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NEPAL ANNUAL REVIEW 2015 “Save the Children pays no regards to politics, race or religion. A child is a child, whether red, white, brown or black.”

Eglantyne Jebb, Founder of Save the Children (1876-1928) Our Vision, Mission and Values

Save the Children is the world’s leading independent organisation for children. We are 30 national organizations working together to deliver programs in more than 120 countries around the world. Our Vision A world in which every child attains the right to survival, protection, development and participation Our Mission To inspire breakthroughs in the way the world treats children and to achieve immediate and lasting change in their lives Our Values Accountability: we take personal responsibility for using our resources efficiently, achieving measurable results, and being accountable to supporters, partners and, most of all, children. Ambition: we are demanding of ourselves and our colleagues, set high goals and are committed to improving the quality of everything we do for children. Collaboration: we respect and value each other, thrive on our diversity, and work with partners to leverage our global strength in making a difference for children. Creativity: we are open to new ideas, embrace change, and take disciplined risks to develop sustainable solutions for and with children. Integrity: we aspire to live to the highest standards of personal honesty and behavior; we never compromise our reputation and always act in the best interests of children. Contents

2 Country Director’s message 3 Nepal Program: Results for Children in 2015 5 Humanitarian 7 Child Rights Governance 9 Child Protection 11 Education 13 Health and Nutrition 15 HIV and AIDS 17 Child Poverty and Livelihoods 19 Donors and Working Partners

© Save the Children 2015 Front Cover: Phurpu was born a month after the 25th April earthquake with the help of Save the Children’s medical team at a health post in Rasuwa (Photo by Bijay Gajmer/Save the Children)

All photographs: Save the Children or partner staff unless stated otherwise Country Director’s message

transitional shelters, warm clothing and insulation during the winter period. We also helped 2,000 children represent the voices of all affected children; summarized in a report for stakeholders to address on protection, health and sanitation and education concerns. With children at the center of our work, Save the Children also led the Consortium on “Child- Centered Disaster Risk Reduction” and backed the formation of a National Comprehensive School Safety Framework. For Nepal, there was reason to mark the achievement made in reaching the United Nations Millennium Development Goal (MDG) target four. The country’s Under Five mortality reduced from 162 for every 1,000 live births in 1990 to 54 at the end of 2015, an achievement to which Save the Children also contributed by training more than 8,000 frontline health workers in 2015 alone, besides offering multiple health and awareness When there is a reference to 2015, it’s the devastating raising services. With the goal achieved, Save the Children’s global campaign “Every One” to earthquake and its effect on the more than 8 million advocate for obtaining MDG goal 4 also came to an end. people that stands out. Save the Children immediately Even against the backdrop of our emergency response for 2/3 of the year, I can report that responded to the earthquake with life-saving supplies, there was no let down in our scheduled development work in six other thematic areas of and continued assisting children and their families during work. Excluding our emergency work, we helped directly assist more than 1.71 children and the recovery period. We had prepositioned supplies in 3.1 million adults. Specifically for children at the community level, our advocacy on various locations in the country and that made it governance resulted in local bodies increasing budget allocation for children by 15 %. possible for us to respond in the first 48 hours. As an To conclude the year, my spirits were raised in particular by Article 39 of Nepal’s new international humanitarian organization whose history constitution which categorically guarantees “every child” the right to education, health rests on working during disasters and emergencies, our services and right to be protected from harm. This guarantee and the provision for redress national and international staff were supported with to guarantee those rights for every child should be seen as a new chapter for the full growth supplies and logistics from storage hubs across cities in potential for every child in Nepal. Asia. At the end of 2015, we were able to help close to 550,000 earthquake affected people, of whom more In conclusion, I also express my gratitude to our partners, local and central government than 60 % were children. bodies for their support in helping us reach and assist children to grow and develop. Education cannot stop even in a disaster, and that drove us to build Temporary Learning Centers. To keep children and their families safe and healthy, Child Friendly Spaces were set up and affected farmers were provided seeds during the planting season. Likewise, Delailah Borja thousands of children and their families in the most Country Director, Nepal and Bhutan Program remote affected areas were provided materials for

2 541, 627 Nepal Program: Results for Children in 2015 Our Nepal Earthquake Response Program reached 541,627 people including 326,030 children In 2015, we reached over 4.6 million children through our work, including over 2 million children directly 200m In Dhading, Gorkha and Sindhupalchowk, 15,438 families were provided with winterization kits/or cash vouchers worth NRs. 200 million.

259, 239 children had access to high-impact life saving interventions through Save the Children supported activities or facilities.

75% 75 percent of grade three children achieved mastery in literacy, a 10% increase from 2014 in our working areas.

45 VDCs 26 village development committees in Achham, 14 in Doti, 5 in Bajura were declared chhaupadi shed free VDCs under our child protection program.

