Anglican Diocesan Development and Relief Organisation (ADDRO), Bolgatanga
Programmes Activities Report Jan-Dec 2016
ADDRO Board of Directors
ADDRO; P. O. BOX 545; BOLGATANGA
TABLE OF CONTENTS
Management of Anglican Diocesan Development and Relief Organization (ADDRO) presents Annual programme report for January to December, 2016. The report provides an overall update of ADDRO’s programmes and projects within the 2016 fiscal year. It highlights progress of activities implemented, key results achieved, challenges as well as lessons learned during the period under review.
The report focus on the two broad programmes of the organization, namely, the Integrated Community-Based Health Program (ICBHP) and the Food Security & Livelihood Improvement Program (FSLIP).
Ghana has over the past decades made some impressive strides in the fight against poverty; but the three northern regions continue to experience significantly high levels of poverty (GSS, 2014). The concentration of poverty in these regions gives rise to food insecurity and poor livelihoods. It is the desire to address the endemic food insecurity, malnutrition and precarious livelihood outcomes occasioned by high incidence of poverty that the Anglican Diocesan Development and Relief Organization (ADDRO) with funding from the Episcopal Relief and Development has been addressing with the food security and livelihood support programme in the Upper East Region of Ghana.
The Food Security and Livelihood Improvement Program seeks to address the following objectives:
- To increase household agricultural production and productivity by 40% by 2017
- To improve household food security through agro-processing and storage.
- To improve household food security through improved environmental practices.
- To increase micro-entrepreneurs access to financial services by 40% to promote Small and Medium Enterprises (SMEs) by 2017.
The program is progressively making strides towards attainment of the program goal and objectives. The following achievements were made within the year.
A total of 125 new farmers comprising 56 males and 69 females joined the program this year and acquired relevant knowledge and skills in Good Agricultural Practices in the areas of farm planning, land preparation, planting, fertilizer application and weed control. This brings the total number of crop farmers under the program to 1,085 comprising of 611 males and 474 females
Another 123 new farmers comprising of 2 males and 118 females also received breeding stock of sheep and goats in addition to capacity building in improved livestock husbandry practices to go into livestock production as income generation businesses. This also increased the number of livestock farmers on the program to 560 (77 males and 483 females).
A total of 102 micro entrepreneurs comprising 83 females and 19 males also received training in business management and 85 (10 males and 75 females) received credit to engage in income generation activities. The seventeen people who were not given credit are old members who were interested and participated in the training.
Besides, 47 Savings with Education groups comprising a total of 816 members were formed and trained. The groups have made accumulative savings of GH¢ 28,241.00 by the end of December, 2016.
The Integrated Community Based Health Program (ICBHP) was started in 2013. The program seeks to contribute to the improvement of maternal and child health. The projects under the (ICBHP) are as follows:
Integrated Community Case Management (iCCM)
The Integrated Community Case Management (iCCM) is a strategy to extend case management of childhood illness beyond health facilities to community levels so that more children can access to lifesaving treatments.
With this iCCM, ADDRO uses front-line health workers called Community Based Agents(CBAs) at the community level who are trained, supplied with iCCM commodities and supervised to diagnose and treat children under five years with malaria, pneumonia and diarrhoea, using ACTs (Artemisinin-based Combination Therapy), oral antibiotics, oral rehydration salts and zinc.
ADDRO continuously build capacity of the CBAs to enable them screen for the three diseases and administer treatment based on the results of the examination and diagnostic testing of; malaria using RDTs, pneumonia using counting beads and diarrhoea using disease history and physical examination.
The organization also incorporates Social and Behaviour Change Communication Strategy (SBCC) in the program to positively influence social determinants of health such as knowledge, attitudes, norms and cultural practices.
The aim of the SBCC strategy is to improve health outcomes in households and communities by promoting healthy lifestyles such as early health seeking behaviours, proper hand washing, Antenatal visit, skilled delivery, exclusive breastfeeding and sleeping under insecticide treated net to limit the impact of ill health. The CBAs are trained on SBCC activities and equipped to carry out SBCC activities in the communities for the general population as well as specific groups including the mothers’/caregiver groups.
The iCCM program operates in eight (8) sub- Districts in Ghana. The operational regions and districts where the sub-district are located are: Bawku West and Builsa North in Upper East region, Karaga in the Northern region, Nadowli in the Upper West region, Bosome Freho in the Ashanti region, Akwapim South in the Eastern region and, Anyinabrim and Abrabra in Sefwi Wiawso in the Western region of Ghana.
The program seeks to address two main objectives:
- Increase mothers’/primary caregivers’ knowledge and practice of key behaviours in health promotion, disease prevention; appropriate home care, and healthcare seeking for malaria, diarrhoea, and pneumonia.
- Increase access to and use of quality health care in rural areas for mothers, children, and their families.
Highlights of activities implemented during the period under review to include the following:
Nine (9) ADDRO staff and 21 GHS staff benefitted from a training of Trainers (ToT) workshop on social and behaviour change communication (SBCC). This training empowered them with effective skills that enabled them to design and deliver effective SBCC cascade trainings of CBAs at the community levels.
SBCC cascade trainings of CBAs were organised in each of the seven sub districts under the ICCM program. A total of 228 CBAs made up of 116 males and 112 females received this training.
ICCM medicines were procured by ADDRO and distributed to all seven sub districts.
Besides, during the period under review, 95 community sensitization sessions (durbars) were organized for community members by all the program Regional Coordinators. In all, 8,559 community members comprising 3,477 males and 5,082 females participated in this activity. These resulted in increased mothers / primary caregivers’ knowledge and practice of key behaviours in health promotion, disease prevention, appropriate home care, and healthcare seeking for malaria, diarrhoea, and pneumonia.
All Regional Coordinators facilitated the entry of iCCM data collected from CBAs into District Health Management Information system (DHMIS). The DHMIS is a software that supports the capture of data linked to any level in the health sector of the country.
The HIV/AIDS Project
The project aims to ensure increases in the uptake of HIV Testing and counselling (HTC) through religious congregations and mobile outreaches among others.
The project addresses the following objectives:
- To promote safer sexual practices among 30 religious congregations in three Districts in the Upper East Region by the end of June, 2016
- To promote the uptake of HIV testing and counselling services among 30 religious congregations in three Districts by the end of June 2016
- To sensitize18,900 youth and adults among 30 congregations in three districts on HIV/AIDs stigma reduction and discrimination practices against PLHIV by end of June 2016
The support of peer educators among other groups in HIV/AIDS outreach and clinical activities has contributed to reduce the negative effects of stigma and promoted healthy sex behaviours, thereby creating hope among the populace.
Distribution of Long Lasting Insecticide Nets (LLINs) Campaigns and Post Distribution Check-ups (PDCU).
In 2016, Episcopal Relief & Development and the Anglican Diocesan Development and Relief Organization (ADDRO), with support from Against Malaria Foundation (AMF), collaborated with Ghana’s National Malaria Control Program (NMCP) to carry out LLINs mass point distribution in three regions of Ghana; namely Northern, Upper West and Greater Accra Regions. The distribution was done in selected districts; 20 in Northern Region, 12 in Greater Accra Region and all the eleven districts in Upper West for a period of 2.5 years. The Post-Distribution Check-Up (PDCU) helps to assess net usage and provide statistically significant and locally actionable information to the relevant Ghana Health Services (GHS)/NMCP leaders, to contribute to health intervention decisions and planning.
ADDRO has successfully completed the first round of PDCUs in these regions.
