2013 Sudan CHF. 1 st Round Sector Defense Sector: HEALTH

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1 2013 Sudan CHF 1 st Round Sector Defense Sector: HEALTH Khartoum (OCHA), 29 January 2013 United Nations, Sudan 1

2 Key Issues to be Addressed 1. Access to primary health care including maternal and child health services (accessible, acceptable and appropriate) 2. Health information systems, focus is Disease surveillance systems, (Early Warning Alert and Response System and Routine surveillance system) 3. Human resources for health (HRH); # of health workforce WHO benchmark is 2.28 health care professional per 1000 population whereas it is 1.23 per 1000 population for Sudan and per 1000 population for Darfur and Protocol areas 2

3 CHF Geographical Priorities 1. Darfur States (North, West, Central, South and East Darfur) 1.4 million IDPs, 165,000 returnees, ongoing conflict and displacements 2. Protocol Areas (Abyei, Blue Nile and South Kordofan) 695,000 severely affected people in SK & BNS, about 49,000 people in Abyei, delivery through national and international partners(scs-s, Pancare, SRCS, Mubadirun, SMoH)- direct CHF fund $ 600,000, pass through WHO $ 822,090) 3. Eastern States NGOs cease operation in mid 2012, Prone to natural disasters (floods), high malnutrition rates, and epidemics (viral hemorrhagic fever, hepatitis E, Acute Watery Diarrhea, Meningitis etc.) 3

4 CHF Sector Priorities Three CHF priorities, approved by CHF Advisory Group in the Policy Paper 1. Increase access and strengthen quality of primary and referral healthcare services for IDPs, returnees, and communities affected by conflict and natural disasters 2. Improve emergency preparedness, risk reduction, disease surveillance, prevention and control of epidemic prone and communicable diseases and public health threats 3. Procure and pre-position core pipeline for drugs, kits, reagents and medical supplies to ensure emergency response capacity in the sector (unlike other sectors did not ask for an early core pipeline) 4

5 Sector Strategy for Addressing the Priorities 1. Maintain and strengthen the provision of health services mainly focusing on primary health care (minimum basic package ) and first level referral services. 2. Provide essential drugs, medical supplies, equipment, diagnostic tools etc. 3. Rehabilitate essential structure and functional capacities of prioritized health facilities 4. Capacity-building of health workforce (Government and NGOs) at all levels 5. Strengthen Health information system ( EWARS /Routine Disease surveillance system) 6. Ensure sustainability of health services ( for example INGOs/UN agencies partnership, training of NNGOs by REDR, RRT/MoH role in YF outbreak response, long term training- midwifery schools) 5

6 What Evidence Supports Your Identified Priority Needs? Health priority needs has been collected/assessed through specialized health sector tools : 1. HeRAMS Darfur (Health Resources Availability Mapping System)- assessing and monitoring available health resources at facility level-(structure, functionality, inpatient facility, management, health personnel, health services) 2. EWARS/Routine Disease surveillance system Darfur/Sudan 3. ESP- Non Darfur States (Emergency State Profile) 4. Sudan Health map (2012) 6

7 HeRAMS- Health Facilities in Greater Darfur Total Number of HFs in Greater Darfur : 718 ( NGOs: 285 and SMoH: 433) 4% 15% Full Managed by SMOH 46% Full Managed by NGOs 35% Managed by SMOH with Support from NGOs Managed by community with Support from SMOH (Source HeRAMS, Q3 2012) 7

8 HeRAMS- Health Facilities in IDP Camps in Greater Darfur 80 Funding of HFs in IDP Camps (Total 101 HFs) CHF Funded Other Funds MOH NGOs (Source HeRAMS, Q3 2012) 8

9 HeRAMS- Gap in Health Personnel in Basic Health Units in Greater Darfur 90% Gap In BHUs Health Personnel-Greater Darfur 80% 70% 69% 74% 62% 77% 79% 60% 50% 40% 30% 20% 10% 0% MA Nurse MW Vacc VTMW 9

10 HeRAMS- Gap in Health Personnel in Primary health care centers in Greater Darfur 90% Gap In PHCCs Health Personnel-Greater Darfur 84% 80% 70% 60% 57% 50% 47% 40% 30% 20% 10% 11% 17% 20% 0% MA Nurse PHO MW Vacc Lab Person 10

11 EWARS/Disease surveillance system Yellow Fever Outbreak in Greater Darfur 11

12 Immunization Coverage Penta3, Sudan (FMoH) 12

13 Immunization Coverage Measles, Sudan(FMoH) 13

14 Affected Population and Target Beneficiaries HWP Targeted beneficiaries Category of affected people male female total IDPs and returnees 1,256,850 1,308,150 2,565,000 Affected Host communities 699, ,438 1,372,322 Totals 1,956,734 1,980,588 3,937,322 CHF targeted beneficiaries CHF beneficiaries: 452,792 Children < 1 year of age: Male: 221,868 Women of Child bearing age:

15 Why is CHF funding critical right now to meet these sector priorities? health matters to everyone 1. Continuous and sustained health care requires predictable and timely funds. 2. Funding covers critical humanitarian health needs and ensure that there are no gaps without timely, flexible and predictable funding 3. Impaired /inadequate primary health care services 4. Disruption of disease surveillance systems (85% reporting compliance required by surveillance system) 5. Deteriorated maternal and child health conditions 6. Dis continuation in availability of essential life saving drugs 15

16 How were value for money and low indirect costs ensured? 1. Projects assessed by quality, efficiency and outcomes 2. Capitation system this system puts a price on head of every beneficiary (cost per beneficiary ranged between USD, higher cost in remote locations) 3. Cost containment -Proportion of direct/indirect cost; standard costs for staff, rehabilitation etc. 4. Sole service provider in a high and critical need area 5. Avoidance of overlapping or duplication ( example in Zam zam and Ottash Camp) 16

17 CERF Strategy and complementarity with CHF? 1. Ensure delivery of PHC services to the most vulnerable including mental health and psychosocial support 2. Ensure availability of emergency reproductive health kits such as clean delivery kits, midwifery kits etc. 3. Addressing life threatening conditions related to communicable diseases 17

18 TRG Approach to determining project allocation amounts? 1. Projects- strategic, sufficient funds to implement identified priorities 2. Evidence base capacity; previous performance, absorptive capacity at field level, speed of delivery etc. 3. Geographical coverage; projects covering areas as prioritized in CHF policy paper 4. Cost effectiveness - comparing cost and outcome/output 18

19 Summary of TRG-endorsed proposals for sector: Total requested amount: USD 21,094,935 Total rec. amount for CHF:USD 6,164,837 Total rec. amount for CERF:USD 3,017,900 Core pipeline amount requested :USD 2,180,604 Total rec. sector envelope (CHF+CERF+Core Pl):USD 11,363,341 Total number of projects submitted: 33 Total number of projects recommended: 18 Breakdown: UN (24%); INGO (33%); NNGO (17%), Core Pipeline (26%) 19

20 Project Recommended for CERF Funding (if any): Total amount: USD 3,017,900 Appealing UN organization(s): UNICEF, UNFPA, WHO Implementing partners: World Vision Sudan, SRCS, Concern, FPDO 20

21 Total recommended CHF envelope versus historical trend or basis for envelope: Year Overall CHF Amount (US$) Sector Envelope (US$) ,510,586 6,941, % ,056,036 4,149, % ,441,569 5,233, % ,825,139 4,345, % ,800,902 8,663, % ,619,451 7,880, % ,973,435 9,950, % Average 6,737, % 2013 (proposed) 8,345,441 Percentage of Overall (%) 21

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