plan 435IXIL HEALTH CLINICS

Summary

The "Area de Salud" that manages health care in the Ixil region of Guatemala has decided to decentralize health care for the area. They have identified three health clinics where they would like help in improving sanitation and hand washing for patients.

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Background

Within the last 5 years the govenment has built small health clinics in rural villages to decentralize health care from the national hospital in Nebaj. The structures are adequate for the hospital personnel to treat, and diagnose patients, but did not take into account the large numbes of people waiting for treatment and their sanitary needs. All of the communities have a water system , but no public sanitary and hand washing facilities. This project is the beginning of a process to provide such facilities at the rural clinics by Agua Para La Salud.

Location

Municipality of Nebaj, Guatemala, Ixil region of Quiche department, Guatemala

Attachments

  • Doc GLOBAL_E...
  • Xlsx 3_BANOS_...
  • Doc Nebaj_Ar...
  • Xlsx 3_BANOS_...
  • Xls 3-CABIN_...
  • Xls Septic_t...

Focus

Primary Focus: Sanitation - Community
Secondary Focus: Hygiene Education

People Getting Safe Drinking Water: 0

The health clinics do not have water or hand washing available for patients waiting for treatment and diagnosis. The numbers are from the government health office. The use of water at this location is a suppliment to the water the villagers have in their homes.

School Children Getting Water:

People Getting Sanitation: 2,562

The population noted is the population of the communities where the health clinics are located. Most families have latrines in their homes and this facility will provide a suppliment to the sanitation in the village.

People Getting Other Benefits: 2,562

The project is being implemented along with the government program to increase health service on a weekly basis from the present monthly visit.

Application Type: Program Funding

Start Date: 2012-10-01

Completion Date: 2013-01-25

Technology Used:

The facilities proposed have been constructed numerous times in schools and have been designed to withstand intensive use by the public. The facilities are easily maintained and have locking doors to prevent valdalism.
Each village committee will work along with Agua Para La Salud to complete the construction and provide local labor and materials.

Phases:

The project in the four health clinics will be done over a period of four months ,after receiving funding, by trained masons who have executed these designs on many occassions.

Community Organization:

The clinics were built by the Guatemalan government and turned over to the care of each community. The local "Area de Salud" has technitians who monitor the maintenance by the communities of the clinic to ensure a safe and clean environment for patients, doctors and nurses.

Government Interaction:

The project will enhance the capability of the health authorities to improve patient treatment on a weekly basis.

Ancillary activities:

The health clinics also provide a location for health classes; prenatal care; distribution of food supliments; and vacinations.

Other Issues:

Without the new facilities people waiting are forced to take care of their natural needs by using nearby corn fields and forests.

Maintenance Revenue:

The clinics are managed by the community under the supervision of the hospital staff.
Each community has a local trained resident in charge of the clinics.

Maintenance Cost: $200

Metrics:

The hospital staff and the "Area de Salud" keep records of the clinic activities and monitor maintenance.
Agua Para La Salud will monitor the facilities in the following manner:
1) Check the septic tank for solid levels and drain field for leakage on a yearly basis.
2) Check the functioning of the flush toilet mechanism and door operation on a yearly basis.
3) Monitor the effectiveness of the community and Area de Salud to manage the facilities and keep them in good and clean condition.

Cost: $23,893

The total cost of the project includes the contribution by Global Water for the fourth clinic.

Co Funding Amount: $5,973

Agua Para La Salud has funding from Global Water to finance the Xepiun clinic.

Community Contribution Amount: $2,500

The communities will contribute non skilled labor for 6 weeks at about six men per day ; and the rock needed for the bases of the structures.

