1unite for children

Through a participatory and holistic approach, UNICEF is supporting communities in the DRC to take their health into their own hands.

HealtHy villages

Healthy Villages is a national programme in the Democratic Republic of the Congo that empowers communities and local health authorities to work together to improve child health. Through the programme, communities take charge of their own health by working as a first step to improve sanitation and hygiene practices and create sustainable access to clean water.

Design: How it works

Villages request to participate in the programme through a commitment by the whole community to achieve Healthy Village standards. Once this request is received, the local health authorities visit the village and explain the terms of the programme; if the community agrees, a memorandum of understanding is signed.

The community elects a Village Committee, which becomes the driver behind inclusive improvements in health, sanitation and hygiene. The committees must be composed of at least 50 per cent women or girls.

With support from health zone workers, the Village Committees lead the community in a participatory process to

identify and articulate their desires for a healthier environment for themselves and their children. The village analyses their current situation and creates a community action plan to achieve their goals.

The community works together to implement locally appropriate water, sanitation and hygiene infrastructure such as protected drinking water points, hygienic latrines, hand washing stations and waste disposal areas. Local health authorities and non-governmental organizations provide technical and logistical assistance for the construction of infrastructure only when these are not available locally.

After an average of 12-18 months,

2when the village has reached seven key targets related to water, sanitation and hygiene, the village is awarded Healthy Village status. The villages achievements are verified through a household survey to confirm the level of WASH knowledge and practices, as well as any decrease in illness from diarrhoea among children, and a visit by the Chief Medical Doctor of the Health Zone to certify that the community infrastructure meets technical standards. A celebration is organised with local leaders, dignitaries, and media coverage.

seven stanDarDs of a HealtHy village

Have an active health or water committee At least 80 per cent of the population has access

to clean water At least 80 per cent of households use hygienic

latrines At least 80 per cent of the households dispose of

their waste hygienically At least 60 per cent of the population washes their

hands before meals and after latrine use At least 70 per cent of the population understands

the fecal-oral route of disease transmission Clean the village at least one time per month

Deliver: What has been achieved

To date two million people in the DRC have gained access to water, sanitation and hygiene through the Healthy Villages, Healthy Schools programme.

Discover: What is working Holistic view of child health: Past programmes tended

to focus on child health as separate from the environment in which children live. The Healthy Village programme takes a broader view, recognising that children live within a dynamic

UNICEF/DRC/Asselin2

3UNICEF, government health officials and NGO partners help communities to choose infrastructure solutions that are appropriate for them, like this water-free latrine.

social and physical environment, and that it takes a village to improve child health. Healthy Villages is one part of a national two-part programme, the other part being Healthy Schools. These programmes work together to improve health outcomes for children in the two critical places where they spend the most time.

Participation, motivation, commitment and ownership: Since communities themselves have to request to participate in the programme, the level of motivation and commitment is high from beginning. From there, the whole community participates in the process of analysis, planning, action and evaluation. Villages develop a sense of responsibility for their own health, and take pride in celebrating what they have achieved. This creates a high level of ownership of the villages progress and gives people the shared knowledge, skills and motivation to bring about lasting individual and social change.

Building on communities strengths and capacities: The Healthy Villages approach is created around the belief that communities already have skills and capabilities that they can build on in order to take responsibility for their own health. Participatory approaches help communities to recognise their strengths and create plans for how to use these strengths to achieve their goals.

Inclusion and diversity: Healthy Villages is based on an understanding that communities are not homogenous, but are diverse groupings of people. Because the programme can only be achieved with the full participation of everyone in

UNICEF/DRC/Ridsdel

4The best thing [since we joined the Healthy Villages programme] is that we now have clean drinking water. Since then, there are far fewer illnesses in our village. Before, people used to get sick often, and even die - especially the smallest children. Now, we dont have to be afraid anymore. My dream for the future is that our children will also be benefitting from the same thing.

Anne-Marie Anifa, President of the Healthy Village committee, Maindombe

You should have seen our village before. If you went to the toilet, it stank and it was full of maggots and flies, and the chickens spread them everywhere. People used to be afraid to come here. When we celebrated achieving our Healthy Village status, it was such a joy and a huge honour - we were even on television! Our village really increased in standing that day. Now people want to come here.

Genevieve Odia, Healthy Village committee member, Kankolomo

Before we joined the Healthy Village programme, our village was not clean at all. There was rubbish in the streets and we didnt have good latrines, or know about hand washing. When we joined the Healthy Villages, we all got together to clean up the village. Now, every home has a rubbish pit, a hygienic toilet, and a handwashing station. We can serve as an example to other villages.

Karifano Kongo, President of the Healthy Village committee, Demba

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Peak moments

5the village, the programme brings different groups together, and ensures that vulnerable people and marginalised groups are included from the outset.

Generating a sense of rights and responsibilities: The Healthy Village programme brings local health authorities and communities together in the realisation that a healthy life is not only their right, but also their responsibility. The programme creates a relationship of mutual accountability and transparency between citizens and the state for health infrastructure and healthy behaviours. UNICEF promotes the roles and responsibilities of provincial and local health staff while building their capacity to fulfil their obligations.

Broad partnerships for health: For many years, non-state organisations such as religious groups or community organisations have played a key role in delivering services to the population in the DRC. The Healthy Villages programme recognises the capacities of these groups and encourages the state and the villages to work with them, all the while promoting the long-term responsibility of the state to provide services to rural people.

Dream: vision for the futureUNICEFs vision is that no child should die of preventable diarrheal disease. In the next five years, UNICEF will support the government to expand the programme to thousands of additional schools and villages. At the same time, the programme will introduce on-going support for villages and schools who have already been certified as healthy to ensure that the results achieved are sustained. It will also introduce a catch-up component to re-certify villages and schools whose healthy

status has been lost. By 2017, UNICEFs vision is that over 5.5 million Congolese, of which almost 50 per cent are children, will benefit from the Healthy Village, Healthy Schools programme.

The National Poverty Reduction Strategy (2011) has recommended the scale-up of Healthy Villages programme interventions as a top priority for reducing poverty and accelerating progress towards the millennium development goals. In a country the size of the Democratic Republic of the Congo, no single partner can support the scale of programming that is required. UNICEF is working with the government to develop an open-source model so that the Healthy Villages approach will be adopted by others. UNICEFs vision is that eventually the tools and approaches of Healthy Villages will be adopted and standardised at national level.

PartnersPartnerships are crucial for UNICEFs work. UNICEF thanks its partners, UK aid, Government of Japan, USAID and the UNICEF National Committees for the successful collaboration. To access a complete list of implementing partners, please visit:: www.ecole-village-assainis.cd.

6Hand washing with soap or ash is one of the critical behaviours taught by the Healthy Villages program that has a huge impact on the health and well-being of children.

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