3 Nepal Program: Our Reach Financial Expenditure 2015 Theme Description Revised thematic Themewise % expenses Thematic Area Direct Reach Indirect Reach Education 8,683,165 13% Children Adults Total Children Adults Total Health 4,244,626 7% Child protection 180,837 115,950 296,787 394,408 427,780 1,227,215 Nutrition 17,778,260 27% Education 657,418 171,829 829,247 665,069 288,746 1,222,506 Child rights governance 930,357 1% Health 99,432 65,743 165,175 129,695 27,655 257,928 Child protection 3,174,276 5% Nutrition 1,043,844 964,642 2,008,486 1,529,432 2,580,739 6,803,278 Humanitarian 12,547,595 19% HIV and AIDS 13,764 160,976 174,740 26,589 283,215 462,121 HIV / AIDS 6,935,706 11% Livelihoods 18,365 35,092 53,457 57,817 47,572 155,664 Livelihoods 3,944,880 6% Child rights governance 59,514 44,288 103,802 123,868 101,093 338,175 Non-Thematic 6,684,197 10% Humanitarian 352,667 238,842 591,509 97,809 40,892 183,394 Total 64,923,061 100% Others 0 521 521 0 0 0 Gross Total 2,425,841 1,797,883 4,223,724 3,024,687 7,625,593 10,650,281 Double Counting Adjustment 388,492 175,106 563,598 387,017 300,273 687,290

Total people reached 2,037,349 1,622,777 3,660,126 2,637,671 7,325,320 9,962,991 Livelihoods Non-Thematic 6% 10%

HIV / AIDS Education 11% 13%

Child protection 5% Health 7%

19%

Nutrition Child Rights Governance 28% 1%

4 Humanitarian

Reached 10,385 households with unconditional cash transfer, In 2015, we carried out the our largest humanitarian 495 temporary learning centers response in Nepal. We raised over 52 million (TLCs) set up and 451 winterized, helping families buy essential helping over 191,678 children items immediately after the USD and reached 541,627 people affected by the resume schooling disaster, amounting to over NRs. earthquake of whom 326,030 were children. 155 million

Nepal Earthquake Response The 7.8 magnitude earthquake in April 2015 was the worst natural disaster to strike Nepal in over 80 years. The last one was in 1934. This time, the destruction centered around the rural mid-hills of Nepal, destroyed homes and affected the lives of people who live in geographically challenging terrain. The death count reached almost 9,000 and more than 22,000 people, including children, were injured.

Immediate and Initial Response (April 25, 2015 - June 30, 2015) Preparedness and planning helped Save the Children launch an immediate response within the first 24 hours after the earthquake. National staff trained in humanitarian response, were deployed and prepositioned stocks in four locations in Nepal, including Kathmandu, proved to be life-saving for many in the aftermath of the disaster. The response was fortified by the deployment of Save the Children’s experienced surge capacity teams to provide specialized expertise to Roshan (12), was helping his mother gather firewood on 25 April 2015. His home succumbed to the the response. tremors but none of his family members were inside at the time of the earthquake. He lives in Sertung During the initial response period, Save the Children focused on the most urgent which rests at an elevation of 1,640 m and can only be reached on foot. At the peak of winter, his humanitarian needs, with programming focusing on providing temporary shelter village receives at least 3 feet high snowfall. Save the Children used helicopter drops to send winter support and essential relief materials. There were safety and information kits with warm blankets, caps, socks, scarves and tarpaulins among other materials. Roshan says, “The messages across several media platforms, particularly aimed at the needs of woollen cap is great!” people with the monsoon season approaching.

5 Relief and Early Recovery Responding rapidly to the earthquake, our services of over 20 million USD in the first eight carried out in partnership with Plan logistics unit put together a team of logisticians, months of the response. To meet the needs of International, UNICEF and World Vision, in (July 1, 2015 - 31 October, 2015) national and international in Kathmandu and affected communities during the winter, the collaboration with the government. The Access became a huge challenge, with dry emergency field sites within the first ten days. logistics team arranged more than 20 MI-17 heavy findings of the consultation were reflected and landslides and monsoon rain cutting off road We moved more than 3,000 metric tons of lift helicopter rotations to support families in high quoted in our joint advocacy work as well as access to several of the affected emergency relief supplies to the earthquake altitude areas. Government of Nepal’s Post Disaster Needs communities in high mountainous areas. Assessment. affected areas of operation, sourced locally and In July 2015 we launched a Save the Children reached out to the also received by air freight from the report, “After the Earthquake: Established 49 Outpatient Therapeutic affected communities during this period with organisation’s prepositioning hubs around the Nepal’s Children speak out” Centers (OTPs) and 26 Mother-Baby Areas multi-purpose cash distributions, allowing globe. Key support and shipments came from our which was based on (MBAs) provided quality nutrition evaluation the most-affected communities to buy the India, China and Philippines offices. The Nepal consultation with 1,838 boys services and provided treatment for severely things they needed to meet their own country program’s logistics and procurement and girls from 14 most-affected malnourished children from six months to immediate needs. Key relief and response teams were able to channel in supplies and districts. The consultation was five year old children. activities and community mobilization were implemented with and always through local NGO partners and in coordination with local government. Recovery Phase and Transition to Development (November 1, 2015 - April 2018) Save the Children’s focused priority during this phase had been on the relief and recovery needs of those communities living in high altitudes and remote locations. Our teams carried out a large and complicated winterization project in the remote mountains of Gorkha and Sindhupalchowk districts, ensuring that these communities had essential amenities to survive the winter and stay warm. This is one of the first Temporary Learning Center built after the April earthquake.

