CMC-Nepal School Mental Health Programme

Semi-Annual Report January – June 2019

Submitted to: Felm

Prepared by:

Centre for Mental Health and Counselling – Nepal

(CMC – Nepal)

Thapathali, Kathmandu

Contact: PO Box 5295, Kathmandu, Nepal

Email: [email protected]

Website: www.cmcnepal.org.np

August 2012

Location of the Project: Province No 3: Kalika, Gosaikunda, Amachhodigmo, Uttargaya and Naukunda Rural Municipality of Rasuwa district Gandaki Province: Palungtar and Gorkha Municipality, Sahid Lakhan, Siranchowk, Sulikot, Bhimsen, Arughat and Gandaki Rural Municipality of Gorkha district Karnali Province: Baghchaur, Bangad Kupinde and Sarada Municipality, Kalimati Rampur and Chatreshowori Rural Municipality of Salyan district Sudhirpachhim Province: Bhajani, Gauriganga and Godawari Municipality, Kailari and Joshipur Rural Municipality of Kailali district.

Name of the project: School Mental Programme (SMHP)

Short description of the project current situation1:

This was the first half of the second year of the fifth phase (2018 to 2021) program, which was implemented in 23 (rural) municipalities of 4 project districts as stated above. This program is implemented based on Memorandum of Understanding (MoU) signed with Centre for Education and Human Resource Development (CEHRD) at central level and with all (rural) municipalities at local level. This project has covered the catchment of 70 schools and 10 health facilities. SMHP is financially supported by the Felm, Finland.

This main aim of the project is to bring the impact in quality learning of the school going children and adolescents through the promotion of psychosocial well-being. This project was designed following the research-based intervention approach. The baseline research study was conducted in the first quarter of the year 2018, followed by midline study in second quarter of the year 2019. The major indicators of evaluation study were the drop-out rate, school attendance rate, learning achievement rate, school truancy and psychosocial wellbeing of the school going children and adolescents. School attendance rate is increased by 14% (baseline-69.25%, midline 83.25%) and learning achievement is increased by 13% (baseline-45% and midline 58%). Similarly, school truancy in baseline study was 12% now it is reduced by 9% and dropout rate in the baseline was 10%, which is reduced by 5% in the midline study. The emotional and behavioural problems (EBPs) is reduced to 11.9% (baseline 17.2%). Further, happiness index rated in Teacher Rating Form (TRF) by the class teacher is increased by 5.2% (baseline 45.8%) and in Self Rating, 57% students reported that they are happy (baseline 20%)2. The decrease in the EBPs, school truancy and drop out and increase in happiness, learning achievement and school attendance indicates that the psychosocial wellbeing of the students is improved.

In this six-month period 140 focal teachers from 70 schools received refresher training and supervision support in student counselling. All 70 schools have been practicing school counselling and apart from those schools, 32 schools (45% schools) managed a separate student counselling room. 398 students received individual counselling services by trained focal teachers in this reporting period. Among them 226 (49%) students have shown better progress in EBPs according to the measurement of the progress matrix and teacher rating form used in each sessions of school counselling. Six percentage of children with the EBPs were referred for further support to the health facilities for mental health service and 45% students are still in follow-up with psychosocial focal teachers at schools for counselling services. 459 teachers received basic orientation on psychosocial promotional activities and helped in practice of classroom psychosocial intervention at classrooms and referral of the children with EBPs to the psychosocial focal teachers. Promotional boards and positive disciplinary tools are practiced in 407 classrooms of 70 schools by 407 teachers. In 87% schools, there is practice of group participatory learning and cyclic sitting arrangements. 7630 school children and adolescents benefited from classroom based promotional activities. 86% school developed child protection policy (baseline-nil). In 85% schools' students reported that there are not any forms of the punishment (physical, mental etc). In this six-month period 2970 adolescents’ students attended adolescent health awareness interaction sessions. Child marriage is reduced to 12 in this reporting period,

1Briefly describe (max 700 characters) 1) the main results achieved during the reporting year 2) any other significant events or processes which took place 3) numbers of rights-holders and duty-bearers / beneficiaries. 2 Midline study report of SMHP, July 2019

which was 98 in December 20183. In addition, 67% school managed sanitary pad for adolescents’ girls' students. 6823 parents involved in parenting education sessions. The mid-line study report showed that 59% parents’ is participated in school activities and 68% parents reported that they listened their children feeling at home4.

180 health workers received basic orientation on mental health and psychosocial support in this six-month period in joint collaboration and cost sharing with the concerned (rural) municipalities of Salyan and Kailali. 16 trained health workers of 10 health facility of Salyan and Kailali district received mental health clinical supervision at health facility level from psychiatrist. 7 health workers/social workers completed six months advanced psychosocial counselling training in this reporting period. 546 new, along with 34 children and 2002 old clients having mental health problems received mental health service. 63 people received psychosocial counselling services by trained health workers. 283 members of FCHV, mother group, traditional healers, family members of the people with mental health problems and other stakeholders have received basic orientation in mental health and psychosocial support. 128 members from the four Self Help Groups of Salyan district received training on rights based mental health approach. The SHGs in collaboration with the local DPOs submitted the program and budget related to mental health to the concerned (rural) municipalities.

