Mauritania Red Crescent Programme Support Plan 2008-2009 National Society: Mauritania Red Crescent Programme name and duration: Appeal 2008-2009 Contact Person: Mouhamed Ould RABY: Secretary General Email: m.raby06@yahoo.fr Executive summary Precarious weather and environmental conditions, combined with locust invasions in 2005 led to a food crisis in the Sahel region. This led to relatively high death rates (35 per cent in 2006) among children aged under five years as a result of malnutrition. The death rate among the children aged under five years, the main victims of malnutrition, was 125/100000 in Mauritania in 2005 (HDI, 2006). Malaria is still the major cause of child mortality and morbidity; less than 2 per cent of the children aged under five years sleep under bed nets in Mauritania (HDI, 2006). In addition, the communities have poor access to safe drinking water and basic sanitation, which is the main cause of diarrhoeic diseases and other parasite-related diseases that affect the children's nutritional status (HDI, 2006). According to studies carried out by the stakeholders in this operation, most of them agreed that the 2005 crisis was a chronic situation of food insecurity. This called for a programme-based approach with solutions in terms of reducing vulnerability, as opposed to an emergency response. This could be achieved through improving the access to safe water and better water and basic-sanitation services, hygiene and nutrition targeted health education, malaria control, vaccination and improved livelihoods (especially for the women), as all these factors impact on child health, therefore on child nutritional status. Generally, the target population includes children aged under five years as well as pregnant and breastfeeding women. The programme will contribute to improving the health care services (Global Agenda Goal 2) for the vulnerable communities in Mauritania. This will be achieved through: improving the access to safe water and basic sanitation, hygiene promotion, improving the mothers' knowledge on nutrition and the prevention of the malnutrition-related diseases, improving the monitoring of malnutrition among the children and the diseases under epidemiological surveillance, monitoring the immunization status of the children and pregnant women and their access to essential services as well as building the capacity of Mauritania Red Crescent staff and volunteers to implement and monitor the actions contained in this plan. The planned programmes will benefit an overall population of about 120,000 in Mauritania Potential partners for these programmes include the United Nations agencies; the United Nations Children's Fund (UNICEF), the World Health Organization (WHO), the United Nations Development Programme (UNDP) and the World Food Programme (WFP), the Qatari Government, Partner National Societies (PNS), the International Committee of the Red Cross (ICRC), the UK Government s Department for International Development (DFID) and the European Union (EU), among other organizations. Context Mauritania has an estimated population of 3,177,388 inhabitants (as at 2006), who live on an area of 1,030,700 square kilometres. The health situation is marked by a high national malnutrition rate of about 35 per cent, and a 9 per cent rate of exclusive breastfeeding. Mauritania also experiences a high prevalence of mild diarrhoea (18 per cent), acute respiratory infection (ARI, 17 per cent), and malaria (4.7 per cent). Safe water coverage is 53 per cent, against 34 per cent for correct basic sanitation (UNDP, 2006).
Table 1: Health indicators Health indicators Values Maternal death rate 1.35% BCG 83.86% Full vaccination course 22.43 VAT 2 Pregnant women 35.78% Neo-natal death rate 0.11% Overall malnutrition rate 32% Chronic malnutrition rate 35% ARI prevalence 17% Prevalence of mild diarrhoea 18% Exclusive breastfeeding 9% HIV prevalence 0.8 Iodized salt consumption 2 Vitamin A consumption 57.8 Morbidity among children under 5 116/1000 Coverage of toilets 49% Poverty profile 46.30% Women with anaemia 40% Child anaemia 75% Safe water coverage 66% Source: HDI, 2006 Programme purpose and outcomes Health and Care Global Agenda Goal 2: To reduce the number of deaths, diseases, disaster impacts and emergency public health services. This programme considers malnutrition among children aged under five years, pregnant and breastfeeding women, as the final result of worsening food and sanitation conditions. The programme contributes to improving the nutritional status of children aged under five years as well as pregnant and breastfeeding women in the project areas. Programme component: Water and sanitation (WatSan) The purpose here is to improve the access to safe water and basic sanitation in line with the Federation's Global Water and Sanitation Initiative (GWSI). This will be achieved through the construction of new wells/drills or the rehabilitation of the existing facilities. This component includes a major aspect on community-based mobilization around the Participatory Hygiene and Sanitation Transformation (PHAST), which helps the communities to make their own needs assessments, to develop solutions, select their own technological options, to plan for the required resources and do monitoring. This approach thus encourages community involvement. Expected outcome: Access to safe water and basic sanitation for vulnerable communities has Red Cross volunteers are trained as PHAST animators and are active in the field. Schools have access to school latrines and family latrines are built. The WatSan coverage rate has increased; more water points are constructed and used. 2
