amref's annual report for year two of the katine project

1.

2 . KATINE COMMUNITY PARTNERSHIPS PROJECT

3 . ANNUAL NARRATIVE REPORT FOR YEAR TWO

O c t o b e r 2 0 0 8 - S e p t e m b e r 2 0 0 9

1 . Submitted to: The Guardian and Barc lays

Projectduration:Threeyears:October2007–September2010

Prepared by:KCPPTeam,AMREFUganda

Contact person in AMREF Uganda:JoshuaKyallo,CountryDirector,AMREFUgandaEmail:[email protected]

Contact person in AMREF UK:ClaudiaCodsi,UgandaPartnershipsManager,AMREFUKEmail:[email protected]

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Table of Contents

1 . 0

1. ......................................................................................................................................................12.KATINE COMMUNITY PARTNERSHIPS PROJECT .....................................................................13.ANNUAL NARRATIVE REPORT FOR YEAR TWO .......................................................................1

1.Submitted to: The Guardian and Barclays ..............................................................................................1

Katineisoneof17sub-countiesinSorotidistrictwiththeworstindicatorsforpovertyandunderdevelopmentcompoundedbyperiodsofcattlerustlingandinsurgency.Theprojecttakesanintegratedandcommunitybaseddevelopmentapproachandaddressesthecausesofillhealthandpoverty.Theproject’sgoalistoimprovethequalityoflifeforthepeoplelivinginKatine.Theobjectivesaimto improvecommunityhealth,access toqualityeducation,access tosafewater,hygieneandsanitationincreasedincomegeneratingopportunitiesandaimstobuildthecapacityofcommunitiestoengageinlocalgovernancetobemoreinvolvedindecisionmaking.

Amid-termreview(MTR)wasconducted inJuly2009.Thefindings,whichwerefedbacktopartners inaworkshop inSoroti highlighted that AMREF was more or less on track, however could enhance some activities to achieve itsobjectives. Anadditionalyearandmoreresourceswererecommended toembedbehaviours,handover responsibilityand exit from Katine. Recommendations were made to strengthen the community empowerment and livelihoodscomponent, increase access to water and sanitation, provide more desks, books and support to teachers, schoolmanagementcommitteesandpromoteschoolfeeding. Theimpactinhealthdependedalotoncontinuedsupporttothevillagehealthteams(VHTs),moretrainingofhealthworkersandrenovationtotheoperatingtheatreatTiririhealthcentre.ItwasalsorecommendedthatAMREFstrengthensthemanagementsupporttoprojectimplementationteam.

AMREFhastakenonboardtherecommendationsintoitsthirdyearplansandisproposingadditionalfundingtoenhanceprojectactivitieswithaspecialfocusoncommunityidentifiedpriorities.Withadditionalfunding,AMREFaimstoincreasesafewatercoveragefrom66%currentlytomeetthe85%nationaltarget.Anadditional48farmergroupswouldberolledout toachieve100%coverageacross thewholesub-county. Inschools,all childrenwouldhaveaccess todesks, textbooks, better classrooms andmanagement committees would know how tomanage and govern their schools.Workwouldcontinuetosupportvillagehealthteamsto increasehygieneandsanitationcoveragefrom39%currentlyto75%and the capacity of local government and community groups would be built to own and manage their developmentprocess. AMREF agrees that more time is need to gradually phase out from Katine and effectively hand over roles,responsibilitiesandinfrastructureoftheprojecttothecommunityandlocalgovernment. AnadditionalyearwouldallowAMREFtocaptureanddocumentlessonslearntinKatineinordertosharebestpracticewithinSorotiandadvocateforthescaleupand/orreplicationatnationallevelbygovernmentandbilateraldonorsinUganda.

As of September 2009, results show that progress is beingmade towardsmeeting the overall goal and objectives. Asummaryofkeyachievementsarehighlightedbelowwithdetailedprogressagainstplannedactivitiesinsectionof2.0ofthereport.

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In h e a l t h,theprojecthascontributedtoareductioninillness.Healthcentrereportsshowthatdiarrhoeaincidencesforchildrenbelowtheageof fivehavereducedfrom6.8%inSeptember2008to3.7%inSeptember2009. Immunisationcoverage for children against the eight killer diseases has exceeded the Government of Uganda target of 90% andincreased from89.3% in2008 to95.9% in2009.AMREF’ssupport toVillageHealthTeams(VHTs)hascontributed tothese results since VHTs refer patients to the health clinic, support health workers in community outreach healthprovision, and promote household health, hygiene and sanitation. Additionally, the project provided 2800 InsecticideTreatedbednetstothosemostvulnerabletomalaria including1000pregnantmothers,60people livingwithHIV/AIDSand1740childrenunder5yearsofage.

In e d u c a t i o n theprojecthascontributedto increasedenrolment, retentionofpupils inhigherclassesand increasedthenumberofchildrensittingandpassingPrimaryLeavingExaminations(PLE),resultinginmorechildrenbeingabletojoinsecondaryschool.Enrolmenthasincreasedsincethestartoftheprojectby17%(from7,531to9,071pupils)duetoanimprovedteachingandlearningenvironment.ThepassrateatPrimary7(lastyearinprimaryschool)improvedslightlyfrom83% to84% from2007 – 2008.Todate4,025 textbookshavebeenprocuredanddelivered to all 15 schools inKatine.Consequently,10oftheseschoolsaremeetingthedistrictandnationalstandardoftextbooktopupilratioof3:1and1:1respectively.Schoollatrinecoveragehasimprovedfrom91:1atbaselineto43:1todateinall15schools.

Access to s a f e w a t e r h a s i n c r e a s e d from 42% at the start of the project to 66% due to the drilling of newboreholes, therehabilitationandrepairofexistingboreholesandtestingofwaterquality in34watersources.Currently50.2%ofhouseholdsareabletoaccessasafewatersourceatanaveragewalkingdistanceof1.5kmfromtheirhomecompared to 2.5km at the start of the project. Sanitation coverage has increased to 39% from 7% at baseline inhouseholdsandto75%from25%atbaselineinschools.

Toachieve i m p r ove d i n c o m e g e n e r a t i n g o p po r t u n i t i e s,theprojectcontinuestosupport540farmersin18farmergroups.Todatethegroupshaveharvestedthefirstdroughtresistant,highyielding,quick-maturingcassavathatwasintroducedbytheproject.Thisharvesthashelpedthefarmerstomitigatetheeffectsoftheseveredroughtthatwasexperiencedin2009.ThegroupsalsodoubleupasVillageSavingsandLoanAssociations(VSLAs).Mostofthegroupshavecompletedtheirfirstcycleofsavings,withsomesavinguptoUsh3.4million(£1,054).ThesegroupshavesharedouttheirsavingsandprofitswithsomeindividualmembersgettingbetweenUsh50,000-300,000(£16–£93)each.

T o e m pow e r c o m m u n i t i e s t o e n g a g e i n l o c a l gove r n a n c e, the project supported parish developmentcommitteestogenerateplansbasedoncommunitypriorities.Thesehavealreadybeenintegratedintothethreeyearsub-countydevelopmentplantoenhancebetterplanningandservicedeliveryforcommunities.

Whiletherehavebeenachievements,therewerealsochallengesintheimplementationprocessandgapsstillexistthatneedtobeaddressed.Watercoverage,forexamplehasreached66%from42%atthestartoftheproject,butit isstillbelowthenational targetof85%,genderequityandparticipation insomecommunitygroups isstillachallengedue toculturalandeducationalbarriers.Challenges, lessons learntandrecommendationsarehighlighted insection1.1of thereport.

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OBJECTIVE PLANNEDACTIVITIESAND TARGETFOR THEREPORTINGPERIOD

PROGRESS TOWARDS MEETING TARGET RAG STATUS

RED =not achievedA M B E R = b e l owt a r g e t GREEN =ont r a c k

I M P ROV E DCOMMUNITYHEALTH

82 c ommun i t youtreach servicesp r o v i d e d b ycommunity healthcentres

Conducted72outof82plannedoutreachsessions.

