Communitybased health services Specific objective : Through promotion of communitybased health care and first aid activities in line with the ARCHI 2010 principles, the general health situation in four priority districts has improved by the end 2005. Collaboration in promotion, prevention and first aid has contributed to longterm reduction of impact and other sexually transmitted diseases (STD) at household level. By the end of 2005, at least 90% of targeted community members interviewed will know about preventive measures against. By the end of 2005, the incidence of STDs will have decreased by at least 35%, per year as confirmed by the MoH statistics. 196,200 (90% from 218,000 beneficiaries) of community members having knowledge about transmission. 35% decrease in STDs reported in MoH statistics for the target area by the end 2005. A positive attitude towards people living with (PLWHA) in target areas as confirmed by interviews with them. Internal factors: Timely cash flow from HQ to provincial and district level Implementation carried out according to agreed activity plans Timely submission of and response to progress reports and plans. Effective recruitment, training and retention of Mozambique Red Cross staff and volunteers Integrated approach between different Mozambique Red Cross programmes Collaboration between different sectors External Factors: Cooperation and support from government authorities Cooperation and 1 Refresher course for 300 volunteers on and STDs integrated in CBHC/CBFA in four districts. Train 300 volunteers on home support and care for PLWHA. Participate on the distribution of condoms to the target (first aid posts, home visits) Distribute IEC material on and STDs to the volunteers. Refresher course for four health technicians in IEC methodologies on and STDs. Train 24 supervisors for support and monitoring activities on the field.
The impact of malnutrition has been reduced by promotion, prevention and first aid measures in the target communit ies. By the end 2005, 300 volunteers in four districts, working in the community and first aid posts know about supplementary feeding By the end 2005, 300 volunteers know how to detect severe and moderate malnutrition, and how to provide access to the therapeutic feeding. By the end 2005, 200 mothers in four districts, trained in how to prepare support of beneficiary Manageable incidence of disasters and epidemics Adequate funding of the proposed Mozambique Red Cross programme for 2004-2005 Effective coordination with other implementing agencies. Same as above 2 Train 300 volunteers on supplementary feeding for children under-five, pregnant and lactating women in four districts. Detect cases of malnutrition for referral to facilitate therapeutic feeding services, and provides nutritional counselling to mothers. Train 200 mothers on supplementary feeding, hygiene and immunisation information in four districts. Train 24 volunteer supervisors on nutritional survey, monitoring and support supervision
Promotion, prevention, first aid and curative intervention have decreased the prevalence and increased the care for people suffering from outbreaks of malaria, diarrhoea, and TB. supplementary feeding, hygiene information and immunisation. By the end of 2005, 24 volunteer supervisors trained on nutritional survey, monitoring and support supervision. volunteers trained and supported Percentage of Mozambique Red Cross volunteers at first aid posts providing correct treatments for malaria, diarrhoea as confirmed by supervision visits and MoH feedback. four first aid posts rehabilitated. people benefiting from first aid and treatment of the most common diseases. % decrease in number of cases of diarrhoea, and malaria in target. % increase in number of the people who are being treated on TB, referral to the health Same as above 3 Provide first aid and treatment of the most common diseases, as malaria, diarrhoea, and others to approximately 72,500 people Provide training for 300 volunteers in CBHC/CBFA. Introduction training for 300 volunteers on PIMES and refresher course on ARCHI 2010 Increase capacity building in terms of qualified personnel and intensify technical support and supervision to the four priority districts Rehabilitate four first aid posts Provide IEC materials on preventive measures about priority health topics such as malaria, cholera, diarrhoea, TB (40,000 pamphlets) Carry out 10,000 home visits to provide promotion, prevention, and first aid measures. Provide training for 300 volunteers in CBHC/CBFA. Support malaria control activities with MoH and other partners. Detect cases of TB for referral to facilities access to the health centres. Promote the construction for improved and traditional latrines with community participation Educate on correct use and treatment of drinking water sources. Acquire and distribute 100 first aid bags Purchase 75 medical kits (55PS1, 20PS2) Purchase and distribute 8,000 impregnated mosquito-nets
Relief health intervention support has contributed to containing epidemics such as cholera centres by the volunteers. Community members trained and supported. High degree of volunteer participation. people reached annually by IEC on preventive measures. health education sessions held in each district. Increased vaccination coverage in children under-five in target, through IEC sessions four first aid posts rehabilitated families using hygienic latrines. volunteers trained to carry out cholera education through door-to-door visits. Oral rehydration, chlorine, distributed on affected places in the targeted areas according to the needs. A majority of target Same as above Copy 1,000 ARCHI tool kits in Portuguese. Produce 600 T-shirts and 300 caps Provide refresher-training course to 300 volunteers on cholera prevention and cholera response. Provide to the of four districts IEC materials on transmission, prevention and first aid of cholera cases. Plan, implement, monitoring, and evaluation preventive and relief activities related to the cholera. Train, mobilize and educate the community through door-to door visits on preventive and relief activities related to the cholera outbreak. Water chlorinating, latrines and waste disposal construction Provide and distributed ORS to the affected. Collaborate and co-ordinate with core institutions and 4
community members will take preventive measures (drinking only safe water, education on washing hands, refuse disposal). A majority of target community members will take preventive measures (drinking only safe water, education on washing hands, refuse disposal). pamphlets for cholera prevention and treatment printed and distributed to the target. Mozambique Red Cross health sector at all levels will participate in all coordination interagency meetings called by MoH during cholera outbreaks. people of the community mobilized about cholera. cholera cases and deaths decreased in the target 5 organisations.
