Phase 3: Emergency Response for IDPs, Returnees, and Conflict-Affected Communities in Yemen AID-OFDA-G-17-00295

Context: In the North, the Houthi-controlled part of Yemen experienced major political and security crisis due to the disagreement created within the coalition groups-formed government in Sana'a which lately broke out to overt conflict that claimed the lives of many in the capital, including that of the ex-president Ali Abdallah Salah. These incidences had restricted the movement of citizens and impeded the work of humanitarian aid workers, which delayed program implementation as many organizations were closed for weeks.

The bureaucratic procedures to travel to the field remained challenging during the reporting period. Processing sub-agreements, MoU signing with sector ministerial offices and obtaining field travel permits have become more complicated than before and requires long negotiations with the authorities. Additionally, there is confusion regarding roles of the Ministry of Planning and International Cooperation (MOPIC), Minister of Interior (MOI) and the newly-established National Agency for Humanitarian Affairs and Disaster Response office.

Moreover, the ongoing conflict in the country has led to office closure numerous times, particularly in Taiz, which in turn disrupted fieldwork and delayed program implementation coupled with the reasons mentioned above. In Taiz there has been repeated attempts to raid the Mercy Corps enclave office, detaining staff, intimidate Mercy Corps staff and other threats that led to several program suspension.

Moreover, during the reporting period, isolated cases of assassinations by unknown armed groups, criminal activities has increased in the hotspot areas like Taiz and even in Sana’a. The security situation shows that there are indicators that the conflict will escalate over the coming months, which has already affected activity implementation in the field, with limited movement.

In the South, the most consequential events of the reporting period were clashes that broke out on 28 January between the Hadi-affiliated Presidential Protection Forces (PPF) and forces loyal to the secessionist, UAE-linked Southern Transitional Council (STC) led by former governor Aidarous Al- Zubaidi. Three days of heavy armed clashes erupted in Aden between the two parties following calls for the president to replace the cabinet over charges of corruption. The fighting subsided from 30 January as the STC forces took control of most military sites and government facilities in the city, confining the prime minister and other government officials in the Ma’ashiq Palace. Coalition forces in the city and their air forces conspicuously abstained from engaging in the fighting. At least 38 people were killed and 222 more were wounded in the three days of fighting. International organizations in the city went into lockdown and most operations were suspended. Although a cautious calm has settled on the city, the Hadi government’s Ministry of Foreign Affairs issued a defiant statement on 1 February, calling the week’s events in Aden a “failed coup” and blaming the STC for the bloodshed. It also expressed gratitude solely to Saudi Arabia for ending the rebellion but stressed that the administration will “spare no effort” to maintain the unity and territorial integrity of Yemen. Almost a month after the end of the armed clashes in Aden and, in spite of persistent rumors of the imminent formation of a new technocratic cabinet, there has still been no formal agreement between the STC and the Hadi government. The situation in the south remains uncertain. In Aden, a steady rate of security incidents continued, which are largely confined to localized armed confrontations between security units.

Although tensions remain between the political factions, it is not expected that there will be a renewal of fighting in the city in the short term. It is hard to envision how, without significant external support, Hadi government-affiliated forces would benefit from another bout of fighting given their current inferior military strength in Aden. Instead, the friction is likely to continue to manifest as targeted security incidents, with further assassinations, arrests and armed clashes. In the rest of the south, though, the potential remains for the ongoing competition to turn violent.

Program Overview: In Taiz and Al Mahwit, Mercy Corps trained 123 community volunteers for hygiene promotion activities in the community during the reporting period. The training focused on communication skills, community mobilization, participatory hygiene promotion of targeted communities and basic hygiene messages in addition to the reporting mechanism of hygiene and awareness sessions.

In Sana'a and Al Mahwit governorates, 12 WASH projects technical assessments, bill of quantities (BoQs), designs/drawings of the projects were completed, including approval from the donor. The tendering process is ongoing. In Taiz, assessments of four sanitation projects were conducted, of which two were selected taking into account community priority, assessment criteria, project budget and number of beneficiaries from the project at the end. In addition, technical assessments, BoQs, designs for rehabilitation of eight community water points and three solar-driven water pumping system were finalized.

The Mercy Corps livelihood team has established community committees (CCs), conducted orientation session for CCs on the livelihoods program objectives, selection criteria and success factors for the applicants to be selected for this program. The CCs in Bani Sa’ad district submitted 282 new livelihood participants and 142 for livelihood restoration. The application forms were entered into the database, cleaned and verified by the MEL team. The selection process is ongoing based on the criteria. A total of 30 successful applicants will benefit under the new livelihoods and livelihoods restoration section respectively.

In Al Khabt district, Al Mahwit governorate, nutrition assessments were conducted in the five nominated outpatient treatment centers (OPTs) and the team selected 15 health workers to participate in the nutrition activity in the district. Selected health workers attended community-based management of acute malnutrition (CMAM) and infant and young child feeding (IYCF) training. The training was held in Al- Mahwit governorate health office. Nineteen health workers (10 males and nine females) were trained, of which 15 health workers were from five OTPs and four health workers were from the mobile clinic.

In Al Mahwit, Sana’a and Taiz the support to cholera response continued during the reporting period. Health workers and community health volunteers were trained on cholera case definition, case management and referrals, and community cholera prevention. Accordingly, 47, 14 and 39 health workers from Al Mahwit, Sana'a and Taiz respectively were trained. Moreover, 163 community health workers drawn from the three targeted governorates were trained on community mobilization and cholera messaging. Based on the nomination made from the health office, incentive was paid to 284 health workers for those who participated in the cholera response program in Sana’a and Al Mahwit governorates for January, February and March 2018.

Mercy Corps distributed a total of 1,500 cholera prevention kits. Each kit contains two liters of chlorex solution, two jerry cans, 2kg of laundry soap, and 12 pieces of body soap. A total of 51,132 pieces of body soap, 1,699 jerry cans and 514 liters of chlorex solution were distributed to the diarrhea treatment centers (DTCs), for onward distribution to vulnerable households who are at high risk of cholera.

Supported DTCs treated 7,088 acute watery diarrhea patients during the reporting period. Trained community health workers reached 155,827 beneficiaries through hygiene promotion messaging, of which 21,685 beneficiaries received hygiene message for the first time.

In the South, project inception activities were implemented. A kick-off meeting was held in November disussing the program parameters, budget, schedule and workplan amongst others. The selection of target areas were done after the program team conducted actor mapping and stakeholder consultation to determine who, what and where and explore potential collaborations with actors that have similar interventions. Needs assessment was then conducted to verify whether the needs identified during the proposal stage is still valid and to identify new needs that may arise since then. The results of the needs assessment also determines what sectors/sub-sectors will be implemented in the identified target areas based on the set of criteria. For instance, for WASH interventions, target areas selected are the ones with high cholera rate, high cases of malnutrition and poor hygiene practices (such as open defecation

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 2 etc.). For livelihood interventions, target areas with presence of damaged business infrastructures due to the 2015 conflict, high unemployment rate and access to market among others. Community profile was also developed for each selected areas. After the target areas have been selected per governorate, the program team created a community committee in each area either through endorsement or election by community members. Orientation were conducted for each community committee on program overview and their roles and responsibilites. Selection of beneficiaries followed based on set of criteria developed for each sector/sub-sector. Spot checks were then conducted by MEL team to ensure that all beneficiaries selected by the community committee met the criteria for selection. Procurement process followed. All sectors/sub-sectors have commenced activity implementation during this reporting period.

A baseline survey was conducted in October, and a report was submitted to the donor in December.

Sector 1: Water, Sanitation and Hygiene (WASH) Objective 1: IDPs, returnees, and other conflict-affected populations have improved access to safe water and appropriate sanitation facilities, and hygiene practices.

WASH Sector Major Activities:

Sub-Sector 1.1: Environmental Health Indicator 1.1.1 Number of people benefiting from solid waste management, drainage and/or vector control activities (estimated) Target Reporting Period # and % Male/Female % IDPs Cumulative Total Sana’a 0 0 0 0 29,032 Taiz 0 0 0 0 25,007 TOTAL 0 0 0 0 54,039 Indicator 1.1.2 Number of communities targeted by the environmental health program Target Reporting Period District, Governorate Est. Population Cumulative Total 3 0 Taiz 0 0 7 0 Sana’a 0 0 TOTAL 10 0

Additional comments: Solid waste removal: In Hamdan district, Sana’a governorate, Mercy Corps signed an MoU with the Hamdan district Cleaning Fund in order to start implementation of the solid waste removal campaigns starting from May 2018 for 60 days. Mercy Corps is currently recruiting two field monitors to supervise daily activities, including keeping record of the quantity of solid waste removed from each site, to keep log sheets updated and to ensure the figures are accurate, to collect feedback from the community on the quality of the service provided, and to mobilize the community to participate in the cleaning campaign.

During the reporting period, coordination meetings with the manager of Taiz Cleaning and Improvement Fund (TCIF) inside the Enclave took place in March to explore suitable mechanisms for implementing the solid waste removal campaign inside Taiz city. As a result, an official letter has been submitted by the TCIF manager which illustrated the number of TCIF equipment, movement plan which contain a list of locations suggested to be targeted by Mercy Corps under solid waste removal, and the roles of TCIF and Mercy Corps. The preparation of the MoU and a weekly movement plan are ongoing and is expected to be signed between the two parties at the end of April, upon which the implementation of the solid waste removal will commence for 60 days. This activity is believed to benefit the community in reducing the risks from vector-borne diseases and prevention of cholera outbreak/transmission during the rainy season in

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 3 May and June.

Environmental health campaigns: Environmental health campaigns (EHC) assessment was conducted in eight communities in Salh, Al Qahirah and Al Mudhaffar districts, Taiz governorate. The assessment was carried out in order to identify areas that require environmental health campaign interventions. Locations for this activity were selected based on the number of population and the observation of garbage accumulated. As per the result of the assessment, five communities were identified to be targeted under the EHC: Al Dar, Al Mokhalafi, Hawel Saddam, Al Ashrafyah and Al Saeed, while three areas were excluded as Al Takwa was already covered under Phase II, and Al Khather and Sheabhadad have less population. Community members established five community committees for those selected areas through election. The procurement process of purchasing five EHC kits for Taiz is expected to be finalized in April.