Immunisationcoverageforchildren increasedfrom89.3%lastyearto95.9%thisyearforchildren (Source: Soroti Health centre records2009)

GREEN: The project hasexceeded the nationalt a r g e t o f 9 0 %immunisationcoverage

Train 142 VHTson managemento f c h i l d h o o dillness; malaria,d i a r r hoea andhygienepromotion.

142VHTstrained.Malariacasesforunderfivesreducedfrom75.5%in 2008 to 72.9% in 2009. For adultsmalaria cases have reducedfrom57.7%in2008to54.9%bySeptember2009.

Diarrhoeacasesinchildrenunderfivereducedfrom6.8%in2008to3.7%and forchildrenover5 from1.45%to0.9% in2009. (Source:Soroti health centre records 2009)

GREEN: Ontrack

Train 45 healthunit managementcommitteemembers (HUMC)on managementprocesses

45 HUMC members trained and resulted in improved resourcemobilisation atOjomHealth Centre II, an initial contribution of £46was made by community members for the installation of a solarpoweredsystemforexample.

Thecommitteearenowadvocatingtothedistrict forhealthworkersto be posted.As a result, the district posted two healthworkers toOjomHealthCentreII.

GREEN: Ontrack

Renova t i on o fTiririhealthcentretheatre

Consultations have already taken place with theMinistry of Healthandthebiddingprocessisinprogress.

AMBER: Delays due tolengthy consultations withtheMinistryofHealth.

I M P ROV E DA C C E S S T OQUALITYEDUCATION

102 teachers tobetrainedonchildcentredmethodologies toimproveacademicperformance

Trained 102 teachers and gained child centred skills that haveimproved the quality of their teaching reflected in the improvedmethods of teaching and class arrangements for participatorylearning.

GREEN:ontarget

Provide 2000 textbooks to facilitatet e a c h i n g a n dlearning(includingm a t e r i a l s f o rreproductivehealth)

Distributed 2000 textbooks to schools to improve teaching andlearning.10ofthe15Katineschoolsnowmeetthe1:1/3:1textbooktopupilratiobynational/districtstandards.

Thishasimprovedpupilandteachermotivation,easedpupil-teacherclassmanagementandimproveddailyschoolattendance.

GREEN:ontarget

Rehabil i tate 13existingclassrooms

Rehabilitated 16 classrooms, 3 offices, 3 stores and 1 library.Teachingandlearningenvironmenthasimproved.

Classroomhygieneand sanitation has improved, the cement floors

GREEN: m o n e y w a ssaved using local masonsr a t he r t h an e x t e r na lcontractors enabling more

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do not harbour fleas and jiggers that were rampant and affectingchild participation and attendance in previous schools (made frommudandwattle)

c l a s s r o o m s t o b er e h a b i l i t a t e d t h a nbudgeted.

Provide 290 extradeskstoschools

Distributed290deskstoschoolsandpupildeskratioimprovedtoanaverage4:1 forKatine schools,with a third of the schoolsmeetingthestandardratioof3:1.

Classarrangementandteacher–pupilcontacthas improvedtherebyenhancingchildcentredteaching.

GREEN:ontarget

Conduct 3 eventsin music, drama,s p o r t s t ostrengthen schoolhealth clubs inhygienepromotion

Held3events.15schoolsreceivedsetsofmusic,danceanddrama(MDD) equipment to strengthen school health clubs’ to carry outhealth promotion in personal hygiene and sanitation education inschoolsandcommunities.

GREEN:ontarget

C o n d u c t 3advocacy forumsw i t h f e m a l eteachers to berole models forgirls

Femalerolemodelsvisitedallschools,encouragedpupilstostayinschool and gave career guidance. An anticipated increase in pupilretentionisexpected.

GREEN:ontarget

C o n d u c t 3s e s s i o n s f o rschoolmanagementcommittees(SMCs ) andparents teachersassociations(PTAs)

Strengthened all 15 SMCs and 15 PTAs. This has increasedaccountability, ownership and management of school affairsincluding reducing teacher absenteeism. PTAs have been able toimprove community participation in school development evident intheparentsconstructingteachers’housesin7schools.

GREEN:ontarget

I M P ROV E DA C C E S S T OSAFE WATER,HYGIENEA N DSANITATION

Wa t e r q u a l i t ysurveillance andt e s t i n g o n 3 4water sources inKatine.

Testedsamplesfrom34watersources.Allthewatersourcesmetthenational&WHOstandards.

GREEN:ontarget

Improvingpersonal hygieneand san i ta t i onp r a c t i c e s i ncommunities andinschools

Constructed 13 new four-stance VIP latrines and 5 ecologicalsanitation latrines in 15 schools in Katine, thereby reducing thepupil /stance ratio from 91:1 at the start of the project to 43:1 atpresent.

AMBER: Materials forObyaraischoolwerestolenandreportedtothepolice.

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Support to VHTsa n d P a r i s hSanitationCommittees onTotal Sanitationa n d H y g i e n ep r o m o t i o n a thousehold level,creation of Idealhomesteads.

The latrine coverage has improved from 7% at baseline to 39%.There are now 312 ideal homesteads in the community, whichincludes hand-washing facilities, drying rack, latrine, rubbish pit,cleancompound,bathshelter,andanimalhouse.

GREEN:ontrack

Improvedoperat ions andmaintenance ofw a t e r a n dsanitationfacilities

Trained11waterandsanitationcommitteesofotherwatersourcesnotbuiltbyAMREF,on their rolesand responsibilities inmanagingandmaintainingwatersources.

Asaresult,functionalityofexistingwatersourceshasimprovedfrom70%atbaselineto97%thisyear.

GREEN:ontrack

INCREASEDINCOMEGENERATINGOPPORTUNITIES

T r a i n i n g 1 8farmersgroupsongroupmanagement

Trained all groups alongside the District Community DevelopmentDepartment in groupmanagement, resulting in the formulationof afarmer’s group constitution that governs their operations. There isimproved record keeping, and equal participation from men andwomen.

GREEN:ontrack

C o n d u c t 4quarterlymee t i n g s w i t hlivelihoodsstakeholdersforum

4 meetings held, resulted in community contribution for theconstruction of the farmers’ produce store to ensure food securityandincreasedincomethroughcollectivemarketingoftheirproduce.

GREEN: ontrack

Establishment offarmer led on-farm trials anddemonstrationsamong t he 18farmersgroups

Held 11 demonstrations. Farmer groups have already harvestedtheircassavaandreplantedformultiplication.

GREEN: ontrack

Trainingof7para-vets

Trained7para-vetswhichincludedastudyvisittoOxfaminKotido.This empowered the para-vets with the necessary knowledge andskillstodeliverqualitycommunitybasedanimalhealthservices.

GREEN: ontrack

Provide drug kitsfor7para-vets

Drugkitsprocured(assortedveterinarydrugsandinstruments). A M B E R : De l a y s i nprocurement. Distributioninthenextquarter.

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Train 18 farmersg r o u p s i nbusinessmanagement andagriculturalmarketing

Held training for 18 groups; improved farmer’s business skills asdemonstrated by increased borrowing of VSLA funds andengagement in alternative income generating activities by thefarmers.

GREEN: ontrack

C o n s t r u c t acentral produces t o r e f o r t h efarmers

Construction ongoing. The use of the community participatoryapproach to construction has increased skills and ownership inKatine.

AMBER: below target.Workisstillinprogress.

Establish farmerled on-farm trialsanddemonstrationsamong t he 18farmersgroups

Held 11 demonstrations and the farmer groups have alreadyharvestedtheircassavaandreplantedformultiplication.

GREEN:ontrack

On-farmtrialopendays for farmerinnovations:Publicpresentation anddisplays

Preparationsinprogress,tobedoneinthenextyear. RED: Prolonged droughtdestroyed much of thecrops provided as seedsin2009.

C o m m u n i t i e se m p o w e r e dto engage inl o c a lg o v e r n a n c e

Hold5subcountyconsultativemeeting on IECm e s s a g e s o ngovernance/rightstoservices

3 meetings held and IEC (Information Education, Communication)parish committees have been formed for dissemination of relevantmessagesincommunities.

