Single Form for Humanitarian Aid Actions

SINGLE FORM 27/11/2007 EUROPEAN COMMISSION DIRECTORATE-GENERAL FOR HUMANITARIAN AID - ECHO

SINGLE FORM FOR HUMANITARIAN AID ACTIONS1

1. GENERAL INFORMATION 1.1 Name of Humanitarian Organisation/Country of registration: Oxfam Novib - Netherlands 1.2 Title of the Action: Community-based Therapeutic Care (CTC) Programme in Mogadishu, Somalia 1.3 Area of intervention (country, region, localities): 16 districts of Mogadishu, Somalia – Abdul Aziz, Bondhere, Deynile, Dharkeynley, Hamar-jajab, Hamar-weyne, Hawl-wadag, Heliwaa, Hodan, Karaan, Shibis, Shingani, Waberi, Wadajir, Wardhighley, and Yaqshid. 1.4 Start date of the Action: If the Action has already started explain the reason that justifies this situation (urgent Action or other reason): The CTC programme already started in September 2009 but for only 8 of the 16 districts of Mogadishu. SAACID, a Somalia registered NGOS, implemented the programme with technical and operational oversight by Oxfam Novib. Valid International provided training on the technical and practical aspects of start-up and implementation. The purpose of this start-up was to both be able to immediately respond to urgent needs, whilst being able to first pilot the action in a limited and more manageable number of sites to ensure it was suitable for the Mogadishu context. and to serve as practical testing ground for both Oxfam Novib and SAACID on the technical and operational aspects of implementation. In December 2009, a mid term evaluation was conducted by Valid International to assess the stateprogress of the programme implementation against internationally recognised standards, and to identify aspects requiring improvements and changes according to the specific context of Mogadishu. From December 2009 to date, Oxfam Novib and SAACID have taken on board the recommendations from the evaluation and the programme has shown significant improvement in the various indicators of effectiveness. Both organisations believe that ahave realised a Mogadishu- specific CTC model has been achieved; hence continuation of the programme andwhich can now be expanded into the remaining 8 districts of Mogadishu. Considering the urgent need, it is proposed to start no later than June 2010. 1.5 Duration of the Action in months: 12 months 1.6 Start date for eligibility of expenditure: May 2010 Please explain if this date differs from submission initial proposal (see 1.10) 1.7 Requested funding modalities for this agreement 100% financing  Co-financing  Multi-donor (for International Organisations)  In case of 100% financing: justify the request 1.8 Urgent action Yes  No  If yes: ECHO Primary emergency decision  ECHO Emergency decision  Other ECHO decision  Please justify:

1At proposal stage fill the numbered paragraphs, except those which start with [INT] (to be filled in at intermediate report stage) or with [FIN] (to be filled in at final report stage). At intermediate and final report stage, modify only key data in the numbered paragraphs (using strikethrough). [Proposal][Agreement ECHO/…] – version [Date] 1 SINGLE FORM 27/11/2007 1.9 Control mechanism to be applied: A  P  1.10 Proposal and reports Initial proposal  date: dd-mm-yy06.04.2010 Revised proposal N°...  date: dd-mm-yy ECHO reference A/… date: dd-mm-yy Intermediate report  date: dd-mm-yy Final report  date dd-mm-yy 1.11 [INT] List the supplementary agreements and exchange of letters after signature of the Agreement up to intermediate report stage 1.12 [FIN] List the supplementary agreements and exchange of letters after submission of the Intermediate report up to final report stage

2. NEEDS ASSESSMENT 2.1 Date(s) of assessment; methodology and sources of information used; organisation/person(s) responsible for the assessment

Date(s) of Methodology / Sources of Information Used Organisation / Person(s) Assessment responsible for Assessment 27th – 30th Exploratory assessments/feasibility study to Theresa Banda, CTC Advisor, October 2008 determine potential for a CTC programme and Valid International capacity of SAACID and Oxfam Novib: Andy Marshall, Humanitarian Unit, Methodology: Review of relevant literature and Oxfam Novib reports; meetings and discussions with key Peter Kamalingin, Representative, informants from Oxfam Novib, SAACID Australia, Humanitarian Planning, Oxfam UNICEF, WFP, MedAir, MSF-E, DRC, FSNAU and Novib Somalia Nutrition Cluster Sources: . Key informants from Oxfam Novib, SAACID, UNICEF, WFP, MedAir, MSF-E and DRC; SAACID reports and proposals . FSAU, Somalia Nutrition Update July – August 2008 . Review of data from the MUAC screenings at the SAACID wet feeding centres in Mogadishu. . Somalia Nutrition Cluster, Guidance for Approaches for Management of Acute Malnutrition October 2008 . Valid International, Community-based Therapeutic Care (CTC): A Field Manual 2006 . DRC, Evaluation report of the wet feeding project in Mogadishu April 2009 Assessment to inform actual design Paul Binns, CTC Advisor, Valid International Methodology: Review of relevant literature and reports; meetings and discussions with key informants from Oxfam Novib, SAACID, UNICEF, WFP, FSNAU, MedAir, MSF-E and DRC Sources: . Key informants from Oxfam Novib, SAACID, UNICEF, WFP, MedAir, MSF-E and DRC . SAACID, Report on key local leader informants [Proposal][Agreement ECHO/…] – version [Date] 2 SINGLE FORM 27/11/2007 for rapid assessment of IDPs in Mogadishu and Afgoye District, Lower Shabelle, June 2007 . SAACID, Report on IDP male and female focus groups for the rapid assessment of IDPs in Mogadishu and Afgoye District, Lower Shabelle, June 2007 . Mark Myatt et al, The effect of body shape on weight for height and MUAC-based case definitions of acute malnutrition in Ethiopian children, Annals of Human biology 2009 . Mark Myatt, Baseline assessment for SC-UK’s “Result Three” interventions in rural areas of Belet Weyne district of Somalia, 2006 . IASC Nutrition Cluster Informal Consultation, Transitioning to the WHO Growth Standards: Implications for Emergency Nutrition Programmes, 25-27 June 2008 December Mid term evaluation of the pilot CTCctc phase. Ernest Guevarra, CTC Advisor, 2009 Valid International Methodology: Qualitative and quantitative programme data analysis and programme evaluation Sources: . Focus group discussions with SAACID programme staff . Key informants from SAACID and Oxfam Novib . Routine programme data taken from database . Out Patient Therapeutic Care (OTP) admission cards . CTC progress reports

2.2 Problem statement and stakeholder analysis It is no question that Oone of the most difficult problems facing the residents of Somalia is the country’s very critical food security and nutritional situation. The Food Security and Nutrition Analysis Unit (FSNAU) of Somalia’s recent nutrition situation report for the post deyr 09/10 indicates that global acute malnutrition rate for the whole country is around 19% and severe acute malnutrition rate at 4.5%. Whilst there are no figures available specific to Mogadishu, anecdotal reports and evidence points to malnutrition rates higher than this prompting FSNAU to label it as being in very critical situation.

However, despite the problem being clear, interventions done in Mogadishu aimed at reducing these rates lack either the appropriate methodology to treat the children suffering from acute malnutrition specifically or that the scope and scale of interventions does not match the magnitude of the problem. While food aid by WFP and other agencies through general food distribution or supplementary feeding through targeted CSB provision can potentially prevent occurrence of acute malnutrition and support those who are moderately malnourished, it doesn’t treat cases of severe acute malnutrition who are the ones most susceptible to various morbidities and mortality. On the other hand, therapeutic feeding programmes have been put in place by organisations such as MSF and ACF and have been successful in treating cases of severe acute malnutrition through the use of ready-to-use therapeutic food (RUTF). However, due to various reasons such as the volatile security situation in Mogadishu, increasing the scope and scale of these programmes have proven to be difficult with MSF even pulling out of the area due to serious security incidents experienced by its programme.