Fund Requested: $17,920

Implementing Organization:

Attachments

  • Doc GLOBAL_E...
  • Xlsx 3_BANOS_...
  • Doc Nebaj_Ar...
  • Xlsx 3_BANOS_...
  • Xls 3-CABIN_...
  • Xls Septic_t...
  • 2 participants | show more

    Beneficiary counts

    Rajesh Shah of Peer Water Exchange

    Hola Lynn, Are people going to drink at the handwashing station? ----------- I think that the number of people getting water should be zero, since that is normally interpreted as people getting water at home all the time. Also, the people getting sanitation should be zero. Projects like this make counting hard. We can't count t...

    Hola Lynn,

    Are people going to drink at the handwashing station?

    -----------

    I think that the number of people getting water should be zero, since that is normally interpreted as people getting water at home all the time. Also, the people getting sanitation should be zero.

    Projects like this make counting hard. We can't count the beneficiaries since we are afraid of double-counting but we should somehow account for them.

    We do this for school projects; for now, can you just keep beneficiary count in the 'Number of People Receiving Other Benefits' section only?

    Ideas from all members welcome!

    Gracias,
    Rajesh

    • Lynn Roberts of Agua Para La Salud (APLS)

      People waiting to visit the doctors and nurses will be using the water for drinking, but I will change the proposal to identify this use with other benefits.

      People waiting to visit the doctors and nurses will be using the water for drinking, but I will change the proposal to identify this use with other benefits.

  • 2 participants | show more

    Metrics and long-term assessment

    Rajesh Shah of Peer Water Exchange

    In the "Metrics to be Measured" section, we want a list of measurable and trackable impacts you hope to achieve. Maybe it was not clear, but we are looking for specific metrics you will track at some frequency. As stated "PWX will soon offer the ability to track metrics (at differing frequency) to learn about actual operation and asse...

    In the "Metrics to be Measured" section, we want a list of measurable and trackable impacts you hope to achieve.

    Maybe it was not clear, but we are looking for specific metrics you will track at some frequency. As stated "PWX will soon offer the ability to track metrics (at differing frequency) to learn about actual operation and assess impact" with some examples.

    So we want to know what the clinic (or you) will track that can be graphed as a time series? Could you specify about 3 metrics that will help you assess how the system is operating over time? Need a measurement frequency and a scale (could be yes/no or percentage or number).

    Gracias,
    Rajesh

    • Lynn Roberts of Agua Para La Salud (APLS)

      See additions to project proposal under "metrics". The scale would be a simple 1 - 10.

      See additions to project proposal under "metrics". The scale would be a simple 1 - 10.

      • Rajesh Shah of Peer Water Exchange

        Gracias, Senor Lynn. Would there be some measurement of resources (time, money, staff) allocated towards maintenance/repairs that could be tracked? The reason i am asking is to see if any learnings about the components used, design, types could be captured and shared for future projects. Rajesh

        Gracias, Senor Lynn.

        Would there be some measurement of resources (time, money, staff) allocated towards maintenance/repairs that could be tracked? The reason i am asking is to see if any learnings about the components used, design, types could be captured and shared for future projects.

        Rajesh

    • Rajesh Shah of Peer Water Exchange

      Gracias, Senor Lynn. Would there be some measurement of resources (time, money, staff) allocated towards maintenance/repairs that could be tracked? The reason i am asking is to see if any learnings about the components used, design, types could be captured and shared for future projects. Rajesh

      Gracias, Senor Lynn.

      Would there be some measurement of resources (time, money, staff) allocated towards maintenance/repairs that could be tracked? The reason i am asking is to see if any learnings about the components used, design, types could be captured and shared for future projects.

      Rajesh

  • 2 participants | show more

    Health Clinics vs. Schools

    Rob Bell of El Porvenir

    Lynn, Thanks all the good information there. We love your design on the hand washing station. Some minor things and one learning question for my benefit. 1. The community contribution amount - is that the community labor only or is there some materials that the community contributes as well? In our projects in the last few ye...

    Lynn,

    Thanks all the good information there. We love your design on the hand washing station.

    Some minor things and one learning question for my benefit.

    1. The community contribution amount - is that the community labor only or is there some materials that the community contributes as well?