For Sana'a and Al Mahwit, procurement of hand tools for the environmental health campaign is completed and locations for activity implementation identified. Hamdan and Arhab districts in Sana’a and Bani Sa’ad Al-Khabt districts in Al Mahwit are targeted for the campaign.

Sub-Sector 1.2: Hygiene Promotion Indicator 1.2.1 Number of people receiving direct hygiene promotion (excluding mass media campaigns and without double-counting) District, Governorate Target Reporting # and % % IDPs Cumulative Period Reached Male/Female Total Al Mahwit 90,000 0 0 0 0

Taiz 173,948 0 0 0 0

Lahj Male = 4,979 (44%) (Tuban, Al-Hawtah, and 40,000 11,113 Female = 6,134 566 11,113 In Al- Madaribah Wa (55%) (5%) Al- Arah) Al-Dhale’e Male = 1,777 (34%) 5,162 5,162 Al-Dhale’e 30,000 Female = 3,385 0%

(66%) Hadramaut Male = 3,333 (31%) (Al-Mukala’a, 40,000 10,695 172 Female = 7,362 10,695 Ghail Ba Wazair and (2%) (69%) Broom) Total 373,948 26,970 Male = 10,089 738 26,970 (37.4%) (2.7%) Female = 16,881 (62.6%) Indicator 1.2.2 Percent of respondents who know 3 of 5 critical times to wash hands* District, Governorate Target Reporting # and % % IDPs Quarter Period Reached Male/Female Total Sana’a 60% 0 0 0 0 Taiz 60% 0 0 0 0 Lahj 60% 0 0 0 0 (Tuban, Al-Hawtah, and In Al- Madaribah Wa Al- Arah) Al-Dhale;e 60% 0 0 0 0

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 4 Al-Dhale’e Hadramaut 60% 0 0 0 0 (Al-Mukala’a, Ghail Ba Wazair and Broom) * will be reported at the end of the hygiene campaign

Additional comments: In Taiz governorate, hygiene promotion activity started in March in 15 communities.

The process of hygiene promotion activity started with the selection of 62 community volunteers (CVs) from the three targeted districts inside the Enclave (Salh, Al Mudhaffar and Al Qahirah). For the selection of CVs, the program team provided orientation to community committee (CC) on the CV selection process and criteria. Application forms were distributed to CC to be filled by applicants. In total, the team collected 107 applications and the MEL team did a 20% spot-checking. Interviews were conducted with CVs as the final step. Sixty-two CVs were selected based on the results of the interviews in the presence of the MEL team. The selection of the remaining 23 CVs for the other three locations, as well as training and activity of hygiene promotion will start from April.

In Al-Mahwit governorate, 61 CVs were trained in Al Khabt and Bani Sa’ad districts (26 male and 1 female CVs in Al-Khabt district, and 14 males and 20 females in Bani Sa’ad district). The training focused on communication skills, community mobilization, and participatory hygiene transformation of the targeted communities and basic hygiene messages, in addition to the reporting mechanism of hygiene and awareness sessions.

The trained CVs received kits that will be used during the hygiene promotion sessions and door-to-door visits. The hygiene promotion kit includes flip charts, markers, pen, pencils, calculator, soap, notebooks, hygiene promotion manual, IEC materials, and a back bag.

Stakeholder Consultation Meetings At project inception, the program team in Lahj, Al Dhale’e and Hadramaut conducted consultation meetings with various key stakeholders in the target governorates. In the southern governorates, meetings were held with officials from health centers, schools, WASH clusters and other hygiene actors, including WHO to discuss the 3Ws: who, where and when. This helped the program team to identify potential target areas, develop actor mapping and stakeholder database.

Needs Assessment and Selection of Target Areas After identifying potential target areas in Lahj, Al Dhale’e and Hadramaut, needs assessment were conducted to identify target areas based on set of criteria: WASH needs in the area, rate of cholera, water- and vector-borne diseases, malnutrition rate, current hygiene practices, and current socio- economic conditions. A total of 27 targets areas (11 in Hadramaut, nine in Lahj, and seven in Al Dhale’e) were selected for hygiene promotion activities.

Establish Community Committee (CC) A CC was established in each target areas based on the following selection criteria: Members should be a resident of the target area, has good reputation and community acceptance and accepts to work as volunteer. Each CC has five to seven members with at least two female members and one youth representative. An orientation was conducted for each CC to discuss the program overview and their roles and responsibilities. The CC is responsible in identifying potential community volunteers who will be conducting the hygiene sessions. Moreover, the CC will take the lead in resolving internal conflicts among beneficiaries and or community members. The orientation also covers the Internal Feedback Mechanism (IFM) whereby the CC will be part of setting up and implementing the IFM with the Mercy Corps team.

Community Volunteer (CV) Selection The CC identified potential CVs based on set of criteria: 1. Must be IDP, returnee or conflict-affected.

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 5 2. Must be resident of the target area. 3. Able to read and write. 4. Able to conduct door-to-door awareness. 5. Have good communication skills. 6. Should not be a government employee receiving regular salary. 7. Must be at least 18 years old.

Female-headed families (if present) are given priorities. Only one per household will be selected. Community acceptance must also be taken into considerations when selecting CVs. The selected CVs by CC undergo interview and exams. A random spot check by the MEL team is conducted to verify if the candidates match the criteria.

A total of 117 CVs (85 females, 32 males) in three southern governorates (Lahj 45, Al Dhale’e 22 and Hadramaut 50) were selected. The CVs are responsible in conducting the hygiene sessions either through door-to-door or group sessions in public places (schools, mosques, markets etc) and in disseminating IEC materials.

CV Training The selected CVs attended a four-day training on hygiene promotion. Topics include the following: handwashing with soap, disease prevention, proper waste disposal, water treatment and proper hygiene and sanitation practices. Out of 117 CVs selected in the southern governorates (Lahj, Al Dhale’e, Hadramaut), only 116 were trained (one dropped out). (Please see Table 1, Annex II.)

Pre-test and Post-Test of CVs A pre-test and post-test was conducted before and after the training respectively to determine the increase in knowledge of the participants on hygiene promotion. Results showed that the score of participants in Lahj during the pre-test was 54 with the highest score of 90 out of 100 while post-test garnered 52 with the highest score of 97 out of 100. In Hadramaut, pre-test showed 44 with highest score of 88 out of 100; whereas, post-test has 67 with highest score of 97 out of 100. In Al Dhale’e, pre- test results showed 41 with 90 out of 100 as the highest score; while the post-test showed 52 with 96 out of 100 as the highest score.

Hygiene Sessions The hygiene sessions are conducted through door-to-door and or group sessions in public places (schools, mosques, markets etc) by CVs. Topics include proper handwashing, water storage/treatment and waste disposal and disease prevention such as cholera, diphtheria, water and vector-borne diseases.

• Door-to-Door A total of 5,145 door-to-door hygiene sessions were conducted during the reporting period in the southern governorates reaching 23,242 individuals (6,583 households). (Please see Table 2, Annex II.) • Group Sessions In the southern governorates, a total of 85 group sessions were conducted in the last two months in schools, mosques and markets among others reaching 3,728 individuals. (Please see Table 3, Annex II.)

Global Handwashing Day Mercy Corps participated in the celebration of the Global Handwashing Day on October 16, 2017 in Lahj governorate. Activities include hygiene sessions in school and IEC distribution. A total of 91 students attended the sessions.

Spot Check Monitoring Mercy Corps’ MEL and program team conducted regular spot check monitoring in the field to monitor the progress of the CVs, the effectiveness of delivery of hygiene messages and to determine the knowledge increase of the participants. Spot check monitoring are done by randomly selecting participating households on a monthly basis. Results of spot check will be reported at the end of the hygiene campaign.

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 6 Family Hygiene Kit (FHK) Distribution Procurement process is ongoing in the south for the purchase of family hygiene kits. Distribution plan was developed and distribution areas identified. Distribution is planned to take place in June 2018.

Sub-Sector 1.3: Sanitation Infrastructure Indicator 1.3.1 Number of people directly benefitting from the sanitation infrastructure program Reporting Period # and % Target Type Cumulative Total Reached Male/Female Sana’a - 15,164 0 0 0 0

Taiz - 12,131 0 0 0 0 Al Dhale’e – 0 0 0 0 6,402 TOTAL 33,697

Indicator 1.3.2 Number of people who report using a latrine the last time they defecated Reporting Period # and % Target Type Cumulative Total Reached Male/Female Sana’a – 10,614 0 0 0 0

Taiz – 8,492 0 0 0 0 Al Dhale’e - 0 0 0 0 4,482 TOTAL 23,588 Additional comments: Technical Assessment: In Sana’a and Al Mahwit governorates, WASH projects technical assessments, BoQs, designs and tender procedures for the rehabilitation of 12 health facilities took place. Of the 12 projects, two health centers are in Sana’a and 10 facilities are in Al Mahwit (four hospitals and six health centers).

Table 1: List of DTCs targeted for WATSAN projects in Al Mahwit and Sana’a Type of # Projects Name Governorate District # of beneficiaries project 1 Al-Ahjur Health Center Shebam 11,000 2 Bani Sa'ad Rural Hospital Bani Sa'ad 8,635 3 Juma'ah Sarea'a health center Bani Sa'ad 4,196 4 Jabal Al- Al-Arkoab Health Center 8,000 Mahweet 5 Badh Al-Sofla Health Center Al-Mahwit Melhan 3,500 WATSAN 6 Al- Al-Taweelah Health Center 20,176 Taweelah 7 Hufash Rural Hospital Hufash 10,000 8 Al-Khabt Rural Hospital Al-Khabt 92,000 9 Bani Aoe'f health center Al-Khabt 4,998 10 Al-Rojum Rural Hospital Al-Rojum 110,282 11 Khairan Health Center Sanitation Sana'a Sanhan 3,790 12 Tawa’ar Health Center Sana'a Al-Hesn 4,750

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 7

Technical assessments were conducted for four sanitation projects in two districts inside the Enclave. Preparation of BoQs for eligible high priority projects inside the Enclave took place during the period under review, and the final list of proposed projects, along with other BoQs, is expected to be submitted to the ministry inside the Enclave for approval in April. Based on prioritization and needs, Osaifra Sewage and 22 May School projects were selected.