6 Child Rights Governance

SC’s partnership with local NGOs and Partnership with local bodies has Save the Children’s partnership on advocacy with the the local government authorities and enabled 66 of them to adopt ‘Child Central Child Welfare Board resulted in the development community mobilization has resulted in Friendly Local Governance’ (CFLG) of comprehensive indicators to track progress on 9% increase in the number of people framework, providing space for children accessing social protection schemes in to raise their voice in the planning children’s civil, political, economic, social and cultural SC working areas. process and taking the results at scale. rights, which will be used by the government to collect, analyse and publish children’s disaggregated data. 63% (17 out of 27) District Child Welfare Boards (DCWBs) have been able to develop a five-year district strategic plan for children, guiding their work and taking the results at scale.

Save the Children brought together six Terai (southern plain region), it organized a different civil society networks consisting national level workshop to sensitize of more than 750 I/NGOs for the child political parties and called on them to stop centered Universal Periodic Review (UPR) using children for their political agendas. reporting. An intensive lobbying and Together with national civil society advocacy with UN Member States resulted networks, we were able to obtain several in 50 recommendations related to children rights of children including child being raised in Nepal’s review at the Human participation as the fundamental rights and Rights Council. In an effort to strengthen the ‘children’s best interests’ as one of the monitoring of child rights in the aftermath State directive principles in the country’s of the April earthquake, Save the Children new constitution promulgated in 2015. supported the National Human Rights Advocacy for the ratification of the 3rd Commission (NHRC) capacity building Optional Protocol to the Convention on training to ‘Human Rights Mobile Camp’ in the Rights of the Child (CRC) on a 11 most affected districts for increased communications procedure continues with monitoring of children’s situation during key government officials. emergency. In addition to NHRC’s own Save the Children set up 61 child friendly spaces helping 4,823 children enjoy a safer monitoring of the political unrest in the and more secure environment after the April earthquake. Photographer/Save the Children the Photographer/Save 7 Save the Children brought Voice for increased and improved investment in children was Save the Children’s partnership with children has empowered together six different civil continuously raised at both local and national level, resulting in 10% them for their own advocacy as 63% of district and three regional child club networks in working areas are functional and the district society networks consisting of increment in resources generated by DCWBs and 15% increment in the allocation of Village Development Committee (VDC) budget to networks have been able to get 39% of their issues addressed by more than 750 I/NGOs for the children’s issues. relevant district authorities. child centered Universal Periodic Review (UPR) reporting. An intensive lobbying and advocacy with UN Member Children from brick factories put up a play about their lives inside the kilns. The States resulted in 50 children underwent a period of training where they improvised the content of the play. recommendations related to children raised in Nepal’s review at the Human Rights Council. In an effort to strengthen monitoring of child rights in the aftermath of the April earthquake, Save the Children supported the National Human Rights Commission (NHRC) capacity building training to ‘Human Rights Mobile Camp’ in 11 most affected districts for increased monitoring of children’s situation during emergency. In addition to NHRC’s own monitoring of the political unrest in the Terai (southern plain region), it organized a national level workshop to sensitize political parties to refrain from misusing children.

8 Child Protection

In an effort to establishing child protection systems at the local level, referral mechanisms were Our partnership with the Government to fight against practice of established and made functional, as a result of which 1,652 cases of child protection violation were chhaupadi (isolation of women during menstruation) continued in referred through the mechanism to appropriate services. Partnership with local service providers 2015. Fifty Seven VDCs were declared as chhaupadi free, resulting helped 92% (2,615 out of 2,850) of child victims of abuse and exploitation to resume normal life. We supported the removal of 49 children from hazardous/worst forms of child labour and in 99% of school age girls continuing schooling and 93% of women reintegrated them into family/community based care. 71% of children working in non-hazardous and girls staying inside their homes during menstruation. Stepping forms were supported to continue schooling. 108% (1,237 out of a target of 1,150) of OVC have on this successful partnership, Women and Children offices of received services that address priority needs. Achham, Bajura and Doti districts have developed a five-year Chhaupadi elimination strategy with a commitment to continue “My friend was staying in a shed meant for working even after we conclude our support in January 2016. menstruating women. During the night, a snake bit her and she passed away. No one mentioned that she lost her life because she was forced to stay in that tiny, unsafe shed. But that was how I understood that We partnered with local child protection Our work to strengthen child protection segregating girls and women during structures and law enforcement authorities, systems at national and local levels is showing menstruation was not a good practice.” religious and social leaders and children to bring results. Significant results were observed as – Sharada, ninth grader from Achham down incidences of child marriage by 23% in old 80% of Women and Children Service program districts and, a reduction by 7% point Centres of District Police, 33 out of 38 in new program districts (from 48% to 41%). DCWBs and 67% of VCPCs in the working areas have become functional, undertaking - 11 VDCs declared as ‘child marriage free’ VDCs. both prevention and response interventions - 94% of trained parents, teachers, VCPC on child protection. 82 % Save the Children members and other stakeholders took CP trained para-social workers (PSWs) are initiatives managing cases. A draft Alternative Care - 92% teachers and 83% of parents/caregivers had Rules is final and awaiting government not used violence as a discipline technique approval after enactment of the new during three months prior to the survey. Children’s Bill likely to be endorsed by 2016. Together with national civil society networks, - 11% of children and caregivers have used we have been able to secure several child prevention or response interventions protection rights as fundamental rights in the supported by Save the Children. constitution promulgated in 2015.

