Population Growth - What Can We Do About It?

In the next 35 years, the population of Uganda is expected to grow 160% -- from 40 million next year to 104 million by 2050. Uganda Village Project works in several areas that address the effects of population growth: we help women choose when and if they give birth by providing accessible and user-friendly contraceptive services, we work with communities and local government to build shallow wells to ensure infrastructure is in place to meet the needs of growing populations, and we educate about infectious and other diseases that can plague over-burdened health systems and spread quickly when populations swell.

In the Global Health Corps blog, our very own Orrin Tiberi wrote an article about population growth in Africa and the changes this will bring to growth and development on the continent. Check it out at
http://ghcorps.org/whats-love-and-health-got-to-do-with-it/.

Stella: two years later

In 2012, we wrote on this blog about one of our Orphan Support Program students, Stella Nangobi. She had won a scholarship to secondary school because of her hard work with a Children’s Rights and Responsibilities Club, and she was top in her class in her final exams. Stella has continued to impress us over the years. She won a placement in a government university—meaning her tuition is covered—because of her academic performance. For the past several years, she’s been studying to be a teacher so she can continue helping children.

When Stella was 10, she was evicted from the home she was living in by herself. Uganda Village Project staff and board felt that the next decade of Stella’s life should be different, and thanks to some generous donors, we’ve been covering her housing costs while she’s in university. 

Our Orphan Support Program will be phased out at the end of this year so we can focus on our core mission of public health work in rural villages. However, we plan to continue helping Stella with her living costs for her last year of university. She has been a wonderful example of success, and we’re glad that you’ve been on this journey with us and with Stella. We are so grateful for all of the donors who provided scholarship funds over the years to keep Ugandan students in school. Although our direct support for the students is ending as they graduate from their courses, we will continue to follow their progress. We’re so proud of Stella’s hard work, and know she has what it takes to make a difference.

Why Monitoring and Evaluation Matters in Everything

By Orrin Tiberi, Global Health Corps Fellow at Uganda Village Project

Hello from the sunny Iganga, Uganda! For those of you who have not heard of me before, I am the recently arrived Global Health Corps volunteer who will be working in Monitoring and Evaluation for our favorite NGO here in Uganda!! (That would be Uganda Village Project, in case you forgot.) Tuesday the 26th of August marks five weeks that I have been in country, and what an incredible five weeks it has been! I have participated in shallow well clean-ups, malaria sensitizations (which I came to learn was a presentation, not a method of making malaria more sensible), spent a night in the communities, and learned a TON about Uganda Village Project (UVP). You all have participated/supported/championed/been part of an organization that really is having an impact in the Iganga District of Uganda and I am here to help show that impact. We have 8 main goals for the coming year, and probably time for 6 of them, so it is going to be a busy, yet amazing, year here!

This brings me to the topic of Monitoring and Evaluation. I thought in the interests of clarity I would go back to our beloved Oxford Dictionary and define both of these words so we can have a collective understanding of what they mean. According to the Oxford Dictionary, Monitoring is to “observe and check the progress or quality of (something) over a period of time; keep under systematic review”. Uganda Village Project, as many of you know, has been great about keeping track of all their health programs. They can tell you exactly how many hand-washing presentations have been done in a village or what percentage of malaria nets are hung correctly. This is the first step to monitoring: reliably collecting the outputs of an intervention. What Julius and I will be working towards in the coming year is being able to more reliably monitor the current programs of UVP, as well as creating a method for the continuous monitoring of the outcomes of their work. It is great that UVP knows that 70% of the households in the Healthy Villages program have bed nets and have been sensitized to malaria, but how does that affect their health? Are there decreases in symptoms of malaria? Is there an increase in the knowledge base of signs and symptoms of malaria for children? These questions are the type that we aim to be able to measure after this year. By answering these questions, UVP can more accurately represent its work to local partners, international friends of the organization, and in grant applications. Reliable data on these indicators will also allow UVP to continue to make informed decisions about what programs are effective, an essential step if we hope to continue growing in the coming years.

Evaluation is “the making of a judgment about the amount, number, or value of something; assessment”. Whereas monitoring is to make sure the process of an intervention is sound, and to measure some proximal outcomes and outputs of work, evaluation is a measurement of the outcomes and behaviors that may have been influenced by the intervention. This is incredibly important when showing the impact that an organization has had. A thorough evaluation is the way that any organization can say for sure that they have changed the situation for the better.  Monitoring helps with this of course, but as it is run concurrently with the intervention, it is hard to say for certain if the changes seen in the data are going to be long-term changes or just a blip in their behavior.

