Swiss Red Cross International Cooperation Programme Report 2017

25 April 2018 Swiss Red Cross Rainmattstrasse 10 / P.O. Box CH-3001 Bern Phone +41 58 400 4111 www.redcross.ch

Cover Page Volunteers of the Red Crescent Kyrgyzstan are channeling a river in Ozgorush. Disaster Risk Reduction is a programme priority of the Swiss Red Cross in Kyrgyzstan.

Cover photo © SRC, Remo Nägeli Table of contents

Synopsis 7

1. Institutional context 11

Swiss Red Cross 11 Department of International Cooperation 11 The International Red Cross and Red Crescent Movement 12 Partnerships, alliances, networks 12

2. Global context 15

3. Programme results 2017 19

Health 20 Reproductive health 22 Nutrition 26 Disease control 29 WASH 32 Ageing and health 40 Blood safety 44 Eye Care 48 Disaster Risk Management 51 Emergency response 52 Recovery 56 Disaster risk reduction 60 Institutional preparedness 66

4. Continental programmes 73

Africa and the Middle East 73 Latin America and the Caribbean 73 Asia 74 Eastern Europe and the CIS 75

5. Learning process: Partnership and National Society Development 77

6. Awareness-raising in Switzerland 83

7. Financial Report 85

Financial overview 85 Financial results of the International Cooperation Department 86 SDC contribution to the IC Department projects 87 IC Department Project Expenditure and SDC Programme Contribution 87 Programme Budget 2018 88

3 Annex 1: Result framework of the SRC Programme 2017–20 91

Annex 2: Beneficiary statistics 2017 92

Annex 3: Expenditures and SDC contribution 2017 by country 94

Annex 4: Deviations budget versus expenditures 2017 96

Annex 5: Evaluations 2017 97

Annex 6: Publications and presentations at conferences 2017 98

Annex 7: Country Summaries 100 Armenia 100 Bangladesh 102 Belarus 104 Bhutan 105 Bolivia 106 Bosnia and Herzegovina 108 Cambodia 110 Ecuador 111 El Salvador 112 Ethiopia 114 Ghana 116 Haiti 118 Honduras 120 Kyrgyzstan 122 Lao PDR 124 Lebanon 127 Malawi 129 Mali 131 Moldova 132 Nepal 134 Pakistan 136 Paraguay 138 Philippines 140 South Sudan 141 Sudan 143 Togo 144 Vietnam 145

4 Abbreviations

AfSBT African Society for Blood Transfusion OD/CB Organisational Development and Capacity Building ANC Antenatal Care ODA Official Development Assistance BOCA Branch Organizational Capacity Assessment OECD Organisation for Economic Cooperation and Develop- BTS Blood Transfusion Services ment CBDRM Community Based Disaster Risk Management OIAI Office of Internal Audit and Investigation CBHFA Community Based Health and First Aid PHAST Participatory Hygiene and Sanitation Transformation CBO Community Based Organisation PLHA People Living with HIV and AIDS CCA Climate Change Adaptation PNC Postnatal Care CIS Commonwealth of Independent States PNS Partner National Society CLTS Community Led Total Sanitation RANAS Risks, Attitudes, Norms, Abilities and Self-regulation CSPM Conflict Sensitive Project Management RCRC Red Cross and Red Crescent DM Disaster Management SDC Swiss Agency for Development Cooperation DRCE Disaster Response Capacity Evaluation SDG Sustainable Development Goal DRM Disaster Risk Management SECO Swiss State Secretariat for Economic Affairs DRR Disaster Risk Reduction SHA Swiss Humanitarian Aid Unit ECHO European Union Humanitarian Aid and Civil SOCI Selected Outcome Indicators Protection Department SRC Swiss Red Cross ERU Emergency Response Unit TBA Traditional birth attendant EU European Union UHC Universal Health Coverage FACT Field Assessment Coordination Team UN United Nations HBC Home Based Care WASH Water, Sanitation and Hygiene HIS Health Information System WHO World Health Organisation HMIS Health Management Information System WPNS Well Prepared National Society HNS Host National Society HR Human Resources IC International Cooperation Department of the SRC ICRC International Committee of the Red Cross IDP Internally Displaced Person IFRC International Federation of Red Cross and Red Crescent Societies IG Initiative Group IT Information Technology IP Institutional Preparedness KOFF Swiss Platform for Peacebuilding LRRD Linking Relief, Rehabilitation and Development MBTS Malawi Blood Transfusion Services MEL Monitoring, Evaluation and Learning MENA Middle East and Northern Africa MMS Medicus Mundi Schweiz MNCH Maternal, newborn and child health MoH Ministry of Health Movement Movement of the Red Cross and Red Crescent National Societies NBTS National Blood Transfusion Services NCD Non-communicable Disease NGO Non-governmental Organisation NS National Society NSD National Society Development MADAD EU Regional Trust Fund in response to Syrian Crisis MoU Memorandum of Understanding OCAC Organisational Capacity Assessment & Certification

5 6 Synopsis

1. Insight into the organisation

Supreme body: Legal Form: Red Cross Assembly Founded 1866; Association; recognition Governing Board: as National Society renewed in 1951 by Red Cross Council federal decision President: Constituency: Annemarie Huber-Hotz Red Cross Assembly, 24 cantonal associa- Vice-Presidents: tions, 4 Red Cross Rescue Organisations, Toni Frisch and Marc Geissbühler 2 Red Cross Institutions Members: Red Cross Rescue Organisations: Danielle Breitenbücher, Ivo Cathomen, Daniel Biedermann, Swiss First Aid Association, Swiss Life-Saving Adriano P. Vassalli, Guy Mettan, Dieter Widmer Society, Swiss search and rescue dogs Management Board: REDOG, Swiss Army Medical Association Markus Mader, Director-General; Christine Kopp, Health & Integration, Red Cross Institutions: Vice director; Beat von Däniken, International Cooperation; SRC Swiss Blood Transfusion Service, SRC Markus Sieber, Finance, HR & Services; Lukas Sallmann, Humanitarian Foundation Marketing/Comm.; Kurt Buntschu, HR; Sabine Zeilinger, Communication Membership: 498,000 IC Department Head of divisions: Volunteers: 57,900 Asia/Europe: Jürg Frei (U. Schmid) Staff:4,700, including 485 at headquarters Africa/Americas: Lorenz Indermühle (F. Molinari) (340 full-time positions) Disaster Management: Beatrice Weber (P. Morf) Religious affiliation/political status: Programme coordinators: independent and neutral Asia/Europe: Y. Affolter, B. Mueller, A. Papis, Ch. Rutschmann, U. Schmid, Quality standards/certificates: E. Syfrig, A. Vondeling, G. Zipper, S. Hirsig ICS according to OR Africa/Americas: F. Büsch, C. Hinden, C. Humbolt, G. Labhardt, F. Molinari, ZEWO (re-accredited 09.03.2011) U. Schori, F. Weibel, C. Zaugg, M. Rion SWISS NPO-Code Disaster Management: P. Morf, A.K. Moore, A. Schmid; I. Aebersold, IC Department level: HQ and field manual D. Garnier, Th. Büeler, D. Grolimund, W. Nellenstein for Quality Management Unit of strategic and conceptual development: Audit: Ernst & Young AG, Bern Th. Gass (head), C. Aebischer (deputy head), M. Christofori-Khadka, A. Jöhr, S. Loosli, N. Rähle, V. Wieland, M. Noor Finance and Administration: S. Khadka (head), M. Secco, R. Oser, M. Casagrande, J. Pascual, J. Jarosch, H. Schalenbourg, F. Habegger

Thematic Priorities Programme Countries Activities in Switzerland Health Africa/MENA: Ghana, Togo, Mali, South Sudan, Health and integration of elderly care-de- Reproductive health Sudan, Ethiopia, Malawi, Lebanon, Egypt pendent people and migrants, support for Disease control asylum seekers, outpatient care for torture Nutrition Latin America and the Caribbean: Bolivia, and war victims, Red Cross Service, Youth WASH Paraguay, Ecuador, Honduras, El Salvador, Haiti Red Cross, rescue operations (Samaritans, Ageing and health lifeguards, REDOG), volunteer work, blood Blood safety Asia: Bangladesh, Nepal, Pakistan, Cambodia, transfusion services, national disaster aid, Eye care Laos, Vietnam, (Bhutan) SRC nursing assistant training, constructive conflict resolution for young people, emer- Disaster Risk Management Europa/CIS: Bosnia-Herzegovina, Moldova, gency relief. Shelter, housing, non-food items Belarus, Kyrgyzstan, Armenia WASH Economic support Reconstruction of public infrastructure Community-based DRM Institutional preparedness

7 Strategic orientation of the programme 2017–20 The SRC strategy 2020 for international cooperation defines the following strategic objectives: Particularly vulnerable and deprived people and communities: – receive appropriate support to meet emergency needs; – have the capacity to prepare for and respond to disasters appropriately and are in a position to adapt to climate change; – have access to good quality health care; – are able to have an impact on health determinants and to demand their right to health.

Context Strategic objectives 2017–20 Climate change has become a key determinant for global health and for the The strategy 2020 for international cooperation defines the occurrence of disasters, the two spheres of the SRC programme 2017–20. Cli- following strategic objectives: mate change is increasing the intensity, frequency and uncertainty of weath- Disaster Risk Management: The SRC strengthens its disaster er-related hazards, shocks and stresses. At the same time, extreme weather is management: it acts professionally in all phases and at the tran- increasing the vulnerability of communities and individuals, especially when sition points in the disaster management cycle. combined with other drivers of risk such as conflict, migration and urbaniza- Health: Health is the priority of medium- and long-term pro- tion. By 2030, it is estimated that up to 325 million of the world,s poor would grammes and a key component of the disaster management be living in the 49 most hazard-prone countries. In East Africa, for example, the cycle. current drought has a devastating impact on vulnerable households. 815 mil- Awareness raising and advocacy: In both the health and dis- lion people worldwide suffer from hunger, two thirds of them live in sub-Saha- asters spheres of activity, the SRC does awareness-raising work ran Africa and Southern Asia. At the same time, more than 2 billion people are in Switzerland and advocates on behalf of the vulnerable. affected by water stress, which will increase with population growth and the Alliances and network: The SRC supports its partner organisa- effects of climate change. The programme 2017–20 of the Swiss Red Cross aims tions with a view to their broad recognition as relevant players at contributing to the Agenda 2030 for Sustainable Development, particularly in the fields of humanitarian assistance and development. The to the Goals that are related to health, water and disaster risks. In the human- SRC becomes more involved in networks and cooperates more itarian sector, SRC through the IFRC supports the Grand Bargain, an agreement closely with Swiss and international agencies. between more than 30 of the biggest donors and aid providers, which aims to Quality and innovation: The SRC adds to its professional exper- allocate more means to local actors for a more effective response to disasters. tise in the health and disasters spheres of activity. In the ongoing development of its quality management system, the SRC stresses outcome-oriented and conflict-sensitive project management.

