1 PROGRAMMA DI INTERVENTO Istruzioni per la compilazione Il Programma di intervento è il formato standard per la presentazione delle proposte al Segretariato di AGIRE. Si tratta di una versione in parte semplificata del single form adottato da ECHO. Il documento va compilato in modo chiaro e sintetico, in lingua italiana o inglese, e deve essere inoltrato in forma elettronica al Segretariato entro 4 settimane dal lancio dell appello. Al Programma di Intervento devo essere allegati i seguenti documenti: Logframe Matrix, Budget di intervento e, qualora il soggetto implementatore sia un partner locale o l alleanza internazionale ovvero il capofila di un consorzio di associati, il relativo Accordo di Partenariato o Accordo di Consorzio. In aggiunta, si può allegare sintetica documentazione relativa al needs assessment condotto dall Associato. Il formato si basa sulla metodologia del ciclo di progetto (PCM). Prima di compilare la parte narrativa del Programma, si suggerisce di lavorare in modo organico sulla Logframe Matrix annessa. Qualora il programma sia multisettoriale, compilare un master logframe, che presenti il programma nel suo insieme e, a cascata, un logframe per ciascuno dei settori inclusi. Per maggiori informazioni sul PCM applicato a questo formato, consultare l ECHO Manual Project Cycle Management (June 2005) 1 e le Logical Framework Guidelines 2, Ulteriori indicazioni sull uso del formato sono disponibili sul documento di ECHO Single Form Guidelines 3. Per compilare il Budget di Intervento (anch esso costruito sul formato ECHO), si faccia invece riferimento alla Budget Nomenclature indicata nelle Budget Guidelines 4 di ECHO. In generale il budget iniziale può essere presentato con il livello di dettaglio indicato nel formato (titolo + capitolo: 4 digit), tuttavia il rapporto finale dovrà prevedere almeno 6 o 8 digit (titolo, capitolo, articolo, elementi). Appello /Appeal Associato - Consorzio 5 / Member Agency Consortium Titolo del programma / Programme title East Africa s Crisis Cesvi Providing basic emergency health services to host community and IDPs in Mogadishu. 1 Vedi 2 Vedi 3 Vedi 4 Vedi 5 Se consorzio, indicare il capofila e le organizzazioni associate consorziate.
2 Indicare un titolo il più specifico possibile [max 120 caratteri]. Sommario / Abstract Fornire riassunto giornalistico del programma: localizzazione, obiettivi, strategia, beneficiari, risultati attesi. [max 10 righe] The action will be taking place in Mogadishu, the pre-selected districts are Hamar Weyne, Karaan, Hawl Wadaaq and Wardhiigley.. The objective is improving the health condition of population living in the Capital of Somalia through the provision of basic health services. Fixed health facility and mobile teams will be functional to reach the beneficiaries in the fastest and most effective way. Beneficiaries will be the host community living in the selected district and the IDPs coming from South Somalia. During the implementation of the action, 10,500 beneficiaries will receive basic emergency health care. 1. ANALISI DEI BISOGNI / NEEDS ASSESSMENT 1.1 Periodo di assessment / Date(s) of assessment Indicare le date e il periodo di copertura del needs assessment. [max 5 righe] The rapid assessment took place in July 2011 for 5 days, 3 districts were assessed, Darkenlhey, Wajir and Hamar Weyne. Another assessment took place in August 2011 in Karan, Hawk Wadaaq and Wardhigley district. We are monitoring the data mainly on a daily basis, trying to cross them with different sources. 1.2 Metodologia di analisi / Methodology and sources of information used Specificare in quale modo è stata condotta l analisi e quali sono state le fonti di informazione utilizzate. [max 30 righe]. The needs assessment has been conducted taking into consideration the emergency context in which the intervention will take place: a team of 3 Somali staff (including one medical doctor) has been quickly recruited and deployed to the selected districts in Mogadishu, in order to assess the needs of the population. In the meantime, CESVI Regional Office in Nairobi staff has attended all the relevant coordination meetings selecting cluster according to sectors of intervention and gathered all the available information on the scenario in Mogadishu; the following data sources have been taken into account to draft the action: - FSNAU (Food Security and Nutrition Analysis Unit) - UNHCR (PMT data) - 3W matrix divided by cluster (WASH, Nutrition, Health, Food) - UNICEF available updated data on nutrition According to the information shared at cluster level, big gaps in terms of provision of health and nutrition services are still present