9 10 Sisters Rina and Rima lost their home to the Save the Children initiated a case management earthquake in April last year. Neighbors offered system for children at risk in emergencies, like them a space in their makeshift shelter and gave for sisters Rina and Rima. Village Child them food for almost a month. Their father, Protection Committees (VCPCs) have been who had not been in contact with them, came trained to identify cases that need immediate back and converted their cow shed into a attention and assistance. A circle of friends temporary shelter. (peers) and a protection circle is formed around the children to support children at risk. With The girls have come a long way since that fateful community support, Save the Children is Saturday. They attend school regularly, do their supporting 518 such cases in earthquake homework and play with friends. But their affected districts. grandmother worries about her grandchildren’s safety and wellbeing.

Ninth grader Shanker who lives with polio stopped going to school when his sister Reshma dropped out to earn some extra income for the family. The Village Child Protection Committee in Sunsari provided a bicycle to Shanker to go to school on condition that his sister also resumes school. Both brother and sister go to school on the bicycle.

10 Education

Education interventions reached 657,418 children (50% of girls) Learning achievement of 75% of grade three children 58% of Save the Children grade three and grade five achieved Mastery in supported primary schools and 171,829 adults (48% female) in 2015, providing support students increased to Literacy, a 10% increase met the four defined QLE through 1,452 ECCD centers and 1,305 schools (81 Madrasas), 51.4% and 51% respectively from 2014. guiding principles. from baseline 45% and which contributed to Literacy Breakthrough. 44%.

Save the Children’s innovative approach emergent literacy and math (ELM) was started in close collaboration with the Government of Nepal. Reporting results show 59% (target 49%) of ECCD centers met 4 defined QLE (quality learning environment) guiding principles. Around 74 % four-year- old children in our working areas are now enrolled in Early Childhood Care and Development (ECCD) centers while 46 % children entering grade one had ECCD experience. We continued to be the voice for children to ensure their rights to Early Childhood through ECCD caucus of parliamentarians to establish ECCD as a common agenda among political parties and it resulted in the inclusion of ECCD as Basic Child Rights in the New Constitution.

In 2015, we focused on scaling up of Literacy We focused on creating evidence of reaching Boost to contribute to National Early Grade geographically and socially isolated children by Reading Program. This was done by working jointly with the government and strengthening the capacity of staff on Early community-based organizations. This was done Grade Reading and Literacy Boost Assessment, by mapping of pocket areas through CEMIS, developing master trainers through training of focused enrolment campaigns and educational trainers, capacity building of Resource Persons support by establishing endowment fund for and teachers and promotion of reading culture. children from marginalized communities. We continued advocating an approach for expansion This year, 80 different new titles of fact books of free and compulsory basic education to were developed, among which 15 titles were increase access for all children. As a result, 23 printed in Braille to promote inclusive education new VDCs and 263 new schools are practicing and to advocate for the need of additional free and compulsory basic education. reading materials for children with special needs.

11 12 We introduced an innovative approach of Attendance After a five-day Early Literacy and Math training, ECCD facilitator Nirmala completely Audit and mobilized Lead Resource Persons to increase attendance and regularity of children in changed her teaching style. “I started teaching through songs, games and group work. I schools. In partnership with the Ministry of Education, color stones from the river and use them to teach children numbers.” Save the Children supported to develop and test the school based learning achievement framework. We continue to pursue advocacy for the implementation of Schools as Zones of Peace (SZOP) at the local and national level, increasing child participation in SMC, declaration of free and compulsory primary education, and education for children with disability. Child participation and protection have been established as cross cutting theme in education. As a result, 68% of schools have active participation of children in SMC with almost equal level of representation of boys and girls. In 2015, 51% of schools declared SZOP with monitoring systems in place. We are also leading the Consortium on Child- Centered Disaster Risk Reduction and contributing to the formation of National Comprehensive School Safety Framework. Save the Children’s contribution to Humanitarian Response was a priority and we actively contributed as co-lead of EiE cluster. We established 586 inclusive TLCs with WASH facilities and winterized 450 TLCs, trained 3,350 teachers and DEO personnel on psychosocial support and distributed education and recreational kits reaching over 190,000 students (91,678 boys; 100,000 girls) in 9 most earthquake Nirmala with her young students from the early childhood care and affected districts. development center

12 Health and Nutrition

A year after the earthquake, Bimala with her youngest son Bijay Save the Children initiatives continued in collaboration with visits the local health post in Panchkhuwa Deurali VDC, which has the Government of Nepal’s Department of Health Services to been running from the (Alpha) medical tent set up by Save the increase access of newborn, child, adolescent, and pregnant and lactating mothers to quality health and nutrition services in 45 Children. She had previously given birth to her third son, Bibek, in districts. the health center originally built by Save the Children in 1988.