2. Financial Context

2017 (in CHF 1,000) SRC International Cooperation Department Projects (in CHF 1,000) SRC HQ Expense: 2014 2015 2016 2017 131,911 Project Implementation Expenses 39,210 45,913 51,048 46,901 IC Department Ex- pense: 59,339 SDC Programme Contribution 2014 2015 2016 2017

Remarks: Development Cooperation 9,800 10,800 11,100 10,100 SDC contributions to Emergency Relief & Humanitarian Aid 2,500 2,500 2,500 2,500 the IFRC through the Mandate Projects 2,966 4,141 3,971 2,841 tripartite SDC-SRC- IFRC agreements are Country specific Relief/ Development Cooperation 1,087 148 80 0 not included in this Water Consortium 84 526 754 509 total Total SDC Contribution 16,437 18,115 18,405 15,950 SDC SHA Services 717 732 Total SDC with SHA Service 19,122 16,682 SECO Mandate 72 59 Total SDC & SECO 19,194 16,741

8 3. Partnership with SDC

Strengths and weaknesses in the cooperation between SDC and SRC

 – Good collaboration in the Core Learning Group of the evaluation of the SDC Institutional Partnerships. – Good basis for partnership building. – Good introduction of new team after the changes at SDC. – Increasing dialogue between SDC, IFRC and SRC, including Tripartite agreement. – The solid funding basis of the SDC programme contribution allows SRC to act at places or within topics that might be difficult to fund through other channels but where the most vulnerable population can be reached. – The solid funding also provides SRC with a planning reliability that other RC partners do not have and makes SRC a more valuable partner in the long term, focusing on organizational development and sustainability of its partners.

 – No continuity in dialogue with IP after Petra Winiger left. – Not clear who is SDC counterpart in joint learning process. – Focus on specific topics instead of organisations might reduce the institutional exchange and also the advantage of the joint learning with SDC. – Joint learning is driven much more by the NGO than by the SDC representatives. – Interest in annual meeting by SDC was moderate, while the joint learning would have been an opportunity for both organisations. – The general pressure on funding is partially transferred to NGOs.

Measures to be taken: – Define the regular exchange with IP and SRC. – Commonly advocate for Swiss funding for international cooperation. – Show added value of programme contribution with co-funding by the NGOs and increased impact at local level.

4. Important aspects of the programme implementation

Successes – The SRC improved its programmatic outcome monitoring through a reinforced and more systematic indicator tracking system, including electronic data collection for selected standard indicators. – In a new collaboration with the EPFL Lausanne, the SRC developed a comparative impact evaluation concept for the DRR project in Honduras. The research project won the SDC Impact Award, and reflects the aim of the SRC to strengthen evaluation and learning. – One of the outcome highlights 2017 was the increase of the proportion of births attended by a skilled health worker – a SDG maternal health indicator – across various SRC programme countries. Community-based birth preparation and referral mechanisms were key factors contributing to this success. – The SRC provided 34 delegates to IFRC emergency response units, which is the highest number of SRC deployments for many years. The SRC humanitarian programme increasingly addresses aid for refugees and displaced people, such as in Greece, Syria, Lebanon, Bangladesh, South Sudan, and Uganda. – The SRC entered into long-term partnership agreements with a growing number of National Red Cross and Red Crescent Societies, such as for example in Kyrgyzstan, Ethiopia, Belarus and Malawi. Failures – The earthquake recovery programme in Nepal did not materialize the way SRC had planned. SRC and the Nepal Red Cross reconstructed fewer houses than intended due to erratic regulations of the Nepali government. – Given the severe malnutrition in sub-Saharan Africa and South Asia, the SRC,s record of accomplishment in nutrition is still modest, in both development and humanitarian programmes. Challenges – Cooperation and partnership with National Red Cross and Red Crescent Societies is a balancing act in many SRC programme countries. On the one hand, SRC is committed to invest into the organisational development and capacities of the partner organisations, which is a long-term goal. On the other hand, the SRC strives at effective performance and good results for beneficiaries, which is a short-term goal. Weak capacities of partners can hamper result goals, and poor governance of partners impede a long-term perspective on organisational development. Experiences – The SRC is strengthening its multilateral cooperation and collaboration within the Red Cross Movement. In South Sudan and Somaliland, for example, the SRC jointly implements operations with the ICRC and the IFRC. In the IFRC region of Eastern Europe, the SRC is a leading partner in the domain of elderly care. In collaboration with the IFRC Secretariat, the SRC is an increasingly important partner at the technical level, for example in the sectors of cash programming, emergency medical services, and community health.

9 Reconstruction10 after the devastating hurricane in Haiti: SRC employee Olnick Jean-Baptiste trains carpenters in renovation techniques so that the houses would resist future storms. © SRC, Remo Nägeli 1. Institutional context

Swiss Red Cross humanitarian crises: deployment of personnel to In the domain of Monitoring, Evaluation and the IFRC Emergency Response Unit (ERU) for the Learning (MEL), the IC Department introduced relief missions after the hurricane in Dominica an Outcome Monitoring scheme that will allow In 2017, the SRC has changed its Red Cross stat- and St. Marteen; support to the IFRC led relief tracking of selected key outcome indicators utes in order to reorganize the governing operation for the Myanmar refugees in Bangla- throughout the programme phase 2017–20. The structure. The SRC governing board was en- desh; support to the IFRC response to the hunger Outcome Monitoring Scheme operationalises larged with three more members (12 members: crisis in Somalia; continuing support to migrants the institutional impact model and allows visual- 5 from cantonal sections, 3 from rescue organi- in Greece and Macedonia. In Syria, the SRC and izing the contribution to the SDGs (Sustainable sations, 1 youth RC, 2 independent and the pres- the Syrian Arab Red Crescent agreed on a hu- Development Goals). With the aim to strengthen ident), whereas the executive committee of the manitarian partnership. Moreover, the SRC their outcome monitoring capacities, SRC dele- cantonal sections was dissolved. This step allows started supporting the Ukraine Red Cross to gations and partner organisations were sup- the SRC to have one line of decision including all strengthen their home care system. ported with guidelines and standardized surveys member organizations. in order to conduct data collection at household Regional knowledge exchange between the or health facility level, using digital data collec- The SRC is implementing its Strategy 2020 to SRC delegations is a priority of the IC Programme tion tools, such as KoboToolbox. Another high- strengthen services and capacities in Switzerland 2017–20. The four continental programmes light in MEL was the SDC Impact Award that was and abroad. The focus was on developing a new foresee regular exchange meetings as well as granted to SRC for a planned evaluation on the health approach called “Gesundheit für alle” and regional capacity building for SRC delegations in impact of the DRR programme in Honduras. The an education and training platform. The SRC is selected technical domains. In 2017, two one- evaluation will be done in collaboration with the the second largest provider of non-formal train- week regional workshops were held. In Ghana, Ecole Polytechnique Fédérale de Lausanne (EPFL) ing courses in Switzerland after the Migros Club the African SRC delegations worked on Disaster in 2018. SRC and EPFL will investigate the level of School. Risk Reduction (DRR), security risk management, community resilience, the mitigation of flooding and Conflict Sensitive Project Management and landslide events, and the community disas- The Department for domestic affairs “Health and (CSPM). In Lao, the European and Asian delega- ter preparedness in DRR intervention villages Integration” has set up a new division “Social tions met for a training in participatory monitor- compared to villages with no DRR intervention. Integration and Migration” in order to guaran- ing techniques and for updates on disaster pre- tee a better coordination and services for the paredness and CSPM. The Finance and Administration Unit invested migrant population in Switzerland. It will focus significantly in human resources, providing train- on protection issues, counseling and advocating Based on the training package and the toolbox ing and development opportunities to its fi- for the needs and rights of vulnerable migrant for Conflict Sensitive Project Management nance officers from the SRC programme coun- groups. (CSPM) completed in 2016, the SRC started the tries. Financial management workshops were roll out of the CSPM mainstreaming process in conducted this year in Nepal, Moldova and Hon- The programme “Twice Christmas”, a collabora- the country programmes: All Programme Coor- duras where national finance officers from 17 tion between the Swiss Radio Broadcast Associa- dinators and Country Coordinators completed SRC programme countries came together to en- tion (SRG SSR), the Swiss postal system (Post) and the Swisspeace online course on CSPM. The hance their thematic knowledge and skills in in- the SRC, has initiated some changes in 2017. The CSPM toolbox was introduced at the annual the- ternal control system, preventing fraud and cor- new focus will be on delivering assistance in kind matic workshop ,Fragility and Resilience, at the ruption, and managing independent external to those most in need in Switzerland and with SRC Headquarters, at a refresher training for audits. The continued in-country coaching from cash contributions abroad avoiding costly and Emergency Response Team (ERT) pool members, SRC HQ finance officers during their project -mis time consuming transports of donated goods. and at the above mentioned regional work- sions and back-office support has contributed shops. The SRC Issue paper on Health Series No significantly to improve the quality of the pro- 6, Health Programming in Fragile Context, pub- ject,s financial management and financial re- lished in May 2017, presents the results and con- porting. The SRC Finance and Administration clusions of the SRC learning process on working unit,s coordination and communication with the Department of Interna- in fragile contexts. SDC,s Finance and Administration has been strengthened. One outcome of the joint SRC and tional Cooperation With the aim to reinforce SRC,s security risk SDC collaboration is the development of SRC,s management in the programme countries, the Terms of Reference for External Audits following IC security adviser conducted assessment and international auditing standards and at the same In 2017, the IC Department,s portfolio of long- training missions to the SRC delegations in Ne- time fulfilling the requirements as stated in the term country programmes remained stable: SRC pal, Bangladesh, Honduras, Mali, Ethiopia and El SDC funding agreements. maintained SRC delegations in 26 programme Salvador. The new SRC security risk management countries (see map on page 18). In Cambodia, framework requires every delegation to conduct the SRC closed the country programme after a security risk assessment, and to establish a con- more than 30 years of partnership and coopera- tingency plan, a local security plan, and a medical tion with the Cambodian Red Cross and with the emergency plan. Ministry of Health. In addition to the long-term programmes, the SRC responded to a number of