in Mogadishu. Gaps have been recently increased by the huge influx of IDPs coming from South Somalia in search of humanitarian assistance. Starting from this background of information, the team carried out a rapid need assessment in Darkanley, Wadajir and Hamar Weyne Districts, focusing on the health/nutrition status of the host community and IDPs. Same kind of assessment has been carried out in Karaan, Hawl Wadaaq and Wardhigley districts. The data collected have been analyzed by CESVI health senior staff, already active in other Regions in Somalia and working in health and nutrition ongoing program. At the end of the analytical process, the data have been shared and cross-checked with relevant humanitarian actors also involved in Mogadishu.The emergency situation in Mogadishu is currently evolving on a daily basis. Hundreds of IDPs are gathering in the city every day, the locations of IDP spontaneous settlements change very quickly. Local Authorities are not following clear and straight rules, especially in terms of managing and coordinating the humanitarian interventions.
3 1.3 Definizione dei problemi /Problem statement Riassumere i risultati dell analisi dei bisogni, indicando le conclusioni più rilevanti ai fini della programmazione dell intervento. Qualora sia disponibile, allegare eventuale rapporto. [max 1 pagina]. The data collected during the assessment in three districts in Mogadishu report the following situation: - Very poor provision of basic health services - Very few health facilities are operating. Most of them are in very precarious conditions, either in terms of infrastructures either in terms of medical supplies - Lack of skilled health staff - Lack of quality drugs and medical equipments - Prevalence of GAM at critical level among IDPs (>=15%) and at serious level among host community (10 14%) - Influx of IDPs increasing on a daily basis (around IDPs entering into Mogadishu every day) - IDPs have no access to health facilities (it is very difficult for them to have access to the existing Health facilities) - Humanitarian response suffers from poor coordination, - Local Authorities are still weak in their role of Coordination Body - Presence of many LNGOs in charge of the main health facilities but without providing any services The situation reported by CESVI assessment team shows a critical situation in Mogadishu. A response is promptly needed, despite of dearth of coordination among the involved humanitarian actors, in order to prevent serious AWD/cholera outbreaks. In such a over-crowded urban context would be a humanitarian catastrophe (Official information regarding AWD/Cholera outbreaks are spread on a daily basis, most of them already confirmed by WHO. Furthermore, statistic analysis have always stressed that in Somalia the peaks concerning AWD/cholera outbreaks happen between the months of September and October). The data underline a huge gap in terms of primary health care and the difficulty/impossibility of reaching the existing health facilities for the IDPs; from this point, CESVI s intervention will be focusing on the rehabilitation of a fixed health structure in a crucial location of Mogadishu (probably Hamar Weyne District given the central location, number of beneficiaries and health facilities availability),, plus the set up of two mobile clinics in order to reach the most difficult areas (IDP spontaneous settlements and gatherings); CESVI is currently assessing districts recently freed by Al Shabaab, such as Karaan, Hawl Wadaaq and Wardhigley; an action developed in these ex AS districts would be extremely effective for the following reasons: - Very few Humanitarian Organizations are providing assistance in these districts - No possibility of overlapping or duplication with other Organizations; - Population originally displaced from these districts because lack of security and basic services would be in the position to come back to their homes The health staff in the fixed structure and in the mobile teams will be targeted with extra training in order to reach a fair level of updated skills; the lack of quality drugs available on the market will be compensated by purchasing a stock of medicines and medical equipment in Nairobi from certified suppliers to be delivered directly in Mogadishu through Humanitarian Flights, such as ECHO flights (European Commission). The mobile clinic system will be useful also as referral system to the other actors delivering different health services (nutrition, EPI, SC, etc.), such as SOS Kinderdorf, which runs a Hospital in Yaaqshiid district, easily reachable from Karaan, Wardinghiigley and Hawl Wadaaq districts. Local NGOs could be partners to develop awareness health and hygiene campaigns within host community and IDP settlements. 2. STRATEGIA GENERALE DELL ASSOCIATO / GENERAL STRATEGY 2.1 Strategia paese / Strategy in the country