Savings with Education
ADDRO tries to empower its beneficiaries economically, hence introduced savings with education in two sub districts in the upper east region, Chuchuliga and Sapeliga. The savings with education program is a savings-led microfinance program that provides basic financial services to the very poor and those living in rural communities (especially women). Group members come together to save money for their welfare. Members borrow from these savings to either start or expand their existing business. ADDRO’s role in this saving with education is to build capacity of group members and guide them in their transactions. Health messages on malaria, diarrhoea, pneumonia, child nutrition and any health issue of interest to the groups are also discussed during meeting days.
Programme Development and Staffing issues
- Early this year, ADDRO entered into partnership with a UK-based donor known as Against Malaria Foundation (AMF). This year, AMF supported ADDRO and National Malaria Control Program (NMCP) to distribute 2,686,808 LLINs in the Northern, Upper West and Greater Accra regions. Under this project, ADDRO and Episcopal Relief & Development will carry out monitoring of campaign activities and Post-Distribution Check-Ups (PDCU) of these LLINs in 43 districts across these three regions for a period of two and a half years.
- ADDRO in partnership with Ghana Health Service (GHS) supervised the distribution of LLINs in Upper East Region. In all, 617,000 LLINs were distributed to beneficiaries in the region. The Upper East LLINs was however not part of the AMF support.
- ADDRO has established a regional office in Accra for the Greater Accra team.
- On the AMF project, ADDRO recruited eight new staff to join the existing regional coordinators and HQ Team to implement the programme in the afore-mentioned three regions.
- The BCC officer, Ebenezer Ndebilla was also elevated to join the management team as the Food Security and Livelihood Program Coordinator to fill the vacuum created by Emmanuel Tia Nabila, who exited from the organization.
- David Akurikiya has been recruited as project officer on the FSLP to replace John Manyeyii who passed away in March this year.
- Ayariga Samson Austin was also recruited to support the FSLP team on Binaba as Juliana Awini was reassigned to the Health Programme in Zebilla in the Bawku West District.
- Over 60 data entry clerks have been recruited on temporary basis to enter all data in the AMF supported project.
Pictures of partners with ADDRO staff
ADDRO was privileged to be visited by our Episcopal Relief and Development Partners from 18th to 21st January 2016. The pilgrims/partners were very excited and happy with the work of the Organization. They visited the following project sites:
- The Anglican Women Development Centre (ANWOC) where a durbar was held and they interacted with a number of project beneficiaries including shea butter and groundnuts processors groups.
- Azongi community where they observed CBAs giving health education on childhood Malaria, diarrhoea and pneumonia as well as treatment. They also observed LLINs hanged in the rooms and interacted with beneficiaries.
- Teshie where persons with disabilities have carpentry workshop for woodwork.
- Sumbrungu to observe women in basketry works, where these women weave baskets and other art works.
- Kalbeo to observe our micro credit beneficiary groups in processing of groundnuts and rice, and weaving of traditional cloths.
- Sirigu community, where they interacted with basket weavers.
- Binaba community, where they had a short church service, observed rice and shea butter processors working with a processing equipment-a grinding mill. They also interacted with women beneficiaries of ruminants and the donkey project.
The overall, the implementation and outcomes of the programs during the period under consideration chalked a number of successes. To this end, I would like to take this opportunity to congratulate and thank all ADDRO staff for their relentless efforts. I also wish to register my profound gratitude to the Board of Directors, collaborators and partners of ADDRO without whom it would not have been easy to go this far. On behalf of our program beneficiaries and communities, I thank you all for your contribution in making a difference in their lives.
Rt. Rev. Dr. Jacob Ayeebo
The Food Security and Livelihood Support Program (FSLP) is one of the two main programs of ADDRO funded by the Episcopal Relief and Development (ERD), USA. The goal of the program is to contribute to the eradication of extreme poverty and hunger, which will further contribute to promote gender equality and women empowerment and ensure environmental sustainability. The specific objectives of the program are to:
- Increase crop yield and improve animal management by 20% by 2017.
- Improve household food security through supporting agro-processing (60% of women increase level of processing) and improving effectiveness of crop storage by 2017.
- Improve long-term household food security through sustainable management of natural resources.
- Improve small and medium businesses by providing support to entrepreneurs.
The various categories of people who benefited from the program include the following:
- Crop Farmers groups
- Farmers in Animal rearing –
- Agro-Processors groups
- Micro credit groups and
- Donkey set women groups:
A summary of the activities carried out within the period included; Support 200 farmers with improved seed varieties of maize, conduct participatory workshops on improved farming and tillage practices, demonstrate improved farming practices (Integrated Crop and Pest Management) using farmer Field Schools, conduct monitoring of project activities, empower 120 farmers with improved breeding stock of goats & sheep, train 120 farmers in improved husbandry practices (including simple medication and watering), support women to establish pig farms as income generating project, provide essential veterinary drugs, vaccines and supplies for vaccination and treatment of project livestock, train 20 Community Extension Volunteers to support technology transfer in their communities, provide incentives for Community Extension Volunteers (Wellington boots, Protective Clothing, etc.), Support 30 women with shea-nuts to process into shea-butter and sell to increase their income levels, support 30 women with paddy rice to process for sale, train entrepreneurs in credit and business management and record keeping, facilitate the establishment and development of entrepreneurial groups, and provide micro-credit to entrepreneurs to engage in income-generating ventures (new clients).
All these planned activities for the year were successfully carried out, notwithstanding the few challenges such as delay in release of funds by Episcopal Relief and Development, which resulted in unnecessary pressure on programme staff to implement according to work plan after funds were later received and torrential rainfalls that affected attendance of programme meetings by participants. Details of the activities carried out are indicated below.
Program planning meeting
A meeting of the program implementing staff was held in Bolgatanga on the 8th February, 2016. to look at the detailed programme activities for 2016 and to share programme targets among themselves particularly the four programme centres, namely, Sherigu Anglican Women Development Centre, (SAWDC), Anglican Women Development Centre, (ANWOC), Binaba Area Community Health project (BACH) and Bongo Community Based Rehabilitation project. The meeting also enabled programme Officers who participated in the planning meeting in Accra to discuss and share with colleagues’ decisions that were taken during the Accra meeting especially on the savings with Education programme.
Training of facilitators and supervisors on saving with Education (SwE)
In order to effectively commence the Savings with Education programme, Facilitators and supervisors were trained. The training took place from the 9th to 12th February, 2016 at the Extee Crystal Hotel, Bolgatanga. The training was facilitated by Kellie McDaniel and Priscilla Amuah, all staff of Episcopal Relief & Development. Thirteen (13) staff of ADDRO benefitted from the training. The key components of the training were the introduction to savings with education, the formation of savings groups, rules and regulations governing saving groups, the formation of management committees of saving groups and the roles of each management committee member, etc. The workshop was practically oriented as it entailed group presentations at each stage. Participants were at each stage put into groups to perform a task and make presentations to fellow participants. The training manual along with necessary forms and tools were shared with participants.
Community Mobilization/ promotion meetings on saving with Education
During the period under review, field officers organized participating communities and introduced to them the concept of Saving with Education (SwE). Field officers gave a brief introduction to saving with education, its benefits to members of the groups and how groups could be formed and managed. Savings with Education is a method of saving where interested community members are guided to form groups of 20-25 members each. They elect their leaders, set rules to guide them and save regularly into a cashbox at each meeting day. Saving group members can decide to give loans to members from their savings or wait until their savings mature at a specified date when members share the money among themselves. Thirty-five (30) saving groups were formed and members trained.