Table 2: List of sanitation projects assessed during reporting period in Taiz No. Name of water Type of Sub-district District Governorate # of beneficiaries project assessed project (people) 1 Osaifra sewage Sanitation Osaifra Al Qahirah Taiz 2,700 2 22 May school Sanitation Altahrir Al Qahirah 300 IDPs Alasfal 3 Sheab Algharghor Sanitation Al_Bea'rarah Al 720 Mudhaffar 4 Almoshareffa Sanitation Alhaseb Al 450 sewage Mudhaffar

Technical Assessment: Designs and BoQs for two sanitation projects in Al Dhale’e have been approved for implementation in May.

Table 3: Number of technical assessments conducted during the reporting period per governorate

No. Name of sanitation Type Sub-district District Governorate # of project of beneficiaries project 1 Rehabilitation the WASH Al Arshy Al Dhale’e Al Dhale’e 780 sewage system 2 Rehabilitation the WASH Al Madena Al Dhale’e 840 sewage system

Sub-Sector 1.4: Water Supply Infrastructure Indicator 1.4.1 Number of people directly benefiting from the water supply infrastructure program Reporting Target* # and % Male/Female % IDPs Cumulative Total Period Lahj - Abyan - Al Dhale’e - Hadramaut - Taiz – 13,426 0 0 0 0 Sanaa – 15,461 0 0 0 0 Total – 28,887 0 0 0 0 Indicator 1.4.2 Water supplied per beneficiary in litters per person per day (through water trucking) Reporting Target # of households % IDPs Cumulative Total Period 3 Litres per March 2,922 47% 2,923 person/per day

Additional comments:

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 8 Consultation Meetings: A coordination meeting with the manager of MOPIC inside Taiz city was conducted and a summary of the program activities was submitted. MOPIC has also given a list of projects to Mercy Corps to be considered if the organization meets the criteria for WASH project selection following a feasibility assessment.

Step-by-step Process to Select Community Projects: To ensure appropriate and transparent site selection, Mercy Corps used a participatory and consultative process involving stockholders, relevant local authorities such as GARWAPs as well as CCs and other community representatives. As part of the process, Mercy Corps completed the following steps: • Mercy Corps met with government officials at governorate and district levels • Focus group discussions were held at village level • Semi-structured one-on–one interviews with key community members, focus group discussions (FGD) with various groups from the community • Open community meetings on problem identification and project prioritization

Site selection criteria: The following criteria were used when selecting the project sites: • Lack of or poor existing infrastructure • Needs-based prioritization • Project site selected/accepted by community • Materials needed to implement the project can be delivered on time • Site security and accessibility • The site constitutes a community asset creation such as rehabilitation of community infrastructures like wells, water networks roads etc. • Site is not funded or in a plan to be constructed/rehabilitated by the government or by other NGOs.

Technical Assessment: During the reporting period, technical WASH assessments were conducted based on a list of 12 potential projects inside Taiz city using the participatory approach (four are located in Al Mudhaffar district and in Al Qahirah district). Of the 12 water projects assessed, four were selected based on set criteria, budget and benefit to community. BoQs were prepared for the four projects. The selected projects are Mohammed Haza, Abdulkarime Almogahed, Almoshareffa Well, and Obaid Well. (Please see Table 4, Annex II.)

Water trucking: Emergency water trucking started in Taiz on 20 March with 32 water points inside and outside Taiz, which were targeted under Phase II (12 water points inside the city and 20 water points outside the city). As part of the activity set-up, the program team conducted an assessment to check the status of the water points – to check water tanks, any change with the number of IDPs or other factors on the ground. The assessment report showed that all water tanks still exist and are in good condition, with some complaints number on them.

The total amount of safe drinking water supplied during the 12 days in March was 2,104,800 litres for 2,922 households (1,413,300 liters reaching 1,962 households outside the Enclave; while 691,500 liters were received by 960 households inside the Enclave. Each household received 60 litres as per Sphere standards for households with seven members.) Water trucking monitoring was conducted for 12 water points in Salh, Al Mudhaffar and Al Qahirah districts inside the Enclave. As per the result of monitoring, 100% reported that water distributed did not cause any issues, such as diarherrea or stomach pain and they have not faced any issue during receiving the water. A total of 67% of respondents reported that the water trucking helped them to save money, enabling them to buy other lifesaving basic commodities, and 33% reported that the Mercy Corps water points solved the issues of unavailability of and getting pure water, especially in the current situation.

NON-WASH Community Projects

1. Rehabilitation of Irrigation Channels

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 9 Stakeholder Consultation Meetings: The program team conducted actor mapping through consultation meetings with relevant stakeholders in Lahj, Abyan and Hadramaut. These include Irrigation and Agriculture Office, INGOs, local council and local community leaders. As a result of the consultation meetings, Mercy Corps will be implementing the rehabilitation of irrigation channel projects in partnership with the Irrigation and Agriculture Office who will provide technical support and skilled workers in selected project areas. Mercy Corps will also collaborate with CARE in the implementation of one irrigation channel in Abyan. CARE is rehabilitating the sub-irrigation channels while Mercy Corps will rehabilitate the main channel.

Technical Assessment: During this reporting period, technical assessments were conducted in Lahj, Abyan and Hadramaut. The irrigation channel projects are being complemented with Mercy Corps’ EC- funded program, “Maximizing Opportunities for Rural Enterprises” (EC-MORE), aimed at increasing rural incomes through strategic investments in the sesame value chain. The OFDA grant will support this program by rehabilitating the irrigation channels damaged during the 2015 conflict to increase farm productivity of the farmer beneficiaries. Hence, the target areas selected for these projects are the areas where the EC program is covering. A total of 21 technical assessments have been conducted in the southern governorates during the reporting period. These projects aim to rehabilitate the irrigation channels by removing Sesban trees, mud and rocks that block the water flowing along the irrigation paths. The project will be complemented with Cash for Work (CfW) component where laborers will be selected from the community and will receive cash for their hard labor. (Please see Table 5, Annex II.)

Rehabilitation Works: Out of the 21 technical assessments conducted, 17 rehabilitation of irrigation channel projects were approved for implementation during this reporting period in Lahj (seven), Abyan (nine), and Hadramaut (one). One has been completed in Lahj during the reporting period. Fourteen projects were completed in April and will be reported in the next semi-annual report (one in Hadramaut, four in Lahj, and nine in Abyan). The remaining two rehabilitation of irrigation channel projects in Lahj are still ongoing and will be completed in May. All completed projects have resulted to water flowing into the farmlands after the rehabilitation works in the main and sub-channel paths have been rehabilitated. These irrigation channels were damaged during the 2015 conflict and due to the collapse of government infrastructures, no assistance was given to the affected farmers and communities from the government to restore their main source of income, which is farming. Mercy Corps through the EC-funded program has provided technical support on farm productivity as well as sesame seeds to the farmers in the target areas. With the water flowing from the main irrigation channel to the farmlands, the OFDA grant intervention will further support these farmers by increasing their farm productivity which will result to availability of local produce, decrease in prices of vegetables and restoring income source to former displaced farmers. In addition, cash support are given to selected beneficiaries from the target communities through cash for work mechanism (see CfW details under Temporary Labor sub-sector). It is expected that farmers who left to look for other income source will return to their community and restore their livelihood after the irrigation channels are rehabilitated.

Mercy Corps also encouraged community contribution from the community to promote ownership of the project. In Lahj and Abyan, communities contributed by providing local materials like cleaning tools, fuel and oil for the saw among others. In Abyan, one of the villages donated bulldozer services to help the laborers in the excavation works. They also contributed by renting a truck to transport the laborers from their homes to the site. They also provided petroleum pump to transfer the water in the concrete channel to outside the channel.

In Hadramaut, the water overflows during the rainy season damaging the farmland in Al Hilah village. The community decided to increase the height of the irrigation sides by 140m as their contribution to the project. They donated 700 concrete blocks, 24 cement bags (50kg per bag), soft sand for the building of the blocks and free skilled labors for three days. In Al Rabedah area, the community leaders negotiated with the contrator to add 16 hours of work for free as his countribution to the community project.

The rehabilitation of irrigation projects are complemented with awareness raising on the importance of Sesban trees. This activity aims to encourage the community members to continuously uproot the growing Sesban trees along the channel path while at the same time promoting the many benefits of

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 10 Sesban trees in health, livestock and agriculture and domestic use. Six extension agents were trained to deliver the messages on the best economical and household usages of Sesban trees products. The messages are delivered to the agricultural offices located in the targeted communities, the community leaders and the households residing in these communities through door-to-door visits and leaflets/posters distribution with the main awareness raising messages.