[Proposal][Agreement ECHO/…] – version [Date] 3 SINGLE FORM 27/11/2007 It is this challenge that Oxfam Novib’s implementation of the community-based therapeutic care (CTC) programme in Mogadishu tries to address through a local implementing partner, SAACID. SAACID has a reputable track record of successful implementation of various programmes in the volatile context of Mogadishu including a citywide wet feeding programme which provides 80,000 hot meals per day. This is a testament to SAACID’s strong logistical capacity and more importantly to its underlying implementation approach that is rights-based and anchored on community empowerment. The security and protection required by any programme to reach appropriate scope and scale in Mogadishu was achieved by SAACID’s constant engagement and dialogue with the community-at-large and with key local leaders from all sectors of society. This approach has gained SAACID legitimacy and support from the Mogadishu society in general, which makes them well-placed to implement CTC. SAACID’s current implementation of CTC in 8 districts in Mogadishu with minimal security incidents proves this. Drawing from the experiences of the wet feeding project, SAACID will seek to deliver CTC programme to cover 16 districts of Mogadishu as a way of winning “city wide buy in” and support to the programme. In doing so, Oxfam Novib and SAACID pay specific attention to the complimentary services provided by other agencies including ACF and MSF. In all the areas proposed in this expansion phase, there are no, if not limited Out Patient Therapeutic Care (OTP) and Supplementary feeding Programmes (SFP) operations in place. Coordination of this services have been and will continue to be negotiated and coordinated through the Mogadishu nutrition coordination forum which meets regularly in the field and shares its minutes with the nutrition cluster in Nairobi. The insecurity and the total breakdown of health and social services in the city, coupled with continuous fighting mean that the needs are much higher than SAACID can meet.

2.3 Summarise findings of the assessment (include full report in annex, if relevant) and link these to the Action

Feasibility The first two preparatory (exploratory) assessments in December 2008 and in April 2009 indicated that the implementation of a CTC programme in Mogadishu is a feasible venture provided the caveats of security and logistical supply are met. The most recent assessment done in December 2009, to evaluate the current CTC programme implementation in 8 districts, has shown that it is indeed a feasible venture with the anticipated issues of security and logistical supply having been effectively mitigated by the implementing partner. This recent assessment also highlighted certain problem areas such as high default rates which, for a relatively new programme, is typical. Appropriate changes and improvements were recommended and already implemented such as improved community outreach mechanisms to raise awareness regarding the programme and to trace absentees and defaulters so as to get them to follow-up in the clinics. Currently, defaulter rates have gone down to well within Sphere standards. It is this experience and learning from the pilot 8 sites that both Oxfam Novib and its implementing partner, SAACID, are taking with them in the implementation of the programme in the additional 8 districts of Mogadishu. Need Location The preparatory assessments have indicated the need for proper planning of the geographical distribution of the chosen clinics so as to ensure equal access to the sites by all sectors of the population irrespective of clan or residency status. The CTC programme is and will therefore be implemented from the rehabilitated Mother and Child Health and Nutrition Centres (MCHNs). The actual rehabilitation of MCHN clinics has widespread support among the stakeholders and provides a platform for more sustainable and add on health interventions. The preparatory assessments have indicated the need for proper planning of the geographical distribution of the chosen clinics so as to ensure equal access to the sites by all sectors of the population irrespective of clan or residency status. The Mid term evaluation reports recommends that further expansion of services should take into consideration the complexity of the whole programme and the context in which it is being implemented. Any expansion plans should be informed by a thorough evaluation of the current programme implementation on the basis of which a proposal for scaling-up be drafted and submitted to respective funders for financing. In the most recent assessment of the current programme, it has been shown that the implementing partner has both the technical and logistical capacity for CTC and more importantly has the ability to adopt to the context and to recommendations made to improve programming. Furthermore, the recent mid term evaluation has indicated that expansion into other districts of Mogadishu has the potential to address defaulting caused by displacement as more sites across Mogadishu will provide greater options for beneficiaries to seek care. [Proposal][Agreement ECHO/…] – version [Date] 4 SINGLE FORM 27/11/2007

Programme DesignBeneficiary selection criteria The preparatory assessments have recommended specific admission and discharge criteria for the various therapeutic components i.e. SFP and OTP and for the various types of beneficiaries of the programme. These criteria can be found in Section 4.2.4 and have been used in the current programme implementation in 8 districts and proposed to be used in the further 8 districts that the programme intends to expand into. However, Oxfam Novib and SAACID intend to start collecting height data for all of the children admitted into the programme so as to compare the Middle Upper Arm Circumference (MUAC) standards currently used by the programme with the WHO growth standards for weight-for-height. If analysis of data show that there is a significant number of children who should be in the programme by WHO growth standards but are currently not admitted based on the MUAC standards, then admission and discharge criteria will be changed so as to include weight-for-height measurement. Community involvement As for community mobilisation and outreach, it has been recommended that this component be conducted in a planned way immediately following implementation of the OTP and SFP. A short delay between opening of the MCHN clinics and community outreach has been suggested to allow the new trainees time to adjust to the clinical care regime but should not be delayed for more than one month. This is meant to ensure the presence of the logistical pipeline and the resources to cope with increased demand. According the most recent assessment, this recommendation has been followed although the delay was more than a month from implementation. This has allowed for the pipeline to be well-established but also contributed to considerable defaulting at the early stages of the implementation as the mothers were had to be discouraged due to limited available resources. This was eventually rectified. For the proposed expansion, the above recommended timing of community outreach will be followed while ensuring that it is not delayed any further than planned.

Coordination with other actors In terms of inpatient care, the initial assessments have recommended close coordination and referrals with ACF who operate Therapeutic Feeding Centres (TFCs) in Hodan and Abdul-Aziz districts. Appropriate liaison was made and protocols of referral established with ACF. However, in the recent mid term evaluation, it has been shown that there are still some gaps in terms of the communication and referrals lines between SAACID and ACF. Also, the sites in which the TFCs are located have been reported to be in areas very close to the most intense fighting and are therefore considered by most beneficiaries as dangerous to go to. Hence, most opt not to go and instead stay in the OTP despite their need for inpatient care. For the proposed expansion, the same mechanism of referral will be continued while negotiating with ACF to consider relocating their current TFC sites or setting up new ones in other areas. However, should this not be possible, Oxfam Novib and SAACID, in consultation with the various nutrition actors through the Somalia Nutrition Cluster, will consider setting up stabilisation centres from where severely malnourished children with medical complications will be referred and treated. In all and throughout the CTC design, both UNICEF and WFP have continued to commitexpressed their continued commitment to provide Ready to use Therapeutic Food (RUTF) supplies and Ready to Use Supplementary food (RUSF) supplies. This will also continue to be coordinated via the Somalia nutrition cluster.

2.4 [INT] If changes in needs assessment at intermediate report stage, please explain 2.5 [FIN] If changes in needs assessment after intermediate report, please explain

3. HUMANITARIAN ORGANISATION IN THE AREA OF INTERVENTION 3.1 Humanitarian Organisation's presence in the area of intervention: brief overview of strategy and current or recent activities in the country Oxfam Novib, through its partner organisations, has been working in Somalia for 15 years with the overall aim of reducing the suffering of the Somali people afflicted by disasters in general and those who are most vulnerable – women, children, the elderly and marginalised groups – in particular. To achieve this aim, Oxfam Novib provides the Somali people with life-saving assistance and more importantly, addresses the underlying causes of their vulnerability.

[Proposal][Agreement ECHO/…] – version [Date] 5 SINGLE FORM 27/11/2007 In addition, Oxfam Novib has an important portfolio in development and civil society capacity building. Since 2001, Oxfam Novib has implemented a major EC-funded civil society capacity building programme, a result of which has been the strengthening of more than a hundred local Somali organisations to a level where at least 60% of them are now actively engaged in both development and emergency assistance work in Somalia. SAACID, the implementing partner of this action, is one such partner. In 2007, Oxfam Novib implemented the Emergency Preparedness and Response Action (EPARA), a humanitarian capacity building project through which 28 local Somalia organisations strengthened their capacity for humanitarian preparedness and response. As both a humanitarian and development agency, Oxfam Novib seeks to maximise opportunities and works with partner organisations in such a way that emergency response interventions are designed and implemented with a consciousness on forming key links to the possible rehabilitation and sustainable development phase later on. Oxfam Novib’s current humanitarian interventions in Somalia revolve around four main sectors and 2 crosscutting issues: Emergency Water and Sanitation: Currently (and since 2007) supporting provision of water (through piped water systems) and sanitation services for 100,000 IDPs in Afgooye corridor specifically in Ceelasha and Lafoole, and, through integrated services, in other parts of the country including Hiran and in Somaliland Togdheer region. Nutrition intervention: Since 2009, ON in cooperation with its local partner SAACID is supporting running community therapeutic centers in 8 sites in 8 districts in Mogadishu. SGBV and protection responses: Since 2007, implementing various protection and women focused interventions. Special focus on reducing vulnerability of displaced and poor women and girls to sexual and gender based violence in South central Somalia. Emergency livelihoods: Oxfam Novib, in partnership with SIDA and Dutch government, has been implementing emergency livelihood interventions for IDPS and vulnerable host communities in South central Somalia – Hiran, the Shabelles since 2006, This has benefited more than 100,000 IDPs and host communities directly. Humanitarian Capacity building: One of Oxfam Novib’s cross cutting issues is Humanitarian humanitarian capacity building interventions for communities and local partner organisations. It centers on community managed disaster risk reduction programmes, humanitarian programme quality issues and security context programming. Humanitarian policy work: The second cross cutting issue, and aAs part of and as abeing the country lead for Oxfam International, Oxfam Novib has an active humanitarian policy advisory unit based at the regional office in Nairobi. The unit is engaged in knowledge sourcing and research on best practices that are shared within the IASC framework and globally for the purpose of improving the humanitarian practices and policies. The policy unit will continue to positively engage with the donor community and with the communities and other actors on how best to deliver quality and effective assistance to the people in need and to ensure their protection.

