Sudan High priority 2b - The principal purpose of the project is to advance gender equality Gemta Birhanu,

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1 Sudan 2017 Appealing Agency Project Title Project Code Sector/Cluster Refugee project Objectives WORLD RELIEF (WORLD RELIEF) Comprehensive Primary Health Care Services For Vulnerable Communities in West and Central Darfur SUD-17/H/ Health No The overall project objective is to improve access to integrated primary health care services for conflict-affected 252,000 ( women) populations individuals (women, men, girls, boys, and especially children under five years old) among IDPs, returnees, pastoralist, and host communities in Azum, Geneina, Kerenik, Sirba, Nertiti and Golo localities of Central Darfur and Geneina Locality of West Darfur. Beneficiaries Implementing Partners This project contributes to the three HRP health strategic outcomes. From the total, the project allocated 10% of the resources to contribute to the first outcome which is strengthen the capacities to prepare, detect and respond promptly to public health risk or events at federal, state and locality level. The project main focus is on the second outcome allocating about 60% of the resource. The second outcome reads provide primary health care services including referral services for vulnerable population affected by conflict and natural disasters. The second focus of the project is on outcome 3 which is ensure Maternal and Child Health (MCH) services for the reduction of maternal and child morbidity and mortality among vulnerable populations and 30% of the resource has been allocated to contribute to this outcome. Total: 252,000 IDPs, host communities, pastoralists and returnees Female: 131,040 Male: 120,960 Children (under 18): 110,225 Adult (18-59): 131,695 Elderly (above 59): 10,080 IDPs: 75,600 Returnees: 50,400 Host communities: 100,800 Other group: 25,200 pastoralists Almasar Project Duration Jan Dec 2017 Current Funds Requested $760,665 Priority / Category Gender Marker Code Contact Details High priority 2b - The principal purpose of the project is to advance gender equality Gemta Birhanu, Cash transfer programming Is any part of this project cash based intervention (including vouchers)? Conditionality: Restrictions: No Estimated percentage of project requirements to be used for cash/vouchers: 0 Page 1 of 5

2 Needs People living in West and Central Darfur suffer from low access to health care, high disease prevalence and mortality rates & frequent disease outbreaks. In both states our health records shows that ARI, Malaria, diarrhea & eye infection are the leading causes of morbidity and mortality especially in children. As these are commonly caused by communicable diseases there is a high need to strengthen the linkage between wash, nutrition and health sectors and create awareness in the needy communities to improve the situation. The other field level findings from team report shows that community health seeking behavior in both states still needs to be further strengthened even though there is high differences in the two states. To this end WR will further strengthen the capacity of community health promoters in creating awareness & strengthen the early referral system through strengthening house to house visit. Health facility assessment conducted by World Relief team indicate that all the facilities supported by World Relief in Central Darfur & some in west Darfur requires rehabilitation and internal furniture and supplies support. Due to limited availability of resources the rehabilitation activities has been prioritized among the eight health facilities and priorities are given to Tendelti, Center 8, Jabal Ahmar & Noorselam health facilities. The Sudan MICS 2014, which covers thirty-one indicators related to child mortality, child survival, and maternal health, indicates that Central Darfur is far below the national average in most of the indicators. The survey indicated that 67.9% of mothers attend antenatal care provided by skilled health personnel at least once, but only 47.1% of mothers attend antenatal care for the WHO defined standard of at least four times. Only 37.5% of births are delivered by skilled attendants, and just 9.5% of mothers deliver at health institutions as compared to the national averages of 77.7% of women who deliver with a skilled attendant and 27.7% of women who deliver in a health facility. Especially in Golo areas many health facilities have been left inoperable, creating an urgent need for basic and specialized health care. Also, an interagency assessment (including WRS) done in Thur in West Jebel Marra Locality found only one functioning PHC lacking cold chain, experiencing drug shortages, & in need of physical rehabilitation. There has been frequent occurrence of communicable diseases outbreaks in west and Central Darfur state. During the last four years there were communicable disease outbreaks of scabies, leishmania, yellow fever, meningitis and dengue fever. World Relief in collaboration with SMOH, WHO and UNICEF played a great role in containing the diseases and reducing the impacts of the outbreaks. Inadequate knowledge on preventive measures and management of the communicable diseases has been among the main reasons for the frequent outbreaks. To this end, there is a need to strengthen the capacity of our health facilities on EWARS reporting and creating community awareness. The 2016 HeRAM 4th quarter report showed that only 24% in Geneina, 0% in Azum & 56% Nertiti health facilities in the surveyed localities are reporting regularly to WHO and MoH. This also reveals that there has been big gap in getting accurate epidemiological trends of communicable diseases contributing to late detection of outbreaks and then late responses. WRS conducted household and community level health, wash and nutrition assessment in Golo mainly in Kolmol, Tarbil, Kairo & other villages and the result shows that there is high need to basic services. More than new returnees and 2419 nomads are without wash, health and nutrition services. The local assessments further demonstrate, only 2% of women reported delivering at health facilities. Child immunization rates were only 78%, & no survey respondents reported receiving all recommended vaccine for children. Activities or outputs Page 2 of 5