4 Fornire indicazioni sulla presenza e il lavoro già svolto nell area o nella regione, dando particolare risalto ai collegamenti esistenti con il presente programma. [max 1 pagina]. CESVI is directly in Somalia since 2008, running projects in South Central, Somaliland and Puntland, but as Una s consortium member since April 2005 collaborating with UN-HABITAT in the Somalia Urban Development Programme (SUDP) to implement activities in the Solid Waste Management sector. At he moment CESVI is implementing a health program in South Central Somalia in the Regions of Mudug and Hiran, funded by different donors such as DG ECHO, CHF Somalia, UNICEF; four health centers are managed directly by CESVI in Mudug, providing basic emergency health services to the population and IDPs in rural and semi-rural areas of the Region, the other two HCs are located in Belet Weyne Town, where CESVI is running the facilities through a local partner, GEELO. In 2011 CESVI has added Nutrition and EPI components to the health program in Mudug, targeting children and mothers, thanks to a long term agreement signed by UNICEF, which will include CESVI in UNICEF strategy in South Central Somalia up to CESVI will be soon starting two new interventions in Mogadishu, one funded by Italian Cooperation and one by UNICEF; the Italian Cooperation funded project will be mainly focusing on WASH and Protection activities, while together with UNICEF a Child Protection project will be developed in the Capital of Somalia and also in Gedo Region, at the border with Kenya and Ethiopia. The 2 years PCA with UNICEF for nutrition and EPI in Mudug (that will be extended up to 2015) will be the key to integrate nutrition and EPI services (long term and very expensive programs) to the health intervention planned with this proposal, in order to have in few months a fully operational Health Post in the heart of Mogadishu, providing a complete health package to host community and IDPs. 2.2 Esperienze precedenti / Previous operations Indicare esperienze nell implementazione di programmi simili a quello presentato. Indicare quali lezioni sono state apprese da esse e come hanno influenzato la progettazione dell intervento proposto. [max ½ pagina]. As already mentioned above, CESVI has long experience in health program in South Central Somalia, where it is carrying out the following services to the population and IDPs: - Basic emergency health care - Nutrition Program (OTP) - EPI - Referral system The program has being developed in fixed health facilities and mobile teams in order to reach also the most remote areas and bring health services to the people, who cannot reach the centers. The ongoing health program did teach good practical lessons, especially concerning the start up of a health intervention in such an emergency situation; the best move is to establish a presence in the field through a Health Post, providing primary health services and then to add the extra components such as nutrition and vaccination. The reason to develop the program in this way is primarily because the basic health component is more feasible and effective in a short term scenario, while a component like nutrition cannot be developed in few months, given that after the admission of a child into the program, this can last up to 4 months, before the next admission. Also from a budget prospective, the start up of nutrition and EPI programs need a long term development given that the supplies necessary are very expensive and not easy to get in the field. 3. QUADRO OPERATIVO / OPERATIONAL FRAMEWORK 3.1 Localizzazione / Exact location of the operation Specificare esattamente dove viene realizzato il programma. The intervention will be taking place in Somalia, Mogadishu, some districts have been pre-selected during first assessment (see map no. 1): - Hamar Weyne District, Elgab Ambulatory (see pictures below) - Karaan District, Karaan MCH - Hawl Wadaaq and Wardhiigley districts, focusing on the area of the famous Bakara Market
