Beruflich Dokumente
Kultur Dokumente
Picture above: Leya Igitu, at a village savings and loans group in Ojemorun village
Contact person in AMREF Uganda: Joshua Kyallo, Country Director, AMREF Uganda
Email: Joshua.kyallo@amref.org
Contact person in AMREF UK: Claudia Codsi, Uganda Partnerships Manager, AMREF UK
Email: c.codsi@amrefuk.org
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An additional phase out year (4th year) has been agreed in principle. The end of the project would therefore be
October 2011.
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Table of Contents
Executive summary 04
3.1 Goal 07
4.1 Health 09
4.2 Education 11
4.4 Livelihoods 17
8.0 Annexes 26
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ARVs Anti Retro-Viral drugs
EU European Union
HC Health Centre
3
OVCs Orphans and Vulnerable Children
This report marks the first six months of implementation in the third year of the Katine
Community Partnerships project (KCPP) implemented by AMREF in partnership with the
Katine community, the Soroti local government, the Guardian and Barclays with FARM-Africa
providing technical advice on livelihoods. The overall goal of the project is to improve the
well-being of people living in Katine. The project takes an integrated and community based
development approach to address the underlying social determinants of poor health and
poverty. Addressing community health, access to quality education, safe water, hygiene and
sanitation, increased income generating opportunities and community empowerment to
engage in local governance all work to complement each other to achieve sustainable
community development.
The third year of the project builds on the recommendations of the Mid Term Review (MTR)
held in July 2009. The findings highlighted that AMREF was more or less on track however
needed to strengthen some areas to maximise impact. This could be achieved through more
resources and an additional year to exit Katine. The health component was on track but its
success depended on the continued training of health workers and renovations of Tiriri
Health centre. The education component, also on track, would benefit by strengthening
school governance and follow up support to teachers. The water and sanitation component,
although reaching its original objective, would have a lasting impact if water coverage could
increase from the current 66% to 85% to meet the national target for 2010. Two of the
components (livelihoods and community empowerment) needed more time and resources to
realise their objectives. The community empowerment component could be strengthened
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by introducing a rights-based approach and gender awareness increased. AMREF could
expand the reach of farmer groups to all 66 communities in Katine. An additional year would
give AMREF more time to implement the above recommendations and systematically hand
over responsibility to community groups and local government structures to ensure
continuity and sustainability.
In the last six months, the project has rolled out 48 new farmer groups to the existing 18
supported by the project to cover all 66 villages. AMREF has started to drill more water
sources to meet the 85% target for water coverage and a rights based approach has been
introduced. A fourth year extension of the project and additional funding was agreed in
principle by Barclays and the Guardian to address these recommendations. Between
October 2009 and March 2010, the project built on progress from preceding years, while
implementing the MTR recommendations.
Overall the project has met 70% expenditure against the overall budget to date with most
activities on target. The main underspend this year is in the health and livelihoods
component, with other components reaching their targets for the year. A summary of
progress against planned activities is highlighted below. A more detailed explanation is in
section 4.0 of the report.
To improve access to quality education, the project has continued to work with
communities and local government to promote greater community involvement in school
governance and access to quality education for all children. Women teachers were
supported to act as role models and host advocacy meetings in communities to increase
community awareness and commitment to send Orphans and Vulnerable Children (OVCs) to
school. Concurrently, 42 teachers received training by the project on special needs teaching
to improve the provision of inclusive education. The project constructed four new classrooms
(Ogwollo and Ojom primary schools) and rehabilitated 8 (Ochuloi and Ayonyi primary
schools) equipping them with desks to improve school learning. Since the project began,
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Soroti districts Health Management Information Systems (HMIS)
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school enrolment figures have increased to 21%, indicating increased access to education.
AMREF’s partnership with the District Education Office (DEO) to provide regular support
supervision on school planning has resulted in improved capacity of teachers to complete
the school syllabus. School management and governance is improving, School Management
Committees (SMC) and Parent Teacher Associations (PTA) have now put in place a well
formulated development plan for every school monitored on a regular basis. Teachers are
reporting improved welfare; their allowances are now being paid on time and they have
better housing prospects with each school having at least two houses for teachers nearby.
Progress against planned activities and expenditure for this component are on target.
To improve access to safe water and sanitation, the project identified four new
communities to benefit from five newly drilled and installed boreholes to meet the MTR
recommendations of increasing water access to 85%. To improve operations and
maintenance of these water sources, four new water source committees (selected by their
communities) received training. The project also identified and supported 10 vulnerable
households in the community with 2,500-litre rain water jars and supplied and installed two
rain water harvesting tanks of 10,000 litre capacity in Ojom and Ogwolo primary schools.
The project continues to work alongside VHTs in the promotion of better hygiene and
sanitation in the communities. An additional 86 new ideal homesteads were established as
a result of replicating ‘ideal homesteads’ established earlier in the project and supported by
VHTs. There are now 398 ideal homesteads in total in Katine sub-county, improving hygiene
and sanitation standards in Katine. Planned activities and expenditure for this component
are on target.
To achieve improved livelihoods, the project set up 48 new farmer groups with 1,340
farmers. Every village3 in Katine is now represented by a farmer group and the project
continues to support them with capacity building and monitoring as well as farm inputs such
as seeds, implements, veterinary, technical and supervisory services. In order to strengthen
the ability of rural institutions to access advisory services and markets for their produce for
increased income, the project supported farmer groups to form an apex association (Katine
Joint Farmers Association) to coordinate all farmers groups, manage the produce store,
support farmer groups in Katine in marketing activities, oversee the animal health service
provision and assess quality of farm produce. The farmers went on a study tour to a
progressive NAADS4 farmer group in Gweri and Ngora Sub Counties where they studied new
technologies and best practice in farming such as citrus fruit production in Gweri for which a
fruit factory is soon going to built by the government in Soroti. This component achieved the
majority of the planned activities however remains underspent due to a decision to delay
the distribution of seeds to the 48 newly formed farmer groups from March 2010 to
August 2010. The spending will be in line by the end of the project year.
The farmer groups are also involved in Village Savings and Loans Associations that
have completed their first cycle of savings. Currently the groups’ savings ranges between
Ushs 1,000,000 to Ushs 4,500,000 with all 66 groups accumulating Ushs 72,504,550 million
(£22,482.03). Different group members said they used their share amount to purchase
different assets such as cows/ bulls, goats, chickens, mattresses, clothing. Some were able
3
There are 66 villages in Katine sub-county
4
National Agricultural Advisory Services, whose vision is to become a decentralized, farmer owned and private
sector serviced extension system contributing to the realization of the agricultural sector development objectives.
