GHARF Background

Global Health Awareness Research Foundation (GHARF) is a non-governmental organisation (NGO).  GHARF was founded in 1996 by a group of concerned individuals who through field research identified gaps in health care delivery and education particularly in the area of information dissemination on sexuality and reproductive health and rights and communicable disease transmission in rural communities, especially as it  relates to adolescents and women.

 During Prof. Nwaorgu’s sojourn as a Takemi Fellow, at the Harvard School of Public Health, she had been advised by both Dr. Cash and Dr. Rachel Snow to register an NGO on her return to Nigeria. This would enable her source for funding from donor agents in USA and other countries since they will not readily fund programmes through the government in Nigeria because of military rule in the country at the time. Based on this advice and subsequent discussions with Mrs. Nike Esiet (who was attending a summer school at the Harvard School of Public Health) and Prof. Friday Okonofua (a visiting fellow in the Department), Prof. Nwaorgu used the resources available at the Harvard School to develop a proposal on Adolescent Sexuality and Reproductive Issues.

 Prior to the above, in Nigeria, a WHO communicable disease research team comprising Dr. Onyegegbu, Dr. Okeibunor, late Dr. Madu and Prof. Nwaorgu was already in place carrying out projects in various communities in Enugu State. This crop of individuals through their long-standing experience in community-based programmes appreciated the problems encountered by adolescents and women. Their desire to contribute positively to the reduction of sexuality and reproductive health problems, and communicable diseases, especially among adolescents and school children in various communities in Nigeria through correct information communication was paramount in initiating the idea of having an NGO. The name GHARF was coined in September 1995 by Prof. Nwaorgu, Dr. Okeibunor and Dr. Ephraim Madu while attending a WHO protocol development workshop in Addis Ababa, Ethiopia.

 While the procedure for the registration of the organization with CAC was being initiated by Prof. Nwaorgu, she also submitted the proposal developed in Harvard to MacArthur Foundation under the institutional grant through the British Council in October, 1995. By March 1996 the organization had been fully registered with the CAC in Abuja.

 The inaugural meeting of GHARF was held in September 1996 in our old office at 84 Ogui Road, Enugu. The following members were in attendance at this meeting: Prof. Nwaorgu, Dr. Okeibunor, Prof. Nkechi Eneobong, Dr. Onyegegbu, Dr. Anozie Ozumba and Prof. Ofomata. At this meeting the objectives and goals of GHARF were presented to members present for endorsement.

 GHARF started its activities in 1996 in partnership with a Corporate Organization, Smith Kline Beecham, in the area of deworming of school children with antihelminth drug (Zentel) for improved growth. This activity took GHARF to five schools in Ogwogo Nike, Amagunze and Gabon Camp. It was during their visit to Gabon Camp community that members encountered at first hand the stark problems and resolved to tackle them by intensifying awareness activities on adolescent reproductive health issues and deworming activities. Teenage pregnancy was a huge problem in Gabon Camp. With the lack of health facilities, these young teenagers depended solely on Traditional Birth Attendants (TBA) in the community for child delivery.  GHARF initiated a sensitization workshop for in-school adolescents from 20 post primary schools from Ebonyi State in collaboration with ANPPCAN on adolescent sexuality and reproductive health issues. In September, 1996 our proposal was approved by MacArthur Foundation but it was subject to a visit by Dr. Leni Silverstein, the Senior Programme Officer, for MacArthur Foundation in Chicago. This visit finally took place on the 19^th of February, 1997. Following Dr. Silverstein’s visit, GHARF received her first Institutional Grant from MacArthur Foundation in June 1997.

 The purpose of the grant was to institute peer education programme in post primary schools in Enugu State. This therefore was our starting point in adolescent “peer education” as an effective approach for reduction of sexuality and reproductive health problems including HIV/AIDS through correct information communication.

 Our activities were however not restricted to peer education alone. Massive public awareness, sensitization and education were paramount during the early days. Hence in May 1998, GHARF in collaboration with Planned Parenthood Federation of Nigeria (PPFN), Society for Family Health (SFH), Women and Youth Sustainable Development Organisation (WYSDO) and Enugu State Ministry of Health, organised a one day “Health Life” rally for in-school adolescents from 40 post primary and vocational schools in Enugu State at the Enugu stadium. The purpose of the rally was to sensitize, mobilize and educate adolescents on common health problems that endanger their lives and future. To ensure adolescents participated fully, a combination of inter-educational drama, role-play, quiz and songs were used to depict the consequences of risky adolescent sexual behavior. Participating schools were quizzed and the best schools went home with a plaque. All participating schools were also presented with certificates. This memorable activity was jointly sponsored by the participating organizations and Enugu South Local Governmental.