AMBER: Issues resolvedin 3 meetings, savingmoney for procurement ofextraIECmaterials.

Carry out 7 localradioprogrammest o i n f o r mcommunitiesaboutVHTs

9 radio talk shows broadcast thereby increasing access toinformationabouthealthandotherdevelopmentissues

GREEN: 2 extra talkshows broadcast at noextracost

Conduct 1 parishdevelopmentcommittee (PDC)t ra in ing and 4PDC Follow upmeetings

2 training sessions and 4 PDC meetings held to supportdecentralised planning. Lower level plans now reflected in sub-countyplans.

GREEN:Ontrack

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Conduct 1 RightsBased Approach(RBA) orientationtraining for KCPPs t a f f a n d s u bcounty extensionw o r k e r s a n dleader

Both groups had a 2 day in-house training on the Rights BasedApproach (RBA)which has helped the project team tomainstreamrightsissuesintheirwork.

AMBER: trainingrequiredmoretimethanthenumberof days allowed. Plannedfornextquarter

Conduct monthlyprojectmanagementcommittee (PMC)me e t i n g s a n dquarterly projectsteeringcommittee (PSC)meetings

The project organised 7 PMCmeetings and 3 PSCmeetings. Themeetings at both levels discussed project progress, reviewed andcontributed to the MTR adjustments and recommendations for theproject.

AMBER: Notallmeetingst o o k p l a c e a s M TRprocess took up t imescheduledformeetings

2.0 PROGRESS OF PLANNED ACTIVITIES

2 .1 Descr ip t ion of per formance

2 . 1 . 1 I m p r ove d C o m m u n i t y H e a l t h

i ) VHT t ra in ing , fac i l i t a t ion and communi ty hea l th act ion

Theprojectconductedfive-daysoftrainingfor142CommunityMedicineDistributors(CMDs),whoarecomprisedofVHTmembers,onHomeBasedCare(HBC)managementofchildhoodillnessaswellascollectinghouseholdpopulationdatarelevanttohealthactivities.

Duringthetraining,theylearnthowtotreatfever,pneumonia,diarrhoea,earinfections,eyeandskininfectionsathome.Strategiestoreducemalariaanddiarrhoeainthecommunitieswerealsocoveredincludingtraininginthecorrectuseoflonglastinginsecticidetreatedmosquitonets(LLINS),theuseofFansidarinpregnantmothers,andenvironmentalcontrolmeasures.

As a result, diagnosis of diseases at community level and referral of patients to the health centres for treatment hasincreased. Health centres have reported a drop in malaria for children under five from 75.5% in 2008 to 72.9% inSeptember2009.Forchildrenabovetheageoffiveandadults,theincidenceofmalariahasreducedfrom57.7%in2008to 54.9% by September 2009 (Soroti District HMIS, 2009). Improvements in hygiene practices and treatment at thehouseholdlevelhaveledtoareductioninthenumberofdiarrhoeacasesbeingreportedtohealthcentresasshowninthetablebelow.

Y e a r D iar rhoea cases for <5 Dia r rhoea cases fo r ≥5

Oct2007toSept2008 6.8% (501 cases of diarrhoea out of 1.45%(162casesofdiarrhoeaoutof11,653

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9,245 patients who visited the healthcentre)

patientswhovisitedthehealthcentre)

Oct2008toSept2009 3.7% (313 cases of diarrhoea out of8,544 patients who visited the healthcentre)

0.9% (136 cases of diarrhoeaout of 14,819whovisitedthehealthcentre)

(Source; Soroti District HMIS, 2009)

Therewas improved coordination and referrals as project and health centre staff held fourmonthly VHT coordinationmeetings involving all VHTs in all six parishes. These coordination meetings involved discussions on VHT generalperformance,giving feedbackonprevious reports/activitieschallenges, trackingand the replacementof twoVHTswhohaddied.

Ofthe272VHTsfromthe66villages,85wereselectedandtrainedonfamilyplanning.ThetrainedVHTsareresponsiblefor sensitising communities on the benefits of family planning, dispellingmyths andmisconceptions, promoting familyplanninguptakeandmakingreferrals to thehealth facilities.Asaresult, thecontraceptiveacceptor ratehas increasedfrom1%inthepreviousyear(63womenaccessingfamilyplanningof the5,909ofreproductiveage)to4.3%thisyear(251womennowaccessingfamilyplanning).

Asaresultof trainingVHTs tosupportcommunitiesandhouseholds inHIV/AIDScounsellingand testing,a numberofclientsreferredbytheVHTstothehealthcentreforHIVcounsellingandtestinghaveincreasedasperthetablebelow:

C a t e g o r y Oct 2007 to Sept 2008 Oct 2008 to Sept 2009

Pregnantmothers 1,340 1,814

Childrenunder5years 2 23

5-<18years 118 217

18yearsandabove 818 2,303

TotaltestedforHIV 1,278 4,357

IntegratedtreatmentofHIV/AIDSandTBhasimprovedduetospecifictrainingtohealthworkersthatencouragestestingandtreatingdiseasesholistically.ThismeansthatpatientswhotestpositiveforHIVarealsotestedforTBandmalariabecausethesearesomeofthecommonopportunisticinfections. Asaresult,atotalof472clients(217malesand255females) with TB have beenmonitored during home visits (Soroti District HMIS, 2009).Nopatienthasdefaulted fromtreatmentsofar,whichwillincreasechancesofrecovery,reducedrugresistanceandultimatelyimprovequalityoflife.

InordertomotivateVHTsintheirvoluntaryrole,theproject provided 350pairsofgumbootswhichAMREFprocuredandgavetothe272VHTsand78TBAsinKatine.Thiswasinadditiontothe272bicyclesgiveninthefirstyearoftheproject.A total of 350T-shirts have also been procured and distributed to theVHTs andTBAs,with amessage on the backencouragingthecommunitytosupporttheworkofVHTsinpromotinghealthactivities.

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Theprojectprocuredanddistributed2,800longlastinginsecticidetreatednets(LLINs)to1,740childrenunderfive,1,000pregnantmothersand60peoplelivingwithHIV/AIDS(PLWHAs)thisyear.HealthworkersthroughantenatalclinicsandVHTsinthecommunityraiseawarenessontheproperuseofLLINsandhavehandedoutadultsizedtreatedbednets.Mosthouseholdshavemorethanonechildunderfivewhoshareabed;soonebednethasbeengivenperhousehold.Itisexpectedthatifproperlyandconsistentlyused,thenumberofmalariacaseswillcontinuetoreduce.

i i ) Improv ing the qua l i t y o f hea l th i n f r a s t ruc tu re

Theprojectaimstostrengthenthehealthsystemto improvethequalityofpreventiveandcurativehealthservices.The

project constructed and provided essential equipment and reagents for a new laboratory at OjomHealth Centre II to

improvethediagnosisandmanagementofpatientswithmalaria,TBandHIV,thethreekillerdiseasesinUganda.This

hashelpedtoimprovepatientcareandmanagement.

i i i ) Increasing the capacity of health workers

AMREFfacilitatedtechnicalsupportsupervisiontoimprovetheabilityandperformanceofthelaboratorytechnicalstaffforproperdiagnosisofHIV,tuberculosis,syphilis,bloodparasiticinfectionsandotherroutinelaboratorytests.Thisinvolvedthedistrictlaboratoryfocalperson,seniorlaboratorytechniciansfromSorotiregionalreferralhospital,andprojectstaffinallthreehealthcentresinKatinesub-county.Thesupportprovidedhasenabledlabstafftoproducereliable,reproducibleandqualitylaboratoryresultsthatarecriticalforearlydiagnosisofhealthconditions.Withthisinterventionmanypatientshaveaccessedreliablelaboratoryteste.g.3153malariatestsand4357HIVtestswereperformedthisyearcomparedto340malariatestsand540HIVtests,reported6monthsagointhefirstquarterof2008. The rise in the latter part ofthe year was due to increased mobilisation of communities and the availability of permanent laboratory staff postedto Ojom Health Centre II.