Project officers also facilitated similar trainings at the community levels after their trainings. Out of these trainings 30 groups of 740 members were formed. At the close of 2016, the following were achieved by members: Cumulative value of savings GH¢ 32,355, Cumulative value of group funds GH¢37,811 and Value of active loans GH¢22,340
Capacity Building for ADDRO Staff
In order to enrich the capacities of the staff working on the food security program, a four-day capacity training workshop on Good Agricultural Practices (GAP), small ruminant management and micro-credit management were organized for them from the 26th-29th April, 2016. It was a trainer of trainer’s workshop aimed at equipping program staff with the requisite knowledge on the above topics to enable them provide similar trainings to the program beneficiaries at the community level. However, training of the beneficiaries was conducted in collaboration with the Ministry of Food and Agriculture extension officers at the operational districts. In all, nine (9) program staff benefitted from the training.
Workshops on improved farming and tillage practices
During the period under review, participating beneficiaries selected to benefit from the input support programme were trained on good agricultural practices to equip them with the necessary skills and knowledge on maize production to enable them use the input support effectively. These trainings were participatory by nature and facilitators employed practical demonstrations to make the trainings lively. Some of the good practices include weeding, spacing, fertilizer application, integrated pest management, contouring, composting etc. In all, two hundred (200) beneficiary farmers were trained comprising 103 males and 97 females. The farmers were admonished to plough across the path of water or across slopes to prevent erosion from washing away the soil nutrients. In fertilizer application, farmers were taken through how to apply and when to apply. They were taught that the appropriate fertilizer to use as basal application is the NPK and that should be done two (2) weeks after shooting, and that when applying the fertilizer, a hand full of fertilizer should be applied to five (5) holes in a bed and not more or less to provide the necessary amount of nutrients needed for growth.
They were also educated that SA (Nitrogen Base Fertilizer) is the best fertilizer used for the second application and that, it is done six (6) weeks after planting. The facilitator advised the farmers to bore holes close to the crop, apply the fertilizer and burry it to avoid evaporation or being washed away by a heavy rainfall immediately after application.
Farmers were also advised not to farm close to river banks because any time the river overflows, the farm lands will be flooded and their crops can be washed away leading to the farmers losing their crops and farm lands.
The workshops offered farmers the opportunity to also share experiences on the methods of farming they have been practicing over the years which do not give them good yield and expressed happiness in the new farming methods that they had learnt and hoped it will help improve on their yield this farming season.
Fig 2 Field officer doing practical demonstration during GAP training
Support 200 farmers with improved seed varieties of maize and soya bean
The period witnessed the distribution of maize seed and chemical fertilizer to two hundred (200) participating farmers for the 2016 farming season. These were made up of 103 males and 97 females. Each beneficiary was supported to cultivate an acre of land by providing them with 9kg of maize seed and 3 bags of chemical fertilizer per acre of farmland.
Train 120 farmers in improved husbandry practices (including simple medication and watering)
After sensitizing beneficiary communities on the intervention, many applications were received and screened; and subsequently 120 farmers selected to benefit from the intervention. The beneficiaries were later trained by government Veterinary service officers with support from ADDRO program staff on improved husbandry practices such as proper housing, feeding and identification of animal diseases and treatment. On housing, participants were told that the proper housing units should possess the following features: proper and adequate space for the animals, should prevent animals from adverse weather condition such as extreme cold or heat and serve as security, contain windows and doors for ventilation situating on well drain soil with floor ramped and wall plastered and roofed, regular cleaning, feeding and watering.
Good feed, according to the facilitator, promotes animal growth and health. Feed should contain protein, carbohydrate and minerals to enhance development in the animals. They were advised to provide supplementary feeding especially during the dry season, and to try as much as possible to prevent their animals from the adverse condition of whether such as rain from beating their animals. He also added that farmers should try as much as possible to isolate pregnant ones and feed them adequately.
In all, 120 women who were selected to benefit from the animal support were trained and supported with either goats or sheep based on individual request. Two animals were given to a woman to rear and after two years, two offspring would be recovered and passed on to new beneficiaries. To ensure the beneficiaries are given healthy ruminants, all animals purchased or recovered for distribution to beneficiaries were vaccinated against the common diseases that affect small ruminants before passing on to the beneficiaries. The total number of animals distributed to beneficiaries were two hundred and forty (240).
After training the selected women on improved husbandry practices, each received two (2) small ruminants for rearing. The ruminants were either improved breeding stock of goats or sheep depending on the request made by beneficiaries. In presenting the animals to the women, project officers admonished beneficiaries to take good care of the animals so that they can repay the two offspring two years later and still have enough to sell and cater for their personal needs.
Fig 3 Small ruminants ready to be distributed to beneficiaries
Support women to establish pig farms as income generating projects
The programme supported six women to establish piggeries as income generating projects to support themselves. Each woman was provided with two pigs and supported to construct housing units to house them. The purpose was to empower them economically through the rearing of the pigs as they can generate income from the sale of the pigs which are high breeding animals. It was also to attract other pig farmers in the communities to build similar houses for their pigs instead of rearing them using the free range method. However, to ensure proper care for the pigs, beneficiary pig farmers were trained on improved care of pigs. The topics treated include; housing of pigs, feeding, and identification and treatment of pigs. On housing, farmers were admonished to provide enough ventilation since pigs do not strive well in heat
Provide essential veterinary drugs, vaccines and supplies for vaccination and treatment of project livestock
ADDRO in collaboration with the Veterinary Services officers went round and vaccinated small ruminants of old beneficiaries that have been supported by ADDRO against common diseases in all programme communities. This practice was to ensure the animals are healthy at all times and also to improve good
Train 20 Community Extension Volunteers to support technology transfer in their communities
Volunteers who play pivotal role in the implementation of the food security project. They were selected by community members to support programme staff to mobilize communities and beneficiaries to implement for activities. The criteria for selecting a community volunteer was that, a volunteer should be willing do the work free of charge and should be residing in the community. Besides, a volunteer was expected to possess some qualities including; being an honest and trustworthy person, easily approachable and reliable.
The volunteers were taken through good agricultural practices for maize production, rearing of small ruminants and business management. On good maize farming practices, they were taken through the best ploughing methods, planting, weed control methods, and fertilizer application. They were as well taken through how to identify diseases in animals and refer quickly to the veterinary officers for prompt action. They were taught to assist farmers built housing units that were well ventilated enough to house their animals. On business management, they were taken through record keeping to enable micro entrepreneurs take proper records of their businesses.
In all, twenty (20), community extension volunteers comprising 17 males and 3 females were selected and trained to support the implementation of programme activities. These volunteers were provided with incentives such as bicycles, programme branded T-shirts, wellington boots, bags, rain coats and others to enhance their work in the field.
Provide incentives for Community Extension Volunteers
As part of measures to motivate community extension volunteers to give up their best in supporting the farmers, the programme provided some incentives to the volunteers. The incentives provided were, for example, were bicycle tires and tubes to replace worn-out ones on the programme provided bicycles, wellington booths, and rain coats. These items are meant to facilitate the work of the community extension volunteers. In all, sixty (60) old community extension volunteers were provided with the above incentives to facilitate their work
Support 60 women with shea-nuts and paddy rice to process into shea-butter and rice respectively and sell to increase their income levels
In contributing to empowering women economically, sixty (60) women were supported with cash amounts to enable them purchase shea-nuts and paddy rice to process into shea-butter. The essence of this intervention is to support women to acquire a trade by adding value to the sheanuts and earning high incomes, thus, making them economically independent.
However, these support to the women processors were preceded by training sessions to provide the women processors with the necessary skills to be able to operate profitably. The participants were taken through basic hygiene in food processing, packaging, storage, and marketing of their products to prospective buyers. Participants were admonished to practice good hygiene and proper packaging of their products to make more profits.