5 According to the situation in the field, hundreds of new IDPs entering in Mogadishu every day, IDP settlements relocated continuously, dozens of Organizations starting activities on a daily basis, it is necessary to be flexible in terms of chosen district, that s why CESVI has been assessing (assessment currently still ongoing) different locations in order to avoid duplication and overlapping and maximize the available resources. Map no Periodo di implementazione / Implementation period Indicare data di avvio delle operazioni e durata del programma in mesi. L eleggibilità della spesa può anche essere retroattiva: in tal caso occorrerà specificare le azioni già realizzate nel successivo riquadro delle attività. The implementation period is from 1st September to 29th February The intervention will be benefiting of a CESVI/Other Donor contribution, which will probably become effective at the end of the first three months of AGIRE project, extending the whole program to a total duration of at least 9 months. 3.3 Beneficiari / Beneficiaries
6 Indicare: 1) stima attendibile dei beneficiari diretti (per settore di attività); 2) informazioni sulla popolazione potenzialmente interessata ( catchment population); 3) modalità di coinvolgimento dei beneficiari nella definizione, implementazione e valutazione del programma. [Max 1 pagina] Direct Beneficiaries: - According to CESVI health experience in South Central Somalia, a health post in a semi-rural area can receive an average of 25/30 patients per day; considering the Mogadishu scenario (urban emergency with big influx of IDPs), we can estimate at least 50 patients per day, that means a total of 7,500 visits for the months from October to February (September will be needed for rehabilitation of the facility and staff recruitment). The outreach mobile clinics will be reaching an average of 20 patients per day per clinic, which means a total of about 3,000beneficiaries. Direct beneficiaries Total=7,500 (fixed health facility)+ 3,000 (mobile clinics) = 10,500. Involvement of beneficiaries in the implementation and evaluation of the program: - Host community representatives have been consulted during assessment in order to choose the best location in terms of needs. - IDP leaders have been consulted to understand possible routes of mobile clinics according to location of IDP settlements around the district (still ongoing) - Ministry of Health has joined the CESVI assessment team in visiting the Elgab Ambulatory and discussing with beneficiaries and LNGOs present in the area, CESVI intervention has been welcomed very much - Evaluation questionnaire will be available (in Somali) to the patients to help them expressing their opinions about CESVI intervention - Community Health Workers will be selected within host community and IDPs to strengthen the link between health services available and beneficiaries; the CHWs will be very helpful to reach the most vulnerable groups (children and women) within the IDP settlements. 3.4 Settori di attività / Sectors of activity Specificare, sottolineandoli, i settori di attività del programma. Food security Non Food Items Water & Sanitation Rehabilitation/continuum Health Disaster preparedness & mitigation Nutrition Special mandates Shelter Specific actions Demining and awareness 3.5 Obiettivi generali / Principal objectives Specificare gli obiettivi generali a cui il programma intende contribuire. [Max 40 righe] The main objective of the intervention is to improve the health condition of host community and IDPs in Mogadishu. 3.6 Obiettivo specifico / Specific objective Indicare, per ciascun settore di attività, l obiettivo specifico che si intende realizzare. L obiettivo specifico deve essere uno solo per ciascun logframe. [Max 1,5 pagine] The specific objective is to provide basic emergency health services in Mogadishu 3.7 Risultati e indicatori / Results and indicators Definire gli output del programma, indicando per ciascuno di essi l obiettivo specifico a cui si riferiscono. I risultati sono sostanzialmente i prodotti finali delle attività intraprese. Aggiungere anche i relativi indicatori ( smart ) e le fonti di verifica per il successivo monitoraggio del programma. [Max 2 pagine] Result: - basic emergency health services are provided in Bakara Market area through fixed health post and 2 mobile clinics - 11Health staff involved in the action is trained and updated - enough stock of medicine and medical equipment is provided