Additionally,theprojectfacilitatedtwojointtechnicalsupportsupervisionvisitsbythedistricthealthteamandprojectstaff.The aim was to improve capacity of health workers to assess and treat using integrated management of childhoodillnesses(IMCI)guidelinestoimprovepatientcareandmanagement.

TheprojectconductedajointtrainingofVHTsandhealthcentrestaffonimprovingthereferralsystemandVHTsupplysystem,inordertosupportthecontinuityofhealthcareprovision.ParticipantsdevelopedaVHTsreferralformwhichisnowbeingused,andthishasimprovedthesystemforreferringclientsfromthecommunitytohealthcentres.

The project conducted training formembers of the three health unitmanagement committees (HUMC) of Tiriri HealthCentreIV,KatineHealthCentreIIandOjomHealthCentreII.Thetrainingcoveredtherolesandresponsibilitiesof theHUMC, how to enhance supervisory skills and staff motivation, quality assurance techniques and better financialmanagement: planning, budgeting, accountability and reporting of health services. As a result, due to lobbying at thedistrict level, the supply of drugs has improved from once in four months to twice in the same period. Communitymembers have beenmobilised by the HUMCs to make contributions towards the development of health centres, forexample,thecommunitycontributedUsh600,000(£106)fortheroofofKatineHealthCentreIIwhichwasblownoffbystrongwindsanda furtherUsh150,000ascontribution for the installationofasolarpoweredsystem forOjomHealthCentreII.TheHUMChaslobbiedfor4newhealthstafftobepostedtoKatinehealthcentres.

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i i i ) Improv ing hea l th serv ices for ch i ldren and pregnant mothers

Theprojecthassupported155immunisationoutreachservicesandalsoadvocatedthroughthedistrict,toacquireafridgeforimmunisationsupplieswhichhasbeeninstalledatOjomHealthCentreII.Theprojecthasprovidedgasforthefridge,facilitatedthecoldchaintechnicianandtransportationandnowthecoldchainservicesarefullyoperationalatthehealthcentre.TheprojectalsosupportedchildhealthdaysinOctober2008andApril2009withthesupportoftrainedcommunityvaccinatorsandparish mobilisers.Asaresult,healthcentrerecords(HMIS),showimmunisationcoveragehasincreasedfrom89.3% last year to95.9% thisyear for children immunisedagainstmeasles,polio, tuberculosis,whoopingcough,hepatitisB,tetanus,haemophilusinfluenzaanddiphtheria.

HealthworkersweretrainedonPreventionofMothertoChildTransmissionofHIV/AIDS(PMTCT)andfollowingthis,atotalof1,814mothershaveaccessedcounsellingandtestingthroughthePMTCTprogramme.41motherstestedpositiveand only 17 HIV positivemothers received ARVs for prophylaxis (ARV coverage of 41.5%). (Soroti District HealthManagement Information Systems, 2009). In an ideal situation every positive pregnant mother would be given ARVtreatmentaslaboursetsinwhileatthehealthfacility.HoweverinKatine,manypregnantwomenstilldeliverathomeandthereforedonothaveaccesstothedrug,despitehealthfacilitieshavingthenecessarydrugsinstock.

Duetotheinadequatenumberofmidwivesinthesub-countyandotherbarrierstoaccessandutilisationofhealthfacilitiesduringpregnancyandbirth,manywomeninKatinecontinuetorelyononTraditionalBirthAttendants(TBA)fordelivery.Theproject staff andmidwives held 11monthly sensitisationmeetings, one at the end of everymonthwith 78TBAs.These coordinationmeetings involved discussions on how to identify high risk pregnancies, pregnancy danger signs,preventionofmother tochild transmissionofHIV/AIDS(PMTCT), recordkeeping, immunisation, referralofmothers forANC and delivery at the health facility. Health centre records show to date 119.5% new ANC coverage of mothersattendingantenatalclinics(thepercentageishighbecausethehealthcentrealsoservestheneighbouringsub-counties).Thepercentageofwomenwhodeliverfromhealthfacilitieshasincreasedfrom33%atbaselineto53%asofSeptember2009.

2.1 .2 Improved access to qua l i ty educat ion

1. ......................................................................................................................................................12.KATINE COMMUNITY PARTNERSHIPS PROJECT .....................................................................13.ANNUAL NARRATIVE REPORT FOR YEAR TWO .......................................................................1

1.Submitted to: The Guardian and Barclays ..............................................................................................1

2 . 1 . 3 Improved access to safe water, sanitation and hygiene

i ) Water qua l i ty surve i l l ance and test ing

AMREF supported water quality surveillance and testing for 34 water sources, which were sampled and tested forbacteriological and physical chemical parameters. From the findings, all of the water sources met WHO acceptablestandardsofwaterquality.

The project conducted an assessment on all the water sources constructed by the project in a bid to reassure thecommunitythatthewatersourcesweresustainableandthattheywereabletowithstandtheseveredroughtexperiencedinKatinein2009.

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From the findings,all thewatersourceswere found tohavesufficientwater for thecommunities.However therewerecasesofoverextractioninsomecommunitieswhereAMREFrealisedthatonewatersourcemeanttoserveatleast250people,wasbeingusedbyover600people(thewatersourcewasbeingsharedbyfourvillages).

i i ) Improving the rates of personal hygiene and sanitat ion pract ices in communit ies and inschools ; construct ion of hygiene and san i tat ion fac i l i t i es in schools

Theprojecthasbeenabletoconstruct13four-stanceventilatedimprovedpit(VIP)latrinesin15schoolsofKatinesub-county.Thepupil/stanceratiohasimprovedfrom91:1atthestartoftheprojectto43:1todate.Thelearningenvironment,especiallyforthegirlshasgreatlyimproved,asmostoftheseparatefullyequippedfacilitiesforboysandgirlshavebeenconstructed.

Anewtechnology foranimalexcretadisposalhasbeen introduced,particularly targetingschoolchildrenascommunitychangeagents tohelp in the replicationanduptakeof the technologyby thewiderKatinecommunity.Asa result theprojecthasbeenabletoconstructfiveecologicalsanitation(ECOSAN)latrinesinschoolsthisyear.Thelatrinesarefordemonstrationpurposesandlearningsothatwithtimethetechnologycanberolledouttothewidercommunity.

Inaddition toerectingECOSANfacilities,awarenessandsensitisationmeetingswithschoolpupilshavebeenheld,aswell as distribution of health promotional (IEC)materials to the schools where the facilities have been constructed toincreaseunderstandinganduptakeofECOSANtechnology.

i i i) Support to VHTs, Water and Sanitation Committees (WSC), Parish Sanitation Committees(PSC) and community members on hygiene and sanitat ion promotion at household level

Sanitation has improved in households helped by the increased local production and use of sanplats (sanitationplatforms). Local skills and sale of sanplats have been developed for future sustainability. During the first projectimplementation year, 24masonswere trained in sanplats production. TheParishSanitationCommittees (PSCs)werechargedwiththeresponsibilityofsupervisingtheworkofthemasons;monitoringsanplatsproductionandsales.

Sanplatshavebeenproducedinallparishes,howevertherearedifferencesregardingproductionandsales.Someofthechallenges experienced include poor leadership, lack of coordination by the parish chiefs, better and lucrativeopportunities for themasonsand thedwindlingmarket for thesanplatsascommunityprioritieschanged toaddressingmorepressing issues,asa resultofdroughtandsubsequentcrop failure.Howeverafteraseriesofmeetingswith therelevantstructuresthisactivityisnowontrack.TheprojectidentifiedmasonsfromOlwelaitoproducethesanplatsandinOchuloiandOjamaparishestwopeoplewereidentifiedtospearheadtheproductionexercise.Theprojectnowhasover367newsanplatsmadeby themasons, andover 185 sanplats sold andusedby the communities in their householdlatrines.

i v ) S u p po r t t o V H T s a n d P S C s o n t o t a l s a n i t a t i o n a n d hy g i e n e p r o m o t i o n a t h o u s e h o l dlevel for the creat ion of ideal homesteads

ThroughworkingwiththeVHTsandPSCs,thelatrinecoveragehasimprovedfrom7%atbaselineto39%inthisreportingperiod.Todate,over2,048householdsinKatinehavelatrinesintheirhomesteadsoutofatotalof5,221householdsinthesub–county(Soroti District HMIS October, 2009).

