Amref six-month Katine report - Oct 2009 to Mar 2010

8/9/2019 Amref six-month Katine report - Oct 2009 to Mar 2010

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KATINE COMMUNITY PARTNERSHIPS PROJECT

6 MONTHLY REPORT FOR YEAR THREE

Submitted to: The Guardian and Barclays

Picture above: Leya Igitu, at a village savings and loans group in Ojemorun village

Project duration: October 2007 September 20101

Prepared by: KCPP Team, AMREF Uganda

Contact person in AMREF Uganda: Joshua Kyallo, Country Director, AMREF UgandaEmail:[email protected]

Contact person in AMREF UK: Claudia Codsi, Uganda Partnerships Manager, AMREF UK

Email: [email protected]

1An additional phase out year (4th year) has been agreed in principle. The end of the project would therefore beOctober 2011.

1
mailto:[email protected]:[email protected]:[email protected]:[email protected]


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Table of Contents

List of Acronyms Used in the Text 03

Executive summary 04

1.0 Background Information 06

2.0 Problem Analysis 07

3.0 Project Design 07

3.1 Goal 07

3.2 Specific Objective 07

3.3 Expected outcome 07

3.4 Implementation Strategy 08

3.5 Governance, sustainability Plan and Phase Out Strategy 09

4.0 Description of Progress against Planned Objectives by Outputs,

Performance and Outcomes

09

4.1 Health 09

4.2 Education 11

4.3 Water and Sanitation 15

4.4 Livelihoods 17

4.5 Community Empowerment 20

5.0 Levels of Integration among components 21

6.0 Partnerships and Coordination with other bodies 22

7.0 Risks,Challenges, Solutions, Lessons and Recommendations 23

8.0 Annexes 26

8.1 Case studies

8.2 Financial report

8.3 Integration of KCPP interventions to achieve sustainable community

development

LIST OF ACRONYMS USED IN THE TEXT

AIDS Acquired Immune-Deficiency Syndrome

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ARVs Anti Retro-Viral drugs

CASHE Community Approach to Sanitation and Health Education

CBO Community Based Organisation

CMDs Community Medicine Distributors

DDP District Development Plan

DEO District Education Officer/Office

DHT District Health Team

DIS District Inspector of Schools

DSC District Steering Committee

DTPC District Technical and Planning Committee

EU European Union

FGD Focus Group Discussion

GDP Gross Domestic Product

HC Health Centre

HIV Human Immune-deficiency Virus

HMIS Health Management Information Systems

IMCI Integrated Management of Childhood Illnesses

MPM Hand Pump Mechanics

MTR Mid Term Review

MWE Ministry of Water and Environment

NAADS National Agricultural Advisory Services

IDPs Internally Displaced Persons

IEC Information, Education and Communication

IGAs Income Generating Activities

ITNs Insecticide Treated Nets (for protection from mosquitoes)

IMCI Integrated Management of Childhood Illnesses

KAJOFA Katine Farmers Joint Forum

KCPP Katine Community Partnership Project

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OVCs Orphans and Vulnerable Children

PDP Parish Development Plan

PLE Primary Leaving Examinations

PTAs Parents Teachers Associations

SMCs School Management Commmittees

SODIFA Soroti District Farmers Association

TAU Training and Advisory Unit

UWESO Uganda Womens Efforts to Save Orphans

VHTs Village Health Teams

VSLA Village Savings and Loans Association

VIP Ventilated and Improved Pit Latrines

WATSAN Water and Sanitation

WHO World Health Organisation

WSCs Water Source Committees

1.0 EXECUTIVE SUMMARY

This report marks the first six months of implementation in the third year of the Katine

Community Partnerships project (KCPP) implemented by AMREF in partnership with the

Katine community, the Soroti local government, the Guardian and Barclays with FARM-Africaproviding technical advice on livelihoods. The overall goal of the project is to improve the

well-being of people living in Katine. The project takes an integrated and community based

development approach to address the underlying social determinants of poor health and

poverty. Addressing community health, access to quality education, safe water, hygiene and

sanitation, increased income generating opportunities and community empowerment to

engage in local governance all work to complement each other to achieve sustainable

community development.

The third year of the project builds on the recommendations of the Mid Term Review (MTR)

held in July 2009. The findings highlighted that AMREF was more or less on track however

needed to strengthen some areas to maximise impact. This could be achieved through more

resources and an additional year to exit Katine. The health component was on track but itssuccess depended on the continued training of health workers and renovations of Tiriri

Health centre. The education component, also on track, would benefit by strengthening

school governance and follow up support to teachers. The water and sanitation component,

although reaching its original objective, would have a lasting impact if water coverage could

increase from the current 66% to 85% to meet the national target for 2010. Two of the

components (livelihoods and community empowerment) needed more time and resources to

realise their objectives. The community empowerment component could be strengthened

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by introducing a rights-based approach and gender awareness increased. AMREF could

expand the reach of farmer groups to all 66 communities in Katine. An additional year would

give AMREF more time to implement the above recommendations and systematically hand

over responsibility to community groups and local government structures to ensure

continuity and sustainability.

In the last six months, the project has rolled out 48 new farmer groups to the existing 18supported by the project to cover all 66 villages. AMREF has started to drill more water

sources to meet the 85% target for water coverage and a rights based approach has been

introduced. A fourth year extension of the project and additional funding was agreed in

principle by Barclays and the Guardian to address these recommendations. Between

October 2009 and March 2010, the project built on progress from preceding years, while

implementing the MTR recommendations.

Overall the project has met 70% expenditure against the overall budget to date with most

activities on target. The main underspend this year is in the health and livelihoods

component, with other components reaching their targets for the year. A summary of

progress against planned activities is highlighted below. A more detailed explanation is insection 4.0 of the report.

To improve community health, the project continues to increase community awareness of

health services through health workers and Village Health Teams (VHTs). Through antenatal

classes and in the community, health workers and VHTs provided 1625 Insecticide Treated

bed nets to those most vulnerable to malaria including 650 pregnant mothers, 60 people

living with HIV/AIDS and 915 children under 5 years of age. 7,103 Long Lasting Insecticide

Treated Bednets have so far been distributed since the project began in 2007. AMREF

trained community vaccinators to support immunisation outreaches and held outreaches for

national child health day programmes resulting in 5,909 additional children immunised in

the last six months bringing immunisation coverage to 96%2. 31 community health workers

were trained on strategies to improve the quality of Prevention of Mother to ChildTransmission of HIV (PMTCT) services and on strategies to combat TB. This resulted in more

health workers able to offer PMTCT services to pregnant women and 220 TB patients in

Katine receiving improved TB care and support from health facilities. The above activities

were on target against the plan. However, there was a delay to the renovations of Tiriri

operating theatre and connection of running water to the maternity ward and theatre

contributing to an underspend, however procurement of a consultant and work began in the

first quarter of 2010.

To improve access to quality education, the project has continued to work with

communities and local government to promote greater community involvement in school

governance and access to quality education for all children. Women teachers were

supported to act as role models and host advocacy meetings in communities to increase

community awareness and commitment to send Orphans and Vulnerable Children (OVCs) to

school. Concurrently, 42 teachers received training by the project on special needs teaching

to improve the provision of inclusive education. The project constructed four new classrooms

(Ogwollo and Ojom primary schools) and rehabilitated 8 (Ochuloi and Ayonyi primary

schools) equipping them with desks to improve school learning. Since the project began,

2Soroti districts Health Management Information Systems (HMIS)

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school enrolment figures have increased to 21%, indicating increased access to education.

AMREFs partnership with the District Education Office (DEO) to provide regular support

supervision on school planning has resulted in improved capacity of teachers to complete

the school syllabus. School management and governance is improving, School Management

Committees (SMC) and Parent Teacher Associations (PTA) have now put in place a well

formulated development plan for every school monitored on a regular basis. Teachers are

reporting improved welfare; their allowances are now being paid on time and they have

better housing prospects with each school having at least two houses for teachers nearby.