11 The International Red Cross common denominators in fraud cases should be Partnerships, alliances, identified and more will be invested in corrup- networks and Red Crescent Move- tion prevention. It is important to note, that the ment current corruption prevention policy and the OIAI only address cases where resources of the IFRC secretariat are involved. The Secretariat has The SRC is a pro-active member of various net- The Statutory Meetings of the Red Cross and no authority over the National Societies and – works and alliances both in Switzerland and Red Crescent Movement (RCRC Movement) even in corruption cases – cannot intervene abroad. The following is a selection of exchange, took place in Antalya, Turkey, in November 2017. without the consent of the NS concerned. networking and advocacy activities in 2017 (see The IFRC General Assembly elected its new Gov- also the list of SRC presentations at conferences erning Board, four Vice Presidents and the new Together with Switzerland, the IFRC is leading in annex 6). President of the IFRC, Francesco Rocca (Italy). The the Grand Bargain work-stream on Localization SRC, as the host-state to the IFRC secretariat, of Aid. The RCRC Movement with its 191 local Various exchange meetings were held with SDC, holds the IFRC Vice-Presidency ex-officio and is a responders in the shape of National Societies is e.g. Institutional Partnerships, the Global Pro- standing member of the IFRC Governing Board. well placed to follow-up on this commitment. gramme Health, the Humanitarian Aid. The SRC Important decisions of the General Assembly Accordingly, the IFRC and the ICRC jointly was a member of the Core Learning Partnership were the adoption of the Global Migration Strat- launched the National Society Investment of the evaluation of the SDC institutional part- egy including the Road Map for its implementa- Alliance. Through the alliance, the ICRC and the nerships. tion, the updated Plan and Budget for 2018–19 IFRC, together with their donors, aim at scaling as well as the decisions to advance on the issues up their investment in the operational and func- The partnership with the SwissRe foundation on of integrity and Federation-wide fraud and cor- tional capacity of National Societies. the Resilience Programme in Central America ruption prevention, Gender balance in leading continued in its third year. Regular exchanges positions within the Movement, and the elabo- At the technical level, SRC continued to support with SwissRe and scientist experts were held, the ration of the overarching IFRC Strategy 2030. A the Programme Division of the IFRC Secretariat regional resilience workshop in El Salvador held, very challenging and sensitive issue for the IFRC through a financial contribution and expertise in and the supported projects continued as remains the formula for the calculation of the the programme areas Emergency Medical Ser- planned. The trust between the two organisa- Statutory Contributions of the National Societies vices, Maternal and Child Health, Community tions has grown over time and with the common to the IFRC Secretariat, which is perceived as un- Resilience, and in the Global Migration Taskforce. platforms of work. fair by the National Societies (NS) paying the The SRC health advisors participated in IFRC largest contributions. A solution must be found global technical network meetings, such as the Joint learning events were carried out with Swiss by the next General Assembly in 2019 without Emergency Response Technical Working Group NGOs, such as SolidarMed on conflict-sensitive lowering the overall amount of roughly 35 mil- and the International Health Adviser group. SRC project management and with Helvetas on part- lion as it would be impossible for the Secretariat hosted the annual meeting of the DRR advisers, nership and organisational development. A to renounce on a part of its already very scarce and took part at the global meeting of the Or- learning event was held between Swiss NGOs on unrestricted resources. ganisational Development advisors group. In the reconstruction and rehabilitation in urban envi- domain of shelter and reconstruction, the DACH ronments. SRC is also a member of the so-called At the Council of Delegates – bringing together recovery network between the Austrian, Ger- Swiss Knowledge Management Think Table. the IFRC, all NS and the ICRC – resolutions were man and Swiss Red Cross developed a common adopted on a wide variety of themes like human- recovery strategy within the IFRC framework. The SRC has actively participated in several work- itarian education, elimination of nuclear weap- ing groups of the Medicus Mundi Switzerland ons, mental health, and the compliance with the In reaction to the violent state of the world, the (MMS) network, for example on sexual and re- International Humanitarian Law. An important ICRC continued to raise its yearly budget to the productive health and on implementation re- step was the adoption of the Movement-wide amount of 1.7 billion. The ten main ICRC opera- search. SRC was a contributing and sponsoring Principles of Resource Mobilization. Their objec- tions in 2017 were Syria, Iraq, South Sudan, Nigeria, NGO of the MMS Symposium on non-communi- tive is to jointly maximize the income of the Somalia, Afghanistan, Yemen, Democratic cable diseases (NCDs), where results from Bela- Movement, mainly through strengthening the Republic of Congo, Ukraine, and Israel and the rus and the integrated care model in the SRC fundraising expertise and capacities of the NS. To Occupied Territories. In 2017, the SRC started an ageing programmes were presented. Further- do so, the resolution also includes the creation of integrated partnership with ICRC in South Sudan more, the SRC projects contributed several arti- a virtual Fundraising Hub and a fundraising in- where SRC seconds staff and supports the plan- cles to the MMS bulletin (see annex 6). vestment mechanism to provide seed funding to ning and implementation of an integrated NS. project in northern South Sudan. The SRC is an active member of the Swiss Malaria Group, a consortium of research insti- Under the IFRC Secretary General As Sy, the Sec- tutes, pharmaceutical industries and NGOs sen- retariat started the zero tolerance culture to- sitizing the local public and advocating for Swiss wards fraud and corruption in mid-2014. The engagement in malaria prevention and elimina- Office of Internal Audit and Investigation tion. (OIAI) was created in 2015 reporting directly to the Secretary General and under oversight of the The SRC played an active role in the Swiss NGO independent Audit and Risk Committee. The DRR Platform, where it is represented in the OIAI has three functions: internal audits (risk- steering committee and in the core group. Mem- based and published on the website), investiga- ber organisations and a wider community of tions, and coordination of external audits. The practice, including the SDC, participated in the OIAI is very successful – which is a highly ambiv- annual Face-to-Face Workshop on ecosys- alent statement – in discovering fraud and cor- tem-based DRR and five learning events. An ruption, trying to recover money from deceivers E-Learning Course on DRR and Climate Change and insurance whenever possible. For the future, Adaption (CCA) was released on the Platform,s

12 website, comprising the basics including practical examples in five modules. Together with the Centre for Development and Environment (CDE) of the University of Berne, the Platform published the book “Where people and their land are safer”, containing a collection of good practices in DRR and illustrating important linkages between DRR and sustainable land management. The Platform participated at the Global Platform DRR in Mexico as an active member of the Swiss delegation. The Platform also pursued its policy dialogue, contributing to the Swiss DRR working group and its consultative group, maintaining its dialogue with Swiss Solidarity and working at the global level through the Global Network of Civil Society Organisations for Disas- ter Reduction.

During the final year of the SDC supported phase SRC chaired the Swiss NGO Water and Sanita- tion Consortium and led the discussion on future opportunities for the Consortium and its members. The steering board decided to continue the efforts of common exchange and knowledge management and prepared the phase 2018 of the consortium without SDC support. At the beginning of 2018 and after the SDC mandated evaluation of the consortium will be completed, discussion among the partners and with SDC will try to explore future possibilities of cooperation and co-financing mechanisms for water, hygiene, sanitation and family garden irrigation. The SRC has been re-elected to chair the Consortium in 2018.

SRC remains a member of Swiss Water Partner- ship. While the partnership has less direct profit for the benefit of the projects, it provides a good platform of exchange among government, aca- demia, business and civil society.

The SRC is a partner organisation of Alliance Sud. Migration was an important topic discussed during 2017. The member and partner organisations agreed to develop a common concept on migration. The NGO Platform, hosted by Alli- ance Sud, participated in the core learning partnership (CLP) of the external evaluation of the SDC Institutional Partnerships. SRC played a key role in the group of six NGOs in the CLP.

As a member of the Swiss Platform for Peace- building KOFF, SRC regularly takes an active part in the KOFF intervision group and the roundta- bles. In 2017, the thematic focuses on psychosocial support and on the shrinking space for civil society organizations were of particular interest for SRC.

The Swiss commitment to the development and implementation of the Agenda 2030 and the continuous dialog between Swiss administration and civil society organizations on this issue were at the origin of the foundation of the Swiss Civil Society platform of the Agenda 2030, in which SRC is actively involved.