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to start up businesses while others expanded their existing business in Katine. With
improved income, Katine residents are building up the self-confidence to manage their lives.
Their confidence to participate in public meetings is improving, especially for women who
make up the majority of these farmers.
In the remaining six months, AMREF will continue to implement the recommendations of the
midterm review. Key plans include continued support to VHTs through support supervision
and training of health workers on promoting counselling and testing services for HIV/AIDS;
more support to enable community ownership of school supervision and promotion of
inclusive education of girls, disabled, orphans, and vulnerable children. The project will
address the MTR recommendations to increase access to water sources to meet the 85%
target and in livelihoods the focus will be on continued support and monitoring to the newly
formed 48 farmer groups, agribusiness management training and collective marketing. In
community empowerment the project will address the recommendation of rolling out rights
based training while working closely with the various community structures to begin to
phase out and exit from Katine while handing over responsibility.
1.1 Introduction
This report covers the progress that has been made by the project from October 2009 to
March 2010 in the third year of the Katine Community Partnerships project (KCPP). The
project is funded by Guardian reader donations while the Guardian tracks the project’s
development on-line and in print. Barclays matches reader’s funds and draws on their
business expertise to integrate a model of financial inclusion providing loans through village
banks6.
Uganda is one of the poorest countries in the world, ranking 146th out of 177 in the 2004
Human Development Index. The population of Uganda is estimated at 28 million and life
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PDC is one of the governance structures established by the government in a decentralised system to promote a
bottom-up approach to development.
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Implemented through CARE and a local NGO, UWESO (Uganda Women’s Effort to Save Orphans)
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expectancy is 49.3 years according to the World Health Organisation. A contributing factor
to low life expectancy in Uganda is the fact that 31% of the population currently lives below
the poverty line (UBOS 2007). AMREF’s work in Katine is structured within the national
planning framework, which is outlined in the PEAP7 soon to be the National Development
Plan (NDP)8.
Soroti, located in eastern Uganda, consists of three rural counties (Kasilo, Serere and Soroti)
and one municipality (Soroti municipality). There are 17 sub-counties, including three
divisions of the Soroti municipality. The total population of Soroti district is 371,986
according to the 2002 UBOS census. Now peaceful, the district is considered post-conflict
with recent periods of insurgency and cattle rustling which led to loss of lives, displacement
and depletion of the number of animals and other valuable property. Internally Displaced
People (IDPs) have now returned to their communities. 76% of household main economic
activity is subsistence farming, cattle rearing and petty trade (UBOS9 2002 Census).
Poverty prevalence is at 77%, compared to the national average of 31%10. Malaria is the
leading disease burden in Soroti District, contributing to 96% of reported morbidity. Only
19% of the population lives within 5km of a health facility, far lower than the national
average of 49%. HIV/AIDS remains a key challenge.
In education, the pupil to teacher ratio stood at 1:59 while the desired minimum standard is
1:54. In addition, the pupil to classroom ratio is 1:83 where the minimum standard is 1:54.
Soroti still needs approximately 200 trained teachers to meet the increasing number of
children joining primary school every year.
According to district records, safe water coverage in Soroti district at the start of the project
stood at 76%, which is over the national average of 65%. Functionality rate of installed
water facilities is at 89%. Results from the AMREF EU project survey in 2007 indicated that
latrine coverage in the district was at 68%, also above the national average of 65%. As
much as the government has strengthened decentralisation in Uganda - with the sub-county
as the lowest unit of development planning and implementation - this has almost exclusively
emphasised the service delivery aspects of governance. Communities’ engagement in
development and decisions that affect them remains weak. The KCCP is working to empower
communities and to strengthen dialogue with the systems for service delivery so that they
can demand their right to development.
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Poverty Eradication Action Plan, a national framework for fighting poverty
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Uganda developed the three yearly Poverty Eradication Action Plan (PEAP) in 1997. It has had three phases. Now
the government has come up with a National Development Plan to replace the PEAP. The PEAP focused on reducing
poverty but now the NDP focuses more on creating wealth (Ministry of Finance, Planning and Economic
Development, Government of Uganda). The NDP was launched on Monday 19.04.2010.
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Uganda Bureau of Statistics
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UBOS, Mapping the Poor, 2004
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Out of the 17 sub-counties and three municipality divisions in Soroti district, Katine is one of
the sub-counties with the worst indicators for poverty and underdevelopment. A comparison
of Katine indicators with that of the 2006 Uganda Demographic and Health Survey shows
that overall baseline conditions for the Katine population are worse than average for rural
areas of the country.
When AMREF addressed project priorities with the sub-county and district leaders, needs
were identified in the areas of health, education, water and sanitation, livelihoods and
community empowerment.
A household baseline survey was conducted by AMREF in January 2008 to assess the needs
further. The results demonstrated that the overall conditions in Katine sub-county were
uniformly poor11. Access to safe water in Katine was at 42% and latrine coverage was at
44%, far lower than the above mentioned averages for Soroti district. In some parishes, like
Olwelai, latrine coverage was only 24% compared to 68% in Soroti district. The school
dropout rate was at 19% for boys and 22% for girls and the pupil to classroom ratio was at
91:1. Also, 16% of children aged 7-12 were orphans.
3.1 Goal
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Katine household baseline executive summary, page 2. The baseline survey was conducted by AMREF with
support from UBOS (Ugandan Bureau of Statistics)
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3.3 Expected Outcomes
Health
Education
• Improved access to quality primary education for all children and greater community
involvement in school governance
WATSAN
Livelihoods
• Stronger ability of rural institutions to access both advisory services and markets for
their products for increased production and income
Community Empowerment
AMREF’s key development goal is to close the gap between communities and basic service
delivery systems through its Community Based Development (CBD) approach. AMREF builds
the capacity of communities, strengthens the government systems of service delivery and
carries out operations research to find out what works, document the findings and share
them with other NGOs and government and advocate for best policy and practice. The
development approach also ensures that the project components of health, water and
sanitation, education, livelihoods and community empowerment work to reinforce each
other for integrated development.
