This program earned a Platinum award.
The Ndlovu Care Group (NCG) is an NGO focused on empowering rural communities towards sustainable community health and community care. To this end, NCG aims to establish partnerships with government departments, CSO and corporate groups, and roll out Rural Advancement Programmes (RAPs) in different areas. These include Autonomous Treatment Centres (ATCs), supplying community healthcare; and Community Care, Health, Awareness and Mobilisation Programmes (CHAMP). The aim is to empower local community members to run the RAP, and locals are trained to take over the projects as soon as possible. Responsibilities are also delegated to the lowest rank that can fulfill the role, which again encourages capacity-building. The RAP includes capacity-building; information and education on health and related issues to encourage behaviour change, early care-seeking behaviour (eg. early HIV testing, CD4 screening, treatment for opportunistic infections, treatment adherence), and risk-reduction; primary health-care, malaria, TB and HIV/AIDS care; childcare programmes addressing the needs of OVCs; and research, monitoring and evaluation. The CHAMP includes a 12-hr clinic; a 24-hr clinic for maternity services and dedicated HIV in-patient care; a dedicated HIV-laboratory; and a research, monitoring and evaluation department. It also has programmes in arts, sports, culture, and music; an OVC programme (including nutritional programmes with vegetable gardens, and environment programmes)’ entrepreneurial efforts (bakery, car wash, nappy factory, IT school); basic infrastructure provision (bore-holes, waste removal, sewerage) The ATC offers the primary health-care for malaria, TB and HIV/AIDS; VCT; and treatment to those already infected.
Innovation: Bringing good-quality primary healthcare and education to rural areas means much better chances of locals in those communities having better healthcare, and living safer lives. The more that prevention is pushed as a policy, the sooner the HIV/AIDS, TB and malaria epidemics can be brought under control. Also, empowering local community members to run the projects improves the chances of the intervention being sustainable in the future.
Effectiveness: RAPs have been set up in Elandsdoorn (Limpopo); in Lillydale (ATC is functional, CHAMP still in development); and Utah (ATC is under construction). To date, 3100 children are enrolled in the OVC programme, 58 child-headed households have been registered; there are 4 nutritional units with vegetable gardens; 4 pre-schools are involved in the various programmes; and there is an environmental programme taking township children in Nature Reserves and educating them about nature conservation. 36 bore-holes have also been dug in Moutse (Elandsdoorn); and 2200 patients have started ART in Lillydale in less than two years.
Poverty Impact: 350 people are employed by the various NCG projects, with 90% being local community members. The focus on prevention also has a large impact on the community – preventing people getting ill in the first place saves large amounts of money, and saves hugely in terms of human resources.
Sustainability: As the project gains international recognition, the donor funding pool grows. However, as the projects develop, the funding needs also change. To build a local NCG initiative costs roughly R15m, including the ATC, buildings, and technical resources. Few of the projects are able to be self-sustainable yet, and are therefore still heavily reliant on funding. However, training local community members to run the project does make it more sustainable, at least in terms of human resources. Also, because government has not bought into the project on a large scale, the majority of funding comes from international funders. These include PEPFAR, the EU, DFID and DANIDA. Government departments have provided training and educational programmes; however, little funding has been available.
Replication: The main obstacle to replication would be funding. Many of the related projects would require funding for start-up, even if ways could be found to be self-sustainable (eg. through income-generation projects; vegetable gardens etc). NCG aim to replicate RAPs throughout the country, under NCG (and have at least 5 RAPs by 2012); and if funding becomes available, it seems like that they will do so. The ongoing evaluation and monitoring has also meant that the process of establishing similar projects is well-documented. So if funding is accessed, replication would be possible.