New Funding Model
Malaria continues to be a major contributor to public health and economic burden in Cambodia with high rates of morbidity and mortality, hence malaria control is a priority for Cambodia. The National Strategic Plan for Elimination of Malaria (2011-2025) aims to ensure that no artemisinin-resistant malaria parasites are detected in Cambodia by 2015, to eliminate falciparum malaria as well as malaria deaths by 2020, and to eliminate of vivax malaria by 2025, in line with the global call for elimination and eradication of malaria.
Program implementation in Kampot, Koh Kong, Preah Sihanouk, Kampong Chhnang, Kampong Speu, Pursat, Kep and Takeo provinces. The program focuses on information, education and communication (IEC)/ Social Behavior Change Communication (SBCC) interventions, particularly through community mobilization: raising awareness of malaria among at-risk populations, increases use of bed nets (particularly for children) and other prevention measures, and promotes individual awareness and self-protective changes for the general population. PfD is building the capacity of community health workers in effective IEC/SBCC tools and skills to effectively identify Key Affected Population (KAP) in or near their villages and to mobilize their communities toward health goals to achieve long-term sustainability.
- Train, inform, and educate key village members (e.g., maternal and child health and mobile/ migrant population (MMP) key persons) about malaria risk, prevention, diagnosis, and treatment.
- Mobilize communities through strengthening relationships between VMW/health facilities and key community members for prevention and referral to VMWs/health facilities including tracking of case referral from community to VMW/HC
- Conduct BCC Impact Assessment (KAP Survey) and develop BCC interventions, IEC/BCC toolkits, and training materials; build capacity of existing sub-national health systems and staff.
Result of the program is on-going, but as of July 2017:
- Trained 253 health center staff on ToT approach for participatory community mapping and group identification and BCC approach
- Trained 11 Village Malaria Workers (VMW) on participatory community mapping and group identification and BCC
- Conducted the World Malaria Day in seven target provinces with average of 300 participants in each event
- Co-organized two kick – off workshop for consortium members and government health partners and national consultation workshop on BCC message and approach.
- Carried out Knowledge, Attitude and Practice (KAP) survey in eight target provinces with the results:
- Proportion of population that slept under an insecticide-treated net* the previous night in target districts (77%)
- Proportion of children under five years old who slept under an insecticide-treated net* the previous night in target districts (76%)
- Proportion of pregnant women who slept under an insecticide-treated net* the previous night in target districts (73%)
- Percentage of population at risk of malaria living in the targeted VMW/VHSGs villages who go to a VMW/VHSGs/MMW when they have a fever (5%)
- Percentage of population at risk of malaria living in the targeted villages who correctly identify symptoms of malaria (79%)
- Percentage of population at risk of malaria living in the targeted villages who correctly identify cause of malaria (83%)
- Percentage of forest goers living in targeted villages who slept under an ITN the last time they were in the forest (71%)
Improve and Expand Water and Sanitation Services in Nigeria: The Water and Development Alliance (WADA) III project in Nigeria will improve and expand access to safe, affordable, sustainable and reliable water and sanitation services in Abia and Cross River States, Nigeria. WADA is a unique partnership between Coca-Cola and the U.S. Agency for International Development (USAID) that addresses community water needs in developing countries around the world and is managed by the Global Environment and Technology Foundation (GETF)
Access to clean water and improved sanitation facilities is a daily challenge for many Nigerians. The program is designed to strengthen the capacity of local institutions; construct and rehabilitate WASH facilities; and promote hygiene education in schools, health centers and communities in Abia and Cross River states. Working with the Tulsi Chanrai Foundation (TCF), PfD will collaborate with government and private entities including the state Rural Water Supply and Sanitation Agency (RUWASSA) and Local Government Areas (LGA) to: increase access to and utilization of improved water sources; improve sanitation; and promote appropriate hygiene education in rural communities, schools and health facilities within the selected communities.
PfD will collaborate with the State Governments of Abia and Cross River to improve and expand access to safe, affordable, sustainable and reliable water and sanitation services in rural communities. More specifically, through the WADA Project, PfD will:
• Establish (where not available) and/or strengthen the capacity of the community institutions including WASHCOMs and Environmental Health Clubs (EHC) in schools to drive the implementation of WASH services in their respective communities
• Train and mentor established community institutions – WASHCOMs, VLOMs, EHC, etc. – WASH facility maintenance/repairs and management of facilities/services to ensure sustainability of project interventions
• Rehabilitate and/or construct water and sanitation facilities, including boreholes, latrines, and hand-washing stations in schools and healthcare facilities in 20 rural communities each in Abia and Cross River states
• The project will directly benefit 80,000 men, women and children in the target rural communities: Of these 80,000 beneficiaries:
56,000 will have improved water access (at the household level)
440 economically empowered women
80,000 will have improved sanitation access
220 economically empowered youth
PfD is piloting an early warning system in Kratie province to improve tracking the emergence and spread of drug resistant parasites. The approach combines the experience of PfD in implementing interventions towards mobile migrant populations (MMP) and at community level, the expertise of the London School of Hygiene & Tropical medicine (LSHTM) in conducting operational research in Cambodia on MMPs and on drug resistance and the technical skills and expertise of Pasteur Institute in Cambodia (IPC) in molecular epidemiology. The project focuses on the Cambodia-Vietnam border where recent research results have documented the emergence of artemisinin resistant strains in Bin Phuoc province in Vietnam and delayed parasite clearance time in Snuol area in Kratie province (with the potential threat to spread to neighboring Kratie province in Cambodia).
