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Juliet Waterkeyn & Andrew Muringaniza. Africa AHEAD Association.
It is clear that CHCs are not only a popular strategy but that they do in fact produce high levels of hygiene behaviour change. Zimbabwe is not the only country to report good case studies of the CHC approach. In West Africa, Community Health Clubs are being used to rebuild society after a devastating civil war. In Guinea Bissau CHCs in remote rural villages complement an intervention to improve infant mortality, and in Uganda, CHCs have been used to improve home hygiene and create a demand for sanitation in the war toen IDP camps of the north. Whilst in these examples the CHC approach is being done through NGOs on a fairly small scale, in Rwanda the Ministry of Health is planning to introduce health clubs into everyone of the 14,000 villages in the country. In Asia, Vietnam leads the way with training through the MoH which aims to start CHCs in all 25,000 villages. Countries where this can be scaled up may well be able to meet the MDG
targets, given the power of CHC to stimulate demand led safe sanitation.