Sesban trees can be used as livestock feeds, fire wood for cooking and heating, soil nutrients among others. A total of 1,200 households have received the awareness messages. While the awareness session is still ongoing, there were several community members including CfW beneficiaries who are already collecting the uprooted sesban trees during and after the clearing operation in the irrigation channels. In Lahj, three farmers collected the extracted Sesban trees during the clearing operations to sell as firewoods. Wassem Mohammed Mohsen Mohammed, 41, from Al Serdah village, was one of the farmers and beneficiaries of the CfW who sold firewoods for YER 11,000 (USD 44) per bundle. He managed to earn YER 20,000 (USD 80) and purchased two sheeps for breeding. One of the sheeps gave birth. He also bought one cow from the additional income he earns. From being a CfW beneficiary to selling firewoods, Wassem has now a new livelihood, that of breeding livestock animals. Similarly, Fahed Awed Mohammed Al-Zanqly, 40 yrs old, also sold the firewoods he collected during the clearing operation. From his income, he bought ten cooking gas cylinders to add to his stock in his shop and sells it in his village. In Abyan, Hajah Hidrah Mohammed Alrusasy, collected woods and used it for cooking in her home. The remaining woods she sold it in bundles which gave her additional income to meet her family’s basic needs. Another CfW laborers, Yunis Aabed Ibrahim, benefitted from the Sesban trees by collecting the branches and building a small house for his family. In Assufal village, the community committee negotiated with the contractor, Al Osrah Company to provide free bulldozer service for three days in exchange of collecting the Sesban trees. Al Osrah Company is also working in coal production made of wood. Mercy Corps coordinated with the government office, irrigation office and the company on how the community can benefit from the removal of the sesban trees in the Batays channel.

Table 4: Number of Individuals benefitted from the completed non-WASH community projects per project # # % % Total # # % Governorate District Project Name Male Female Male Female Benefi- HHs IDP IDP ciaries s s Rehabilitation and 1,056 1,044 50.2 49.71 2,100 300 140 6.67 cleaning up of irrigation 9 Lahj Tuban channel in Al-Serdah village Note: Most of the projects have been completed in April; hence, it will be reported in the next reporting period

2. Other Community Projects Consultation Meetings: A coordination meeting with the Education Office was conducted to identify any rehabilitation intervention in schools in Al Dhale’e governorate.

Technical Assessment: Two technical assessments were conducted for non-WASH projects in Al Dhale’e governorate.

Table 5: Non-WASH projects which were assessed during reporting period per area No. Name of Project Type of Sub-district District Governorate # of HHs project 1 Rehabilitation Al Garba Non- Al Garba Al Dhale’e Al Dhale’e 150 primary school in Al Garba WASH village 2 Rehabilitation the health Non- Lakmat Salah Al Dhale’e 200 center in Lakmat Salah WASH

Sector 2: Economic Recovery and Market Systems

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 11 Objective 2: Communities (including households, businesses, etc.) have recovered from the crisis quickly and sustainably.

ERMS Sector Major Activities: Sub-Sector 2.1: Livelihood Restoration Indicator 2.1.1 Number of people assisted through livelihood restoration activities, disaggregated by sex # and % Cumulative Target Reporting Period % IDPs** Male/Female Total Sana’a – 10 0 0 0 0 Al Mahwit - 10 0 0 0 0 Taiz – 10 0 0 0 0 Hadramaut - 10 0 0 0 0 TOTAL - 40 0 0 0 0 Indicator 2.1.2 Percentage of beneficiaries reporting their livelihoods restored within three to six months after receiving support* Cumulative Target Reporting Period %Male/Female % IDPs Total Sana’a – 60% 0 0 0 0 Al Mahwit – 60% 0 0 0 0 Taiz – 60% 0 0 0 0 Hadramaut -60% 0 0 0 0 TOTAL – 60% 0 0 0 0 Indicator 2.1.3 Total USD amount channeled into the program area through sub-sector activities** Cumulative Location Target Reporting Period Total Sanaa - $30,000 0 0 0 Al Mahwit - $30,000 0 0 0 Taiz - $30,000 0 0 0 Hadramaut - $30,000 0 0 0 Total - $120,000 0 0 0 *will be reported in the final report **will be reported in the next semi-annual report

Additional comments: Five CCs were established to facilitate the livelihoods restoration and new livelihood activities in Hamdan district, Sana’a governorate. A total of 12 CCs were formed in Bani Sa’ad district of Al-Mahwit governorate after coordinating with the community leaders. Orientation was given to the committees on goals, objectives, and activities of OFDA 6 program, including the role of CCs and the criteria for the selection of CC members.

Three coordination meetings were held with local authorities' representatives from the three districts inside the Enclave in order to discuss the implementation of livelihood restoration and new livelihood activities. As a result, official letters were submitted by mangers of Al Qahirah, Salh and Al Mudhaffar districts, which illustrate a list of areas for the new livelihood in the districts. Salh district will only be targeted under the livelihood restoration.

Community Committee Formation: After the target areas are selected during the program inception,

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 12 CC is established per target location. The community committees were formed after the coordination meetings with the community leaders, local councils and community members. Community members identify and conduct election during the selection of CC members. After the selection process, elected CC members undergo an orientation with Mercy Corps on their roles and responsibilities, program overview and the CARM mechanism. In Hadramaut, six CCs were formed in Ghail Ba Wazir, Al Mukalla and Brom Mayfa districts.

Proposal Writing Development Training: In Hadramaut, proposal writing training was conducted for two days for applicants from Al Mukalla, Ghail Ba Wazir and Brom Mayfa districts. The training aims to teach the applicants on how to write their business proposal and budget plan. 29 participants attended the training.

Beneficiary Selection: The beneficiary selection process was done in two stages. First, CC conducts the preliminary selection based on set of criteria: severity and sources of vulnerabilities, household composition (age and gender), coping strategies and access to resources. A total of 35 potential beneficiaries were selected in Hadramaut. MEL conducted spot checks to ensure that all 35 selected by CC met the criteria. Out of the 35, only 30 applicants were qualified to go to the second stage. The 30 applicants attended the proposal writing training where they were required to submit a business proposal and budget plan at the end of the training. Second, a vetting committee selects the final grantees based on the business proposals/budget plan submitted (see below for more details).

Table 6: Disaggregation of livelihood restoration shortlisted applicants per governorate Governorate # of Applications Gender % of IDPs/ % of Female Male Female Returnees Applicants Hadramaut 30 20 10 30% 30% Total 30 20 10 30% 30%

Establishment of Vetting Committee: The vetting committee members were selected based on the eligibility criteria: should have a bachelor in business studies or relevant majors; have minimum of two years experience in Small Medium Enterprise; must have experience in writing and reviewing business proposals/marketing and budget plan; must demonstrate strong monitoring and evaluation skills; and, must be available during the designated time for proposal review and monitoring visits. The VC’s role is the review the applicant’s proposals and select the best qualified proposals/beneficiaries who will receive the livelihood grants. In Hadramaut, the VC members are composed of representatives from the University of Hadramaut (UoH) (1), Ministry of Planning and International Cooperation (1), Nama’a Institute Foundation (1) and non-program staff from Mercy Corps (2).

Review and Selection of Business Proposals: The VC members review and select business proposals based on set of criteria: applicants have similar business prior the 2015 conflict but was completely damaged during the war; the applicant’s business provides socio-economic impact to the community (preferably, the only business providing such services); and have previously employed local workers within the community. In addition, the VC will take into consideration the proposals that are most feasible and respond to the local market opportunities/demand. All the proposals are coded to maintain anonymity to avoid any bias and or favouritism during the selection process. It took three days for the panel deliberation and scoring process of the proposals and seven days for the shortlisting per districts.

In Hadramaut, 10 beneficiaries were selected as grantees. Each grantee will receive a ceiling of $3,000 (actual amount is based on their budget plan) in instalments. Selected businesses include vegetable shop, barber shop, groceries among others.

Table 7: Type of business per governorates Type of Business Hadramaut Total Number Cloths shop 1 1 Beauty Saloon 1 1 Fisherman 2 2

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 13 Grocery and bar 2 2 Bakery 1 1 Cafeteria 1 1 Mobile vegetable shop 1 1 Sweets and cakes shop 1 1 Total 10 10

Transfer of Grants: In Hadramaut, transfer of the first instalment will be done at the end of April 2018.

Business Trainings: Training needs assessment have been completed for the Phase 2 grantees in Lahj, Abyan, Al Dhale’e governorate. The assessment aims to identify the actual needs of beneficiaries in terms of building their capacity on business and financial management such as bookkeeping and accounting among others. Assessment of trainers and training centers have been completed. Procurement is now ongoing for the selection of trainers and training centers.

Sub-Sector 2.2: New Livelihoods Development Indicator 2.2.1 Number of people assisted through new livelihoods development activities, disaggregated by sex Reporting # and % Cumulative Location Target Period % IDPs Male/Female Total Reached Male: 48 (40%) 120 Aden 120 120 24 (20%) Female 72 (60%) Male: 20 (50%) Hadramaut 40 40 6 (15%) Female: 20 (50%) 40 Sanaa 80 0 0 0 0 Taiz 120 0 0 0 0 Male: 68 (42.5%) Total 360 160 30 (18%) Female: 92 (57.5%) 160 Indicator 2.2.2 Percent of people continuing in their new livelihoods by program completion* Reporting Cumulative Location Target Period % Male/Female % IDPs Total Reached Aden 50% 0 0 0 0 Hadramaut 50% 0 0 0 0 Sanaa 50% 0 0 0 0 Taiz 50% 0 0 0 0 Indicator 2.2.3 Number of new micro and small enterprises started** Target Reporting Period Reached Cumulative Total Aden – 6 0 0 Hadramaut – 4 0 0 Sanaa – 10 0 0 Taiz – 10 0 0 TOTAL 30 0 0 Indicator 2.2.4 Total USD amount channeled into the program area through sub-sector activities*** Target Reporting Period Reached Location Cumulative

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 14 Total $80,000 0 Aden 0 $45,000 0 Hadramaut 0 $125,000 0 Sanaa 0 $125,000 0 Taiz 0 TOTAL - 0 0 $375,000 *will be reported in the final report **will be reported in the final report ***will be reported in the next semi-annual report

Additional comments: Primary data was collected through field visits and interviews with the owners of vocational centres who had experience in training different social groups on specific skills. A total of 282 new livelihood applicants from Mahwit registered to participate in the vocational training. The application forms were entered, cleaned and verified by the MEL team. The applicants are going through the interview process based on the selection criteria and the success factors. Interviews with the applicants is in process to finally select 80 program customers whom will be involved in the vocational training program.