 Also in 1998, a sensitization and education programme on SRH was organized in collaboration with Rotary Club of Ekulu for all post primary schools in Achi, Oji – River Local Government. This event took place at the Corpus Christi College, Achi.

 Why GHARF

While carrying out research activities in some communities in Enugu State, researchers and professionals who make up the GHARF team became more aware of the poor reproductive health outcomes (teenage pregnancies, death due to illegal abortion, harmful traditional practices) and communicable diseases (malaria, helminthiasis, schistosomiasis etc) in various rural communities among children, adolescents and women. These problems were exacerbated by poor education and traditional beliefs. This gap in adequate health information motivated the GHARF team to develop a campaign to disseminate information on sexuality and reproductive heath (SRH), and communicable diseases. This is in view of the fact that government alone will be unable to reach some of these remote communities with information without contribution by other stakeholders. 

What has been GHARF’s Role

GHARF’s main goal since establishment in 1996 has been to contribute towards the reduction of teenage sexual activity, improve reproductive health outcomes and reduce communicable diseases among adolescents, children and women in rural communities. Research has confirmed that more than 150 out of every 1000 girls give birth before the age of nineteen. From GHARF’s current survey, some of the reasons for this include mistake and accident (53%), poverty (14%); lured into it (14%) and other (20%). Teenage pregnancy has resulted in high mortality and morbidity rates from unsafe abortion, with over 80% with abortion complications. Also it is estimated that 72% of all deaths among young girls under 19 years and 50% of Nigeria high maternal mortality rates are among young girls who procure unsafe abortion. GHARF’s contribution therefore is to avert adolescent mortality and morbidity due to sexuality and reproductive health in our society.

 GHARF believes in evidence-based approach for problem solving. This is why a needs assessment or situation analysis precedes any intervention in all GHARF activities. This helps to lay the foundation and establish the baseline,  and also ensures that beneficiaries are fully involved in planning and information delivery. Hence, GHARF’s spectacular achievements in this endeavour since the beginning. Indicators/check lists are developed and used for programme monitoring in all cases.

 GHARF’s baseline survey on sexuality and reproductive health issues in 11 schools in Enugu State in 1997/1998 provided immense information on why adolescents and women are vulnerable to certain negative risky behaviour in our society. 

GHARF Objectives

·    To improve information dissemination on sexuality and reproductive health issues including HIV and AIDS and other communicable diseases e.g. malaria, through the use of trained peer educators, media programmes, drama, fact sheets, posters and brochures among youth and other community members.

·    To increase public awareness and health education campaign on sexuality and reproductive health issues including HIV/AIDS, tropical disease prevention and control in schools and communities through formation of school health clubs and community-based organization.

·    To increase the economic base of adolescents and women through income generation activities and other poverty alleviation programmes, including micro-credit loans.

·    To decrease the level of teenage pregnancy and sexually transmitted infections, including HIV/AIDS, among adolescents and youths.

·    To scale up Family Life and HIV/AIDS Education (FLHE) in Enugu State at all levels in collaboration with Enugu State Ministry of Education.

·     To improve women and adolescents skills in advocating and lobbying for participation in decision-making and enforcement of laws on Harmful Traditional Practices in various communities.

·     To increase awareness and knowledge of parents, teachers, guardians, policy makers, media practitioners, and other community members on sexuality, reproductive health issues and rights.

·     To work and build coalitions and partnerships with the public and private sectors, international and local NGOs and CSOs, share information on sexuality and reproductive health issues and communicable diseases control.

Strategies Adopted for Achieving Organizational Objectives

1.       Education

·        Peer education

-         In school adolescents

-         Youths in communities

-         Women  Community Based Organisation (CBO) members

·        Public Education and Sensitization Workshops

-    Workshops for parents, guidance counsellors, community members, Faith Based Organisation, media practitioners

-     Radio and TV programmes including jingles, drama.

-     Newsprint

-     Women August meetings

2.       Capacity Building

-    Computer training for in-school adolescents

-     Income generation activities: cosmetology, bead, hat and soap making and confectionary for out-of-school youth and young widows

-     Life skills training for youth, in and out-of-school adolescents and women

-     Leadership training for women CBO members

-     IEC materials development

-     Teacher training for FLHE implementation in schools

-     Inspectorate Division and PPSMB staff for monitoring FLHE teaching in schools

3.       Advocacy and Policy Issues

-     Policy makers at various levels e.g. Government officials in the Ministries, Traditional rulers, Local Government Chairmen, School Principals and Head Teachers.

