCDs in sub-Saharan Africa.

Figure 1: Snap shot of CNCD-Africa membership by December 2010

Figure 2: Snap shot of CNCD-Africa membership by December 2010

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CNCD-Africa Website and Pre-launch HighlightsA web-designer was engaged in establishing a website for CNCD-Africa. The tasks included web design; domain name registration; hosting plans; and an electronic database system. This was achieved by integrating both websites [AIHD & CNCD-Africa] to make the backbone a dynamic, interactive and database driven website that would support many platforms, being tailored for growth by allowing easy updates as the organization expands. The web portal can be found at www.aihdint.org/cncd.

At the local level, continued advocacy and collaboration with WHO-Kenya and the NCD Division, the Ministry of Public Health and

Sanitation led to the hosting of a one day national workshop. The workshop, titled the “Inaugural National NCD Stakeholder’s workshop”, was held in July 2010 at the Lenana Mount Hotel in Nairobi. It brought together over 60 participants representing different professional associations, government departments, CSOs, hospitals, universities and research institutions.

Following these and other related developments, CNCD-Africa leadership has been incorporated into the national Intersectoral Consultation Committees (ICCs) coordinated by the Division of Health Promotion (DHP) and the Division of NCDs (DNCD), MoPHS. It also serves on the Technical Working Group (TWG) of the DHP.

Participants during the Inaugural National NCD Stakeholder’s workshop

Participants during the Inaugural National NCD Stakeholder’s workshop

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Participation in NCD meetingsThe secretary, Mr. Owuor, made a presentation during the Africa Heart Network’s workshop held at the World Cardiology Congress in Beijing, China in June 2010.

Dr. Amuyunzu-Nyamongo attended the Diabetes Leadership Forum Africa in Johannesburg, Republic of South Africa on September 30 and October 01, 2010. The meeting attracted more than 260 delegates from 32 sub-Saharan African countries. The two-day Forum highlighted the urgent need to address the rapidly growing burden of diabetes and other NCDs in sub-Saharan Africa and the developing world, and was attended by government officials, including ten Health Ministers or mandated representatives, international organisations, patient associations, businesses, NGOs and healthcare

professionals. This forum led to an African diabetes leadership forum call for activism around non-communicable diseases.

CNCD-Africa Official Launch in Geneva Perhaps one of the most significant achievements of the project was the participation in IUHPE Conference in July 2010 in Geneva, Switzerland and the subsequent launch of the Consortium during a workshop entitled “Non-Communicable Diseases in Africa and other developing countries: Integrating a Health Promotion approach to NCD prevention and control.” The workshop had an international panel of experts and the ceremony was officiated by the then President of the IUHPE and Director of the Chronic Diseases Division, CDC-Atlanta, Dr. David Mc’Queen.

Participants follow proceedings during the Geneva workshop and subsequent launch of CNCD-Africa

Participants follow proceedings during the Geneva workshop and subsequent launch of CNCD-Africa

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Documentation CNCD-Africa has been leading in the conceptualization, drafting and publication of several documents including newsletters:1. The CNCD-Africa’s founding document;2. Mapping of status of NCDs policies in

sub-Saharan Africa: Discussion paper (16 countries have been assessed so far);

3. NCD Policies in Africa; 4. NCDs in Africa: a Position Paper; 5. 2 Newsletters and brochures; and6. Web-based database of members’ activities.

3. Working with the Urban Poor in Mitumba Informal Settlement

Mitumba is an informal settlement located in Nairobi’s South C area. Mitumba is a Kiswahili

word meaning “second hand goods”. AIHD has been collaborating with the community since January 2006. Over the years, the Institute has partnered with the community through the Mitumba Trust Community Based Organization (MTCBO) which it helped establish in the year 2007. The MTCBO has acted as an umbrella for the Community Actions, thus the partnership has led to the establishment of:

• A home based day-care centre for youngchildren of working mothers;

• Sanitation project – a ten door ablutionblock;

• Environmentalcleanlinessactivities;• TrashtoTreasures(T2T-K)project;and• Recycling of plastic bags through the

groups: Jitegemee, Hamza and Dandora.