Uganda Village Project has been very proactive in this area as well. One of the main tasks that Julius and I will be working in this coming year is an evaluation of the impact of UVP’s work on the 88 villages that had been selected to be a part of the Healthy Villages Initiative. Currently UVP has intervened, or is currently in the process of working with 24 of these villages. We will use the rest of the villages as a comparison to evaluate the impact on overall health that UVP has precipitated. Currently we are in the proposal stages of this evaluation, gathering the necessary documents that are needed to receive Institutional Review Board approval for working with community members. After this is achieved, we plan to start with data collection in early 2015. As I said before, it is going to be a busy year!

Monitoring and Evaluation are sometimes criticized upon for not valuing the individual. It is easy for a single person to get lost in numbers, but with numbers we are able to tell so much more than what can be seen on an individual level. This year Julius and I hope to be able to bring the bigger picture into clarity, while not forgetting the amazing people and stories that are present in our analysis. We both look forward to a life changing year, and hope to share more of it with you in the upcoming months.

If you want to see more of the day to day life in Iganga, please follow me on Twitter @otiber or on Instagram @ofteted. Any questions or comments you may have can be directed to my email orrin@ugandavillageproject.org.

Welcome to our Global Health Corps Fellows!

UVP is extremely excited to host our first cohort of fellows from the Global Health Corps. GHC's mission is to "to mobilize a global community of emerging leaders to build the movement for health equity". Learn more about the organization here. Our fellows this year are Julius and Orrin, who will be helping us improve our monitoring and evaluation tools.

Julius: I graduated in 2014 from Makerere University, with a degree in statistics majoring in development planning. After my internship program at Economic Policy Research Center (EPRC) - Uganda, I was retained as a research assistant for two years prior to joining GHC. During the post recruitment months by GHC I worked in Rakai for the World Bank on a research project about nutrition and health among children.

During university, I volunteered for a non profit local organization (Good Care Foundation), that seeks to unite the youth and mobilize them in changing the dimensions of a vulnerable society financially and socially into a developed and self perpetuating one. Here, I spearheaded capacity building programs in high schools, conducted seminars and conferences aimed at promoting awareness of teenage pregnancies and fighting HIV prevalence among youth.

Orrin: Hello everyone!  First off I am super excited to be part of the UVP family.  Though I only arrived 10 days ago in Iganga, I already at home with all the staff and am slowly getting familair will all the projects.

My first foray into public health was in middle school, where I entered the school science fair showing the effects of secondhand smoke on house flies.  They all died in under a minute, not surprisingly, and though I didn’t get first place my passion for public health was born.  I stayed involved in smoking cessation through high school and my undergraduate studies at the University of Montana.   After graduation I successfully applied to the Peace Corps Master’s International in Public Health at the University of Pittsburgh, where I studied Behavioral and Community Health.  

After my first year of classes I left to Riobamba, Ecuador for 27 months where I worked in with the Ministry of Health on their new campaign to decrease adolescent pregnancies.  After the end of the program I transitioned to work in a public university at their wellness department doing sexual health work. I helped the office create a baseline survey to measure their impact and ran the first cohort, ultimately sampling 5% of the student body.I returned to Pittsburgh in 2013 to finish up my degree, where I interned at Global Links helping to create an monitoring and evaluation plan for their future interventions.

I am extremely excited to work with the Uganda Village Project and hope that through our work that UVP is able to strengthen their international profile as a NGO as well as improve aspects of their current data collection.

Buwoira: A Successful Summer in Many Ways

As the summer comes to an end, the one and only Buwoira Launch Team prepares to leave Uganda.

We knew from the start that to be the only team in a completely new village to UVP would be a challenge – but as soon as we arrived we rolled up our sleeves and started working as hard as we could.