4.       Research and Documentation

·        Operational research activities including monitoring and evaluation

·        Consultancies

·        GHARF newsletter, fact sheets etc.

5.       Service Provision

·        Library service for adolescents

·        Recreational service for adolescents

·        Counseling and medical service

6.       Annual Review Workshops

Interactive and learning of best practices from each other for beneficiaries at all levels.

7.       Networking, coalitions and partnership building

·        Exchange programme for peer education (in and outside Nigeria)

·        Learning visits to other NGOs for GHARF staff.

8.       Organizational Institutionalization

- Staff development in and outside the organization

- Attendance at workshops

- Capacity development

- In house – seminars

- Training in FLHE implementation

- On job training e.g. computer training, community mobilization and

   sustainability, 

            - Attendance at local and international conferences and presentation 

              of scientific papers.

9.       Gender and Rights Training

    - Women CBO’s on lobbying and advocacy

    - In and out of school adolescents

GHARF activities are carried out in the following Thematic areas:

-         Peer Education

-         Reproductive Health and HIV/AIDS

-         Gender and Rights

-         Poverty Alleviation/Income Generation Activities (Integrated Reproductive Health Activities)

-         Research and Documentation

-         Information Dissemination/Publication

Achievements 

1.       The in-school peer education programme which started with training of 220 peer educators in August 1998 now have over 8000 members in 50 primary and post primary schools in Enugu State. Peer education instituted in schools as reported by most of the principals have brought dramatic changes in schools hence most of the GHARF peer educators were appointed school functionaries.

2.       The peer educators initiated a linkage through the formation of GPEN (GHARF Peer Educators Network). They meet three times every academic session. GPEN was officially inaugurated in December 2005. GPEN plans and execute their activities and have developed a system of reaching out to their members in each school.

A GHARF Forum was also formed by peer educators who have graduated from various post primary schools. This is to link them with peer education activities in various tertiary institutions.

3.       GHARF has successfully partnered with the public sector in carrying out Family Life and HIV/AIDS programme in Enugu State. Capacity of about 490 teachers and 30 inspectors and PPSMB staff were built for teaching and monitoring FLHE teaching in schools respectively. GHARF also facilitated the development of the integrated scheme of work for FLHE.

4.       Both in-school and out of school rural adolescent girls have given testimony on how the income generation activities have impacted of their lives that of the families and communities. About 200 in-school adolescents in 8 post primary schools and 400 out of school adolescent girls in 9 communities have gained from the ICT and income generation activities, respectively.

Some CBO members reported that with the income generation skills, one can now feed well and contribute to the upkeep of their families and thereby changed their lifestyle. Most are now self-reliant-and can fend for themselves.

5.       GHARF was appointed a member of the Enugu State Poverty Alleviation Committee between 2004 and 2005 under the pioneer Commissioner for that Ministry. (Late Mr. Ogbonnaya Ike)

6.       GHARF trained women CBO members in GHARF communities have been successful in advocating for inclusion of their members in the community decision making hierarchy, e.g. Igwe of Ozalla has appointed two women as members of his cabinet.

7.       GHARF peer educators, guidance counselors and principals have reported decrease in teenage pregnancy among female adolescents in their schools, e.g. Obioma High School has this to say “since inception of the peer education programme”.

8.       When this programme started in 1998 there was lack of trust of guidance counselors by students who called guidance counselors “basket mouthed”. Now there is improved relationship between guidance counselors and students.

9.       GHARF has intensified its community intervention on Harmful traditional practices (HTPs) including FGM in 8 communities in Enugu and Ebonyi States through capacity building for women CBO members on lobbying and advocacy and radio programmes and jingles.

10.     Two GHARF peer educators were selected for the Life Vanguard Osogbo, British Council/VSO 6 month’s leadership exchange programme to UK (3 months) and Nigeria ( 3 months).

11.     Using the PRSHH programme, 82 out-of-school youths in intervention sites were reached and with multiplier effect, they also reached 3509 peers within 10 months leading to an increase in SRH knowledge among out of school youths in the state.

Appreciation

 GHARF has recorded many achievements because of the relentless effort, sacrifice and contribution of some individuals and groups.  

First we thank God for leading us through the journey so far and for giving the founding fathers the vision to decide to contribute to community and humanity service. These individuals, mainly the members of GHARF advisory board, volunteered two days every week to travel to various schools and communities for baseline data collection without receiving any stipend.

 GHARF wishes to express appreciation for the contribution of its members of Board of Trustees, especially the Chairman Dr. Nwakoby, for their diligence in guiding our policy implementation and ensuring GHARF is on course in advancing its objectives.