    In our projects in the last few years, where we thought it was difficult to get the community to contribute, we have actually had great successes in getting the community to support the project financially.

    2. Seeing as the health clinics are a government facility (or am I mistaken on that assumption), has the local government (Alcaldia or municipality) offered to contribute financially towards these projects?

    3. Looking towards the future and the sustainability of the septic tanks, are there local options for emptying them out? How is the access to these clinics to pump them out? In Nicaragua, outside of Managua it would be difficult to access these services, and there are very few places to dump the waste safely. Maybe Guatemala has better options on this score than we do.

    4. On our side, we haven't done any projects in health clinics to this point, just communities and schools. Have you seen any differences between working in schools and health clinics? i.e. any interesting learnings worth sharing?

    Thanks,
    Rob

    • Lynn Roberts of Agua Para La Salud (APLS)

      The communities have been lied to so many times by the government and other agencies that we usually come to agreements with them once the funding is secured. We have discussed their role in the project and they normally provide the un skilled labor; rock for balast under the structures (5 cubic meters); and wood planks for forms. The ...

      The communities have been lied to so many times by the government and other agencies that we usually come to agreements with them once the funding is secured. We have discussed their role in the project and they normally provide the un skilled labor; rock for balast under the structures (5 cubic meters); and wood planks for forms.

      The local alcalde has indicated that he would like to support our projects, but as indicated above we wait until the funding is secure before making final arrangements. This has worked well in the past and the alcalde has been contributing sand and gravel.

      Since very few chemicals and solids other than heces enter the septic tank the pumping is not required for at least a decade from my experience with schools and sometimes not then. The service trucks for the septic tanks at the local national hospital come once a year from Guatemala city to service the hospital septic tanks and this is the service we or the hospital staff anticipate using if needed.

      The health clinics are new for us as well. We entered into the area at the request of Save The Chilkdren. So far there has been very strong support from the communities since the clinics treat them and their children and see this as a very high priority. Maintenance is a concern of mine since so many people are involved, so we will have a specific agreement with the village health promoters concerning this issue before construction begins. We lasao give classes on how to fix the flush toilet.

      • Rob Bell of El Porvenir

        Lynn, Sounds good. We operate somewhat similarly with the communities. They know they will have to contribute financially (as well as sweat equity) beforehand, but the exact details are usually worked out once the project starts, although they often have an idea of what they will be contributing beforehand. With the local government...

        Lynn,

        Sounds good. We operate somewhat similarly with the communities. They know they will have to contribute financially (as well as sweat equity) beforehand, but the exact details are usually worked out once the project starts, although they often have an idea of what they will be contributing beforehand.

        With the local governments, we have MOUs (in Spanish) with each one that they will earmark 10-15% of project materials costs for all our projects each year. Each year we send them the specific list of projects that we have funded (or very likely to be funded) so they can put it into their annual budget. Seems to work well. If you are interested, I can send you a copy of one of the MOUs and you can see if it would be helpful to you. This year is an election year here, so we have an opportunity to push up the percentages - we are hoping to see 15-25% at least.

        Glad to hear there is a pumping out service you can tap into...

        Rob

        • Lynn Roberts of Agua Para La Salud (APLS)

          Thanks Rob. Yes send a copy of the MOU. Alñways interested in how to lever government agencies.....Lynn

          Thanks Rob. Yes send a copy of the MOU. Alñways interested in how to lever government agencies.....Lynn

      • Lynn Roberts of Agua Para La Salud (APLS)

        Thanks Rob. Yes send a copy of the MOU. Alñways interested in how to lever government agencies.....Lynn

        Thanks Rob. Yes send a copy of the MOU. Alñways interested in how to lever government agencies.....Lynn

    • Rob Bell of El Porvenir

      Lynn, Sounds good. We operate somewhat similarly with the communities. They know they will have to contribute financially (as well as sweat equity) beforehand, but the exact details are usually worked out once the project starts, although they often have an idea of what they will be contributing beforehand. With the local government...

