Health

PEFO promotes both preventive and curative measures in granny households to ensure good health. Under public health hygiene and sanitation among grandmothers are maintained through periodical health promotion exercises in the community and with the community where minimum standards are emphasized; latrine, kitchen, drying line, and utensil rack. Until 2013, PEFO has been providing clinical health services to mainly caregivers/grannies through working with other agencies in health service delivery to facilitate direct medication and periodic referrals. Medical camps and mobile clinics are some of the approaches that PEFO uses to make health care accessible and affordable by grannies.

Of recent, PEFO works with government health centres within the proximity of granny communities in a way of empowering them in the long run to respond to the health needs of older persons. One of the major projects here is the Granny Health reserve pool where grannies save UGX 1,000 on a monthly basis. PEFO tops up this fund and uses it to enable grannies access drugs and medication that are not available in government health centres within their communities.

We have been able to establish a productive working relationship with the Jinja district health department. Together, we are working on empowering health workers to serve older persons effectively through numerous trainings, encouraging health centres within Jinja district to develop and implement own older persons’ policies to guide their interaction with and service to older persons. The objective is geared towards behavioral change; that health workers will start looking at older persons with a right to be served and a right to receive quality services just like any other citizen and on the other hand, grannies (older persons), will start appreciating seeking health care from health centres and quit self-medication.

Livelihood

The focus here is ensuring food and income security in target caregiver households using community driven and sustainable approaches. The program draws a lot of support from community based farm school in promoting agricultural livelihoods in both crop and animal husbandry among grannies following the innovative revolve approach (Revolve a seed, a sucker, a goat, a pig), value addition and marketing skills while streamlining aspects of age, HIV/AIDS, climate and gender in her implementation. The livelihood projects centre around; Promoting indigenous foods among caregivers households; Increasing the availability of food by sustainably increasing agricultural production and productivity; Improving access to food by meeting immediate food needs and addressing; ensuring longer-term accessibility through sustainable livelihoods; Increasing availability and access to quality nutritious food by diversifying diets while integrating nutrition and food safety considerations; Increasing stability of food security by strengthening sustainable management of the food value chain and promoting research and development to broaden and deepen publicly available significant improvements to food security outcomes among caregivers.

Main intervention areas under livelihoods & community development:

Revolve projects

Granny households are given an IGA asset of their choice (commonly grannies have chosen goats, pigs, cows, banana suckers, and seeds). The revolve project model is hinged on a practice that 50% of grannies receive the initial disbursement of any of the IGA assets except for the seeds which are received by all. The first 50% beneficiaries are expected to give back to the project from the initial harvest or produce. For seeds, they give back 10% of the harvest; this harvest is re-distributed among the weaker grannies with less ability or labour to grown own food. In the case of animal, grannies return 2 piglets and one kid to the project. These are again monitored at the farm school, treated and revolved back to other granny households that did not benefit from the initial distribution. These assets are given to grannies after numerous training's in managing them and income generating. The essence is that grannies use these assets to supplement on their earnings from other income sources. Maintenance of these assets is closely supervised by both granny leaders (livelihood committees to be specific) and field staff. A monthly report on the status and profitability of these assets is submitted to the project staff.

Granny Micro-credit scheme;

Until 2013, the Micro credit department was providing small loans and trainings in savings and Business management for grandmothers and HIV-positive women to start their own small businesses such as coffee bean buying, drying and selling, vegetable gardening, clothes trading and raising livestock. The women would pay back their loans (plus 3% interest) in bi- weekly installments over a four months period, and put small amounts of money into savings. Many of the women were able to start thriving farms or businesses and have found that they experience less stigma and discrimination because of their new established productive status and relatively consistent income. The isolation they earlier suffered from main stream micro finance institutions that regard them as “credit risk” lessened after the introduction of small soft loans by PEFO. However, in 2013, the department took on a new approach which entails empowering grannies to make weekly savings through their clusters of 20. The clusters are registered at respective sub county levels as SACCOS. To date, 620 grannies have joint bank accounts in friendly commercial banks where they deposit weekly savings from members. The grannies have been encouraged to save from every little income and from these savings; they lend to each other and pay back with an interest. The dividends are divided among members every end of year.

Adopt a goat project

This project is specifically tailor made for teenage mothers in Busia district. It was started as an emergency response to the rapidly growing number of child and teenage pregnancies reported frequently in the national media. The UDHS Report, 2000/01 also singles out Busia district as a district with the highest percentage of teenage pregnancies and childbearing at 37% in the whole of Uganda which has over 100 districts. The project was therefore established to help uplift the status of, and empower the single teenage mothers.

The project uses “a goat” as a tool to economically empower teenage mothers to provide for themselves and the babies. The goat ceremonies are on the other hand used as platforms for educating the general community mostly parents and community leaders on the need for them to take front stage in mitigating factors leading to teenage motherhood but also adopt healthy and humanistic approaches in dealing with such cases when they occur. The project supports teenage mothers regain their self esteem after unplanned pregnancies and dropping out of school by giving them a chance to return to school.

Peer learning

Peer learning is a very key component in all livelihood interventions. Our livelihood approaches encourage information and skills empowerment as opposed to handouts. This way of working with grannies places training at the centre. So often we bring in external trainers to train our grannies but we also so much emphasis the role of learning knowledge sharing among grannies. Each group of grannies is responsible for the progress of its members. Home to home follow ups are conducted by grannies to assess application of new knowledge learned.

Webonereku Women’s project (Fireless cookers)

This project is managed by a group of 22 women who make cooking bags. These bags save 80% of cooking fuel that would otherwise be needed to cook in their absence. The project arose from the need to find a remedy to the overwhelming rural cooking challenges majorly faced by women. Fuel concerns go beyond the increasing financial and time costs.

The environmental changes resulting from rapid deforestation have prompted periods of drought and food shortages and these weigh heavily on the subsistence farmers who make up the majority of this community (86% of the national population). In addition to being unable to feed themselves during periods of drought, many lose their only additional source of income –the sale of surplus food. Some efforts have been made by the community to address the above problems. Lorena stoves were introduced by many local NGOs to reduce fuel consumption and smoke production but their adoption is low and their effectiveness to meet the above needs has not been proven.

For this group, much deeper knowledge and understanding of the problems and potential ways to address such challenges so they themselves can arrive at a solution which best addresses their needs and be in a position to adapt that solution as circumstances change over time. In addition, the necessity for sustainable income generating projects which do not rely solely on the performance of crops was another ground for this venture.

Members of Webonereku Women’s groups have demonstrated the will, creativity and determination to address these problems. Over a period of 2 years (2012-2013), the women have worked with PEFO to understand and produce variety of fuel efficient technologies. Local and international knowledge and experience was drawn on. The fireless cooker is based on the principal that if food is placed in an insulated container after being only briefly boiled the retained heat will finish the cooking process without additional heat being required.