The document summarizes World Relief Rwanda's Umucyo Community and Savings Project from 2001-2006 which utilized over 2,800 care group volunteers in 202 care groups. After requests from volunteers, the project trained care groups to start income generating activities like selling health products, animal husbandry, and crafts. This led to assets like 1,443 goats and $13,000 cash. The project reduced under-5 mortality an estimated 7% annually according to the Lives Saved Tool compared to increased mortality in the surrounding region. Lessons included starting income generation after establishing trust and using financial benefits to further health objectives.

1. Care Groups and Income Generation
Lessons Learned from World Relief Rwanda Umucyo CSP (2001-2006)
Melanie Morrow & Melene Kabadege
CORE Group Spring Meeting
April 23, 2013

2. World Relief’s Umucyo CSP
Location: 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 HH
Care Groups: >2800 Volunteers in 202 Care Groups; HH visits 2x/mo
Persistent Request: “We want to do income generating activities!”
Backstop Fears: “The project will lose focus!”
Care Groups and Income Generation
World Relief Rwanda Umucyo CSP (2001-2006)

3. What happened instead, after midterm:
Care Groups registered as formal associations, were trained in
financial record keeping, opened bank accounts. (CS staff trained by
Urwego, WR’s microfinance institution, to train CG associations).
Association Governance: President, VP, Secretary & Treasurer
Different from CG leadership (division of labor) but business
transacted during CG Meeting, after health agenda.
Care Group Volunteers = Social Marketing Sales Force
ORS packets, ITNs, water chlorination
Growth Monitoring
Each CG Volunteer tracked the stock and sales of a separate item,
with signoff from the treasurer. Other special roles: Hearth, GMP
Care Groups and Income Generation
World Relief Rwanda Umucyo CSP (2001-2006)

4. More of what happened…
Additional IGAs: animal husbandry, crafts, joint crop harvest and
sale, selling small fish procured trips to the lake, etc.
Annual Volunteer Incentives: Care Groups requested investment in
Associations (e.g. a pair of goats) over individual volunteer incentives.
Savings and Loan: CG volunteers contributed their personal savings
on a monthly basis; After one year from savings and IGA, the
associations were allowed to make their first withdrawals. Many chose
to make small loans to members at terms set by the association (3%
over a three month period). Some associations chose to lend money
specifically for school fees for members’ children.
Care Groups and Income Generation
World Relief Rwanda Umucyo CSP (2001-2006)

5. Using the Revenue
Every three months, the associations reviewed their earnings and
decided 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 Hearth
Reinvestment
e.g. “Ambulance Hammock” rental for emergency transport
Care Groups and Income Generation
World Relief Rwanda Umucyo CSP (2001-2006)

6. Assets and Achievements
Project Input for Annual Incentives: 836 goats
Care 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 active
ITN Coverage (CG Associations sold subsidized ITNs)
*Prior to national campaign for mass distribution later in 2006
Care Groups and Income Generation
World 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. Project Impact:
Estimated Annual Mortality Reduction using LiST
Community-based intervention packages facilitated by NGOs
demonstrate plausible evidence for child mortality impact. (Health
Policy and Planning, 2013: 1-13. Jim Ricca, Nazo Kureshy, Karen LeBan,
Debra Prosnitz, and Leo Ryan)
From Table 5: Changes in U5MR directly measured by DHS and estimated for
project area by modeling with LiST.
Measured
annual
decrease in
U5MR (DHS)
Estimated annual decrease in
U5MR modeled using LiST,
ONLY PROJECT interventions
modeled in LiST
World Relief
Rwanda
-3.4 7.0
The annual mortality rate for the region (Cyangugu & West Province) increased according to sub-
analysis of the DHS from 2000 to 2005, while decreasing in the project area from 2001 to 2006, the
latter based on project intervention data modeled in LiST.

8. Lessons
• Start with a well-managed program
• Introduce $ activities after Care Group Volunteers have
demonstrated their commitment to health aims of project and trust
has been built amongst members.
• IGAs can further health objectives (sale of health-related
commodities, nutritious foods)
• Financial benefits can be socially directed (PD/Hearth)
• Adding IGAs and savings to Care Groups can be an incentive to
volunteer participation rather than a distraction.
Care Groups and Income Generation
World Relief Rwanda Umucyo CSP (2001-2006)