Meet the Team

Zaam Community Health Development Organisation (ZACHEDO) was started initially in 1993 as a health component called Zaam clinic for implementing health facility based interventions and providing curative/ treatment services to outpatient children and disadvantaged adults living in the slum communities within Makindye division. As the demand for inpatient and maternity services increased, Zaam clinic was expanded to Zaam Medical Centre providing a comprehensive health care package with an inpatient capacity of 20 beds. However from the analysis, 75% of the disease burden handled at the health facility could be prevented by the community itself at household level once given the necessary knowledge and skills. It was also noted that the high poverty levels within the urban slum communities created a barrier to the access of quality health care. Therefore in 2011, ZACHEDO was formed and it attained a legal status as a fully registered Community Based Organisation. (CBO).

Strategic Plan 2016 – 2020.

The strategic plan has been developed to provide a road map for the next five years and at the same time ensure that the plan is in line and contributes to the plans of KCCA: Makindye Division, the National Health Policy II, the National Health Sector Development Plan 2016-2020, and the UN-Sustainable Development Goals..

Vision:
A healthy community free from preventable causes of ill health and death. Zachedo’s approach to resolving community problems is to work with communities themselves especially women because “WHEN YOU TEACH A WOMAN, YOU TEACH A NATION”.

Mission:
To empower disadvantaged communities (particularly women) in urban slums to overcome preventable causes of ill-health and deaths through economic sustainabilty . health promotion and disease prevention programs.

Core values:

1. Transparency and accountability: In all our transactions we ensure transparency and accountability with clients and partners.

2. Quality service: we are obliged to provide quality service in whatever we do.

3. Strategic partnerships: ZACHEDO is not a jack of all trade. It values partnership with donors,institutions,ministries, CSOs, the private sector and other CBOs to provide synergy or support and avoid duplication.

4. Integrated health care delivery:To be effective and achieve impact with our interventions include health promotion, disease prevention and curative care.

Principles:

1. Community involvement for sustainability: In order to attain a critical mass and sustainability for our interventions, we involve communities/households in decision making for their health particularly in health promotion and disease prevention.

2. Equality and non-discrimination: All human beings are equal and entitled to their human rights without discrimination of any kind, such as race, color, sex, ethnicity, age,language, religion, political or other opinion.

3. Pro-poor: we strive to ensure the right of disadvantaged slum communities to enjoy the highest attainable standard of physical and mental health.

4. Team work: we believe in team work.

5. Gender-sensitive: we are gender-sensitive and responsive to gender issues in health delivery. We endeavor to disaggregate health data by age and sex and carry out gender analysis on the results in order to enhance the effectiveness and efficiency of our interventions.

Goal:
To contribute to the reduction of morbidity and mortality due to communicable and preventable diseases/conditions among disadvantaged communities living in urban slums of Kampala city, Wakiso and Iganga
districts of Uganda.

Strategies.
1. SO1 – To reduce morbidity and mortality arising from preventable
causes of ill health through integration of health promotion and disease
prevention interventions into curative services.

2. SO2 – To expand a community based health approach to health service
delivery within the urban slums of Kampala and beyond to Wakiso/Iganga
districts.

3. SO3 – Strengthen Zachedo’s capacity to mobilize technical, material and
financial resources to subsidize quality health care for the poor.

4. SO4- To enhance community’s social-economic status through building
capacity for entrepreneurship skills,vocational skills training and formation
of savings co-operatives for micro-enterprise development.

General Objectives:
1. To involve disadvantaged communities in urban slums in identifying root causes of morbidity and mortality through problem identification, priority setting, developing plans of action, managing and evaluating interventions.

2. To promote individual and community responsibility for better health through behavior change, capacity building, participatory planning and governance amongst marginalized groups living in urban slums of Kampala Wakiso and Iganga districts of Uganda.

3. To increase access to integrated health promotion, disease prevention and curative initiatives with a focus on malaria, HIV/AIDS, STIs,TB, Cholera, Dysentery, Ebola, maternal and child health, adolescent sexual and reproductive health rights, access to water and sanitation amongst the vulnerable groups living in urban slums of Kampala city, Wakiso and Iganga districts of Uganda.

4. To strengthen co-ordination and collaboration of interventions with key partners such as government line ministries, local governments and other relevant stakeholders that promote health for disadvantaged communities in urban slums of Kampala city, Wakiso and Iganga districts of Uganda.

5. To generate, document and share best practices of primary health care and community based health care approaches for communities in urban slums with emphasis on health promotion, disease prevention and early health seeking behaviour.

6. To advocate for appropriate policies and strategies that promote better health for disadvantaged communities living in urban slums of Kampala, Wakiso and Iganga districts of Uganda.

7. To spearhead the planning, implementation, monitoring and evaluation of projects managed by the Organization funded by donor agencies and/or members at all levels.

8. To engage in resource mobilization to enhance health and development initiatives amongst disadvantaged communities in urban slum areas of Kampala city, Wakiso and Iganga districts of Uganda.

Priority Intervation Areas.