The revised CBIMCI package has been endorsed and is currently being rolled out. We continue to introduce innovation in our programs, some of which are ‘My First Baby’ a pilot project to reach adolescent pregnant women and “Foot Length” project to identify low-birth weight babies and a tail on package (an additional add on training to the original one) for CBIMCI in emergencies. Save the Children carried out a first of its kind assessment of the situation of 31 public hospitals to identify main gaps for standardized quality of health care services. We have strengthened our partnership with the government through our involvement in the technical working groups in MNCHN, been an integral part of developing the every new born action plan (ENAP) and Nepal Health Sector Support Program (NHSSP) III and contributed to various clusters in the emergency.

- 259,239 children had acccess to high-impact hospital continuum of maternal and newborn ‘life-saving’ interventions through Save the care (CBNCP+MNH), as 58% of women used Children-supported activities or facilities. skilled birth attendants for delivery against a target of 60% an increase from 41% from last - 3,118 health care workers completed pre- year. On an average 82% received the service or in-service training for management or recommended 3 visits in 7 days after delivery delivery of priority child health and nutrition for new born care in SC project districts to a topics using nationally standardized curriculum. target of 70%. For coverage of childhood Save the Children’s ‘Reaching the Unreached’ illnesses, data from the district shows 43% of strategy is being piloted in three districts …, the children under five in selected districts were aiming to make quality health and nutrition treated for acute respiratory infection and 91% services available to children and mothers from sought treatment for diarrhoea with ORT and underserved populations. Result in selected Zinc. Bimala Pariyar with son Bijay districts shows increased use of household to

13 14 Save the Children scaled up Infant and Young Child Results of the scale up of the school health and nutrition program show 93% of school children Feeding (IYCF) program with the government and reported washing hands with soap and water after using the toilet and 86% of schools having other agencies. Results show that 82% newborns received breast feeding within an hour of being born. functioning latrines. Results of the scale up of the school health and nutrition program show 93% of school children reported washing hands with soap and water after using toilet and 86% of schools having functioning latrines. Similarly, Essential Hygiene Action and Essential Nutrition Action implemented in 41 Suaahara districts resulted in a 57% of caretakers with appropriate hand washing behaviour. Through the SUN SCO alliance, we advocated on advocacy and on initiating the concept of Baby Friendly Hospital Initiative through orientations in two major hospitals in Kathmandu. Save the Children held interactions with parliamentarians and conducted public hearings to advocate for effective implementation of MSNP. A total of 754 health workers trained on various health related trainings such as ASRH, SBA, FP, CBNCP, IMNCI, MHPSS, and 7,635 front line health workers were trained in IMNCI and MHPSS (emergency response). 40 nursing focal teachers were trained through pre-service training and 3,455 health workers and 1,2291 front line health workers trained in SHN, IYCF/MIYCN and Community Nutrition Package. The results of supporting government to scale up nutrition services in remote areas show 21% increment of children under six months who are exclusively breast-fed in program districts.

14 HIV and AIDS

Mijar family’s home was destroyed during the April 2015 earthquake. With Our HIV and AIDS program focused on enhancing the three family members living with HIV, the family dug into the rubbles to find knowledge and skills of youth and children on HIV, their antiretroviral therapy (ART) medication and were lucky to find them. promoting access to HIV related services for PLHIV, The Global Fund approved a top-up funding to the existing HIV grant of Save creating an enabling environment for CABA and the Children to respond to the needs of people living with HIV and people at promoting access to HIV prevention and treatment services among Most at Risk Population (MARP). risk of HIV affected by the earthquake. Seen here in the photo below is the family’s temporary shelter.

The partnership of Save the Children behavioral surveillance among different with Ministry of Health, Government of key populations were the major Nepal was made stronger this year as achievements in HIV program in 2015. Save the Children became the only In the year 2015, 13,764 children were Principal Recipient (PR) for all three directly reached by HIV program among diseases (HIV, TB and Malaria). SC which 6,354 were girls and 7,410 were worked in close coordination with boys. Total people reached indirectly was Department of Health Services before 462,121. Planning Policy and International Cooperation Division (PPICD), National One of the major activities was scale up Centre for AIDS and STD control, of HIV testing services through HIV Logistic Management Division, National testing and counselling centers (HTC) Public Health Laboratory, Regional and Community Based Testing (CBT) to Health Directorate and District Public prevent HIV. One of the major Health offices for expansion of HIV achievements in 2015 has been the services and provision of quality services introduction of CBT, an innovative for people living with HIV through out approach. Though national level the country. Roll out of community based discussions are ongoing about the testing (CBT), expansion of sites for viral modality of CBT, the national load sample collection, initiation of DNA stakeholders recognize SC for being a PCR for early infant diagnosis, scale up of pioneer in the start up of CBT. PMTCT services and integrated bio

15 16 14 year old Nira* lost both her parents to AIDS at the age of seven. On antiretroviral therapy, she has to walk four hours from her home to get to the district hospital. With the cash transfer program In the year 2015, 13,764 children were directly reached by HIV program support she receives every month, she saved enough to buy herself a bicycle. She can now make the among which 6,354 were girls and 7,410 were boys. Total people reached trip to the hospital easily on her bicycle. She also cycles to the school and to extra classes. Every indirectly was 462,121 month, Save the Children in collaboration with Global Fund transfers Rs. 1000 to children living with HIV in 45 districts. So far 1,239 children have enrolled in the program as of 15 November 2015.

