MOZAMBIQUE Humanitarian

Situation report No. 4

Reporting Period: 1 – 31 May 2021

Highlights Situation in Numbers 689,000

children in need of • The situation in Cabo Delgado remained mostly humanitarian assistance calm in May though access is a challenge with tens of thousands in hard-to-reach or inaccessible areas 1.3 million • Over four million people were reached in 2021with people in need UNICEF’s COVID-19 prevention messages (OCHA Dec 2020)

• UNICEF supported set up of 20 temporary learning 732,000 spaces and provision of kits 9,000 children this year Internally displaced

• Over 4,800 households in Cabo Delgado were (IOM, April 2021) reached in May with cash transfer for three months >67,000 • UNICEF immunized 7,094 children aged 9 to 23 Internally displaced from

months in May 2021 Palma

(IOM, 3rd June 2021)

UNICEF’s Response and Funding Status UNICEF Appeal 2021 US$ 96.5 million

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Funding Overview and Partnerships UNICEF’s 2021 Humanitarian Action for Children appeal, revised in June 2021 due to escalating needs, requests $96.5 million to provide lifesaving and life-sustaining services for children and their caregivers in . Thus far in 2021, UNICEF Mozambique has received $16,3 million for its humanitarian response from the Governments of Canada, Japan, Norway, Sweden, Italy, the United Kingdom, Education Cannot Wait and the UN’s Central Emergency Response Fund. This includes UNICEF’s Global humanitarian funding allocations of $3.9 million to support ongoing response activities. UNICEF expresses its sincere gratitude to all our donors. The 2021 appeal, however, still has a funding gap of 69 per cent as detailed in Annex B. Significant needs remain for all of UNICEF’s ongoing emergency programmes. Without the required funding, UNICEF will be unable to provide access to safe water, health and nutrition services, learning opportunities, critical child protection support and support to survivors of gender-based violence.

Situation Overview & Humanitarian Needs Insecurity in Cabo Delgado, including , led to further population displacements. Since the attack on Palma town on 24 March, 67,848 people1 have sought refuge in neighbouring districts mostly in Nangade, Mueda and Pemba, of whom 86 percent are living within host communities. About 43 percent of the IDPs are children and nearly 850 were identified as unacompanied or separated from their parents. In a 12-month period (April 2020-April 2021), the number of IDPs has quadrupled standing at 732,227 people 2 displaced and living in five provinces in central and northern Moambique as per the last assessment report provided by IOM (April 2021). Over 90 percent of the IDPs are in Cabo Delgado, while the remaining are living in Nampula, Niassa, Sofala and Zambézia provinces. Fortysix percent of the IDP population are children and a total of 2,733 children have been uncompanied or separated since the start of tracking. IDPs continue to note their top three needs are food, shelter and access to water and sanitation services. Lack of access and security restrictions have hampered data collection efforts and hence Mocimboa da Praia, Muidumbe, and Palma were not assessed. In Cabo Delgado, closure of health facilities have been reported in Ibo and Quissanga districts and to a lesser extent in Meluco and Mueda districts. Health challenges reported by IDPs include overcrowded facilities and lack of doctors. Figure 1: Map of population displaced due to conflict in Cabo Delgado as of April Education is also a concern, especilliay in Ibo, 2021- IOM. Quissanga and Macomia districts, where reports indicates IDP children cannot access learning opportunities due to lack of school materials, teachers and classrooms. According to Integrated Phase Classification (IPC) analysis for malnutrition conducted in Cabo Delgado in February 2021, it is estimated that 75,000 children under five years3 will suffer from acute malnutrition. The analysis indicates that districts with limited/no access—including Palma, Nangade, Macomia and Quissanga—will likely deteriorate to severe (IPC 3) and critical (IPC 4) levels. Contributing factors for this deterioration are partly due to conflict (access to health services) but also food insecurity, very low quantity and quality of food consumption, weak access to safe water and sanitation.

1 https://reliefweb.int/report/mozambique/displacement-tracking-matrix-mozambique-emergency-tracking-tool-ett-report-no-101 2 https://reliefweb.int/report/mozambique/iom-mozambique-dtm-baseline-assessment-report-round-12-cabo-delgado-nampula-niassa 3 2