Progress against planned activities and expenditure for this component are on target.

To improve access to safe water and sanitation, the project identified four new

communities to benefit from five newly drilled and installed boreholes to meet the MTR

recommendations of increasing water access to 85%. To improve operations and

maintenance of these water sources, four new water source committees (selected by their

communities) received training. The project also identified and supported 10 vulnerable

households in the community with 2,500-litre rain water jars and supplied and installed two

rain water harvesting tanks of 10,000 litre capacity in Ojom and Ogwolo primary schools.

The project continues to work alongside VHTs in the promotion of better hygiene andsanitation in the communities. An additional 86 new ideal homesteads were established as

a result of replicating ideal homesteads established earlier in the project and supported by

VHTs. There are now 398 ideal homesteads in total in Katine sub-county, improving hygiene

and sanitation standards in Katine. Planned activities and expenditure for this component

are on target.

To achieve improved livelihoods, the project set up 48 new farmer groups with 1,340

farmers. Every village3 in Katine is now represented by a farmer group and the project

continues to support them with capacity building and monitoring as well as farm inputs such

as seeds, implements, veterinary, technical and supervisory services. In order to strengthen

the ability of rural institutions to access advisory services and markets for their produce for

increased income, the project supported farmer groups to form an apex association (Katine Joint Farmers Association) to coordinate all farmers groups, manage the produce store,

support farmer groups in Katine in marketing activities, oversee the animal health service

provision and assess quality of farm produce. The farmers went on a study tour to a

progressive NAADS4 farmer group in Gweri and Ngora Sub Counties where they studied new

technologies and best practice in farming such as citrus fruit production in Gweri for which a

fruit factory is soon going to built by the government in Soroti. This component achieved the

majority of the planned activities however remains underspent due to a decision to delay

the distribution of seeds to the 48 newly formed farmer groups from March 2010 to

August 2010. The spending will be in line by the end of the project year.

The farmer groups are also involved in Village Savings and Loans Associations thathave completed their first cycle of savings. Currently the groups savings ranges between

Ushs 1,000,000 to Ushs 4,500,000 with all 66 groups accumulating Ushs 72,504,550 million

(22,482.03). Different group members said they used their share amount to purchase

different assets such as cows/ bulls, goats, chickens, mattresses, clothing. Some were able

3There are 66 villages in Katine sub-county

4National Agricultural Advisory Services, whose vision is to become a decentralized, farmer owned and private

sector serviced extension system contributing to the realization of the agricultural sector development objectives.

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to start up businesses while others expanded their existing business in Katine. With

improved income, Katine residents are building up the self-confidence to manage their lives.

Their confidence to participate in public meetings is improving, especially for women who

make up the majority of these farmers.

To empower communities to engage in local governance, the project continued to

increase community capacity to plan and budget for community needs by providing trainingto parish development committees5 on community participatory planning and budgeting.

Currently, all 6 parishes have produced their development plans to be incorporated in the

new sub-county development plan for financial year 2010/2011. The project facilitated sub-

county Project Management Committee (PMC) and district Project Steering Committee (PSC)

meetings to discuss and review the project progress on the MTR recommendations. These

meetings have improved coordination, ownership and involvement from local government

stakeholders and partners in the implementation of the project. The project also procured

and supported parish development committee members from all six parishes with 122

bicycles. Increased mobility has resulted in improved planning and coordination with

stakeholders; there are weekly field monitoring visits held and prompt attendance of

meetings. The activities are all on track for this component.

In the remaining six months, AMREF will continue to implement the recommendations of the

midterm review. Key plans include continued support to VHTs through support supervision

and training of health workers on promoting counselling and testing services for HIV/AIDS;

more support to enable community ownership of school supervision and promotion of

inclusive education of girls, disabled, orphans, and vulnerable children. The project will

address the MTR recommendations to increase access to water sources to meet the 85%

target and in livelihoods the focus will be on continued support and monitoring to the newly

formed 48 farmer groups, agribusiness management training and collective marketing. In

community empowerment the project will address the recommendation of rolling out rights

based training while working closely with the various community structures to begin to

phase out and exit from Katine while handing over responsibility.

1.0BACKGROUND INFORMATION

1.1 Introduction

This report covers the progress that has been made by the project from October 2009 to

March 2010 in the third year of the Katine Community Partnerships project (KCPP). The

project is funded by Guardian reader donations while the Guardian tracks the projects

development on-line and in print. Barclays matches readers funds and draws on their

business expertise to integrate a model of financial inclusion providing loans through village

banks6.

1.2 Development Context in Uganda

Uganda is one of the poorest countries in the world, ranking 146th out of 177 in the 2004

Human Development Index. The population of Uganda is estimated at 28 million and life

5PDC is one of the governance structures established by the government in a decentralised system to promote abottom-up approach to development.6Implemented through CARE and a local NGO, UWESO (Uganda Womens Effort to Save Orphans)

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expectancy is 49.3 years according to the World Health Organisation. A contributing factor

to low life expectancy in Uganda is the fact that 31% of the population currently lives below

the poverty line (UBOS 2007). AMREFs work in Katine is structured within the national

planning framework, which is outlined in the PEAP7 soon to be the National Development

Plan (NDP)8.

1.3 Development context in the district of Soroti

Soroti, located in eastern Uganda, consists of three rural counties (Kasilo, Serere and Soroti)

and one municipality (Soroti municipality). There are 17 sub-counties, including three

divisions of the Soroti municipality. The total population of Soroti district is 371,986

according to the 2002 UBOS census. Now peaceful, the district is considered post-conflict

with recent periods of insurgency and cattle rustling which led to loss of lives, displacement

and depletion of the number of animals and other valuable property. Internally Displaced

People (IDPs) have now returned to their communities. 76% of household main economic

activity is subsistence farming, cattle rearing and petty trade (UBOS9 2002 Census).

Poverty prevalence is at 77%, compared to the national average of 31%

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. Malaria is theleading disease burden in Soroti District, contributing to 96% of reported morbidity. Only

19% of the population lives within 5km of a health facility, far lower than the national

average of 49%. HIV/AIDS remains a key challenge.

In education, the pupil to teacher ratio stood at 1:59 while the desired minimum standard is

1:54. In addition, the pupil to classroom ratio is 1:83 where the minimum standard is 1:54.

Soroti still needs approximately 200 trained teachers to meet the increasing number of

children joining primary school every year.

According to district records, safe water coverage in Soroti district at the start of the project

stood at 76%, which is over the national average of 65%. Functionality rate of installed

water facilities is at 89%. Results from the AMREF EU project survey in 2007 indicated thatlatrine coverage in the district was at 68%, also above the national average of 65%. As

much as the government has strengthened decentralisation in Uganda - with the sub-county

as the lowest unit of development planning and implementation - this has almost exclusively

emphasised the service delivery aspects of governance. Communities engagement in

development and decisions that affect them remains weak. The KCCP is working to empower

communities and to strengthen dialogue with the systems for service delivery so that they

can demand their right to development.

1.4 Development Context in Katine sub-county

7 Poverty Eradication Action Plan, a national framework for fighting poverty

8Uganda developed the three yearly Poverty Eradication Action Plan (PEAP) in 1997. It has had three phases. Now

the government has come up with a National Development Plan to replace the PEAP. The PEAP focused on reducing

poverty but now the NDP focuses more on creating wealth (Ministry of Finance, Planning and Economic

Development, Government of Uganda). The NDP was launched on Monday 19.04.2010.

9 Uganda Bureau of Statistics

10UBOS, Mapping the Poor, 2004

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Out of the 17 sub-counties and three municipality divisions in Soroti district, Katine is one of

the sub-counties with the worst indicators for poverty and underdevelopment. A comparison

of Katine indicators with that of the 2006 Uganda Demographic and Health Survey shows

that overall baseline conditions for the Katine population are worse than average for rural

areas of the country.