Programme component: Mother and child health The community-based volunteers will be mobilized to monitor diseases under epidemiological surveillance (cholera, measles and meningitis, among other diseases), to promote the vaccination of pregnant women and children as well as the use of insecticide-treated bed nets. Women's groups will be mobilized to help in the prevention of malnutrition-related diseases through sensitization on nutrition and exclusive breastfeeding. They will also promote the use of insecticide-treated bed nets (ITNs), addressing fever and mild diarrhoeic cases at home, prevention against ARI, vaccination of children aged under 11 months and pregnant women as well as family planning. In addition, the socio economic status of women will be improved in this process. Expected outcome: Mothers' knowledge nutrition and prevention against malnutrition-related diseases, and their awareness of the importance of mass immunization have been Children aged between 6 and 9 months are receiving quality food supplements. Prevalence of diarrhoea-related diseases among children aged under five years has decreased and the numbers of ARI are properly managed by mothers. Children aged under five years and pregnant women are sleeping under ITNs. Expected outcome: Malnutrition among children aged under five years as well as pregnant women s vaccination status, and access to essential products is Pregnant women are monitored and directed to vaccination stations. Children aged under 11 months receive correct vaccination. Children are exclusively breast-fed during the first four months. Malnourished children are identified and directed to nutrition centers and their nutrition status is Expected outcome: Income of members of women groups has increased. Members of women s groups are supported in coming up with IGAs. Women supported to implement IGAs have functional bank accounts. Programme component: Health care management skills of the National Society. Expected outcome: The capacity of the Mauritania Red Crescent in terms of health care has New staff are recruited and Red Crescent staff and volunteers are trained. Red Crescent volunteers are recruited and maintained. Training sessions are conducted in targeted localities. Capacity Building Global Agenda Goal 3: To build the capacity of the local community, the civil society and the Red Cross/Red Crescent staff to address the most urgent vulnerabilities. The overall organizational development activities match with the Global Agenda Goal 3 and lay emphasis on capacity building within National Societies and communities. The objective of the 3
organizational development programme is to improve National Societies capacities in service delivery to the most vulnerable populations, in conformity with Federation s new directions. The main challenge is to scale-up programmes for more impact. Expected outcomes (overall for Sahel Region) All the National Societies have developed strategic plan in line with the recent directions of the Movement and are scaling up their initiatives through long term planning in health and food security related issues. Governance and Management bodies are reinforced with support of professional staff and provision for training. The volunteers management systems are improved within support of National Societies for policy development and establishment of functional data base. Better knowledge on Red Cross/Red Crescent activities in the different countries through realization of TV documentaries in National Societies with successful and consistent projects. National Societies finance management systems are improved through provision of regional guidelines in finance management and regular audit or performance evaluation. Management capacities at the Zone level are maintained and improved through cost sharing in the different country projects. The organizational development programme for the Sahel Region aims to accompany the Mauritania Red Crescent for the implementation of these various commitments and policies by contributing to decrease vulnerability of people living in Mauritania through improved service delivery and strengthen the governing, managerial and financial capacities at headquarters, branch and link levels. Programme development: Capacity of the National Society to assist the most vulnerable. Expected outcome: Governance and management bodies are reinforced with support for professional staff and provision of training. A revised strategic plan for 2009-2012 is prepared. New projects are accepted and are being implemented. Existing partners are maintained and new ones are acquired. A new organization chart for the headquarters exists. Expected outcome: Volunteers management systems are improved, within support to the National Society for policy development and establishment of a functional database. Clear disseminated policies on volunteering and youth exist. Annual reports and assessment on volunteers and human resources are available. Expected outcome: National Society s finance management systems are improved through provision of regional guidelines in finance management and regular audit or performance evaluation. Existence of a resource mobilization strategy. Increase in financial resources. 4
Table 2: Target Population: Programme components Water and sanitation Hygiene promotion 110 water facilities Latrines Improved women's knowledge and practices Outbreak and malnutrition surveillance Training on income generation activities Funding income generation activities National Society capacity building -PHAST training -PHAST training of trainers -Training on project monitoring and evaluation -Relief volunteer training Target Population -120,000 persons -33,000 persons (300 persons per water point) -8,200 persons (12 schools and 1000 families) -30,000 children aged under five years -7,800 pregnant women -3,000 women -600 women -240 PHAST facilitators; -30 PHAST trainers -25 Mauritania Red Crescent staff -1,050 Red Crescent volunteers Capacity and experience The Mauritanian Red Crescent, within the framework of the Irish Government s organization development allocation for the Sahel Region, recruited a health coordinator for the National Society. The Federation continues to support the position of Secretary General of the National Society. It is hoped that the Federation will support the key positions for future projects that the National Society expects to. The National Society has recruited a new finance manager with the support of Spanish Red Cross. The recruitment of a focal point for volunteers management is in progress with Federation