13 People in South Sudan suffer from a severe drought and a violent conflict. In collaboration with the ICRC and the local Red Cross,14 the Swiss Red Cross responds to the hunger crisis. In some areas, food aid by air is the only way to help. © Danish Red Cross, Jakob Dall 2. Global context

The Sustainable Development Goals report 2017 decline in health status and health-service cover- would be living in the 49 most hazard-prone of the United Nations states that “the pace of age among poor populations is part of the cause countries. In order to achieve the SDG 13 mitigat- progress observed in previous years is insufficient (Gwatkin 2018). Gaps in service coverage remain ing climate change and its impacts will require to fully meet the Sustainable Development largest in the poorest quintile, which reinforces building on the momentum achieved by the Goals (SDGs) and targets by 2030. Moreover, (…) the importance of structuring health services so Paris Agreement on Climate Change. As of 7 June advancements have been uneven across regions, that no one is left behind. 2017, 148 Parties had ratified the Paris Agree- between the sexes, and among people of differ- ment and 142 communicated their nationally ent ages, wealth and locales, including urban Health research and development is vital not determined contributions (NDCs) to the UN and rural dwellers. Faster and more inclusive just in ensuring the availability of appropriate Framework Convention. However, this positive progress is needed to accomplish the bold vision health technologies but also in ensuring access dynamic is suffering a setback with new US ad- articulated in the 2030 Agenda” (United Nations by all affected populations. Ensuring access to ministration. Stronger efforts are also needed to 2018). This statement also has to be seen in the health technologies is key for the protection and build resilience and limit climate-related hazards light of continued lack of basic data along with promotion of health. However, despite improve- and natural disasters. Many countries have be- weak statistical systems, which remains a major ments in recent decades, innovation for new gun implementing national and local disaster obstacle to monitor progress in the SDGs. By the products remains focused away from the health risk reduction strategies. However, important end of 2017, there were no data for about two- needs of those living in the poorest countries. For efforts still have to be done at community level. thirds of the 232 SDG indicators, and 88 indica- example, as little as 1% of all funding for health tors have neither an agreed methodology nor research and development is allocated to dis- Fragile and conflict affected contextscontinue data for measuring them. Statistical capacity still eases that are predominantly incident in devel- to represent around 80 per cent of the world,s needs strengthening and data literacy must be oping countries, such as Malaria, Tuberculosis humanitarian caseload and many face recurrent enhanced at all levels of decision-making. and Neglected Tropical Diseases, despite these cycles of conflict and poverty. This is com- diseases accounting for more than 12.5% of the pounded by the increasing incidence of complex The 2030 Agenda provides a real opportunity global burden of diseases (WHO 2017). emergencies involving armed conflicts, state col- to place health in all domains of policy-making, lapse, inter-communal violence, food insecurity, to break down barriers and build new partner- Currently, more than 2 billion people are affected disease outbreaks and natural disasters. Tar- ships, and to bring coherence to policies and by water stress, which still will increase with geted obstruction and attacks on aid workers in actions. Among the many examples of key syner- population growth and the effects of climate conflict contexts are on the rise. Access to af- gies that characterize the SDGs, health stands on change. Achieving universal access to drinking fected populations remains a critical challenge in common ground with social inclusion and pov- water, sanitation and hygiene and ensuring that many countries particularly in Africa and the erty alleviation, and efforts to move towards uni- services are safely managed (SDG 6) remain ma- Middle East. Complex emergencies, recurrent versal health coverage (UHC) contribute directly jor challenges, and meeting them is crucial to disasters and protracted crises, such as in Syria, to public security. In addition, ending hunger further progress in health, education and pov- South Sudan or Somalia, present the challenge and achieving food security and improved food erty eradication. for the international aid community to develop safety and nutrition (SDG 2) are vital for health new tools and programming approaches to mit- and development, while the provision of clean Over the last 10 years, disasters and crises have igate increasingly acute and chronic vulnerability water and sanitation (SDG 6) could substantially left 0.7 million people dead, over 1.7 billion peo- and to strengthen capacities to respond in these reduce the hundreds of thousands of deaths ple affected and caused more than 1.4 trillion US challenging contexts. It also requires substan- each year caused by diarrheal diseases. Thus, in Dollar of damage. Economic losses from disas- tially more efforts to prevent such crises from the SDG framework, health both contributes to ters such as flooding, earthquakes, tsunamis and even arising. For the ending of such humanitar- and benefits from all the other goals. cyclones are now reaching an average of 250 to ian crisis, however, political solutions are needed 300 billion US Dollar each year (IFRC 2017). as a basic prerequisite. Target 3.8 on UHC lies at the center of SDG 3 on Floods continue to affect more people globally health, including full access to and cover-age of than any other type of disaster. Climate change Global hunger and food insecurity are persis- health services, with financial risk protection, de- is increasing the intensity, frequency and uncer- tent, with the United Nations Food and Agricul- livered via equitable and resilient health systems. tainty of weather-related hazards, shocks and ture Organization (FAO) estimating that about The health-related targets of the SDGs cannot be stresses. At the same time, climate change is ex- 815 million people in the world, or one in nine, met without making substantial progress on acerbating or increasing vulnerability to different suffered from chronic undernourishment in UHC. However, unless health interventions are hazards, especially when combined with other 2016; 60 per cent of them are women. The 2017 designed to promote equity, efforts to attain drivers of risk such as urbanization, conflict and report on State of Food security and nutrition in UHC may lead to improvements in the national migration. Evidence indicates that the risk expo- the World indicates that in 2016 “food security average of service coverage while inequalities sure of persons and assets in all countries has situation has worsened in particular in parts of worsen at the same time. Recent studies have increased faster than vulnerability has decreased, sub-Saharan Africa, South-Eastern Asia and indicated that overall, health inequalities have thus generating new risks and a steady rise in Western Asia, and deteriorations have been ob- been decreasing in terms of reproductive, mater- disasters losses with a significant economic, so- served most notably in situations of conflict and nal and child health intervention coverage, and cial, health, cultural and environmental impact, conflict combined with droughts or floods” (FAO child mortality. However, inequalities have been especially at the local and community level, in 2017). In June 2017, 37 countries were reported growing in a small but substantial proportion of both urban and rural contexts. By 2030, it is esti- to require external assistance for food, out of countries, and in many of these countries, a mated that up to 325 million of the world,s poor which 29 were in Africa. Four countries

15 (Somalia, South Sudan, Yemen, and Northern of large numbers of migrants and refugees to response programs and massively underfunded Nigeria) were on the brink of famine, with over Europe was at times met with anti-migrant rhet- forgotten crises. It also limits the flexibility of hu- 20 million people facing critical levels of food oric in the political discourse, policies and media. manitarian actors to react to emerging crises and insecurity. Multiple forms of malnutrition coex- The persistence of negative perceptions towards exacerbates their reporting burden. In the light ist, with countries experiencing simultaneously migration has created challenges for govern- of rising populism, an intensifying public debate high rates of child undernutrition, anemia ments, efforts to promote integration. Yet, fore- on the shaping of development cooperation and among women and adult obesity. Rising rates of cast labour and skill shortages in the short to international solidarity takes place in most West- overweight and obesity add to these concerns. medium term will challenge both employment ern countries, including Switzerland. While Childhood overweight and obesity are increas- and economic growth prospects for the EU. Official Development Assistance (ODA) means ing in most regions and in all regions for adults. of OECD countries are diminishing worldwide, In 2016, 41 million children under five years of Changes in financing and the strengthening of the Swiss Parliament at least narrowly rejected age were overweight. quality and accountability initiatives in the hu- further budget cuts on development coopera- manitarian sector have been given new impetus tion. Yet, future budget cuts or reallocation of International migration has become an integral through the 2016 World Humanitarian Summit,s funds to humanitarian aid and in favor of migra- part of national economies and societies. Grand Bargain. However, the implementation tion programs are to be feared. There is also a risk Well-managed migration brings important ben- of the Grand Bargain also shows significant chal- that, at the political level, the private sector,s efits to countries of origin and destination, as lenges: Commitments to greater transparency contributions to a public-private development well as to migrants and their families. But when and better data standards sit uneasily with calls partnership will be considered as substitute for it is badly managed, humanitarian concerns for simplified reporting. Increased cash-based diminishing ODA contributions. arise. Out of the approximately 244 million mi- assistance lies in tension with the commitment grants in the world, not all are vulnerable. How- to direct funding to local organisations. And ef- A baseline assessment and gap analysis of Swiss ever, in recent years, a significant increase in forts towards the 25 per cent funding target for implementation of the Agenda 2030 allowed displacement, both internal and across borders, local organisations are at odds with commit- the identification of policy coherence issues and took place, which has largely stemmed from civil ments on un-earmarked funds. The Grand Bar- facilitated the dialogue with stakeholders from and transnational conflict, including acts of vio- gain,s most difficult challenge probably is its lack the civil society, science and the private sector. lent extremism outside actual war zones. Current of political pragmatism. What seemed possible This process and the first Voluntary National data of the International Organisation for Migra- on paper has become more difficult to put into Review, to be submitted at the 2018 High Level tion (IOM) indicate that in 2016 there were 40.3 practice. Signatories are becoming more risk Forum at the UN Economic and Social Council, million internally displaced persons (IDPs) world- averse as they attend to domestic pressures and hopefully also will promote the high relevance of wide and 22.5 million refugees (IOM 2017). The say they are not in a position to fund local organ- the Agenda 2030 up to the level of the Federal fastest-growing refugee population was spurred isations directly. The need to demonstrate results Council. by the protracted crisis in South Sudan. This to parliaments and taxpayers is also driving de- group grew to over 1.4 million. Since late August mand for more earmarking and demonstration 2017, more than half a million Rohingya refu- of results, which again is at odds with the com- gees had fled from Myanmar to Bangladesh, mitment to reduce the reporting burden. adding further to the world,s displaced population. The ongoing conflict in the Syrian Arab Re- The increase in local procurement through the public saw the number of refugees from that localization agenda and the shift in resources country reach approximately 5.5 million. In 2016, from international to national actors as agreed for the third consecutive year, Turkey was the on in the Great Bargain will have an effect on the largest host country in the world, with 2.9 million capacity and expertise of international aid agen- refugees, mainly Syrians (2.8 million). At the end cies. For instance, cash transfer programming, of 2016, there were 31.1 million new internal instead of in-kind assistance, has the transform- displacements in 125 countries, triggered by dis- ative potential to allow technology and partner- asters and conflicts. When new displacement by ships with the private sector to deliver aid in new conflict and violence is measured as a proportion and more efficient and effective ways. Yet, while of the population, the Syrian Arab Republic re- this approach can empower disaster-affected emerges at the top (with 4,400 displacements people, the use of cash transfers alone to meet per 100,000 inhabitants), followed by El Salvador specific technical needs moves significant poten- (3,600 per 100,000 inhabitants). El Salvador has tial risks almost entirely onto recipients. Without consistently been one of the most violent coun- associated support to manage this risk, such as tries in the last decade; however, the internal the transfer of skills, technical assistance or an displacement stemming from criminal and gang appropriate regulatory and approval environ- violence in that country is largely invisible. ment, recipients of such cash assistance can be left with unmet needs or increased vulnerabili- Migration issues have remained high on the Eu- ties. ropean agenda in 2017 and have regularly been tackled in ministerial and heads of State or gov- Armed conflicts, fragile contexts and higher risks ernment meetings. In 2016, nearly 390,000 peo- of climate change and natural disasters consid- ple arrived in Europe through the Mediterra- erably increase the need for humanitarian aid. nean region by both land and sea. The Central The funding capacity of the international com- Mediterranean route from Libya to Malta and munity to meet these needs lags far behind: In Italy was by far the deadliest route for irregular 2017, only 49 per cent of the needed resources migrants in the world, with estimates of over of 24.1 billion US Dollars was covered. The trend 4,500 fatalities and missing migrants – the larg- towards more earmarked funding reinforces a est number ever reported in the region. Arrivals widening disparity between some well-funded