In this reporting period, 27 education coordinator received training on school mental health from 10 municipalities (rural) of Salyan and Kailali districts. MPAC was also conducted in Chatreshwori Rural Municipality in Salyan, Kalika Rural Municipality in Rasuwa and Bhajani Municipality in Kailali. CMC-Nepal also organized review meeting with the head-teachers in Gorkha, Salyan and Kailali. Similarly, one even of joint monitoring visit was also conducted in Salyan and Kailali districts where the representatives from the health and education division from the Ministry of Social Development of Sudhir Pachhim and Karnali Province joined, along with the representative from Felm-Nepal. After the ongoing advocacy at local level and visible results from the program implemented schools, Kalika Rural Municipality implemented school mental health program in 7 schools with their own budget. 12 (rural) municipalities included mental health into their programs, plan and further allocated budget for the year 2019/2020 (Nepali fiscal year 2076/077) 5.

In second half of the year, CMC-Nepal will develop exit plan and share this plan with the concerned (rural) municipalities. CMC-Nepal will conduct joint supervision meeting among the trained education coordinators and elected representatives and officials of the (rural) municipalities, training for president of the SMC and PTA in continuing school mental health activities and conduct exit meeting jointly with the (rural) municipalities representatives and head-teachers. CMC-Nepal will conduct supervision for the psychosocial focal teachers, reinforcement to the teachers in practice of classroom-based activities, training to the child club and orientation to the adolescents’ students and parenting education, mhGAP and psychosocial counselling training for health workers, mental health and psychosocial supervision, empowerment of SHGs. CMC-Nepal will select 12 schools out of 70 schools and support those schools in development of child friendly model class.

CMC-Nepal conduct end-line study in all 70 schools in the fourth quarter of the year and carry out the external evaluation in Gorkha and Rasuwa in third quarter to measure the effectiveness of school counselling program. In addition, CMC-Nepal will organize social audit, MPAC meeting, learning sharing meeting and joint monitoring visits. CMC-Nepal will explore the new project location and select working (rural) municipalities in Gorkha, Salyan and Kailali in coordination with concerned District Coordination Committee. Reporting organisation: Centre Telephone & Fax: Web: www. cmcnepal. org.np for Mental Health and 977-1-4102037 Counselling-Nepal (CMC-Nepal) 977-1-4102038 Address: Thapathali, Kathmandu E-mail: Contact person: Post Box No: 5295 [email protected] Ram Lal Shrestha Executive Director

3 Head-teachers report, June 2019 4 Mid-line study report, July 2019 5 Program and budget presented by the (rural) municipality in the municipality council for the year 2019/2020 (2076-2077) 1, Direct and Indirect Beneficiaries 1.1 Direct Beneficiaries – Rights holders The main right-holders of the project are school children and adolescents, with especial focus on children with emotional and behavioural problems who received psychosocial service at schools and also from health facilities. Likewise, students benefited from classroom based promotional activities are also the main right holders. The teachers, parents and other community people with mental health and psychosocial problems is also considered as main right-holders who are also received mental and psychosocial service from the health facilities.

TOTAL for reporting period

Direct rights- A. 7638 holders

Women Men Girls Boys

(yrs 18+) (yrs 18+) (yrs 0-17) (yrs 0-17) B. C. D. E.

1251 892 2913 2582 … which include … F. Persons with F1. F2. F3 F4. disabilities (physical 36 32 51 41 and other forms of the disability) G. Ethnic minorities, G1. G2. G3. G4. indigenous peoples, 793 165 2094 1845 persons discriminated based on caste

1.2 How did these rights-holders participate in the project implementation during the reporting period? Describe participation by each group of rights-holders.

The main rights-holders i.e. school children participated in project implementation through engaging in classroom based psychosocial promotional activities, child club activities and adolescents’ health awareness interaction at schools. The children with emotional and behavioural problems participated in student counselling service at schools. Parents participated in parental psycho-education events at school and provided support and care to their children.

People (including parents, teachers and students of the project schools) with mental health problems participated in the project implementation through accessing mental health and psychosocial counselling service from the health facilities. The people having mental health problems and their families (Self Help Group-SHG) involved in creating awareness to reduce stigma associated with mental illness and lobbying at local level to prioritize mental health issues in planning and budgeting of local level.