Train entrepreneurs in credit and business management and record keeping
Micro-credit beneficiaries who were selected to benefit from the 2016 micro-credit support from the programme were trained on credit and business management before the disbursement of the credit facility to them. The entrepreneurs comprised of 10 males and 75 females. The micro entrepreneurs were taken through the credit policy of the organization, customer care relationship and how to keep proper records of their businesses. They were admonished to take records of all transactions very seriously as it will help them determine whether they are making profit or losses. Proper record keeping could also help them obtain more financial support from other financial institutions to expand their businesses.
Fig 4 Micro-credit beneficiaries undergoing credit and business management training
Provide micro-credit to entrepreneurs to engage in income-generating ventures (new clients)
After successfully undergoing credit and business management training, micro-entrepreneurs were given cash loans ranging from GH¢200.00 to GH¢1,000.00 each depending on the assessment made on the client’s ability to repay loan by the loans committee. Though, the programme initially planned to support 60 beneficiaries, it managed to increase the number of beneficiaries to 85.
Demonstrate improved farming practices (Integrated Crop and Pest Management) using farmer Field Schools.
To further engage farmers to put into practice the knowledge acquired during the training on good agricultural practices, four maize demonstration farms were set up by ADDRO in some of the programme operational communities. Two were set up at Gbere-Kpalsako and Zuayanga communities under the Anglican Women Development Centre (ANWOC), one at the Binaba Area Community Health Project (BACH) at Kansoogo community and one at the Sherigu Anglican Women Development Centre (SAWDC) at Yindure community. At these farms, the farmers were guided by Agricultural Extension Officers and Programme staff to practically grow maize applying the good agricultural practice methods learnt and also using their traditional methods of farming to enable them appreciate the knowledge acquired. Thus, an acre of land is acquired and divided into two equal parts. One half of the farm is used to implement the good agricultural practices learnt and the other half used to implement the normal farmers’ practice. They were taken through the various stages of cultivation; good maize planting methods, proper fertilizer application and weed control methods. The purpose was to see which practice will produce the highest yield.
Fig 5 Farmers during sowing and fertilizer application on a demonstration farm
Conduct mid-term review meeting
During the period under review, a programme meeting comprising all programme field staff, Monitoring and Evaluation Officer and Programme Coordinator was held to review the activities implemented, share experiences and find possible solutions to challenges encountered within the period. Field staff shared their experiences on the program activities. For instance, some cash loan beneficiaries who owed a project centres and applied to a different project centre for another loan were detected. Project officers who were suspicious contacted their colleagues to verify but realized some defaulted in repayment in their previous loan, thus was disqualified. They therefore called for close collaboration and networking in the implementation of their daily activities.
Field staff also revealed that the period was hectic and tiresome since they had to implement both period one and two activities within period two due to late receipt of funds
Provide training on harvesting, handling and disinfection of targeted crops
This training was attended by one hundred and ninety-four (194) maize crop farmers comprising 96 females and 98 males. Six (6) of the farmers could however not attend the training sessions due to various reasons. The purpose of the training was to improve the skills of the farmers on how to effectively reduce post-harvest losses, improve on storage of food and thus, improve on the quality of grain for use by consumers. They were taken through the appropriate chemicals to use for the storage of their grains and the use of improved storage structures and facilities like improved poly-sacks for the storage of various agricultural products. The training was intensive with practical illustrations and pictorial presentations on the dos and don’ts of maize and soybeans cultivation to remove or reduce mycotoxins/aflatoxins diseases to insignificant levels.
The farmers expressed happiness about the new and improved storage methods they learnt and promised to put to practice the new knowledge acquired. Project officers made follow up visits to farmers and were happy to see them implementing the new storage methods learnt.
Fig 6: Agricultural Extension Officer taking farmers through post-harvest training
Train and support farmers on compost and manure production
The use of compost has become necessary because most soils are poor in organic matter and nutrients and unable to support plant growth. The loss of soil fertility is caused by bush burning, continuous cropping, overgrazing and erosion. Farmers thus resort to the use of inorganic fertilizers to boost their crop productivity. However, the continuous increase in fertilizer prices increases the farmers cost of production. To reduce this problem, farmers were taught to consider the use of compost which can be produced with locally available decomposable materials.
The farmers were taken through the various methods of compost making such as the pile method, which is good during the rainy seasons, the pit method which is good all year round and the ‘zai’ method which is almost all year round. Farmers were as well taken through the importance of compost to the soil. They were made to understand that the use of compost improves water intake and root penetration as well as improving the resistance of plants to pests and diseases. Farmers were also encouraged to produce some organic mature from their animal droppings and organic waste from their homes in large quantities that can reduce their use of inorganic fertilizers. During practical sessions, extension officers with support from ADDRO field officers demonstrated to farmers how to prepare compost using the pit method, which is the farmers considered as the cheapest with easily available materials. This strategy of the program in supporting farmers to produce compost to fertilize their farms has been embraced by all participating farmers
Fig 7: Farmers taken through how to make compost using the pit method
Organize experience sharing workshop for farmers
The purpose of this activity was to create an opportunity for farmers to learn from each other’s success stories as well as challenges in order to assist in the adoption of improved practices. This was against the background that farmers do not all accept and adopt innovations and improved technologies at the same rate and time. While some will adopt early, some will wait to see the result from the early adopters before using the innovation or technology. Sharing experiences on the success stories and challenges of the improved practices was one of the strategies for facilitating adoption. During the discussions, farmers shared with one another some best farming practices that have helped them to get better crop yields. Examples of the best farming practices identified were burying of fertilizer during application, proper weed control, early planting and harvesting at the right time. The farmers generally were of the view that the YARA Actyva fertilizer supplied by ADDRO was very good and effective in maize cultivation and asked for this brand for subsequent years. The participants were made of ninety-three (93) males and ninety (90) females.
Organize sensitization on bush fire prevention and controlled burning
This training was organized in the form of community meetings in which the two hundred (200) maize crop farmers participated. However, considering the interactive nature of the meetings, some interested community members who were not the target members of the groups took part in the sensitization sessions. This brought the number to two hundred and fifty-nine (259) participants, comprising one hundred and thirty-one (131) males and one hundred and twenty-eight (128) females. The sensitization sessions were facilitated by ADDRO staff with support from Extension officers. The topics discussed included causes of bush fires, effects of bush fires, prevention of bush fires and how to control fire outbreaks. In some of the areas, community chiefs admonished community members to desist from burning the bushes and farmlands before cultivation. They further added that where it is necessary to burn, they should adopt controlled burning to avoid the spread of fire.
Fig 8: Farmers undergoing bush fire sensitization training
Demonstration farms field days
During the farming season, field days were held in each of the four (4) demonstration farms mentioned earlier for the farmers. The essence of these field days were to bring the beneficiary farmers together to share ideas on the new and improved methods of farming. The lands for the demonstration farms were provided by volunteer farmers and the beneficiary farmers, who also did the sowing and planting. Field officers together with the extension officers took farmers through the protocol adopted for the demonstration farms.
The farms were one acre and they were divided into two equal parts; one half of the farm used for the high technology field and the other half used for the farmer practice field. On the high technology field, all practices were recommended by the Agricultural Extension Officer and the field officer. The farmers were allowed to carry out all practices in the way they have been practicing.
Field officers regularly visited demonstration farms to ensure that farmers follow the various practices till maturity and subsequently harvesting.
On the whole, it was discovered that the high technology field practice produced more yield than the farmer practice and thus, farmers were admonished to adopt the good agricultural practices. The table below shows an output from the field.
|TREATMENT||5m * 5m plot
|5m * 5m plot maize grains (kg)||Estimation by acre (4,000m2)||Remarks|
|High Tech||96||5.5||8.8 maxi bags||Higher yield|
|Farmer Practice||80||4.4||6.4 maxi bags||Low yield|
Fig 9: Farmers at the Gbere-Kpalsako demonstration farm on the field day shelling the maize
Participate in National Farmers’ Day Celebration
The National Farmers’ Day, which is celebrated on the first Friday of December each year was organized during the year under consideration. ADDRO, a major stakeholder in the agriculture sector in the Upper supported the Ministry of Food and Agriculture (MOFA) in the four districts the programme operates to award hardworking farmers in their districts.