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health committee and the farmers’ forums to ensure that they play their roles effectively. A
sub-county project management committee has been established to provide oversight to the
operational aspects of the project. The committee is involved in the project activities and
action plans are shared on a regular basis. The committee is chaired by the sub-county chief
and co-chaired by the AMREF Deputy Country Director.
At the district level, the district steering committee’s role is to ensure that the project is
aligned to relevant government policy and programmes including the district development
plan and sector strategies and has effective partnerships. It is chaired by the Chief
Administrative Officer who is the head of the civil service at the district level; the AMREF
country director also co-chairs the committee. These are the structures that have been put
in place to manage the project and to ensure that decision-making is a bottom-up and a
participatory process. A draft exit strategy is being developed and shared with stakeholders
so that there is an agreement on key sustainability strategies for a successful exit by AMREF
at the end of the fourth year of the project.
In the last six months, the project distributed a total of 1,625 long lasting insecticide treated
mosquito nets (LLINs) to high risk groups; 915 to children under the age of five, 650 to
pregnant mothers and 60 to people living with HIV/AIDS (PLWHAs). Health workers through
antenatal clinics and VHTs in the community continued to be supported to raise community
awareness on the proper use of LLINs and handed out adult sized treated bed nets. Most
households however, still have more than one child under the age of five sharing a bed and
one bed net is given per household. If households continue to properly and consistently use
nets, malaria cases should reduce.
In the reporting period, 5909 children were immunised against measles, polio, tuberculosis,
whooping cough, hepatitis B, tetanus, haemophilias influenza and diphtheria. The project
supported the implementation of the Ugandan Ministry of Health ‘Child health days’ 12 in
collaboration with health facilities to conduct child health days covering all six parishes in
Katine sub-county. The project supported Child Health day government programmes by
providing fuel for transport and facilitation allowance for health workers, district health team
staff (DHT), community vaccinators and parish mobilisers to carry out the campaign. The
support to health workers has resulted in an increase in the number of children accessing
immunization services reflected by the increase in immunization coverage from 89.3% in
2008 to 95.9% in 2009 for children immunised. This is obtained by using a standard
indicator definition which is universally acceptable in explaining immunization coverage in
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Uganda Ministry of Health organizes child health days every 6 months as a strategy towards promoting child
survival through routine child immunization schedules. This service provide an opportunity to reach immunisation
drop outs (children who have missed out on their immunisation schedules or those who have not completed their
immunisation schedule).
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an environment like Uganda and this is integrated with early infant diagnosis (EID) for
children who are exposed to various health risks.
During the period, the project trained 85 VHTs out of 272 VHTs in Katine sub-county on
sensitising communities about the benefits of family planning. The training supported VHTs
to dispel myths and misconception about family planning and promote family planning
uptake and carry out referrals to the health facilities. The project has only seen an increase
in uptake from 1% in 2007 to 4% currently due to cultural and religious barriers.
Patients in Katine were able to receive improved TB care and support from health facilities
as a result of training provided by the project to community health workers. The training
focused on improving skills on management and follows up of TB/HIV patients including
identification of TB cases in the community and improved referral of TB/HIV patients. In
2009, there were 7 TB cases reported whereas in 2008 there were 17, showing a 10%
reduction in new cases reported according to HMIS. The training covered the relationship
between HIV and TB, drug interaction of ARVs / anti TB drugs, when to start TB patients on
ARVs and complex case management.
To improve the quality of health services, the project trained 31 health workers from all
three supported health facilities in the sub-county on improving the quality of Prevention of
Mother To Child Transmission of HIV (PMTCT) services. Before the training, the health
facilities only had one overstretched health worker trained in delivering PMTCT services for
all facilities. The project trained more health workers to increase the number of personnel
who could offer services to clients rather than rely on the one health worker alone. Service
delivery to pregnant mothers is improving and should result in a reduction in the number of
new born infants infected with HIV.
To improve patient care and management, the project co-ordinated and facilitated two joint
technical support supervision visits by the district health team (DHT). The DHT support
supervision focused on improving health worker knowledge and skills on guidelines and
treatment for integrated management of childhood illnesses (IMCI). Due to mid level health
workers having limited skills, on the job training by the DHT and technical support
supervision greatly motivated them to perform their jobs. Improved motivation and skills
development should result in better management of patients.
The project continued to provide training, technical support supervision, monitoring and
evaluation support to the local community health structures to plan and manage their own
health issues. Three community health unit management committees (24 members) and
272 (166 males, 106 females) VHTs were trained on identifying, planning and budgeting
community health care priorities, management of health facilities including planning,
budgeting, financial performance management, monitoring, and quality care and drug
management. Over the period, the training has resulted in improved management of health
facilities due to increased knowledge and skills of the health centre management
committees, increased sense of being able to make a difference in health outreaches in their
communities, and high sense of self-worth to nurture local planning skills and abilities in
communities. All this will ultimately allow communities to tackle future health issues and
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manage the overall health of their communities. There have been regular meetings, minutes
taken, posting of three new health workers due to lobbying at the district level and more
regular bi-monthly supply of drugs due to joint budgeting between Health Unit Management
Committees (HUMCs) and health workers and follow up by the HUMCs at the district level.
The project trained 272 VHTs on community based health information management
systems including birth and death registration. These VHTs are supported to collect village
health information and report to the health facilities. The link that the VHTs have created
between health facilities and data collected at the community level has strengthened the
planning process and improved availability of services.
Two quarterly local health structure meetings were supported to review and monitor the
implementation of community health actions by VHTs including referral of sick community
members to VHTs and to health facilities, monitoring community health programmes,
reporting health problems to health structures in communities, supporting implementation
of health activities in communities, health planning, budgeting and implementation for
communities. As a result participation of communities in health planning has improved and
is critical to achieving good health outcomes for the community and the planning process
has seen availability of information from the communities for health planning at the sub-
county. In promoting participatory planning, individuals, households and community
members have assumed responsibility and ownership of their health needs.
The project with support from solar aid UK, installed a solar panel to power Ojom HC II. Now
the power is lighting the laboratory and office in case of emergencies at night, powering the
cold-chain system fridges for keeping drugs and vaccines cool (which used to be done in
Atirir HC IV) thus saving on distance and time. Staff houses are also lit which is motivating
for staff to stay in such an isolated part of Katine. The supply of electricity will also attract
staff to live in Ojom in future.
Overall the health component is more or less on target against plans. There was a delay to
the renovations of Tiriri operating theatre and connection of running water to the maternity
ward and theatre which has contributed to an underspend, however procurement of a
consultant and work began in the first quarter of 2010.