Direct Beneficiaries – Duty-bearers and other influential actors

1.3 With duty-bearerFelm refers to political decision-makers, officials and other authorities that bear the responsibility of fulfilling and protecting the realization of rights. With other influential actors Felm refers to key actors of civil society, such as cultural or religious leaders, community and opinion leaders, leaders of civil society organizations, who influence and promote the realization of human rights. Teachers and health workers are main duty-bearers of this program, who are providing psychosocial support and mental health service from the school and health facility. The local political leaders, municipalities, civil society organizations and school management committee (SMC) members and parent teacher association (PTA) members are also considered as potential duty-bearers. The central level authorities of MoE and CEHRD at education and Ministry of Health and Population (MoHP) and DoHS (Department of Health Service) are also considered as key duty-bearers.

TOTAL for reporting period Direct duty-bearers and A. 507 other influential actors

Women A. Men (yrs 18+) (yrs 18+) B.211 C.296

… which include … D. Political decision-makers, officials and authorities D1. D2.

175 249 F. Leaders or key actors of civil society; influential actors F1. F2. from civil society, including from your organization etc.. 36 47

1.4 How did these duty-bearers and other influential actors participate in the project implementation during the reporting period? Describe participation by each group of duty-bearer and other influential actors.

Teachers participated in training and supervision provided by CMC Nepal. They engaged in project implementation through the practice of classroom based promotional activities, child club empowerment, adolescent health awareness interaction and student counseling.

SMC/PTA members supported to the school administation in the effective implementation of school based mental health program. Concerned (rural) municipalities elected memebers and government officials participated in orientation, coordniation meeting, project monitoring and MPAC meeting. Kalika Rural Municipality of Rasuwa, Chattreshwori Rural Municipality of Salyan and Bhajani Muncipality of Kailali included mental haelth component into their program and plan and allocated budget for the next fiscal year (2019-2020).

Indirect Beneficiaries The indirect beneficiaries are the teachers, students and parents benefitted from the non-project schools from the involvement of resource teachers trained by CMC-Nepal. The community people, who received mental health and psychosocial service from the non-project areas are also considered as indirect beneficiaries.

1.5 Report the total number of beneficiaries who have benefited from project activities indirectly during the reporting period (Cell A). These may include both rights-holders (such as community members) and duty-bearers (for example the wider institution or from adjacent regions). No need for further break down or categorization.

TOTAL for reporting period Indirect beneficiaries A.135

1.6 Describe briefly who the indirect beneficiaries were. Community people from non-project location received information of CMC-Nepal’s program and came to the health facilities for mental health and psychosocial counselling service. The head teachers from the non-project schools received orientation on school mental health program through program implemented education coordinator. Similarly, schools’ teachers and students of two non-project schools of Salyan and Kailali benefited during the management of mass conversion disorder.

2. Project Implementation 2.1 Describe briefly how you implemented the project during the first six months of the year. For a more detailed description on specific activities and outputs, fill in the annexed Felm Results Reporting Tool. In the last column of the tool, describe progress, what was achieved and comment on indicator values. In the same column, also identify which of the planned activities for the first half of the year were not implemented.

In this reporting period, CMC-Nepal reinforced to the teachers who have been practicing classroom based promotional activities in all 70 schools. Further, CMC-Nepal focused its activities to strengthen the capacities of trained psychosocial focal teachers through conducting supervision at field level and distance coaching. One event of five-day training was conducted in Salyan and Kailali for the same focal teachers in career counselling, with the aim to support to the trained teachers to facilitate career guidance to the secondary level students. Additionally, one event tof three days refresher training conducted for the psychosocial focal teachers of Gorkha and Rasuwa districts. Interactions with adolescent's students about their health and psychosocial development issue and meeting with child club members was also carried in this reporting period. CMC-Nepal provided two sets of promotional boards for two classrooms of each 50 schools and provided emergency support to the students from deprived family/community.

In this reporting period, CMC-Nepal further strengthened the referral places at 10 health facilities of Salyan and Kailali for the people with mental health and psychosocial problems. In Chattreshwori and Bhajani, the referral places for the treatment of children, teachers and parents from the project schools of Salyan and Kailali was developed in the respective primary health centres. The mental health clinical and psychosocial supervision was continued to backstop to the trained health workers in order to provide quality mental health and psychosocial service. In Rasuwa, the mental health service from the psychiatrist was continued through the Jibjibe primary health centre. CMC-Nepal completed six month's advanced psychosocial counselling training in this reporting period and their skills in psychosocial counselling was enhance through conducting supervision and distance coaching. Their skills were further enhanced through engaging them in conducting group sessions and counselling sessions in the field. CMC-Nepal provided technical support to conduct mental health orientation for health workers and mental health camp; these events were organised for the health workers of 13 municipality in Kailali and 6 municipalities of Salyan from the provincial and local level budget. MHSWs supported to 10 SHGs meetings and income generating activity in Kailali and Salyan districts. 4 SHG groups received further training in rights based mental health approach and organization development. More than 80% SHGs submitted the plan and budget to the concerned (rural) municipalities for mental health awareness activities. With the continued advocacy from the CMC-Nepal and SHGs, all 10 (rural) municipalities allocated budget for psychotropic medicine and purchased medicine at least one time during this 6 months’ period, which covered 80% of total demand.

