Building healthier communities in the Western Cape

The purpose of Mamelani Projects is to empower and strengthen marginalised communities by listening to the particular needs of women, youth and children. Mamelani’s primary focus is on developing people through health education, skills training and personal development programmes.

OVERVIEW

Mamelani sees its work as a response to a need that was identified in the communities where it operates to improve the state of basic health education. Beneficiaries are widely consulted in putting together training programmes to suit their particular needs and the programmes are designed to be experiential, with feedback seen as an integral part of all the programmes.

The Wellness Workshops aim to provide community-based health education in a format that empowers individuals and groups to make informed decisions about their health and to better care for themselves and their families. The workshops are tailored to the needs of very low-income families and are attended mostly by women. They are designed to provide accurate information regarding major illnesses, with an emphasis on low-cost ways of strengthening the body’s immune system; promoting the correct use of medication in conjunction with home-based remedies; and ensuring that participants are able to access clinic services and apply this knowledge at home.

The workshops run over an eight-week cycle and will reach an estimated 600 people over the course of the year (based on 24 workshops accommodating 25 people each). Mamelani also aims to disseminate knowledge through a ‘ripple effect’, whereby direct beneficiaries spread the lessons learned throughout their communities and thereby improve the general level of understanding of basic health issues. Each group is offered a healthy cooking demonstration and Mamelani offers refresher workshops to the groups that have received training.

WHAT WE LIKE ABOUT THIS PROJECT

• The information in the workshops gives participants a low-cost way of keeping healthy. In the long term this should lessen the impact of conditions like diabetes, hypertension and malnutrition, and should also delay the need for HIV positive people to go onto antiretroviral therapy. This will ease the burden on the health services, which are under tremendous strain.
• The workshops respond to an identified need in the communities they are held.
• By addressing nutrition and medication as responses to HIV together, the workshops strive to provide accurate information in order to clarify the mixed messages and confusion that has characterised the debate on treatment in South Africa.

EXPECTED LIFE CHANGE

An investment of R90,102 will fund 24 training workshops, each attended by 25 participants. This works out to fractionally more than R150 per direct life change. It is also expected that each participant will implement the lessons learned in the workshops in their own home and, where applicable, in the homes of the people they care for. As a result, the intervention will have a high number of indirect beneficiaries as well.

NEED

With the vast majority of government health resources being heavily overburdened with the responsibility of delivering primary health care services, little time or resources are available to address the need for education and support relating to health and nutrition. This situation is particularly prevalent in impoverished urban and rural communities resulting in many vulnerable people being poorly equipped to understand or take responsibility for health-related issues.

Education in health and nutrition is widely accepted as a key component in promoting optimal health and reducing the risk of developing chronic diseases. However, despite a number of national health and nutrition programmes being initiated in South Africa over the past decade, thousands of people continue to suffer from malnutrition and other debilitating conditions such as TB, Diabetes and HIV/AIDS. This situation not only poses a major threat to the health sector but also impacts negatively on the livelihood of the South African population.

Mamelani Projects’ Wellness programme attempts to fill this gap by encouraging people to be more informed about their health and available health services in order to take an active role in managing their own bodies.

STRATEGY

With a public health system that is stretched beyond capacity by the demand for its services, very few resources are dedicated to basic health and nutrition education. While the Department of Health has implemented some programmes at clinic level, the information does not always reach those in the community. Mamelani Projects’ Wellness programme attempts to fill this gap by working with people at community level and encouraging them to be more informed about their health and available health services in order to take an active role in managing their own bodies.

ACTION PLAN

Preparation

The programme has already begun and no further preparation is needed

Implementation

• A total of 24 workshops are planned for the Western Cape over a twelve-month period.
• Each Workshop will comprise six intense work sessions that will take place over a period of eight weeks. Eight individual groups will participate in each eight-week cycle.
• Mamelani Projects will facilitate private consultations with participants when requested.

Monitoring and Evaluation

• Knowledge gained by participants is measured through the pre- and post-session questionnaires. The questionnaires aim to capture information on knowledge gained in the workshops; the effect of the information on the individual, the integration of the information with already accepted ideas regarding health, the effectiveness of the workshop format and elements that helped or hindered behaviour change.
• During private consultations with beneficiaries, the facilitator records specific areas of lifestyle change with which the beneficiary is struggling. Progress made in incorporating the lifestyle change as well as any health benefits experienced as a result, are monitored and recorded during each subsequent consultation.
• Facilitators prepare weekly evaluations of the workshops highlighting both positive and negative aspects. New questions that emerge during work sessions are recorded, researched and integrated into the programme material. The Mamelani staff meet weekly to discuss the progress made by each group, share challenges and concerns and plan for the week ahead.

ORGANISATION ASSESSMENT

Mamelani is a small but growing organisation that has clearly identified the needs that it seeks to address and has forged a strong network of partnerships with organisation that are able to deliver related services. Mamelani thus sees itself as playing a niche role within a bigger holistic framework that seeks to raise the standard of public health in South Africa.

The organisation is staffed by small team of passionate individuals. The organisation fosters a culture of consultation and is constantly reviewing and updating its programmes in order to overcome new challenges.

RISK PROFILE

Key Strengths

• Concept: Workshops fill a particular gap in current health strategies and will have a far-reaching impact beyond the direct beneficiaries. By targeting individuals, and particularly women, who are responsible for other people’s nutrition, the intervention will have an immediate impact on a wider pool of people than those attending the workshops.
• Design: The workshops are consultative and the facilitators have demonstrated their ability to adapt course content depending on the context in which they take place. The workshop facilitators have demonstrated their ability to build relationships in the communities where they work, and, as a result, Mamelani is always in touch with the changing needs of their beneficiaries.
• Capability: The organisation has a proven track record of implementing similar project, and works has developed a strong network of partnerships which support its operations.
• Control: Workshop facilitators always work in pairs. This is so that they are able to call on each other to fill in any gaps in each other’s knowledge, as well as to provide a mechanism for feedback and peer-assessment.

Key Risks - Low

• Concept: While the workshops encourage participants to go for health checks, and emphasise the importance of knowing one’s HIV status, they do not arrange for any of these checks themselves. Arranging for tests would save participants the cost and inconvenience of travelling to clinics. This is to some extent tempered by the referral network that the organisation has developed.
• Sustainability: Despite some efforts to generate income, Mamelani will continue to rely on donor funding for the foreseeable future. This is somewhat mitigated by having a formal, documented fundraising strategy.