7 - 2 Mobile clinics are functional within the selected district Indicators: - No. 11 of health staff/6 month operational in health post and mobile clinics. Drugs and medical equipments available throughout the project implementation - Average of. 30 of patients (disaggregated by sex and age) per facility (1fixed and 2 mobile) per day (total of 90 visits per day) - No. 11 health staff active in the health centre and mobile clinics - No. 2 of mobile clinics functional throughout project implementation Sources of verification: - Monthly report prepared by local staff involved in the action - Staff contracts and attendance sheets - Patient register - Register for correct/proper use of medical protocols - Drugs register - Mobile clinics logbook and register 3.8 Attività / Activities Descrivere le azioni che si devono intraprendere per ottenere i risultati sopra indicati e indicare una tempistica generale di realizzazione. Mantenere anche in questa sezione la suddivisione per settori di attività. [Max 3 pagine] Respect to the initial idea we are not going to do vaccination because EPI need a lot of time, specialized staff and more money (especially for cold Chain e relative equipment). As we are at an initial phase, it s better to coordinate for epi and nutrition programs with Unicef, leading agency for such kind of supplies. Activities: - Rehabilitation of health center: the health post will be rehabilitated in order to reach minimum standards for an health structure in an emergency context; a private contractor will be in charge to rehabilitate the facility, this contractor will be selected through a regular procedure according to the context. In case a health facility will not be available in the selected district, a house/building will re rented as temporary health facility and the funds allocated for the rehabilitation will be used in part to pay the rent; at the same time CESVI staff will be working with the community to select a building, which will be donated by the community as a fixed Health Facility (remaining funds, if necessary, will be used for rehabilitation of this structure) - Provision of drugs and medical equipments: according to the scenario, drugs and medical equipments will be purchased in Nairobi from certified suppliers to ensure quality of the products; the supplier is selected through a standard negotiated procedure launched by CESVI staff in Nairobi; drugs will be delivered to Mogadishu thanks to EC humanitarian flights connecting Nairobi to the Capital of Somalia - Awareness campaigns on Hygiene and health: awareness campaigns will be developed within the host community and IDPs to spread concepts concerning hygiene promotion and basic health; the campaigns will be carried out through CHWs and, most probably, an local partner (LNGO) in order to reach more beneficiaries - Health staff for fixed facility and mobile clinics will be selected in loco by a CESVI Doctor, in charge of the project implementation; two different kind of nurses will be selected, head nurses (1 each mobile clinic and 2 in the center) and auxiliary nurses (2 each mobile clinic and 2 in the center). Training will be provided by CESVI doctor - Start up of mobile clinics services: two vehicles will be equipped as mobile clinics and will be functional for all the project implementation; these clinics are useful to reach the most vulnerable groups (children and women), who cannot reach the fixed structure due to their weak condition. CESVI has a huge experience in delivering health services through mobile clinics, given that it has currently five teams functional in the field in South Central - Specific training on mobile clinic: specific training for staff engaged in mobile clinics will be carried out by CESVi doctor in the field - Provision of medical equipment to mobile clinics: mobile clinic specific equipment will be purchased and installed in the vehicles to meet minimum standards for emergency intervention
8 - Monitoring Mission: one mission will be carried out by CESVI Senior Staff based in Nairobi Regional Office to monitor and evaluate the project implementation 3.9 Monitoraggio e valutazione / Monitoring and Evaluation Indicare i meccanismi di monitoraggio e valutazione previsti dall Associato come complementari a quelli disposti dal Segretariato di AGIRE. [Max 1 pagina] The project will be directly implemented by CESVI local staff; the doctor in charge for the health activities is a high skilled Somali Doctor with huge experience in Somalia context, he has already worked with CESVI to develop the program in Mudug Region. The doctor will be benefiting of all the health tools developed by CESVI over the years in South Central Somalia for reporting and monitoring; some tools will be slightly modified and adapted to the urban context in which this intervention will take place in order to catch very sensitive data. The doctor will be sharing with the project manager in Nairobi all the health data and other important information (pictures, training report, staff attendance sheet, security reports) on a weekly basis, the PM will summarize all the info into a monthly report available to the donors and other humanitarian actors. A M&E mission will be carried out by the PM just before the end of the project in order to collect all the information needed to evaluate the global intervention of CESVI. Upon request of the CESVI doctor, the PM could travel to Mogadishu in advance to re-address the project in case of need. Cesvi logistician is going to deliver daily brief to the doctor in order to have always an up to date picture of situation. 