* Name changed

Care, support and treatment was one of the major focus area in the last year. Through community home based care (CHBC) and community care centers Living with HIV and on antiretroviral therapy, she is running a tailoring shop and saving for her child’s future. (CCC) people living with HIV are provided with knowledge and skills on self care, ART adherence, dealing with care, lessening stigma and discrimination, management of Opportunistic Infections (OIs) and ensuring access to care. Our program also prioritizes caring and supporting for HIV affected children without adequate care. 1,239 children living with HIV received the cash transfer services that address their priority needs like education, protection and livelihood, which is 95% achievement against the anticipated target of 1,294. In 2015, we provided HIV testing and counselling services through static HTC sites in 16 districts and thorough CBT in 42 districts in order to promote access to HIV prevention and testing services among most at risk Population (MARP) to protect themselves against HIV and AIDS and mitigate its impact. The IBBS surveys conducted in 2015 have shown that 84% of FSWs in Kathmandu valley, 64% of PWIDs in eastern region and 55% MSW, 43% TG and 23% MSMs in Kathmandu valley have had access to HIV test in past twelve months.

16 Child Poverty and Livelihoods

A year after the earthquake, Devi is nurturing hope; She is about to give birth in a month’s Millennium Development Goals (MDG) and Sustainable Development time and starting a new business. She received a conditional cash grant of NRs. 15,000, with which she plans to start rearing goats. She also learnt about creating a business plan and Goal (SDG) both have considered poverty as the greatest global skills to run a successful business. challenge and identified poverty reduction as an indispensable Devi says,“ I used to think that goats were only good for making curries during festivals.” requirement for sustainable development. Nepal has made some She is investing some money of her own to buy goats. She is hopeful that her first business venture will yield profit so that she can help her husband by contributing in the household progress towards reducing poverty as the proportion of the expense and save some money for the future of her family.. population below the national poverty line reduced from 42% in 1990 to 25.4% in 2010 (Nepal MDG Progress Report 2013). However, significant disparities remain within the population. Therefore Government of Nepal (GoN) is striving to eradicate poverty particularly of most deprived communities, and people living below the poverty line through a clear constitutional commitment. In this context the Thirteenth Three-Year Plan (2013/14-2015/16) is dedicated to achieve the poverty reduction goals set by MDG and SDG.

In 2015 the SC Livelihood program focused its enterprise have received micro credit facilities from interventions on promoting the use and financial institutions increasing their accesses to establishment of social safety net, creating income micro-finance services. generation options through on- and off-farm The Livelihoods and Nutrition Project (LNP) and interventions, and supporting adolescent/youth Sponsorship project jointly contributed towards transitioning. achieving our objective to increase food and In 2015, 1,141 youths (51% female) were trained on nutrition security of vulnerable families. Farm vocational and micro enterprise skills, out of which production of the targeted households was 57% of them earned an additional income of Rs increased by 37% resulting in household food 72,000 this year. These households have increased provisioning enhancement by 20% leading to an expenditure for children’s wellbeing by 32%. 630 increase in household dietary diversity by 5%. (50% female) deprived youths trained in micro Our community based micro-health insurance has

17 18 mitigated the financial risks associated with health development training manual. SC established a Attending Self Employment Education Program (SEEP) classes for 31-year-old spending of low income families. There are 19,249 MoU with Social Health Security Development Laxmi was an opportunity to learn how to read and write again. She says, “I was people enrolled in the scheme where 37% of them Committee (SHSDC) under Ministry of Health able to learn how to write Nepali alphabets, I learned how to do simple are children. The establishment of Child and Population for supporting them in the calculations and also learned about the importance of saving.” A year after the Endowment Fund (CEF) has been scaled up by preparation of National Health Insurance Policy, SEEP classes, Laxmi can write her own name. She also helps her daughters with mainstreaming into government systems and capacity building of Government staff, and scale up their homework and occasionally visits her daughters’ school to evaluate their cooperatives in all the project areas. A total of 27 of Government’s health insurance scheme in CEFs were established, and 12 VDCs provided funds selected districts. performance. In addition, she also teaches her husband how to read and write. to their newly established CEF. These funds are used to provide the most deprived, vulnerable and orphan children with cash and or other support materials for education, medical treatment or and nutritious food. During the reporting year 1,384 children accessed this fund out of which 681(49%) were girls The aim of such direct support enabled them to continue their education, or have nutritious food, or receive emergency medical support. Save the Children has built partnerships with a wide range of stakeholders (government, development partners, research institutions and private sector) to create enabling policy environment at national and local level to address the issues of unemployment, child hunger, malnutrition and safety net. Government’s Youth Self Employment Fund (YSEF) used the household income and expenditure tracking tool developed by Save the Children in selected districts while SC supported YSEF in scaling up of its use in other districts. YSEF is also using Save the Children’s micro-enterprise