The impact of Mozambique Red Cross Health Programmes has been strengthened and institutional capacity to implement the programme and respond to health related disaster needs has been reinforced. Data in surveys carried out within 4 priority districts. local committees organised working efficiently. Provincial Health Technicians and supervisors trained on PIMES and ARCHI 2010. Quantity and quality of information collected on the Health in the target districts. Number, timeliness, and quality of branch monthly and quarterly health reports on health activities. supervision visits to branch and districts Material for relief activities stocked. Health information system implemented and working. Promptness of Mozambique Red Cross response to disaster (floods, drought, cholera. Increased collaboration with Same as above Carry out four detailed surveys in four districts (PRA assessment) Reorganize and train four local committees in four priority districts Provide refresher training on PIMES and ARCHI 2010 to the four provincial health technicians. Provide training to the 24 volunteer supervisors on PIMES and ARCHI 2010. Provide better cooperation with MoH, UNICEF, WHO and others. Exchange experiences between provincial health coordinators. Provide stock of materials and medical kits for response to disasters. Provide Sphere knowledge on disaster response for the health technicians and supervisors. eight supervision visits from HQ to branch 96 supervision visits from provincial technicians to the districts and. 6
Community home-based care Specific objective: Community home-based care (CHBC) provided to people living with (PLWHA), their families and the community, including the orphans and vulnerable children (OVC) 340 care facilitators (20 in each community) and 85 (five in each community) AICM volunteers trained Improved quality of live of 850 PLWHA (50 in each district) and their families within the community provided Access to support and services to 850 PLWHA and their families increased Capacities of PLWHA improved trough the establishment of 17 self support groups of MoH, PNS, UNICEF, WHO. CHBC volunteers and AIMC trained households with chronically-ill patients receiving training in basic care households that received care kits, medicines, materials care and social support PLWHA referred to health centres Knowledge about increased and misconceptions about the nature of HIV transmission and about PLWHA dispelled Level and consistency of care of chronically ill people increased support groups created PLWHA participating in Functional structures and systems in place. Resources available Communities willing to support PLWHA Lack of willingness of people to join self support Carry out four training workshops for 340 care facilitators (volunteers) and four trainings sessions for 85 AICM Establish CHBC projects in four additional (13 already running since 2003) Provide support and care to 850 PLWHA and other chronically ill people and their families through CBHC (referral, counselling, first aid and basic care issues) Provide care kits and other material to 850 chronically ill people and their families. Carry out home visits to 850 families Refer 200 (approximately 25%) patients to the health centres for treatment Provide basic psycho-social support to the beneficiaries and to the volunteers (care facilitators) Mobilize PLWHA for the establishment of 17 self support groups with CBHC and income -generation activities (one in each district) Train on basic management skills and monitoring to 17 self 7
PLWHAs (one in each district) Community-based social support to 1,000 orphans and vulnerable children provided Improved access to food and quality of diet of 500 most vulnerable PLWHA and 500 orphans and vulnerable children (OVC) Improved quality of services to support/self help groups orphans receiving support memory box project initiated OVC counselled OVC receiving material/food support OVC referred to other community-based organizations or government Number OVC receiving educational support OVC being cared for by other family members or by community members most vulnerable PLWHA and OVC with improved diets and self help skills in food production monitoring/supervisio n visits and reports groups Lack of willingness and lack of resources of family and to integrate orphans Level and consistency of care for orphans Food support available from WFP or other partners Availability of water for the vegetable gardens Funds available help groups Identify and register 1,000 orphans (600 in 2003 already identified, 400 more to be identified in 2004). Provide social support to 1,000 orphans and/or advocate with government and other community-based organizations the care of OVC (food, schooling, clothing and other basic needs, referral to other organizations or government departments, counselling and memory boxes). Mobilization of community leaders (workshops for AICM) to care for orphans Organize OVC support groups Identify 500 most vulnerable PLWHA and 500 OVC by the Provide food packs Establish vegetable gardens Acquisition of agricultural tools, seeds and fertilizers Educate families on appropriate diets for PLWHA Train care facilitators on prevention of TB/malaria Train care facilitators on anti-retroviral and PMTCT (prevention of mother to child transmission) Monitoring, supervision and support visits to field officers and CHBC volunteers three visits per week from provincial officers to field officers and once each three months from HQ to the 8