3.2 Actions currently on-going and funding requests submitted to other donors (including other EC services) in the same area of intervention - indicate how overlap and double funding would be avoided

Following is a list of some of the recent/ongoing humanitarian projects that Oxfam Novib has/is implementing in Somalia since 2008-2010:

Co- Total Back donor Sector of Oxfam Novib Title and implementing Project contributio Activity Contribution Project Area Partner Amount ns Community-Based Therapeutic SAACID Nutrition $745,000 $745,000 $142,000 + Care. Nutrition Response in in kind Mogadishu (CTC) to treat 17,000 supplies children (2009 -2010) (UNICEF and WFP)

[Proposal][Agreement ECHO/…] – version [Date] 6 SINGLE FORM 27/11/2007

Emergency response to livelihood crisis for Mogadishu IDPs & host communities in South/Central Somalia - phase 1 (June 2008- May 2009 and then phase 2 (June 2009- May 2010) HARDO and Emergency CED Livelihoods $3,122,000 $1,231,317 $1,890.683 Lafoole emergency piped water response October 2008 to September 2009 and then October 2009 to September Water and 2010) SAACID sanitation $246,651 $246,651 - Emergency Water and Sanitation for 51,000 IDPs, Afgooye, Lower Shabelle, South Somalia (2008 Water and then 2009 to March 2010) CED sanitation $218,746 $121,746 $97,000 Integrated SGBV & Emergency Livelihoods in Hiran, Middle WOCCA, Protection shabelle, and lower Juba (August HARDO and (SGBV) and 2009 to April 2010) AFREC livelihood $532,000 $232,000 $150,000 Emergency water and sanitation response in jimbiley IDP camp, Jalalaqsi, Hiran HARDO WASH &195,000 $195,000 - Humanitarian Humanitarian capacity building capacity project -2008 – 2010) Multiple building $830,000 $670,000 $160,000 Emergency Relief for mitigating drought effects in Togdheer and Maroodi Jeeh rural areas, Water and Somaliland Candle Light livelihoods $348,562 $348,562 - Drought response in Bari and Water and Sanaaq regions of Puntland ASAL livelihoods $60,000 $60,000 - Drought response and water WASH and trucking Horn relief livelihoods $270,000 $60,000 $220,000 Water Source Rehabilitation Project in Sool and Sanaag regions. July to October 2008 Candle light WASH $385,575 $385,575 -

T O T A L $6,952,959

As for the current CTC programming in 8 districts of Mogadishu, UNICEF and WFP are currently supporting the interventions by way of in kind supplies (RUTF and RUSF supplies). The bulk of the pilot phase was financed from Oxfam Novib’s own internal reserve funds. For the proposed expansion, there is agreement with UNICEF for continued material support for an additional 10 months. However, the proposed financial component has not yet been guaranteed. Should UNICEF be unable to provide financial support, then Oxfam Novib will take on the amount earmarked as UNICEF contribution. As for WFP RUSF supplies, a proposal has been submitted by requesting for continued material support for a period of 6 months starting on. To cover for the anticipated funding gap between April to May 2010 while awaiting decisions on the above mentioned proposals, HRF has been approached for possible bridging of funds to allow for continued operations. However, HRF funding is contingent upon a provisional approval from ECHO. As indicated in the attached budget, specific costs have been clearly delineated between the 4 agencies approached with funding requests hence avoiding the risk of overlap and double funding. [Proposal][Agreement ECHO/…] – version [Date] 7 SINGLE FORM 27/11/2007 It is also important to note that the CTC programme has been designed in consultation with other nutrition intervention actors through the nutrition cluster both at Nairobi and Mogadishu levels so as to avoid overlap and increase complementarilty of existing programmes. As such, there is regular coordination mechanism with Danish Refugees Council (DRC) in relation to its management of a blanket wet feeding project in Mogadishu from which cases of moderate and acute malnourished children are being referred to the Oxfam Novib supported CTC programme. There is also an existing referral mechanism between Oxfam Novib’s CTC programme and the ACF’s TFCs for cases requiring inpatient care. As for the nutrition cluster, it has included CTC programming into the CAP appeal for 2010.

3.3 [FIN] List other Actions carried out by the Humanitarian Organisation or its Implementing Partners in the same period in that area of intervention and how risks for double funding were avoided

4. OPERATIONAL FRAMEWORK 4.1 Exact location of the Action (include map of project location) The project is to be located in all 16 districts of Mogadishu. Following is a map of the project location:

4.2 Beneficiaries 4.2.1 Total number of direct beneficiaries: at least 44,520 direct beneficiaries 5. At least 9,600 severe acute malnourished children under 5 6. At least 28,800 moderate acute malnourished children under 5 . At least 6,120 malnourished pregnant and lactating women

[Proposal][Agreement ECHO/…] – version [Date] 8 SINGLE FORM 27/11/2007 6.1.1 Status of the direct beneficiaries (multiple options possible)  IDPs  Refugees Returnees  local population  Others (e.g. for Grant Facility, thematic funding, etc.) 6.1.2 Specificities of direct beneficiaries (please elaborate; refer to groups as appropriate, e.g. unaccompanied minors, disabled, children, ex-combatants…)

. Severe acute malnourished children under 5 . Moderate acute malnourished children under 5 . Malnourished pregnant and lactating women 6.1.3 Direct beneficiary identification mechanisms and criteria

Beneficiaries will be identified through trained community outreach workers conducting active case finding within their respective target areas using a mid-upper arm circumference (MUAC) tape as measurement tool. Identification will be based on the following criteria:

Severe Acute Malnourished Moderate Acute Malnourished Malnourished Pregnant and Children Children Lactating Women . 6-59 months old . 6-59 months old . Pregnant women in 2nd to and 3rd trimester of pregnancy, or and and . Mothers with babies < 6 . MUAC < 115 mm, or . MUAC ≥ 115 mm to < 124 months mm, and . + or ++ grade bilateral and oedema . No bilateral oedema . MUAC < 210mm and . appetite . clinically well and alert

6.1.4 Describe to what extent and how the direct beneficiaries were involved in the design of the Action Based on the various assessments done prior to the implementation of pilot phase of CTC, it has been noted repeatedly that SAACID’s comparative advantage as an implementing partner of the CTC programme is its close links and contact with the communities they work in. They have utilised these links to ensure the effective implementation of any project they have been involved with, including the much heralded wet feeding kitchens across Mogadishu. The success they have achieved in the wet feeding kitchens has been attributed in part to the participation of the community-at-large, with a specific emphasis on the participation of all clans and IDPs, in the design of the programme which offers a relative uniformity and consistency in service provision to all parts of Mogadishu. Gender mainstreaming was also taken into account with the inclusion of many female representatives in the consultation process. It is based on these same principles of community participation that the current CTC programme in 8 districts has been implemented and that the proposed expansion into all 16 districts will be undertaken. Through consultative workshops and meetings held with community representatives, MCHN sites are chosen and rehabilitated. In addition, selection of community outreach workers and MCHN staff are/were done in consultation with community representatives and leaders. Furthermore, the evaluation proposed for the expanded programme is a new methodology pioneered by Valid International called Semi-Quantitative Evaluation of Access and Coverage (SQUEAC) which not only reports on a headline coverage estimate for the whole programme but more importantly assesses issues of access and service uptake based not only on quantitative data but from qualitative and anecdotal information gathered from programme beneficiaries and the community in generalat large through participatory means. Hence, the SQUEAC process allows for the community’s input into the audit phase of the programme cycle which in turn allows for programme management to adjust, adapt and improve implementation accordingly. In addition, the pilot phase has ensured that community beneficiaries and participants provide direct feedback on the programme through consistent and regular human interest stories and photographs taken [Proposal][Agreement ECHO/…] – version [Date] 9 SINGLE FORM 27/11/2007 and provided by a dedicated story writer and photographer who are trained and coached by Oxfam Novib’ communications support officer. This forms another layer of general feedback about what the communities feel and think of the intervention. The regular field visits by Oxfam Novib and SAACID staff, who interview project beneficiaries is also another form of sourcing beneficiary feedback and which information is used to inform the redesign and implementation of the CTC project.

