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.
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.
As a part of the MARKETS II Project, PfD strengthened the capacity of 20 agricultural producer associations in financial, administrative and group dynamics in Nigeria’s Delta, Edo and Rivers states, enabling them to effectively manage donor funds, provide valuable services that will enable recipients to increase their productivity. PfD has been collaborating with the MARKETS program since its inception, especially in the development of the Nigerian Agricultural Enterprise Curriculum (NAEC), which PfD has integrated into many of the business development services trainings it has conducted over the years for agricultural entrepreneurs.
In January 2015, PfD signed an agreement with Chemonics to participate in its USAID-funded MARKETS II project to provide institutional capacity building to selected smallholder agricultural producers and processors in three states in Nigeria. The Organizational Capacity Assessment (OCA) Tool was adapted by PfD and endorsed by the technical staff of MARKETS II Project which was administered to each of the selected groups. The OCA Tool was designed specifically for the selected smallholder agricultural associations to diagnose the strength, weaknesses and opportunities available to and existing within these groups. The OCA Tool was designed to assess capacity of the associations in six key areas/sections – governance, human resource management, financial management, monitoring, evaluation and reporting, sustainability, public relations and partnership.
The first MARKETS activity was a highly successful program that fostered private sector-led agricultural productivity, advanced agriculture and trade policy reform, improved farmers’ access to new agricultural technologies, and strengthened both public and private institutions. MARKETS II extended the MARKETS model to improve the performance of Nigerian poor rural farmers or smallholders, their incomes and nutrition through proven private sector demand driven market interventions. The program focused on smallholder farmers who cultivate between 1 and 5 hectares of land, up to 80% of whom are women.
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.
From November 2011 to July 2016, PfD implemented the USDA-funded Growing Resources for the Enhanced Agricultural Enterprises and Nutrition (GREEN) Project in six southern states in Benin: Atlantique, Littoral, Couffo, Mono, Oueme and Plateau. Through GREEN, PfD provided valuable training to over 7,300 agricultural producers and through increasing the farmers’ net income, benefited 36,000 family members.
The GREEN project worked with Beninese farmers’ associations to train vegetable growers to increase the money they take home from their harvests through better growing techniques, through strategies to decrease spoilage between the field and the market, and through improving their understanding of market-driven production. Centered on tomatoes, peppers, and leafy greens, the trainings GREEN provided focused on improving water and soil resources, appropriate use of pesticides, dry season cultivation, and how to handle vegetables immediately after harvesting. GREEN worked with growers’ associations on marketing and business strategies to help them maximize their earnings potential as a group.
GREEN trained 7,390 agricultural producers in vegetable value chain theory, market assessments, and modern methods to improve agricultural production. As a result of PfD’s work, 97% of participating GREEN farmers now produce in response to what the market wants, and 95% of GREEN farmers have increased their vegetable production by an average of over 160% by increasing the number of cultivation cycles from two to three and four ties per year. GREEN’s final evaluation also showed, farmers increased their net income by over 220% and created over 8,600 seasonal jobs.