16 17 SRC programme countries 2017

Belarus

Moldova

Bosnia Armenia Kyrgyzstan

Lebanon Pakistan Nepal Bhutan Bangladesh Laos Mali Sudan Honduras Haiti Vietnam El Salvador Cambodia Togo South Ethiopia Ghana Sudan Ecuador

Malawi Bolivia

Paraguay

18 3. Programme results 2017

In 2017, SRC implemented 111 health and disaster The programme reached 4.6 million beneficiaries, risk management projects and contributions in 38 of which 41 per cent in Asia, 39 per cent in Africa, countries. 26 countries are considered programme 12 per cent in Europe, and 8 per cent in Latin countries where SRC is present with a delega- America, see the detailed programme statistics in tion office and a mid- to long-term term country annex1. The number of beneficiaries decreased strategy. The map on page 18 shows that SRC com- substantially from 11.6 million in 2016 due to the bined long-term development cooperation with completion of an SDC mandate in Kyrgyzstan which temporary emergency relief operations in 20 out of had reached a population of more than 6 million. 26 countries. Linking relief, recovery/rehabilitation and development is a distinctive cooperation ap- This chapter reports the results and lessons learnt in proach of SRC,s, particularly in fragile contexts and 2017 by the SRC in respect of its thematic priorities disaster-prone countries. in health (reproductive health, nutrition, disease control, WASH, ageing and health, blood safety, eye care) and the phases of its Disaster Risk Man- agement (DRM) work (emergency response, recovery, Disaster Risk Reduction (DRR) and institutional preparedness).

The SRC monitoring methodology In order to keep track on results and progress across the inter- Outcome indicators (SOCI) measure the change effect of the national programme, SRC uses 53 standard output indicators services and interventions delivered by the project. In most of and 27 selected outcome indicators (SOCI) covering the the cases, SOCI are indicators related to coverage: they meas- health and DRM thematic priorities. Both output indicators ure what proportion of a target population fulfills a particular and SOCI are project-level indicators. In its annual reporting quality criteria defined by the indicator, for example the per- 2017, every country delegation provided standard output centage of households using and maintaining an improved data through a Microsoft Sharepoint-based online tool, and latrine, or the percentage of villages covered by a functional outcome data through an SRC monitoring platform using emergency committee. The SOCI are aligned to the SDG indi- KoboToolbox. cators (see annex 1). Out of the thematic indicator toolboxes, developed according to the SRC impact model, each country The standard output indicators measure the number of ben- programme started in 2017 measuring properly minimum eficiaries reached through project interventions. The standard two outcome indicators, selected according to the thematic output indicators include direct and indirect beneficiaries, priorities of each programme. Results 2017 are visualized and defined as people who thanks to the SRC project received any discussed in the thematic chapters as in the country summa- kind of service during the reporting year. Direct refers to a spe- ries. In most cases these figures are baseline data, as the pro- cific delivery point and time, when the beneficiary receives the jects started in 2017. The number of selected outcome indica- service. Indirect means that the service is not provided by the tors used and measured on a yearly basis shall increase. In project, but by intermediaries, such as volunteers, community order to improve the systematic and comprehensive outcome workers and committees who act as multipliers. Thus, num- monitoring, covering all projects and all thematic priorities, bers of indirect beneficiaries are approximations only, as the this process will be further strengthened through ongoing project cannot verify the exact number of recipients of the training and development of adequate tools for data collec- service. The term service can include information dissemi- tion and analysis at outcome level. nated face-to-face for the purpose of education, awareness raising, etc. Information disseminated through media such as radio, TV, the Internet or the press are excluded from the SRC beneficiary count. A beneficiary can receive services in more than one thematic domain, for example a health promotion message and a food package from the same project. To determine the total number of beneficiaries, double counting must be taken into consideration to avoid summing up the wrong figures and over-report beneficiary numbers.

19 Health

The SRC health programmes address both the de- ing contributed to substantially improved access to mand and the supply side of health systems. On the essential health services, for example a 27 per cent one hand, SRC supports communities with their increase of family planning consultations and a 21 volunteers doing health education and health proper cent increase of Syphilis and HIV tests. Thanks motion, aiming at behaviour change and improved to SRC investments in health systems, the user sat- access to service providers. On the other hand, SRC isfaction rate in Nepal increased from 48 per cent to health programmes support health systems to 96 per cent in 2017. meet the needs of the population and to improve the quality of care. To improve service quality, projects in Laos, Bangla- desh, Nepal and Pakistan have introduced supervi- In 2017, the SRC health programme reached sion checklists for local authorities and governmen- 4.1 million beneficiaries. The number dropped tal supervisors, to assess and build capacity in qual- from 10.8 million in 2016 due to the completion of ity of care. All four countries still lobby to introduce the national “Community Action for Health” pro- the checklist as a standard into the health system to gramme in Kyrgyzstan. This project had an exten- enable regular monitoring and supervision activities sive reach of 6 million beneficiaries and involved as stipulated in the national health policies. SRC cre- almost 2,000 village health committees. ated a Community of Practice in Reproductive Health in Asia that promoted the successful replication of In the reporting year, volunteers, community the Laos supervision model to Pakistan. In Bangla- health workers and health committees contin- desh, the supervisory visits carried out by govern- ued the important work of health education and ment staff increased from 25 per cent at baseline to health promotion through house-to house visits, 62 per cent in 2017. This project further propelled theatre and radio emissions, in mothers clubs, com- the establishment of systematic referral mechanisms munity committees, schools and songs, to raise and guidelines among all levels of health facilities. A knowledge and awareness on all aspects of health functional referral system was also developed in the behaviour and care. Pakistan health project. Out of 110 pregnant women referred, 104 arrived at the referral secondary facility With the aim to be better prepared in case of ob- (95 per cent) and 100 cases (77 per cent) received stetric emergencies, communities and mothers a follow up through back-referral to the respective groups have established emergency referral funds primary health facility. and transportation systems in Nepal, Pakistan, Honduras and Ghana. In Nepal for example, Good health information systems and social pro- mother groups saved almost 25,000 Swiss Francs tection measures are other key elements of a in an emergency referral fund, which allowed well-functioning health system. In Bolivia, by the 451 women a safe delivery. In Honduras, commit- end of 2017, all health facilities in the project area tees increased the provided seed capital by up to were equipped with computers and software for three times. In Ghana, 221 patients were referred the development of the health information sys- to health facilities by means of community-funded tem. The maternal and child health project in Laos tricycle ambulances. had a strong impact on the quality of health data entry at district level and the data analysis at na- Building on its important community work, SRC is tional level. The SRC project in Laos also made an also engaged in strengthening the health care outstanding contribution to the development of system. SRC projects supported the construction the national health insurance system, which served and renovation of public health infrastructure in 71 per cent of the population in 2017, and under Nepal, Bangladesh, Pakistan, Laos, Paraguay, Bo- which the entire population will be covered as livia, South Sudan and Egypt, including equipment from 2018. The SRC project in the region of Sekong and staffing. In 2017, SRC contributed to health in- showed that health insurance in Laos can lead to a frastructure for refugees in Bangladesh Cox Bazaar massive growth of health utilization by the poor. for the Rohingyas and for Syrian refugees in Greater Health facility utilization in Sekong was up to five Cairo in Egypt. In Paraguay, SRC health strengthen- times higher than the national average.

20 Number of beneficiaries in health

2016 2017

Total Health 10,769,097 4,145,800

Primary health care services 1,899,799 1,499,786

Health promotion 7,412,301 698,283*

Social health protection 120,598 418,442

Community Health Workers trained 6,141 8,435

Health groups supported 3,839 1,978

* excluding health promotion in WASH projects

21 Reproductive health

Monitoring of selected outcome indicators As from 2017, the SRC monitors the following outcome indicators. SRC programme countries provide projectbased indicator data in accordance to their thematic priorities (see details on methods in chapter 3 above). Note that projects have different durations so that the year of baselines and targets vary.

RH4: % of births attended by skilled health personnel RH5: % of women having received four or more ante- natal care check-ups during the last pregnancy

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Honduras Laos Luang Prabang Bolivia Ecuador Laos Luang Prabang Laos Sekong Mali Nepal Laos Sekong Malawi Nepal Pakistan Pakistan Contributes to SDG target 3.1: Contributes to SDG target 3.1: By 2030, reduce the global maternal mortality ratio to less By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births than 70 per 100,000 live births

RH6: % of children between 12 – 23 months vaccinated RH7: % of women of reproductive age (15-49 years) using three times for DTP and other additional vaccine any kind of family planning method

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Bolivia Laos Luang Prabang Bolivia Laos Nepal Pakistan Laos Sekong Pakistan Paraguay

Contributes to SDG target 3.2: Contributes to SDG target 3.7: By 2030, end preventable deaths of newborns and children By 2030, ensure universal access to sexual and reproductive under 5 years of age, with all countries aiming to reduce healthcare services, including for family planning, informa- neonatal mortality to at least as low as 12 per 1,000 live tion and education, and the integration of reproductive births and under-5 mortality to at least as low as 25 per health into national strategies and programmes 1,000 live births