Since the project started in October 2007, enrolment has increased by approximately 21%.
Updated enrolment figures are as follows:
N.B Percentage increases in enrolment 2007 to 2008 was 6%, 2008 to 2009 was 12% and
2009 to March 2010 first term 5%14
5000
4000
3000
Boys enrollm ent
2000
Girls enrollm ent
1000
0
2007 2008 2009
Over the period of reporting, the project continued to observe an increase in the number of
children completing primary level education and overall retention of children in schools;
more children are now sitting for primary leaving examinations (PLE) and attaining PLE
levels in subsequent years. There has been a reduction in the number of children unable to
sit their PLE as seen in the table below and an improvement in the general performance of
children in PLE examination in all schools.
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Term one enrolment figure which cannot yet be considered for reporting – since the term has not ended.
14
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Some children get married off before the sit their exams due to illnesses and absconding from school. Some
remain at home to take responsibility of household activities in events like mother being sick, orphaned
households, parents not at home. Exam enrollment for 2010 cannot be reported now as the data can only be
reported at end of school year. However enrollment in this term has shown a 5% increases compared to only 2% in
2009 term one.
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Year No of children No of children % children Examples of
registered for unable to sit unable to sit reasons for not
national exams taking exams
The above trend indicates there is a general improvement in the retention of children in
schools. This should result in improved literacy and increased enrolment into high school.
The longer girls stay in school the less likely they are to be involved in early marriages.
At the start of the project in 2007 the PLE pass rate was at 87.7% and failure rate was at
12.3%; in 2008, the PLE pass rate was at 85.9% and failure rate was at 18.3%. In 2009, the
PLE pass rate is at 88.9% and failure rate at 15.3%.
Year Registered No. Pass No. Failure Registered but did Total
Pupils Pass Rate Failure Rate not sit exam Registered
Boys Girls
The project facilitated the district education department to conduct two support supervision
exercises in order to improve performance and management of schools. This took place in
all the fifteen primary schools and provided continuous mentoring and counselling to
teachers and school management committees including parents and teachers associations.
AMREF organised a meeting for 90 teachers to draft lesson plans and work plans for the first
term in 2010. The project has noted improved lesson planning and completion of the
syllabus and this is as a result of teacher training by the Centre Coordinating Tutor (CCT),
area inspector of schools and District Education Officer (DEO). There was a noted reduction
in teacher absenteeism in subsequent months and a complete education sector database
which can be attributed to KCPP continuous supervision of school performance in
conjunction with district partners.
The school health clubs have scaled up their activities towards promoting a healthy school
environment and improved sanitation in schools. In the last six month, the school health
clubs received and planted a total of 4,500 ‘special’ trees that can help to earn an income,
provide shade, provide nutritious fruits and can be used for learning in science subjects.
These included 1,500 neem trees, 1,500 pine trees, and 1,500 eucalyptus and 1,500
improved orange seedlings. Each school health clubs planted 100 improved oranges, 100
neem trees, 100 pine trees and 100 eucalyptuses. The project also provided school health
clubs with 105 watering cans, 75 water jericans. Children participated in preparing the sites
for planting, planting trees and are now caring for the tree seedlings by watering them daily.
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This activity has enabled them to gain practical skills in agriculture and to learn how to
maintain value and protect their environment.
In the last six months, the project in partnership with the district education department
supported eight women teachers from Katine schools to be role models for girls by leading
community advocacy sessions in four communities. These meetings addressed key issues
including how communities can strengthen OVC support systems for access to health and
education services, how OVCs can be actively involved in day to day learning activities at
the community and in schools to avoid stigma and discrimination, what role can people play
to ensure OVCs education and wellbeing; the role of parents, teachers and community
leaders. Discussions have raised awareness on inclusive education for orphans and
vulnerable children resulting in increased community support to send Orphans and
Vulnerable Children (OVC) to school.
In 2009, AMREF trained 42 teachers including 10 women in all 15 schools on special needs
teaching and handling of children with different disabilities. This training complemented the
aforementioned community sessions on the need to promote inclusive education. In the
reporting period, the project has observed significant enrolment of OVCs in schools and in
communities more OVCs are now being encouraged to attend school and participate in other
activities. Of the 9,071 children aged 6 - 12 enrolled in schools in 2009, 1,613 (767 female,
847 male) are OVCs. Increased school attendance will contribute to improved integration
and self esteem. The number of OVCs who registered for first term in school is expected to
have increased however the data has not yet been compiled and this should be available in
the next reporting period.
Through two workshops in the reporting period, the project trained 60 SMCs and 15 PTAs
newly elected executive members on roles and responsibilities according to the new
Education Act of 2008 to improve planning for schools. In partnership with the district
education department, the project conducted support supervision in all schools to ensure
effective school planning and syllabus completion, the support also provided guidance and
monitoring of school management and teacher/pupil attendance. Teachers were previously
unsupported and tended to plan individually but this has changed as teachers come to plan
together in a coordinated way and all issues related to the year’s syllabus are discussed,
planning done jointly with support from the District education office. The completion of the
syllabus encourages more time for revision and better grades from pupils.
At the start of the project PTAs and SMCs were inactive. By the end of 2009, the PTAs and
SMCs performance has improved in all the schools in Katine sub-county. During this period
the district education department organised support supervision and monitoring exercises;
all the schools had at least completed an average of two teachers' houses, teachers
reported improved welfare as their allowances are being paid on time with reduced
irregularities in the payments as was experienced before. Each school in Katine now has a
well formulated development plan and the PTAs and SMCs were meeting regularly and at
least twice in the 6 month reporting period to follow up on the implementation of the school
development plans and assess progress being made to improve performance and facilities in
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schools. The project is seeing increased ownership which contributes to the sustainability of
the project.
“AMREF has supported schools with desks, some of us have not been sitting on desks but now all of
us sit on desks. AMREF has also helped people through the VHTs [village health team members] who
have been trained on health in the villages. They have helped and sensitised people to have latrines
and washing racks at their homes and people have taken heed. People are now healthy, because
latrines are in place in the villages. Even children who fall sick and not coming to school are not
many.” Mary Aobo, Atirir village, who completed primary seven at Katine-Tiriri Primary
The education component is ahead of target to achieve its plans at this point in the project
with spending in line with where it should be 6 months into the year.