Labour Market Assessment: Market assessment was done through 24 FGDs and 36 Key Informant Interviews (KIIs) for potential trainees and enterprise owners in Al Mudhaffar, Salh and Al Qahirah districts, Taiz. The results of the assessment has shown their preferred courses and marketable skills for men as mobile maintenance, electricity courses in the field of solar panel installation, computer maintenance, first aid courses courses. For women, the most preferable skills are hairstyling and make- up services, engraving, tailoring, first aid courses, incense collection and trading, and sweets industry. For enterprises assessment, it was found that majority of business owners in Al Mudhaffar, Al Qahirah and Salh with 70%, 64% and 60% respectively indicated that they are accepting trainees for apprenticeship program. Moreover, an initial assessment of training centres was conducted for 17 training centres in 13 areas in Al Mudhffar and Al Qahirah districts. The assessment focused on their ability to deliver quality trainings, types of training courses, the possibility of implementing the training with Mercy Corps and the cost of the training courses. The assessment findings showed that most of training centres have appropriate training environment as well cover almost all the trainings/courses, which are preferred, by men and women mentioned above. Moreover, most of the centres have specialized trainers staff and special training rooms for each training. (See Table 6, Annex II.)

Salient findings of labor markets assessment conducted in the targeted communities in Al-Mahwit and Sana’a governorates is presented below: 1. When asked what type of business activity women can participate in their area, 32% of respondents in Sana’a said women could work in sewing, 29% said that women could work in a female-only clothing shop, 29% agreed that women might work in a grocery store as long as it is in the village as women are not allowed to work as sellers in markets, and 9% said they could work as housekeepers. 2. For Al Mahwit governorate, 29% of respondents agreed that women could work in the sewing line, 23% said they could work as sheep grazers (shepherdess), 19% agreed to clothes selling clothes, and Types of work women are permitted to do 16% said women What are the types of works Women can do could work as sellers in a grocery store. 0% Others 13% 29% Clothing 19%

9% Cattle Livestock 23% 32% Sewing 29% 29% MERCY CORPS AID Grocery-OFDA /-G fresh-17-00295 food : Yemen Semi-Annual Report16% #2 October 2017 – March 2018 Page 15

Sana'a Governorate Al Mahwit Governorate

Accessibility for women to markets remains a challenge. A total of 71% of respondents in Sana’a said that women could not go to the market due to the limited transportation services, 45% of respondents in Al Mahwit said the same but this was due to cultural barriers. However, 14% and 27% of respondents in Sana’a and Al Mahwit respectively said there were no restrictions for women to go to markets.

Accessibility to access to markets for women

Are there any restrictions for Women to access the market

71% Transportation 9%

0% Not Allowed 9% 0% Cultural barriers 45%

14% Prices 0%

14% None 27%

Sana'a Governorate Al Mahwit Governorate

Regarding the change of price in commodities, 100% of respondents in both Sana’a and Al Mahwit said there has been a daily price increase. Commodity price changes

Major findings from male focus groups discussion (FGDs): 1. In Al Mahwit governorate, 91.7% of male respondents do not have jobs and 8.3% are employed by the government but have not been paid due to the deterioration of the political and economic situation in the country. In Sana’a governorate, 100% of respondents across all groups agreed that women could work as long as the work is suited to a woman’s nature and personality. In Al

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 16 Mahwit governorate, 60% of respondents agreed that women could work while 40% disagreed, citing customs and traditional beliefs, as well as the low level of education amongst women. 2. For the required skills for employment in Sana’a governorate, 50% of respondents agreed that their area needs an electronic maintenance shop, as the residents currently have to travel outside their settlement to get an electrician to repair their equipment. 3. Some 15% proposed some of the residents be trained to become mechanics as there are no mechanics in their villages, and the closest mechanic is situated in Sana’a. 4. Some 13% of respondents’ preference is to be trained on agriculture to assist farmers enhance agriculture outputs in Hammdan. 5. In Al Mahwit, the required jobs for men are agriculture (20%), engineering (17%), teachers (17%), and doctors (17%).

Major points from women FGD: 1. A total of 63% of female respondents agreed that sewing is the most in-demand job for women, while 22% agreed that hairdressing is another potential skill for employment. 2. Only 10% of respondents said women could work in a grocery store as long as it is situated in the village. 3. Some 7% proposed women trained to become midwives, as there is a shortage of midwives in their villages. 4. In Al Mahwit, the required jobs for women are health workers (90%), teachers (47%), and sewers (33%).

Assessments for three vocational training centers for new livelihood participants from Bani Sa’ad district were done in Bajel and Al Hudaida cities due to the proximity to Bani Sa’ad district. The assessments focused on the ability of conducting the trainings, types of training courses, training methodology, qualification of the trainers, where trainees would be living during the training, and the possibility of implementing the training. (Please see Table 7, Annex II.)

Labor Market Assessment (LMA): In the southern governrates, LMA was conducted during the program inception to understand the functionality of the market and to look into details the supply and demand of the labor force in each targeted governorates. In addition, the LMA will help determine what skills are needed to meet demands, which livelihoods are appropriate in certain areas and how many business owners are willing to support an apprentice amongst others. Results will be used in program planning and in improving the program design based on the current situation. The LMA was conducted separately in the northern and southern governorates.

In the southern governorates, results showed that the most sought-after skills in Aden are mobile maintenance, computer maintenance, electric wiring, air condition maintenance and repair, photography, tailoring, hairstyling and makeup services for women, cake baking and carpentry. In Hadramaut, the top skills needed are vehicle maintenance, computer maintenance, electrical works, air condition repairs, sewing, hairdressing and makeup, sweets and cake baking and henna tattoo. Based on the results, Mercy Corps should align its new livelihood interventions on the socio-economic profile of the target areas. It should also consider partnership with private sector in terms of provision of technical support, supporting SMEs and reviving vocational training centers. Mercy Corps should also empower the potential of disadvantaged and vulnerable groups through training and mentoring and provision of start-up capital grants and or providing necessary tools. Mercy Corps should also give priority in creating female- only safe workspaces to address the cultural restrictions among Yemeni women.

Capacity Assessment for Training Center: Capacity assessment were conducted with potential vocational training centers in Hadramaut and Aden to assess the service providers their ability to conduct vocational skills training, qualification of trainers, availability of existing training curriculum or the capacity to design new training curriculum. The table below shows the initial findings of the assessment. (Please see Table 8, Annex II.)

Establishment of CC : CC were set-up in eight districts in Aden and two districts in Hadramaut. Members were selected through recommendation and election by community members. Orientation was

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 17 given to CC members in each areas on program overview, roles and responsibilities and beneficiary selection criteria and procedure.

Beneficiary Selection of Trainees: The CC selected beneficiaries based on the vulnerability criteria including the following: IDP, returnees or conflict-affected; resident in the area of intervention; at least 18 years and above; able to read and write; and, no permanent income. Additional criteria to be prioritized if present in the community includes the following: female-headed households, has at least one member with chronic illness, children below five years, people with disability and who lost their primary breadwinner during the conflict.

Mercy Corps’ MEL team conducted random spot checks of the beneficiary list to verify if the selection was done fairly and in accordance to the set of criteria. Out of the 541 beneficiaries selected by CC in the southern governorates (Aden and Hadramaut), 462 were qualified and have met the criteria.

Interview of Applicants for the Vocational Skills Training: The trainers at the vocational training center together with the Mercy Corps’ program team interviewed the shortlisted applicants. The interview aims to identify the skills needed by the applicant, availability for the said training, how the applicant will benefit from the training and their future plans as well as their background and qualification. Another spot check was conducted by the MEL team to ensure that the final selection by the trainers were done fairly based on the criteria.

Final Selection of Trainees: Only 160 out of the 541 shortlisted applicants in the southern governorates (Aden and Hadramaut) were selected as trainees for the vocational skills training. (Please see Table 9, Annex II.)

Vocational Skills Training: Two vocational training in Aden and three in Hadramaut are currently on- going. Table below shows the duration, courses and number of participants for each training

Table 8: Vocational skills training courses per governorate Governorate Type of Courses Duration Number of Participants Aden Air Conditioning 60 days (240 hours) 27

Mobile Phone Repair 60 days (240 hours) 26

Photography 60 days (240 hours) 21

Hairdressing 60 days (240 hours) 33

Tailoring 60 days (240 hours) 13

Hadramaut Make up Services 60 days (240 hours) 10

Tailoring 60 days (240 hours) 10

Air Conditioning 60 days (240 hours) 10

Electric wiring 60 days (240 hours) 10

Business Trainings: Training needs assessment have been completed for the Phase II grantees in Lahj, Abyan and Al Dhale’e governorates. The assessment aims to identify the actual needs of beneficiaries in terms of building their capacity on business and financial management such as bookkeeping and accounting among others. Assessment of trainers and training centers have been completed. Procurement is now ongoing for the selection of trainers and training centers.

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 18 Sub-Sector 2.3: Temporary Employment Indicator 2.2.1 Number of people employed through CFW activities, disaggregated by sex Area Target* Reporting Period # and % Male/Female % IDPs Cumulative Reached Total Sana’a 388 0 0 0 0 AlMahwit 410 0 0 0 0 Taiz 698 0 0 0 0 Lahj 514 348 Male 247 (70.98%) 7.18% 348 Female 101 (29.02%) Abyan 514 422 Male 367(86.97%) 5.45% 422 Female 55 (13.03%) Hadramout 477 110 Male 76 (69.09%) 0% 110 Female 34 (30.91%) Aden 100 0 0 0 0 Al Dhale’e 224 0 0 0 0 Total 3,325 880 Male 690 (20.75%) 880 Female 190 (5.7%) Indicator 2.2.2 Average total USD amount per person earned through CFW activities Target Reporting Period Location Cumulative Total Reached $150 $ 141.09 Lahj $ 141.09 $15 Abyan $150 Hadramaut Indicator 2.2.3 Total USD amount channeled into the program area through sub-sector activities Target (USD)* Reporting Period Location Cumulative Total (USD) Reached (USD) 376, 074 0 Sana’a 0 343,638 0 Taiz 0 241,346.57 9,453.13 Lahj 9,453.13 241,346.57 0 Abyan 0 224,107.53 0 Hadramout 0 120,673.29 0 Al Dhale’e 0 17,239.04 0 Aden 0 Total 1,564,425 9,453.13 - 9,453.13

Additional comments:

Labor Market Assessment: Labor market assessment was conducted in order to understand the availability of laborers in the targeted areas, the wages of skilled and unskilled laborers, the possibility of women working as temporary laborers, the possibility of men and women to gain access to the markets, the availability of basic commodities in the markets. The respondents have shown acceptance for women to work and participate in community works through cash for work. In terms of laborers’ wages, in Taiz it was found that average wage for skilled labour is YER 5,500 (approximagtely USD 14.30), while unskilled laborers receive YER 3,000 (approxiately USD 7.80).