18 Our Donors Our Partners

A range of partners across Nepal support our programs in the field. Our work in Nepal is made possible by the generous support of institutional and One Foundation (China) Our partners for 2015 are listed below: individual donors. Our donors for 2015 are listed below: Pierre and Pamela Omidyar Fund Population Council All private and individual donors Aasman Nepal (AN), Ramechhap Samenwerkende Hulporganisaties (SHO) – Netherlands Americares Aavash Samuha, Lalitpur Swedish Emergency Fund (SEF) Banyan Tree Foundation Arunodaya Yuba Club (AYC), Bara, Rautahat & Parsa Swedish International Development Cooperation Agency (SIDA) Bezos Family Foundation Association for Helping the Helpless (AHH), Banke Swiss Private Foundation Bulgari Astha Samuha (AS), Rupandehi The United Nations Children's Fund (UNICEF) Comic Relief Backwardness eradication society,Nepal (BES) Nawalparasi Thrive Solar Energy Cummins Foundation Bank of Kathmandu (BoK) Kathmandu UBS Optimus Foundation d.light Banke Unesco Club (BUC), Banke UN World Health Organization Danish International Development Agency (DANIDA) Bheri Environmental Excellence Group (BEEG), Banke United Nations High Commissioner for Refugees (UNHCR) Department for International Development (DFID) – UK Blue Diamond Society (BDS) USAID - United States Agency for International Development Department of Foreign Affairs and Trade (DFAT) – Australia Jhapa/Morang/Siraha/Sunsari/Kathmandu, Bardiya, Dang World Food Programme (WFP) Disasters Emergency Committee (DEC) – UK Centre for Community Development Nepal (CCDN) Disney Worldwide Services, Inc Makwanpur EC - European Commission Change Team (CT), Banke European Commission’s Humanitarian Aid and Civil Protection Department (ECHO) Child Development Society (CDS), Kathmandu Ford Foundation Child Development Society (CDS), Udayapur Gates - Bill & Melinda Gates Foundation Children as Zone of Peace and Protection (CZOPP), Kathmandu Global Affairs Canada (DFATD) Children Women in Social Service and Human Rights (CWISH), Global Fund to Fight AIDS, TB and Malaria Kathmandu Government of Finland Ministry of Foreign Affairs Chitwan Sakriya Samuha (CSS) Chitwan Humanitarian Coalition – Canada Chitwan Sakriya Women’s Foundation (CSWF) Chitwan IKEA Civil Society Alliance for Nutrition, Nepal (CSANN) Kathmandu Institute of Reproductive Health, Georgetown University Community Action Center Nepal (CAC –Nepal) Kavre International Organization for Migration (IOM) Community Development Center (CDC) Nuwakot ITV “Text Santa” Programme – UK Community Development Forum (CDF) Doti KOICA -Korea International Cooperation Agency Community Family Welfare Association (CFWA) Dhanusha Margaret A. Cargill Foundation Community Human Resource Development Program (CHURDEP) Ramechhap Merck Company Foundation Community Support Group (CSG) Ministry of Foreign Affairs (MFA) – Finland Kaski, Lamjung, Gorkha, Tanahu, Syangja, Parbat, Baglung Ministry of Foreign Affairs (MFA) – Norway Consortium of organization working for child participation Ministry of Foreign Affairs (MOFA) Netherlands (Consortium) Kathmandu Ministry of Foreign Affairs and Trade, New Zealand (NZ-MFAT) Cottage and Small Industries Development Board (CSIDB Pyuthan MISEREOR Dalit Development Society (DDS) Salyan Norwegian Agency for Development Cooperation Dang Plus, Dang Office of U.S. Foreign Disaster Assistance (OFDA)