- Conduct research to inform surveillance of drug resistance and establish an “early warning system”
- Measure drug resistance focusing on K13 (a protein that is strongly linked to artemisinin resistance)
- Strengthen tracking and information systems for MMPs
- Implementation of Plasmodium Falciparum (Pf.) Day 28 follow up and admission of Pf. Day 28 positive patients by health facilities to track drug resistance (train health staff on early diagnosis and treatment (EDAT) and second line treatment based on national treatment guideline; train VMW on EDAT)
PfD is piloting an early warning system in Kratie province to improve tracking the emergence and spread of drug resistant parasites. The approach combines the experience of PfD in implementing interventions towards MMP and at community level, the expertise of LSHTM in conducting operational research in Cambodia on MMPs and on drug resistance and the technical skills and expertise of IPC in molecular epidemiology. The project focuses on the Cambodia-Vietnam border where recent research results have documented the emergence of artemisinin resistant strains in Bin Phuoc province in Vietnam and delayed parasite clearance time in Snuol area in Kratie province (with the potential threat to spread to neighboring Kratie province in Cambodia).
The four focal areas of PfD’s community development work for the Allen Foundation in Stung Treng and subsequently Kratie province were: 1) economic development, particularly supporting rural livelihoods; 2) public health and sanitation; 3) public education and local capacity building, particularly improving community knowledge of health, nutrition, and agricultural practices; and 4) assessing and addressing problems in community infrastructure. A silk weaving training program was added to the project in 2001 with help from Veterans International. The World Food Program contributed rice to rice banks PfD built in Stueng Treng as part of its agricultural development support activities.
The project goal was to facilitate community development and quality of life within the eight communities. More specifically, through working with local structures such as Village Development Committees (VDCs), the project aimed to support community-initiated activities in: (a) economic development; (b) public health and sanitation; (c) public education and local capacity building; and (d) community infrastructure and communications.
The project completed “rice banks” in five villages across Stung Treng and Kratie. The banks have improved food security for poor farming households that are at risk of going in to debt or losing their land during periodic food shortages. Working through PfD, World Food Programme provided the rice stock for the banks to these community-constructed facilities. Members of the bank may then borrow from this stock during seasonal shortages; after harvest, borrowers then repay the bank with rice plus an extra 10% “interest” payment in rice. PfD also convinced local banks to provide credit for fertilizer and other key agricultural inputs.
With additional funding from the Allen Foundation, PfD also completed 100 latrines benefitting 567 community members, and provided sanitation education to families throughout the community.
The Agricultural Development Program exceeded its original objectives and close coordination with both the Provincial governments and Departments of Agriculture ensured successful implementation of the field programs. The four objectives of this program, improving agricultural productivity, enhancing household nutrition, supporting the Provincial Agricultural Extension Service, and improving access to markets, are interlinked and many of the activities completed by PfD spanned across more than one objective.
The first objective of the program was to improve agricultural productivity. PfD undertook a number of activities to accomplish this objective, including the introduction of new plant varieties, planting demo plots for farmer education, working with village veterinary workers and other volunteers to improve pig and poultry rearing, and introducing fish farming to households. Activities undertaken to achieve the second objective, to improve household nutrition, included introducing alternative farming techniques to combat cultivation difficulties during the dry season, incorporating fish farmed by the household into their diet, and the distribution of clay water filters. The third objective, to support provincial departments of agriculture was achieved through engaging associate staff to conduct field activities, conducting study tours to expose field personnel to developments abroad, training and providing support for field operations, and developing extension and training materials designed specifically for ADP activities. For the final objective, to improve access to markets, PfD designed, modified, and tested farm equipment for local manufacturing and commercialization and also collected information on market prices for a wide range of agricultural commodities.