      Lynn,

      Sounds good. We operate somewhat similarly with the communities. They know they will have to contribute financially (as well as sweat equity) beforehand, but the exact details are usually worked out once the project starts, although they often have an idea of what they will be contributing beforehand.

      With the local governments, we have MOUs (in Spanish) with each one that they will earmark 10-15% of project materials costs for all our projects each year. Each year we send them the specific list of projects that we have funded (or very likely to be funded) so they can put it into their annual budget. Seems to work well. If you are interested, I can send you a copy of one of the MOUs and you can see if it would be helpful to you. This year is an election year here, so we have an opportunity to push up the percentages - we are hoping to see 15-25% at least.

      Glad to hear there is a pumping out service you can tap into...

      Rob

      • Lynn Roberts of Agua Para La Salud (APLS)

        Thanks Rob. Yes send a copy of the MOU. Alñways interested in how to lever government agencies.....Lynn

        Thanks Rob. Yes send a copy of the MOU. Alñways interested in how to lever government agencies.....Lynn

    • Lynn Roberts of Agua Para La Salud (APLS)

      Thanks Rob. Yes send a copy of the MOU. Alñways interested in how to lever government agencies.....Lynn

      Thanks Rob. Yes send a copy of the MOU. Alñways interested in how to lever government agencies.....Lynn

  • 2 participants | show more

    Water, Health & Hygiene

    Paul Kaufman of Aqua Clara International

    This looks like a very good project and it is clear that these latrines and hand washing stations are needed. I have 3 questions. 1. In your proposal it is clear that there are no public water sources in the nearby areas. Is there a water source already at the clinic, and if so, is there sufficient water for a 'flush toilet' system...

    This looks like a very good project and it is clear that these latrines and hand washing stations are needed.

    I have 3 questions.

    1. In your proposal it is clear that there are no public water sources in the nearby areas. Is there a water source already at the clinic, and if so, is there sufficient water for a 'flush toilet' system? Will you be installing systems that use minimal water usage as toilets are some of the greatest culprits of wasting water?

    2. Are the people in the area familiar with using the flush toilet system, or will this be a new concept for them?

    3. You mentioned Health and Hygiene training. Who will be conducting these training sessions?

    Thank you again for your valuable work, and I look forward to your response.

    Paul from Aqua Clara

    • Lynn Roberts of Agua Para La Salud (APLS)

      All of the villages where the clinic facilities will be built have viable gravity fed water systems. All of the water systems are part of our Circuit Rider program which gives technical assistance to the villages to maintain their water systems. In a number of the villages we installed the water system some years ago following the civil w...

      All of the villages where the clinic facilities will be built have viable gravity fed water systems. All of the water systems are part of our Circuit Rider program which gives technical assistance to the villages to maintain their water systems. In a number of the villages we installed the water system some years ago following the civil war.
      The village water committees along with the health authorities will maintain the facilities proposed.
      The villages are familiar with flush toilets and we will give classes to the village on how to repair the toilets during the construction. We have a protable, plastic toilet tank that we use to train the village committees.
      The local health authority along with holding diagnostic clinics also schedule classes on a variety of health issues min these local village clinics.

      • Paul Kaufman of Aqua Clara International

        Thank you for your rapid response Lynn and for clarifying some of my queries. Are you able to find toilets that are more economically friendly with their use of water, or is this not available where you are working? Paul

        Thank you for your rapid response Lynn and for clarifying some of my queries. Are you able to find toilets that are more economically friendly with their use of water, or is this not available where you are working?

        Paul

        • Lynn Roberts of Agua Para La Salud (APLS)

          The toilets are the low water usage toilets with 4.8 liters per flush.

          The toilets are the low water usage toilets with 4.8 liters per flush.