support. Quality, accountability and learning The approach that the National Society will use will basically be community-based. This reflects ARCHI 2010, the Ouagadougou Declaration, and the Algiers Plan of Action. The communities will participate in social mobilization campaigns to promote hygiene. Communitybased volunteers will conduct monitoring of the immunization of the children aged under 11 months old, monitoring malnutrition and the diseases under epidemiological surveillance will be carried out by. The PHAST community-based approach will help communities to assess their own water resource and sanitation needs in relation to diarrhoeic diseases, to develop solutions for their WatSan problems, to select their own technological options and to plan for the required resources. Monitoring will be the key activity to any community involvement. This approach will be adapted to the different programme target components. Health and administrative authorities will be involved in the decision making processes. Making relevant water and sanitation facilities available will basically consist in building modern wells, with the relevant equipment (rehabilitate or create pulleys, drills to rehabilitate, and family latrines with dry pits and school latrines. For wells, beneficiaries will contribute their manpower and building materials, local availability. In order to support the replication of water and sanitation actions in other areas of the target region, alliances will be established with international and donor organizations. The lessons learnt will be documented. The technologies to be used will be very simple and easily replicable by the communities. In addition, there will be intensive training in order to reach the larger number of volunteers. Human resource capacity building will also help replicate actions more efficiently. 5
The evaluation/audit of the National Societies management systems started in 2007, with the support of the Spanish Government funding. This exercise will establish a base line data for the overall capacity building regarding finance development activities and draft regional guidelines for finance management in National Societies. The National Society was supported in developing long-term projects in the framework of the exit strategy of the Sahel food security operation. These new long-term projects have become the framework of new partnerships between the National Society and its partners: Partnerships and civil society engagement The Mauritania Red Crescent has built partnership with Spanish Red Cross and French Red Cross. However, the insufficiency of human resources such as a disaster management coordinator, and a programme coordinator to assist the Secretary General still remains a limit to scale up programmes with a better involvement of the civil society. At community level, Mauritania Red Crescent has showed its capacity particularly on social mobilization activities during epidemics outbreaks, mass vaccination campaigns, distribution of ITNs, where the National Society works closely with the Ministry of Health (MoH) and the local communities. Red Cross/Red Crescent collaboration The ICRC, French Red Cross, Spanish Red Cross and the Federation are working together with the National Society to address the problems of the most vulnerable. French Red Cross and the ICRC have offices in Nouakchott and the Spanish Red Cross in Nouadhibou. However, all Movement partners organize meetings and consultations in order to harmonize approaches. Federation is supporting the Mauritania Red Crescent in technical areas such as health programmes, public health in emergencies (PHE) during epidemic outbreaks, disaster preparedness and response as well as food security projects. The Federation s support also includes volunteer management system, improvement of the governance and management bodies as well as the financial resource management system. The ICRC also gives support from its office of Nouakchott and the regional delegation based in Tunis. Promoting gender equity and diversity The programme will be conducted in a way to ensure active participation of women in decision making, regarding their health status and that of their children. Using women in aspects concerning behaviour change helps to include women s specific needs. Improving the economic status of women will be key to their involvement in decision-making process regarding health issues within their households and communities. In addition, analyzing the roles of men and women, especially during the PHAST process, will facilitate the integration of the gender factors in the actions. The members of the water point management committees and the volunteers in charge of monitoring pregnant women and children aged under 11 months will include at least 50 percent women. Risk Identification and management The major risk of management is the insufficiency of human resources within the National Society and the lack of partners and funds to implement projects. Implementation and management arrangements The health coordinator is managing all programmes including health and disaster management; there is a crucial need to recruit a disaster management officer and a programme coordinator. This whole technical team will assist the Secretary General in its role of coordinating all programmes. The recruitment of a focal point for volunteer management is under way. 6