MPAC meetings were conducted in Kalika Rural Municipality/Rasuwa, Chatreshwori Rural Municipality/Salyan and Bhajani Municipality/ Kailali. Joint monitoring visit was also conducted in Kailali and Salyan. A review meeting with the head-teachers along with the elected ward-chairperson, mayor, deputy mayor and officials of the concerned municipality, was also conducted in all four project districts.

In second quarter of this year, CMC-Nepal involved in collection of the data for midline evaluation. We conducted focus group discussion with the parents, teachers, students and SMC/PTA and further observed classrooms where the classroom based promotional activities is implemented. CMC-Nepal also collected dropout rate, learning achievement, student attendance and school truancy rate of the students from the school's records and FLASH report. Teacher Rating Form (TRF) was also used to measure the psychosocial well-being of the students, who were included in the baseline study.

2.2 Did the implementation differ from the original plan? How? Give reasons for the changes.

The original plan and budget submitted in year 2017 was revised in November 2018 and the final approval from Felm was obtained in February 2019. The major changes were in the activity level (activity 1.1.1, 1.3.2, 2.1.1, 2.2.3, 2.3.2, 3.1.1, 3.1.2 and monitoring and evaluation and the changes did not have impact at outcome and impact level rather it was expected to contributed to achieve better outcome. The justification for the changes was provided to Felm at the time of revision requested. An additional budget was requested to Felm to cover the deficit in the community mental health and psychosocial support programme, funded by TEAR Australia and NPR 2,124,451 was approved by Felm as a co-funding in that project. The revision in the project plan and result based matrix was also submitted to Felm to reflect the changes in the original plan and result based matrix.

2.3 Explain how you will continue to work during the second half of the year.

In second half of this year, we will focus school supervision, conduct training (child protection, role and responsibility etc.) for the members of the child club, orientation to the adolescents’ student's health issues and parenting education. We will organize a training for the president of SMC and PTA and conduct meeting in presence of the representatives of concerned (rural) municipalities to increase the ownership of the project activities.

CMC-Nepal will organize training, with emphasis on the management of mass conversion disorders and suicide prevention to the education coordinator of all working (rural) municipalities of Rasuwa and Gorkha districts. The supervision meeting will also be organised jointly with the education coordinators and concerned representatives of all working (rural) municipalities of four districts.

As part of health component, CMC-Nepal will organize mhGAP and psychosocial counselling training for those health workers who are newly appointed after the federal level employee adjustment. Further, it will continue backstop to the trained health workers in both mental health and psychosocial supervision, along with continuous supervision to the trained psychosocial counsellors of the referral health facilities. CMC-Nepal will take initiation to form loose network of SHG at provincial level with representation from Salyan, Surkhet and Jajarkot districts and facilitate them to organize provincial level stakeholders with the government and other organization working in mental health and disability.

CMC-Nepal conduct end-line study in all 70 schools in the fourth quarter of the year and further carry out the external evaluation in Gorkha and Rasuwa in third quarter to measure the effectiveness of school counselling program.

In addition, CMC-Nepal will organize social audit, MPAC meeting and exit meeting with concerned (rural) municipalities. CMC-Nepal will explore the new project location and select working (rural) municipalities in Gorkha, Salyan and Kailali in coordination with concerned District Coordination Committee.

Fill in the annexed Felm Results Reporting Tool. 3. Challenges in Project Implementation

3.1 What were the main problems/challenges during the first half of the year? What did you do to overcome the problems/challenges?

This project was designed for four years to implement the activity in 70 schools for two years and in next 70 schools in next two years. While implementation of the project activities in 70 schools in first two years, CMC- Nepal learned that the allocated time of two years period was found too short to follow-up the research project and even we realized that the time period of two years was not adequate to observe the changes from the project intervention. This project in new project location was started just after the election of the local, provincial and federal level of the government. Most of the local level were engaged in policy development and personnel management and they gave less attention in integration of school mental health component into their programs, plan and budget. As mentioned in the short description chapter and section 2.3, we will prepare the exit plan, share to the concerned (rural) municipalities and work on it for the sustainability of the program. However, we still feel that most of the (rural) municipalities are not ready to take ownership of the program through the integration into their regular programming of health and education. To make them responsible for the ownership of the program, we need to maintain certain contacts with the trained teachers and head- teachers of the project schools of Bhajani/Kailali and Chattreshwori/Salyan and with the concerned (rural) municipalities at least for a year after 2019. We recommend the following activity for the year 2020 in both Bhajani Municipality and Chattreshwori Rural Municipality.