The project identified and supported ten vulnerable households with a 2,500-litre rain water
harvesting jars constructed by community masons that the project trained. These were
provided to 8 households with elderly persons and two to households of persons affected /
living with HIV/AIDS. These jars are providing storage to over 60 people in Katine sub-county
and has built on the project’s previous year’s interventions to increase water coverage to
85% (national target), contributing to reducing preventable illnesses and death from water
borne diseases.
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i) Capital cost contribution by the community, ii) community meeting a target of 30% improvement in sanitation
and hygiene, iii) community to provide a signed land agreement indicating community ownership of the land where
the water source will be located or drilled, iv) community selection and formation of WSCs who oversee the
management and maintenance of the water source facility, v) a prepared Operation and Maintenance plan that will
be used for the management of the water source facility, vi) community providing a signed a MoU detailing roles
and responsibilities of the community, WSCs and stakeholders in the ownership, use and maintenance of the water
source.
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Fig.3 Above, Kevina Alupo gets water from a newly constructed water jar. AMREF constructed water jars to benefit
households with elderly and vulnerable persons.
The project in coordination and collaboration with the district water department conducted
water quality testing and surveillance in all 68 existing water sources in Katine. Samples
were collected, analyzed and results shared with the communities through the sub-county
health committees and the parish development committees. VHTs, water source committees
(WSCs) and hand pump mechanics (HPMs) supported the process through mobilization of
communities to promote hygiene in all the water sources.
The project supplied and installed two rain water harvesting tanks of 10,000 litre capacity in
two schools (Ojom and Ogwolo primary schools) to promote behavioural change through
hand washing and the safe water chain17 amongst school children, teachers and
communities. This has contributed to an improvement in hygiene, reduced incidence of
worm infections and reduced water born diseases, resulting in healthier children more able
to attend class and participate actively in school activities. Enrollment figures in Ojom and
Ogwolo primary schools are 346 (boys 168, girls 179) and 518 (boys 265, girls 253)
respectively.
The project is working with school health committees in the planning and implementation of
school health and sanitation activities and completed the construction of six ventilated
improved pit latrine (VIP) in four primary schools (Ojom, Ogwolo, Amorikot, Adamasiko
primary schools and two in Merok primary school). The project also rehabilitated six VIP
latrines with fixed metallic doors and carried out repair works of damaged parts in Katine,
Olwelai, Oimai, Ojama and two in Ajonyi primary schools. These latrines are expected to
improve sanitation and reduce disease in schools.
The project reactivated 12 water and sanitation committees and provided refresher training
on the CASHE model AMREF has used in other parts of Africa (the Community Approach to
Sanitation and Hygiene Education). This was based on the observation that previous water
sources established prior to the KCPP were not operational, unattended to and not meeting
water source standards as required by the national guidelines with no-one responsible for
maintenance. Instead of putting new sources, the project reactivated and has so far trained
four water source committees of Ochuloi Parish on operation and maintenance of water and
sanitation facilities, management of water user fees and simple book keeping. They are
currently involved in the promotion of community ownership and management of the
sources to users of those water sources.
The VHTs are important structures in the promotion of total sanitation and hygiene in
villages in Katine using various approaches such as home to home visits and drama to
communicate these messages. The project has developed a programme involving VHTs in
Katine to scale up their activities aimed at promoting ideal homesteads and attainment of
total sanitation. To support VHTs in the promotion of ideal homesteads, three coordination
meetings were held with VHTs from Ochuloi, Olwelai and Ojom Parishes to develop tools and
agree on strategies for conducting home visits and supporting the promotion of hygiene and
sanitation activities in all the villages in Katine.
17
Safe water chain is ensuring safe water collection, transportation, storage and consumption at household level.
18
The project continues to work with VHTs in the promotion of better hygiene and sanitation in
the communities through a new approach of community led total sanitation and hygiene
(social marketing approach)18 by using locally available materials in the construction and
maintenance of sanitation facilities and by showing the benefits of sanitation facilities to
promote better hygiene and sanitation. As a result there are now 86 new ideal homesteads19
increasing the total from 312 in 2008 to 398 by March 2010.
AMREF facilitated joint quarterly monitoring support visits by members of the sub-county
health committee to collect and analyse field information. The participatory approach taken
has encouraged and improved community based monitoring and has enabled communities
to manage their own water supply and sanitation development initiatives to improve
community water supply, sanitation and hygiene practices.
Continued support to Parish Sanitation Committee (PSC), VHTs, WSCs and hand pump
mechanics through routine quarterly coordination meetings has strengthened their ability to
ensure maintenance, repair and protection of these new boreholes.
Fig 3. In the picture above, Francis Ocago attends to his shop at Olwelai centre in Katine sub-county. His shop
business has progressed and he attributes this to having joined VSLA activities.
Farmers in Katine have prepared over 920 acres of land as multiplication sites for the first
planting season and the project is procuring over 900 bags of groundnuts, 3,960 kilograms
of upland rice and 90 tins of assorted vegetable seeds (cabbages, onions, and tomatoes) to
distribute to farmer groups for the second planting season in August. This was because
there was a need for 3,000 tonnes in bulk of groundnut seeds which was not readily
18
Social marketing is promoting a product as a tool that if used individually and as a community brings benefits to
all. Individuals or groups are encouraged to spend time, energy and money to acquire them. E.g. sanitation
platforms (sanplats).
19
This is a traditional homestead with a main house/hut, a hut for children, a hut for visitors, a latrine with a tippy
tap, a bathroom, drying rack for plates, separate house for goats and spacious clean compound.
19
available in Soroti in time for the earlier season. Each farmer is using half an acre of land to
demonstrate improved farming technologies to other members of the community. Over 200
acres of drought resistant, high yielding, quick-maturing cassava that was introduced by the
project in 2008 has now multiplied in the planting season. Since all villages now have model
farm groups, more people will be able to benefit from improved food security and improved
income.
The farmer groups are also VSLAs that have completed their first cycle of savings. In the
previous cycle, a total of Ushs 161, 465,850 was saved and shared with each individual
member receiving between Ushs 50,000 to Ushs 300,000 (£16 – £93) depending on their
share value. Currently the groups’ savings ranges between Ushs 1,000,000 to Ushs
4,500,000 with all 66 groups accumulating Ushs 72,504,550 million (£22,482.03).20
The VSLAs now have a social fund contribution in addition to their savings, which ranges
between Ushs 100 to Ushs 200 per person per meeting and is contributed to each time the
group members sit in the weekly meeting. This fund is separate from the savings and has no
interest rate attached to it and is accessible to individual group members as and when
specific household emergencies arise such as medication, food, school fees and buying of
household assets.