Summary Analysis of Programme Response

Health UNICEF is committed improving the welfare of children affected by humanitarian crises in Mozambique with particular focus on those affected by the conflict in the north. To strengthen the response in Cabo Delgado, UNICEF is developing new partnerships (Doctors with Africa - CUAMM, and Action Contre la Faim - ACF), to support delivery of essential services at health facility and community levels. The approach includes integrated mobile health brigades and outreach to children and mothers in remote communities. UNICEF supported the delivery of 3,000 mosquito nets to prevent malaria as part of survival kits, distributed in hard-to-reach areas to 1,500 families. UNICEF also distributed 18 community health workers medical kits for treatment of common illnesses in communities with IDPs of which 10 in Montepuez, 4 in Ancuabe, and 4 in Chiúre districts, UNICEF2021/Sualei reaching 4,500 patients. Four temporary clinic tents were deployed and raised in IDP camps in Ancuabe and Chiúre districts while two were raised in , expected to benefit over 1,700 families in resettlement centres. To respond to reported cases of measles in Sofala and Cabo Delgado, UNICEF increased efforts on routine immunization reaching, in May, 7,094 children of 9 to 23 months including 5,705 in Cabo Delgado, 420 in Manica, 853 in Sofala, and 116 in Nampula provinces. The support to measles prevention in 2021 included an immunization campaign in Cabo Delgado which reached 294,230 children under 15 years. With support from UNICEF 26,991 children under one year have been completely immunized, and 189,644 children and women accessed primary health care. UNICEF also supported COVID-19 vaccination that covered 3,432 people above 50 years in the resettlement centres in .

Nutrition The nutrition landscape in Cabo Delgado is deteriorating and is likely to further deteriorate, particularly in northern districts, due to the significant disruption of health and nutrition services. UNICEF and the Ministry of Health are conducting cluster coordination meetings at the national and Cabo Delgado levels to strengthen actions for prevention, case detection and treatment. Through an established partnership with the NGO AVSI Foundation, UNICEF is supporting nutrition screenings, referrals and infant and young child feeding (IYCF) counselling and support to caregivers and children 6 to 59 months among both host communities and IDPs. At the transit centre in Pemba, AVSI is conducting regular cooking demonstrations teaching mothers to prepare nutritious meals for their children. A nutritional screening conducted in Matemo island (part of ) reached 202 children 6 to 59 months and 30 pregnant Figure 2: IPC Acute Malnutrition projected situation in Cabo and breastfeeding women (PLW). Of those, ten children Delgado, October 2021 to January 2022. and three PLW were found with acute malnutrition and enrolled in treatment programmes. Tents and therapeutic nutrition supplies—including ready-to-use-therapeutic foods and therapeutic milks—were delivered to Médecins Sans Frontières to expand nutrition assistance in Mueda, Montepuez and Nangade districts allowing for treatment of 300 children 6 to 59 months for two months. Similar support was provided to the Provincial Health Directorate of Cabo Delgado, including eight inpatient outpatient kits sufficient for the treatment of 500 children over three months. As part of the response to Cyclone Eloise, UNICEF delivered 3,591 cartons of RUTF and 100 cans of therapeutic milk to reinforce acute malnutrition treatment in resettlement sites in Sofala and Manica Provinces. This will allow for treatment of 3,591 children with severe acute malnutrition (SAM) over four months. Integrated mobile brigades working

3 in these areas screened 443,766 children 6 to 59 months, of whom 3,220 were referred for treatment, while 27,389 mothers and caregivers of children under two received IYCF counselling.

Child Protection In Cabo Delgado, UNICEF conducted a child protection response and situation analysis within the Child Protection Area of Responsibility which identified significant gaps. Child protection agencies are currently reaching less than 30% of the targeted communities. To expand our reach, UNICEF is currently in the process of signing new agreements with six partners in Cabo Delgado to cover six districts. In addition, increased vulnerabilities of displaced children, especially those without documentation, have been identified. Unverified reports on child recruitment and use, and cases of child right violations, have also been received. UNICEF continued to provide psychosocial support to displaced and host communities, reaching 256 children (121 girls). The response to unaccompanied and separated children has been ongoing, and UNICEF partners registered 18 unaccompanied children (7 girls) who have been placed in family-based alternative care. Through collaboration with IOM and the government, a training on unaccompanied and separated children will be conducted in June to further strengthen the capacities on stakeholders to improve quality, coordination, and services. To respond to the needs of individual children through case management services, 61 children (28 girls) received individualized support; of these 20 are children with disabilities. Additionally, 381 children (237 girls), were referred to other services to ensure integration of children in schools, and treatment of illness to health posts. UNICEF in coordination with partners, continued to strengthen disability-inclusive response through training of 99 stakeholders from the Government including: National Directorate of Social Action, Ministries of Health, Education, and Justice, the police, the Provincial Attorney’s Office, as well as IOM, Save the Children, AVSI, Forum of Disabled Mozambican Associations and Child Help Line. At the community level, 199 Child Protection Community Committee members were trained on disability and inclusive protection services. UNICEF supported the training of 110 helpline attendants (Alô Vida helpline) and 56 social action technicians for the provision of remote psychosocial support to children and their caregivers during COVID-19. As part of the Cyclone Eloise response, 436 children in are receiving psychosocial support through child friendly spaces operated by World Vision. Moreover, in May, 3,408 birth registrations have been registered among those displaced by the cyclone. Education To date, UNICEF and partners have supported over 53,673 children (24,841 girls) with distance education. 7,666 children (4,414 girls) were involved in ‘catch up’ programs, 417 teachers (216 female) trained in mental health and psycho-social support (MHPSS) and 5,506 children (3,175 girls) were assisted in MHPSS. In Cabo Delgado, UNICEF in collaboration with Education Provincial Directorate (DPE), has initiated the installation of 149 temporary learning spaces (TLS) with 20 completed including 1,000 desks. Additionally, 9,000 learners’ kits and 100 school-in-a-box packages benefiting 4,000 children have been distributed in Montepuez and Pemba districts, while distribution in Mueda and Nangade continues. To support the ©UNICEF/2021/Soares continuing education of adolescent girls, 500 menstrual hygiene management kits have been distributed in Montepuez, Pemba, Mueda and Nangade for 500 girls. UNICEF partner AVSI Foundation is supporting learning activities at the Pemba ‘Centro Desportivo’ centre for 200 children and youth. UNICEF printed and distributed of 30,000 posters for all schools in the country on COVID-19 prevention.