6.1.5 Other potential beneficiaries (indirect, "catchment", etc.) As a result of the selection of the MCHN clinics as sites for OTP and SFP implementation, serving other potential beneficiaries such as under five children and mothers in general is a possibility. According to the initial programme design, the MCHN clinics would implement only CTC nutrition services. But once the programme has become well established, the clinics will then will be able to provide a platform for the introduction of other health programming for mothers and children through partnerships with other agencies. Oxfam Novib is already in discussions with UNICEF and Medair for the possible provision of complementary services within the MCHN clinics. World Vision International has shown a willingness to consider provision of technical and in-kind support to add TB awareness, education and consultation capacity at the 16 sites; and, as their budget frees up, add salary support for a TB referral component. Also, Oxfam Novib is looking into the possibility of increasing the capacity of the current implementing partner SAACID with additional technical and financial assistance so as to enable SAACID to provide these complementary services itself. Furthermore, community sensitisation and mobilisation activities to be conducted will cover the whole community in the target areas and are thereby directly benefiting from increased awareness and knowledge about malnutrition, its causes and treatment. As the CTC intervention is largely out patient, it affords, especially to the mothers, some spare time to attend to other day to day activities necessary for the wellbeing of the entire family.

6.1.6 Direct beneficiaries per sector: Sector Number of beneficiaries Nutrition 44,520 total 9,600 severe acute malnourished children under five 28,800 moderate acute malnourished children under five 6,120 malnourished pregnant and lactating women

6.1.7 [INT] In case of changes, please explain 6.1.8 [FIN] In case of changes, please explain 6.1.9 [FIN] Estimate per type of beneficiaries female: … %, male: … % (total female + male= 100%) infants (< 5y): … %, children (< 18 y): … %, elderly: … %

6.2 Objectives, Results and Activities 6.2.1 Operational Overview of the Action: Log-frame2 (max. 3 pages)

Title of the Community-based Therapeutic Care Programme in Mogadishu, Somalia. Action Principal To contribute to the mitigation of the effects of acute malnutrition among children under-five and pregnant and lactating women in Mogadishu Objective through integrated and community-based programming. Intervention Logic Objectively Verifiable Indicators Sources of Verification Risks and Assumptions

Specific Acute malnourished children . At least 70% of acute . MCHN monthly and . Security in Mogadishu Objective under 5 and malnourished malnourished children in community reports, database remains at a level by which pregnant and lactating women Mogadishu are treated in staff are able to continue to . Referral slips and reports within target areas are treated in one of the 16 MCHN clinics provide services and carers from community outreach 16 MCHN clinics in Mogadishu. (coverage). are able to access the workers services. . At least 9,600 severe acute . SQUEAC investigation malnourished children . Families consider nutritional needs of children as a . At least 28,800 moderate household priority acute malnourished . The project tracking . At least 6,120 malnourished mechanisms are able to pregnant and lactating mitigate againstprevent any women possible diversions of assistance. . The contingency plans in place ensure there are no pipeline breakages of supplies. Result 1: Identified community- . 16 functional community- . Photos of daily operations of . Security in Mogadishu owned MCHN clinics are owned MCHN sites the MCHN sites remains at a level by which Results functional in 16 sites in staff are able to continue to . MCHN monthly reports Mogadishu. provide services and carers

2 This table will be annex I of the signed Agreement. It has to give a comprehensive overview of the different elements of the Action. It will only contain concise information on results and activities. Any changes made to the log-frame at intermediate report or final report stage will be done using strikethroughs. [Proposal][Agreement ECHO/…] – version [Date] 11 SINGLE FORM 27/11/2007 are able access them. Result 2: Trained community . 480 trained community . Referral slips and reports . Families consider nutritional outreach workers are able to outreach workers from community outreach needs of children as a identify and refer acute workers household priority . At least 50% of admissions malnourished children under 5 are from community . MCHN community reports and malnourished pregnant and outreach workers lactating women from within . SQUEAC investigation target areas to the 16 MCHN . 90% of referrals made by clinics in Mogadishu community outreach workers are appropriate . Locations from which referrals are coming from

Result 3: Trained technical and . 64 trained nurses support staff in 16 MCHN clinics are able to manage and care for . 112 trained support staff acute malnourished children . MCHN monthly reports, . under five and malnourished For OTP: Cure rate >75%; database Death rate <10% and pregnant and lactating women . SQUEAC investigation appropriately. Defaulter rate <15% . For SFP: Cure rate >75%; Death rate <3% and Defaulter rate <15% Result 1: . Security in Mogadishu remains at a level by which Activities 1. Furnishing and provision of required equipment and supplies to MCHN clinics. staff are able to continue to 2. Maintenance of MCHN clinics. provide services and carers are able to access them. 3. Securing and safeguarding of 16 MCHN sites through community-initiated security and safety mechanisms.

Result 2: 1. Identification of new community outreach workers. 2. Training and refresher training for community outreach workers. 3. Continued community sensitisation and mobilisation on the CTC programme.

[Proposal][Agreement ECHO/…] – version [Date] 12 SINGLE FORM 27/11/2007 4. Screening, identification and referral of cases to MCHN clinics. 5. Follow-up of absentees and defaulters.

Result 3: 1. Identification of new MCHN clinic staff. 2. Training and refresher training of MCHN clinic staff to be held in Burcao, Somaliland by Valid International. 3. Anthropometric and clinical assessment of acute malnourished children and malnourished pregnant and lactating women referred to the MCHN clinic and of those following-up. 4. Provision of appropriate treatment based on set guidelines and protocols 5. Continued technical support from Oxfam Novib 6. Continued education of carers on key care messages of CTC. Pre-conditions Rehabilitated MCHN sites are not damaged or taken over by armed groups/militias in Mogadishu.

[Proposal][Agreement ECHO/…] – version [Date] 13 SINGLE FORM 27/11/2007 6.2.2 More detailed information per result3

6.2.2.1 Result 1: Identified community-owned MCHN clinics are functional in 16 sites in Mogadishu. 6.2.2.1.1 At proposal stage - Total amount: 291,576 EUR - Sector: Nutrition Related sub-sector: Prevention of under nutrition, nutritional rehabilitation and supplementation - Beneficiaries (status + number): at least 9600 severe acute malnourished children, at least 28800 moderate acute malnourished children, at least 6120 malnourished pregnant and lactating women - Indicators for this result: 16 functional community-owned MCHN sites - Activities related to the result 1. Furnishing and provision of required equipment and supplies to 16 MCHN clinics. 2. Maintenance of 16 MCHN clinics. 3. Securing and safeguarding of 16 MCHN clinics through community-initiated security and safety mechanisms. - Means4 and related costs Unit Cost- Total- Line Item Number % Months/Days Euros Euros Result 1:: Identified community-owned MCHN clinics are functional in 16 sites in Mogadishu. EQUIPMENT-Saacid Scales 8 100% lump 71 571 Total on Equipment 571 PROGRAMME ACTIVITIES Supplementary Feeding Programme Warehousing and Logistics Warehouse security 8 100% 12 71 6,857 MCH security 64 100% 12 54 41,143 Warehouse Storekeeper 2 100% 12 107 2,571 Warehouse Assistant Storekeeper 2 100% 12 86 2,057 Logistics Officer 1 100% 12 571 6,857 Assistant Logistics Officer 1 100% 12 286 3,429 Local staff - Eid bonus @ 1% of gross salaries 1 100% lump 519 Warehouse 2 100% 12 536 12,857 Fumigation of warehouse 2 100% 12 286 6,857 Transportation of supplies from warehousing to sites 2 100% 12 1,786 42,857 Vehicle 2 100% 12 1,286 30,857 Minivans to transport critical cases to TFC sites 4 100% 12 1,286 61,714 Water for site operations 16 100% 12 71 13,714 Sub-total 232,291

3 Per result identified in the log-frame, more detailed information necessary for a good understanding of the proposal/ report will be completed here. A specific sub-section per result at proposal, intermediate report and final report stage has been foreseen (don't update information from a previous stage in this section, comment the change in the appropriate sub-section of the result). See also the guidelines for more information (e.g. for the list of sectors and related sub-sectors). Also the main foreseen procurement procedures will have been identified (as well as in section 4.4 – work plan). 4 The main means and costs (the sum of the indicated costs has thus not to be equal to the total amount for that result) have to be identified to ease understanding how the results will be reached and the activities implemented.