22 One of the main risk factors for high maternal per cent within one year. In Laos, an increase from morbidity and mortality is the absence of skilled 16 per cent to 47 per cent was achieved since 2014. health personnel during the delivery. SRC projects A knowledge, attitudes and practice survey showed in reproductive health therefore put a special fo- a strong relation between the number of ANC visits cus on promoting safe deliveries. As diagram RH4 and an institutional delivery. In Pakistans Manoor shows, the proportion of deliveries attended by valley, only 19 per cent pregnant women reported skilled birth personnel is on the rise in most of the access to ANC, up from 9 per cent at baseline. Even SRC projects. though the health infrastructure has improved, their utilization is still lagging behind, mainly be- In Laos, safe deliveries by skilled birth attend- cause of lack of knowledge and cultural barriers. In ants have increased mainly due the project,s focus a survey, people stated to use the health facilities on training and supportive supervision of commu- for medicines (58 per cent) and treatment (49 per nity midwives. From 2014 to 2017, the number of cent), followed by services for children, but least for community midwives tripled, and their levels of pregnant women (10 per cent ANC, 8 per cent de- knowledge and practical skills improved from 43 livery; family planning 6 per cent). per cent to 84 per cent. Even though progress has been remarkable, unattended home deliveries pre- Surveys in Bolivia, Ecuador and Malawi were carried vail in many project areas, including Laos and Nepal. out in 2017, showing that 90 per cent, 40 per cent In Mali, the situation is alarming with more than 90 and 13 per cent of pregnant women received four per cent of the deliveries not attended by a health or more ANC visits during their last pregnancy. Fac- worker. tors of success and barriers to the uptake of ANC need to be carefully assessed and addressed in each In order to increase access to health care in the country to meet the standards as per WHO guide- war-affected region of Maiwut, South Sudan, lines. SRC has started collaboration with the ICRC, and seconded a health delegate to support the activi- In Ghana, mother club members carried out 4,285 ties around primary health care. Intensified conflicts household visits. There has been a more than three- hampered project implementation. Nevertheless, fold increase of visits to pregnant women in the health staff was trained, health facilities equipped same area. 57 per cent of the pregnant mothers and the health centres were able to carry out 14,724 who delivered at the health facilities were referred patient consultations, 1,566 antenatal care consul- and escorted by mother club members and 1,322 tations, and 3,618 vaccinations of children under mothers received post-natal visits from mother club the age of five. The permanent presence of a mo- members. 95 per cent of the PNC visits took place bile midwife and an SRC health delegate allowed within the first seven days of life. Of significant confor greater community outreach services and concern was the increase in infected cords. With inten- tributed to a significant improvement in training sive education on cord care by mother club mem- of traditional birth attendants. The ICRC maternity bers during home visits, community gatherings and department operated 24 hours seven days a week on radio discussion, no cord infection was reported and was staffed at all hours. Despite these efforts, towards the end of the year. more than 95 per cent of the deliveries in the area still take place at home. SRC has stepped up its health interventions for children. In 2017, the SRC programme reached 30 The promotion of antenatal care (ANC) and post- per cent more children than in 2016. As diagram natal care (PNC) in the communities has been a RH6 shows, vaccination rates on diphtheria, pertus- central intervention in all SRC maternal and child sis and tetanus (DPT3) in children between 12–23 health projects. SRC monitors the proportion of months of age have increased in Laos and Pakistan pregnant women attending at least four ANC visits, from baseline. In Bolivia vaccination rate stands at as recommended by the World Health Organisation 68 per cent in 2017. Social mobilization by volun- (WHO). Diagram RH5 shows that ANC coverage in teers and community health workers had a positive Bangladesh has increased from 17 per cent to 59 impact. In Malawi, SRC supported two major child

23 access to health services in their communities has increased from 38 per cent to 71 per cent. Young people were trained as peer trainers on topics such as sexually transmitted infections, use of condoms, sexual health and rights, and pregnancy prevention methods. In a survey in El Salvador, 110 out of 270 families stated, that they have improved their communication and conflict management skills which allowed them to solve conflicts without violence. In five schools, violent incidents could be reduced by 64 per cent. In the SRC project area in Honduras, thanks to the targeted efforts of SRC and the Hon- duran Red Cross, the percentage of teenage preg- A nurse provides ante-natal care in the Chomphet district of Laos. Thanks to the SRC mater- nancies in the project areas was 13 per cent, which nal health programme in Laos, more women have access to care and safe delivery. © SRC is lower than the national average of 24 per cent. In Ecuador however, despite the project interventions, teenage pregnancy rate remained high, calling for new strategies and intercultural approaches. In Par- health days organized by the Ministry of Health, aguay, a new and innovative element was sexual targeting children aged 6 months to 15 years for education with 4 –9 year old school children, using measles vaccination, bilharzia control, worm pre- methodologies and approaches adapted to their vention, nutrition assessment, vitamin supple- age. ments and admission of malnourished children for therapeutic feeding. In order to further tackle child Sexual and Gender Based Violence is a huge prob- health issues and malnutrition in Laos, the project lem in many SRC programme countries, for example launched an initiative to investigate different per- in South Sudan, Ecuador, Bolivia and Honduras. Red formance mechanisms for village health workers. Cross staff and volunteers received training regard- The results are expected in 2018 and will inform ing rape, forced marriage and sexual harassment the future of the SRC health programme in Laos. and on root causes of gender based violence. Vol- unteers were trained in psychosocial first aid, and In five countries, SRC directly addresses improved health staff were trained in counselling and how to family planning, as shown in diagram RH7. In Pa- properly care for rape victims. At community level kistan, an increase in the uptake of family planning in South Sudan, awareness sessions on early and methods from 28 per cent to 35 per cent was re- forced marriage as well as HIV/AIDS were carried corded within one year. In the traditional environ- out. A more open discussion has started around ment of rural Pakistan, family planning counselling these topics which is a novelty as they are heavily is addressing specially married couples after they stigmatised. had their first child. A baseline study in Paraguay showed mixed results with a good level of knowl- In order to support victims of violence in Hondu- edge but little behaviour change. Yet, large knowl- ras, awareness raising campaigns on the availability edge gaps in the domain of sexual and reproductive of psychosocial support were conducted, resulting health prevail, particularly in young women, as an in an increased demand for psychosocial and men- SRC supported survey showed. tal health support in the urban health project. The project successfully negotiated with the college of SRC and partners in Ecuador, Paraguay, Honduras psychologists of Honduras to provide psychosocial and El Salvador were particularly active in creating care services in two urban health facilities. These awareness about reproductive health and rights facilities have increased their compliances to qual- among adolescents, tackling the high teenage ity standards from 24 per cent at the beginning to pregnancy rates in their respective countries. By the 70 per cent at the end of the project. Beneficiary end of 2017, the number of adolescents who had satisfaction remained high in both health facilities

24 (65 per cent and 72 per cent). Also, in two projects in South Sudan, child friendly spaces were established, where children and youth are relieved from their traumatic experience they faced.

Number of beneficiaries in maternal and child health

2016 2017

Maternal health: deliveries 8,367 11,762

Maternal health: ante-natal care n/a 20,206

Child health 196,468 269,429

Lessons learnt ––Community-based preparation and referral ––Policy influence is gradually increasing, particu- mechanisms, such as safe motherhood revolv- larly in those projects that have been doing ing funds and local transportation schemes, health system strengthening for some time. have essentially contributed to augment insti- Influence in social health protection, health in- tutional deliveries. formation management systems and quality of ––Volunteers and health committees are an im- care have been observed. portant link between the community and the ––Combining health with disaster risk reduction health system. Projects must ensure that health and WASH projects has increased in the past staff acknowledges their complementary role year, leveraging better impact and benefitting and do not perceive them as a threat. from good reputation and demand in the com- ––SRC can have an impact on the quality of health munity. care services under the condition that the SRC ––Using multiple channels and being innovative and its partners work hand in hand with the in health promotion is likely to have more and public health care system and the local health a quicker impact on behaviour change. authorities. SRC and partners are perceived as ––Working with multiple stakeholders leverages important players in health by the government the impact on health outcomes, as seen in Hon- authorities in South Sudan, Bangladesh, Nepal, duras. Laos, and Pakistan.

25 Nutrition

NU2: % of children from 0–59 months of age who receive NU3: % of infants < 6 months of age received only breast foods from 4 or more food groups on the previous day milk on the previous day

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Bolivia South Sudan Haiti Pakistan South Sudan Togo

Contribute to the following SDG targets: 2.2: By 2030, end all forms of malnutrition, including achiev- 3.2: By 2030, end preventable deaths of newborns and chil- ing, by 2025, the internationally agreed targets on stunting dren under 5 years of age, with all countries aiming to reduce and wasting in children under 5 years of age, and address neonatal mortality to at least as low as 12 per 1,000 live births the nutritional needs of adolescent girls, pregnant and lac- and under-5 mortality to at least as low as 25 per 1,000 live tating women and older persons births

In communities, mother clubs are important vehi- to an increase of exclusive breastfeeding in Togo, cles to disseminate nutrition information and to ad- Laos and Bangladesh. The proportion of infants be- dress malnutrition in SRC projects in Togo, South Su- low 5 months of age that are exclusively breastfed dan and Nepal. Members of the mother clubs and increased in two urban slums in Bangladesh from community health workers sensitize communities 41 per cent to 63 per cent and from 44 per cent on breastfeeding, hand washing, complementary to 89 per cent. The awareness raising campaigns feeding, kitchen gardens, prevention of diarrhea, and the regular health sessions, carried out by the malaria and pneumonia, vaccination, antenatal and health volunteers, might have contributed to this postnatal care as well as growth monitoring. In Bo- positive development. In Sekong province of Laos, livia, 63 per cent of the surveyed children receive a exclusive breastfeeding has stagnated at around 84 balanced diet, whilst the data from South Sudan re- per cent for the last three years. flect the catastrophic state of nutrition, see diagram NU2. As diagram NU3 shows, exclusive breastfeed- SRC projects in Bolivia, Laos, Haiti and Malawi pro- ing rates and practices vary extremely among coun- mote growth monitoring as an important inter- tries. Whilst in Togo the exclusively breastfeeding vention to detect child malnutrition. In Malawi rate is above 70 per cent, in South Sudan, Haiti and alone, more than 16,500 children were monitored Pakistan rates are lower than 35 per cent. A thor- for their growth and, if malnourished, referred for ough understanding of cultural practices and be- therapeutic feeding. While in Bolivia 63 per cent liefs, as well as economic reasons have contributed of children appear for regular growth monitoring,

26 data from Laos are less promising with only 38 per cent in Luang Prabang and an equally low and declining uptake on growth monitoring of young children in Sekong. It appears that the process of growth monitoring has not been institutionalized as part of the regular routine child care assessment. The same applies for the health project in Pakistan, where growth monitoring has been largely neglected despite pertinent advice to take this up.