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Thisprogresshasbeenreacheddue to theeffortsof thepeople involved incommunitybasedmanagementstructures(VHTs, WSCs, PSCs, Sub-county Sanitation Sub-committees), who on a regular basis move through the villagesconductingawarenesscampaignsandcommunitymeetingsontheimportanceofsanitationandhygiene,andthebenefitsofadecentlatrineindiseasepreventionandtheissuesaroundcontaminationofwatersources.

Todatethereare312idealhomesteads(basedonacommunity-ledtotalsanitationandsocialmarketingapproach.)Thecomponentsofan idealhomestead includehand-washing facilities,dry rack, latrine, rubbishpit,cleancompound,bathshelter,andanimalhouse.Weexpectthenumberstorisewhenweacquirethepromotionalmaterialsthatwillhelpthecommunitystructuresdotheirworkbetter.

v) Promotion of Personal Hygiene and Sanitat ion Educat ion in schools

TheWater and Sanitation, and Education project officers and assistants workedwith teachers and pupils to promotePersonalHygieneandSanitationEducationinschoolsinKatine.Theprojectsetupschoolhealthcommitteesinallthe15primaryschools inKatine,whicharenow responsible forpassingonmessagesonsanitationandhygiene topupils inschoolsthroughhealthparades,theerectionoftippytapsandpromotionalmaterialsamongstothers.Thishascontributedtoincreasedratesofpersonalhygieneinchildren.

Theprojectprovidedbehaviourchangecommunicationmaterialsontheuse,operation,maintenanceandapplicationofby-products(excretausedasfertiliserandpesticide)andheldadvocacymeetingsonecologicalsanitationin10schoolswheretheECOSANlatrineshavebeenconstructed.

ThecomponentinstalledthreerainwaterharvestingtanksinAmorikot,KadinyaandObyaraiprimaryschoolstopromotehandwashingatcriticaltimesandtosavetheprovisionofsafedrinkingwatertothepupils.

Theprojecttrainedteachersonhygieneandsanitationpromotioninschools,aswellasintroducingthemtopromotionalmaterialsthatcouldbehelpfultothemandthepupilsduringawarenessmeetings,andalsoduringpersonalhygieneandsanitationlessons.

v i ) I m p r ove d o p e r a t i o n s a n d m a i n t e n a n c e o f w a t e r a n d s a n i t a t i o n f a c i l i t i e s ; t r a i n i n g o fWater and San i tat ion Committees

Therehasbeen improved functionalityofwatersourcesconstructedbyotheractorsbesidesAMREFsince theprojecttrained 11 additional Water and Sanitation Committees (WSCs) raising the figure to 97% from 87% functionality atbaseline.The trainingcovered rolesand responsibilities,sanitationandhygienepromotion, introduction tosimplebookkeepingandrecordsmanagementaswellasoperationsandmaintenanceoftheirwaterandsanitationfacilities.

vi i) Support to hand pump mechanics, water and sanitation committees

Handpumpmechanics(HPMs)setupandtrainedbytheprojecthaverepairedandmaintainedwatersources.Theyhaveaddressedsanitaryrisksaroundwatersourcestopreventstagnationandmosquitoesbreedingbyallowingthepercolationofspillagewaterbackintothewatercycle.Thewaterandsanitationcommitteeshavebeensupportedonhowtomobiliseandmanagewateruserfees.

2 .1 .4 Improved income genera t ing oppor tun i t i e s

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i ) Increase capacity of rural innovation groups (RINGS) to manage themselves for improveda n d s u s t a i n a b l e l i v e l i h o o d s

Training was provided to 18 farmers groups on group dynamics, management, gender, planning, visioning andparticipatorymonitoringandevaluation.Groupleadersweretrainedinneedsassessmentwhere36grouprepresentatives(18womenand18men)participated.Trainingonleadership,conflictmanagement,andfinancialmanagementwasalsoconductedand54leaders(20womenand34men)participated,witheachgrouprepresentedbythreekeypeople(i.e.thechairperson, secretary and treasurer). As a result, the farmers groups have become more responsive to their groupoperations.Thegroupmembersarenowmoreawareoftheirrolesandresponsibilitiesaswellasthoseoftheirleaders.Some groups (e.g. Ajonyi “B”) have prompted their representatives to improve on their leadership. The groups arecapableofholdingtheirweeklyVSLAmeetingsandresolvinginternalissueswithoutsupportfromtheprojectteam.

i i ) L i v e l i h o o d s s t a k e h o l d e r s ’ f o r u m m e e t i n g s f o r c o - o r d i n a t i o n o f l i v e l i h o o d si n t e r v e n t i o n s

A livelihoods stakeholder’s forum was established in the first year of the project. This is composed of developmentpartners working in Katine, including other NGOs, local government, farmers, the private sector and persons withdisabilities. The forum was established with the purpose of coordinating and sharing livelihoods interventions by thevarious players within Katine to minimise duplication of effort and resources and create synergy for sustainabletransformation.

Inoneofthemanymeetingsheld,theforumdiscussedandagreedonestablishingafarmers'producestore.TheKatinesub-county local government donated land for the store and the 18 groups offered to contributematerials and labourtowardstheconstruction.Discussionsonthemanagementstructureofthestorearestillon-going.

i i i ) Support ing farmers to improve crop product ion

Asameansofboostingproduction,farmerswereprovidedwithinputs.Atotalof7.3tonsofgroundnutseed,1.2tonsofuplandriceand10850g-tinsofvegetableseedsweredistributed to farmers.Theseedswereused toestablishgroup-managed nurseries fromwhich the farmerswould transplant the seedlings to plant in their own home. Each farmer’sgroupalsoreceivednurserybedmanagementimplementsincludingwheelbarrows,spades,wateringcans,forkedhoes,rakes,sisalstringandmeasuringtape.

AMREFfacilitatedatrainingoftrainersincollaborationwiththedistrictnaturalresourcesdepartmentonnaturalresourcesmanagement with emphasis on nursery bed establishment and management. It involved 10 extension workers (twowomen)and18farmers(sixwomen).Thetrainersthentrainedmembersofthe18groups.Asaresult,somegroupshavestartedtosetupthenurserybedsatgroupandindividualmemberlevels.

ThelivelihoodsteamsetupastudyvisittoSerere,oneoftheNationalAgriculturalResearchStationslocatedwithinSorotiDistrict. It involved18 farmers’grouprepresentatives (11women;11men),onesub-countyextensionworker, thesub-countysecretaryforproduction,andthedistrictwomancouncillorforKatine.Farmerswereexposedtovariousimprovedtechnologies forcropand livestockproduction includingsoil improvement technologies.Asaresultof thevisit, farmersappreciatedthetechnologiesthatwerebeingpromotedundertheprojectespeciallytheimprovedcassavavarieties.

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Farmershavecontinuedtomanagetheirimprovedcassavagardensof Akena and 2,961varietieswhichareresistanttobothcassavamosaicdiseaseandbrownstreakvirusdisease,andarealreadymaturing.Asaresult,11farmergroupshavealreadyharvestedtheircassavacrops.Thetuberswereconsumedandhelpedtocushiontheeffectof therecentdrought and accompanying food shortage. In some groups (e.g. Ojemorun), some non-group members have alsobenefited through adopting the new technology. The cassava experiment demonstrates that the technology has beenappreciatedandadoptedbytheKatinefarmingcommunity,notonlybythefarmersparticipatingintheKCPPsupportedgroupsbuteventhoseoutsidethegroupsandamultipliereffectisbeingrealised.

i v ) Support for community an imal hea l th serv ices

Duringthefirstyearoftheproject,seven(twofemale,fivemalepara-vets)wereselectedincollaborationwiththedistrictveterinary office to provide animal health services in the community. During this reporting period, the para-vets weretrainedoncommunitybasedanimalhealthserviceandgeneralanimalmanagement.To-date,startupkitsforthepara-vetsincludingassortedveterinarydrugsandinstrumentshavebeenprocured.DiscussionswithFARM-AfricaandSorotiDistrict Veterinary Office about another training package for para-vets on business management are ongoing. Oncompletionofthetraining,thepara-vetswillreceivethestartupkitsandstartofferingqualityanimalhealthservicestotheKatinelivestockfarmers.Thisservicewillberenderedatanaffordablecosttoenablethepara-vetstoreplenishtheirkitsandsoensuresustainabilityofthisservicebeyondtheprojectlife.