2.0 PROBLEM ANALYSIS

When AMREF addressed project priorities with the sub-county and district leaders, needs

were identified in the areas of health, education, water and sanitation, livelihoods and

community empowerment.

A household baseline survey was conducted by AMREF in January 2008 to assess the needs

further. The results demonstrated that the overall conditions in Katine sub-county were

uniformly poor11. Access to safe water in Katine was at 42% and latrine coverage was at

44%, far lower than the above mentioned averages for Soroti district. In some parishes, like

Olwelai, latrine coverage was only 24% compared to 68% in Soroti district. The school

dropout rate was at 19% for boys and 22% for girls and the pupil to classroom ratio was at91:1. Also, 16% of children aged 7-12 were orphans.

Livelihoods, which depend mostly on agriculture, have been disrupted by 20 years of

internal conflicts and cattle rustling. There was a rebellion by the Uganda Patriotic Army in

Teso region (where Soroti is based) from the late 1980s to the early 1990s and an incursion

by the Lords Resistance Army from the Acholi region into Teso region from 2003 to 2006.

Due to poverty, marginalisation and a disconnect between the formal governance system

and the community, the population was not actively involved in decision making processes

in local government. The low indicators stated in the baseline survey suggested a

community in critical need of empowerment with information and tools to improve their own

capacity for making a positive difference to their lives.

3.0 PROJECT DESIGN

3.1 Goal

To improve the quality of life of the people of Katine

3.2 Specific Objectives

3.2.1 Improved community health

3.2.2 Improved access to quality primary education

3.2.3 Improved access to safe water, sanitation and hygiene (WATSAN)

3.2.4 Increased income-generating opportunities

3.2.5 Communities empowered to engage in local governance

11 Katine household baseline executive summary, page 2. The baseline survey was conducted by AMREF with

support from UBOS (Ugandan Bureau of Statistics)

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3.3 Expected Outcomes

Health

Increased community awareness, access to and utilisation of health services incommunity and health facilities.

Education

Improved access to quality primary education for all children and greater communityinvolvement in school governance

WATSAN

Increased community access to and utilisation of improved water and sanitationfacilities

Improved hygiene practices in households

Improved operations and maintenance of water sources

Livelihoods

Recovery of livelihoods through diversified and improved sources of income

Stronger ability of rural institutions to access both advisory services and markets fortheir products for increased production and income

Community Empowerment

Increased community capacity to plan and budget for community needs

Stronger community capacity for data gathering and utilisation.

Community demanding and achieving their rights and services

3.4 Implementation Strategy

AMREFs key development goal is to close the gap between communities and basic service

delivery systems through its Community Based Development (CBD) approach. AMREF builds

the capacity of communities, strengthens the government systems of service delivery and

carries out operations research to find out what works, document the findings and share

them with other NGOs and government and advocate for best policy and practice. The

development approach also ensures that the project components of health, water and

sanitation, education, livelihoods and community empowerment work to reinforce each

other for integrated development.

3.5 Governance, Sustainability Plan and Phase-Out Strategy

The KCPP project is strengthening the functionality of existing community-based structures

like water source committees, VHTs and Parent Teacher Associations (PTAs).

Simultaneously, it works with and builds the capacities of local government structures like

the parish development committees, the parish sanitation committees, the sub-county

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health committee and the farmers forums to ensure that they play their roles effectively. A

sub-county project management committee has been established to provide oversight to the

operational aspects of the project. The committee is involved in the project activities and

action plans are shared on a regular basis. The committee is chaired by the sub-county chief

and co-chaired by the AMREF Deputy Country Director.

At the district level, the district steering committees role is to ensure that the project isaligned to relevant government policy and programmes including the district development

plan and sector strategies and has effective partnerships. It is chaired by the Chief

Administrative Officer who is the head of the civil service at the district level; the AMREF

country director also co-chairs the committee. These are the structures that have been put

in place to manage the project and to ensure that decision-making is a bottom-up and a

participatory process. A draft exit strategy is being developed and shared with stakeholders

so that there is an agreement on key sustainability strategies for a successful exit by AMREF

at the end of the fourth year of the project.

4.0 Description of performance against plans and targets

4.1. Improved Community Health

4.1.1 Improving community-based prevention, treatment and care for HIV/AIDS,

malaria, TB, Reproductive Health, and childhood illnesses

In the last six months, the project distributed a total of 1,625 long lasting insecticide treated

mosquito nets (LLINs) to high risk groups; 915 to children under the age of five, 650 to

pregnant mothers and 60 to people living with HIV/AIDS (PLWHAs). Health workers through

antenatal clinics and VHTs in the community continued to be supported to raise community

awareness on the proper use of LLINs and handed out adult sized treated bed nets. Most

households however, still have more than one child under the age of five sharing a bed and

one bed net is given per household. If households continue to properly and consistently use

nets, malaria cases should reduce.

4.1.2 Improving health services for children and pregnant mothers

In the reporting period, 5909 children were immunised against measles, polio, tuberculosis,

whooping cough, hepatitis B, tetanus, haemophilias influenza and diphtheria. The project

supported the implementation of the Ugandan Ministry of Health Child health days12 in

collaboration with health facilities to conduct child health days covering all six parishes in

Katine sub-county. The project supported Child Health day government programmes by

providing fuel for transport and facilitation allowance for health workers, district health team

staff (DHT), community vaccinators and parish mobilisers to carry out the campaign. The

support to health workers has resulted in an increase in the number of children accessing

immunization services reflected by the increase in immunization coverage from 89.3% in2008 to 95.9% in 2009 for children immunised. This is obtained by using a standard

indicator definition which is universally acceptable in explaining immunization coverage in

12Uganda Ministry of Health organizes child health days every 6 months as a strategy towards promoting childsurvival through routine child immunization schedules. This service provide an opportunity to reach immunisation

drop outs (children who have missed out on their immunisation schedules or those who have not completed their

immunisation schedule).

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an environment like Uganda and this is integrated with early infant diagnosis (EID) for

children who are exposed to various health risks.

During the period, the project trained 85 VHTs out of 272 VHTs in Katine sub-county on

sensitising communities about the benefits of family planning. The training supported VHTs

to dispel myths and misconception about family planning and promote family planning

uptake and carry out referrals to the health facilities. The project has only seen an increasein uptake from 1% in 2007 to 4% currently due to cultural and religious barriers.

Patients in Katine were able to receive improved TB care and support from health facilities

as a result of training provided by the project to community health workers. The training

focused on improving skills on management and follows up of TB/HIV patients including

identification of TB cases in the community and improved referral of TB/HIV patients. In

2009, there were 7 TB cases reported whereas in 2008 there were 17, showing a 10%

reduction in new cases reported according to HMIS. The training covered the relationship

between HIV and TB, drug interaction of ARVs / anti TB drugs, when to start TB patients on

ARVs and complex case management.

4.1.3 Improving the quality of health services

To improve the quality of health services, the project trained 31 health workers from all

three supported health facilities in the sub-county on improving the quality of Prevention of

Mother To Child Transmission of HIV (PMTCT) services. Before the training, the health

facilities only had one overstretched health worker trained in delivering PMTCT services for

all facilities. The project trained more health workers to increase the number of personnel

who could offer services to clients rather than rely on the one health worker alone. Service

delivery to pregnant mothers is improving and should result in a reduction in the number of

new born infants infected with HIV.

To improve patient care and management, the project co-ordinated and facilitated two joint

technical support supervision visits by the district health team (DHT). The DHT support

supervision focused on improving health worker knowledge and skills on guidelines and

treatment for integrated management of childhood illnesses (IMCI). Due to mid level health

workers having limited skills, on the job training by the DHT and technical support

supervision greatly motivated them to perform their jobs. Improved motivation and skills

development should result in better management of patients.