In the first cycle of savings, group members acquired different household assets with their
share amount of between 50,000-300,000 Ushs per person. Different group members said
they used their share amount to purchase different assets such as cows/ bulls, goats,
chickens, mattresses, clothing. Some were able to start up businesses while others
expanded their existing business in Katine. With improved income, Katine residents are
building up the self-confidence to manage their lives and their self-esteem is improving to
participate in public meetings, especially women who make up the majority of these farmer
groups. (See field story attached in the annex).
In collaboration with the district development office and commercial office, the project
trained 66 group leaders on needs assessment, conflict management, group leadership,
financial management and report writing. This has strengthened group management and
groups are now demonstrating improved ability to resolve their own problems such as
managing conflicts of roles and responsibilities within the groups, addressing
mismanagement of groups’ funds etc.
The project facilitated farmer groups to form an apex association KAJOFA (Katine Joint
Farmers Association). The association will support farmer groups in Katine to carry out
marketing activities, oversee the provision of animal health services, ensure farm produce
quality at the grassroots levels and assist in the management of the farmer produce store.
In collaboration with the district development office and commercial office, 12 elected
leaders of KAJOFA were trained on leadership roles and collective marketing.
The association has eased coordination between AMREF, the sub-county and other
stakeholders implementing livelihoods activities. The association plays a key role as a link
20
The 48 new farmer groups enrolled in the project were previously practicing VSLA model with UWESO/CARE.
20
between the farmers and the livelihood stakeholders’ forum and has been instrumental in
data collection on the various livelihood activities at household level. Monitoring of group
activities has improved with the formation of the farmers’ association. For all farmer groups
in a parish in Katine, there are two contact farmers who are members of the KAJOFA
leadership, acting as Parish coordinators who connect the farmers in each parish with the
livelihood stakeholders’ forum and KCPP. These coordinators monitor the farming and VSLA
activities of all farmer groups in their parish through contact person (group leaders) in each
farmer group at village level. They then share their reports on a quarterly basis with KCPP
and KAJOFA leadership on performance of each group members resulting in improved
monitoring of group activities. Issues related to farmer groups are now being addressed and
represented as the association has a representative in its executive from each of the
parishes doubling as farmer group parish coordinators.
A livelihoods stakeholders’ forum coordination meeting was held to develop a joint strategy
for marketing of agricultural produce using the produce store currently under construction
by the project in Katine sub-county. The livelihood stakeholders’ forum jointly explored and
agreed on the strategy of linking farmer groups to government programmes to
continue receiving support after the project phased out. The stakeholder forum also
agreed on a collective marketing strategy with crops to be collectively marketed through the
produce stores; including groundnuts, maize, cassava, sunflower and upland rice.
In the last six months, the project trained 30 selected members of the farmer groups as
trainers to roll out the ‘farmer field school approaches’ to famers in the sub-county in order
to improve productivity. This is a participatory methodology where farmers learn, apply and
transfer improved methods of farming together on demonstration plots. This approach also
allows farmers to learn about group dynamics and management, soil science and nutrient
dynamics, soil fertility management, crop management and where they copy and apply their
farming activities in their respective villages. Those who are now trained have established
15 demonstration farms showcasing the four most commonly grown crops in Katine
(groundnuts, maize, upland rice and beans). The trainers through demonstration farms
trained 1,420 farmers on the farmer field school approach to farming.21
The project supported farmers’ study tour to progressive NAADS farmers in Gweri and Ngora
sub-counties, Soroti District to share experiences on agricultural innovations and new
farming technologies as the new planting season begins. 55 farmer representatives, two
sub-county staff, one district staff and three KCPP staff participated. This exchange should
contribute to improved farming practices among the farmers in Katine, increasing
agricultural productivity and food security.
There are now 60 nursery beds with cabbages, onions, and tomatoes due to the projects
supporting 60 farmers from farmer groups (15 per parish) with assorted improved vegetable
21
The training also addressed soil and water conservation, soil erosion control, soil fertility management, addition
of organic matter, use of improved farm inputs, correct crop spacing, intercropping, use of organic and inorganic
fertilisers and early planting and integration of enterprises for income generation.
21
seeds. Of the 60 farmers, 30 are women and have learnt how to make a small organic
garden that can begin providing sustainable supply of onion, cabbage and tomatoes.
The project has also established an animal service centre in Katine in collaboration with the
sub-county and the District Veterinary Office (DVO) under the District production
department. Farmers will be able to access animal health services from the centre. Initially
the project had planned to recruit, train and equip seven para-vets22 who are resident in the
communities to offer animal health services but out of the seven trained, four returned to
school and two were employed by another organisation in another district. Only one of the
seven para-vets has remained in Katine. AMREF had discussions with the DVO’s office and
agreed to have a central service centre where farmers in Katine could obtain the animal
health services from the remaining Para-vet who would run a veterinary drug shop and
service will be able to contact the para-vet from his drug shop and he can then attend to
animals. A space has been offered in one of the offices at the produce store to house the
drug shop and serve as the service point where the para-vet will operate from.
The office block of the farmers produce store has been completed and the main store is at
the roofing level. In collaboration with FARM-Africa, the sub-county and District partners, the
project has allocated one room out of the three in the office block section to house the
animal health service centre.
One office unit will house the market information centre supporting farmers to access
information about markets locally, nationally and internationally. The Apex organisation
(KAJOFA) will be responsible for updating the market information on a weekly and monthly
basis.
Key messages for posters, drama groups and radio talk shows have been agreed and
finalised by the Information Education and Communication (IEC) working groups at the sub-
county and district. Messages related to community rights and obligation, health, education
and safe water and hygiene practices such as the importance of immunising all children,
benefits of children attending and staying in school including messages on services available
and their rights to access them were developed for dissemination.
The community media centre continues to play a major role in providing Katine community
members with access to a wide range of information, there is an increasing interest on the
use of the community media centre from students, teachers and community members who
visit the facility on an average of five to ten people per day. Community members are
trained on basic computer skills to enhance accessibility and use of the internet.
During the period, the project facilitated two online chats between Katine communities and
the Guardian readers. In coordination with community media facilitator, Katine communities
and Guardian readers were able to share information and ideas about the project. Some
community members are now able to read and contribute to blogs on the project website.