[Proposal][Agreement ECHO/…] – version [Date] 14 SINGLE FORM 27/11/2007 Outpatient Therap e utic Programme OTP - Operations OTP site furniture 16 100% lump 357 5,714 Sub-total 5,714 Sub total Result 1 238,577

6.2.2.1.2 Intermediate report - Total amount: …….…... EUR - Update5 on indicators - Update5 on beneficiaries (status + number) - Update5 on activities - Update5 on means and related costs 6.2.2.1.3 Final report - Total amount: …….…... EUR - Indicators for achieved result - Final state on beneficiaries (status + number) - Activities accomplished - Finally committed means and related costs

6.2.2.2 Result 2: Trained community outreach workers are able to identify and refer acute malnourished children under 5 and malnourished pregnant and lactating women from within target areas to the 16 MCHN clinics in Mogadishu. 6.2.2.2.1 At proposal stage - Total amount: 106,847 EUR - Sector: Nutrition Related sub-sector: Prevention of under nutrition, nutritional rehabilitation and supplementation - Beneficiaries (status + number): at least 9600 severe acute malnourished children, at least 28800 moderate acute malnourished children, at least 6120 malnourished pregnant and lactating women - Indicators for this result: 1. 480 trained community outreach workers 2. At least 50% of admissions are from community outreach workers 3. 90% of referrals made by community outreach workers are appropriate 4. Location from which referrals are coming from - Activities related to the result 1. Identification of new community outreach workers 2. Training and refresher training for community outreach workers 3. Continued community sensitisation and mobilisation on the CTC programme 4. Screening, identification and referral of cases to MCHN clinics 5. Follow-up of absentees and defaulters - Means4 and related costs Unit Cost- Total- Line Item Number % Months/Days Euros Euros

5 Update and explanation to be provided on progress as well as on changes made to the proposal.

[Proposal][Agreement ECHO/…] – version [Date] 15 SINGLE FORM 27/11/2007 Result 2:Trained community outreach workers are able to identify and refer acute malnourished children under 5 and malnourished pregnant and lactating women from within target areas to the 16 MCHN clinics in Mogadishu. PROGRAMME ACTIVITIES Community Mobilisation and Training Media and workshops Media and education messaging 1 100% 12 714 8,571 Citywide community mobilization workshops 2 100% lump 1,200 2,400 Outreach worker training workshops 480 100% 4 times 2 4,114 Local authority meetings 25 100% 12 times 5 1,500 Story writer 1 100% 12 250 3,000 Photographer 1 100% 12 143 1,714 Community Liaison 16 100% 12 86 16,457 Community Outreach Coordinator 1 100% 12 571 6,857 Outreach Team Leaders 80 100% 12 43 41,143 Local staff - Eid bonus @ 1% of gross salaries 1 100% lump 613 Sub-total Result 2 86,370

6.2.2.2.2 Intermediate report - Total amount: …….…... EUR - Update5 on indicators - Update5 on beneficiaries (status + number) - Update5 on activities - Update5 on means and related costs 6.2.2.2.3 Final report - Total amount: …….…... EUR - Indicators for achieved result - Final state on beneficiaries (status + number) - Activities accomplished - Finally committed means and related costs

6.2.2.3 Result 3: Trained technical and support staff in 16 MCHN clinics are able to manage and care for acute malnourished children under five and malnourished pregnant and lactating women appropriately. 6.2.2.3.1 At proposal stage - Total amount: 873,838 EUR - Sector: Nutrition Related sub-sector: Prevention of under nutrition, nutritional rehabilitation and supplementation - Beneficiaries (status + number): at least 9600 severe acute malnourished children, at least 28800 moderate acute malnourished children, at least 6120 malnourished pregnant and lactating women - Indicators for this result: 1. 64 trained nurses 2. 112 trained support staff 3. Cure rate > 75%, Death rate < 3%, Defaulter rate < 15% for SFP 4. Cure rate > 75%, Death rate < 10%, Defaulter rate < 15% for OTP - Activities related to the result 1. Identification of new MCHN clinic staff 2. Training and refresher training of MCHN clinic staff.

[Proposal][Agreement ECHO/…] – version [Date] 16 SINGLE FORM 27/11/2007 3. Anthropometric and clinical assessment of acute malnourished children and malnourished pregnant and lactating women referred to the MCHN clinic and those follow-up) 4. Provision of appropriate treatment based on set guidelines and protocols 5. Continued education of carers on key care messages of CTC

Means4 and related costs Unit Cost- Total- Line Item Number % Months/Days Euros Euros

Result 3:Trained technical and support staff in 16 MCHN clinics are able to manage and care for acute malnourished children under five and malnourished pregnant and lactating women appropriately. Supplementary Feeding Programme Warehousing and Logistics Food Distributors 16 100% 12 71 13,714 Generator operations and maintenance 1 50% 12 429 2,571 RUSF and RUTF packet disposal 1 100% 12 571 6,857 Sub-total 23,143 Outpatient Therap e utic Programme OTP - Operations Cleaners 17 100% 12 57 11,657 Site Storekeeper 16 100% 12 86 16,457 Weighers/measurers 48 100% 12 86 49,371 Registration Clerk 32 100% 12 107 41,143 Head Nurse 1 100% 12 571 6,857 Site Leader (nurse) 16 100% 12 286 54,857 Site Nurse 48 100% 12 250 144,000 Local staff - Eid bonus @ 1% of gross salaries 1 100% lump 3,490 Medicine +transporatation cost lump 15,000 15,000 RUTF+transporatation costs lump 136,429 136,429 Sub-total 479,262 2nd phase OTP/SFP Training Nutrition Training Session in Burao, Somaliland International staff flight fare 2 100 1 1,429 2,857 International staff visas 2 100 1 64 129 International staff per diem 2 100 13 11 279 Mogadishu staff airfares (including all visas and airport charges) 27 100 1 136 3,664 Mogadishu staff per diems 27 100 13 25 8,775 Berbera costs tax charges 27 100 1 13 347 training venue, hall and related charges 1 100 13 7 93 Sub-total 16,144 2 refresher training session in Burao, Somaliland International staff visas 2 100% 1 64 129 Airfare - Nairobi-Burao 2 100% 1 714 1,429 International staff per diem 2 100% 8 71 1,143 Mogadishu staff airfares (including all visas and airport charges) 72 100% 1 179 12,857 Mogadishu staff per diems 72 100% 7 days 36 18,000 Berbera costs 72 100% 1 13 926 Sub-total 34,483 Sub Total Result 3 553,031

[Proposal][Agreement ECHO/…] – version [Date] 17 SINGLE FORM 27/11/2007 6.2.2.3.2 Intermediate report - Total amount: …….…... EUR - Update5 on indicators - Update5 on beneficiaries (status + number) - Update5 on activities - Update5 on means and related costs 6.2.2.3.3 Final report - Total amount: …….…... EUR - Indicators for achieved result - Final state on beneficiaries (status + number) - Activities accomplished - Finally committed means and related costs

6.2.2.4 Other costs6 Intermediate Final Initial amount amount Committed Communication Visibility and information 5,714 Other costs 41,756

Total other costs 47,470

6.3 Work plan (e.g. annex Gantt chart) 6.3.1 [INT] Revised work plan, if changed after proposal 6.4 Monitoring, evaluation, audit and other studies 6.4.1 Monitoring of activities (explain how, by whom)

Oxfam Novib has a very long track record and has developed strong competencies to deliver and monitor interventions through alternative and complimentary partnership approaches. Oxfam Novib invests in the long term development of the capacity of local community and local organisations. This is the essence of its humanitarian capacity building interventions such as EPARA referred to in section 3.1. The Oxfam Novib monitoring approach is at four major levels including at the community, implementing partner, external and Oxfam Novib level. In the CTC programme, t The programme activities are monitored through a hierarchy of reporting mechanisms. For the OTP and SFP component of the programme, there is one nurse for each district who functions as site leader and is in charge of the technical supervision and logistical operations of the MCHN clinic. All MCHN staff report to the site leaders. The nurse site leaders collate weekly data generated by the clinics and then prepare monthly reports which are submitted to a head nurse who is tasked with the overall supervision of the OTP and SFP components. In a given month, the head nurse is expected to spend one day at each MCHN clinic to provide hands-on guidance and supervision to the clinic staff. Depending on the level of support and supervision required by the clinic staff, the head nurse can spend anywhere from a couple of hours to a full day. The remaining days of the month are spent on collation of the reports from each clinic and entering of information into the database which, in turn, is submitted by the head nurse to the SAACID programme coordinator based in Nairobi. The programme coordinator oversees the overall programme implementation and receives regular technical support from the Oxfam Novib nutrition programme manager also based in Nairobi. For the community outreach component of the programme, there are 5 outreach team leaders in each district who are in charge of planning and implementing outreach activities within their districts together with a team of thirty (30) community outreach workers. The outreach team leaders liaise with MCHN clinic

6 The last table groups the costs that have not been dedicated to one specific result (support costs, feasibility studies, audits etc. as explained in the guidelines). The total of the total amounts mentioned per result and in this table will correspond to the subtotal direct eligible costs in the table section 11.

