23rd March, 2009
The recent debate in Katine about the need for the project to invest more resources into "hardware," such as physical infrastructure, has highlighted an issue that is core to sustainable community development. Although "software," such as skills development, is the engine for social transformation, in the context of a rural community with limited access to basic services, the hardware component becomes a necessary entry point around which the community can begin to internalise the software elements.
We would argue that Katine's success depends on a balance between hardware and software. Visible infrastructure developments, such as new boreholes and new schools, become catalysts for social change as they provide hope that lives may be changing for the better. But without proper training, involvement and education, the infrastructure becomes little more than a symbol, limited in its use. It is vital to strike a balance between hardware and software. What lasts forever is knowledge and skills (software) gained through capacity-building initiatives.
The AMREF development model is based on the understanding that governments are ultimately responsible for the provision of basic services. The role of an NGO like AMREF is to work with communities to demonstrate approaches that can be applied to other districts with financial input from the government, donors and other development actors. To this extent, the community based development approach is always an effort to retain a balance between the tangible needs of the community, such as the development of schools, boreholes, and other infrastructure, and long-term initiatives that promote sustainability, such as education and training.
AMREF puts communities at the heart of planning for their development by ensuring there is a balance between the provision of services and the involvement of communities to make those services last.
This is why in Katine we place emphasis on community awareness, mobilisation, organisation and advocacy at sub-country, district and national levels. AMREF engages people in the development process and ensures they are central to managing their assets fully while also ensuring communities are aware of their rights to these services.
By knowing your rights, you can influence government policy and programmes more easily. By ensuring that appropriate policies and effective systems for delivering social services are put into place, in consultation with residents, the community is able to improve their own living environment, household income, security and access to justice.
AMREF tests existing approaches used by local government to deliver social services to show how much more effective they would be with greater community participation and strengthened systems.
The Katine project aims to increase the participation of communities in planning for and managing their own health and other services. For instance, the construction and repair of classrooms is reinforced by the training of school management committees, school health clubs and parent teacher associations. Similarly, the training of village health teams and community health workers is enhanced by improvements to clinics and laboratories and the availability of insecticide-treated nets. In the same vein, the installation of water and sanitation facilities is accompanied by information on basic hygiene in an effort to prevent water-borne diseases.
Because of the poverty levels in Katine, largely attributed to the displacement of the population during the insurgency period as well as cattle raids by the Karamojong several years ago, the Katine project has allocated substantial funds for schools, boreholes and laboratories. The hardware activities are supported by a range of human and social development initiatives aimed at ensuring full community ownership and long-term project sustainability.
Hardware costs are significantly higher compared to software costs. Building a school, for example, costs more than training a teacher. With this in mind we must note that reducing training may not necessarily lead to a substantial increase in the hardware budget.
Naturally, poor communities like Katine, where most people live on less than $1 a day, prefer tangible hardware and material investments. Governments also evaluate progress in development in terms of physical infrastructure. However, AMREF believes that the mere existence of physical infrastructure without the commensurate human and social development investment does not result in sustainable community development. The decision as to what comes first and the levels is dependent on the level of development at which a particular community has reached.
If you take education as an example, it is of little use to construct classrooms without teachers. At times, the teachers might be available, but in most cases you will find that there are many areas in which they might have inadequate skills or are untrained. For instance, Katine sub-county has a community school with five classrooms that house more than 350 children, but the school lacks trained teachers. Although the Katine project might build new classrooms in the school, the lack of skilled teachers might end up undermining the quality of learning further.
Health and other basic services in Katine are weak. Before the project's intervention, the village health teams that were in place were not functional. They were inadequately trained, with most having had only a day of training about their roles. The Katine project has provided these teams with training alongside the health centre management committees to ensure the referral and supportive supervision system works. Each specialist within a village health team — such as community medicine distributors, traditional birth attendants, and community vaccinators — has their own needs and a specific training module that takes time and money to implement.
Still within health, the AMREF strategy is supportive of government policy to shift the emphasis away from curative to preventive intervention. Some 80% of diseases in Uganda are preventable at the community and household level. While the project might build new health units, the existing ones already lack drugs and health workers. Our efforts have, therefore, been directed at lobbying for staff, drugs and equipment before beginning the construction of more health facilities that might not be utilised unless those constraints are addressed. Getting the health system to deliver by empowering the community to demand better services and improved healthcare at all levels is core to the Amref development model.
The community based approach used by AMREF endeavours to strike a balance between perceived community priorities and the need to inform the development process. It is for this strategic reason that the Katine project has invested effort and resources in strengthening the capacity of community structures to create a sustainable mechanism through which the community can engage and provide leadership within Katine and other development initiatives. We can encourage the ongoing debate as the approach cannot answer all development questions, but we believe that by putting the community first, we open a door for wider participation and engagement, which could offer a new way in addressing developmental challenges.
Dr Florence Muli-Musiime is AMREFs deputy director general and Joshua Kyallo is AMREF's country director for Uganda