During these seven weeks, there were moments of self doubt and many challenges, but as we look back we are proud of how much work we were able to accomplish in this small village. As a group we grew closer and closer together as we visited schools, churches, houses and boreholes to mobilize the community for our outreaches, walked miles and miles to survey every single house in the community, stayed up late (that’s around 9 pm in village time!) to plan education sessions and mobilization strategies, learned how to use market rice bags as educational posters, built tippy taps and sanitation facilities for community members who couldn’t do it themselves (the elderly, the disabled and single women), organized workshops to teach building skills to those who could, and practiced our Lusoga greetings to perfection.

When we reflected on success stories from the summer, we couldn’t decide exactly what we wanted to share. Our experience in this village taught us so much, and was so rich in every way that to choose one event seemed difficult.  We could talk about our education sessions on important health topics (HIV, family planning, sanitation) - many of these moments were very important to the community as it was sometimes the only contact they had with the health care system (in the case of HIV and malaria testing days and contraceptive distribution) or with a reliable information source about conditions that were so common in the village. Or maybe mention that we were the only village to implement the Sanitation Push initiative, a UVP program that has as main objectives promoting education on good sanitation practices and also facilitating and organizing the community to make sure all households have the basic sanitation facilities (latrine, tippy tap, plate stand, washroom and trash pit), by subsidizing basic materials and providing support to those who need it. Or the fact that our baseline survey was able to cover almost all households in the village and provide UVP and the government with essential data on the sanitation status and malaria net usage in Buwoira.  

But somehow we wanted to say something else. This village gave us much more than we had hoped for. Our success stories are many, although they are not always conventional. For Manon, success was teaching the kids in the primary school how to build tippy taps and wash their hands. For Michael, it was seeing his beautifully drawn posters (aka rice bags) used as essential parts of our education sessions, complimented by both UVP staff and the community members. Said can’t think of success without mentioning when we visited all the Village Health Team households and built each one of them tippy taps and plate stands – chopping down the wood, hammering nails and working together as a team. Kenny says one of his biggest accomplishments was having community members tell him that they had complete trust in what he said during meetings. Kimberly will never forget the beautiful children she met and the easy and innocent way they demonstrated their affection (sometimes following her and holding her hands for miles!) For Leticia it was easy – hearing people she had never met before call her name (‘’Latisha’’) affectionately and invite our group into their homes for tea or a plate of jackfruit to thank the work we’ve done.

In these weeks, our vision as a team was clear – to have a deep and lasting impact in Buwoira. In every way, we feel we accomplished what we came here to do. But somehow we could not have predicted that Buwoira would also have a deep and lasting impact in all of us.

Bukaigo: School WASH Sensitization

Hello from Bukaigo! Here is blog 3, a video of our school WASH sensitization. We went to The Ark Junior School, a private primary school in Bukaigo, to educate the students about sanitation and hygiene. We had a great time. Please enjoy!

Kasambiika 2: Borehole Clean-Up Day

Before our Borehole Clean-up Day, we had a meeting with Kasambiika 2's Borehole Committee. We discussed the challenges we would need to overcome in planning the activity. The major challenge was that the village did not have nails to build a fence around the borehole; they also did not have the money to purchase them. We coordinated with the the VHT's to spearhead a fundraising effort to purchase nails for the project.

On the morning of the Borehole Clean-up Day we went to K2’s first Borehole in Namabaale. To our surprise the borehole, which completely lacked a fence when we visited two days earlier, was surrounded by the fencing foundation of wooden poles. Men from the surrounding community were gathering around carrying wood, nails, hammers, pangas, and digging materials ready to work. Apparently the villagers were embarrassed about the condition of their borehole when our UVP team came to visit a few days before. So they anxiously began to work together to prepare for our clean-up, which included overcoming financial problems through rapid fundraising for nails.

The community members and our UVP team combined efforts to ensure the proper construction of the borehole fence. The Kasambiika 2 villagers truly took ownership in their borehole clean-up. About 20 people were digging, cleaning out the grass, cutting poles, constructing the fence, and cleaning the surrounding area. We were happy to see community members collaborating to create their own sanitation solutions. Within a few hours the Namabaale borehole was completely transformed and in compliance with government recommendations. The morning of our Borehole Clean-up Day was a complete success.

Our second borehole already had a fencing structure in place, providing entry for those retrieving water and preventing animals from accessing the water.  A number of women and children came to help us weed around the fencing and to clear excess grass. The work went quickly and efficiently as we took turns weeding with the few hoes we had. The men who came cleaned the mud and debris from the drainage pool, which had accumulated water. Typically, community brick makers use water from the drainage pool for their bricks, but they hadn’t retrieved water lately. We advised the community to drain the pool regularly in order to prevent mosquitoes from breeding and animals from drinking from the pool.  If the vigor with which the community worked is any indication of its commitment to borehole maintenance, the boreholes will be in excellent condition for months to come.