 GHARF wishes to express appreciation to her staff – programme and support staff for their ability to cope with all the demands posed by GHARF programmes, including the challenges experienced during its execution.

At the onset there were only four programme and support staff in the organization plus two co-opted from Joe Nwaorgu and Associates Office (Ms Patricia and Mrs. Ogonna Uwaezuoke). They included our devoted and efficient secretary Ms Mary Nwanji, Mrs. Dympna Ogbuagu (Nee Amadi), Ms. Helen Ani, Mrs. Maurine Okolo and an NYSC member (Dr. Henry Ajala). These individuals received a stipend of N2,000 as their monthly salary. Presently the organization has grown over years from three programme staff to twenty-nine. GHARF wishes to thank its entire staff both past and present, both permanent and volunteers, for their contribution and commitment in seeing the organization through. It is worth mentioning that some of these staff has now moved up to greater heights. We give Glory to God for this!

Worthy of mention are our stakeholders especially in the public sector. GHARF wishes to thank the members of the “think tank” committee on FLHE who through their efforts and commitment have ensured that the partnership between the public sector, specifically the Ministry of Education, and GHARF was fostered. GHARF wishes to thank in a special way the Hon. Commissioner for Education, Dr. Martin Chukwunweike, the Hon. Commissioner for Women Affairs, Princess Peace Nnaji, Hon. Commissioner for Health, Dr. Idike, Hon. Commissioner for Human Development and Poverty Alleviation, Mr. Osita Ogwuoti, the present Permanent Secretary MOE, Mr. Nwaebim and his predecessor Mrs. Regina Emehelu, the Head of Service Chief Clement Okwor, under whom the partnership was initiated. GHARF deeply appreciates the School Principals, Head Teachers and Guidance Counselors in fifty schools where GHARF instituted its peer education programme. The Zonal Educational Officers in the 6 Educational Zone in the State especially Chief C. A. N. Okorie in Agbani Educational zone, who was one of our pioneer principals, and the PPSMB team. The Traditional Rulers, LGA Chairmen, Priests and Rev. Fathers. GHARF also appreciates the peer educators in various schools, the out of school youths and the women groups in various communities where GHARF has its programme. GHARF will not forget the officials of the GHARF peer educators clubs in various schools, officers of GPEN and GHARF Forum.  Without these individuals carrying out our programmes, out success to date would have been very difficult.

 Also worthy of mention are those who helped GHARF at the initial stages by scrutinizing our programme and advised us on how things could work better – these include Ms. Fiona Dubley of British Council, Mr. Bright Ekweremadu (SFH), Cecilia Asogwa (DEC) Mr. S. Anom (UNICEF). Mrs. Nike Esiet (AHI); Dr. Delano (AR).

 GHARF achievements could not have been a reality without technical and financial support from our funders who believe that the work we are doing is helping to bring about change in Nigerian society. Their investment in GHARF demonstrates their confidence that funds will be well utilized. GHARF would in particular like to acknowledge and thank the MacArthur Foundation, The Ford Foundation for West Africa, Global Fund for Women, World Bank, UNICEF, Rainbow♀, UNDP, IMO, MSA, DFID, PATHS, Pathfinder, Action Aid Nigeria, SFH, and US Embassy through the Ambassador’s project. GHARF will also remain grateful to numerous local donors who have contributed immensely in both cash and kind in our activities. This includes the Rotary Clubs of Ekulu and New Haven who went ahead to honour GHARF for her community effort. The former Chairman Enugu South LGA Prince Hon. Goddy Agbo, Smith Kline Beecham who started GHARF off through provision of zentel for the deworming of school children.

 GHARF wishes to thank NGOs in and out Enugu, who have encouraged, trusted and offered hands of partnership in all our activities inspite of high competition for funding – CIRDDOC, WACOL, WARO, Life Vanguard Osogbo, Dr. Ugwu, DEC, SWEWP, and Forward Africa. GHARF also wishes to thank our key print and electronic media supporters – particularly, Radio Nigeria, The Sun, Guardian, New Age newspapers.

 Lastly, GHARF  wishes to thank the Enugu State Government for providing the enabling environment for GHARF to carry out its activities in both the primary and post primary schools and various communities in the State, and much more for accepting to partner with GHARF in the implementation of FLHE in the State.

The Way Forward 

·     We will continue monitoring all the programmes even when funding from donors has ceased. Without monitoring, projects are abandoned by beneficiaries.

·     GHARF will be advocating for micro-credit support for its vocational skills beneficiaries and link them up with entrepreneurs and improve packaging of their products for various outlets.