4.1.4 Improving rural health systems

The project continued to provide training, technical support supervision, monitoring and

evaluation support to the local community health structures to plan and manage their own

health issues. Three community health unit management committees (24 members) and

272 (166 males, 106 females) VHTs were trained on identifying, planning and budgeting

community health care priorities, management of health facilities including planning,

budgeting, financial performance management, monitoring, and quality care and drug

management. Over the period, the training has resulted in improved management of health

facilities due to increased knowledge and skills of the health centre management

committees, increased sense of being able to make a difference in health outreaches in their

communities, and high sense of self-worth to nurture local planning skills and abilities in

communities. All this will ultimately allow communities to tackle future health issues and

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Figure 1: A completed classroom block at Ogwollo Community Primary

School

manage the overall health of their communities. There have been regular meetings, minutes

taken, posting of three new health workers due to lobbying at the district level and more

regular bi-monthly supply of drugs due to joint budgeting between Health Unit Management

Committees (HUMCs) and health workers and follow up by the HUMCs at the district level.

The project trained 272 VHTs on community based health information management

systems including birth and death registration. These VHTs are supported to collect villagehealth information and report to the health facilities. The link that the VHTs have created

between health facilities and data collected at the community level has strengthened the

planning process and improved availability of services.

Two quarterly local health structure meetings were supported to review and monitor the

implementation of community health actions by VHTs including referral of sick community

members to VHTs and to health facilities, monitoring community health programmes,

reporting health problems to health structures in communities, supporting implementation

of health activities in communities, health planning, budgeting and implementation for

communities. As a result participation of communities in health planning has improved and

is critical to achieving good health outcomes for the community and the planning process

has seen availability of information from the communities for health planning at the sub-

county. In promoting participatory planning, individuals, households and community

members have assumed responsibility and ownership of their health needs.

4.1.5Improving health infrastructureThe project with support from solar aid UK, installed a solar panel to power Ojom HC II. Now

the power is lighting the laboratory and office in case of emergencies at night, powering the

cold-chain system fridges for keeping drugs and vaccines cool (which used to be done in

Atirir HC IV) thus saving on distance and time. Staff houses are also lit which is motivating

for staff to stay in such an isolated part of Katine. The supply of electricity will also attract

staff to live in Ojom in future.

Overall the health component is more or less on target against plans. There was a delay to

the renovations of Tiriri operating theatre and connection of running water to the maternity

ward and theatre which has contributed to an underspend, however procurement of a

consultant and work began in the first quarter of 2010.

4.2 Improve access to quality education

4.2.1 Improving learning and teaching environment in school

In the last six month, the

project completed the

construction of four newclassrooms in two primary

schools; two classrooms in

Ogwollo primary school, two

classrooms in Ojom primary

school, each with an office

space and a store. Eight further

classrooms were rehabilitated

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in two primary schools; one in Ochuloi primary school and four classrooms in Ajonyi primary

school, each with one office space and a store. The classrooms were equipped with desks to

support child learning.

Since the project started in October 2007, enrolment has increased by approximately 21%.

Updated enrolment figures are as follows:

Years 2007 2008 2009 201013

Girls 3745 3911 4599 4840

Boys 3786 4063 4472 4735

Totals 7531 7974 9071 9575

N.B Percentage increases in enrolment 2007 to 2008 was 6%, 2008 to 2009 was 12% and

2009 to March 2010 first term 5%14

Figure 2: School Enrolment by Year15

0

1000

2000

3000

4000

5000

2007 2008 2009

Boys enrollment

Girls e nrollment

This progressive increase in enrolment is an indication of making education more accessible

for all children of school going age in Katine.

Over the period of reporting, the project continued to observe an increase in the number of

children completing primary level education and overall retention of children in schools;

more children are now sitting for primary leaving examinations (PLE) and attaining PLE

levels in subsequent years. There has been a reduction in the number of children unable to

sit their PLE as seen in the table below and an improvement in the general performance of

children in PLE examination in all schools.

13Term one enrolment figure which cannot yet be considered for reporting since the term has not ended.

14

15Some children get married off before the sit their exams due to illnesses and absconding from school. Some

remain at home to take responsibility of household activities in events like mother being sick, orphanedhouseholds, parents not at home. Exam enrollment for 2010 cannot be reported now as the data can only bereported at end of school year. However enrollment in this term has shown a 5% increases compared to only 2% in2009 term one.

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Year No of children

registered for

national exams

No of children

unable to sit

% children

unable to sit

Examples of

reasons for not

taking exams

2007 300 15 5% sickness, domestic

chores, girls being

married off2008 425 11 2.5%

2009 453 8 1.8%

The above trend indicates there is a general improvement in the retention of children in

schools. This should result in improved literacy and increased enrolment into high school.

The longer girls stay in school the less likely they are to be involved in early marriages.

At the start of the project in 2007 the PLE pass rate was at 87.7% and failure rate was at

12.3%; in 2008, the PLE pass rate was at 85.9% and failure rate was at 18.3%. In 2009, the

PLE pass rate is at 88.9% and failure rate at 15.3%.

Table 1 PLE Performance in Katine since Project Inception in 2007

Year RegisteredPupils No.Pass PassRate No.Failure FailureRate Registered but didnot sit exam TotalRegistered

Boys Girls

2007 198 102 250 87.7% 35 12.3% 15 300

2008 229 162 356 85.7% 76 18.3% 11 426

2009 238 214 395 88.9% 68 15.3% 08 452

Source: EMIS Soroti District

The project facilitated the district education department to conduct two support supervision

exercises in order to improve performance and management of schools. This took place in

all the fifteen primary schools and provided continuous mentoring and counselling to

teachers and school management committees including parents and teachers associations.

AMREF organised a meeting for 90 teachers to draft lesson plans and work plans for the first

term in 2010. The project has noted improved lesson planning and completion of the

syllabus and this is as a result of teacher training by the Centre Coordinating Tutor (CCT),

area inspector of schools and District Education Officer (DEO). There was a noted reduction

in teacher absenteeism in subsequent months and a complete education sector database

which can be attributed to KCPP continuous supervision of school performance in

conjunction with district partners.

The school health clubs have scaled up their activities towards promoting a healthy school

environment and improved sanitation in schools. In the last six month, the school health

clubs received and planted a total of 4,500 special trees that can help to earn an income,

provide shade, provide nutritious fruits and can be used for learning in science subjects.

These included 1,500 neem trees, 1,500 pine trees, and 1,500 eucalyptus and 1,500

improved orange seedlings. Each school health clubs planted 100 improved oranges, 100

neem trees, 100 pine trees and 100eucalyptuses. The project also provided school health

clubs with 105 watering cans, 75 water jericans. Children participated in preparing the sites

for planting, planting trees and are now caring for the tree seedlings by watering them daily.

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This activity has enabled them to gain practical skills in agriculture and to learn how to

maintain value and protect their environment.

4.2.2 Promoting inclusive education

In the last six months, the project in partnership with the district education department

supported eight women teachers from Katine schools to be role models for girls by leadingcommunity advocacy sessions in four communities. These meetings addressed key issues

including how communities can strengthen OVC support systems for access to health and

education services, how OVCs can be actively involved in day to day learning activities at

the community and in schools to avoid stigma and discrimination, what role can people play

to ensure OVCs education and wellbeing; the role of parents, teachers and community

leaders. Discussions have raised awareness on inclusive education for orphans and

vulnerable children resulting in increased community support to send Orphans and

Vulnerable Children (OVC) to school.

In 2009, AMREF trained 42 teachers including 10 women in all 15 schools on special needs

teaching and handling of children with different disabilities. This training complemented the

aforementioned community sessions on the need to promote inclusive education. In thereporting period, the project has observed significant enrolment of OVCs in schools and in

communities more OVCs are now being encouraged to attend school and participate in other

activities. Of the 9,071 children aged 6 - 12 enrolled in schools in 2009, 1,613 (767 female,

847 male) are OVCs. Increased school attendance will contribute to improved integration

and self esteem. The number of OVCs who registered for first term in school is expected to

have increased however the data has not yet been compiled and this should be available in

the next reporting period.