          • Paul Kaufman of Aqua Clara International

            Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage. Sounds like a great project and I wish you the best of luck. Paul

            Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage.
            Sounds like a great project and I wish you the best of luck.
            Paul

        • Paul Kaufman of Aqua Clara International

          Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage. Sounds like a great project and I wish you the best of luck. Paul

          Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage.
          Sounds like a great project and I wish you the best of luck.
          Paul

      • Lynn Roberts of Agua Para La Salud (APLS)

        The toilets are the low water usage toilets with 4.8 liters per flush.

        The toilets are the low water usage toilets with 4.8 liters per flush.

        • Paul Kaufman of Aqua Clara International

          Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage. Sounds like a great project and I wish you the best of luck. Paul

          Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage.
          Sounds like a great project and I wish you the best of luck.
          Paul

      • Paul Kaufman of Aqua Clara International

        Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage. Sounds like a great project and I wish you the best of luck. Paul

        Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage.
        Sounds like a great project and I wish you the best of luck.
        Paul

    • Paul Kaufman of Aqua Clara International

      Thank you for your rapid response Lynn and for clarifying some of my queries. Are you able to find toilets that are more economically friendly with their use of water, or is this not available where you are working? Paul

      Thank you for your rapid response Lynn and for clarifying some of my queries. Are you able to find toilets that are more economically friendly with their use of water, or is this not available where you are working?

      Paul

      • Lynn Roberts of Agua Para La Salud (APLS)

        The toilets are the low water usage toilets with 4.8 liters per flush.

        The toilets are the low water usage toilets with 4.8 liters per flush.

        • Paul Kaufman of Aqua Clara International

          Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage. Sounds like a great project and I wish you the best of luck. Paul

          Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage.
          Sounds like a great project and I wish you the best of luck.
          Paul

      • Paul Kaufman of Aqua Clara International

        Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage. Sounds like a great project and I wish you the best of luck. Paul

        Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage.
        Sounds like a great project and I wish you the best of luck.
        Paul

    • Lynn Roberts of Agua Para La Salud (APLS)

      The toilets are the low water usage toilets with 4.8 liters per flush.

      The toilets are the low water usage toilets with 4.8 liters per flush.

      • Paul Kaufman of Aqua Clara International

        Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage. Sounds like a great project and I wish you the best of luck. Paul

        Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage.
        Sounds like a great project and I wish you the best of luck.
        Paul

    • Paul Kaufman of Aqua Clara International

      Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage. Sounds like a great project and I wish you the best of luck. Paul

      Thanks Lynn. i'm sure you have already heard or tried this...but in various parts in Africa we would add several large stones in the flush tanks to further reduce the water usage.
      Sounds like a great project and I wish you the best of luck.
      Paul

  • 2 participants | show more

    Carolyn Meub of Pure Water for the World

    Good morning, This looks like a great project! I just have a few questions: - Will the staff at the clinics be maintaining the sanitation facilities and handwashing stations ( locking, unlocking, cleaning, etc) or will the village health promoters? - Will there be hygiene educational trainings held for community members? Any monitor...

    Good morning,

    This looks like a great project! I just have a few questions:

    - Will the staff at the clinics be maintaining the sanitation facilities and handwashing stations ( locking, unlocking, cleaning, etc) or will the village health promoters?
    - Will there be hygiene educational trainings held for community members? Any monitoring of these facilities?

    Thanks!
    Jamin
    Pure Water

    • Lynn Roberts of Agua Para La Salud (APLS)

      The " Area de Salud" is a regional govenment institution responsible for the management of the facilities in conjunction with a health promoter in the villages where clinics are located. We will arrange with the Artea de Salud, the village promoter ,and village committee to draw up an agreement concerning management of the new facilities. ...

      The " Area de Salud" is a regional govenment institution responsible for the management of the facilities in conjunction with a health promoter in the villages where clinics are located. We will arrange with the Artea de Salud, the village promoter ,and village committee to draw up an agreement concerning management of the new facilities. The Area de Salud is in the final stages of implementing a full time presence in these 5 clinics and identified the clinics as a priority for them out of the 60 + villages in the municipality of Nebaj.