The Federation is providing technical, financial support and advice based on policy, strategic planning, coordination and integration of programmes. The Federation s mission consists of harmonizing approaches and ensures better coordination between all components of the Movement. Coordination meetings and technical workshops on health and disaster management are organized with the National Society and its partners. The ICRC, Spanish Red Cross and French Red Cross are also involved in this process. Monthly, quarterly, half-year and annual reports/updates are developed to show the achievements, impact and constraints of the different programmes. These programmes and financial reports are shared with all stakeholders and can serve as a marketing tool for potential donors. The monitoring and evaluation mechanism will consist of: Organizing, right at the beginning of the project, a baseline data collection. This task needs to be carried out by a study firm specialized in evaluation; Conducting monitoring missions by local and national teams; Carrying out periodical operational planning sessions; Conducting interim evaluations (internal) by end of 2008, and a final evaluation (external) by end of 2009. Data on project management and progress will be systematically collected using forms specifically designed for the volunteers women s groups leaders. Similarly, for every National Society running a project of over CHF 500,000, a monitoring and evaluation officer will be recruited to organize the monitoring, evaluation and planning system. Sustainability The following elements will help make the actions sustainable: Use of existing women's groups that are already operational within the areas; Create local sections (at village level) to carry out monitoring activities at local level; Set up IGAs for members of women's groups; Involve health and water departments' staff and contracting authorities to help manage the facilities and structures left by the project; Implement planned activities mainly at community level. 7
Planning and resources summary matrix National Society : Mauritania Red Crescent (MRC) Programme period : 2008-2009 Global Agenda Goals Programme Component Output (Expected results) Indicators Target Population Goal 2: Reduce the number of deaths, illnesses and impact from diseases and public health emergencies. Water and sanitation. Maternal and child health. R1. Access to safe water and basic sanitation. R1. Mothers knowledge of best food practices and prevention of malnutrition related diseases and their awareness about the importance of mass vaccination campaign is 240 Red Cross volunteers are trained as PHAST animators and are active in the in the field; 15 schools have access to school latrines and family latrines built for 700 people in 2009. 107 water points built and number of additional persons having access to water 9000 children of 6 to 9 months have received quality food supplements. Prevalence of diarrhoea related diseases among children under 5 has decreased and the numbers of ARI properly cared by mothers. 15,000 children under 5 years and 3900 RC PHAST animators, Pupils, Targeted Population. Mothers, Children, Pregnant women, Target populations. Partners Government, IFRC, UN Agencies, Associations for development NGOs. Government, IFRC, UN Agencies, Associations for development, Other NGOs.
R2. Malnutrition among children U 5 as well as pregnant women vaccination status, and access to essential products is R3. The income of women s group members is pregnant women sleep under ITNs. Number of children under 5 vaccinated during mass campaign, number of RC volunteers trained and number of localities covered by the campaign. 3900 pregnant women monitored and directed to vaccination stations and 3,300 children U 11 months receive correct vaccination. 5000 children are exclusively breast-fed during the first 4 months. 90% of malnutrition cases have been identified directed to nutrition centers and their nutrition status 3000 women members of 100 women s groups initiated to IGAs management Pregnant women, Brest-feeding women, Children. RC women s group members. Government, IFRC, UN Agencies, Associations for development, Other NGOs. Government, IFRC, UN Agencies, Associations for
techniques and supported to implement IGAs. 600 women supported for IGAs in 2009; 270 women (of women supported to implement IGAs have a functional bank account. development, Other NGOs. Health and care capacities R1. MRC health and care management capacities Number of persons recruited, and number of Mauritania RC staff and volunteers trained. Number of new volunteers recruited and maintained. Number of RC training sessions organized in 2009 in targeted localities. RC technical staff, New volunteers, Target populations. Government, IFRC, UN Agencies, Associations for development, Other NGOs. Goal 3: Increase local community, civil society and Red Cross Red Crescent capacity to address the The National Society s capacities in service delivery to the most vulnerable are R1. Governance and management bodies are reinforced. A revised strategic plan for 2009-2012. Number of projects accepted and implemented, and number of partners NS governance and management bodies, Volunteers, Vulnerable communities. IFRC, ICRC, PNS, Local and international NGOs.
most urgent situations of vulnerability. R2. The NS volunteer s management system is R3. Improved financial management system. maintained and new one attracted. A new organization chart for the headquarters. Policies on volunteer and youth disseminated. Annual reports and assessment on volunteers and HR available. Financial statements available. Regular financial audit organized. Goal 4: Promote respect for diversity and human dignity, and reduce intolerance, discriminatio n and social exclusion. R.1.The capacity of the National Society to respond effectively to the needs of the most vulnerable has been strengthened. R.2.The National Society has adopted a common strategy to discourage illegal immigration. Government of Mauritania, Spanish Agency for International Cooperation (AECI), Spanish Red Cross, Spanish Government, IFRC
R.3.The National Society works in close collaboration with the government in eradicating the illegal immigration scourge and is involved in making decisions related to the fight against illegal immigration. R.4.National Society volunteers conduct sensitization sessions among the youth about dangers linked to illegal immigration. R.5. National Society volunteers provide psychosocial support to traumatized returnee illegal immigrants. R.6.
Humanitarian assistance is given to returnee illegal immigrants transferred through medical structures. R.7. There is better knowledge of National Society activities in the country through airing of TV documentaries on successful and consistent National Society projects.