4. RISCHI E CONDIZIONI / RISKS AND ASSUMPTIONS 4.1 Pre-condizioni / Pre-conditions Identificare le ipotesi favorevoli che devono essere soddisfatte prima che abbia inizio la realizzazione del programma. [Max ½ pagina] Assumptions: - Security situation in Mogadishu improves or remain stable - Local government ensures a stable presence - Community involvement in the project - Availability of skilled medical staff - Coordination mechanisms in place and functional 4.2 Analisi dei rischi / Risk assessment Identificare i fattori esterni che possono impedire il raggiungimento di obiettivi generali e specifici e la realizzazione delle attività previste. Definire per ciascuno di essi le strategie di risposta previste. [Max 1 pagina] Risks: - Major Epidemic outbreaks: strengthen referral system to Regional Hospitals - Movements disrupted by security threats: mobile clinics staff will be relocated in the health centre to reinforce services at the facility - Private health sector hostility: ongoing communication will be ensured for all the duration of the project to avoid misunderstanding and miscommunication - Unavailability of skilled medical staff: health staff will be selected in other regions and moved to Mogadishu - Major population movements in or out the project area: mobile clinics routes could be changed according to new displacements 5. SICUREZZA /SECURITY 5.1 Situazione sul terreno / Situation in the field Fornire una valutazione sulla sicurezza sul terreno relativa all attuazione del programma. [Max 30 righe]
9 The current security situation in Mogadishu is slightly improving during the last weeks. The Transitional Federal Government (TFG) has reinforced its presence in the districts of: - Dharkenley - Wadajir - Waberi - Hamar Jab Jab - Hamar Weyne - Shingaani - Boondheere The very recent withdrew of AL Shabaab (AS) from most of the districts previously under their control is a major defeat for AS. Mogadishu was a symbolic fight, and AS again recently announced publicly than more than 2000 fighters would join the Ramadan offensive to capture the city. This comes after a long series of difficulties for AS : Bin Laden and Fazul killing, the loss of two strategic towns of Bulo-Xawo and Dhoobley in South Somalia, the loss of some strategic districts of Mogadishu, especially the lucrative Bakara market, the difficult management of the famine, the continuous loss of community support and the deeper division among AS leaders. At the moment the following districts have been reported to have passed fully under AMISOM / TFG control: Hodan Wardhigley Hawl-Wadaag Shibis Karaan After having lost conventional fights, AS most probably will shift to guerilla tactics: IEDs, mines, suicide bombers, hit and runs attacks. In such a scenario, Mogadishu, although fully under control by AMISOM/TFG forces, could see an increase of such attacks. 5.2 Protocolli di sicurezza / Security protocol Riassumere i protocolli di sicurezza adottati dall organizzazione e quelli specifici messi in atto per questo programma. [Max ½ pagina] CESVI security procedures for South Central Somalia are in place and up to date on monthly basis or more often in case of need; some of them will be re-adapted to meet the needs for the Mogadishu scenario. The CESVI Regional Security Advisor (RSA) is based in Nairobi and will be monitoring the project in every step, mission to the field could be organized if necessary. The CESVI Logistician will be in charge to gather security information in Mogadishu, attend security meetings with Humanitarian Actors and Authorities and draft security reports on a weekly basis; all this information will be sent to the RSA for further analysis and sharing at Nairobi level. Four professional guards will be recruited by the logistician in consultation with the Doctor, after approval from RSA, who will analyze CVs and verify information; these guards will be full time employed at the health centre to guarantee security for beneficiaries and CESVI staff. 6. RISORSE NECESSARIE / RESOURCES REQUIRED 6.1 Budget di programma / Total budget Indicare il budget complessivo dell intervento e fornire eventuale giustificazione dei centri di costo considerati più rilevanti [Max ½ pagina]. The total budget is Main budget lines are: - Health centre rehabilitation: a light rehabilitation is needed to reach health minimum standards according to WHO regulations. - Mobile clinics rent: two mobile clinics are needed to reach the most vulnerable groups within IDPs, monthly rent is estimated around 1,500 per mobile clinic. 6.2 Risorse umane / Human resources