The major findings form the assessment for Sana’a and Al Mahwit are: • The availability of unskilled laborers is very high due to the effect of the conflict. It is obvious that the conflict has affected many people, leading to an increase in unemployment rates not only in the targeted areas, but across the country. However, in some areas, skilled laborers often come from other villages due to the shortage number of skilled laborers in those areas. • For Hamadan district, Sana’a governorate, 91% of skilled labor comes from other areas, while 40% of skilled labor for Bani Sa’ad district in Al Mahwit comes from other areas. The survey results show that 70% of people in Hammdan district, Sana’a governorate and 82% in Bani Sa’ad

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 19 district in Al Mahwit governorate said that unskilled laborers are available in their villages during the whole year. However, 30% of people in Sana’a and 18% in Al Mahwit said there is shortage of unskilled laborers in their villages as the laborers look for work in Sana’a, Hudaidah and Al Mahwit cities. • During the planting and rainy season, the availability of laborers decreases. During that period, laborers work on their lands or work as planters for framers. The analysis shows that 73% of people in Sana’a and 60% in Al Mahwit governorate have said that laborers become busy during the planting and rainy seasons. • The average daily rate for skilled laborers in Sana’a is YER 6,727 (approximately USD 26.87) whereas in Al Mahwit governorate it is YER 3,450 (approximately USD 14). The average daily rate for unskilled laborers in Sana’a is YER 3,273 (approximately USD 13) and in Al Mahwit is YER 1,600 (approximately 6.40). The average rate in Al Mahwit is lower than in Sana’a as employers in Al Mahwit provide breakfast, lunch and Qat for laborers on top of the daily beside the wages. • A total of 100% of respondents in Sana’a governorate said it is not acceptable for women to work as temporary laborers in the community. However, most of them said it is possible for women to work in female-oriented jobs, such as sewing. In Al Mahwit governorate, while 50% of people.

Laborers selection under the cash for work (CfW) in the 10 WASH projects in the targeted DTCs in Al- Mahwit governorates was conducted. The selection of the labor was done after community sensitizations by OFDA team where the health facilities heads, community leaders, local councils and community members were involved. During the community sensitization meetings, the criteria of the labors to be selected was discussed. Mercy Corps field staff had given an introduction to the attendants about the program, WASH interventions and the purpose of selecting the skilled and non-skilled labors.

Table 9: Allocation of skilled and unskilled labourers for health facilities WASH facilities rehabilitation Gov. District Health Facility No. of non- No. of No. of participants in skilled Skilled the community labors labors sensitization meetings selected selected Total Females Males Alkhabt Alkhabt Rural 10 2 31 7 24 Hospital Bani Awf Health 10 2 19 2 17 Center Hufash Alsafageen Rural 20 2 15 0 12 hospital Bani-Sa’ad Alkhamees DTC 20 2 29 4 25 Joma’at Sare’a 20 2 22 3 19 DTC Malhan Badah Assofla 20 2 14 0 14 DTC Al Taweelah Al Taweelah DTC 20 2 11 0 11

Mahwit Al Rojum Al Rojum DTC 10 2 31 1 30 - Jabal Al Al Arkoob DTC 20 2 21 6 15 Al Mahwit Shebam Al Ahjur 20 2 13 0 13 Total 170 20 206 23 180

Market Assessment: Initial results of the market assessment in the southern governorates shows that the average daily wage for skilled is YER 4,037.75 (USD 16) while for unskilled is YER 2,154.50 (USD 8.60). However, these wages are much less than what Mercy Corps provided in Phase II Emergency Response for IDPs, Returnees, and Conflict-Affected Communities in Yemen. Because of this discrepancy, the program team will conduct another market assessment in May to confirm if the rate is still considerable and commensurate to the current market prices and labor rate.

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 20 Selection of CfW Beneficiaries: The CfW mechanism is a component integrated with the WASH and non-WASH rehabilitation projects. Laborers, both skilled and unskilled are selected from the community and are given cash for their hard labor to support them meet their basic needs. The laborers are selected by the CC based on the set of criteria: must be IDPs, returnees or conflict-affected, no permanent job, a resident of the target village, head of the family, 18-60 years old, with national ID and availability during the whole period of the project. Additional criteria were prioritized if present in the community: with family member with chronic illness and children under five, people with disability, have more than seven members of the family. In Yemeni culture, women are not allowed to work hard labor; hence, women and girls will not be targeted for any projects that require hard and highly skilled labors. After selecting the beneficiaries by CC, Mercy Corps’ MEL team conducts spot check monitoring of the beneficiaries to ensure that they met the set of criteria.

During these reporting period, a total of 67 individuals (37 males and 30 females) benefitted from one completed non-WASH project in Lahj governorate with USD9,453.13 channeled to the project.

Table 10: Number of CfW direct beneficiaries per governorate for completed NON WASH community projects TOTAL TOTAL AMOUNT # TOTAL # OF CFW AVERAGE GOVER- PROJECT # OF # SKILLED CHANNELED DISTRICT UNSKILLED #MALES #FEMALES DIRECT EARNED/ NORATE NAME DAYS LABORS TO THE LABORS BENEFICIARIES PERSON PROGRAM (USD) (USD) Al Lahj Tuban Serdah 20 60 7 37 30 67 9,453.13 141.09 village TOTAL

Sector 3: Nutrition Objective 3: Improved access to live-saving nutrition services for acutely malnourished girls and boys under 5 years and for pregnant and lactating women.

Nutrition Sector Major Activities:

Coordination Meetings: During this period, Mercy Corps conducted nutrition assessment in the five nominated OTPs. The team also selected 15 health workers in Al Khabt district, Al Mahwit governorate. The 15 health workers selected per OTP as below:

No. Governorate District Health Facility Targeted Population Total # of Health # of Female # of Male surrounding the OTPs Workers nominated for Health workers Health workers the OTPs 1 Al Mahwit Al-Khabt Al-Hathan 3,577 3 2 1 2 Al-Khabt Al-Thahir 8,866 3 2 1 3 Al-Khabt Wadi 3,966 3 1 2 Ayan 4 Al-Khabt Bayt Al- 2,217 3 2 1 Malahi 5 Al-Khabt Al-Shaafil 6,800 3 2 1 Al-Sofla Total 284 25,426 15 9 6

Collection of preliminary data for nominated fixed and mobile OTPs was done in coordination with the GHO inside and outside enclave in Taiz.

During the reporting period, the procurement process of the health facilities (OTPs) supplies has started with the provision of furniture and hygiene materials for health facilities inside and outside the city.

Training of health workers on CMAM and IYCF completed in Al-Khabt district in Al Mahwit governorate.

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 21 The training was held in Al-Mahwit governorate health office. Nineteen health workers (10 males and nine females) were trained, of which 15 HWs were from five OTPs and four from the mobile clinic team. The pre- and post-test results showed a huge progress from 47.3% to 90.6%.

Sub-Sector 3.1: Infant and Young Child Feeding and Behavior Change Indicator 3.1.1 Total number of people receiving behavior change interventions (disaggregated by sex and age) Reporting Period # and % Male/Female % IDPs Cumulative Total Target Reached 29,080 0 0 0 0 Indicator 3.1.2 Number of Mother Support Groups established and having regular meetings during the program period Target Reporting Period Reached Cumulative Total 50 0 0 Indicator 3.1.3 Number and percentage of infants 0-<6 mo. who are exclusively breastfed

Target Reporting Period # and % Male/Female % IDPs Cumulative Total Reached 257 (15%) 0 0 0 0 Indicator 3.1.4 Number of infants 6-24 months receiving food daily in 4 food groups Target Reporting Period # Male/Female % IDPs Cumulative Total Reached 70% (4,544) 0 0 0 0

Additional comments: Sub-Sector 3.2: Management of Moderate Acute Malnutrition (MAM) Indicator 3.2.1 Total number of children 6-59 months screened for acute malnutrition Target Reporting Period # Male/Female % IDPs Cumulative Total Reached 29,080 0 0 0 0 Indicator 3.2.2 Number of sites managing MAM Target Reporting Period Reached Cumulative Total

18 0 0 Indicator 3.2.3 Number of people admitted to MAM services by sex and age Target Reporting Period # Male/Female % IDPs Cumulative Total Reached 3,539 0 0 0 0 Indicator 3.2.4 Number of health care providers trained in the prevention and management of MAM and SAM, by sex Target Reporting Period # Male/Female % IDPs Cumulative Total Reached 180 0 0 0 0

Additional comments: Sub-Sector 3.3: Management of Severe Acute Malnutrition (SAM) Indicator 3.3.1 Number of health care providers and volunteers trained in the prevention and management of SAM, by sex and age Reporting Period # Male/Female % IDPs Cumulative Total Target Reached

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 22 180 0 0 0 0 Indicator 3.3.2 Number of sites established/rehabilitated for inpatient and outpatient care Target Reporting Period Reached Cumulative Total

18 0 0 Indicator 3.3.3 Number of people admitted to SAM services, by sex and age Target Reporting Period # Male/Female % IDPs Cumulative Total Reached 1,245 0 0 0 0 Indicator 3.3.4 Rates of admission, default, death, cure, relapse, nonresponse-transfer, and length of stay Target Reporting Period # Male/Female % IDPs Cumulative Total Reached Default <15% 0 0 0 0 (187) Death <10% 0 0 0 0 (124) Cure 75% (934) 0 0 0 0 Relapse <5% (62) 0 0 0 0 Length of stay 0 0 0 0 <90 days

Additional comments: Sub-Sector 3.4: Nutrition Systems Indicator 3.4.1 Nutrition information systems are established and functioning (Y/N) and if yes, number of nutrition systems established and functioning District/ Governorate Target Reporting Cumulative Total Period Reached Al Khabt/Mahwit , Maqbanah, 3 0 0 Mashra'ah in Taiz Total 0 0 0

Sector 4: Health Objective 4: To contain the cholera outbreak in affected communities and prevent the disease spread in “at risk” communities through provision of life saving assistance and long-term interventions to build community resilience to shocks.