 2 events of supervision meeting of the psychosocial focal teachers  One event of joint meeting among the concerned (rural) municipalities and head teachers  One round of supervision at school level. The mental health components of previous community mental health and psychosocial program was added to the School Mental Health Program and it was difficult to CMC-Nepal to be detached from the awareness and strengthening SHGs activities. These events demanded more time of the Mental Health Social Worker (MHSW), which limited them to engage fully in the school mental health activities in the focussed (rural) municipalities i.e. Bhajani and Chattreshwori. It caused more pressure to the School Mental Health Supervisor (SMHS) and even the targets of conducting parenting education, interaction meeting with the SMC and PTA members, interaction with the child clubs and adolescent's health awareness workshop was not fully achieved during this reporting period. With realizing these facts, we have decided to lower down the activities of mental health components in other (rural) municipalities effective from the second half of the year 2019 so that MHSW also involve regularly with SMHS in the focussed (rural) municipalities.

3.2 Are there any significant risks to the project not achieving its objectives that you foresee? Which type of risks? What can be done to minimize their impact? Refer to the risk assessment in your project plan.

There was plan to develop a guideline of the school counselling in collaboration with Ministry of Education, Science and Technology and CEHRD. However, due to the structural changes at central level, this been delayed to proceed the development of such guideline. The development of master trainers at central level does not seem possible at the changed federal context and we have focussed at local level to develop such trainers. The above risks are external and CMC-Nepal will put efforts at all three layers of the government to achieve stated objective.

4. Finance Report Fill in the Felm finance report format covering the reporting period. After you have completed the finance report format, provide the following information here:

4.1 What was the expenditure (% of the budget) during the first half of the year?

The total expenditure of the project during this reporting period was NPR 9,760,901 during the first half of the year 2019 (41% of total budget).

4.2 If the expenditure for the different budget headings was well beyond or under 50% for this reporting period, explain the reasons for the under/over expenditure. Make clear reference to the annexed Felm Results Reporting Tool on which activities caused the under/over expenditure.

The expenditure of the following budget heading has gone beyond 65% or under 35% of the total annual budget and the reason for this over and under expenditure has been explained below.

Activity 1.1.2: This budget also includes the production and airing cost of the radio program. We completed the process of finalization of the consulting organization for the development of the radio program. Due to near to closure of the Nepali year end, we postponed to produce radio program and air it for August 2019. This also includes printing cost of the leaflet of life skills education materials that will be developed and printed in the second of the half of the year.

Activity 1.2.1: Due to the engagement of CMC staff in mid-line data collection and final examination at schools, we didn't manage to complete parenting education in all 70 schools. So, allocated budget has been less consumed. However, we will utilize this budget in Q3 and Q4.

Activity 1.2.2: Same Note of Activity 1.1.3

Activity 1.3.1: Same Note of Activity 1.1.3

Activity 1.3.2: Same Note of Activity 1.1.3

Activity 2.1.1: CMC-Nepal conducted two events of 5-days training in school counselling (4th module) in Salyan and Kailali that's why the expenses have gone higher because it has consumed almost 50% of the total budget of this account heading.

Activity 2.1.2: This is the budget of counselling materials to the schools and emergency support (medicine, education etc) to the selected students. CMC-Nepal will provide counseling materials in Q3 and complete the distribution of emergency support to the needy students Q3.

Activity 2.2.2: The adjustment of the government employee i.e. health workers as per the federal structure is not yet ended. There was high possibility of the transfer of the trained health workers so we delayed the refresher training for the staff nurse and ANM. We will conduct this training in Q3.

Activity 2.3.1: Due to the engagement of the mental health social workers in mid-line data collection and psychosocial counselling training we did not manage to conduct mental health orientation as per previously planned. We will speed up these events from Q3 onwards.

Activity 2.3.2: Same notes as of Activity 2.3.1

Activity 3.1.1: CMC-Nepal has planned to develop district level resource team to train head-teachers of all the (rural) municipalities from their regular activities. We completed first module training to the education coordinators and selected head-teachers in Salyan and Kailali. There is further plan to conduct such training in Gorkha and Rasuwa district as well. Once training completes, we will conduct supervision which consumes almost all the budget.

Activity 3.1.2: We only managed to organize Review Meeting with Head Teachers in Rasuwa and we have plan to organize same event in other 3 districts.

Activity 3.2.1: We will print one reference manual (anti-bullying) in school counselling from this budget and we will finalize the development by Q3 and print it Q4.

Activity 3.2.2: There was only few meetings, where CMC-Nepal had to attend and meetings will be more in the coming days and the cost also will come later. Furthermore, we have planned two meetings at provincial level and one meeting at central level.

Activity 3.2.4: The event will be organized at end of this year in two municipalities and two provinces once we will have results of end-line as well.

Recruitment of School Supervisor: This is one-time expense of the advertisement and the process of recruitment is already completed.

Interaction with Media: We will conduct media interaction in the second half of the year, which makes positive variance lower in the next reporting.

Mid-line study: We completed data collection of the mid-line study and all the budget has been consumed. We are in process of the writing report of mid-line study and the negative variance will be not be more than 10%.

Social audit: social audit will be conducted in two municipalities in second half of the year.

Staff's Training and Development: Not appropriate training found for the admin/finance staff. Possibly, we will send short term training course to the admin staff in Q3.