All programme staff participated in celebrating the day in the various districts. In addition, the Programme coordinator also participated in the regional farmers’ Day celebration.
Donkey set financing project
Two separate meetings were held with donkey set beneficiaries in Bongo and Bawku West to determine the challenges confronting beneficiaries in the repayment of their loan facility and together find solutions to them, to enable the beneficiaries repay their loans. It was found out that their major challenge was that the repayment period was short. Thus, the loan repayment period was rescheduled to another 12 months to afford them more time to repay
Some beneficiaries also reported that their donkeys were stolen whiles some reported dead. Management is yet to take a decision on these issues and communicated to affected people.
Field monitoring forms a major strategy in the implementation of the program since it helps track performance of the program indicators. This activity was carried out at different levels; at management and field levels.
At the management level, the new program coordinator undertook a day monitoring/familiarization visits to each of the project offices to acquaint himself with happenings in the respective offices as well as solicit their views on possible proposals that can be implemented to make the program more effective. He also undertook monitoring visits during the promotion meetings with community members to introduce the concept of SwE. The coordinator also followed the various activities carried out during the demonstration farming to ensure that the field staff and extension officers followed the protocol designed for the farm demonstrations. Visits were also made to some training sessions to support the field staff in carrying out the trainings.
The Monitoring and Evaluation officer visited project centres and collected data for period one. The data was based on the programme indicators, for example, number of communities selected, number of beneficiaries selected for support in 2016, among others. The M&E officer further visited the programme centres to train staff and enumerators to collect baseline data on 2016 beneficiaries. Other management staff including the Head of Programs, Accounts officer and the Executive Director also conducted field visits to various project locations to assess the compliance with the program strategy and the use of program inputs by the project officers and the participants. This was to ensure that the program inputs and resources were used correctly for the intended purposes. Management staff monitoring was also to provide supportive supervision to the field staff and validate data and reports received from the field.
Field officers also monitored participants’ adoption of good agricultural practices. These visits served as opportunities to field officers to offer advice on how to increase their efficiency, and thus, their income levels. The areas monitored during the period were on micro-credit, input support, animal farmers, crop farmers and selected new farmers for 2016.
Monitoring of project activities at the field level was carried out by project officers. Beneficiaries of the farm inputs (maize farmers) were visited to assess their crop yield performance. The micro-credit beneficiaries were also visited regularly to see the progress of their businesses, processors to assess their progress and animals’ beneficiaries to be sure farmers were practicing the skills acquired during the training sessions. Programme coordinator also paid regular visits to some communities to assess the extent to which programme staff have implemented activities.
It is hoped that the programme will achieve its objectives set for the year 2016 as a result of these constant monitoring interventions.
Programme review meeting
All the program staff met in the course of the period to review the activities carried out, shared ideas on best practices and challenges encountered during the period. Some of the experiences shared included adoption of strategies for successful implementation of the program such as scheduling of meetings early in the mornings before farmers leave for their farms. Additionally, scheduling two meetings at the same time was discouraged as this will not enable two field staff to attend the same meeting together. Project officers also shared some successes chalked from the field which could be replicated by other project officers in their communities.
There was also an annual review meeting held for all programs staff to review the program activities for the year. Program officers presented activities implemented for the year, successes, and challenges encountered and the solutions proposed. There was an open forum session for participants to either ask questions or share experiences.
|Implementation Challenges||Proposed Solutions|
|The rains did not start in good time, thus slowed agricultural activities||Farmers were advised to consider planting short maturing varieties|
|The delay in release of funds has affected program activity implementation||In future funds to ADDRO should be released on time to ensure timely and effective implementation of activities|
|Heavy rainfall during the period thereby affecting programme meetings and the fear that the heavy rains could result in poor harvest||Programme meetings such as trainings should be done early before the rains set in|
|The period has been hectic and tiresome since they had to implement both period one and two activities within period two due to late receipt of funds||Funds should be released on time to ensure timely execution of activities|
|Difficulty in recovering loans from recalcitrant micro-credit beneficiaries||Intensify monitoring of various defaulters and writing them reminder letters|
MOFA lauds ADDRO for great contribution
The activities of ADDRO is not only acknowledged by program beneficiaries, but highly appreciated by key collaborators like the Ministry of Food and Agriculture (MOFA). During the program staff capacity training workshop held in Bolgatanga, the facilitator on Good Agricultural Practices, Mr, Zimmi Alhassan, who is the deputy regional extension officer, acknowledged the contribution of ADDRO to maize production in the region. He said ‘the training on good agricultural practices to the farmers in your operational area especially in Binaba area coupled with the input support from ADDRO has helped increase maize production in such areas’. He further commended the organization Community Agricultural Extension Volunteers model, which to him has contributed tremendously in the knowledge base of farmers on good practices since the volunteers are readily available at the community to offer support to the farmers.
Women farmers now own more animals
Mrs Akugri Mmalebna hails from Boya-Kpalsako, a suburb of the Bawku West District. She is a beneficiary of the ADDRO small ruminant support programme. During vaccination and recovery of offspring to pass on to new beneficiaries, Mrs Akugri was full of praise for ADDRO and its partners for their support which now makes her a responsible mother. According to Mrs Akugri before she was enrolled onto the programme she could not feed herself and her children properly but after the intervention three years ago, she can now boast of seven animals of her own which she sells some to provide some basic needs for the family. She indicated she sold one animal to buy chemical fertilizer to apply on her maize farm. She even added that the animal droppings are used as manure to fertilize her farm. According to Mrs Akugri but for this intervention “I would have been nobody in this community but now because I can feed my children and buy school things for my children, people now give me respect”. She added that “May the God that sees us and we don’t see him, bless ADDRO and the white people very much so that they continue to get enough and support we the poor.”
Women’s income levels improving rapidly
In 2014, fifty (50) women benefited from the agro-processing equipment support package. It was to enable them increase the quality of processed food products as well as reduce the drudgery involved in such businesses through the provision of improved processing equipment and business management skills training. This would eventually lead to an increase in women farmers’ income through the sale of processed food products.
Through this intervention, Mrs. Anamzei Abambisida, a 41-year old woman with six children, with no educational background from Kpantarigu was amongst the beneficiaries of this program. She received two bags of sheanuts. By the middle of 2016, she made significant gains from the processing of sheabutter and decided to go into sale of provision. Her is now worth One Thousand Five Hundred Ghana Cedis (GH₵1,500.00) which is 650% more than her start-up capital of Two Hundred Ghana Cedis (GH₵200.00) which was the cost of the two bags of sheanuts in 2014. With these gains she is now able to purchase foodstuff to supplement what she gets from her farming activities. She was also able to register for the national health insurance scheme. She was also able to renew her insurance and that of the children on yearly during the year under review. She was also able to pay school fees for two of her children at the senior high school together with other needs of her six children. In her own words, “This would have eluded me but for the intervention of ADDRO and its partners.”
The Integrated Community-Based Health Program (ICBHP) seeks to contribute to reduction of communicable diseases including; malaria, pneumonia, diarrhoea and their related morbidity and mortality among children under five years, and to promote appropriate health seeking behaviour among mothers in rural communities. The program uses the iCCM strategy to provide health care especially to children under five years, pregnant women and care givers. This strategy uses trained community based agents (CBAs) to provide diagnostics and treatment and SBCC activities for illnesses such as malaria, diarrhoea and pneumonia for sick children with difficult access to case management at health facilities. These three conditions are known to be the leading cause of deaths in children under five years of age. Information on these three conditions were collected and entered in to the District Health Information Management System (DHIMS2) for policy decision at the national level.