The home-based day-care centre provides a place for the mothers to leave their young children (aged 12-36 months) when they go out job-hunting. The centre is a community initiative, managed and run by a mother selected by the community. The mother has been trained and continues to receive instructions on nutrition, child nurturing and child health.

Other activities have included the construction of an ablution block and support towards community cleanliness. Young people have been empowered and supported to spearhead the clean-up activities.

Activities at the home-based day-care centre

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4. The Community Action Project (CAP)

Reusing Plastic Bags for Health and DevelopmentThis is an action research project, which entails collecting non-biodegradable plastic bags from Dandora dump site and turning them

into laundry bags, shopping baskets, trash baskets, etc. The Institute, in partnership with community members, initiated the project in 2009. So far over 30 women have been trained in Mitumba in the art of crocheting using recycled plastic bags. The products have been sold in various trade fairs in Nairobi and through partners in markets outside Kenya.

Dandora waste dump site

The bags are aired to dry

The bags been washed and disinfected

Some of the visitors to CAP

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Growing Interest and More Partnership BuildingThe American Women’s Association (AWA) has been a key supporter of this programme. It provided a water tank and a sewing machine for use by the women in Mitumba. In addition, AWA has been instrumental in marketing the products made by the group to local and external markets.

Due to increased interest in the products, in 2010 training sessions were held with other interested groups: Kibera Group; Salvation Army- Hamsa; Lang’ata Women’s Prison; and Hawkers Market, Parklands. The project initiated collaboration with Rusinga School and Braeburn Schools, as a way of teaching the children the value of recycling and caring for the environment.

An exchange visit to Kasikeu (Dorcas Beads) was undertaken in October 2010 to share and learn ideas on how to make beads from paper and other locally available reusable materials to enhance the value of their products.

5. Trash to Treasures Kenya (T2TK)

A partnership of community-based self-help groups have partnered to clean the environment and turn reusable trash in the form of plastic bags, newspapers and magazines into creative saleable products. The partnership is made up of the Salvation Army Hamsa, Lang’ata women’s prison, and Hawkers

Partners on a site visit

Market Parklands. The groups produced a range of products that include:

• Plasticbags:thesearecrochetedintoitemsof diverse use such as waste baskets, school pencil pouches, clutch bags, floor mats, shopping bags and tabletop baskets and laundry bags;

• Magazines: used for making paper beadsas jewelry and for decorating the plastic products;

• Newspapers:usedtomakepencilsthatarevery popular with schools.

Although the products produced by the women are of high quality, the groups need support with access to materials and further training to improve on their innovations. There is need for enhanced partnerships with schools, workplaces, hotels and supermarkets as sources of raw materials and product outlets.

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Lucy Maina (pictured) is 39 year old, married and mother of three children (pictured on the right). She lives in Mitumba and used to offer domestic services including washing clothes in the middle class estate as her main source of income. The earnings from this process were meagre and could not sustain her and the family. She joined Juala Tujitegemee Women’s group in 2009 and learnt how to crotchet using recycled plastic bags. Through this project, Lucy says that she has been able to pay fees for her children and she no longer experiences the financial anxiety she used to live with in the past.

“We have an account with Trash to Treasures, whereby 40% of the earnings from the goods sold is used for fare, to buy disinfectants and for running the day to day activities of the group,” says Lucy. “We also have an account known as Voluntary Savings and Loan (VSL), whereby every member contributes Sh. 200 bi-weekly. Members are allowed to borrow up to Sh. 10,000. All loans are repaid with 10% interest. ”

“Learning how to crotchet is easy, what matters is how often one practices and being creativite in terms of new ideas. Being in this group has accorded me with certain advantages for example, I have easy access to loans and I can always provide social and financial support to my fellow members,” She reported.

Mrs. Lucy Maina

Lucy hopes that people can be made aware of their efforts and the important role they are playing in environmental cleanliness. She hopes that through such recognition, groups such as the National Environment Management Authority (NEMA), would appreciate and

support such efforts. There is need to expand the programme activities to include other poor women who could benefit from reusing trash. She considers the project a sure way out of poverty.

