Implementation challenges for Community Health Clubs in Rwanda

The document examines the rollout of Community Health Clubs (CHCs) in Rwanda, highlighting a gap between national policy and local implementation. While the model is praised for its cultural alignment and focus on positive peer pressure, it suffers from fragmented, donor-driven funding, poor coordination between districts and NGOs, and a lack of harmonized monitoring. The report emphasizes the need for increased government funding, inclusive strategies to reach vulnerable groups and men, and a shift toward district-level ownership to ensure sustainable hygiene and sanitation behaviour change.

• The implementation of Community Health Clubs (CHCs) in Rwanda is fragmented and heavily dependent on external donors, leading to inconsistent monitoring and evaluation across the country.
• There is a significant disconnect between the national policy framework and local execution, characterized by inadequate financial resources at national and district levels and a lack of clear roles for actors.
• The CHC model is considered culturally appropriate for Rwanda because it utilizes positive peer pressure and consensus rather than shame-based triggers.
• Long-term handwashing behaviour change is hindered by the limited duration of the six-month training period, the high cost or unavailability of soap, and water shortages in hilly regions.
• Monitoring of CHCs is primarily conducted by implementing partners rather than district environmental health officers due to a lack of technical and financial resources, such as data management systems.
• Current implementation risks excluding vulnerable populations, including those with mobility issues, new residents, and men, who are less likely to attend meetings than women.

APA

Ekane, N., Dickin, S., Gabrielsson, S., Ntakarutimana, A., & Rujeni, N. (2019). Implementation challenges for Community Health Clubs in Rwanda. Stockholm Environment Institute. https://www.sei.org/wp-content/uploads/2019/11/sei-brief-rwanda-chcs.pdf

Chicago

Ekane, Nelson, Sarah Dickin, Sara Gabrielsson, Amans Ntakarutimana, and Nadine Rujeni. Implementation challenges for Community Health Clubs in Rwanda. Stockholm Environment Institute, 2019. https://www.sei.org/wp-content/uploads/2019/11/sei-brief-rwanda-chcs.pdf.

Wikipedia

{{cite report |last1=Ekane |first1=Nelson |last2=Dickin |first2=Sarah |last3=Gabrielsson |first3=Sara |last4=Ntakarutimana |first4=Amans |last5=Rujeni |first5=Nadine |title=Implementation challenges for Community Health Clubs in Rwanda |publisher=Stockholm Environment Institute |date=October 2019 |url=https://www.sei.org/wp-content/uploads/2019/11/sei-brief-rwanda-chcs.pdf |access-date=17 August 2026 |via=Climate Insights Directory}}

BibTeX

@techreport{ekane2019implementation, author = {Ekane, Nelson and Dickin, Sarah and Gabrielsson, Sara and Ntakarutimana, Amans and Rujeni, Nadine}, title = {{Implementation challenges for Community Health Clubs in Rwanda}}, institution = {Stockholm Environment Institute}, year = {2019}, month = oct, url = {https://www.sei.org/wp-content/uploads/2019/11/sei-brief-rwanda-chcs.pdf}, urldate = {2026-08-17}, note = {Indexed by Climate Insights Directory} }