22
Short for para-veterinarians. People trained at diploma and certificate level to provide animal health services
22
The project has recorded a remarkable increase in the number of school going and non
school going youths visiting and using the resource centre. Out of the 300 visitors per
month, over 60% are youth, aged 10-16 years. Enhancing their information needs improves
their knowledge and self-esteem to engage in discussions and public debates.
KCPP conducted two training sessions in community participatory planning and budgeting
for two Parish Development Committees of Ojom and Ochuloi Parishes. The training was
followed up by meetings to facilitate the process of community action planning and
meetings were organised and facilitated in Ojama, Ojom and Merok Parishes to assess and
monitor the implementation of action points agreed upon in their training and their planning
process. These exercises stressed community needs and priorities to be reflected in the sub-
county’s three-year development plan. Currently, all 6 parishes have produced their
development plans to be incorporated in the new sub-county development plan for financial
year 2010/2011. The annual budget framework process which takes four months to set at
the sub-county level and is are revised annually to reflect community priorities then
proceeds to district and national level for approval. The plan has incorporated parish
priorities.
The project organised three Project Management Committee (PMC) meetings and one
Project Steering Committee (PSC) meeting. The PMC at sub-county level supports the day to
day running of the projects and the PSC at the district level provides technical and policy
guidance to the project. The meetings at both levels discussed and reviewed project
progress the project has made on the
implementation of the MTR recommendations and
the project’s technical approach. These meetings
have improved coordination, ownership and
involvement from local government stakeholders
and partners in the implementation of the project.
Fig 4. Alice Alolo, a parish development committees (PDC) member from Merok parish receives her bicycle at the
AMREF office in Katine.
The integrated nature of the project addresses the underlying socio-economic factors of
health and wellbeing in the implementation of activities. Project officers responsible for
23
Activities include: community data collection, mobilization of communities for village and parish meetings, consultations with
the communities during the planning process, community sensitization on development issues and overseeing and supervising
development projects in their areas.
23
each component have worked closely together to complement each of the other
components to ensure benefits to the people of Katine.
The project has brought VHTs and health workers to run child health days and trained
teachers on reproductive health through health outreaches in schools. Classrooms
rehabilitated or built have considered the increase in enrolment, and this therefore impacted
the number of latrine stances the project made available in the schools.
There is improved hygiene and sanitation in schools and in the community as a result of
latrines and tippy taps which contributes to a cleaner home and school environment. Better
health results in less money and time spent on seeking healthcare (travel costs and
treatment costs) and more time to go to school or work.
“AMREF constructed the Omulai borehole in my villages to give us clean water. Clean
water is very important because it keeps me healthy. If I use clean water I don’t get any
diseases. [And] because the borehole is near home, I take a short time to collect water
and I am never late at school. I must be luck because I collect water from a short
distance and manage to go to school early.” Mary Anyumel, 10 years, in primary
5.0 PARTNERSHIPS
four AND COORDINATION
at Katine primary school WITH OTHER BODIES.
AMREF implements its work by partnering closely with communities24 in order to build their
capacity, improve the reach of work and ensure sustainability in approaches by working
through existing structures. The project continued to mentor parish, sub-county and district
counterparts in the departments of health, water and sanitation, livelihoods, education and
community empowerment in all its activities. These included:
• Government structures
• NGOs and CBOs (Community Based Organisations) who share the same vision and
objectives i.e. Tran cultural Psycho-Social Organisation (TPO), TASO and UWESO.
Below is how each component of the KCPP worked in partnership with a number of
stakeholders.
5.1 Health
Partnered with the district health team in joint trainings and joint field supervision. Also
participated in the district health sector coordination meetings to which other NGOs also
participate.
24
Community partnerships is one of AMREF’s three strategies where by we jointly identify a problem and develop a
common plan to address it and share responsibilities between AMREF and the communities, working with
community groups and community based project committees.
24
Participated in national programmes like national child days plus campaigns and
international programmes like World AIDS day.
5.2 Education
Worked with the district education working group that includes the district education
department, SNV, Child Fund International, World Vision, TEDDO, Right to Play, TEMEDO and
others organisations by sharing information, best practices, making policy recommendations
and coordinating activities by themes and geographical areas of operation.
5.3 WATSAN
Joint implementation of water quality testing and surveillance activities with the district
water and sanitation department. The project hosted a team from directorate of water
development25 who were on a monitoring visit in preparation for the water and sanitation
sector performance report that would inform and feed into the discussions during the
Government of Uganda/Donor Sector which discussed funding gaps, challenges and new
strategies to improve the sector.
As a member of the District Water and Sanitation Coordination Committee, The project
supported Soroti District Water Department in implementing national sanitation week, a
national strategy aimed at achieving total sanitation at household and institutional level.
5.4 Livelihoods
Worked closely with the district local government departments especially district natural
resources department, Works, community development, production and marketing on
training of farmers.
Planned and worked closely with FARM-Africa on farming issues for technical support and
UWESO/CARE on VSLA activities. Participated in the livelihoods stakeholder forum with other
NGOs ; Soroti District Farmers Association (SODIFA), Community Development Initiatives
(CIDI), Temele Development Organisation (TEMEDO) and Transcultural Psychosocial
Organisation (TPO)
A MoU is being finalised between AMREF and CARE to streamline issues of joint
implementation, coordination and information sharing in Katine and at country
office level.
Collaborated with NAADs programme through exchange visits to NAADS model farmers and
also collaborated with the private sector foundation, Teso region in collective marketing
through exchange visit to farmers in Mbale District.
25
DWD is a technical unit in the Ministry of Water and Environment that deals with all sanitation and water issues
in the country. Each region, including Teso in Soroti, has a Technical Assistance Unit with specialists.
25
Activities were coordinated in partnership with relevant stake holders through District Project
Steering Committee and sub-county Project Management Committee bringing together
technical heads at district, sub-county and community level in planning and implementation
of the project.
6.1 Risks
1. Brown borehole water – When a borehole is pumped rapidly and large volumes of
water come out, brown and rusty pellet like substances come with the water. This has
lowered community interest in the water and a risk of the communities abandoning the new
water sources, reverting to other sources like rivers and ponds that may be clear but unsafe.