To achieve its vision and mission, the ZACHEDO provides technical support in its thematic areas to the vulnerable and marginalized groups living within the urban slums and rural areas in Uganda. These mainly include children, adolescents, women, sex workers and refugees. Our key focal areas are as listed below:

• HIV/AIDS
  In Uganda HIV/AIDS remains one of the main causes of high mortality rates. The HIV epidemic in Uganda is generalized and mature with an average HIV prevalence rate of 6.4%. The prevalence rate is higher in urban (10.1%) than in rural areas (5.7%) and higher in females than males. The main modes of HIV transmission are sexual intercourse (75%) and mother-to-child transmission (18%) multiple sexual partners. Low condom use, high prevalence of herpes simplex virus type 2 (HSV-2) and other sexually transmitted infections, gender inequality, poverty, low knowledge of one’s HIV status are critical factors driving the epidemic. HIV fuels the tuberculosis (TB) epidemic; 60 per cent of the TB patients are found to be HIV positive and 30 per cent of deaths among people living with AIDS are attributed to TB.
  ZACHEDO’s key focal area with respect to the HIV/AIDS epidemic is to provide prevention, care and treatment support programs. This includes HIV counseling and testing, enrollment of positive clients into care, life skills and sustainable livelihood development.

• MATERNAL AND CHILD HEALTH.

In Uganda, children below 15 years and women of child bearing age constitute 46% and 20% of the population respectively. Maternal deaths remain high with a maternal mortality ratio (MMR) of 435/100,000 The rate of reduction of MMR is slow, and far from the UN-SDG target of 131 by 2015.The leading direct causes of these deaths are hemorrhage (26%), sepsis (22%), obstructed labour (13%), unsafe abortion (8%) and hypertensive disorders in pregnancy (6%). The major determinants of MMR are the high fertility rate (6.7), high rate of adolescent pregnancy (25 percent), low contraceptive prevalence rate (24 per cent), low proportion of deliveries supervised by a health professional (42 per cent), and inadequate access to emergency obstetric care (EmOC). Lack of decision making at household level by women affects their health seeking behavior even during pregnancy. The referral mechanism faces challenges of poor road networks or terrain. Infant and under-five child mortality rates stand at 76/1,000 `and 137/1,000 respectively. Neonatal deaths which occur in the first month of infancy contribute to 38% of all infant deaths. Over a half of the total newborn deaths occur during the first week of life, mainly in the first 24 hours of life. Majority of newborn deaths result from infections (febrile illness), asphyxia, birth injuries and complications of pre-maturity. Low birth weight underlines 40-80% of newborn deaths. Malaria/febrile illness (49%), neonatal causes (14%), diarrheal disease (10%), acute respiratory infection and HIV/AIDS (4.0%) are the main causes of childhood morbidity and mortality. Malnutrition is an important underlying cause in around 60% of child deaths (UNICEF, 2012). An estimated 20% of under-fives are underweight and 32% are stunted.
ZACHEDO’s interventions on improving maternal and child health include youth sensitization programs to prevent recourse of unintended pregnancies which lead to unsafe abortions, child nutrition and immunization programs, increasing access to antenatal care services and safe deliveries.

• ADOLESCENT, SEXUAL AND REPRODUCTIVE HEALTH RIGHTS
  Adolescents (15-24 years of age) constitute 34% of the population. Cultural beliefs and norms make adolescents vulnerable to sexual and reproductive health complications including the high prevalence of STIs/HIV/AIDS. Adolescents lack knowledge and life skills to protect themselves. Adults shy away from discussing sexual matters with them. Only 47% of people report discussing sex with family members, while 63% report discussing sexual matters with their peers. As a result there is a high rate of teenage pregnancy of 32% leading to school dropout or seeking illegal abortion as well as other complications. Urban slum areas are high refugee resettlement areas and in addition attract young immigrants from rural areas with the hope of experiencing a lavish city life. With little education and practical skills development these youth are highly involved in prostitution, drug use as income generating alternatives.
  ZACHEDO works to improve access to youth friendly health services as a vital component for ensuring sexual and reproductive health (SRH) and well-being of adolescents. The service provision approach involves the use of a combination of trained health workers, peers, adolescent-friendly facilities and broad information dissemination via the community, schools, and mass media.

• WATER AND SANITATION
  In the slum community garbage is dumped onto the roads and left there for weeks before it is collected. Smelly sewage coupled with used polythene bags fill the open drains. It is not uncommon to see some women cooking food next to a pit latrine. People do not seem to mind about their hygiene at all yet the human body requires clean water, a safe environment, and basic hygiene for its maintenance and protection from disease. Every day, approximately 4,500 children under age five die due to unsafe water and sanitation practices. People Living with HIV (PLHIV) are more susceptible to infection. Clean water, appropriate sanitation facilities and basic hygiene practices are essential for the prevention and control of infection.
  ZACHEDO implements activities for improving quality of drinking water, provision of sanitary latrines, and improving cleanliness and hygiene practices such as hand washing before eating and using a pit latrine. Studies indicate that safe water and sanitation interventions reduce morbidity and mortality: for example, water treatment using chlorine products at the point-of-use can lead to a reduction of diarrheal episodes by 35 to 39 percent; improved sanitation can reduce diarrhea by 32 percent; and promotion of hand washing can result in a decrease in diarrhea cases by as much as 45 percent.
• ECONOMIC EMPOWERMENT AND SUSTAINABLE LIVELIHOOD DEVELOPMENT.
  Communities especially women are engaged in economic employment programs to create sustainable livelihoods. As ZACHEDO we believe women's increased earning capacity, in turn, has a positive effect on children's nutrition, health and educational prospects since women invest first in their families.