In Haiti, the health and nutrition project tackles various dimensions that address malnutrition in an integrated approach. Almost 15,000 people were reached during the year through large sensitization Through the Bangladesh Red Crescent Society, the SRC supported food aid for the Rohingya refugees. © SRC campaigns, cooking demonstrations, kitchen gardening set-ups and cultural activities. Families are replicating, harvesting and storing seeds for the establishment of small family nurseries that are used in setting up new gardens. This participative approach In East Africa, seven million children suffer hunger has led to a strong ownership and so far 57 repli- and malnutrition due to the devastating drought. cations have been observed. Similar activities were SRC responded with nutrition in emergency in- carried out in Manoor valley in Pakistan where 64 terventions in Somaliland, where SRC supports an men and 85 women were trained in crop diversifica- IFRC project, and in South Sudan in collaboration tion and kitchen gardening. The focus remained on with the ICRC. In Ethiopia, 472 volunteers were sowing methods and diseases treatment for maize trained in malnutrition screening, referral and fol- crop and vegetables of tomato, chili, cucumber and low-up of severely malnourished children as well potato. as hygiene and health promotion to reduce water- borne diseases. After the training, volunteers visited For improved nutrition in schools, the Malawi and and assessed 10,247 households reaching more Swiss Red Cross supported 13 pre- and primary than 60,000 people. Through the household visits, schools in Salima district through an eight month the volunteers identified 2,643 malnourished chil- school feeding program, in order to reduce acute dren under the age of five and 319 pregnant and malnutrition in the target area, and to mitigate the lactating mothers in need of supplementary food, effects of food insecurity among the most vulnera- who subsequently received blended cereal, soya, ble people affected by the drought. The initial target beans and oil during 3 months and an additional of students was exceeded by 20 per cent, reaching 75 kg of maize to support other family members. in total almost 12,000. Ten permanent kitchen and To avoid further nutritional and economic deterio- kitchen shelters were constructed and equipped ration after the drought, 115,478 livestock received with utensils and hand washing facilities. Vegetable veterinary medicines and 15 community animal gardens have been set up at nine primary schools workers were trained. and two community based child care centers. More than 70 per cent of the target schools produced Families affected by other disasters, such as the hail their own food. Nutrition is also a focus in SRC school storm in Paraguay and the floods in Bangladesh re- WASH projects, for example in Nepal, Togo and Laos ceived food packages or cash grants and seeds (see section WASH below). A knowledge, attitude to restart farming. Cash distributions were also and practice (KAP) survey in secondary schools in the done in Bosnia-Herzegovina to support vulnera- SRC project area in Laos showed that 15 per cent of ble people over the harsh winter time. Active age- the students eat food from the school garden. Only ing self-help groups also implemented small food 16 per cent reported that they ate four or more food projects for the most vulnerable. Poor and elderly groups the previous day. clients of two home care centres in Armenia were

27 assisted over the winter months with food support next to the medical and social care services. The SRC,s “Twice Christmas” campaign funded soup kitchens in Moldova over the harsh winter time. In Kyrgyzstan, about 900 older people in need were assisted with food products during the reporting period. This was possible due to new and intensified local fundraising initiatives.

Number of nutrition beneficiaries

2016 2017

Nutrition 76,278 94,918

Lessons learnt ––In comparison to the previous year, nutrition ––Taking time to unpack cultural traditions and has gained in importance and attention within beliefs around breastfeeding prove beneficial the SRC health programmes. Potential for nu- for targeted interventions and increasing trition-sensitive programming remains in the breast-feeding rate. Sharing country experi- health programmes in Asia and Africa. ences as well as innovation should be further ––Volunteers continue to be a strong and impor- fostered. tant driver of nutrition in the community. How- –– Engaging volunteers for growth monitoring at ever, motivating and retaining them is a chal- the health facilities is not yet well established. lenge, particularly in extremely resource poor A better link between the health system and settings. community health structures (such as the RCRC volunteers) would be beneficial.

28 Disease control

The National Red Cross and Red Crescent Societies at project start to 24 per cent at the end of 2017. and their volunteers continued to be strong actors Cleaning the banks of the capital city,s local river in the fight against communicable diseases, par- was the first public campaign and small project of ticularly in epidemic control. During the cholera the newly founded Bhutanese Red Cross. Despite outbreak in Ghana, sensitization through social the relatively limited impact on the environment, mobilization and mass communication reached this event mobilised the first Red Cross volunteers more than 400,000 people, and 1,600 cholera cases and gained publicity for the new organisation. were identified and referred to the nearest health facilities. In South Sudan, volunteers were trained In Togo, the Red Cross volunteers are recognised on cholera prevention. A stock of preparedness community health workers under the Integrated items was prepositioned, such as water purifica- Community Case Management policy of the Min- tion tablets, hygiene kits and oral rehydration salt, istry of Health. For malaria detection, a baseline ready for use in the case of an epidemic. In addition, study revealed that in the project area, 90 per cent cleaning campaigns were conducted with the re- of the children tested positive were treated by a sult that cholera outbreak at market places could community health worker. On the other hand, only be avoided. 44 per cent of the children suffering from pneumonia were treated by community health workers. In 2017, the infection control project in hospitals in Kyrgyzstan, mandated by SDC, moved into its last Particularly in the African context, prevention, project phase with the aim to develop a sustainable, care and treatment of HIV/AIDS and tubercu- standardized infection control system at national losis (TB) continues to be an important pillar of level. An assessment showed hospital acquired in- the SRC health programmes. In the central region fection in surgical and intensive care units of wor- of Togo, advocacy groups conducted home visits rying 8 per cent, which is three times higher than where they sensitized the household members on officially reported. The study also revealed a low the transmission of HIV and sexually transmitted in- compliance in the rational use of antibiotics and fections (STI), and distributed 18,768 condoms. 389 severe shortages in the microbiological laboratory persons living with HIV/AIDS and 478 orphans and support for infection control. Inquiring women,s vulnerable children received nutrition and school satisfaction with the maternity services, the satisfac- kits. In order to mobilize local actors in Ecuador, tion rate was only 15 per cent. In order to improve members of district health clubs, health promoters the quality of care, standard operating procedures and women leaders were trained on HIV, tuberculo- and instructions on epidemiological surveillance sis and sexually transmitted infections (STI). 18 radio for intensive care units and laboratories were de- spots were developed and broadcasted through lo- veloped and 226 medical specialists trained. cal radios. 120 suspected tuberculosis cases were detected and referred to the nearest hospitals. 35 Volunteers are also the main driving force for en- people living with tuberculosis were counselled vironmental hygiene and vector control against on the importance of adherence to the treatment malaria, dengue and zika in El Salvador, Honduras, protocol. In Nepal, Voluntary HIV Testing and Coun- Togo, Malawi and Bhutan. In El Salvador, 1,486 fam- selling camps were organised and 792 migrants, ilies participated in health campaigns and 1,891 their families and risk population tested for HIV. families were reached through prevention mes- Interactive markets and life-sharing sessions with sages. An assessment showed that 46 per cent of people living with HIV and AIDS (PLHA) reached 73 the families implement at least four healthy meas- communities and 20 schools. Through the collab- ures and practices. In Honduras, even 87 per cent of oration with the national program for the control families adopt at least eight health measures, such of HIV/AIDS in Paraguay, it was possible to provide as vaccination, correct disposal of garbage, safe dis- comprehensive medical and psychosocial care for posal of excreta, treatment of grey water, correct detainees living with HIV/AIDS. In detention places, use of chemical products and others. Consequently, personalized and collective accompaniment space the incidence of diarrhoea among children under was created that allowed PLHAs to maintain good the age of five years has decreased from 53 per cent adherence to treatment and quality of life. Reach-

29 grated community based home care services and through healthy ageing initiatives, see the section below on ageing and health. Due to the closure of the national “Community Action for Health” programme in Kyrgyzstan in March 2017, the number of beneficiaries reached with NCD services declined in 2017. In Nepal, the SRC project carried out diabetes camps, followed by the integration and continuation of diabetes services in six health facilities. 12 health staff were trained in diabetes testing and NCD counselling and referral. However, diabetes is not included in the Government guideline for free treatment of severe non-communicable diseases Growth monitoring among refugees in Bangladesh. Malnutrition combined with infec- for the poor. The new health insurance scheme tious diseases like diarrhoea is a leading cause of child mortality. Growth monitoring provides limited financial support, but geographi- helps identify children at risk. © SRC cal access to treatment is an additional cost barrier.

ing youth and adolescents on HIV prevention and reproductive health issues resulted in an increase of consultations of young people at family planning services. Furthermore, the local partner organization successfully lobbied together with the district health offices for the implementation of a law that guarantees respect, protection and promotion of Human Rights in the treatment of PLHAs.

The SRC country programmes are only gradually addressing the burden of non-communicable diseases (NCDs). Thanks to a continuous dialogue with the regional health authorities, the Belarus Red Cross, experience on healthy life style promotion has been recognized by the government and will be taken over by the local authorities in Grodno Oblast. The endline survey showed that the population covered by the project, in comparison with a control population, practices a healthier lifestyle. Not only people who were directly involved in the community groups for healthy lifestyle, but also people in their immediate vicinity became more physically active: 32 per cent of people were riding a bicycle at least a few times a week versus 19 per cent of the control group; and 71 per cent were going for a walk every day versus 59 per cent. During the project period, 53 per cent reported they switched to healthier diet (versus 42 per cent) and 29 per cent said they lost weight (versus 20 per cent). NCDs are also an integral part of the ageing and health programmes in Belarus, Moldova, Bosnia-Herzegovina, Armenia and Kyrgyzstan, addressed through inte-

30 Number of disease control beneficiaries

2016 2017

NCD services 297,073 25,503

NCD promotion n/a 18,590

Infectious disease control* 422,958 61,182

* As from 2017, the SRC counts direct beneficiaries only, whereas in 2016, beneficiaries reached through radio broadcasts were included.