19 20 Our Partners

Development Project Sercice Centre Nepal (DEPROSC), Kathmandu Manish Care Foundation (MCF), Kaski Rural Community Development Center (RCDC), Lamjung Dharan Positive Group (DPG), Sunsari MenEngage Alliance Nepal, Kathmandu Rural Development and Awareness Society Nepal (RDASN), Rolpa Environment Conservation and Development Forum (ECDF), Taplejung Multidiciplinary Institute for livelihood Enhancement & Natural Resource Mgmt. Rural Development Tuki Association(RDTA), Dolakha Everest Club (EC), Dailekh (MILAN), Myagdi Saarathi Nepal, Kathmandu Family Health Division (DoHS), Kathmandu Multipurpose Development Society (MPDS), Baitadi, Bajhang and Dadeldhura Sabal Nepal, Saptari Federation of Sexual & Gender Minorities-Nepal (FSGMN), Kathmandu Nagarjun Development Community (NDC), Dhading, Banke, Dang Samskritik Sambardhan Tatha Samajik Sudhar Manch (SSSSM), Baitadi Forum for Community Upliftment System (Focus Nepal), Dhading Nangshal Association (NA), Kavre Sathi Samuha (SS), Kathmandu, Nuwakot, Dhading Forum for Rural Development (FORD), Okhaldhunga National Association of People Living with HIV & AIDS in Nepal (NAP+N), Kathmandu Save the Saptari (STS), Saptari Friends Affected & Infected Together in Hand (FAITH), Kanchanpur National Center for Educational Development (NCD), Kathmandu Seto gurans child development service, Baglung, Kapilvastu Gaja Youth Club (GYC), Baglung National Federation of Women Living with HIV & AIDS (NFWLHA), Kathmandu Seto Gurans National Child Development Nepal, Kathmandu Gateway Foundation Nepal (GFN), Kaski National Health Training Center (NHTC), Kathmandu Shanti Jana Aadrsha Sewa Kendra (SJASK), Kavre Hamro Prayas Nepal (HPN), Sindhuli National NGOs Network Group Against AIDS-Nepal (NANGAN), Kathmandu Shilichong Club Social Development Centre (SCSDC), Sankhuwasabha HAPPY Nepal, Jhapa National Rural and community development centre (NARDEC), Gulmi Shree Swanra Integrated Community Development Center (SSICDC), Gorkha HEEHURLDE Nepal, Bhojpur Nava Kiran Plus (NKP), Kailali / Surkhet Shrijana Community Deveopment Centre ( SCDC), Siraha Hilly Region Development Campaign (HRDC), Jajarkot Nawa Chetana Community Development Center (NCCDC), Mustang, Parbat Sindhuli Integrated Development Service (SIDS), Sindhuli Holier Association of Polite & Progressive Youth (HAPPY), Nepal Jhapa Nawa Kiran Sewa Samaj Nepal (NKSSN), Khotang Sneha Samaj (SS), Kathmandu Hoste Hainse Child Development Society, Tanahun Nepal Anti- Tuberculosis Association (NATA), Kathmandu Social Awareness Center (SAC), Surkhet Human Rights and Environment Development Center ( HURENDEC), Udayapur Nepal Health Education, Information and Communication Trainning Center Social Development Forum (SDF), Banke Human Rights Awareness Centre (HURAC), Rolpa (NHEICC), Kathmandu Social Empowerment Building Accessibility Center Nepal (SEBAC_Nepal), Acchham Indreni Service Society (INSES), Siraha/Saptari Nepal Health Research Council (NHRC). Kathmandu Social Service Center (SOSEC), Dailekh Integrated Village Development Service (IVDS), Makwanpur Nepal HIV/AIDS Alliance (NEHA). Kathmandu Society for Local Integrated Development, Nepal (SOLID Nepal), Kathmandu Jagriti Mahila Maha Sangh (JMMS), Kathmandu Nepal National Dalit Social Welfare Organization (NNDSWO). Lalitpur Society for Positive Atmosphere and Related Support to HIV & AIDS Jalpa Yuba Samuha, Udayapur Nepal National Social Welfare Association (NNSWA), Kanchanpur (SPARSHA), Lalitpur & Dhanusha Kalika development center Nepal (KDV), Pyuthan Nepal Redrcoss Society (NRCS). Siraha Society Support Group 2003 (SSG), Rupandehi kalika self reliance social center(KSSC), Kapilvastu Nepal STD and AIDS Research Center (N’SARC), Dailekh/Rolpa Student Awareness Forum (BIJAM), Makawanpur & Parsa Kapilbastu Integrated Development Services (KIDS), Pyuthan/Rolpa Nirdhan NGO, Banke Sunshine social development organization(SSDO), Kapilvastu Kapilvastu Integrated Development Services (KIDS), Pyuthan and Rolpa Panch Tara Yuwa Smrakshyak Manch (PTYSM). Jajarkot Support & Care Rehabilitation Center (SNC), Chitwan Karnali Integrated Rural Development and Recharch Center (KIRDARC), Kalikot Participatory Effort at Children Education and Women Initiative System Development Service Centre (SDSC), Gorkha Khotgadhi Shikhar Samaj (KOSIS), Okhaldhunga (PEACEWIN), Achham/Bajura System Development Service Sentre (SDSC), Gorkha Knight Chess Club (KCC), Jhapa Prerana, Kathmandu, Arghakhanchi & Gulmi Trisuli Plus (TP), Nuwakot KYC - Punarjiwan Kendra Kendra, Morang /Sunsari Public Welfare Society Nepal (Jana Sewa Samaj Nepal), Khotang Tuki Association Sunkoshi, Sindhupalchowk (Tuki), Sindhupalchok Langtang Area Conservation and concerned Society (LACCoS), Rasuwa Recovering Nepal (RN) Kathmandu United Nepal Foundation Lumbini (UNFL), Rupandehi, Kapilvastu & Palpa Lumbini integrated development organization,Nepal(LIDO), Kapilvastu Resource Centre for Primary Health Care (RECPHEC), Kathmandu Village Development and save the Environment Font (VDSEF), Kalikot Mahila Atma Nirvarata Kendra (MANK), Sindhupalchowk Richmond Fellowship Morang (RFM), Morang Women Self - Help Centre (WSHC), Lamjung Mallarani Rural Development Concern Center (MRDCC), Pyuthan Richmond Fellowship Nepal (RFN), Chitwan Working for Access and Creation-Nepal (WAC-N), Achham Management Division ( DoHS), Kathmandu Rukumeli Samaj Development Center (RSDC), Rukum Youth Vision (YV), Bhaktapur & Nawalparasi Manekor Society Nepal (MSN), Rasuwa Rular Society Development Center (RSDC), Sunsari Rural Access Development and Research (RADAR), Dang and Rasuwa

20 Nepal Country Office Tel: +977-1-4468130/4464803 Airport Area Gate, Sambhu Marg Fax: +977-1-4468132 Kathmandu, Nepal Email: [email protected] GPO BOX 3394 nepal.savethechildren.net