Repair and Maintenance: No major repair occurred until Q2 especially in office equipment. There is scheduled repair of the photocopy machine which will come in the coming days.

Local Travel Expenses: We have started to distribute the common cost to other projects as well on the basis of common cost guideline. So, less budget has been used so far for the local travel

Accounting Software: This is annual renewal charge of the accounting software, which we need to pay at the end of the year.

4.3 What is your estimation for funding needs for the rest of the year?

The total estimation of the funding needs for the rest of year is NPR 16,363,550. This figure includes the total figure of the co-funding for the Community Mental Health and Psychosocial Support Programme.

ANNEXES TO BE SUBMITTED WITH THE SEMI-ANNUAL PROJECT REPORT: Felm Finance Report Format Felm Results Reporting Tool ANNEX: Felm results reporting tool6 Project ______

Impact

Results hierarchy Indicators Baseline Target Indicator value, Describe progress and (2018) (by 2021) reporting indicator values period Original impact Drop-out rate in - Reduced Not available Drop-out rate at baseline statement: program districts by 1.5% drop-out rate study was 10%, now it School going children of the district reduced to 5.29%. and adolescents have improved Reduced by quality learning 5% of project schools

*Learning 45% Increased Increased by Learning achievement is achievement by 10% 13% 58% (source: midline rate in program study report) schools

Outcome 1

Results hierarchy Indicators Baseline Target Indicator Describe progress and (20xx) (by 2021) value, indicator values reporting period Original outcome *School 69.25% Increased 83% Students school statement: attendance rate in by 10% attendance is improved by School going children program schools from 14% and adolescents in baseline program schools have improved psychosocial % of school going wellbeing children that EBP Reduced Reduced Mid-line study showed that

report improved 17.2% by 60% by 28% EBPs is reduced to 12.4% psychosocial (EBP from 17.2% wellbeing 12.4%) Output 1.1: (name of # of teachers 60 800 149 407 teaches practiced output) Teachers have practice the teachers teachers classroom based increased capacity to classroom based psychosocial promotional practice child friendly psychosocial activities in all 70 program classroom promotional schools. 51% achieved. management and activities parenting education 407 classes (350 classes from CMC's support and 57 # of classrooms 20 700 258 by schools' initiatives) used using material classroo classrooms classroom-based materials regularly ms regularly. 58% achieved.

6This should be based on your approved results matrix for the Felm supported project. Add new rows and modify numbering to match your original project plan and its results matrix as well as the annual work plan.

Activity 1.1.1 # teachers from 68 800 154 445 teachers from 35 Capacity building of basic schools teachers teachers basic schools, 56% teachers in receive from 140 from 35 achieved in total targets. psychosocial orientation basic basic schools The number of teachers promotional activities schools received received backstopping is school-based backstopping not included in the actual as they were the same teachers

650 teachers from 35 # teachers from 295 500 305 secondary schools, 130% secondary teachers teachers achieved schools received from 48 from 35 orientation secondar secondary y schools schools received school-based backstopping Activity 1.1.2 # of set of 2 5 - Career counselling English Develop new and material revised version and parenting flip revise previous manual and produced chart (2 sets) was and reference developed in year 2018 promotional materials7 on school mental health Activity 1.1.3. # of sets of 38 700 100 268 promotional boards Providing promotional promotional promotiona provided to 70 schools; boards and other new boards l boards school managed 101 sets material to schools of promotional boards Output 1.2: (name of # parents who are Almost 15000 1750 8573 parents participated output) involved in none of parents in school activities, 57.2% Parents, and other school-activities the achieved stakeholders increased parents involve in their support in parenting promotion of education psychosocial wellbeing of their children 70% parents reported they % of parents that 2 50% 70% practiced supportive report they behaviour to their children practice (source: FGD with parents supportive during mid-line study) behavior towards their children at home

3% % of project Increased Increased schools that by 15% to 20% receive material or financial

7 Academic and career counselling manual (3rd module), parenting education booklet, audio-visuals materials on promotional activities at schools, revision of 1st and 2nd school counselling modules