The team together with the district veterinary officer, FARM-Africa training and advisory unit coordinator, sub-countyextensionstaffandKCPPprojectstaffparticipatedinastudyvisittoKaramoja(MorotoandKotido)wherethepracticeofCommunityAnimalHealthWorkers(CAHW)isinplace.Thevisitingteamespeciallythepara-vetslearnthowthepracticeismanagedonacommercialbasis.

v) Business & marketing skills are enhanced to access better markets for their products

TheprojectusesvariousapproachestoenabletheKatinefarmingcommunitytoappreciatetheconceptoffarmingasabusiness(FaaB).Theapproaches involvetechnical trainingto improveonthefarmers’businessskillsandalsoengagethem in study visits to other places where other farmers are pursuing the same–adopting the concept of learning byseeing.

Twophasesoftrainingonbusinessskillsimprovementandagriculturalmarketingwithemphasisoncollectivemarketinghave been conducted in all 18 farmers groups. Both training sessionswere preceded by training of trainers thatwasconductedincollaborationwithUgandaWomenEffortToSaveOrphans(UWESO)andSorotidistrictcommercialofficeinbusinessmanagementandagriculturalmarketinginvolving10extensionstaff(onewoman)fromKatineandotherpartsofthedistrict.Thesetrainersthentrainedthe18farmersgroups.UWESO’sninecommunitybasedtrainers(fourfemale;fivemale)werepartofthesecondphaseofthebusinessmanagementtraining.

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Thetrainingshaveimprovedthefarmersunderstandingof basic business principles. They have been able to utilise their VSLA funds to invest in different incomegeneratingactivities including financing more farming activities than before, and boosting their incomes, and diversifying theirincomessourcesandoptionsinthefaceofcropfailureduringdisasterslikedroughtanddiseases.

TheprojectteamorganisedastudyvisittoLiraandNakasongoladistrictsinvolving18farmerrepresentatives,twosub-county staff, two district staff and three KCPP staff. In Nakasongola, the team shared experiences about cassavaprocessingandmarketingwiththeNakasongolaDistrictFarmersForum(NADIFA)whileinLira,theteamlearntfromthewomen’s group how it has evolved over time up to the present status where they are now successfully engaged incollective marketing of their produce. These lessons will give confidence to farmers on the process they are in toultimatelyengageinsuccessfulcollectivemarketing.

Above: Katine farmers breaking ground for the foundation of the produce store construction

vi) VSLA operations within the 18 farmers groups

VSLAoperationswithinthefarmersgroupshavebeensuccessful.Sixfarmersgroupshavealreadysharedtheirfirstcycle(12months)ofVSLAtransactions,andhavebegunthesecondcyclewithoutanexternalfacilitator.Theremaininggroupsare still running their first cycle, and progressing well. At the time of closing the cycle, Olwelai Farmers Group hadaccumulatedaboutUSh3.3million (about £1000)with other groupsaccumulatingabout the sameamount. Thereareother members of the community who have organised themselves and started, on their own, new VSLA groups bylearningfromthealreadyestablishedandtrainedgroups.ThefactthattheoldgroupshavestartedonthesecondroundofVSLAoperationswithoutanyexternaltechnicalfacilitator,andthatnewgroupsaremushrooming,impliesthatfarmershavemasteredtheVSLAconcept,andappreciatedthebenefitsassociatedwithVSLAanditssustainability.Moneysavedin the form of shares bought has been loaned to individual group members to carry out various income generatingactivities such as trading in agricultural produce, livestock, fishmongering, brewing, butchering, operating restaurants,artsandcrafts,buyingfishingequipments,amongothers.Loanshavebeenrepaidwithinterestandtherehavebeennosignificantdefaults.Themoneysaved in theformofwelfare fundshasbeen loanedto individualgroupmembersatnointerestforpaymentofmedicalbills,buyingscholasticmaterials,foodandclothes.

Ingroups thathavecompleted their firstcycleandsharedmoney, individualmembershaveboughtcattle,paidschoolfeesandexpandedtheirbusiness.UWESOandCAREhavesupportedtheestablishmentofover140VSLAsinKatineofwhichthe18farmersgroupsarepart.

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SecurityhasbecomeachallengefortheVSLAgroups.Recently,robberstargetedagroup.ThegrouplostUsh4.2million(£1,300).Theproject iscurrentlyhavingdiscussionswithCARE,UWESOandBarclaysonsafeguardingthesecurityofmoneyforthegroups.

2.1.5 Communities Empowered to Engage in Local Governance

i ) Prov ide informat ion on community ’s r ights to bas ic serv ices such as hea l th , water andeducat ion; communit ies empowered through IEC messages

TheprojecthasincreasedthecapacityoftheKatinecommunitytoacquireinformationthroughIECmessagesdevelopedwith the sub-county and district IEC committees. Themessages are designedwith the aim of changing attitudes andcreatingawarenessonrightsandresponsibilities.Whenpeopleknowtheirrights,theycandemandforbetterservicesandholdtheirleadersandotherserviceprovidersaccountable.Examplesincludet-shirtsandpostersprovidedtocommunitiesreading‘itisyourrighttobeheard,speakoutincommunitymeetings’.

i i ) Bui ld the capacity of community structures and enhance community p lanning to bettermeet community needs

TheprojectconductedtwoPDCtrainingsessionsinMerokandOjamaparishes.Thetraininginplanningandbudgetingattracted27participants inMerokparish includingParishDevelopmentCouncillor (PDC) village representatives, LocalCouncilIchairpersons(LCI),anLCIIchairperson,aParishchiefandanopinionleader.InOjamaparish,32participantsattendedincludingPDCvillagerepresentatives,LCIchairpersons,LCIIchairpersonandaparishchief.

Theskillsacquiredwillenable thePDCand the local leadersofMerokandOjamaparishes tosupport thecommunityparticipatoryplanningprocess,therebyempoweringtheircommunitiestoidentifyneedsandprioritiesthroughabottomupparticipatoryapproachaspertheUgandandecentralisedsystemofgovernance.FourfollowupmeetingstosupportthePDCsinall theparishesastheydevelopedtheirplansweremade.Asaresult, thePDCcapacitywasstrengthenedtofacilitatecommunityplanning;allsixparisheslatermanagedtodevelopandsubmittheirparishplanstothesub-county.AMREFinterventioninregardtofacilitatingPDCtrainingingeneralcontributedtothetimelysubmissionandintegrationofparishplansintosub-countyplansfor2009-2012.