The substances are natural iron chemicals that pose no health threat but which does makes
the water unpleasant to drink. This has now happened at five out of the new eight boreholes
installed by AMREF. These substances are caused by high concentrations of Iron and Total
Dissolved Solids in the water which is a characteristic feature in the area, and has equally
affected non-AMREF boreholes not only in Katine but also in the neighbouring sub counties,
according a Soroti District Water Resources Report(October 2008).
With the help of Hand Pump Mechanics trained by AMREF, AMREF is encouraging the
communities to collect operations and maintenance funds, to facilitate the mechanics to
clean the pipes as a temporary measure; this has been done in all five communities. But the
problem keeps recurring. We are also encouraging communities to collect more funds, to be
able to save enough money to buy new pipes in future to replace the damaged ones. The
government has established a technical assistance unit in Soroti for Teso region with
specialists in water and sanitation. One of their roles is to de-ionise the water sources with
new technology and we are already planning with them. The technology involves inserting a
device with chemicals inside the shaft, at the point of the water coming out that dissolves
the solids and sieves the water before it comes out, ensuring its clean and safe drinkable
water.
1. The inadequate supply of medicines: Coartem, oral rehydration salt and panadol for
home based management of childhood illnesses continues to hamper the work of the
community medicine distributors. AMREF is advocating together with other NGOs for the
government to ensure that there is availability of drugs. Already, drug supplies have
improved from being supplied every four months to heath units to every two months
currently. The government has also changed the strategy from buying 30% of the drugs
at national level and 70% at local government to 70% from the national drug authority
and 30% from local governments. We are yet to see the improvements.
2. Staff shortage in all the three health facility makes conducting outreaches
difficult: The project has embarked on advocacy of health workers to be recruited by
the district to support the limited staff at the health centres. The district health office has
responded by recruiting and posting a laboratory assistant for Ojom laboratory, a health
26
assistant to Ojom H/C II and two more staff to Tiriri H/C IV and the project is optimistic
that the government will continue to recruit more staff based on a promise by the district
Chairman. Advocacy is a continuous process and AMREF is continuing to lobby the
government.
3. Low participation of men in reproductive health: Although there is low participation
of men due to cultural beliefs and a strong catholic faith, the project is encouraging male
participation through IEC messages promoting behavioural change. For example, posters
showing a man escorting his wife to an antenatal check up will encourage men to do the
same.
4. Cultural and religious barriers affecting HIV prevention efforts, PMTCT and
family planning. Some of these beliefs include acceptance of polygamy, a woman not
being allowed to divorce her husband because it brings shame to the family. The project
is promoting messages on behavioural change through community training, radio
programmes, IEC materials with messages such as pregnant mothers should test for HIV
to ensure they protect their new unborn baby.
6. The increasing demand for more safe water sources in the community and our
inability to address the demand has been the WATSAN components major challenge.
AMREF is working with the community structures to create awareness and manage
expectations and maximise benefits within the available resources. The project expects
to increase the water coverage from the current 65.6% to 85% by the end of the project
which will provide adequate water for at least everyone in Katine. (85% water coverage
is the Government if Uganda’s target for 2010. 100% is the Government’s target is for
2015)
8. A motivation package for VHTs is not yet clearly defined and various options are
being explored. Some VHTs are not committing to work until a motivation package is
clear. The project, alongside the district is currently discussing with VHTs the various
options to come up with an agreed one.
1. Improve security of VSLA funds: The practice of VSLA repaying all loans two
months before the end of the cycle to share money within group members has
attracted theft. AMREF has recommended that if possible the model be reviewed to
27
address this, especially security of money. CARE has now negotiated with banks for a
VSLA related product that will allow VSLAs to deposit money in these banks. CARE
has also allowed the VSLA approach to be integrated in the other project
components, like WATSAN where WSCs are already lending money collected for
borehole repair among themselves, but a process of the principles needs to be
followed.
26
SACCO – Government supported savings and credit co-operatives at sub-county levels
28
More community members will be trained on basic IT skills and governance /phase out
meetings will be held with sub-county and district partners.
7.0 FINANCIAL REPORT SUMMARY As of March 20010, two and a half years into the
project, AMREF spent 70% of the total year 1-3 revised budget 27 of £2,869,598. Below is a
breakdown of key reasons for under/overspend against the Oct 07-Sep 10 budget. The
financial report is a separate annex and should be read in conjunction with the summary
below. The narrative below relates to any significant under or overspend against the budget.
Project activities: The main under-spend is in the health component and relates to a
delay in the renovation of Tiriri health centre operating theatre and connection of running
water to maternity and theatre. Procurement of a consultant started and work began in the
first quarter of 2010. The spending should be in line by the next reporting period.
Under Livelihoods, an agreement to delay the distribution of seeds to all 48 newly formed
farmer groups from March 2010 until August 2010 contributed to the under-spend. These
costs will be in line by the end of the project year. FARM-Africa monitoring costs were not
invoiced in this reporting period but will be invoiced by the by end of the project year.
Under the community empowerment component, funds have been allocated later in the
year to hold meetings with the community, sub-county and district to implement the
sustainability phase of the project through the exit strategy/plan.
The under-spend in year 3 of project support costs relate to the non recording of fuel cost
within the period as they were not invoiced at the time. This will be invoiced in time before
the end of the project year.
Project management: The under-spend under country office support costs relates to non
travel and accommodation in the UK by staff in Uganda. There are plans for country office
staff to visit the UK later in the project year to bring this back in line with the budget.
UK management costs: All fundraising costs (donation processing costs and staff time)
and programme costs (salary, travel to Uganda and advocacy costs) are in line with the
budget. Management costs are higher than expected due to an overspend in legal costs in
the first year of the project to cover a lengthy three-way contractual agreement process.
Although there have been no communication costs incurred to date, there are
communication materials planned towards the end of this year relating to donor stewardship
and so these costs will be in line.
Contingency and agency support costs: In order to meet the midterm recommendations
of increasing access to safe water, the proposal recommended using costs from year 1-3
contingency budget line of £30,000 to cover the gap in year 3 to increase access to safe
water, leaving a balance of £7,549 contingency funds in year 3.
The 12% administrative charge of the total direct costs of the project is split equally
between AMREF UK and AMREF Uganda (6%/6%) and is in line with the budget.
27
The original 3 year budget in 2007 was set at £2,599,944. Following the midterm review, AMREF increased
funding for year 3, so that the total revised budget up to the end of year 3 amounts to £2,869,598. This means an
additional £269,654 has been allocated to year 3 of the budget to fund the recommendations from the MTR.
29
8.0 ANNEXES
30