The CBAs were provided with treatment manual that guides them to decide how and when to treat children with cases of malaria, diarrhoea and acute respiratory infections (Pneumonia) in children aged 2months to 59months. They also provided health education on these conditions to community members, manage drugs and supplies and report iCCM activities to ADDRO regional Coordinators and GHS staff.
ADDRO in partnership with Ghana Health Service (GHS) supervised the work of CBAs in all the sub districts across the six regions. Ghana Health Service (GHS) developed appropriate iCCM strategies and provided technical guidelines to the program. Also staff of GHS at the district and sub district levels monitored and supervised the work of the CBAs and ensured that data on iCCM activities from CBAs were entered into the District Health Management Information System (DHMIS2) for policy decision by Ministry of Health (MOH.
The program operates in six (6) regions but seven (7) sub-districts in Ghana. The operational Regions and Sub-districts are as follows:
- Bawku West in Upper East Region
- Builsa North also in Upper East Region
- Karaga in the Northern Region
- Nadowli in the Upper West Region
- Bosome Freho in the Ashanti Region
- Akwapim South in the Eastern Region and
- Sefwi Wiawso in the Western Region of Ghana.
In each of these selected districts, the iCCM interventions are being implemented in one Health Sub-District, which is cluster/number of communities demarcated by GHS for health service provision.
- Increase mothers’/primary caregivers’ knowledge and practice of key behaviours in health promotion, disease prevention, appropriate home care, and healthcare seeking for malaria, diarrhoea, and pneumonia.
- Increase access to and use of quality health care in rural areas for mothers, children, and their families.
- Monitoring and Supervision of iCCM activities in ADDRO’s sub districts
- Participate in coordination meetings with GHS and other health stakeholders
- Facilitate integration of CBAs data into Health Management Information Systems (DHMIS2)
- CBAs educate community members on hygiene and sanitation (proper hand washing)
- CBAs educate community members on hygiene and sanitation (proper hand washing)
- Participation and supervision of LLINs Point distribution in Upper East.
- Training of Supervisors & Facilitators for Savings with education
- Procure Bicycles for CBAs in southern Ghana to facilitate movement for iCCM sensitization activities.
- Sensitization of community members by ADDRO /GHS staff on Malaria, Diarrhoea and Pneumonia
- ADDRO Staff facilitate SBCC activities with mothers/primary caregivers (monthly meetings)
- Community Mobilization for Savings with education
- Savings Groups Formation & Trainings
- Monitoring & Supervision of Savings with education Group
- TOT training for GHS/ADDRO Staff on hygiene and sanitation, iCCM and SBCC
- Refresher training for CBAs on hygiene and sanitation, iCCM and SBCC
- Program mid-term evaluation
Social and Behaviour Change Communication (SBCC) activities
A series of Social and behaviour Change Communication (SBCC) activities (sensitization/ durbars) on malaria, diarrhoea, Acute respiratory Infection (ARI), child nutrition and the importance of ANC and CWC attendance were carried out in various communities in all ADDRO’s seven sub districts. The main focus of these SBCC activities was to raise the awareness on the prevention of these conditions as well as the treatment options available at the community level- seeking care from CBAs. These SBCC activities also demystified cultural practices that influenced health seeking behaviour negatively so as to positively influence health seeking behaviour of community members. In these SBCC activities, small groups were organized for sensitization activities from one community to another. These sensitization sessions were facilitated by GHS staff and supported by ADDRO regional Coordinators.
On malaria, facilitators guided participants to discuss causes, predisposing factors to getting the disease, signs and symptoms, prevention and treatment. On preventive measures, emphases were played on community members sleeping under LLINs every night throughout the year. Environmental cleanliness was also encouraged to avoid it serving as breeding places for mosquitoes and contraction of malaria.
On diarrhoea, discussions were centred on the causes, signs and symptoms, prevention and treatment. Personal and environmental cleanliness such as keeping children’s finger nails short, thorough hand washing with soap and water and having pit latrines or burying human excreta as effective ways of preventing diarrhoea are encouraged.
Discussions on ARI were also focused on causes, signs and symptoms, prevention and treatment. Mothers/caregivers are encouraged not to expose the children to the hazards of the weather.
Education was also given on the importance of attending ANC, CWC and basic child nutrition including exclusive breast feeding. Mothers were also encouraged to complete all immunization schedules for their children to prevent diseases such as pneumonia, measles, and yellow fever just to mention a few.
The table below summaries the sensitization activities in the seven sub districts.
|№||Region||Sub district||Total no of communities||No of communities
|No of sessions
Monthly Group Meeting with Caregivers/Mothers
Fig 11 ADDRO Regional Coordinator and GHS staff with mothers/caregivers at Chuchuliga Health Centre on CWC day
Sensitization sessions with mothers/caregivers were also held by ADDRO regional Coordinators. These meetings were held at various communities and health Centres on their CWC and ANC days. At these meetings, mothers were educated on the causes, prevention and treatment of childhood diarrhoea, malaria, pneumonia as well as the need to seek early and appropriate medical care for these conditions. Mothers were also encouraged to take immunization seriously as it prevents children from other diseases and also beneficial to children’s growth and development. The importance of ANC attendance and skilled delivery were also discussed. The table below contain summary of various meetings with mothers/care givers in all the sub districts.
Summary of Monthly Group Meeting with Mothers/care givers.
|No||Region||Sub district||No of sessions||Attendance|
ICCM ACTIVITY BY CBAs.
Throughout the year, CBAs visited households, provided treatment and gave health education on malaria, pneumonia, diarrhoea and basic hygiene practices, example hand washing with soap.
The table below shows the performance of iCCM activities by CBAs in all the seven sub districts during the period under review.
Table showing CBAs Activities
|# of children brought to CBA to be checked for illness.||7,824|
|# of children with fever||6,045|
|# of children with fever tested with RDTs||4,265|
|# of children tested positive||3,668|
|# of children tested negative||597|
|# of RDTs positive cases given A/A||3,668|
|# of children treated without testing with RDT||1,812|
|# of children seen with fast breathing||1,644|
|# of sick children with fast breathing( pneumonia) given Amoxicillin||1,657|
|# of children seen with diarrhoea||1,487|
|# of sick children with diarrhoea given ORS||1,482|
|# of sick children with diarrhoea given Zinc||1,482|
|# of children referred||59|
|# of community sensitization meetings||117|
|# of monthly meetings with mothers/care givers||100|
Program Health Coordinator attended a regional Health performance review meeting on August 24, 2016 in Upper East region, Bolgatanga. The review meeting was attended by all districts directors of health services, Non-Governmental Organizations/Civil Society Organization (NGO/CSOs) in health and other key stakeholders such as the Regional Coordinating Council. In his welcome address the regional director of health acknowledged the contribution of all NGO/CSOs to the achievement of health goals in the region. On iCCM, ADDRO was commended for its contribution towards the achievement of iCCM targets in the two sub-districts in Upper East, namely, Chuchuliga and Sapeliga.
Collaborative meetings were also held by the various ADDRO regional health Coordinators and GHS staff (district malaria/iCCM focal persons, sub district leaders and sub Community Health Officers (CHOs), who supervises CBAs at the communities) to plan and agree on iCCM activities implementation schedules at the communities.
Integration of iCCM DATA into DHMIS2
The District Health Management Information system (DHMIS2) is software that supports the capture of data linked to any level in the health sector of the country.
