Care Groups and Income GenerationLessons Learned from World Relief Rwanda Umucyo CSP (2001-2006)Melanie Morrow & Melene Ka...
World Relief’s Umucyo CSPLocation: Nyamasheke District, Western Province, Rwanda(Former Kibogora Health District)6 Interve...
What happened instead, after midterm:Care Groups registered as formal associations, were trained infinancial record keepin...
More of what happened…Additional IGAs: animal husbandry, crafts, joint crop harvest andsale, selling small fish procured t...
Using the RevenueEvery three months, the associations reviewed their earnings anddecided how to use the revenue:Health ins...
Assets and AchievementsProject Input for Annual Incentives: 836 goatsCare Group Association Assets after two years:1,443 g...
Project Impact:Estimated Annual Mortality Reduction using LiSTCommunity-based intervention packages facilitated by NGOsdem...
Lessons• Start with a well-managed program• Introduce $ activities after Care Group Volunteers havedemonstrated their comm...
Care Groups and Income Generation - Lessons Learned from World Relief Rwanda_Melanie Morrow_4.23.13
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Care Groups and Income Generation - Lessons Learned from World Relief Rwanda_Melanie Morrow_4.23.13

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  • According to the study authors: Baseline (2000 DHS) Regional U5MR in Cyangugu was 158.0; Endline (2005 DHS) Regional U5MR for West Province was 178. (The former Cyangugu Prefecture, where the project was located, became part of West Province in 2002, due to national changes in administrative structure.)
  • Care Groups and Income Generation - Lessons Learned from World Relief Rwanda_Melanie Morrow_4.23.13

    1. 1. Care Groups and Income GenerationLessons Learned from World Relief Rwanda Umucyo CSP (2001-2006)Melanie Morrow & Melene KabadegeCORE Group Spring MeetingApril 23, 2013
    2. 2. World Relief’s Umucyo CSPLocation: Nyamasheke District, Western Province, Rwanda(Former Kibogora Health District)6 Interventions: Malaria, HIV/AIDS, Nutrition and Breastfeeding,Diarrhea, Immunization, and Maternal & Newborn Care.Total Population: 152,981 people in 29,166 HHCare Groups: >2800 Volunteers in 202 Care Groups; HH visits 2x/moPersistent Request: “We want to do income generating activities!”Backstop Fears: “The project will lose focus!”Care Groups and Income GenerationWorld Relief Rwanda Umucyo CSP (2001-2006)
    3. 3. What happened instead, after midterm:Care Groups registered as formal associations, were trained infinancial record keeping, opened bank accounts. (CS staff trained byUrwego, WR’s microfinance institution, to train CG associations).Association Governance: President, VP, Secretary & TreasurerDifferent from CG leadership (division of labor) but businesstransacted during CG Meeting, after health agenda.Care Group Volunteers = Social Marketing Sales ForceORS packets, ITNs, water chlorinationGrowth MonitoringEach CG Volunteer tracked the stock and sales of a separate item,with signoff from the treasurer. Other special roles: Hearth, GMPCare Groups and Income GenerationWorld Relief Rwanda Umucyo CSP (2001-2006)
    4. 4. More of what happened…Additional IGAs: animal husbandry, crafts, joint crop harvest andsale, selling small fish procured trips to the lake, etc.Annual Volunteer Incentives: Care Groups requested investment inAssociations (e.g. a pair of goats) over individual volunteer incentives.Savings and Loan: CG volunteers contributed their personal savingson a monthly basis; After one year from savings and IGA, theassociations were allowed to make their first withdrawals. Many choseto make small loans to members at terms set by the association (3%over a three month period). Some associations chose to lend moneyspecifically for school fees for members’ children.Care Groups and Income GenerationWorld Relief Rwanda Umucyo CSP (2001-2006)
    5. 5. Using the RevenueEvery three months, the associations reviewed their earnings anddecided how to use the revenue:Health insurance membership,Buying agreed items for members (soap, cloth, etc.)Contributions to PD/Hearth menu to benefit children in HearthReinvestmente.g. “Ambulance Hammock” rental for emergency transportCare Groups and Income GenerationWorld Relief Rwanda Umucyo CSP (2001-2006)
    6. 6. Assets and AchievementsProject Input for Annual Incentives: 836 goatsCare Group Association Assets after two years:1,443 goats, 9 cows, and $13,000 USD cash (in RWF)Sustainability: 6+ years post-project: 11% (23/202) CG Assoc. still activeITN Coverage (CG Associations sold subsidized ITNs)*Prior to national campaign for mass distribution later in 2006Care Groups and Income GenerationWorld Relief Rwanda Umucyo CSP (2001-2006)ITN use prior night Baseline 2002 Final 2006* DHS 2005, Western Prov.Children 0-23m ~2% 70% 12% (U5)Pregnant women ~2% 78% 16%
    7. 7. Project Impact:Estimated Annual Mortality Reduction using LiSTCommunity-based intervention packages facilitated by NGOsdemonstrate plausible evidence for child mortality impact.(Health Policy and Planning, 2013: 1-13. Jim Ricca, NazoKureshy, Karen LeBan, Debra Prosnitz, and Leo Ryan)From Table 5: Changes in U5MR directly measured by DHS and estimatedfor project area by modeling with LiST.Measuredannualdecrease inU5MR (DHS)Estimated annual decrease inU5MR modeled using LiST,ONLY PROJECT interventionsmodeled in LiSTWorld ReliefRwanda-3.4 7.0The annual mortality rate for the region (Cyangugu & West Province) increased according tosub-analysis of the DHS from 2000 to 2005, while decreasing in the project area from 2001to 2006, the latter based on project intervention data modeled in LiST.
    8. 8. Lessons• Start with a well-managed program• Introduce $ activities after Care Group Volunteers havedemonstrated their commitment to health aims of project and trusthas been built amongst members.• IGAs can further health objectives (sale of health-relatedcommodities, nutritious foods)• Financial benefits can be socially directed (PD/Hearth)• Adding IGAs and savings to Care Groups can be an incentive tovolunteer participation rather than a distraction.Care Groups and Income GenerationWorld Relief Rwanda Umucyo CSP (2001-2006)

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