4.2.3 Strengthening community ownership and management of schools

Through two workshops in the reporting period, the project trained 60 SMCs and 15 PTAs

newly elected executive members on roles and responsibilities according to the new

Education Act of 2008 to improve planning for schools. In partnership with the district

education department, the project conducted support supervision in all schools to ensure

effective school planning and syllabus completion, the support also provided guidance and

monitoring of school management and teacher/pupil attendance. Teachers were previously

unsupported and tended to plan individually but this has changed as teachers come to plan

together in a coordinated way and all issues related to the years syllabus are discussed,

planning done jointly with support from the District education office. The completion of the

syllabus encourages more time for revision and better grades from pupils.

At the start of the project PTAs and SMCs were inactive. By the end of 2009, the PTAs and

SMCs performance has improved in all the schools in Katine sub-county. During this period

the district education department organised support supervision and monitoring exercises;

all the schools had at least completed an average of two teachers' houses, teachers

reported improved welfare as their allowances are being paid on time with reduced

irregularities in the payments as was experienced before. Each school in Katine now has a

well formulated development plan and the PTAs and SMCs were meeting regularly and at

least twice in the 6 month reporting period to follow up on the implementation of the school

development plans and assess progress being made to improve performance and facilities in

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schools. The project is seeing increased ownership which contributes to the sustainability of

the project.

The education component is ahead of target to achieve its plans at this point in the project

with spending in line with where it should be 6 months into the year.

4.3 Improve access to safe water, sanitation and hygiene

4.3.1 Increasing access to safe water

In the last six months, the project in

partnership with the district waterdepartment and the sub-county water and

sanitation committee identified five new

communities where five boreholes would be

drilled and installed; four will be provided

by the project and one by the district. To

strengthen community participation and

management of drilling new boreholes,

AMREF supported the communities to

identify and select four new water source

committees (Olocoi, Abarilela, Apuuton and

Ojago villages), each comprising nine members. The project provided training to the

committees on how to manage the drilling process, the preconstruction phase, and

promotion of sanitation and hygiene at community level, as well as meeting the sector

guidelines six critical requirements for communities. 16 The plan currently is to drill and

install the boreholes in the next six months.

The project identified and supported ten vulnerable households with a 2,500-litre rain water

harvesting jars constructed by community masons that the project trained. These were

provided to 8 households with elderly persons and two to households of persons affected /

living with HIV/AIDS. These jars are providing storage to over 60 people in Katine sub-county

and has built on the projects previous years interventions to increase water coverage to

85% (national target), contributing to reducing preventable illnesses and death from water

borne diseases.

16i) Capital cost contribution by the community, ii) community meeting a target of 30% improvement in sanitation

and hygiene, iii) community to provide a signed land agreement indicating community ownership of the land where

the water source will be located or drilled, iv) community selection and formation of WSCs who oversee the

management and maintenance of the water source facility, v) a prepared Operation and Maintenance plan that will

be used for the management of the water source facility, vi) community providing a signed a MoU detailing roles

and responsibilities of the community, WSCs and stakeholders in the ownership, use and maintenance of the water

source.

17

AMREF has supported schools with desks, some of us have not been sitting on desks but now all of

us sit on desks. AMREF has also helped people through the VHTs [village health team members] who

have been trained on health in the villages. They have helped and sensitised people to have latrines

and washing racks at their homes and people have taken heed. People are now healthy, because

latrines are in place in the villages. Even children who fall sick and not coming to school are not

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Fig.3 Above, Kevina Alupo gets water from a newly constructed water jar. AMREF constructed water jars to benefit

households with elderly and vulnerable persons.

The project in coordination and collaboration with the district water departmentconducted

water quality testing and surveillance in all 68 existing water sources in Katine. Samples

were collected, analyzed and results shared with the communities through the sub-county

health committees and the parish development committees. VHTs, water source committees(WSCs) and hand pump mechanics (HPMs) supported the process through mobilization of

communities to promote hygiene in all the water sources.

The project supplied and installed two rain water harvesting tanks of 10,000 litre capacity in

two schools (Ojom and Ogwolo primary schools) to promote behavioural change through

hand washing and the safe water chain17 amongst school children, teachers and

communities. This has contributed to an improvement in hygiene, reduced incidence of

worm infections and reduced water born diseases, resulting in healthier children more able

to attend class and participate actively in school activities.Enrollment figures in Ojom and

Ogwolo primary schools are 346 (boys 168, girls 179) and 518 (boys 265, girls 253)

respectively.

4.3.2 Increasing access to basic sanitation and improved hygiene

The project is working with school health committees in the planning and implementation of

school health and sanitation activities and completed the construction of six ventilated

improved pit latrine (VIP) in four primary schools (Ojom, Ogwolo, Amorikot, Adamasiko

primary schools and two in Merok primary school). The project also rehabilitated six VIP

latrines with fixed metallic doors and carried out repair works of damaged parts in Katine,

Olwelai, Oimai, Ojama and two in Ajonyi primary schools. These latrines are expected to

improve sanitation and reduce disease in schools.

The project reactivated 12 water and sanitation committees and provided refresher training

on the CASHE model AMREF has used in other parts of Africa (the Community Approach toSanitation and Hygiene Education). This was based on the observation that previous water

sources established prior to the KCPP were not operational, unattended to and not meeting

water source standards as required by the national guidelines with no-one responsible for

maintenance. Instead of putting new sources, the project reactivated and has so far trained

four water source committees of Ochuloi Parish on operation and maintenance of water and

sanitation facilities, management of water user fees and simple book keeping. They are

currently involved in the promotion of community ownership and management of the

sources to users of those water sources.

The VHTs are important structures in the promotion of total sanitation and hygiene in

villages in Katine using various approaches such as home to home visits and drama to

communicate these messages. The project has developed a programme involving VHTs inKatine to scale up their activities aimed at promoting ideal homesteads and attainment of

total sanitation. To support VHTs in the promotion of ideal homesteads, three coordination

meetings were held with VHTs from Ochuloi, Olwelai and Ojom Parishes to develop tools and

agree on strategies for conducting home visits and supporting the promotion of hygiene and

sanitation activities in all the villages in Katine.

17Safe water chain is ensuring safe water collection, transportation, storage and consumption at household level.

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The project continues to work with VHTs in the promotion of better hygiene and sanitation in

the communities through a new approach of community led total sanitation and hygiene

(social marketing approach)18 by using locally available materials in the construction and

maintenance of sanitation facilities and by showing the benefits of sanitation facilities to

promote better hygiene and sanitation. As a result there are now 86 new ideal homesteads19

increasing the total from 312 in 2008 to 398 by March 2010.

4.3.3 Strengthening community capacity to manage water sources

AMREF facilitated joint quarterly monitoring support visits by members of the sub-county

health committee to collect and analyse field information. The participatory approach taken

has encouraged and improved community based monitoring and has enabled communities

to manage their own water supply and sanitation development initiatives to improve

community water supply, sanitation and hygiene practices.

Continued support to Parish Sanitation Committee (PSC), VHTs, WSCs and hand pump

mechanics through routine quarterly coordination meetings has strengthened their ability to

ensure maintenance, repair and protection of these new boreholes.

4.4 Increasing income generating opportunities

The component is conducted in partnership

with FARM-Africa and with CARE and UWESO

to support VSLAs. The project continued to

support the 540 farmers in 18 model farmer

groups with farm inputs, capacity building and

monitoring as they enter into the new planting

season. Taking on board the midterm review

recommendations, an additional 1,302 farmers

from 48 existing Village Savings and Loan

Associations (VSLAs) were enrolled into the

farmer groups activities of the project. To

date, a total of 66 farmer groups with 1,842

(596 males, 1248 females) individual members

in Katine are being supported to engage in the projects livelihood activities; each village

now has a farmer group.