All the ADDRO Regional Coordinators continually worked in collaboration with Ghana Health Service (GHS) to facilitate entry of iCCM data collected by CBAs into the DHMIS. Data collected by CBAs were summarized into two templates and given to GHS and one for ADDRO use. On the agreed day for the data entry, the ADDRO Regional Coordinator usually sends his copy to the District Health Information Officer to validate the data before it is entered into the DHMIS2. This exercise was done monthly. Whilst entering these data at the various district levels, the information is seen at the various health levels- district, regional and national.
Procurement of Bicycles for CBAs
Fig 14 Bicycles presented to Parkro Sub district (GHS, Eastern Region) for ADDRO CBAs
CBAs were provided with bicycles to facilitate their movement to provide health education and treatment of children under five years in hard and far to reach communities. In the southern sector- Ashanti, Eastern and Western regions 130 bicycles were bought for CBAs to facilitate their work. The CBAs in the Northern sector- Northern, Upper East and Upper West had their bicycles in 2015
Distributed bicycles were done through the respective Districts Health Administrations.
Review Meeting with CBAs
ADDRO regional coordinators in the three Northern regions held separate review meeting with CBAs in their respective regions. This was necessary following the introduction of the Seasonal Malaria Chemotherapy (SMC) in most of the regions in Ghana. SMC as the name suggest is a seasonal malaria preventive treatment given to children below the ages of five years. This activity carried out for three successive months during the malaria peak season (July-September, 2016) to prevent children under 5 years from getting malaria. During this period, children less than five years could only be treated with Artemether Lumefantrine but not with Artesunate Amodiaquine. During the three months’ period, CBAs recorded significant decline on the number of children treated though peak season for malaria. The reason was because CBAs had Artesunate Amodiaquine but not Artemether Lumefantrine. However, malaria treatment with ACT or A/A was permissible after the three months’ period.
Following this exercise, ADDRO organized review meetings to re-orient its CBAs on the SMC to ensure that the necessary quality assurance measures were followed. The review meetings also afforded ADDRO the opportunities to demystify any wrong perception that CBAs may have about the SMC and iCCM. Regional Coordinators also reviewed the data collection tools with CBAs during this meeting. Though few CBAs did not turn up, their partners were around for the training.
Consultative Meeting with DHA
ADDRO/Episcopal Relief & Development in collaboration with GHS with support from AMF carried out mass LLINs distribution in Greater Accra, Northern and Upper West regions. Having successfully distributed these LLINs to 43 selected districts in these regions, ADDRO /Episcopal Relief & Development/NetsforLife® strategy requires a follow-up of each net that reached the beneficiaries. This strategy involves:
- Monthly Sensitization of households on malaria, diarrhoea and ARI issues.
- Quarterly follow-up on LLINs and data collection on condition and usage of the LLINs
In view of this, ADDRO held consultative meeting with District Health Administration Teams in all the three regions to brief them on this strategy and the intention of using their existing community volunteers who could read and write for the exercise. They were also requested to assist ADDRO recruit to replace volunteers who could not read and write as the tasks requires some level of reading and writing. These meetings were held on different dates, Greater Accra was October18 to November 4, 2016, Upper West November 7 to 14, 2016 and Northern region November 31 to 3rd December, 2016.
Recruitment of Sub District Volunteer Supervisors.
ADDRO/Episcopal Relief & Development initially agreed to use Sub District Supervisors for the Post Distribution Check Ups (PDCU) AMF to supervise volunteers for the NetsforLife® strategy. However, during the consultative meetings with various DHA especially Accra and Upper West, they disagreed with this idea. The reasons for their disagreement were that:
- GHS implement, supervises and are responsible for all outcomes (positive and negative) of health programs in Ghana.
- The strategy, though not pervasive, involves giving of health messages on malaria, diarrhoea and pneumonia which the SDS have no adequate knowledge and capacity to supervise the volunteers
- GHS recruited and trained these volunteers and responsible for their supervision in all health programs.
- GHS has the capacity to train and guide these volunteers on the health messaging
- GHS will not allow any other persons to supervise their (GHS) volunteers
ADDRO discussed these challenges from the field with Episcopal Relief & Development and it was agreed to allow the GHS train and supervise the volunteers for the follow up strategy. To this end, GHS provided ADDRO with all the SDS for the three regions. The details are given in the table below:
|Region||Number of SDS|
Training of Sub District Volunteer Supervisors (SDVS)
The main roles of SDVS who are GHS staff involve recruitment and training, effective monitoring and supervision of community volunteers for the LLINs follow-up and health messaging on malaria, diarrhoea and pneumonia in all beneficiary households.
ADDRO organized a one-day Training of Trainers (TOT) for all the SDVS who also organized cascade trainings for the volunteers in their respective sub districts. The organization developed a training guide that was used for the training of both SDVS and volunteers involved in the monthly sensitization and quarterly data collection. The sub district volunteer supervisors also used this same guide to train the volunteers for the follow-up and health messaging.
ADDRO headquarters staff organized a one-day Training of Trainers (TOT) on the follow-up strategy and included the use of the data collection tool and health messages for the its regional staff. The training of the SDVS was facilitated by both ADDRO regional and GHS staff. GHS facilitators (mostly malaria focal persons) trained the SDVS on the causes, signs and symptoms, prevention and home management of Acute Respiratory infection (ARI) or suspected Pneumonia, Diarrhoea and uncomplicated Malaria. Besides, the regional staff of ADDRO also educated the SDVS on the use of the data collection tool (filling the monthly activity form), roles and responsibilities of SDVS and Volunteers.
The one-day training was carried out using the following methods:
- Pre- and Post-Test
- Presentations and Discussions
- Practice filling data collection forms using scenarios
Details of attendance and training are provided in the table below:
|REGION||TOTAL SDVS||NUMBER TRAINED||REMAINING TO BE TRAINED|
Recruitment of community volunteers
Recruitment of community volunteers for the follow up strategy for Northern and Upper West regions was completed, with a total number of 5,076 community volunteers for these two regions made up of 1,511 for Upper West and 3,565 for Northern region. In Greater Accra region, volunteers declined due to low incentive (GH¢ 20 per quarter). Volunteers’ proposal was between GH¢ 150 to 200 every month. The explanation was that due to the urban nature of the region, GHS usually hire and pay volunteers any time there was a campaign. GHS further explained that during the LLINs mass distribution in July 2016, volunteers were offered GH¢ 20 per day; and even with that, most of them refused to work because the amount was not enough. GHS had to rely on their staff and community members who had just completed Junior and Senior School graduates who were home at the time.
ADDRO discussed the challenge on Greater Accra with Episcopal Relief & Development and it was resolved to do the follow up in only two out of the 12 districts in the region. The amount for volunteers from the other ten districts was used to raise volunteers’ allowances to GH¢100 in two districts for them follow up, which they gladly did.
Replacement and Training of CBAs
During the period under review, we lost four (4) CBAs- one in Chuchuliga, one in Nadowli and two from Sapeliga sub districts. Two CBAs in Bosomefreho in the Ashanti region also travelled out of their communities. To this end, ADDRO worked with GHS in these sub districts and replaced them. A short training for these new CBAs were also organized. After the training they were paired with the old CBAs.
Split of Sub district into two
The Anyinabrim sub-district in the Western region was divided into two sub districts by GHS. This split became necessary due to the large size of the sub district. This will help in effective and efficient administration of health services and monitoring. The new sub district is Abrabra. Due to this development ADDRO will be working with 8 sub district in 2017. The 54 CBAs formerly in the Anyinabirim district, has also been split with 20 CBAs in Anyinabrim and the remaining 34 in Abrabra.