support from stakeholders Activity 1.2.1 # of parents 600 15000 1750 8573 parents from 70 Parenting education for receive parenting schools received parenting promotion of child education education. 57.2% friendly environment at achieved. home Activity 1.2. # of 0 4 105 events 385 events conducted, Meeting/interaction meetings/interacti events/y in 70 34.4% achieved with school ons ear in schools management each committee (SMC), schools parent teachers 1120 association (PTA), events local government and 1100 (1017 old and 83 other stakeholders on # of stakeholders 0 1680 1100 new SMC/PTA members need of psychosocial participating in SMC/PTA participated support activities at meetings members schools attended Output 1.3: % of project None of 80% 46% 86% of project schools schools practice the practiced child protection Child protection policy child protection schools policy. and practice is in place policy in project schools Activity 1.3.1 # of child clubs - 140 child 70 clubs 70 child clubs (1436 total, Empowerment of child receive clubs 1256 old+180 new) clubs on child knowledge on received knowledge on protection child protection child protection, life skills, and life skills child marriage etc in this reporting period. Activity 1.3.2 # boys and girls 0 12300 948 girls & Total 8649 (4722 girls and Orientation on receive girls and 814 boys 3927 boys) received adolescents girls health orientation on 11332 orientation on awareness and early adolescents girls boys adolescents' health marriage health awareness awareness, psychosocial and early development and child marriage marriage. 36.6% achieved Activity 1.3.2 # of schools that - 140 70 All 70 schools Orientation to school received training administration, SMC and administration, SMC PTA received orientation and PTA about child about child protection protection policy policy. Total Felm expenditure for this outcome during the reporting period (refer to financial report): NPR 1,509,743 (15.5% of total expenditure)

* 51% learning achievement and 67% school attendance was shared in the baseline study report and annual report of 2018 that was covered only 45 schools of Salyan and Kailali. Now, additional 25 school's base line information is also calculated including Gorkha and Rasuwa. So, there is difference in learning achievement and school attendance.

Outcome 2

Results hierarchy Indicators Baseline Target Indicator value, Describe progress and (2018) (by 2021) reporting period indicator values Original outcome statement: # children and 0 5000 398 students 897 students received School children, adolescents students individual teachers, parent and receive psychosocial other community people individual counselling at schools have access to psychosocial (18%) psychosocial counseling counseling at and mental health school services # % of children 0

in counselling 100% 50.2% 450 children, who that have received counselling improved have improved psychosocial psychosocial wellbeing wellbeing

# students, 0 5000 546 1943 people received teachers, mental health service, parents and 38.9% achieved other community people receive mental health and psychosocial service at health facility

Output 2.1: School # of program 23 140 2 schools Altogether, 50 schools based psychosocial school have schools have psychosocial support unit is psychosocial support unit, 35.8% functioning in program support unit achieved. However, all school 70 schools have been providing psychosocial counselling service by the trained teachers.

A total of 70 difficult # of difficult 0 400 25 cases from the schools cases from referred to health school referred facilities to referral health facilities Activity 2.1.1 # of teachers 48 280 140 teachers 140 teachers trained Training and supervision trained in school teachers received third and supervised in to psychosocial focal based module training, school based teachers for prevention psychosocial received psychosocial support and early intervention of support supervision and EBP refresher training Activity 2.1.2 # school 20 140 - 70 schools already Material/technical received support received materials for support in the the psychosocial establishment of for psychosocial counselling in year psychosocial counseling counselling unit 2018. CMC-Nepal unit at schools provides additional materials in second half of the year. Output 2.2: Referral # of referral 2 8 Continued 50% target is service of mental health place developed reinforcement in achieved. and psychosocial 4 referral places support is developed in health facilities in program areas Activity 2.2.1 # prescribers 10 40 - 41 health workers Mental health training receive basic including 8 medical and and refresher officers received basic supervision/mentoring of training in mental training in 2018 the paramedics, with health emphasis on children’s mental health issues # - 3 2 events 16 trained prescribers supervision/case supervisio supervision received supervision supervision by n/year from the psychiatrist psychiatrist Activity 2.2.2 # of nurses 4 40 11 trained 7 nurses and ANM Psychosocial counseling receive nurses and received training in training and supervision psychosocial ANM received psychosocial of the staff support/ supervision in counselling in year nurse/auxiliary nurse, counseling psychosocial 2018. A total of 11 with emphasis on training counselling nurse/ ANM received children’s psychosocial support supervision issues Activity 2.2.3. Advanced # of nurses at - 8 5 health - psychosocial hospital that workers/social counselling training to receive workers staff nurse of referral advanced completed 6 hospital to provide counselling months psychosocial counseling training advanced service for the referred psychosocial cases from schools counselling training Output 2.3: # of SHGs that - 40 10 Lobbying was Self-Help Groups conduct lobbying conducted in all 10 protect the rights of the meeting with (rural) municipality, persons with mental local where mental health health and psychosocial government service is continued. disabilities All municipalities have agreed to allocate the budget for awareness activity and medicine. Activity 2.3.1 # of people with 400 1000 295 875 people were Orient person with mental health referred until this mental health problems problems refer reporting period and their families to health service members, and FCHVs facilities by SHG on mental health issues and FCHV and social stigma

Activity 2.3.2 # of SHG formed 13 40 No new group Total 14 SHG and one Formation and support and received formed district level SHG for functioning SHGs training 4 old SHG received regular received support from CMC- training in rights Nepal based mental health Total Felm expenditure for this outcome during the reporting period (refer to financial report): NPR 2,301,476 (23.6% of total expenditure)