Health Sector Major Activities: Sub-Sector 4.1: Health Systems and Clinical Support on Cholera Response Indicator 4.1.1 Number of health workers trained on case definition, diagnosis and management protocols Target Reporting Period Cumulative Total 135 99 99 Indicator 4.1.2 Number of Diarrhea Treatment Centers (DTCs) established with the required WASH facilities for management of severe cases Target Reporting Period Cumulative Total 16 12 12 Indicator 4.1.3 Number of Oral Rehydration Centers (ORCs) established at community and primary health care level for management of mild and moderate cases

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 23 Target Reporting Period Cumulative Total 80 73 73 Indicator 4.1.4 Number and percentage of DTUs supported by USAID/OFDA out of stock of essential drugs Target Reporting Period Cumulative Total 16 0 0 Indicator 4.1.5 Number and percentage of health facilities supported by USAID/OFDA submitting weekly cholera-based surveillance reports Target Reporting Period Cumulative Total 16 0 0

Additional comments: Identification of targeted areas/ Health facilities: The coordination started with the GHO inside the Enclave. However, the GHO wrote an official letter, stating the targeted districts (Al Qahirah and Al Mudhaffar) are targeted by other agencies. The GHO recommended Mercy Corps target other districts where there is a need. This changed the initial plan for the districts. Coordination was then resumed with the GHO outside the Enclave, who identified 20 health facilities in four districts: in Tai’zyiah (nine), Mawiyah (four), Sabir Al-Mawadem (two) and Maqbanah (five), However, the permit for field visits was only given for 15 health facilities, excluding those in Maqbanah district. Field visits for needs assessment was done for the 15 health facilities, and two of the assessed facilities were planned to be operated by other partners, leaving Mercy Corps with 13 oral rehydration centers (ORCs) to be targeted in three districts.

Planned Governorate District Health Facility intervention Al-Takasor HU Alhoban ORC Al-Shefaa HC ORC Attawoni Atebi HC ORC AtTai’zyiah Ashawkani HC ORC Alramadah HC ORC Adaesah HC ORC Taiz Al- khraib HU ORC Mehrabah HC ORC AlDahrah HC ORC Mawiyah Faqeed Mohammed Hashim HC ORC Al-Awman HC ORC Al- Adenah HC ORC Sabir Almawadem Tubashea'ah HC ORC

Health Facilities Needs Assessment: Needs assessment for health facilities was conducted in the targeted ORCs in Attai’ziyah, Mawiyah, and Sabir Almawadem districs. The needs assessment for health and WASH was conducted in 15 ORCs. General key findings are as follows: • Almost all health facilities (DTCs and ORCs) report daily of receiving variable number of patients presented with acute watery diarrhoea (AWD), and positive cases of cholera (diagnosed positive by RDT). Although there were no cases with severe dehydration that either needs referral or resulted in death during the last two-week period of assessment. • Almost all DTCs and ORCs have their capacity to deal with the caseloads except for Mehrebah Health Centre, where the caseload was much higher than its capacity.

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 24 • Most health facilities have their water source from well or rain water harvest and treated with chlorine. Many health facilities need support for water trucking, chlorine, maintenance for damaged water system, and needs for solar powered pump. • Most health facilities have an inclinator to burn solid waste. Few do not have inclinators but they burn solid waste, regardless. • Most of health facilities have hand-washing stations (at least one) but most stations need to be rehabilitated and supplied with chlorinated water and soap. • Almost all health facilities have shortage in medical supplies and they need to be supported. The following is a list of needed medical and material supplies:

Medical supplies : Other material supplies: a. ORS • Chlorine tab or powder, soap, detergent, b. IV fluids (R.L), infusion set, holder IEC material c. IV cannulas, plaster, cotton, syringe • Calibrated jug, disposable spoons and d. Disposable gloves, mask, head cups, stationery cover, gown • Sphygmomanometer, scale, tables, chair e. Cholera RDT • Brooms, spade, buckets, elastic bags for f. Medication (antibiotic, zinc, waste antiemetic ) • Containers for water, cleaner gloves and shoes

WASH Assessments of Health Facilities Technical Assessment: Based on the final list of health facilities identified by GHO to be targeted, a technical assessment was conducted for 10 health facilities (DTCs) (five health facilities inside the city, five outside the city), as per the table below:

Table 11: List health facilities assessed for WASH facilities No. Name of Type of Sub- District Governorate #of water project district beneficiaries(people) project assessed 1 Aljmhori Reh. Aljmhiri Al Taiz 200,000 Hospital Qahirah 2 Alta’awon Reh. Almasbah Al 50,000 Hospital Qahirah 3 26 Reh. Delux Al 20,350 Septemper Qahirah 4 Alwahda Reh. Aldaboah Al 15,600 Qahirah 5 22May Reh. Aldomina Al 6,150 Mudhaffar 6 Alkharaeb Reh. Alkharaeb At 8,746 Ta'iziyah 7 Alomaqy Reh. Jundia At 11,319 suflaa Ta'iziyah 8 Abdulqader Reh. Aljundia At 9,302 Zagal Aloulya Ta'iziyah 9 Alshokani Reh. Aljundia At 10,499 Aloulya Ta'iziyah 10 Alshifa Reh. Aljundia At 4,218 Aloulya Ta'iziyah

From the above assessed health facilities, four inside the city have been selected for the final list. The

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 25 primary observation of assessment showed that four centers need to be intervened and rehabilitated as the WASH facilities are damaged and not in service; they serve a large number of beneficiaries (more than 200 people a day); and are considered to be the highest priority. Tender process for the rehabilitation of the four health facilities in Taiz governorate (Enclave) took place during the reporting period.

ORPs supplies: After the needs assessment, a list of needed supplies for each health facility was prepared. The needed NFIs and other supplies as per the MOPHP and health cluster SOPs for the ORCs were purchased: • Tables and chairs for patients • Disposable gloves • Disposable head covers • Disposable gowns • Disposable face mask • Sprayers for 0.2% • Feces and vomitus bucket • Waste drums • Detergent • Hand soap • Spades • Mops • Plastic bags • Large circular plastic basins • Measuring cups • Disposable cups and spoons • Cholera prevention kits

Other items – oral rehydration salt, Ringer lactates, cholera rapid diagnostic test, cannula, chlorine tablets – were requested as a donation from the World Health Organization (WHO). Distribution of NFIs to the ORCs and cholera kits will be conducted from April onwards and will be reported in the next semi-annual.

Selection of Health Workers: Selection of 65 health workers and support staff (cleaners) (52 health workers, 13 cleaners) was done through nomination by the GHO. The Mercy Corps team verified the eligibility of nominated staff.

Health Worker Training: Training of health workers was carried out for 61 health workers in Sana’a and Al Mahwit (48 male and 13 female), and 39 (23 male and 16 female) from the selected workers representing the targeted health facilities in Attai’ziyah, Mawiyah, and Sabir Almawadem districts, Taiz governorate. The training was facilitated by the governorate health office in Sana’a and held in the training hall in Yemen Tech Institutes over two days. The training focused on the following subjects: • Acute watery diarrhea and cholera definition • Treatment of cholera cases in ORPs, and referral mechanism • WASH activities related to cholera in health facilities and water chlorination • Practical demonstration for the process of using cholera RDT, hand washing, and records management • Handling of dead bodies and disinfecting cholera patients’ waste materials • Basic messages for raising awareness for prevention of Diphtheria

Pre- and Post-Test: Pre-and post-tests were conducted for 39 health workers (23 males and 16 females) outside the Enclave. The results show that 87% (34 workers) passed the pre-test, and 97% (38 workers) passed the post-test. A total of 87% (34 out of 39) showed an improvement and increase in health knowledge.

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 26 PRE-POST FINDING

87%

Health workers passed Post test 97%

Health workers passed Pre test 87% 82% 84% 86% 88% 90% 92% 94% 96% 98%

Evaluation of health workers was conducted during the two-day training in order to identify the trainees' feedback regarding to the training and measure the satisfaction level. The result of the first day showed that majority expressed their satisfaction with materials shared, training session, participation and the trainers have the knowledge of the training topics. Whereas, majority (95%) reported that the trainer was well prepared and the objective of training were clearly defined and the training time was sufficient. Furthermore, during the second day of training for the second group, results showed that majority (100%) reported that objective of training were clearly defined, there were encourage for participation and interaction, training experience is useful and it will help during the work and trainer have the knowledge of the training topics. Almost all (89%) respondents reported that training content was organized/easy to follow, trainer well prepared, and the training time was sufficient.

Memorandum of understanding (MoU): An MoU was signed between Mercy Corps and Taiz GHO that outline different project activities, project coordination, roles and obligations of each party. After the signing of MoU, the distribution and delivery of supplies to each targeted health facility was done and the supported ORCs started working and providing health care to AWD/cholera patients.