WASH In May UNICEF started a new partnership with the NGO Helpcode covering the hard-to-reach district of Mueda which will assist with distribution of interagency kits for 1,500 HH, construct latrines in transit centres and will provide access to water through network extension and boreholes rehabilitation. In May over 6,000 people had access to safe water in Cabo Delgado. Improvement of the existing FIPAG water network and drilling of new boreholes in the 25 de Junho camp in is under discussion, as well as possible switch towards semi-permanent de-sludgeable latrines for sanitation; however large investments required for water supply should be balanced with the “temporary” nature of the camp.

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To support ongoing needs from Cyclone Eloise, UNICEF is partnering with four NGOs to provide WASH services in IDP resettlement areas. While all emergency transit sites have closed, resettlement sites require household latrine support and increased water supply coverage. While no more large-scale distributions are planned, a UN to UN agreement is being prepared with the World Food Programme for a joint voucher intervention in Eloise-stricken districts of Buzi and Sussudenga, to be started in June. Another similar joint voucher intervention is under discussion for Montepuez district in Cabo Delgado. In , UNICEF and AVSI Foundation continue with WASH works in COVID-19 isolation wards, and prevention activities in markets and other public places. Social Protection and Cash-Based Programming As part of the Government’s support to IDPs in Cabo Delgado, UNICEF is providing technical assistance to the National Institute for Social Action (INAS) on a cash transfer for 5,008 registered displaced families living in Chiure. The payment is made in two tranches of MZN 4,500, each payment being for three months. The first payment took place from 26-29 May reaching 4,802 HH. The cash transfer was launched by the Provincial Director of Gender, Child and Social Action, the District Permanent Secretary, a representative of the Embassy of Sweden and UNICEF. To coincide with the payments, UNICEF simultaneously offered health and nutrition activities, including screening for severe acute malnutrition and sexual and reproductive health consultations. Communications for Development (C4D) As part of the Cyclone Eloise response, UNICEF, with FutbalMas, conducted approximately 400 sessions to provide psychosocial support to more than 1,200 children and adolescents in Sofala. In Cabo Delgado, the rehabilitation of the community radio in Ancuabe district was finalized and is now reaching approximately 40,000 people with content on life- saving practices. UNICEF is continuing to support to Ministry of Health in address COVID-19 needs through new TV spots on safety and efficacy of the COVID-19 vaccine, as well as continuing preventive practices. As a result, approximately 4 million people have been reached with COVID-19 specific messages. Prevention of Sexual Exploitation and Abuse To ensure emergency staff understand PSEA issues, staff conducted a session with the Pemba-based team on PSEA, abuse of power, and protection against retaliation. Internal education and processes were also scaled up with training for field- and Maputo-based staff, inclusion of PSEA in UNICEF’s internal risk management review, and guidance for management staff on how to support PSEA sensitization. Over 175 partner staff received PSEA training in five provinces; 17 government staff also participated in a PSEA session. Regarding interagency PSEA, the Government Engagement Strategy was finalized and submitted for the pre-approval of the Resident Coordinator. Additionally, messages for PSEA IEC materials for staff were finalized and the PSEA Network database of implementing partners assessed by different agencies, which identifies gaps and capacities, was completed.

Humanitarian Leadership, Coordination and Strategy UNICEF leads the WASH, Education in Emergencies, Nutrition Clusters and the Child Protection sub-cluster or Area of Responsibility. Overall coordination in Cabo Delgado was strengthened with the arrival of the Deputy Humanitarian Coordinator based in Pemba. In Sofala, the provincial government approved the Education in Emergency (EiE) Cyclone Eloise Response Plan. WASH and Education clusters have created a working group focused on WASH in schools, to coordinate an improved response to the growing demand.