10 Indicate le figure di staff necessarie alla realizzazione del programma, evidenziando quali sono direttamente coinvolte nelle attività e quali svolgono invece funzioni di supporto. Specificare eventuale staff a livello di headquarters. [Max ½ pagina] Support Staff: - Project Manager (1), based in Nairobi, he/she will be the person in charge of the entire project Activity staff: - Logistician (1), based in Mogadishu, in charge of office management, drugs store management, transports, security, he/she reports to the PM - Doctor (1), based in Mogadishu, in charge of all the health activities, he reports to the PM - Nurses (4), skilled nurses will be operational in the HC (2) and mobile clinics (1 each mobile team), report to the Doctor - Auxiliary Nurses (6), operational in the HC and mobile clinics, report to head of nurse - Guards (4), they will be in charge for the security at the HC, they report to the Logistician 6.3 Risorse materiali / Material resources Indicare veicoli, equipaggiamenti e attrezzature da acquistare o noleggiare per la realizzazione del programma. Specificare le modalità di procurement e successivo hand-over. [Max ½ pagina] - Car rent: in Mogadishu used by Logistician, Doctor and PM (when in mission), it will be selected by Single Quotation - HC rehabilitation: contractor will be selected by negotiated procedure, if security will allow, otherwise a less visible SQ will be chosen - Drugs and medical equipments: supplier will be selected in Nairobi by negotiated procedure - Mobile Clinics Rent: selected by SQ in loco 7. SOSTENIBILITA E TEMI TRASVERSALI / SUSTAINABILITY AND MAINSTREAMING 7.1 Exit Strategy Indicare strategie di hand-over, coordinamento con organizzazioni e/o autorità locali, iniziative di capacity building,etc. The intervention will take place in a very emergency context, sustainability at the moment can only be ensured through humanitarian assistance. CESVI is already dealing with different international donors to guarantee a longer presence in Mogadishu. However CESVI is in contact with the Ministry of Health, who showed big interest for the project and has already come to visit the health facility during the assessment. CESVI will be carrying out training for the medical staff in order to enhance their skills to guarantee quality health services. Moreover CESVI will work in partnership with a LNGO to develop awareness campaign activities for two main reason: - LNGOs are well eradicated in the context, they know the people and the context more than anyone else, they work is essential to properly reach the population. - CESVI will be building the LNGO capacity throughout the project duration, involving their staff in all the aspects of the intervention (programme, finance, security, etc.) in order to put them in the position to receive a proper hand-over and run the program in autonomy 7.2 Linking Descrivere come si intende collegare il programma di risposta all emergenza con le attività di ricostruzione e sostegno allo sviluppo già in corso o previste per il futuro. Currently in Mogadishu there are not development activities ongoing, the scenario is a complex emergency and it is impossible at the moment to foresee reconstruction interventions to link to the project.
11 7.3 Cross Cutting Issues Indicare in che modo si intendono tenere in considerazione i seguenti temi trasversali: diritti umani, genere, impatto ambientale, prevenzione dei rischi [Max 1 pagina] 8. COORDINAMENTO / COORDINATION 8.1 Accordi con autorità nazionali e locali / National and local authorities Indicare se sono state ottenute autorizzazioni ad operare, oppure sono stati siglati MOU o accordi con le autorità nazionali e locali. The planned intervention has received the informal authorization from the Ministry of Health, before officially starting the activities an authorization letter will be drafted and signed by local authorities to avoid any problem with the community. 8.2 Comitati di coordinamento / Field co-ordination fora Descrivere l eventuale partecipazione dell Associato a comitati di coordinamento sul campo con altre agenzie umanitarie. CESVI is active member in the health, nutrition, protection and WASH clusters; moreover it regularly attends Regional meeting organized ad hoc and technical working groups. The presence of CESVI staff both in the field and in Nairobi ensures constant attendance at the most important coordination meetings avoiding gaps in communication. The project will benefit of the direct contribution of the CESVI Emergency Coordinator for Somalia and indirectly of the Regional Representative. 