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Some of the products from re-used plastic bags

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6. Women and Children’s Health and Livelihood Project

The Lavender Foundation and Donner Foundation of the USA funded this project. The main aim was to support households affected by Post-Election Violence (PEV) as a result of the disputed presidential elections of 2007. The project, implemented in Bungoma, Busia and Kakamega in Western Province extended support with access to healthcare and livelihood. AIHD partnered with Kimilili Integrated Development Education Programme (KIDEP) in the implementation of the project. A baseline survey conducted at the beginning of the project established that women had borne the brunt of the violence in various ways:

1. Loss of lives;2. Physical injury due to cuts, burns, beatings

and stoning;3. Rape, including the defilement of children;4. Loss of livelihoods - granaries had been

burnt, businesses destroyed while crops were left untended as a result of violence and evictions;

5. Loss of social capital due to deaths of spouses, offspring and siblings which left many women without critical form of financial support; and

6. Early marriage of girls due to household hardships.

Seed FundingSeed funds were given to 15 women groups in the three sites – five per county.With thefunding, the groups engaged in a variety of income generating activities including farming and petty business. Thirteen out of the 15 groups are doing well, while two collapsed mainly due to loss of capital. Out of the thirteen groups, five have done very well including:

• Vegetablefarming(Bungoma);• Hardware(Kakamega);• Cereals farmers,poultrykeepingandbrick

making (Busia).

In the health sector, there was collaboration with government district hospitals and vouchers were provided for women and children who needed health care during the 12 months of project implementation. The systems allowed the health facilities to recover the money from KIDEP. This project allowed patients on long-term treatment (e.g. ARVs) who had been lost to follow-up to restart treatment.

The Director of KIDEP at the time Ms. Sophie Kibuywa, was of great value to the project due to her mobilization and empowerment skills to local communities.

The main aim was to support households affected by Post-Election Violence (PEV) as a result of the disputed presidential elections of 2007.

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Ms. Rahel A. Oyugi

7. Prevention of Crime and Violence

AIHD is currently implementing an Action Research (AR) pilot Project on prevention of crime and violence in Korogocho informal settlement of Nairobi. This is a multi-country pilot project, funded by the World Bank in Kenya and Ivory Coast. The Kenyan component is being implemented in collaboration with the City Council of Nairobi, local administration and the communities.

In May-June 2010, Dr. Amuyunzu-Nyamongo and Ms. Oyugi (pictured) attended a workshop sponsored by the World Bank in Marseille, France. The meeting was aimed at refining and harmonizing the research protocol. The project focus is to work with communities in identifying the problems, analyzing the causes and defining priority actions. A steering committee that will bring together key stakeholders in crime and violence prevention will be constituted to guide the project activities.

The AR seeks to engage the community in a participatory way, through Monitoring and Evaluation (M&E), planning and implementation.

The Crime and violence prevention pilot project was successfully launched at the Ole Sereni Hotel, Nairobi on November 17, 2010. The occasion was also utilized to disseminate the results of a study conducted by AIHD on

behalf of the World Bank in Korogocho and Viwandani in 2008/9 on crime and violence.

8. Social Protection Programme

Designing and Implementing Social Projects in AfricaThis is a five-year course (2010 – 2014) thatseeks to effectively train policy makers. It is a collaborative project led by Economic Policy Research Institute (EPRI) in partnership with the Government of Kenya (GoK), Maastricht University, UK-Aid, and DFID. A team of international experts, skilled professionals and leaders in Social Protection deliver the course. AIHD was involved in coordinating the trainings.

The initial course was held in Sun n Sand in Mombasa, Kenya from November 21 to December 04, 2010. It brought together 31 participants from six African countries (Kenya, Uganda, Malawi, Zambia, Sudan and Ethiopia). The Minister of Gender, Children and Social Development of Kenya, Dr. Naomi Shaban, officially launched the Mombasa course.

9. Maiuni Water and Sanitation Project

The origin of Maiuni Water and Sanition project goes back to the year 2008 following a chance meeting of Dr. Mary Amuyunzu-Nyamongo

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and Richard Bayles who had spent sometime in the area as a peace corp.