Fig 3. In the picture above, Francis Ocago attends to his shop at Olwelai centre in Katine sub-county. His shopbusiness has progressed and he attributes this to having joined VSLA activities.

Farmers in Katine have prepared over 920 acres of land as multiplication sites for the first

planting season and the project is procuring over 900 bags of groundnuts, 3,960 kilograms

of upland rice and 90 tins of assorted vegetable seeds (cabbages, onions, and tomatoes) todistribute to farmer groups for the second planting season in August. This was because

there was a need for 3,000 tonnes in bulk of groundnut seeds which was not readily

18 Social marketing is promoting a product as a tool that if used individually and as a community brings benefits to

all. Individuals or groups are encouraged to spend time, energy and money to acquire them. E.g. sanitationplatforms (sanplats).

19This is a traditional homestead with a main house/hut, a hut for children, a hut for visitors, a latrine with a tippytap, a bathroom, drying rack for plates, separate house for goats and spacious clean compound.

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available in Soroti in time for the earlier season. Each farmer is using half an acre of land to

demonstrate improved farming technologies to other members of the community. Over 200

acres of drought resistant, high yielding, quick-maturing cassava that was introduced by the

project in 2008 has now multiplied in the planting season. Since all villages now have model

farm groups, more people will be able to benefit from improved food security and improved

income.

The farmer groups are also VSLAs that have completed their first cycle of savings. In the

previous cycle, a total of Ushs 161, 465,850 was saved and shared with each individual

member receiving between Ushs 50,000 to Ushs 300,000 (16 93) depending on their

share value. Currently the groups savings ranges between Ushs 1,000,000 to Ushs

4,500,000 with all 66 groups accumulating Ushs 72,504,550 million (22,482.03).20

The VSLAs now have a social fund contribution in addition to their savings, which ranges

between Ushs 100 to Ushs 200 per person per meeting and is contributed to each time the

group members sit in the weekly meeting. This fund is separate from the savings and has no

interest rate attached to it and is accessible to individual group members as and when

specific household emergencies arise such as medication, food, school fees and buying ofhousehold assets.

In the first cycle of savings, group members acquired different household assets with their

share amount of between 50,000-300,000 Ushs per person. Different group members said

they used their share amount to purchase different assets such as cows/ bulls, goats,

chickens, mattresses, clothing. Some were able to start up businesses while others

expanded their existing business in Katine. With improved income, Katine residents are

building up the self-confidence to manage their lives and their self-esteem is improving to

participate in public meetings, especially women who make up the majority of these farmer

groups. (See field story attached in the annex).

4.4.1 Enhancing the capacity of rural community based organisations (innovationgroups)

In collaboration with the district development office and commercial office, the project

trained 66 group leaders on needs assessment, conflict management, group leadership,

financial management and report writing. This has strengthened group management and

groups are now demonstrating improved ability to resolve their own problems such as

managing conflicts of roles and responsibilities within the groups, addressing

mismanagement of groups funds etc.

The project facilitated farmer groups to form an apex association KAJOFA (Katine Joint

Farmers Association). The association will support farmer groups in Katine to carry out

marketing activities, oversee the provision of animal health services, ensure farm produce

quality at the grassroots levels and assist in the management of the farmer produce store.

In collaboration with the district development office and commercial office, 12 elected

leaders of KAJOFA were trained on leadership roles and collective marketing.

The association has eased coordination between AMREF, the sub-county and other

stakeholders implementing livelihoods activities. The association plays a key role as a link

20The 48 new farmer groups enrolled in the project were previously practicing VSLA model with UWESO/CARE.

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between the farmers and the livelihood stakeholders forum and has been instrumental in

data collection on the various livelihood activities at household level. Monitoring of group

activities has improved with the formation of the farmers association. For all farmer groups

in a parish in Katine, there are two contact farmers who are members of the KAJOFA

leadership, acting as Parish coordinators who connect the farmers in each parish with the

livelihood stakeholders forum and KCPP. These coordinators monitor the farming and VSLA

activities of all farmer groups in their parish through contact person (group leaders) in each

farmer group at village level. They then share their reports on a quarterly basis with KCPP

and KAJOFA leadership on performance of each group members resulting in improved

monitoring of group activities. Issues related to farmer groups are now being addressed and

represented as the association has a representative in its executive from each of the

parishes doubling as farmer group parish coordinators.

4.4.2 Improving coordination of rural livelihoods support to Katine community

A livelihoods stakeholders forum coordination meeting was held to develop a joint strategy

for marketing of agricultural produce using the produce store currently under construction

by the project in Katine sub-county. The livelihood stakeholders forum jointly explored and

agreed on the strategy of linking farmer groups to government programmes to

continue receiving support after the project phased out. The stakeholder forum also

agreed on a collective marketing strategy with crops to be collectively marketed through the

produce stores; including groundnuts, maize, cassava, sunflower and upland rice.

4.4.3 Increasing the productivity of crops and livestock production to improve

food security and income

In the last six months, the project trained 30 selected members of the farmer groups as

trainers to roll out the farmer field school approaches to famers in the sub-county in order

to improve productivity. This is a participatory methodology where farmers learn, apply and

transfer improved methods of farming together on demonstration plots. This approach also

allows farmers to learn about group dynamics and management, soil science and nutrient

dynamics, soil fertility management, crop management and where they copy and apply their

farming activities in their respective villages. Those who are now trained have established

15 demonstration farms showcasing the four most commonly grown crops in Katine

(groundnuts, maize, upland rice and beans). The trainers through demonstration farms

trained 1,420 farmers on the farmer field school approach to farming.21

The project supported farmers study tour to progressive NAADS farmers in Gweri and Ngora

sub-counties, Soroti District to share experiences on agricultural innovations and new

farming technologies as the new planting season begins. 55 farmer representatives, two

sub-county staff, one district staff and three KCPP staff participated. This exchange should

contribute to improved farming practices among the farmers in Katine, increasingagricultural productivity and food security.

There are now 60 nursery beds with cabbages, onions, and tomatoes due to the projects

supporting 60 farmers from farmer groups (15 per parish) with assorted improved vegetable

21The training also addressed soil and water conservation, soil erosion control, soil fertility management, additionof organic matter, use of improved farm inputs, correct crop spacing, intercropping, use of organic and inorganic

fertilisers and early plantingand integration of enterprises for income generation.

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seeds. Of the 60 farmers, 30 are women and have learnt how to make a small organic

garden that can begin providing sustainable supply of onion, cabbage and tomatoes.

The project has also established an animal service centre in Katine in collaboration with the

sub-county and the District Veterinary Office (DVO) under the District production

department. Farmers will be able to access animal health services from the centre. Initially

the project had planned to recruit, train and equip seven para-vets22 who are resident in thecommunities to offer animal health services but out of the seven trained, four returned to

school and two were employed by another organisation in another district. Only one of the

seven para-vets has remained in Katine. AMREF had discussions with the DVOs office and

agreed to have a central service centre where farmers in Katine could obtain the animal

health services from the remaining Para-vet who would run a veterinary drug shop and

service will be able to contact the para-vet from his drug shop and he can then attend to

animals. A space has been offered in one of the offices at the produce store to house the

drug shop and serve as the service point where the para-vet will operate from.

4.4.4 Improving access to returns from markets and marketing

The office block of the farmers produce store has been completed and the main store is atthe roofing level. In collaboration with FARM-Africa, the sub-county and District partners, the

project has allocated one room out of the three in the office block section to house the

animal health service centre.

One office unit will house the market information centre supporting farmers to access

information about markets locally, nationally and internationally. The Apex organisation

(KAJOFA) will be responsible for updating the market information on a weekly and monthly

basis.