      The hand washing stations and fluch toilet/ seprtic tank complexes are designs that we have used for several years and since they are concrete and block with steel doors they stand up very well to constant use such as schools and public places. The only item in the facilities that needs constant monitoring are the flush toilet mechanism. Our masons and Circuit Riders give classes to the local villagers on how to maintain the flush toilets and the parts are available in local hardware stores. Our Circuit Riders make visits to these sites during the year to check on the maintenance. The Area de Salud also has technicians who are responsible of these clinic facilites and their maintenance. The doctors and nurses who will work in the clinics feed information to the technical and admin. staff at the Area de Salud concerning maitenance needs. Cleaning of the facilities is the responsibility of the Area de Salud in conjunction with the village. Individuals are designated to carry out this function.

      The facilities are focal points for the Area de Salud and the local national hospital in Nebaj to carry out childrens vaccinations, health classes, diagnoistic activities, well baby clinics, and government and NGO food distribution to eliviate hunger.

    • Lynn Roberts of Agua Para La Salud (APLS)

      The " Area de Salud" is a regional govenment institution responsible for the management of the facilities in conjunction with a health promoter in the villages where clinics are located. We will arrange with the Artea de Salud, the village promoter ,and village committee to draw up an agreement concerning management of the new facilities. ...

      The " Area de Salud" is a regional govenment institution responsible for the management of the facilities in conjunction with a health promoter in the villages where clinics are located. We will arrange with the Artea de Salud, the village promoter ,and village committee to draw up an agreement concerning management of the new facilities. The Area de Salud is in the final stages of implementing a full time presence in these 5 clinics and identified the clinics as a priority for them out of the 60 + villages in the municipality of Nebaj.

      The hand washing stations and fluch toilet/ seprtic tank complexes are designs that we have used for several years and since they are concrete and block with steel doors they stand up very well to constant use such as schools and public places. The only item in the facilities that needs constant monitoring are the flush toilet mechanism. Our masons and Circuit Riders give classes to the local villagers on how to maintain the flush toilets and the parts are available in local hardware stores. Our Circuit Riders make visits to these sites during the year to check on the maintenance. The Area de Salud also has technicians who are responsible of these clinic facilites and their maintenance. The doctors and nurses who will work in the clinics feed information to the technical and admin. staff at the Area de Salud concerning maitenance needs. Cleaning of the facilities is the responsibility of the Area de Salud in conjunction with the village. Individuals are designated to carry out this function.

      The facilities are focal points for the Area de Salud and the local national hospital in Nebaj to carry out childrens vaccinations, health classes, diagnoistic activities, well baby clinics, and government and NGO food distribution to eliviate hunger.

    • Lynn Roberts of Agua Para La Salud (APLS)

      The " Area de Salud" is a regional govenment institution responsible for the management of the facilities in conjunction with a health promoter in the villages where clinics are located. We will arrange with the Artea de Salud, the village promoter ,and village committee to draw up an agreement concerning management of the new facilities. ...

      The " Area de Salud" is a regional govenment institution responsible for the management of the facilities in conjunction with a health promoter in the villages where clinics are located. We will arrange with the Artea de Salud, the village promoter ,and village committee to draw up an agreement concerning management of the new facilities. The Area de Salud is in the final stages of implementing a full time presence in these 5 clinics and identified the clinics as a priority for them out of the 60 + villages in the municipality of Nebaj.

      The hand washing stations and fluch toilet/ seprtic tank complexes are designs that we have used for several years and since they are concrete and block with steel doors they stand up very well to constant use such as schools and public places. The only item in the facilities that needs constant monitoring are the flush toilet mechanism. Our masons and Circuit Riders give classes to the local villagers on how to maintain the flush toilets and the parts are available in local hardware stores. Our Circuit Riders make visits to these sites during the year to check on the maintenance. The Area de Salud also has technicians who are responsible of these clinic facilites and their maintenance. The doctors and nurses who will work in the clinics feed information to the technical and admin. staff at the Area de Salud concerning maitenance needs. Cleaning of the facilities is the responsibility of the Area de Salud in conjunction with the village. Individuals are designated to carry out this function.