Outcome 3

Results hierarchy Indicators Baseline Target Indicator Describe (2018) (by 2021) value, progress and reporting indicator values period Original outcome statement: National Centre for No Yes No Not achieved Government of Nepal Education replicates best practices of Development comprehensive school (NCED) counseling in school incorporates education system at national, comprehensive province and local level school counseling into teachers’

training

Manuals/Reference No Yes No Reference materials of manual in school comprehensive counselling was school counseling developed jointly developed jointly in year 2018

No of schools - 10 7 Altogether 19 replicates non project comprehensive schools have school counselling replicated practices psychosocial classroom based promotional activities Output 3.1: # of master trainer 30 84 3 education Altogether 30 By 2021, master trainer are developed at coordinator master trainers developed at national, national , province trained developed at province and local level to and local local level replicate comprehensive school counseling Activity 3.1.1 # events of training 4 modules 1 module 1 module for Training and supervision to and supervision 1 Salyan and NCED trainers and resource time/year Kailali persons in comprehensive school counseling Activity 3.1.2 # review meeting 0 80 7 meetings 18 meetings Review meeting with head- conducted conducted up to teachers, resource persons Resource now and local level exploration and channelized Output 3.2: National level We have CMC-Nepal has increased guideline in school No Yes No meeting with collaboration with the counseling high level Government of Nepal to developed authorities in formulate and endorse Policy document second half of comprehensive school developed the year and we counselling policy School based will discuss psychosocial about national training package level guideline developed on this meeting.

Activity 3.2.1 Third (career and No Yes - Third module Develop comprehensive academic was developed school counselling counselling) in 2018 manual/reference materials component of school counselling developed jointly with government

Reference - Will develop in materials of anti- second half of bullying the year Activity 3.2.2 # coordination 0 8 - 2 meetings was Organizing regular meeting meetings at central (2/year) conducted in with DoE, MoE, NCED at and province level 2018. We will central and state level conduct such meeting in second half of the year

Steering committee 0 2 - MPAC meeting formed and (1 Health is conducted conducts meeting and 1 instead of regularly Education) steering committee Joint monitoring visit in the # of joint monitoring 0 4 2 4 joint monitoring project districts from the visits visits in total central and district level and conducted lobby to integrate best practice in school education Will develop best and health system # of best practices 0 At least 1 Not progress practices on the recorded/published outcome of by central and school district level counselling in second half of the year 2019 Experience # of experience Once in a Not any It will be sharing/conference/workshop sharing workshop year progress conducted in with government second half of 2019. # of research article 2 in project In 2018 CMC- developed and phase Nepal presented published its research based scientific paper in the conference Total Felm expenditure for this outcome during the reporting period (refer to financial report): NPR 719,153 (7.4% of total expenditure) OTHER PROJECT ACTIVITIES

Name of activity Indicators (if Baseline Target Indicator Describe (e.g. coordination, applicable) (2018) (by 2021) value, progress and M&E, etc.) reporting indicator values period Review and planning 2 events in 1 event Completed one meeting among the each year event of review staff members meeting Municipality Review 2 events in 3 events Completed three meeting each MPAC meeting Municipalities in each year Social Audit 2 events in - Social audit is each year planned in second half of the year Joint monitoring Two event in Two Organised two each year events events of joint monitoring visit from the provincial and local level authorities Mid-line study Yes Yes Completed mid- line study Recruitment of 1 staff 1 staff Recruited one School Mental Health SMHS for Gorkha Supervisor Orientation to the 3 events - Will be conducted media personnel in second half of the year Total Felm expenditure for this outcome during the reporting period (refer to financial report): The total expenditure of the other Project Activities is NPR 644,022 (6.6% of total expenditure).

.

Annex- 1

Success Story

A girl of class 5 from Kalika Primary School, Salyan was showing different behaviour since last month. She had shown aggressive, irritating and loneliness behaviour. She didn’t want to learn. One of her friends reported that she was trying to hang up by her own shawl in the window of the classroom. When her friend saw this situation, she cried and ran to the office and informed to the teachers. Then all teachers went there. Then they quickly pulled her down.

Effort made for the management of the problem

Teachers called all the students in the classroom and discussed about the problems and also listened the students’ feelings. Then school psychosocial focal teacher started individual counselling with that girl. In the beginning of the session she cried a lot again. The psychosocial focal teacher let her cry for some time then discussed about why she wanted to do such effort, from when she had been suffering from such sad feelings. She continued cried in most of the counselling session. According to her, her parent used to scold and beat her at home.

Then counsellor teacher discussed with her about what would happen after people die? Where do people bring the people after they die? And after death where will people go? Three counselling sessions were carried out with her. When she knew such things about the death of the people, she surprised. The psychosocial focal teacher also talked with parents separately and explained them about their role with their children. The teacher also focused her in psychosocial promotional activities in the classroom.

Present situation

Now she said I won’t do such activities again. She is regularly coming to school. Nowadays she doesn’t show aggressive behavior. Most of the time she looks happy and even active in play activities. She also became hero of the week two times in her classroom. She even suggests her friend not to do such activities.