[Proposal][Agreement ECHO/…] – version [Date] 18 SINGLE FORM 27/11/2007 staff regarding referrals made to the clinic and assess based on referral slips whether or not the referrals made are accurate. Also, the team leaders are provided with a list of absentees and defaulters by clinic staff which the outreach workers are supposed to trace and encourage returning to the clinic for follow-up. The outreach team leaders report on progress and information to a community outreach coordinator who oversees the entire community outreach component of the programme. The community outreach coordinator in turn reports to the programme coordinator based in Nairobi. In terms of operational and administrative monitoring, an administrative coordinator for SAACID based in Mogadishu oversees the operations related to logistics and finance and reports to the Nairobi-based SAACID programme coordinator who in turn is supervised by SAACID’s operations director. For Oxfam Novib, the Nairobi-based nutrition programme manager provides both technical and operational oversight of the programme with regular support and supervision from Oxfam Novib’s Humanitarian Planning Unit representative also based in Nairobi. In terms of financial monitoring, Oxfam Novib has a financing unit based in Nairobi with a full-time accountant dedicated to support SAACID’s finance and administrative officer through regular training to ensure adherence to ECHO’s financial and procurement standards. To further ensure quality and adherence to donor standards, two humanitarian programme officers and one finance advisor based in The Hague, Netherlands provide backstop support for the team in Nairobi. A security advisor is available to provide security-related information relevant to programme planning and implementation. The Nairobi-based programme coordinator from SAACID and the Oxfam Novib nutrition programme manager, both proposed to be funded fully through the ECHO support, have done monitoring visits to Mogadishu in the past and this will be continued for as long as the security situation allows. All monitoring activities are recorded and documented through standardised monitoring and reporting formats and are analysed routinely by both the SAACID programme coordinator and the Oxfam Novib nutrition programme manager to check if the programme is delivering on its mandate. Anticipating the increase in the monitoring requirements of the expanded programme, an Oxfam Novib project assistant funded fully through ECHO support will be hired with the specific role of supporting the nutrition programme manager in information collection, monitoring, and related project tracking which will include the planning and implementation for integrated services in the near future. There is regular phone and email contact between the Mogadishu and Nairobi-based staff and weekly and monthly reports are prepared, shared and made available to the nutrition cluster, to back donors and to UNICEF. As part of the documentation of the programme, a storywriter and a photographer have been budgeted for so as to be able to capture the human interest stories behind the programme. Photographs of children are taken on admission and then on discharge to document the physical changes they have experienced. From the beneficiaries, some arewill be chosen asked to be interviewed by the storywriter who documents the unseen changes in the children, their carers and their families that cannot be captured by a photograph. Throughout the project design and implementation, Valid International CTC advisors maintain regular communication with the Oxfam Novib Nutrition programme manager. The monthly data received are shared with Valid and support and technical input is shared in different ways including telephone, email, and skype. This information and knowledge shared is brought to inform the mid term evaluations and reviews which will, among others, be facilitated by Valid international. As Valid is also working with Oxfam Novib on CTC programme in Afghanistan, lessons on practice and approaches will be cross shared WFP has been involved in regular random monitoring of sites; and this would continue with the expanded intervention. WFP and UNICEF also require the physical return of the empty nutritional supplement sachets – adding an addition layer of accountability for the main in-kind input. The community is also involved in the monitoring in which regular discussions between programme staff in Mogadishu and community representatives are held. In these discussions, the progress of the programme is shared with the representatives and issues relevant to the implementation such as security are brought up for the representatives to give feedback on and possible propose appropriate solutions.

[Proposal][Agreement ECHO/…] – version [Date] 19 SINGLE FORM 27/11/2007 6.4.2 Tick the box if one of the following studies will be undertaken:  an external evaluation during the Action  an external evaluation after the Action  an external audit during the Action  an external audit after the Action  an internal evaluation or internal audit related to the Action 6.4.3 Other studies:  please elaborate: (please remember that for external evaluations, audits and studies financed by the Commission the Terms of Reference have to be agreed by DG ECHO before launching the selection procedure)

7. CROSS-CUTTING ISSUES 7.1 Describe the expected level of sustainability and/or connectedness7 The primary level of connectedness for this programme intervention relates to cooperation with ACF in relation to in-patient care of severely malnourished children with complications. The programme also has good synergies with the citywide wet food programme which provides 80,000 daily 2,000 calorie meals per day to the most marginalised throughout the city. Some 80% of the daily meals go to IDPs. This programme is implemented between SAACID, DRC, WFP and a basket of donors, including ECHO. The programme has an existing MUAC component, which already has strong referral integration with the existing CTC programme; and this would be further strengthened with an expansion of the CTC programme to all 16 districts of Mogadishu City. Interconnectedness has also been created with other local UNICEF and WFP nutritional partners through the establishment of the first nutritional cluster in Mogadishu City’s history. The development of this cluster was an outcome of the first CTC phase; and SAACID now chairs and coordinates the cluster in Mogadishu; and links this cluster to the Nairobi cluster with the technical support of Oxfam Novib. Whilst sustainability of any programme in the context of Mogadishu is often hard to achieve, the approach Oxfam Novib has taken in terms of programme implementation through a local implementing partner ensures a high probability and likelihood of continued long-term benefits for Mogadishu society as a whole. For SAACID, the programme provides the organisation and its staff the opportunity to experience a highly complex operation and gain increasing competency both in the operational and technical aspects on a daily basis. The intensity and frequency of the experience and learning increases the probability that the organisation and its staff will retain the knowledge and skills over a longer period of time. Also, certain capacity that the organisation and its staff will gain are transferable to any other programme and can be continually applied even if the CTC programme itself doesn’t continue. The lessons drawn from and between a similar CTC intervention in which Oxfam Novib is working with local organisations in Afghanistan present a unique opportunity to learn from how CTC can sustainably be delivered in hard to reach areas by local agencies. In terms of connectedness, the CTC approach inherently considers longer-term and interconnected problems into account through the community mobilisation and outreach component which engenders discussion with the target population on their understanding of what malnutrition is and its causes and effects and uses this understanding to encourage engagement and participation from the target population in supporting the CTC programme. On a broader level, Oxfam Novib and SAACID takes into account the community’s ideas and perceptions specific to malnutrition and inputs these into their other programmes that address the longer-term, developmental issues relevant to malnutrition.

7.2 Continuum strategy (Linking Relief, Rehabilitation and Development) As mentioned in Section 5.1, the key continuum strategy for Oxfam Novib is based on a partnership model in which a local NGO such as SAACID has been identified as the implementing partner who benefits directly and indirectly from the learning and experience of implementing this programme making the organisation much capable in doing similar programmes in the future on their own. The rehabilitated MCHN clinics also form a strong foundation for add-on health services that will be useful for the communities not targeted by the current emergency intervention especially mothers and children. These MCHN clinics are community-owned thereby increasing the likelihood that the communities themselves will want to expand the potential services offered by these clinics. The community elders, opinion leaders are themselves involved in the provision of security at the sites. The nurses and support staffing at the centers are identified from among the communities based on agreed criteria, this not only

7 Sustainability and connectedness are similar concepts used to ensure that activities are carried out in a context that takes longer-term and interconnected problems into account.

[Proposal][Agreement ECHO/…] – version [Date] 20 SINGLE FORM 27/11/2007 increases their ability to continue delivering assistance even amidst relatively high insecurity but also the fact that the skills attained out of the training and practices of CTC will remain with the community beyond the immediate project timeline. The structures developed will likely last beyond the emergency phase.