provinces and to the field prevention Specific objective: preventive skills to the target provided Availability of IEC materials at community level 640 volunteers trained Preventive skills among 120,000 youths and OVC (10-24 yrs) in and out of school improved through youth peer education Preventive skills among community members improved Use of condoms increased materials reproduced and distributed volunteers trained coaches identified and youth peers educators trained youths reached and using safe practices to prevent being infected with community leaders mobilized to facilitate HIV prevention sessions condoms distributed people effectively using condoms in sexual relationships with casual partners Functional structures to guarantee the distribution of materials at all levels Continuous support to volunteers provided at community level Difficulty of community (including youths) to use safe sex practices due to cultural values and practices Local supply of condoms available Money to purchase condoms available Select IEC materials Reproduce and adapt the relevant ones for the country context Distribute IEC materials to the Training workshops on preventive activities for volunteers in target Carry out youth-peer education activities for 120,000 youths in schools and 150 peer youth/ovc education sessions per month on prevention carried out in schools 250 sessions per month carried out in Carry out preventive sessions for 144,000 beneficiaries (60,000 in each of the 24 target districts) Purchase and distribution of 400,000 condoms during activities carried out by volunteers KAP (knowledge, attitude and practices) studies to monitor the effective use of condoms Quality of services to Funds available Community appraisals to monitor community perception 9
Reduction of stigma and discrimination Specific objective: The stigma and discrimination related with reduced in and among RC staff & volunteers Water and Sanitation Specific objective: Sound, sustainable environmental services have been established for 100,000 vulnerable improved awareness of PLWHA on their needs and rights increased Increased willingness of to care for 850 PLWHA 850 PLWHA being able to accept and live with their condition positively Hygiene promotion/ sanitation promotion volunteers effectively cover target population of 100,000 in by year 2008 Three sustainable sanitation promotion (hardware) units established in target area which distribute no less than 4,000 SanPlats by 2008 monitoring/supervisio n visits and reports Level of satisfaction among community members on Mozambique Red Cross services in the field of antistigma and discrimination events conducted people reached with antistigma activities At least eight antistigma and discrimination activities carried out in each target district Increased openness about in 80% of trained volunteers promoting hygiene in 2008 Promotion strategy, tactics and tools are sound sanitation promotion units SanPlats distributed/ traditional latrines constructed by householders Acceptance of community members and leaders of the epidemic as a threat to their Volunteers motivation to promote hygiene/ sanitation Socio economic conditions favourable for SanPlat approach to sanitation promotion 10 and level of satisfaction regarding Mozambique Red Cross activities. Integrate anti-stigma and discrimination issues in all volunteer training activities Identify HIV&AIDS volunteers willing to speak out on Carry out at least eight anti-stigma and discrimination activities in each target district Four training workshops for AICM to get them involved in anti-stigma campaigns four meetings with key companies to highlight the need to develop an policy at the workplace Carry out media campaigns and material distribution related to stigma and discrimination Train volunteers in hygiene promotion Plan and implement hygiene promotion activities in synergy with other sectors Establish three sustainable sanitation promotion units Distribute 4,000 SanPlats Train volunteers
people in Nampula, Niassa, Cabo Delgado and Inhambane provinces (one province per year) by 2008 in water supply, sanitation and hygiene Promotion. 50 viable and adequate latrines at households affected by and at schools and health centres in target area by 2008 200 viable, fully functioning and adequate communitymanaged water supplies in low income villages by 2008 200 community-based operation and maintenance and cost recovery systems established and functioning by 2008 Water supply, sanitation and hygiene promotion projects efficiently and effectively implemented using demand responsive community managed approaches by 2008. Increased resources for water/ sanitation and hygiene promotion projects, and contribution to sector Schools and health centres not closed due to insufficient sanitation standards viable and adequate latrines constructed boreholes/ hand pumps constructed/ rehabilitated Project rules adhered to by project partners community- based management teams trained Projects completed as planned on time in budget Income for projects Contribution to sector meetings Skilled professionals available for project Interest in sector from donors remains stable or increases Other sector agencies interested in coordination/ sharing lessons learnt Disaster requiring response occurs Construct 50 latrines at affected households and schools/health centres Build capacity in water supply, sanitation and hygiene promotion Establish 200 community managed water supplies Plan a strategy Coordinate with other sectors Complete participative demand assessment Train community management teams Build SanPlat construction yards Construct and distribute SanPlats Construct latrines Rehabilitate and/or construct boreholes/ hand pumps Advocate for sound sustainable water supply, sanitation and hygiene promotion for vulnerable populations Prepare for disasters requiring a water, sanitation and hygiene promotion response 11
policies, best practices, coordination and cooperation by 2008. Capacity to respond, (and response if necessary) to disasters requiring water, sanitation and hygiene promotion response. Disaster management resourced Disaster responded to Monitor and evaluate Federation support from regional delegation 12