Human Interest Stories and External Media https://www.facebook.com/unicef.mozambique/posts/3963776417040598/ https://www.facebook.com/unicef.mozambique/posts/3973080859443487/ https://www.facebook.com/unicef.mozambique/posts/4028109303940642/

Next SitRep: 30 July 2021 UNICEF Mozambique: https://www.unicef.org/mozambique/en UNICEF Mozambique Facebook: https://www.facebook.com/unicef.mozambique UNICEF Mozambique Humanitarian Action for Children Appeal: https://www.unicef.org/appeals/mozambique

Who to contact for Maria Luisa Fornara Katarina Johansson Jane Strachan further information: Representative Deputy Representative-Programmes Chief Field Operations/Emergency Mozambique Mozambique Mozambique Tel: (258) 21481104 Tel: (258) 21481104 Tel: +258843917926 Email: [email protected] Email: [email protected] Email: [email protected]

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Annex A

Summary of Programme Results UNICEF and IPs Response Cluster/Sector Response Sector Change Change Total 2021 Total since last since last needs4 target results 2021 Total Indicator report target results report Health # of children under-five provided with consultations (sick consultation in HF 84,785 33,914 71,646 0 and MB) # number of children under 15 years receiving measles rubella vaccine 412,954 412,954 294,230 7,094 ▲ during child health days in response to emergency # children and women accessing Not primary health care in UNICEF- 120,000 189,644 26,739 ▲ available supported facilities Nutrition Number of children 6-59 months 16,000 8,000 3,583 363▲ 8,000 3,220 363▲ admitted for treatment of SAM

Number of children 6-59 months 400,000 200,000 145,682 16,805▲ 400,000 118,931 16,805▲ receiving routine vitamin A supplementation Number of children 6-59 months 443,766 500,000 380,000 33,269▲ 380,000 502,072 33,775▲ screened for acute malnutrition (MUAC) Child Protection Number of children who receive case 74,000 11,000 1,180 548 ▲ 11,100 3,269 2,701 ▲ management services Number of children (re)issued with birth Not 100,000 20,570 6,830▲ 100,000 20,388 4,002▲ registration available Number of children who have access to Not psychosocial support through child- 37,000 2,788 692▲ 37,000 2,630 622▲ available friendly spaces and schools Education Nr. or children supported with Not distance/home based learning (Covid- 177,247 53,673 925▲ 498,243 70,227 925▲ available 19 indicator) Number of children receiving access to Not learning (TLS, including basic learning 179,889 51,850 2000▲ 489,243 70,701 2000▲ available materials) Nr. of children receiving personal Not 179,899 16,730 500▲ 489,243 58,723 500▲ hygiene and MHM-kits available WASH Number of people with access to 920,000 216,000 145,202 8,010 ▲ 320,000 210,417 12,315 ▲ sufficient quantity of safe water Number of people with access to appropriate sanitation through 200,000 216,000 46,100 1,720▲ 320,000 48,305 2,720▲ supporting households constructing or rebuilding their latrines # of people reached with critical WASH supplies (including hygiene items) and 800,000 400,000 59,535 6,400▲ 800,000 312,700 35,990▲ services Social Protection # households reached with Not 25,500 4,802 4,802▲ unconditional cash transfers available C4D/AAP # of people reached with integrated- package of life-saving and protective 1,387,493 1,387,493 2,653,304 319,102 ▲ behaviors. # of adolescents and young people engaged in sharing lifesaving and 196,400 protective information and promoting Not 2,707 1,228▲ uptake of services available

4 Total Needs refers to needs identified in the 2021 Humanitarian Response Plan, however UNICEF’s HAC targets cover a broader scope including nationwide needs and COVID-19. 6

Annex B

Funding Status* Funds available Funding gap Sector Requirements* Received Current Carry-over $ % Year Health $12,000,000 1,988,234 1,628,663 8,383,103 70% Nutrition $5,000,000 - 574,556 4,425,444 89% Child Protection $12,371,655 1,497,884 1,811,159 9,062,612 73% Education $24,544,106 857,485 2,298,647 21,387,975 87% WASH $22,468,754 2,975,690 5,525,479 13,967,585 62% Social $17,533,325 6,369,839 291,840 10,871,646 62% Protection C4D/AAP $2,566,080 420,961 1,159,520 985,599 38% Unallocated - 1,615,745 Cross sectoral** - 647,251 Total $96,483,920 16,373,089 13,289,864 66,820,967 69% * As defined in the revised Humanitarian Action for Children Appeal as of June 2021 for a period of 12 months. **Covers costs related to administration and operations, field operations, logistics, warehousing, grants management & reporting

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