3 Outcome 1: To improve access to quality integrated primary health care services for conflict affected populations (women, men, girls, boys and especially <5 children) among IDPs, returnees, nomads, and host communities in Azum, Geneina, Kerenik, Sirba, Nertiti and Golo localities of Central Darfur and West Darfur. Output 1.1: Improved access to consultation and treatment for 252,000 patients including children, PLW, elderly at 12 health facilities in targeting IDPs, returnees, nomads, and host community members. Activities - Maintain service provision of 8 health facilities free of charge consultation and treatment - MOH staff secondement - Support clinic running costs - Rehabilitation of 3 health facilities in Central Darfur - Printing of registration book - Printing of IEC materials - Printing of treatment protocols - Provide refresher training for 20 existing (14 female and 6 male) medical assistants and nurses on safe handling of biohazard material, and disposal of biomedical waste as per WHO recommendations. - Procurement of drugs, medical supplies and furniture for needy health facilities - Support transportation of drugs to the health facilities on monthly basis - conduct regular field monitoring on distribution and management of drugs in clinics - Support 6 mobile clinics to reach remote areas in 20 remote villages - Train medical assistants and nurses on IMCI Outcome 2: Strengthened technical and institutional capacities in Emergency Preparedness and Response at the locality level to prepare for, to detect, to prevent, and to respond promptly to public health risk or events. Output 2.1: Strengthened capacity of community health promoters, community leaders and the 10 health facilities early detection, preparedness and response to emergencies and public health threats. Activities: - Conduct awareness sessions for community leaders and Community Health Promoters (CHPs) on emergency response. - strengthen community based referral and case finding system through engaging community health promoters (household visits and case findings) - Monthly review meetings with community health promoters to strengthen community based case finding and referral system - Train 30 ( 20 female and 10 male) medical assistants and nurses and locality MOH staff on emergency preparedness and rapid response system Outcome 3: Reduced maternal and child morbidity and mortality among vulnerable populations. Output 3.1 Improved reproductive health units services within the health facilities targeting pregnant women and women of child bearing age. Activities - Train village midwives (VMWs) on early referral mechanisms in order to enhance their capacity to facilitate safe deliveries in their communities. - Train Village Midwives (VMW) from the operational areas on the prevention of sexually-transmitted infections and referral pathways for child delivery at health facilities. - Provide clinical and psycho-social management of sexual violence. - medical assistants and nurses training on psycho-social management of sexual violence - Carry out routine immunization campaigns targeting 3953 children under 1 year old and women of reproductive age in the project areas. - Conduct accelerated vaccination expanded program of immunization (EPI) campaigns four times a year in collaboration with the SMoH. - Refresher training for health facilities personnel on basic ANC, delivery, PNC and family planning. Indicators and targets Page 3 of 5

4 Outcome 1: To improve access to quality integrated primary health care services for conflict affected populations (women, men, girls, boys and especially <5 children) among IDPs, returnees, nomads, and host communities in Azum, Geneina, Kerenik, Sirba, Nertiti and Golo localities of Central and West Darfur. Output 1.1: Improved access to consultation and treatment for 156,000 (81120 women) patients 12 health facilities in targeting IDPs, returnees, nomads, and host community members. Indicator 1 Number of health facilities providing Integrated Management of Childhood Illness (IMCI) services Indicator 2: Number of health facilities providing minimum basic package of primary health care services Indicator 3: Number of health workers trained (disaggregated by gender) Target 48 (12 women) Indicator 4: Number of outpatient consultations, sex and age disaggregated Target 156,000 (81120 women) Indicator 5: Number of days of stock out per year for essential medicines. Target 2 days a month Indicator 6: Patient satisfaction rate. Target 80% Outcome 2: Strengthened technical and institutional capacities in Emergency Preparedness and Response at the locality level to prepare for, to detect, to prevent, and to respond promptly to public health risk or events. Output 2.1: Strengthened capacity of community health promoters, community leaders and the 12 health facilities early detection, preparedness and response to emergencies and public health threats. Indicator 1: % complete and timely of weekly surveillance reporting from sentinel sites Target 80% Indicator 2: Number of members of rapid response teams trained (disaggregated by gender) Target 36 (12 women) Indicator 3: Number of emergency events reported. Target 24 Indicator 4: % of emergency events reported, investigated and response initiated to within 72 hours after reporting Target 75% Indicator 5: Number of emergency events investigated and response initiated to within 72 hours after reporting. Indicator 6: Number of members of rapid response teams trained (disaggregated by gender) 0 ( 40 women) Outcome 3: Reduced maternal and child morbidity and mortality among vulnerable populations. Output 3.1: Improved reproductive health units services within the health facilities targeting pregnant women and women of child bearing age. Indicator 1: Number of health workers trained (disaggregated by gender) Target 312 Indicator 2: Number of children below one year vaccinated for measles. Target 5929 (3083 girls) Page 4 of 5

5 Indicator 3: Number of children below one year that received Penta valent vaccination (Penta 3). Target 5929 (3083 girls) Indicator 4: Number of obstetric emergencies referred to secondary or tertiary care Target 256 Indicator 5: Number of deliveries assisted by skilled birth attendants. Target 2565 World Relief(World Relief) Original BUDGET items $ Staff and Other Personnel Costs 71,929 Supplies, Commodities, Materials 464,404 Equipment 2,000 Travel 115,518 Transfers and Grants to Counterparts 22,260 General Operating and Other Direct Costs 41,498 Project support cost 43,056 Total 760,665 World Relief(World Relief) Current BUDGET items $ Staff and Other Personnel Costs 71,929 Supplies, Commodities, Materials 464,404 Equipment 2,000 Travel 115,518 Transfers and Grants to Counterparts 22,260 General Operating and Other Direct Costs 41,498 Project support cost 43,056 Total 760,665 Page 5 of 5

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