The project aims at increasing access to safe water and improved sanitation to the local community. The Institute facilitated the construction of a borehole to serve about 400 households in Maiuni. The next phase is the inclusion of an income-generation component.

The ProcessBefore initiating the project Mr. Bayles, Mr. Senga and Dr. Amuyunzu-Nyamongo held a community meeting during which the community elected a committee to oversee the project activities. During this meeting, consensus was reached to drill a borehole at the AIC Kagundo Primary School compound.

The water project has seen an increased access to water to 60 households who have metered water connections into their homes. The community water points have opened access to those who are yet to install individual meters. During dry season, people come from as far as Mwala to fetch water from the water point adjacent to the school compound.

The community members have lauded the efforts of Mr. Bayles, a member of St. Bartholomew Church, New York for his philanthropic spirit. The water project has created employment opportunities in the community; water vendors, security guard at the borehole and those people in charge of

The Maiuni Community members at one of the meetings The Maiuni Community members at one of the meetings

Construction of thte Maiuni Water and Sanitation tank facility

The finished Maiuni Water and Sanitation tank facility, secured by a fence



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Some more photos of the Water project in Mauini Some more photos of the Water project in Mauini

laying the pipes have gained real time cash to meet their needs.

10. Social Benefits of Onchocerciasis Study

The African Programme for Onchocerciasis Control (APOC) funded this study. The main aim was to assess and document the social benefits of Onchocerciasis control in four endemic countries: Cameroon, Democratic Republic of Congo (DRC), Nigeria and Uganda. The purpose was to develop a tool for measuring social benefits of Onchocerciasis control and other Programmes. The study utilized various tools to collect data and involved a wide range of respondents. Perhaps the most important

contribution to science was the involvement of children in the study. The children drew and interpreted their drawings as part of the data collection process.

Three papers have been published based on the study results:

1. Where would I be without ivermectin: Capturing the Benefits of Community-Directed Treatment with Ivermectin in Africa.

2. Drawing and interpreting data: Children’s impressions of onchocerciasis and community-directed treatment with ivermectin.

3. Changes in stigma and discrimination on onchocerciasis in Africa.

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11. Health Systems Strengthening Study

The Kenyan Health Systems Strengthening (HSS) Study is part of a nine-country and 12-site study coordinated and funded by the World Health Organization, Africa Regional Office (WHO-AFRO) and the African Programme for Onchocerciasis Control (APOC). This project is motivated by the increasing recognition of the need to strengthen the health systems in order to meet the health needs of the people in Africa, who continue to experience high morbidity and mortality from both communicable and non-communicable diseases (NCDs). It is envisaged that strengthening the health service delivery capacity at the local level with greater people’s involvement could facilitate the scaling up of the already proven and cost-effective interventions towards sustainable health care while responding to priority health needs.

The Kenyan study is implemented in collaboration with the Kenya Medical Research Institute (KEMRI) and MoPHS. The Kenyan National Bureau of Statistics (KNBS) supported the project through generating the sample, providing enumeration area maps and the involvement of enumeration officers. The study was conducted in two provinces: Coast (Kilifi, Taita Taveta and Tana River counties), and in Rift Valley (Uasin Gishu, Nandi, Nakuru counties). The study sought views of community members and health care

providers who are so frequently ignored in relation to health care delivery.

12. Internship Programme

AIHD is committed to building the capacity of young people as a means of creating a generation of trained and capable professionals in health and development sector. The institute’s aim is to build the capacity of at least two interns annually.

Mr. Walter Odhiambo Olilo interned on the CBMS project. During his internship period, Walter attended several seminars. He represented the Institute in The Social Impact Analysis Forum held in Benin on October 10 to 13, 2010. The main aim of the forum was to

Mr. Walter O. Olilo Mr. Walter O. Olilo

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create a platform for exchanging experiences on with impact analysis and evidence-based policy making in Africa. While at the meeting, Mr. Odhiambo made a presentation based on the experience of CBMS in Kenya. Walter reported to have benefited from the forum through exposure and new insights from shared experiences by participants from diverse countries. The forum gave him an opportunity to develop professional links and networks internationally.