ADDRO Headquarters staff periodically carried out monitoring visits to communities within the year. Routine monthly monitoring visits was done by the health Coordinator to the various communities. He monitored the work of CBAs, observed and supported them where it was necessary. GHS Supervisors also provide routine visits. This created an opportunity for ADDRO regional staff and GHS to collect and validate data, and identified training needs of CBAs.
Training of facilitators and supervisors on saving with Education (SwE)
The Savings with Education training was the same indicated earlier in the food security programme. The training took place from the 9th to 12th February, 2016 at the Extee Crystal Hotel, Bolgatanga. The training was facilitated by Kellie McDaniel and Priscilla Amuah, all staff of Episcopal Relief & Development. Thirteen (13) staff of ADDRO benefitted from the training. The key components of the training were the introduction to savings with education, the formation of savings groups, rules and regulations governing saving groups, the formation of management committees of saving groups and the roles of each management committee member, etc. The workshop was practically oriented as it entailed group presentations at each stage. Participants were at each stage put into groups to perform a task and make presentations to fellow participants. The training manual along with necessary forms and tools were shared with participants.
After the training, the project officers also facilitated similar trainings at the community levels. Out of these trainings 12 groups of 740 members were formed. At the close of 2016, the following were achieved by members: Cumulative value of savings GH¢23,233, Cumulative value of group funds GH¢ 26,519 and Value of active loans GH¢15,165
One major challenge during the period, was lack of transport at the facilities for referred clients. Some CBAs reported that when children with severe illness and women in labour were referred, they did not get means of transport as a result they got to health facilities late in worse condition. Due to this, some women were assisted to deliver by Traditional Birth Attendance (TBAs) at home which is not encouraged.
Another challenge had to do with CBAs treating malaria in children without testing as a result of RDTs shortages. To this ADDRO engaged GHS at the district and regional levels and had this issue resolved.
Other challenge was the temporary suspension of the use of Artesunate Amodiaquine and non-availability of Artemether Lumefantrine for use by CBAs to treat children under five years suffering from malaria. ADDRO staff however encouraged CBAs to do more SBCC activities and all malaria positive diagnosed cases were referred to the nearest Health facilities.
HUMAN INTEREST STORIES
Fig 15 Madam Vida in her shop at Chuchuliga in the Upper East Region
Savings with Education boosts family income
Madam Vida Abaachab, is a 42-year old trader at the Chuchuliga market in the Builsa North District. Madam Vida trades in foodstuffs such as maize, rice, millet, beans and groundnuts. These produce are always bought in small quantities due to her small income level.
She has been looking for an opportunity to expand her business which never came until April 2016 when Savings with Education was introduced to her by the Anglican Diocesan Development and Relief Organization (ADDRO) in her community, Tiedembilsi. This was what she had to say:
A colleague told me about this Savings with Education group she has joined which is helpful. When I asked of the benefits of joining the group, she told me that group members are engaged in weekly savings so that when the money grows to an appreciable level they could share their savings or lend money out to members. Having thought of saving money to expand my business, I quickly joined Adefitali savings group. When the time for loan disbursement came, I requested for a loan of Two Hundred Ghana Cedis (GH¢200.00) to buy more cereals to expand my business and also to pay back the loan in three (3) months’ time. The loan was given to me without difficulty. My worry of getting money to expand the business is over and I also benefit from health talks during these weekly meetings. I am grateful to ADDRO for this initiative, God bless them.
CBAs work create improved health among families
The project Officer of Western Region, Mr Michael Arthur held a meeting with mothers/ Caregivers at Abrabra sub district. In a quest to find out how the work of CBA in the new sub district, Madam Asibi Jacob, 28-year-old mother with twins has this to say:
“The visits (i.e. Home visits) from our brothers (i.e. CBAs) have really helped us; they educate us on a lot of preventive measures such as importance of sleeping under mosquito nets, proper handwashing, good nutrition, Antenatal visits and compliance with medications during pregnancy has really helped my family from frequently falling sick especially our children. Our brothers (CBAs) give to our children quality medicines that cure their illness and so these days, we hardly visit Abrabra (i.e. Abrabra Health Centre).
Again, I will say it has been a long time since I saw or heard of a child suffering from convulsion in our community which I believe it’s because of the work our brothers George and Gariba (CBAs) are doing with your support (ADDRO support). Apart from attending Child Welfare Clinic, my children hardly fall sick and anytime they did, George and Gariba are my doctors. They live within the community, the treatment is free and I don’t spend on transportation to get my children treated. I pray to God to help ADDRO with resources to continue to help us in this community.
There are an estimated 280,000 people living with HIV/AIDS in Ghana, with a national HIV prevalence rate of 2.1% (2011 HIV sentinel survey). Evidence suggests a stable trend of HIV infection in the general population yet HIV infection is on the increase within. Studies also revealed the low uptake of VCT among the populace and commercial sex workers and the majority of those who tested positive were unaware of their status.
Generally, stigma and discrimination towards HIV/AIDS is recognized as a major obstacle to HIV prevention, treatment, care, and support. This poses challenges to preventing further infections, alleviating the impact, and providing adequate care, support, and treatment.
The HIV/AIDS prevalence rate in the Upper East Region has seen a remarkable drop from 2.4 per cent in 2010, 1.5 per cent in 2011 and 1.37% in 2012. However, Navrongo District maintained a consistency rate of 2.2 per cent in 2010 and 2011, whiles the Bolgatanga Municipality recorded 3.8 per cent in 2010 and 2.2 per cent 2011. These records, though of significant benefit, leaves much to be desired.
Within the reporting period, ADDRO worked within the religious structures (churches and mosques) to ensure a reduction of new infections in various communities.
The project aims to ensure increases in the uptake of HIV Testing and counselling (HTC) through religious congregations and mobile outreaches among others. Key to this project is an effective stigma reduction strategy as indicated in its objectives below. Working at reducing stigma has the potential of reducing the spread of HIV and mortality due to HIV. The support of peer educators among other groups in HIV/AIDS outreach and clinical activities has the potential to reduce the negative effects of stigma. Peer education can also effectively reduce stigma, promote healthy sex behaviours, provide role models, and create hope among the populace.
- To promote safer sexual practices among 30 religious congregations in three Districts in the Upper East Region by the end of June, 2016
- To promote the uptake of HIV testing and counselling services among 30 religious congregations in three Districts by the end of June 2016
- To sensitize18,900 youth and adults among 30 congregations in three districts on HIV/AIDs stigma reduction and discrimination practices against PLHIV by end of June 2016
- Education campaign (one-on-one or in small groups)
- Conduct HIV/AIDS prevention outreach/ sensitization activities among religious congregations
- Organize testing and counselling outreach among religious congregations
- conduct Sensitization meetings/forums with stakeholders (traditional / religious leaders on stigma to enable them lead the stigma reduction education
- Train Peer Educators to conduct education and to distribute condoms
- Organise peer educators review Meeting
- Distribute Condom and Promote use
- Train field level implementation staff
- Train women union in religious congregation (Refresher and replacements) on HIV/AIDS prevention and stigma reduction
- Train clergy and church leaders on HTC including couple testing and counselling
- Conduct Mobile outreach on HTC
The work of ADDRO was successful during the year under review through participatory planning, effective implementation, monitoring and evaluation. Lessons learned from the activities implementation would go a long way to help ADDRO improve upon its strategies in the coming years. Going forward, we shall continue to step up our fundraising efforts in order to secure more sustainable funding for the organisation.
Let me take this opportunity to express my gratitude to the Almighty God, staff, Board members, partners and even volunteers for their dedication and support, which enabled the organization to achieve its objectives.
Once again, I want to render our sincere thanks to you all for your strategic support to the course of ADDRO towards the realisation of our desired goals.
Rt. Rev. Dr. Jacob Ayeebo