I just got back from Rwanda for the Global Health Corps mid-year retreat. As part of the program, each fellowship team was asked to write a case study on a topic that they would like to get ideas and feedback on from the other fellows. Edmund and I met last week and decided we want help brainstorming how to approach the creation of a new health clinic, which will be one of our main tasks for the later part of our fellowship. We were so excited and uplifted by the insight of other GHC Fellows that we thought it would be interesting to get opinions and advise from a wider community. Thus, I am asking you to read the situation below and give us ideas on how to foster community ownership of the project.
(To help spark some creativity, check out this really interesting article, Tales of Shit: Community-Led Total Sanitation. It outlines an innovative and controversial take on community ownership. What lessons from this article should we employ? What tactics should we avoid?)
OK, here is the case study:
Main Challenge
After completing a needs assessment that covered 247 households and 1200 individuals in Nama sub-county, Mpoma Community HIV/AIDS Initiative (Mpoma) met with its health partners to review the data, understand the recommendations of Mpoma beneficiaries, and discuss how to move forward.
(You can find the health assessment here, I would love your feedback on this as well! Ok, back to the case study….)
At the meeting, everyone agreed to build a new clinic near the current Mpoma offices. Partners were enthusiastic to help, pledging resources, expertise and funding. However, Mpoma has not yet held any community meetings to discuss the project. Mpoma staff wants to maintain the excitement of outside partners and the momentum of the project, but they also want to ensure that the community “owns” the clinic.
Background Information
The health assessment revealed that many people that want health services (including: family planning services, malaria treatment, HIV testing, first aid, and so on) do not receive them either because health clinics are too expensive to travel to or because clinics are out of drugs. Mpoma hopes to increase health access by building a health center II that is more accessible, and conducting regular outreach programs for malaria nets, family planning, and eventually other services. Included in Mpoma’s programming is a primary school where many community children receive free or subsidized education. The children at the school will also receive free services from the clinic.
Mpoma is located in a semi-urban area but also does outreach work in the surrounding rural villages. Currently, Mpoma does much of its health outreach work through Village Health Teams (VHTs). These individuals have been trained by the Ministry of Health and given bicycles by the government to aid their efforts. VHTs participated in the health assessment through a series of focus groups in which they helped interpreted and clarify the results of household surveys and offer suggestions for Mpoma’s future programming.
Mpoma staff is extremely small. Currently it consists of a program manager, social worker, nurse, education secretary, agriculture manager, two community volunteers, and two lovely GHC Fellows. Mpoma is supported by a board, which consisted exclusively of members of the community. Mpoma has good relationships with the Local Council (LC1s), sub-county officials, and administrators from neighboring schools.
Now, its your turn!
1. What steps should Mpoma take to promote community ownership of the clinic while still maintaining the excitement of outside partners and momentum of the project?
2. How should Mpoma communicate with its community and beneficiaries? What types of forums, advertisements, and messages would you suggest?
3. How should Mpoma communicate with its partners and funders?
4. What potential pitfalls do you foresee? How could Mpoma work to ameliorate these?