In Cambodia, malaria is a health risk for an estimated 2.13 million people who live or work in close proximity to the tropical forests; and malaria remains one of the leading causes of death in Cambodia. Results from a 2007 large-scale survey indicate that mosquito net coverage (people sleeping under a net) was 80% in most high risk areas, but Insecticide-Treated Nets (ITN) coverage remained low (25%) despite re-treatment efforts. Due to poor health care coverage in endemic provinces, especially in remote locations, access to and use of quality malaria diagnosis and recommended treatment remains a challenge. This issue is inappropriately addressed by the informal and unregulated private sector currently used by 60-70% of Cambodian patients with fever cases. The program aimed to strengthen and scale up the most successful control activities.
In Phase 1 (GF-RCC Round 9), PfD conducted community-based interventions focusing on geographical and strategic areas where gaps have been identified and where government or other organizations have difficulty reaching. PfD focused on reaching out to mobile and migrant population (MMPs) by developing a strategy to work with MMPs, private companies, land development companies, owners of plantations and relevant local authorities at all levels including communities. PfD piloted the design and development of a forest package containing prevention, diagnosis and treatment products to be distributed through various channels to mobile and migrant population and local forest goers. In phase 1, PfD implemented programs in Stung Treng, Kratie, Koh Kong and Kampot provinces. In addition, PfD managed one international NGO sub sub-recipient (SSR) (Equal Access, now localized to Media One), and managed four Provincial Health Department (PHD) SSR in the four provinces. In Phase 2 (GF-SSF), PfD expanded these community-based interventions within Kratie and Koh Kong provinces.
Key Activities for GF-RCC/R9 (phase 1) and GF-SSF (phase 2):
- Case management: trained health staff, Village Malaria Workers (VMW), Mobile Malaria Workers (MMW), and Plantation Malaria Workers (PMW) on early diagnosis and treatment (EDAT), focused on MMPs
- Vector control: supported PHD/OD development of a mass distribution plan and mapped MMP; supported net distribution; designed and piloted forest package distribution for forest goers
- Surveillance: Performed Day 3 follow up of malaria cases to combat drug resistance by ensuring proper treatment
- Behavior Change Communication: created radio programming and community based malaria education; trained school teachers on malaria health education
- Trained 182 MMW and PMW on malaria diagnosis, treatment and health education; 888 Village Health Volunteers (VHV) on malaria health education; 441 School Teachers on malaria school health education using Child–To–Child methodology.
- Tested 4,285 patients suspected of malaria and treated 939 patients diagnosed with malaria; reached 121,354 individuals and 17,218 school children with community – based malaria health education;
- Distributed forest packages which could prevent malaria to 389 forest goers who were at risk malaria.
Final result: PfD achieved 91.4% of company/plantation workers who slept under an insecticide-treated net the previous night; 97.73% of school children who disseminated malaria prevention messages to their friends, families and other community members through various activities; and the forest package helped reduced malaria cases by 64% among forest goers.
In 2011, with a $250,000, 2-year seed grant from USAID, Partners for Development (PfD) implemented its “Providing Rural Communities Equal Care through Commercial Transport” (PROTECT) initiative in Kratie province. PROTECT was funded and implemented as part of USAID’s Saving Lives at Birth partnership to test an innovative approach to overcoming transportation barriers to maternal and newborn services in rural Cambodia.
The PROTECT project aimed to develop a replicable and financially sustainable model to ensure access to ante/postnatal care, and delivery and emergency obstetric care in remote, rural villages of Kratie province, in northeastern Cambodia. With local government guidance and management, PfD tested a model designed to leverage the strong local demand for reliable motor transportation to benefit the area’s pregnant women and new mothers. In addition to ensuring low trip costs, PfD negotiated 24-hour emergency transport service for these women by establishing fixed rates for emergency transport, guaranteeing the availability of transport providers, and creating a revolving village loan fund to provide immediate micro-credit to pay for the emergency travel.
In the 13 month period August 2012 – August 2013, a total of 584 emergency loans were made out of the VLF in the 25 villages. 248 of these (42.5%) were for maternal/newborn care.The remaining 336 loans (57.5%) were for other illnesses or accidents, particularly malaria or diarrheal diseases.
Between September 2011 and September 2013, PfD implemented PROTECT in all villages within two Health Center catchment areas, Prek Prasob and Kanchor, with an estimated combined population of 33,115. The members of each area’s villages are subject to the annual floods that make travel by road arduous and hazardous during monsoon season every year. PfD purchased seven remorque motorbike taxis and two stronger koyun tractor-esque taxis to navigate the steep and muddy hills surrounding Prek Prasob and Kanchor’s villages, and established contracts with the local Commune Councils to ensure their continued functioning in each community.