Ms. Monica W. Lutta

Monica Wabuke-Lutta worked with Health Systems Strengthening Project (HSS) among other activities. She represented the Institute in Ouagadougou, Burkina Faso in September 2010 during a researchers’ meeting to review the tools and harmonize data collection process following the pre-test period. Monica found the experience enriching and she valued the interaction she had with experienced researchers from different backgrounds and countries.

Ms. Monica W. Lutta

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AIHD has cultivated a close relationship with various national, regional and international partners in the implementation of programmes. Some of these partners have supported various programmes since 2006:

OUR PARTNERS

• AfricanMedicalandResearchFoundation(AMREF)• AfricanProgrammeforOnchocerciasisControl(APOC)• AmericanWomenAssociation(AWA)• AssociationforLocalGovernmentAuthoritiesinKenya

(ALGAK)• BartholomewBaptistChurchinNewYork,USA• CentersforDiseaseControlandPrevention(CDC),

Atlanta• Community-BasedMonitoringSystems(CBMS)Network• DepartmentforInternationalDevelopment(DFID),UK• DepartmentofHealth,UK(DOH)• DonnerFoundation• EconomicPolicyResearchInstitute(EPRI)• FamilyHealthInternational(FHI)• FinishEmbassy• InternationalCentreforResearchonWomen(ICRW)• InternationalDevelopmentandResearchCentre(IDRC)• InternationalUnionforHealthPromotionandEducation

(IUHPE)• KimililiIntegratedDevelopmentEducationProgramme

(KIDEP)• LavenderFoundation• LocalAuthoritiesofKilifi,Kisumu,Murang’aandTana

River • MinistryofPublicHealthandSanitation(MOPHS)

• MinistryofStateforPlanning,NationalDevelopmentand Vision 2030

• MitumbaTrustCommunityBasedOrganization(MTCBO)• PEPSICOFoundation• PovertyandEconomicPolicyNetwork(PEP)• RichardBayles• SwedishInternationalDevelopmentCooperation

Agency (SIDA)• SynergosInstitute• UnitedNationsChildren’sFund(UNICEF)• UnitedNationsDevelopmentFundforWomen(UNIFEM)• UnitedNationsDevelopmentProgramme(UNDP)• UnitedKingdomAgencyforInternationalDevelopment

(UK-Aid)• WorldBank• WorldHealthOrganization(WHO),Kenya,AfricaRegion

and Headquarters.• SocialDevelopmentNetwork(SODNET)• KenyaNationalBureauofStatistics(KNBS)• AfricanWomanandChildFeatureServices(AWCFS)• CSA• SUNY-Kenya• KMWA• UNMC

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Strategic Plan Launch The launch of our Strategic Plan 2010-2015 took place at the Laico regency Hotel on August 24th 2010. The Permanent Secretary of the Ministry of Gender, Children and Social Development, Dr. James Nyikal (CBS) was the guest of honor. He lauded AIHD for the launch, and remarked that it was a key milestone for the organization.

The Chairperson of MTCBO Mr. Murithi, Korogocho Area Chief, Ms. Birongo and Mr. Ndunda, an AIHD partner in Dandora on the recycling project represented the communities. Other guests at the meeting included Dr. Boniface K’Oyugi (Director, NCAPD), Dr. Wainaina Gituro (Director, Social and Political Pillars, Vision 2030), Dr. Michael Munavu (World Bank), Dr. Caroline Kisia (Action Health Help Africa), Prof. Elijah Ogola (University of Nairobi) among other distinguished guests and partners.

AIHD’s Website LaunchAIHD established a new website on November 2nd 2010, which is integrated with the CNCD-Africa website. The website is easy to navigate and provides better interactivity. Visitors are

OTHER ACTIVITIES

Guests during the launch of the strategic plan at the Laico Regency hotel Guests during the launch of the strategic plan at the Laico Regency hotel

able to contribute on the different discussion forums. In addition, they are able to join our facebook page and share their views. To visit the website visit: www.aihdint.org.

Technical AssistanceAIHD has provided consultancy services to various local and international organizations in the areas of baseline, mid-term and evaluation survey. In 2010, the institute engaged in the following consultancies:

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(1) CARE-International in Kenya: documentation of Yier Ngima PMTCT project in Siaya, Kenya. The documentation highlighted some of the innovative work undertaken to improve PMTCT service delivery and uptake in Siaya District.