      The facilities are focal points for the Area de Salud and the local national hospital in Nebaj to carry out childrens vaccinations, health classes, diagnoistic activities, well baby clinics, and government and NGO food distribution to eliviate hunger.

    • Lynn Roberts of Agua Para La Salud (APLS)

      The " Area de Salud" is a regional govenment institution responsible for the management of the facilities in conjunction with a health promoter in the villages where clinics are located. We will arrange with the Artea de Salud, the village promoter ,and village committee to draw up an agreement concerning management of the new facilities. ...

      The " Area de Salud" is a regional govenment institution responsible for the management of the facilities in conjunction with a health promoter in the villages where clinics are located. We will arrange with the Artea de Salud, the village promoter ,and village committee to draw up an agreement concerning management of the new facilities. The Area de Salud is in the final stages of implementing a full time presence in these 5 clinics and identified the clinics as a priority for them out of the 60 + villages in the municipality of Nebaj.

      The hand washing stations and fluch toilet/ seprtic tank complexes are designs that we have used for several years and since they are concrete and block with steel doors they stand up very well to constant use such as schools and public places. The only item in the facilities that needs constant monitoring are the flush toilet mechanism. Our masons and Circuit Riders give classes to the local villagers on how to maintain the flush toilets and the parts are available in local hardware stores. Our Circuit Riders make visits to these sites during the year to check on the maintenance. The Area de Salud also has technicians who are responsible of these clinic facilites and their maintenance. The doctors and nurses who will work in the clinics feed information to the technical and admin. staff at the Area de Salud concerning maitenance needs. Cleaning of the facilities is the responsibility of the Area de Salud in conjunction with the village. Individuals are designated to carry out this function.

      The facilities are focal points for the Area de Salud and the local national hospital in Nebaj to carry out childrens vaccinations, health classes, diagnoistic activities, well baby clinics, and government and NGO food distribution to eliviate hunger.

  • Rating: 7

    review by (only shown to members)

    Looks like a straightforward project with reasonable costs. While the Monitoring system addresses the hardware, there could be more qualitative feedback from the community that might provide feedback on non-hardware related issues that could come up. Having a mechanism for documenting community/health worker feedback would provide information that would make this and other projects like this even more effective.

  • Rating: 8

    review by (only shown to members)

    Good project building on established process and expertise.

  • Rating: 9

    review by (only shown to members)

    APLS has solid experience in these areas and a good methodology. I'm glad to help in perhaps a small way with the MOU that we have. No doubt that this is a worthy project.

  • Rating: 9

    review by (only shown to members)

    This looks like an excellent project which has already been proven over time and in different locations. It is clear that Aqua Para Salud has a good relationship in the community and understands the importance of educating the end user. Combined with a strong administration and implementation team, this is a project I would support.

  • Rating: 8

    review by (only shown to members)

    This looks like a great project that engages local agencies and that will improve the health of the patients and community members.

  • Rating: 7

    review by (only shown to members)

    I like the straightforward approach to provide sanitation facilities in high-density areas. I really think this is a great chance to not only influence and promote HBC, but also address the issues of sanitation right on. That said, the technology and costs look very much aligned and at market value. So I think there is good value in this project, though I don't think this is a type of program where it can be replicated and scaled. Furthermore, the M&E is not as clear as I would have liked to see where the HBC can go with this project. For example, one person in the Q&A section mentioned about contribution from the health department itself--to me, materials, time and money are all important but what about ways to get the health and government officials to share in the learning from this project and do more on the governance/influencing side of things?

Name Status Completion Date Amount Assigned
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Ixil health clinic in Quechip Complete - Successful Jun 2013 $5,973
Ixil health clinic in Tujolom Complete - Successful Jun 2013 $5,973
Ixil health clinic in Xepiun Complete - Successful Jun 2013 $5,974