Initially, PfD set a target of $20,000 for the Funds endowment. In September 2014, it provided that $20,000 as a loan to Gerewa, a longtime local partner operating community development activities in Bauchi State in northeastern Nigeria. With this loan of $20,000, Gerewa has in turn issued 182 microloans to help fund small enterprises often kiosks for small-scale trading and for agricultural activities. Sixty three (63) percent of the loans have gone to women, with the loans averaging $110 each. The great majority of borrowers do not have access to conventional bank credit because the banks view them as either too risky to lend to and/or too expensive to monitor. Thus, their only options for credit are moneylenders whose interest rates are typically over 100% per annum. Gerewa, on the other hand, charges about 3-3.3% interest per month on the small loans and also help the borrowers with businessdevelopment skills. Thus, Gerewa will pay PfD approximately $4,000 in interest annually on the $20,000 loan. Separately, PfD is working with another long-time partner, Lift Above Poverty Organization (LAPO), located in southern Edo State. LAPO, amongst its many community development activities, has operated a scholarship program for many years. In September 2014, PfD provided LAPO with $3,125 to fund ten girls with scholarships ranging from $220-500 each; those covered around 40-50% of a girls total cost to attend secondary school for a year. The range in scholarship size is needed because costs will vary by location and type of school (public or private). Thus, the separate loan to Gerewa of $20,000 serves as in effect a scholarship endowment, with annual scholarship funds being generated through the loans interest. Given interest rates on the loan and with one scholarship and attendant monitoring costs averaging $400, PfD can then provide an additional scholarship every time the endowment grows by $2000 beyond its initial $20,000 ($400/$2000=20%).
At inception of the partnership in 2014/15 academic session, the PfD supported 10 secondary school girls with scholarships. This was increased to 15 scholarships in the 2015/16 school year and for this current year, 2016/17 academic session; Twenty-three girls from low-income earning households were supported by the Anne Johnson Memorial Scholarship Fund. These girls received between ₦28,000 to ₦80,000 for tuition and books.
PfD’s five year PINEX program will strengthen the pineapple value chain at all levels in Benin. Pineapple is the third highest agricultural earner in terms of GDP in Benin, and has significant potential for growth. PINEX will:
- Increase agricultural productivity by: building the technical and business management capacity of pineapple farmers, the Pineapple Producers Network of Benin (PPNB), and the Ministry of Agriculture (MOA); connecting producers with access to finance; and enabling the private sector to supply improved fertilizer.
- Improve agricultural processing by building the technical and business management capacity of pineapple processors and the National Association of Pineapple Processing Companies of Benin (NAPPCB), and by connecting processors with access to finance, equipment, and certifications.
- Expand agricultural trade by: building the marketing capacity of pineapple processors; connecting processors with marketing opportunities; establishing a market price and information system; improving border and airport storage and marketing facilities; and supporting innovation and collaboration across the Beninese pineapple value chain.
Activities include training and capacity building with pineapple producers and processors, facilitating agricultural lending and access to inputs, in-kind grants, and building infrastructure to facilitate pineapple production and marketing.
Capacity Building of Local Institutions on WASH: With a Program Cooperation Agreement (PCA) funding from UNICEF, the program is designed to strengthen the capacity of local institutions to drive community-centered WASH Service Delivery. The project specifically targets five Local Government Areas (LGA) in Bauchi State and two LGAs each in three other states – Delta, Edo and Ekiti. It is funded through UNICEF by 1) DFID-supported Sanitation, Hygiene and Water in Nigeria (SHAWN); and 2) EU-supported Niger Delta Support Program (NDSP) and Water Supply and Sanitation Sector Reform Program (WSSSRP). PfD’s role includes building capacity of Water, Sanitation and Hygiene Committees (WASHCOM), WASHCOM Federations and other local institutions to implement and advance WASH activities in rural communities.
The project goal is to strengthen the capacity of local institutions for effective, accountable and sustainable delivery of community-driven WASH and other developments in Bauchi, Edo, Delta and Ekiti States. The specific objectives of the project are:
• To form and strengthen LGA WASHCOM Federations through their role in monitoring and mentoring of community WASHCOMs in the 11 project LGAs;
• To train and mentor 80 selected, active or functional WASHCOMs on expanded roles for community WASHCOMs;
• To support establishment and strengthening of LGA WASH Coordination Forum across 11 project LGAs;
• To generate knowledge management with the development of three case studies and three human interest stories in at least 3 states.
PfD works with the local government Department of Environment (in charge of water and sanitation) and community WASH committees (WASHCOM), focusing on strengthening the ability of communities to identify needs, plan and implement WASH projects. By engaging local leaders who are committed to their own development, PfD ensures the sustainability of the WASH project.
The project currently benefits 2,530 rural communities across the 5 states including formation of WASHCOMs. Also, 11 LGA Coordination Forums and 11 WASHCOM Federations been established and trained in all 11 project LGAs and are currently supporting WASH service delivery in rural communities within these LGAs.