Buvule: Interview with a Community Member

Interview with a Community Member on UVP’s work in Buvule Village

Maggie: Good Morning Sir, we are interns from UVP and we would like to ask you a few questions. Could you spare about 15 minutes to answer them?

Village Man: Good Morning all! I am heading to the rice field but by 15 minutes shall be there

Maggie: Thank you kind sir..My name is Maggie Ashaba and my colleague is by names, Danson Ssajabi.

Danson: What is your name sir?

Village man: My name is Ibanda Nadomi Godfrey; I am a resident of Buvule Village.

Danson: Mr. Ibanda, have you ever heard of an organisation called Uganda Village Project (UVP)?

Mr. Ibanda: Yes, I have.  This project has been running in this village for two years now.

Danson: Oh, that is so great. However, like any other member of this community, you must have had expectations of UVP at the start of its work in this village. What were some of those expectations?

Mr. Ibanda: Indeed, I had many expectations of you people and they ranged from economic, political, social to health.

Maggie: Mr. Ibanda would you like to elaborate on these expectations.

Mr.  Ibanda; I expected to be taught and acquire new skills. I also expected UVP to bring about change in our community in terms of sanitation and hygiene.

Maggie: UVP runs a number of programmes, which offer several services based on its core health focuses. Which of these programmes is your favourite?

Mr. Ibanda: My favourite programme is the one, which deals with sanitation and hygiene in the community.

Danson: Do you mind sharing with us about the sanitation situation within the village before UVP started working in it?

Mr.Ibanda: The sanitation situation was not good at all. Pit latrines were few in number, open defecation was widely practiced, and a vast majority of the population lacked most of the standard sanitary facilities such as washrooms, plate stands and tippy taps. There was also limited access to clean and drinkable water.

Danson: Do you think there has been any improvement in the health of the community since UVP started working here?

Mr. Ibanda: But of course, there has been a tremendous improvement in health! The sanitation and hygiene in the village has changed greatly through the various education sessions on importance of different sanitary facilities such as pit latrines, tippy taps, washrooms etc. This in turn has lowered the incidence of diarrhoeal diseases among the people of Buvule. In addition, the various testing programmes that UVP coordinates such as testing for HIV/AIDS and Malaria enabling community members know their status and hence get treatment have contributed to the improvement of health within the community.

Maggie: How about people’s attitudes towards health, have they changed for the better?

Mr.Ibanda:  Their attitudes towards health are changing progressively. I say this because I see that people here are more willing to participate in health promotion activities than before because they know that the work UVP does is for their good.

Maggie: Am very glad to know that our work has been of so much benefit to this community, but I would like to know how you have benefited personally form UVP work.

Mr. Ibanda: Indeed, I have benefited a great deal. I have acquired knowledge and skills such as how to construct a tippy tap, which I have used to improve the sanitation, hygiene and health at my homestead. The borehole that was constructed by UVP  Buvule this year is quite close to my home. It has made it easier for me and my family members to access clean water for use at home. For this, I am extremely grateful. (Smiles)

Danson: Mr. Ibanda you have talked about acquiring knowledge, but if I may ask, have you tried to share the knowledge you have obtained?

Mr. Ibanda: Yes I do. Whenever I learn anything new regarding health, I try to put it into practice at my home and when visitors come by my home, they notice the change, which I admired by most. I take advantage of such moments to share with these people any knowledge I have acquired. I also take it upon myself to inform my neighbours.

Maggie: As we come to the end of this interview, do you have any recommendations for UVP, which could help us improve on our work in this village?

Mr Ibanda: I have just one recommendation; UVP should continue to conduct monitoring its work in the village to ensure that people do not neglect the knowledge and skills they taught.

Danson: Do you have any final remarks?

Mr. Ibanda: UVP has been of great importance within this locality. You people have done such a great work that has been largely responsible for the improvement in our community’s health. Thank you all so much and God richly bless you. UVP EWANGHALE!! (LONG LIVE UVP)

Maggie:  Thank you for your time