4.5 COMMUNITY EMPOWERMENT

4.5.1 Strengthening local governance using the Rights Based Approach

Key messages for posters, drama groups and radio talk shows have been agreed and

finalised by the Information Education and Communication (IEC) working groups at the sub-

county and district. Messages related to community rights and obligation, health, education

and safe water and hygiene practices such as the importance of immunising all children,

benefits of children attending and staying in school including messages on services available

and their rights to access them were developed for dissemination.

The community media centre continues to play a major role in providing Katine community

members with access to a wide range of information, there is an increasing interest on the

use of the community media centre from students, teachers and community members who

visit the facility on an average of five to ten people per day. Community members aretrained on basic computer skills to enhance accessibility and use of the internet.

During the period, the project facilitated two online chats between Katine communities and

the Guardian readers. In coordination with community media facilitator, Katine communities

and Guardian readers were able to share information and ideas about the project. Some

community members are now able to read and contribute to blogs on the project website.

22Short for para-veterinarians. People trained at diploma and certificate level to provide animal health services

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The project has recorded a remarkable increase in the number of school going and non

school going youths visiting and using the resource centre. Out of the 300 visitors per

month, over 60% are youth, aged 10-16 years. Enhancing their information needs improves

their knowledge and self-esteem to engage in discussions and public debates.

KCPP conducted two training sessions in community participatory planning and budgeting

for two Parish Development Committees of Ojom and Ochuloi Parishes. The training wasfollowed up by meetings to facilitate the process of community action planning and

meetings were organised and facilitated in Ojama, Ojom and Merok Parishes to assess and

monitor the implementation of action points agreed upon in their training and their planning

process. These exercises stressed community needs and priorities to be reflected in the sub-

countys three-year development plan. Currently, all 6 parishes have produced their

development plans to be incorporated in the new sub-county development plan for financial

year 2010/2011. The annual budget framework process which takes four months to set at

the sub-county level and is are revised annually to reflect community priorities then

proceeds to district and national level for approval. The plan has incorporated parish

priorities.

The project organised three Project Management Committee (PMC) meetings and one

Project Steering Committee (PSC) meeting. The PMC at sub-county level supports the day to

day running of the projects and the PSC at the district level provides technical and policy

guidance to the project. The meetings at both levels discussed and reviewed project

progress the project has made on the

implementation of the MTR recommendations and

the projects technical approach. These meetings

have improved coordination, ownership and

involvement from local government stakeholders

and partners in the implementation of the project.

The project distributed 122 bicycles to the parishdevelopment committee members (PDCs) from all

the six parishes. This was in response to the

request made by the PDCs that their major

challenge in carrying out their activities23 was lack

of transport. Since the distribution of bicycles, the

sub county has registered an improvement on the

operation of PDCs as they are now able to carry out community activities and share the

information from those activities such as minutes and reports with the sub-county.

Fig 4. Alice Alolo, a parish development committees (PDC) member from Merok parish receives her bicycle at the

AMREF office in Katine.

4.5.2 THE LEVEL OF INTEGRATION AMONG COMPONENTS

The integrated nature of the project addresses the underlying socio-economic factors of

health and wellbeing in the implementation of activities. Project officers responsible for

23Activities include:community data collection, mobilization of communities for village and parish meetings, consultations withthe communities during the planning process, community sensitization on development issues and overseeing and supervising

development projects in their areas.

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each component have worked closely together to complement each of the other

components to ensure benefits to the people of Katine.

The project has brought VHTs and health workers to run child health days and trained

teachers on reproductive health through health outreaches in schools. Classrooms

rehabilitated or built have considered the increase in enrolment, and this therefore impacted

the number of latrine stances the project made available in the schools.

There is improved hygiene and sanitation in schools and in the community as a result of

latrines and tippy taps which contributes to a cleaner home and school environment. Better

health results in less money and time spent on seeking healthcare (travel costs and

treatment costs) and more time to go to school or work.

Community empowerment component works to strengthen the functionality of all

community based structures in health, education, water and sanitation and livelihoods. This

is achieved by supporting the training of PTAs, SMCs, farmers groups, WSCs, VHTs. The

project has taken on board the midterm review recommendation to strengthen the use of

rights based approaches and gender mainstreaming and inclusion.

5.0 PARTNERSHIPS AND COORDINATION WITH OTHER BODIES.

AMREF implements its work by partnering closely with communities24in order to build their

capacity, improve the reach of work and ensure sustainability in approaches by working

through existing structures. The project continued to mentor parish, sub-county and district

counterparts in the departments of health, water and sanitation, livelihoods, education andcommunity empowerment in all its activities. These included:

Existing community networks

Government structures

NGOs and CBOs (Community Based Organisations) who share the same vision andobjectives i.e. Tran cultural Psycho-Social Organisation (TPO), TASO and UWESO.

Below is how each component of the KCPP worked in partnership with a number ofstakeholders.

5.1 Health

Partnered with the district health team in joint trainings and joint field supervision. Alsoparticipated in the district health sector coordination meetings to which other NGOs alsoparticipate.

24Community partnerships is one of AMREFs three strategies where by we jointly identify a problem and develop acommon plan to address it and share responsibilities between AMREF and the communities, working with

community groups and community based project committees.

24

AMREF constructed the Omulai borehole in my villages to give us clean water. Clean

water is very important because it keeps me healthy. If I use clean water I dont get any

diseases. [And] because the borehole is near home, I take a short time to collect water

and I am never late at school. I must be luck because I collect water from a short

distance and manage to go to school early.Mary Anyumel, 10 years, in primary


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Participated in national programmes like national child days plus campaigns andinternational programmes like World AIDS day.

5.2 Education

Worked alongside local government education department, primary teachers colleges in

planning and implementing activities especially in the implementation of capacity buildingactivities for beneficiaries through primary teachers college (PTC).

Worked with the district education working group that includes the district educationdepartment, SNV, Child Fund International, World Vision, TEDDO, Right to Play, TEMEDO andothers organisations by sharing information, best practices, making policy recommendationsand coordinating activities by themes and geographical areas of operation.

5.3 WATSAN

Joint implementation of water quality testing and surveillance activities with the districtwater and sanitation department. The project hosted a team from directorate of water

development

25

who were on a monitoring visit in preparation for the water and sanitationsector performance report that would inform and feed into the discussions during theGovernment of Uganda/Donor Sector which discussed funding gaps, challenges and newstrategies to improve the sector.

As a member of the District Water and Sanitation Coordination Committee, The projectsupported Soroti District Water Department in implementing national sanitation week, anational strategy aimed at achieving total sanitation at household and institutional level.

5.4 Livelihoods

Worked closely with the district local government departments especially district naturalresources department, Works, community development, production and marketing on

training of farmers.

Planned and worked closely with FARM-Africa on farming issues for technical support andUWESO/CARE on VSLA activities. Participated in the livelihoods stakeholder forum with otherNGOs ; Soroti District Farmers Association (SODIFA), Community Development Initiatives(CIDI), Temele Development Organisation (TEMEDO) and Transcultural PsychosocialOrganisation (TPO)

A MoU is being finalised between AMREF and CARE to streamline issues of jointimplementation, coordination and information sharing in Katine and at countryoffice level.

Collaborated with NAADs programme through exchange visits to NAADS model farmers andalso collaborated with the private sector foundation, Teso region in collective marketingthrough exchange visit to farmers in Mbale District.

5.5 Community Empowerment

25DWD is a technical unit in the Ministry of Water and Environment that deals with all sanitation and water issuesin the country. Each region, including Teso in Soroti, has a Technical Assistance Unit with specialists.

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Activities were coordinated in partnership with relevant stake holders through District ProjectSteering Committee and sub-county Project Management Committee bringing togethertechnical heads at district, sub-county and community level in planning and implementationof the project.

Supported and participated in the National event on the commemoration of International

Womens day held in Katine.

6.0 RIKS, CHALLENGES, SOLUTIONS, LESSONS LEARNT AND RECOMMENDATIONS

6.1 Risks

1. Brown borehole water When a borehole is pumped rapidly and large volumes of

water come out, brown and rusty pellet like substances come with the water. This has

lowered community interest in the water and a risk of the communities abandoning the new

water sources, reverting to other sources like rivers and ponds that may be clear but unsafe.