8.3 Soggetto/i implementatore/i / Implementino partner(s) Specificare se il programma è realizzato attraverso partner locali e/o alleanze internazionali. Indicare tipo di coinvolgimento e precedenti collaborazioni. Allegare gli Accordi di Partenariato (art del Manuale Operativo). The project will be directly implemented by CESVI, at the moment a pre-selection of local partners is ongoing to better develop the awareness campaign activities in the field. If a LNGO will be selected, a official MoU will be drafted. 9. INFORMAZIONI AMMINISTRATIVE / ADMINISTRATIVE INFORMATION 9.1 Desk Officer Segnalare nominativo e contatti per il desk officer, responsabile del programma a livello di Headquarters Simona Caldara Desk officer for Kenya, Somalia & Sudan ph (dir. 063) fax Via Broseta 68/A Bergamo Italy Programme coordinator Segnalare nominativo e contatti per il rappresentante dell Associato, responsabile del programma a livello di paese. Vincent Annoni Nairobi Regional Representative Ph: mob: +254(0) Peponi Town Houses, Peponi Gardens-Peponi Road, Westlands, Nairobi
13 LOGFRAME MATRIX Logica dell intervento Indicatori Fonti di verifica Rischi e Condizioni Obiettivi generali To improve the health condition of host community and IDPs in Mogadishu Assumptions Obiettivo specifico Risultati attesi Provide basic emergency health services in Mogadishu - Basic emergency health services are provided in the selected districts through fixed health post and 2 mobile clinics - Health staff involved in the action is trained and updated - Stock of medicine and medical equipment is provided - Mobile clinics are functional within the selected district beneficiaries in 6 months - 0,75 utilization rate - % correct/proper use of protocol - No. 11 health staff/6month operational in health post and mobile clinics - Drugs and medical equipments enough for a health center and 2 mobile clinics throughout the project implementation - Average of No. 30 of patients (disaggregated by sex and age) per facility (fixed and mobile) per day (total of 90 visits per day) - No. 11 health staff active in the health centre and mobile clinics - No.2 mobile clinics functional throughout project implementation - Monthly report - Internal Evaluation - Patient register - Register correct/proper use of protocol - Monthly report prepared by local staff involved in the action - Staff contracts and attendance sheets - Patient register - Register for correct/proper use of medical protocols - Drugs register - Mobile clinics logbook and register - Security in the selected district stable - Local authorities present throughout project implementation and their continuous support - No interference of local actors Risks - Major Epidemic outbreaks: - Movements disrupted by security threats; - Private health sector hostility; - Unavailability of skilled medical staff; - Major population movements in or out the project area
14 Resources Costs (in ) Attività - Rehabilitation of health center - Provision of drugs and medical equipments - Awareness campaigns on Hygiene and health - Health staff for fixed facility and mobile clinics will be selected in loco by CESVI Doctor, in charge of the project implementation - Start up of mobile clinics services - Specific training on mobile clinic - Provision of medical equipment to mobile clinics - Monitoring Mission 1. Human Resources 1Project Manager/1Logistician/1 doctor/4 senior nurses/6 auxiliary nurses/1rr/1emergency coordinator from HQ/Cesvi health staff in Somalia 2. Travels & Transportation National/International Flights - - Vehicle Rents 3. Equipments & Materials IT equipment Set 4. Running Costs Offices Rent/Consumables & stationery/utilities/communicatio ns & Internet/security system 5. Visibility & other Costs (security and audit) Nairobi office cost/audit/visibility 6. Activities Drugs and medical equipments/ rehabilitation/training of health staff/fuel/mobile clinic rental/health rapid assessment/pre and post/monitoring and evaluation 7. Administrative Costs 1. Human Resources Travels & Transportation 3. Equipments & Materials Running Costs Visibility & other Costs Activities Administrative Costs TOTAL Pre-condizioni - Security situation in Mogadishu improves or remain stable - Local authorities ensure a stable presence - Community involvement in the project - Availability of skilled medical staff Coordination mechanisms in place and functional -Overlapping with other International/local NGO with same Kind of interventions