ThetablebelowgivesasampleofparishprioritiesforMerokparishasperthesubcountyrecords.ThistableillustratesaplanpreparedbyPDCasaresultoftheprojecttraining

L o c a lg o v e r n m e n ts e c t o r

2 0 0 9 - 2 0 1 0 2 0 1 0 - 2 0 1 1 2 0 1 1 - 2 0 1 2

W a t e r /s a n i t a t i o n

C o n s t r u c t 1 n e wborehole at the newHealthCentreII

Construct new Boreholes inApuuton&Oriechoivillage

SinkauguredwellinMerokvillage

H e a l t h Construct Heal thCentreII

Purchase2bicycleambulances ConstructstaffhousesinHealthCentreII

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E d u c a t i o n Construct 7 teacher’shouses in each school(O ima i and Me rokprimaryschools)

Construct 2 block 5 stance pitlatrine in Oimai primary schoolforteachers&pupils

Complete 4 classroom block office andstoreinOimaip/s

W o r k s Open 10 km road fromKa t i ne sub - coun t yt h r o u g h A g o r a t oMeroklandingsite

Road maintenance of 10 kmfrom Katine sub-county toMeroklandingsite

Maintenance of 8 km road from Katinesub-county headquarters through OimaitoMerok

P r o d u c t i o n Train 60 farmers onpests and d iseasecontrol

Purchase improved bulls andimprovedhe-goats

Hold3meetingswith farmersonmodernfarming

PurchaseSerenut4 for10multiplicationsites

Sensitise communities on farmwasteburning

DigcattledipinMerokparish

Train 10 fishermen onmodernfarming

Set 2 seedling nursery sites inOmolokonyandojwinyivillages

Train50farmersonartificialinsemination

E n v i r o n m e n t T r a i n i n g a n dm a n a g e m e n t o fwetland managementcommittees

Formation and training of 10local environmental committeemembers

Construction of permanent cruse inAputonvillage

C o m m u n i t ybased services

Women t ra in ing inbusinessskills

Community sensitisation ofgenderbasedviolence

Purchase of 4 exotic bulls in Merokparish

HIV/AIDS communitysensitisationsmeetings

Training and equipping 4 FALinstructors

Community sensit isat ion on earlymarriage

(Source: Extract from Merok Parish Development Plan, 2008)

i i i ) I m p r ove d s k i l l o f A M R E F s t a f f a n d P a r i s h & S u b - C o u n t y p a r t n e r s i n R i g h t s B a s e dA p p r o a c h fo r b e t t e r p r o g r a m m i n g

RightsBasedApproach todevelopment (RBA)conceptwasrolledout in this reportingperiod.Theproject trainedstaffand sub-county partners in RBA programming. RBA improves on current development approaches since it viewsdevelopmentasaprocesstoachieverights.Rightshaveinternationalstandardsandbenchmarks;governmentsandotherdevelopmentpartnerscanbeheldaccountableiftheydonotreachthosestandards.

iv) Increased community access to internet information and discussion forums

Withthecommunityresourcecentreestablishedwithfourcomputersconnectedtotheinternet,theprojectorganisedtwothree-daynon-residential training courses in basic computer skills for local communitymembers. 14 local communitymembers(8womenand6men)weretrainedinthefirstbatchand15(7womenand8men)weretrainedinthesecondbatch. With this knowledge the community members have been able to access the Guardian/Katine website at thecommunity resource centre and likewise, shared/encouraged the other members of the community to come to the

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resource centre. Throughout this reporting period the resource centrewas overwhelmedwith communitymembers somuchthattheprojecthadtoestablishguidelines,andformeda15membersupervisorycommitteecomprisingmostlyofcommunitymemberstocoordinatethedaytodayrunningoftheresourcecentre.ThereisregularattendanceandlocalviewsarebeingreflectedontheKatinewebsitefromtimetotime.

IT trainees volunteered to train the children of Katine primary school in basic computer skills and thus, these pupilssuccessfullyhadanonlinechatwithchildrenfromtheUKthroughtheGuardian/Katinewebsite,sotheuseofthecentrebythecommunityisalreadytakingroot.

18localcommunitymembersreceivedmediatrainingonvideofilmingorganisedbyUKGuardianofficials.Communitiesareusing thisknowledgeandvideocamerasprovided to themtodocumentand filmcommunity intereststories for theGuardianmediaandotherdevelopmentpartners.

v) St rengthened pro ject in tegra t ion a t communi ty and opera t iona l l eve l

The project organised a partners meeting aimed at drawing modalities for harmonising work among different localcommunitystructures.ThejointmeetingofLCsandrepresentativesfromallthecommunitygroupsclarifieddifferentrolesandresponsibilitiesspecificallyforVHTs,PDC,LCs,parishsanitationcommitteesandfarmergroupsandlookedathowtheserolescouldbeintegratedforeffectiveprojectimplementation.Themeetingwasattendedby18VHTs,12PDCs,sixparishchiefs,12PSCs,12LC1chairpersons,sixLCIIchairpersons,sixfarmer’sgroup’smembers.

v i ) P r o j e c t m a n a g e m e n t s t r u c t u r e s ; c o - o r d i n a t i n g m o n t h l y p r o j e c t m a n a g e m e n tcommittee meet ings

The project organised project management committee meetings to discuss the MTR issues together with externalconsultants.TheprojectorganisedninePMC/PSCmeetingsintotal.ThePMCatsub-countylevelsupportsthedaytodayrunningof theprojects.ThePMCmeetingsdiscussedprogressonKCPPactivities lookingat theachievementsbeingrealised,challengesmetandrecommendations/possiblesolutions.Themeetingsfurther reviewed previousactionplans,preparationsforMTRexerciseandfeedback.TheirideaswereinstrumentalinmakingajustificationforKCPPextension.DuringtheMTR,thePMCgreatlysupportedtheteamforcommunitymobilisation,providingtheirtimeandinformation.

vi i) Conducting project steering committee meetings

Theprojectorganisedtwoprojectsteeringcommitteemeetingsatdistrictlevel.ThePSCatdistrictlevelprovidestechnicalguidancetotheproject.AsinthePMCthePSCmeetingsdiscussedprojectprogress,reviewedandmademodificationtoexistingKCPPworkplansasastartupprocessfortheMTR.ThedistrictpartnersalsoappreciatedAMREF’schangeofapproachfromusingexternalcontractorstousinglocalcontractorsinconstructionwork.

Theprojectalsoorganisedanotherconsultativemeetingwithkeymembersofthedistrictsteeringcommitteei.e.TheLCVchairman, LCV Vice Chairman, Chief Administrative Officer, District planner, District Community development officer,SorotiResidentDistrictCommissionertosharewiththemtheMTRreport,andgetacommonunderstandingofthereportanditsrecommendationsinpreparationfortheMTRworkshopheldinmidSeptember.

2.1.6 Unplanned Outcomes in the course of the year

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ApartnershipbetweenAMREF,GuardianandFUFAwasdeveloped this year.Theaimof thepartnershipwas tousefootballasamobilisationstrategy topromotemessagesonhygiene,healthandsanitation, lifeskillsdevelopment,andbringharmonyandhealingtoacommunitythathasbeenaffectedbyconflict.

Anunplannedoutcomewasthisproject’ssupporttotheKatineHealthCentreII,aprivatenot-for-profitestablishment,torepairablownoffroof.ThiscentreservesKatineParish,apopulationofapproximately6,000people.

3.0 PARTNERSHIPS AND COORDINATION WITH OTHER BODIES

AMREFimplementsitsworkthroughpartnershipsinordertobuildtheircapacity,improvethereachofworkandensuresustainabilityinapproachesbyworkingthroughexistingstructures.Theprojectcontinuedtoworkalongsideparish,sub-countyanddistrictcounterpartsinthedepartmentsofhealth,waterandsanitation,livelihoods,educationandcommunityempowermentinallitsactivities.Theseincludedexistingcommunitynetworks,Governmentstructures,NGOsandCBOs(Community Based Organisations) who share the same vision and objectives i.e. Tran cultural Psycho-SocialOrganisation(TPO),TASOandUWESO.

ThetablebelowoutlineshoweachcomponentoftheKCPPworkedinpartnershipwithanumberofstakeholders.

3 . 1 H e a l t h

Theprojectpartneredwiththedistricthealthteaminjointtrainingsandjointfieldsupervision.AlsoparticipatedinthedistricthealthsectorcoordinationmeetingstowhichotherNGOsalsoparticipated.

ParticipatedinnationalprogrammeslikenationalchilddayspluscampaignsandinternationalprogrammeslikeWorldAIDSday

3 . 2 E d u c a t i o n

The project worked closely with the local government education department, primary teachers colleges in planning andimplementation of activities especially implementation of capacity building activities for beneficiaries through primary teacherscollege(PTC).

Workedwith thedistrict educationworkinggroup comprisedof thedistrict educationdepartment,SNV,ChildFund International,WorldVision,TEDDO,RighttoPlay,TEMEDOandothers.

3.3 WATSAN

Theproject jointly implementedsomeactivitieswiththedistrictwaterandsanitationdepartmentsuchaswaterquality testingandsurveillance.Theprojecthostedateamfromdirectorateofwaterdevelopmentwhowereonamonitoringvisitinpreparationforthewater and sanitation sector performance report that would inform and feed into the discussions during the Government ofUganda/DonorSectorplans.