(2) World Bank, Kenya: AIHD was commissioned to join the core team for the review. The review will culminate in the development of a roadmap for SP programming for Kenya (the report is expected in July/August 2011).

Staff Development Based on formal cooperation between AIHD and the University of Bergen, Norway an employee of the institute, Mr. Gabriel Owiti Oguda, was sponsored for a Masters degree in Health Promotion (MPHIL) at the University of Bergen Bergen, Norway. This is a two-year programme that will include conducting fieldwork in Kenya as part of the course.

AIHD in the Media and Other News In 2010, AIHD activities were featured in various articles in the media. (i) The launch of the crime and violence

prevention, which also served to disseminate a study conducted in Korogocho and Viwandani on the same theme, attracted various media coverage including: Kenya News Agency (KNA), Nation Media Group, Good News Broadcasting System (GBS), Kenya Today, Kenya Broadcasting Cooperation (KBC), KTN, The People Daily and Radio Maisha.

(ii) The launch of the five-year strategic plan also attracted media attention. Gender, Children and Social Development Permanent Secretary, Dr. James Nyikal who was the guest speaker was quoted in both Daily Nation and The standard Newspaper; this was in relation to his speech on health services during the launch.

(iii) In partnership with the African Woman and Child Feature Services, Dr. Amuyunzu-Nyamongo has published various articles on topical issues related to AIHD activities:1. Economic empowerment versus

violence: Women placed on a see-saw as they become financially independent (September 2010)

2. Poverty drives slum women to risky occupations (January 2011)

3. Turning post consumer plastic waste into health and wealth (March 2011)

4. Casting an eye on the social impact of free primary education (March 2011)

Corporate Social ResponsibilityEvery year, AIHD staff participates in the Standard Chartered Nairobi Marathon as part of its social responsibility. Each AIHD staff contributes Ksh. 1,000.00 for the activity. Last year the Nairobi Marathon was able to raise Kes.16.2 million up from Kes.14.5 million in 2009, through registration fee and donations. The increased contribution has enabled the organizers to expand their support for cataract, glaucoma and other trauma related surgeries in various parts of the country.

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Certificates of Merit to Dandora WomenCertificates were awarded to Dandora women on March 11th 2010, to demonstrate appreciation of their participation in the training and crocheting of plastic bags. Reusing plastic bags and other materials remains an area of interest for the Institute.

Naro Moru Staff Development Retreat The AIHD staff attended a retreat in Naromouru, Nanyuki from May 5th up to May 8th 2010. Time away from the office doing other “motivational” activities helps to strengthen relationships and team building. The retreats help employees to get to know each other at a more personal level with a view to creating harmony at work and to realign organizational aims, objectives, vision and mission to personal goals. The staff also used this opportunity to review the Human Resource manual, the draft Strategic Plan and to re-energize after the hustle and bustle of city office life. The activity was fun and full of learning experiences.

AIHD staff members at a past Standard Chartered Marathon event

A participant receives a certificate of merit

A group photo at the Naro Moru River Lodge

A group photo at the Naro Moru River Lodge

A participant receives a certificate of merit

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COMMUNITY BASED HEALTH PROMOTION CRIME & VIOLENCE

WATER & SANITATION RESEARCH & CONSULTANCY INDIRECT COSTS

9%

22%

14%

5%

16%

34%

Annual Expenditure by Activity 2009/2010

Regions of Expenditure 2009/2010

FINANCIAL REPORT

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Annual Expenditure 2004 - 2010

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AFRICAN INSTITUTE FOR HEALTH & DEVELOPMENT. 2nd Floor Wood Avenue Court, Wood Avenue, P.O. Box 4525900100, Nairobi. Tel: +25420387 3385, Fax: +25420 3873385.

Website: www.aihdint.org, Email: [email protected] AFRICAN INSTITUTE FOR HEALTH & DEVELOPMENTANNUAL REPORT

2010

Better health for all people

Our commitment

‘Working with communities for better lives through evidence-based programming”

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aihd annual report 2010

Documents