Mercy Corps is currently supporting two DTCs in Sana’a governorate and 10 DTCs in Al Mahwit:

No. Governorate District DTC 1 Sana’a Sanhan Althabaat Health Center 2 Alhisn Tawar Health Center 3 Al-Mahwit Shibam Alahjor Health Center 4 Altawelah Altawelah Health Center 5 Alrojom Alrojom District Hospital 6 Jabal Almahwit Alarkoob Health Center 7 Alkhabt Bani-Awf Health Center 8 Almerwah Hospital District 9 Bani Saad Jomaat Sarea Health Center 10 Alkhamis District Hospital 11 Hufash Hufash Rural Hospital 12 Melhan Badah-Alsofla Health Center

Incentive payment was done for 284 health workers for those who participated in the cholera response program in Sana’a and Al Mahwit governorates for January, February and March 2018. Of the 284, 116 health workers are from Sana’a governorate and 168 are from Al Mahwit governorate.

Mercy Corps distributed a total of 1,500 cholera response kits. Each kit contains 2 liters of chlorex

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 27 solution, two jerry cans, 2kg of laundry soap and 12 pieces of body soap. In addition, the distribution of 51,132 pieces of body soap, 1,699 jerry cans and 514 liters of chlorex solution were distributed to the DTCs for forward distribution to vulnerable households. Chlorex solution was distributed to 12 DTCs and body soap and jerry cans were distributed to the volunteers in the 12 DTCs and 60 ORPs of Al Mahwit and Sana’a governorates. The volunteers distributed the body soap and jerry cans as part of hygiene promotion in the targeted affected households.

The program supported 12 DTCs in Sana’a and Al Mahwit governorates, treating 7,088 AWD cases. Figures of patients treated from AWD and confirmed cholera patients were reported to WHO and the health cluster as per the chart below:

# 0-5 6-9 10-14 15-17 18-24 25-34 35-49 50+ # of of tota tot Tot Go. l al al M F M F M F M F M F M F M F M F Fe Ma mal le 1 1 1 1 1 1 1 1 1 1 44 38 2 4 4 2 6 4 8 1 2 9 2 4 1 9 12 125 24 Sana'a 3 0 8 6 6 6 2 7 4 9 8 4 4 6 6 9 31 7 88 2 2 2 2 1 1 1 2 3 2 2 2 2 Al 86 74 4 0 7 0 3 9 6 7 1 1 3 6 5 2 23 222 46 Mahwit 3 6 2 3 0 2 8 2 2 2 2 6 1 5 7 9 75 5 00 3 3 4 3 2 1 2 2 3 5 3 4 3 3 Grant 13 11 7 4 1 2 0 3 4 9 4 1 5 1 7 2 36 348 70 Total 06 26 0 9 6 8 0 9 6 1 0 0 5 1 3 8 06 2 88

Sub-Sector 4.2: Communicable Diseases Indicator 4.2.1 Incidence and prevalence of high morbidity rates by type (e.g. diarrhea, ARI, measles, and other), by sex and age Reporting Target Male/Female Cumulative Total Period Diarrhea N/A 0 0 0 ARI N/A 0 0 0 Measles N/A 0 0 0 Other N/A 0 0 0 Indicator 4.2.2 Number and percentage of cases diagnosed and treated per standardized case management protocols, by sex and age Target Reporting Period Cumulative Total -- 0 0 Indicator 4.2.3 Case fatality rates for diarrhea, ARI, measles and other, by sex and age Target Reporting Period Cumulative Total Diarrhea N/A 0 0 ARI N/A 0 0

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 28 Measles N/A 0 0 Other N/A 0 0 Indicator 4.2.4 Case fatality rates for cholera in Mercy Corps-supported ORCs and DTCs, by sex and age Target Reporting Period Cumulative Total N/A 0 0 Indicator 4.2.5 Number of suspected cases of diarrhea referred from ORCs to DTCs, by sex and age Target Reporting Period Cumulative Total N/A 0 0

Additional comments: Sub-Sector 4.3: Community Health Education/Behavior Change Indicator 4.3.1 Number of CHWs trained and supported (total and per 10,000 population within project area), by sex Target Reporting Period # Male/Female Cumulative Total 24 male (24.5%) 70 98 98 74 female (75.5%) Indicator 4.3.2 Number and percentage of CHWs specifically engaged in public health surveillance Target Reporting Period Cumulative Total N/A 0 0 Indicator 4.3.3 Number and percentage of community members utilizing target health education message practices Target Reporting Period Cumulative Total N/A 0 0

Additional comments: Selection and Training of Community Health Volunteers: Selection of community health volunteers (CHVs) started through nomination by GHO. GHO has nominated 65 CHVs for Taiz and 98 for Sana’a. Mercy Corps has conducted interviews and verification to finalize the list of CHVs.

For Sana’a and Al Mahwit, the program has distributed 4,620 information, education and communication (IEC) materials to the 12 DTCs and 60 ORPs as well as IEC materials for 98 CHVs which will be used for awareness sessions.

Under the OFDA cholera response activity, Mercy Corps has been providing supported 12 diarrhea treating centers (DTCs) in Sana’a and Al Mahwit governorates and 13 ORPs in Taiz. In order to support the awareness activity on cholera, 98 CHVs were selected who will be responsible for health education and raising the community awareness within the second catchment population around the supported health facilities (DTCs and ORPs). Those selected CHVs trained by certified trainers from the Ministry of Public Health and Population (MOPHP) on main messages, practical and theoretical methods of delivering the main hygiene and cholera prevention messages. Mercy Corps had also printed supporting documents/ materials for the CHVs such as brochures and IEC calendars of the main messages. CHVs were trained on the main cholera messages, how to prepare weekly and monthly plans, gathering sessions, door-to-door visits. Mercy Corps also pays monthly incentives for CHVs to cover their transportation and communication costs during door-to-door and awareness sessions in their targeted villages for those who meet the goals in their monthly plans.

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 29 Training of 98 CHVs from Sana’a (14) and Al Mahwit (84) governorates was completed. Pre- and post- tests were conducted to evaluate the improvement in knowledge and the 15% improvement was achieved. The training for CHWs included: • Cholera prevention messages to the communities • Diphtheria risk communication and messages • Chlorination for water and water safety methods • Weekly reporting of the awareness sessions and door-to-door activities • Monthly planning for the hygiene activities

Challenges: North • Obtaining travel permits to the field remained a challenge. Even team members who had field travel permits were stopped and detained in the field for hours by representatives of the newly- formed National Agency for Humanitarian Affairs and Disaster Response. This shows that there is competition and confusion regarding the roles of MOPIC, MOI and the National Agency for Humanitarian Affairs and Disaster Response. • Processing sub-agreements and MoU signing with sector offices has become more difficult, particularly with the health office. • The security situation in Taiz Enclave has led to office closure numerous times, which in turn disrupted fieldwork and delayed program implementation. • Related to the security situation, the program was obliged to change target districts to relatively safe yet recommended districts by authorities and clusters. • It was difficult to select staff from health facilities to participate in cholera and nutrition activities as all health staff have not been paid their salaries and the health office was requesting incentives to be given to all staff to avoid conflict. • Delay to get responses from authorities, including to process field travel permits. In some instances, the delay is due to personal deference/contradiction between individuals in IDP Executive Unit/local council and the newly-formed agency which results in no decisions being made. • For Al Mahwit governorate, the topography of the areas makes access very challenging. Moreover, the distance between the ORPs and DTCs requires hours of driving to get from one health unit to another. • The operating environment inside Taiz still remains very complicated, and the availability of authority representatives is limited, which leads to a lack of decision making, as there are many actors operating in the area.

South Hygiene Promotion • Difficulty in finding qualified CVs in some of the target areas. Mercy Corps’ Community Facilitator will conduct the hygiene sessions instead for areas where there are no qualified CVs. • Some villages like in Al-Kood in Hadramaut were reluctant to accept CVs to conduct hygiene sessions inside their homes. Hence, group sessions in public places were done in these areas. After seeing the impact of the sessions, some of the households accepted CVs to conduct hygiene sessions in their homes. • Some community members such as in Al-Qureshi in Lahj refused to participate in hygiene sessions. Program team coordinated with the Imam in Al-Masjed to help encourage people’s participation. However, the Imam refused to support the intervention. The CC is currently helping the program team to resolve this issue. WASH/Non-WASH Rehabilitation Projects/CfW • Laborers have faced difficulties in the clean-up operation along the irrigation channel due to the large rocks that accumulated along the paths and sides. The community members provided a bulldozer as their community contribution to the project. Other contributions include free labor to repair the damaged pipe networks.

MERCY CORPS AID-OFDA-G-17-00295: Yemen Semi-Annual Report #2 October 2017 – March 2018 Page 30 • Incidents of snake bites have occurred in the site during implementation. Community health workers provided assistance to workers while Mercy Corps provided vaccines and medicines through complementary funding. • The manager of the Irrigation Office stopped the work in Abyan due to a conflict with the contractor’s driver. Mercy Corps’ Head of Office invited the manager to the office to resolve the issue. The manager informed Mercy Corps that there was no one from the Irrigation Office have been involved in the implementation and demanded to hire skilled supervisors from his team where the contractors are working. To resolve the issue, Mercy Corps agreed to involve one staff from the Irrigation Office as one of the skillled laborers to provide technical support. Livelihood • Retaining participaiants for vocational skills training has been a challenge, as drop out rates are due to social and or family issues. However, replacement was able to be done from the back-up list.

Lessons Learned: Hygiene Promotion • Monitoring the CV progress through actual demonstration by the CF have helped improve performance of the CVs. • Having a professional doctor as key facilitator during the CV training is more effective specially on understanding disease prevention. It has more impact in terms of participant’s increase in knowledge on this topic. • Conducting hygiene sessions in public can cover a wider broad of audience. • Taking into consideration the gender balance of hygiene participants is important to ensure that all genders and age groups receive hygiene messages. • Establishing student committees in continuing the hygiene campaign in schools is one mechanism to ensure sustainability of the hygiene activities. WASH/Non-WASH Rehabilitation Projects/CfW • Proper coordination among laborers makes work easier and faster during the implementation phase. • It is best for the CC to let them deal with internal conflicts within community and among beneficiaries to promote ownership and accountability. • Coordination with Irrigation Office must be done prior to implementation and should involve them throughout the program cycle.

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