The substances are natural iron chemicals that pose no health threat but which does makes

the water unpleasant to drink. This has now happened at five out of the new eight boreholes

installed by AMREF. These substances are caused by high concentrations of Iron and TotalDissolved Solids in the water which is a characteristic feature in the area, and has equally

affected non-AMREF boreholes not only in Katine but also in the neighbouring sub counties,

according a Soroti District Water Resources Report(October 2008).

With the help of Hand Pump Mechanics trained by AMREF, AMREF is encouraging the

communities to collect operations and maintenance funds, to facilitate the mechanics to

clean the pipes as a temporary measure; this has been done in all five communities. But the

problem keeps recurring. We are also encouraging communities to collect more funds, to be

able to save enough money to buy new pipes in future to replace the damaged ones. The

government has established a technical assistance unit in Soroti for Teso region with

specialists in water and sanitation. One of their roles is to de-ionise the water sources with

new technology and we are already planning with them. The technology involves inserting a

device with chemicals inside the shaft, at the point of the water coming out that dissolves

the solids and sieves the water before it comes out, ensuring its clean and safe drinkable

water.

6.2 Challenges and solutions

1. The inadequate supply of medicines: Coartem, oral rehydration salt and panadol for

home based management of childhood illnesses continues to hamper the work of the

community medicine distributors. AMREF is advocating together with other NGOs for the

government to ensure that there is availability of drugs. Already, drug supplies have

improved from being supplied every four months to heath units to every two monthscurrently. The government has also changed the strategy from buying 30% of the drugs

at national level and 70% at local government to 70% from the national drug authority

and 30% from local governments. We are yet to see the improvements.

2. Staff shortage in all the three health facility makes conducting outreaches

difficult: The project has embarked on advocacy of health workers to be recruited by

the district to support the limited staff at the health centres. The district health office has

responded by recruiting and posting a laboratory assistant for Ojom laboratory, a health

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assistant to Ojom H/C II and two more staff to Tiriri H/C IV and the project is optimistic

that the government will continue to recruit more staff based on a promise by the district

Chairman. Advocacy is a continuous process and AMREF is continuing to lobby the

government.

3. Low participation of men in reproductive health: Although there is low participation

of men due to cultural beliefs and a strong catholic faith, the project is encouraging male

participation through IEC messages promoting behavioural change. For example, posters

showing a man escorting his wife to an antenatal check up will encourage men to do the

same.

4. Cultural and religious barriers affecting HIV prevention efforts, PMTCT and

family planning. Some of these beliefs include acceptance of polygamy, a woman not

being allowed to divorce her husband because it brings shame to the family. The project

is promoting messages on behavioural change through community training, radio

programmes, IEC materials with messages such as pregnant mothers should test for HIV

to ensure they protect their new unborn baby.

5. Accommodation and remoteness of the community schools: Qualified teachers

are being posted to community schools. Although still not meeting the required numbers,is being well responded to by the District resulting in some teachers being posted to

community schools. To fill the gap, it was agreed that community schools should identify

teachers from the community.

6. The increasing demand for more safe water sources in the community and our

inability to address the demand has been the WATSAN components major challenge.

AMREF is working with the community structures to create awareness and manage

expectations and maximise benefits within the available resources. The project expects

to increase the water coverage from the current 65.6% to 85% by the end of the project

which will provide adequate water for at least everyone in Katine. (85% water coverage

is the Government if Ugandas target for 2010. 100% is the Governments target is for

2015)

7. Gender balance: Having strengthened a number of structures, equal gender

representation by numbers and participation in some of the committees is still a major

challenge due to culture and educational backgrounds and some of the committees like

VHTs were elected before the project and they dont have term limits by which they can

be replaced. The project will continue to promote gender awareness and training in

gender mainstreaming and promoting affirmative action in-group formation through

women councillors, local women councils, female teachers, successful business women

etc.

8. A motivation package for VHTs is not yet clearly defined and various options are

being explored. Some VHTs are not committing to work until a motivation package is

clear. The project, alongside the district is currently discussing with VHTs the various

options to come up with an agreed one.

6.3 Lessons and Recommendations

1. Improve security of VSLA funds: The practice of VSLA repaying all loans two

months before the end of the cycle to share money within group members has

attracted theft. AMREF has recommended that if possible the model be reviewed to

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address this, especially security of money. CARE has now negotiated with banks for a

VSLA related product that will allow VSLAs to deposit money in these banks. CARE

has also allowed the VSLA approach to be integrated in the other project

components, like WATSAN where WSCs are already lending money collected for

borehole repair among themselves, but a process of the principles needs to be

followed.

2. Co-ordinate lesson planning with teachers to complete the school syllabus:

Joint lesson planning and preparation of scheme of work by teachers from all the

schools is greatly improving lesson delivery and enabling the schools to complete the

syllabus. We recommend that in future, lesson planning be coordinated and done

jointly.

3. Work with key leaders to promote awareness to eliminate stigma: Up to date

information dissemination about HIV/AIDS and positive living is key in changing

attitudes, behaviours, practices and stigma which hinders access to health care

services.

4. Music Dance and Drama groups are an effective way of communicatingcross cutting messages from all components: This has been demonstrated in

Kalela village, Olwelai parish where VHTs formed a drama group for sanitation and

hygiene education and this has been useful in disseminating health messages as

they draw cheering crowds. While people are being entertained, they gain

information on life skills.

5. PDCs and Local Councils have a strong potential to support communitiesdevelop village/parish plans: with the right level of support to work together andby improving their skills and facilitating them, they are able to mobilise communitiesand monitor development work in their areas.

6.4 Plans for the next 6 months

AMREF will continue to implement the recommendations of the midterm review. In health,the project will continue to help strengthen community outreaches to meet the yearly target

of 52 outreaches. Health Centre workers will be trained to promote counselling and testing

services for HIV/AIDS and AMREF will ensure support supervisory visits continue to enable

VHTs to report at health centres. In education, the project will continue to strengthen

community ownership over school supervision and promote inclusive education of girls,

disabled, orphans, and vulnerable children. To improve teaching and learning, the project

will use music, drama, sports to strengthen the capacity of school health clubs in hygiene

promotion. In water and sanitation, the project will continue to construct household rain

water jars, panel and ECOSAN toilets in primary schools and provide support to VHTs and

Water Source Committees to effectively manage water sources. In livelihoods, the project

will support all farmer groups with ongoing support and capacity monitoring. Two morequarterly meetings will be held for rural livelihoods stakeholder forums and para-vets will be

trained. All 66 farmer groups will receive agribusiness management training and collective

marketing initiatives will be supported through the Katine SACCO26. In community

empowerment, the project will continue to enhance community planning to better meet

community needs through PDC follow up meetings and refresher training, continued training

on rights based approaches to development at the parish, sub-county and community level.

26SACCO Government supported savings and credit co-operatives at sub-county levels

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More community members will be trained on basic IT skills and governance /phase out

meetings will be held with sub-county and district partners.

7.0 FINANCIAL REPORT SUMMARY As of March 20010, two and a half years into the

project, AMREF spent 70% of the total year 1-3 revised budget27 of 2,869,598. Below is a

breakdown of key reasons for under/overspend against the Oct 07-Sep 10 budget. The

financial report is a separate annex and should be read in conjunction with the summary

below. The narrative below relates to any significant under or overspend against the budget.

Project activities: The main under-spend is in the health component and relates to a

delay in the renovation of Tiriri health centre operating theatre and connection of running

water to maternity and theatre. Procurement of a consultant started and work began in the

first quarter of 2010. The spending should be in line by the next reporting period.

Under Livelihoods, an agreement to delay the distribution of seed

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Amref six-month Katine report - Oct 2009 to Mar 2010

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