3 . 4 L i ve l i h o o d s

Theprojectworkedcloselywith thedistrict localgovernmentdepartmentsespeciallydistrictnatural resourcesdepartment,Worksdepartment,communitydevelopment,productionandmarketingontrainingofthefarmers.

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PlannedandworkedcloselywithFARM-AfricaonfarmingissuesfortechnicalsupportandUWESO/CAREonVSLAactivities.Alsoparticipatedinthelivelihoodsstakeholders’forumtowhichotherNGOs(SODIFA,CIDI,TEMEDO,andTPO)participated.

3 .5 Commun i ty Empowerment

Activitieswerecoordinated inpartnershipwithrelevantstakeholders(communitygroups,districtstreeringcommitteeandthesub-countyprojectmanagementcommitteewhowerealsoinvolvedintheMTR.

4.0 CHALLENGES, SOLUTIONS, LESSONS LEARNT AND RECOMMENDATIONS

4.1 Cha l l enges and So lut ions

The i n a d e q u a t e s u p p l y o f m e d i c i n e s (Coartem, oral rehydration salt and Panadol) for the home basedmanagementofchildhoodillnessesishamperingtheworkofthecommunitymedicinedistributors.AMREFisadvocatingtogetherwithotherNGOsforgovernmenttoensurethatthereisavailabilityofdrugs.

Staf f shor tage in a l l the th ree hea l th fac i l i t i e smakesconductingoutreachesdifficult.Theprojecthasembarked on advocacy of healthworkers to be recruited by the district to add to the fewavailable staff at the healthcentres.Thedistricthealthofficehasrespondedbyrecruitingandpostinga laboratoryassistant forOjom laboratory,ahealthassistant toOjomH/CIIandtwomorestaff toTiririH/CIVandtheproject isoptimistic that thegovernmentwillcontinuetorecruitmorestaff.

At the present there is l o w p a r t i c i p a t i o n o f m e n i n r e p r o d u c t i v e h e a l t h a c t i v i t i e s. The project isencouragingmaleparticipation through IECmessagesonbehavioural change.Culturaland religiousbeliefsaffectHIVprevention efforts, PMTCT and family planning. The project is promoting messages on behavioural change throughcommunitytraining,radioprogrammesandbehaviourchange(IEC)materials.

Thepostingofqualifiedteacherstothecommunityschoolsistakinglongerthananticipated.AMREFcontinuestolobbyforthepostingofteacherstocommunityschools. The t ransfer of Kat ine sub-county teachers to other

s u b - c o u n t i e s a f f e c t s t h e c o n t i n u i t y o f p l a n n e d p r o g r a m m e s. The project has negotiated for theretentionofthenewlypostedteacherswithinthesub-countyforat leastaperiodofthreeyears.Theprojectwillcollectdata on the teacherswhowere transferred and those thatwere retained to ascertain the extent towhich the teachertransferswillaffecttheachievementofprojectobjectives.

Theincreasingdemandformoresafewatersourcesinthecommunity,andtheproject’sinabilitytoaddressthedemandhasbeenamajorchallenge.AMREFisworkingwiththecommunitystructurestocreateawareness,manageexpectationsandmaximisebenefitswithintheavailableresources.Theprojectexpectstoincreasethewatercoveragefromthecurrent65.6%to85%bytheendoftheprojectiffurtherfundingisavailed.

Havingstrengthenedanumberofstructures,equalgenderrepresentationandparticipationinsomeofthecommitteesisstill a major challenge due to cultural and educational backgrounds. The project will continue to promote genderawarenessandtrainingingendermainstreamingandpromotingaffirmativeactionin-groupformation.

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4.2 Lessons learnt and Recommendat ions

TheprojectworkscloselywithSorotidistrictlocalgovernmentandshould continuetoadvocateandlobbyfortheplacementofhealthworkers,andteachersandthetimelysupplyofdrugstohealthcentres.

Stakeholders’involvementandlocalcommunityleadersplayanimportantroleinmakinghealthactivitypromotionacceptableandofimprovedquality.

Uptodateinformationdisseminationiskeyinchangingattitudes,behaviours,practicesandstigmawhichhinderaccesstohealthcareservices.

Partnershipiscrucialforsustainabilityofserviceprovisionandimprovesutilizationofscareresources. Strengthening coordination structures ensures real mainstreaming, resource mobilisation and harmonisation.Networkingand informationsharingarenecessaryamongstakeholders toavoidduplicationofactivitiesand tobuildoneachothers’strengthstoenhancecross-organisationallearningandknowledgebase.

TheuseofMusicDanceandDramaiskeyinsanitationandhygienepromotionatcommunitylevelaswellasinschools;thishasbeendemonstratedinKalelavillage,OlwelaiparishwheretheVHTsformedadramagroupforsanitationandhygieneeducation.

Exemplaryleadershipandactiveinvolvementofcommunityopinionleaders,politiciansandreputablepersonsindevelopmentactivitieshelpsenhanceownershipandsustainabilityofdevelopmentinterventions.

ParishDevelopmentCommitteesandLocalCouncillorshavethepotentialtosupportcommunitiestodeveloptheirvillage/parish. They can be supported by improving their skills and providing them with bicycles to mobilisecommunitiesandmonitordevelopmentworkintheirareas.

5.0 FINANCIAL REPORT SUMMARY AsofSeptember2009, 2 years into theproject,AMREFspent £1669490,84.6% of year 1 and 2 budgets. Below is a breakdown of key reasons for under/overspend against the budget. Thefinancialreportisaseparateannexandshouldbereadinconjunctionwiththesummarybelow.

Project act iv i t i es :AllprojectactivitiesinlinewithspendingagainstbudgetapartfromWaterandsanitationandlivelihoods.TheWATSANcomponentoverspent(107%againstthebudget)becauseofhigherthananticipatedcostsfordrillingtheproductionboreholeforAtirirHCIV.Theotherreasonisthefluctuationinpricesofconstructionmaterialduetoanumberoffactors(suchasnationalfuelshortages)beyondAMREF’scontrol.

Inlivelihood,thebudgetisunderspent(43%againstthebudget).Thisispartlyduetoconstructionoftheproducestorewhichstartedlateandsothebudgetwasnotusedupaswasplannedforthesecondyear.Thecosthasbeenreallocatedintothethirdyear.ThedelaywasduetothelengthyprocessesofgeneratingaMemorandumofUnderstandingamongstthestakeholdersincludingfarmers,theSub-CountystaffandAMREF.Theuseofmasonsthatarealreadyinvolvedinschoolconstructionhascompoundedthedelay.Thetrainingforparavetscouldnothappenduetothedelaysinprocuringtherightsuppliesfortheparavetssothisactivityhasbeenre-scheduled.

UK management costs: Allfundraising(donationprocessingandstafftime)andprogrammecosts(salary,travelandadvocacy)areinlinewiththebudgetandadvocacycostswillbeusedupinyear3astheevidencefromKatinecomestofruitionfordisseminationthroughevents.Communicationscostsarelow(43%)ascostshavenotbeenaccountedforyetbutwillbalanceintheNewYear.Managementcostsarehigherthanexpectedduetolegalcostsinthefirstyearasaresultoflengthycontractualagreementprocess.

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M o n i t o r i n g & E v a l u a t i o n :Theoverspendof143%isbecauseintheoriginalbudget,AMREFhadanticipatedaninternalevaluationoftheproject. Intheearlypartofthesecondyear,itwasdecidedbyAMREFthatanexternalreviewbyaconsultantoutsideofAMREFcouldprovidetheprojectwithevidenceonwhatwasworkingandwhatneededtobechangedinordertoachievetheobjectivesoftheproject.

6 . 0 A n n ex e s

6 . 1 A c r o n y m s

6 . 2 B a c k g r o u n d i n fo r m a t i o n

6.3 Write up of degree of Integration

6.4 Case studies

6.5 Table of education faci l i t ies in school

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amref's annual report for year two of the katine project

Documents