7.3 Mainstreaming (e.g. Disaster Risk Reduction, Children, Human rights, Gender, Environmental impacts, others to be specified) Whilst this is primarily a nutrition programme, its implementation incorporates principles of community participation and empowerment (as described in Sections 4.2.5, 5.1 and 5.2) which has been shown to be one of the critical factors contributing to the success of the current implementation in 8 districts in Mogadishu. The programme has given priority to women in the criteria for selection of all technical and support staff working in the MCHN. Furthermore, 70% of the community outreach workers involved in the programme are women and this trend will continue in the second phase of the programme. In addition, the programme has ensured that IDP communities are represented through selection of community outreach workers from their group. As CTC is an out patient programme, it affords the mothers extra time to engage in other important activities e.g. income generating activities and time to attend to other children at home. The handling and disposal of the sachets are done in line with recommended WHO standards and as advised by both UNICEF and WFP. In the training provided by Oxfam Novib and Valid International for the OTP-SFP staffs, safe waste disposal and basic hygiene at the centers are included. Ensuring the availability of water, sanitary facilities and relative space at the CTC sites are standard requirements included in the criteria of selection and design of the MCHN centers. SAACID also employees a rights based approach in the design and delivery of assistance in Somalia and takes part in the continuous appraisal process by Oxfam Novib on all its partners’ interventions. Given that SAACID is also at the same time implementing the wet feeding project, the CTC intervention, targets the severely malnourished children while the wet feeding intervention contributes to reduction in the number of children under the age of five falling into the severely malnourished category.

7.4 [INT] In case of changes or problems to be addressed, please explain 7.5 [FIN] In case of changes or problems to be addressed, please explain

8. FIELD COORDINATION 8.1 Field co-ordination (indicate the Humanitarian Organisation's participation in coordination mechanisms with other relevant stakeholders, e.g. clusters, NGOs, UN agencies, others to be specified as well as the links with the Consolidated Appeal Process, when relevant) Oxfam Novib and its implementing partner SAACID are actively involved in the nutrition cluster both at Nairobi and Mogadishu level. Monthly nutrition cluster meetings in Nairobi are participated in by the Oxfam Novib nutrition programme manager and by the SAACID programme coordinator. In Mogadishu where SAACID is the chair of the Mogadishu Nutrition Cluster, regular cluster meetings have been hard to sustain but SAACID actively initiates and participates in these meetings. Also, regular bilateral coordination meetings are done with other nutrition actors such as ACF who operate in areas within Mogadishu where MCHN clinics have been identified and are operational. Specific links of referrals between the two organisation’s services have been institutionalised. SAACID works with local authorities in the selection and design of the programme although this is limited by the fact that in much of the project area, there is a near total break down of national health service delivery.

8.2 National and local authorities (relations established, authorisations, coordination) SAACID regularly talks to all communities and factions specifically on general and specific concerns about the conflict, the command and control of militias, the shelling of civilian areas, and the necessity of maintaining safe spaces around service delivery sites such as those with the CTC programme. This ongoing dialogue, which is spear headed by community structures (elders, opinion leaders) is appreciated by all parties as a result of which there have been very few security incidents recorded in relation to the pilot CTC programme which has allowed for the current implementation to continue successfully. This same mechanism will be in place for the additional 8 MCHN clinics that will be opened.

8.3 Co-ordination with DG ECHO (indicate the Humanitarian Organisation's contacts with DG ECHO and its technical assistants in the field) Oxfam Novib coordinates with the ECHO office in Nairobi and has had several meetings on possibility of partnerships. Most recently Oxfam Novib invited ECHO representatives on a presentation of the Community-based Therapeutic Care (CTC) programme. In December 2009 Oxfam Novib attended an ECHO conference in Brussels and made a presentation on strengthening local humanitarian capacities in Somalia in which important lessons on delivering assistance in hard to reach areas were shared. Through the Policy Advisory Unit in Nairobi, Oxfam Novib will continue to share field based knowledge and practices with the regional office for the purpose of informing and improving the humanitarian policy and practice environment in Somalia. Oxfam Novib will also continue to keep the ECHO desk office in Nairobi engaged on the same operation.

8.4 [INT] In case of changes or co-ordination problems, please explain 8.5 [FIN] In case of changes or co-ordination problems, please explain

9. IMPLEMENTING PARTNERS 9.1 Name and address of implementing partner(s)

Oxfam Novib SAACID

9.2 Status of implementing partners (e.g. NGO, local authorities, etc.) and their role Oxfam Novib - International NGO based in Nairobi SAACID - Local NGO based in Mogadishu but is also a member of SAACID International incorporated in Australia and USA 9.3 Type of relationship with implementing partner(s) and the expected reporting by the implementing partner SAACID has been a partner organisation of Oxfam Novib for more than 10 years. Oxfam Novib has invested in and has long-term commitments to work with SAACID. For all the projects that Oxfam Novib jointly implements with SAACID, financing agreements will be reached in ways that make clear the obligations and responsibilities of each and specifically the reporting timelines, quality assurance, community participation and good stewardship of resources. For back donor supported grants, we it is ensured that the contracts and financing agreements reached between Oxfam Novib and SAACID will be in line with and shall embed the ECHO conditions. For the CTC programme, monthly, quarterly financial and narrative reports shall beare required. This will be complemented with weekly date from the CTC centres which are analysed by the Oxfam Novib and SAACID project managers based in Nairobi.

9.4 [INT] In case of changes, please explain 9.5 [FIN] In case of changes, please explain

10. SECURITY AND CONTINGENCY MEASURES 10.1 Contingency measures (Plan B/ mitigating actions to be taken if risks and assumptions spelled out in the log-frame materialised) The contingency measures taken by the implementing partner SAACID are both preventative and corrective measures. Even before the risks materialise, SAACID works through community leaders who know all the militia commanders and all the militiamen operating in their area. Community leaders use various deterrent and acceptance approaches to keep the militia commanders and militiamen to stay

[Proposal][Agreement ECHO/…] – version [Date] 22 SINGLE FORM 27/11/2007 away from the CTC sites, or suffer ostracisation from their clan or sub-clan. This strategy has been very successful, as no incidents have been recorded of attacks or threats from militiamen against the programme, CTC sites, or recipients of CTC services. Should security incidents occur, the same community mechanism of reproach is initiated and the culprits made to rectify damages or abuses they have committed. Oxfam Novib has and will continue to work with SAACID to develop and update a contingency plan which will among others include:  Delay/suspend operations for some time and until such a time when it will be possible to resume actions. It is possible that this may not be the same in the entire project location given that the action is to be implemented in 16 districts of Mogadishu so that so that suspension/delay may only be in the districts where it has become impossible to work while it may be possible in another district/zone.  Consulting with DG ECHO possibly reallocating the remainder of the funds to meet urgent humanitarian needs arising from the violence. This will only be with express approval of DG ECHO.  Move the sites to another location/site

10.2 Security considerations 10.2.1 Security situation in the field, describe briefly The situation in Somalia continues to be chaotic with regard to security, affecting the capacity of relief agencies and NGOs to operate or even access the project areas. Indeed a number of aid workers have been killed and or kidnapped over the last few months making it one of the riskiest locations for aid workers in the world today. Currently, Mogadishu is experiencing increasing tension and active fighting between the TFG/AMISOM forces and armed opposition groups. At the same time, the humanitarian crisis is deepening due to a lack of consistent response programmes and the difficulties for IDPs to return to their places of origin. In particular, because of security reasons, there are severe limitations for expatriates to be based in South and Central Somalia permanently. This has gravely hampered relief interventions from INGOs, especially those who do not completely rely on the local partners’ capacity to deliver operations (part of the justification for this action). Except for interventions that are owned and driven by communities, there are not many humanitarian activities being implemented in the field. 10.2.2 Has a specific security protocol for this Action been established? Yes  No  Standard procedures  If yes please elaborate: Oxfam Novib has developed and adopted a comprehensive security protocol to be followed by all Oxfam International affiliates working or travelling to Somalia. The protocol also includes specific plans for security related and medical evacuations. Oxfam Novib is also part of the NGO security coordination frameworks such as the NGO safety and security coordination framework (NGO-SPAS). Oxfam Novib will continue to apply security conscious and conflict sensitive principles throughout implementation for example community owned programming, cross community programming, impartial and consistent provision of assistance, transparency in deliver of assistance and clear communication channels with the communities, inclusive recruitment procedures for staff being sensitive to all clan representations and such other conflict sensitive approaches..

All staff of Oxfam Novib and the partners are trained and informed of security situation in the area in which the action is to be implemented. Oxfam Novib takes specific steps to ensure that the partners it works with are also working in security conscious and sensitive manner for example as part of the humanitarian capacity building project for which SAACID will participate, special focus will be dedicated to security analysis and management practices and competencies.

10.2.3 Are field staff and expatriates informed of and trained in these procedures? Yes  No  10.3 [INT] In case of changes or problems to be addressed, please explain 10.4 [FIN] In case of changes or problems to be addressed, please explain

[Proposal][Agreement ECHO/…] – version [Date] 23 SINGLE FORM 27/11/2007 11. COMMUNICATION, VISIBILITY AND INFORMATION ACTIVITIES 11.1 Planned communication activities (in field and/or in Europe) Oxfam Novib will discuss with SAACID on ways of applying the maximum possible visibility opportunities with SAACID and other participating partners and will hold inductions with the key project staff and SAACID. The induction plans will include an introduction to ECHO and the way the European Commission supports relief efforts to ensure that ECHO’s support will be communicated to the local partners and communities during initial planning meetings. “Support from the European tax-payers” will also be highlighted through a clear communication approach addressing partners/beneficiaries, government and other stakeholders. Currently, due to the security risks involved it is not planned to mark vehicles with ECHO logos but the logos will be attached to the project reports and related publications. SAACID intends to paint the ECHO logo on the walls of the MCHN clinics. Through regular participation in co-ordination meetings and reports, Oxfam Novib will share information on its on-going projects to raise awareness of the partnership ECHO is providing in addressing the humanitarian capacity needs in Somalia. Digital photographs and stories, where appropriate, will be collected throughout project implementation that will be shared with ECHO and used by Oxfam Novib to support its website (subject to an analysis of the security risks associated with branding). The added value of joint visibility and communication activities will be actively explored with other ECHO partners in Somalia. For example, newspaper articles that highlight the work ECHO is supporting will be considered. Specific ideas will be discussed with the ECHO Regional Communications Officer in Nairobi and other agencies, subject to approval of respective projects. In going about with the visibility action, Oxfam Novib will pay due attention to the possible and security related risks associated with visibility in which case this will be shared with ECHO in a timely and transparent way.

11.2 Visibility on durable equipment, major supplies, and at project locations Except for the 8 MCHN sites which have already been rehabilitated through Oxfam Novib’s earlier funding in the pilot phase and the office equipments, this action does not foresee major procurement of durable physical equipments. Engravings of such materials will be done in line with ECHO guidelines and in consultation with ECHO desk office in Nairobi.

11.3 Planned publication activities No major publication is planned at the moment. In the course of the project, Oxfam Novib may, in consultation with ECHO consider the possibility of publishing lessons drawn from the implementation of this action. This will likely be drawn from the project reports and post implementation evaluation.

11.4 [INT] In case of changes, please explain

11.5 [FIN] Report on the relevant activities

12. HUMAN RESOURCES Indicate global figures per function and status

[Proposal][Agreement ECHO/…] – version [Date] 24 SINGLE FORM 27/11/2007 Function S Nu Nu Comm t mb mb ents a er er t of of u staf ma s8 f n/ mo nth in pro ject

Representative, Humanitarian E 1 12 Ox Planning, Horn of Africa (20% time) x mo Novib p nths staff e rt

E 1 12 Ox x mo Novib p nths staff e CTC project Officer-Oxfam Novib (100%) rt N 1 12 Ox a mo Novib ti nths staff o n a Programme Accountant-Oxfam Novib (30%) l N 1 12 Ox a mo Novib ti nths staff o n Programme Support Officer-Oxfam Novib a (10%) l N 1 12 Ox a mo Novib ti nths staff o n Programme Support Officer-Oxfam Novib a (10%) l N 1 12 Ox a mo Novib ti nths staff o n a Project Assistant Officer (100%) l Finance and Administration Manager (15%) N 1 12 Ox a mo Novib ti nths staff o n

8 Expat, local staff, staff of the implementing partner,…

[Proposal][Agreement ECHO/…] – version [Date] 25 SINGLE FORM 27/11/2007 a l

L 1 12 Ox o mo Novib c nths staff a Security Officer (20%) l Country Director L 1 12 SAACI o mo D staff c nths Mogadi a shu l

Chief Financial Officer L 1 12 SAACI o mo D staff c nths – a Mogadi l shu

Programme Coordinator (Nairobi - E 1 12 SAACI International) x mo D staff- p nths Nairobi e rt

12.1 [INT] In case of changes, please explain 12.2 [FIN] In case of changes, please explain

13.FINANCIAL OVERVIEW OF THE ACTION9 Eligible cost of Action10 Initial Intermediate report Final Funding of Action Initial Final state committed budget Budget Committed Personnel costs 211,733 Direct revenue from Action Travel 5,923 Contribution by applicant 283,987 Equipment costs 22,857 Contribution by other donors 306,519 Programme Activities 1,011,649 Contribution requested from ECHO 783,014 Communication, visibility, information 5,714 % of total funding: 57% Administration cost 22,663 Other costs 41,756 Subtotal direct eligible costs 1,322,294 Indirect costs (max. 7%) 51,225 Total Costs 1,373,520 Total Funding 1,373,520

13.1 [FIN] In case of other donors, please identify the donors and the amount provided

9 This table will constitute annex II of the signed Agreement. 10 The partner can use another representation of costs in line with the current practice in its organisation. These headings will become the chapters of the final financial reporting. In case personnel costs and the costs on information, communication and visibility are not explicitly available in section 4.3.2, these have to be explicitly mentioned in this table. [Proposal][Agreement ECHO/…] – version [Date] 27 SINGLE FORM 27/11/2007

14.ADMINISTRATIVE INFORMATION (Marieke Fill this section) 14.1 FPA number (if applicable) 14.2 Name and title of legal representative signing the Agreement 14.3 Name, telephone, e-mail and title of the person(s) to be mentioned in Article 7 of the Agreement 14.4 Name, telephone, fax and e-mail of the representative in the area of intervention 14.5 Bank account Name of bank: […] Address of branch: […] Precise denomination of the account holder: […] Full account number (including bank codes): […] IBAN account code, (or BIC country code if the IBAN code does not apply): […]

15.[FIN] CONCLUSIONS AND HUMANITARIAN ORGANISATION'S COMMENTS

[Proposal][Agreement ECHO/…] – version [Date] 28 SINGLE FORM 27/11/2007 Annex A: Procurement table11 Derog (Forecast) (Forecast) Amount Description of the supplies, services or works Quantity Procurement procedure12 ation Launch date Contracting (EUR) Y/N procedure13 date Ready-to-Use Therapeutic Food (RUTF) 3,500 Routine OTP and SFP Medications Training and Evaluation consultancy

Annex B: Gantt Chart TITLE OF THE ACTION: Community-based Therapeutic Care Programme in Mogadishu, Somalia

11 This table is only mandatory for Agreements with an A-control mechanism. It regroups the main significant procurement procedures for this Action and will be updated at proposal, intermediate report and final report stage. The Partner may attach a table with another lay-out (e.g. already used inside the project) provided that at least the above mentioned information is available. These tables do not have to be provided for Agreements with a P-control mechanism. 12 Open international tender, open local tender, negotiated procedure, single quote, framework contract or use of a Humanitarian Procurement Centre (HPC). 13 The dates can also be expressed in number of weeks after the start of the Action. [Proposal][Agreement ECHO/…] – version [Date] 29 SINGLE FORM 27/11/2007 Result 1: Identified community-owned MCHN clinics are functional in 16 sites in Mogadishu. Activities Stage May Jun July Aug Sep Oct Nov Dec Jan Feb Mar Apr Furnishing and provision of required equipment and supplies to PROP MCHN clinics INT Maintenance of MCHN clinics PROP INT Securing and safeguarding of MCHN clinics through community- PROP initiated security and safety mechanisms INT Result 2: Trained community outreach workers are able to identify and refer acute malnourished children under 5 and malnourished pregnant and lactating women from within target areas to the 16 MCHN clinics in Mogadishu. Identification of new community outreach workers PROP INT Training and refresher training for community outreach workers PROP INT Continued community sensitisation and mobilisation PROP INT Screening, identification and referral of cases to MCHN clinics PROP INT Follow-up of absentees and defaulters PROP INT Result 3: Trained technical and support staff in 16 MCHN clinics are able to manage and care for acute malnourished children under five and malnourished pregnant and lactating women appropriately. Identification of new MCHN clinic staff PROP INT Training and refresher training of MCHN clinic staff PROP

[Proposal][Agreement ECHO/…] – version [Date] 30 SINGLE FORM 27/11/2007 INT Anthropometric and clinical assessment of acute malnourished PROP children under five and malnourished pregnant and lactating women referred to the MCHN clinic and of those following-up INT Provision of appropriate treatment based on set guidelines and PROP protocols INT Continued education of carers on key care messages of CTC PROP INT

[Proposal][Agreement ECHO/…] – version [Date] 31