Lessons learnt ––Volunteers continue to be a strong and impor- ––There is great potential to include NCDs in tant pillar of the Movement, particularly in dis- more SRC health programmes in all continents. ease control and prevention. They reach the Physical activity as an entry-point to NCD con- most vulnerable in remote areas. The IFRC trol in Belarus has proved successful and worth training scheme eCBHFA will address various to replicate in other countries. However, enter- aspects of disease control, but is still under de- ing NCD screening programmes in rural areas velopment. requires a careful assessment about a good ––Integrating preparedness elements and prep- and functional link to continued treatment, ositioning allows quicker reaction during epi- access to drugs and care, as learnt in the case demic outbreaks and should be further ex- of Nepal. panded to countries at high disaster risk.

31 WASH

According to the World Health Organization and tackling WASH in an integrated way combining UNICEF, three in ten people worldwide, or 2.1 bil- traditional and innovative construction work with lion, lack access to safe drinking water at home behavior change activities involving communities, and six in ten, or 4.5 billion, lack safely managed leaders, authorities and partners. In 2017, SRC sanitation facilities in 2017. Billions of people have projects reached a total of 390,829 beneficiaries gained access to basic drinking water and sanita- with water, 170,695 with sanitation, 92,086 with tion services since 2000, but this is not enough to hand washing facilities and 648,308 with hygiene cover the worldwide need and in addition, these promotion interventions. In comparison to 2016, services do not necessarily provide safe water and the global reach of SRC,s WASH interventions has sanitation. Many homes, health care facilities and decreased, especially in hygiene promotion in com- schools still lack soap and water for hand washing. parison with 2016. This is mainly due to the fact that This puts the health of all people, especially young many new project phases started in 2017 where children at risk for diseases such as diarrhea. As a first actions were more dedicated to negotiation result, every year, 361,000 children under the age and baseline studies. of five years die of diarrhea. For this reason SRC is

WH2: % of households using and maintaining clean WH3: % of households using an improved drinking water latrines. source day

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Ethiopia Malawi South Sudan Bangladesh El Salvador Vietnam Sudan Vietnam

32 WH4: % of population using safely managed sanitation WH4school: % of schools using safely managed sanita- facilities tion facilities

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Bangladesh Laos

WH5school: % of schools adopting safe water handling WH6: % of housholds with soap and water at the hand practices washing station commonly used

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Laos Bangladesh Ethiopia Malawi

WH6school: % of schools with soap and water at the hand washing station commonly used

100% Contribute to the following SDG targets: 6.1: By 2030, achieve universal and equitable access to safe 80% and affordable drinking water for all 6.2 By 2030, achieve access to adequate and equitable san- 60% itation and hygiene for all and end open defecation, paying special attention to the needs of women and girls and those 40% in vulnerable situations 6.3 By 2030, improve water quality by reducing pollution, eliminating dumping and minimizing release of hazardous 20% chemicals and materials, halving the proportion of un- treated wastewater and substantially increasing recycling 0% and safe reuse globally Before 2017 Target 6.a: By 2030, expand international cooperation and capacity-building support to developing countries in water and Laos sanitation-related activities and programmes, including water harvesting, desalination, water efficiency, wastewater treatment, recycling and reuse technologies 6.b: Support and strengthen the participation of local communities in improving water and sanitation management

33 Water In some countries, re-occurring natural disasters are a threat to water availability or quality. Some The construction and rehabilitation of water systems programmes have therefore started combining has increased access to safe drinking water for WASH with disaster risk reduction measures. For ex- communities in various programme countries. SRC ample, in Bangladesh, more than 4,000 traditional surveys from El Salvador, Bangladesh and Vietnam tube-wells and platforms were contaminated dur- show that the safe drinking water coverage ranged ing flooding. However, all newly built disaster re- between 69 and 85 per cent in 2017, as illustrated in sistant tubwells withstood contamination. In Cam- diagram WH3. SRC implements construction work bodia, 17 per cent of the water points were disaster and water management in a participatory way, in- risk resistant. When water is completely absent due cluding communities, authorities and other stake- to drought, emergency water trucking is needed to holders to contribute with manual labor or, where prevent human and animal loss. This has been the affordable, with financial contribution. This leads not case in Ethiopia, where a three month emergency only to higher ownership but yields also greater re- project provided water through water trucking to spect and understanding of each other. For example, more than 32,000 people. in Nepal, the project has contributed to 96 per cent (baseline 20 per cent) of households having access All water installations come with the training and to and using safe drinking water in 2017. The “one equipment of water management committees household one tap” approach was a big success, SRC and technicians who are in charge of the mainte- and the Nepal RC have achieved the status as one nance of the water sources. In the SRC project in of the most important WASH partners of the gov- Honduras, 100 per cent of water sources had a ernment. This is mainly due to the successful multi- Management Board and maintenance plans in stakeholder approach in project management and 2017. In Ethiopia, water committees were able implementation linking not only technical expertise to generate sufficient revenues to cover mainte- but also different local sources for financial contribu- nance costs. At the end of this project, 83 per cent tions. In Pakistan, access to safe drinking water has of water supply infrastructure, which was provided increased from 17 per cent to 55 per cent, and 66 per during the previous project, were maintained and cent of households reported that the drinking wa- functional. Training of water technicians can have ter system lies within one kilometer of distance. The several positive impacts as the endline study in Su- self-perceived water quality increased from 27 per dan revealed. In the past, experts from the nearest cent at baseline to 61 per cent at the end of the pro- city needed to be called in case of water pump ject. In Bangladesh, access to safe drinking water has problems. Technicians were not always available increased from 24 per cent in 2013 to 85 per cent in which delayed maintenance work and reduced ac- 2017. In addition, this project has supported, in con- cess to water. In addition, external experts not only sultation with various ministries, the drafting of the charged for the spare parts but also for transporta- Bangladesh Water Rules, which were approved by tion cost and working hours which was a burden for the Executive Committee of the National Water Re- the community. Having now the expertise within sources Council in September 2017 and forwarded the community, reduced the costs of maintenance. to the Law Ministry for vetting prior to gazette. In addition, beside the support for their own community, borehole technicians were able to carry out Implementing WASH in fragile and conflict prone maintenance work for neighboring villages. areas imposes several challenges for project implementation. As for example in Sudan, quality of drill- When available water is not safe to drink, water ing and headwork was weak as reliable contractors needs to be treated either through household were difficult to find within the country. In Pakistan, water treatment or water purification plants. In the team needed to invest a lot of time in conflict res- Togo, awareness sessions for the practice of home olution among communities regarding water rights water chlorination reached approximately 24,700 and water resource management and subsequently people in 2017. The proportion of households with re-designing the water systems. In Ethiopia, project access to better quality water has increased from 27 implementation even came to a standstill due to per cent in 2014 to 76 per cent in 2017 and chlorin- re-occurring conflicts. 34 ating drinking water at household level has become common practice in the project area. Unfortunately, by the end of 2017, 12 out of 42 distributed WATA systems that were used for local chlorine production for water purification were already broken and not in use anymore. In Sudan, 643 ceramic water filters were distributed and in Ethiopia 6,150 households were supplied with chlorine tabs and water filters. The distribution went along with hygiene promotion workshops and sessions on how to use and maintain water filters and correct use of chlorine tabs. In Sudan, 85 per cent of households were still using the filters at the end of the project, and in Ethiopia, 80 per cent of targeted households Hurricane Irma destroyed large parts of the infrastructure in Dominica. SRC and IFRC reconstructed the water supply. © Finnish Red Cross, Nina Svahn practiced correct use of recommended household water treatment. In Cambodia, ceramic water filters were distributed to community members that participated in a Participatory Hygiene and San- itation Transformation (PHAST) programme. In plementation. The blue school approach reinforced order to provide purified water at a large scale at the partnership between the Regional Directorate village level, the project contracted a local NGO to of Education, the Ministry in charge of agriculture, construct two water purification plants. The model and the Togolese RC. Results from the baseline introduced by Teuk Saat 1001 provides a different knowledge, attitude and practice study in Laos con- solution to the availability of affordable drinking ducted in ten schools showed that lack of water, not water in rural areas. Drinking water is sold through enough toilets and no hand washing facilities with locally operated water kiosks on a fee for water and soap were major obstacles for the pupils at school. profit basis to local entrepreneurs who sell it then Diagram WH5 shows that only 14 % of the surveyed to the communities. Technical backstopping for schools apply safe water handling practices. An ab- maintenance and repair is guaranteed by Teuk Saat senteeism rate of 0.29 per cent among secondary 1001 and contract with SRC lasts until mid-2018. school students due to water-borne diseases was During the endline survey, 22 per cent of respond- reported, which is equal to 38 school days lost in the ents stated that they have changed from drinking last month. In comparison, reported absenteeism unpurified water to boiled water or purified water due to menstruation was much less and accounted from a ceramic water filter. In the Bolivia project for 2 school days only. area, water quality and water management is pre- carious. The baseline study revealed that none of the existing water distribution systems have been Sanitation certified for human consumption and only 39 per cent of the observed population adopts safe water The baseline studies in new project areas of Malawi, management practices. South Sudan, Vietnam and Laos showed that 50, 40, 26 and 6 per cent of households use and main- Nepal and Togo are implementing the blue school tain clean latrines, and in Sudan 8 per cent of the concept. The objectives of a blue school is to im- targeted schools. The SRC sanitation projects used prove the health of children at schools and influence different approaches to increase the availability their environment at home. This can be achieved and use of safely managed sanitation facilities. In through the reduction of water-borne diseases, Ethiopia 1,417 households constructed their own a cleaner environment, improved access to safe latrines. Some households received slabs as motiva- drinking water, sanitation and hygiene, and school tion, others constructed the latrine purely with their gardens. In Togo, SRC and the Togolese RC revised own means. The project monitoring revealed that and tested the blue school guidelines for future im- 30 per cent of households used and maintained

35 provide any hardware, but only sanitation and hygiene education through Community Based Health and First Aid (CBHFA). In contrast, SRC in Cambodia used a four-step Participatory Hygiene and San- itation Transformation (PHAST) approach. Af- ter participants had successfully finished a PHAST step, for example a hygiene training, they received a hardware component that allowed them to continue constructing their latrine or hand washing facility. With this approach, 961 subsidized latrines were built, 2,013 subsidized hand washing basins installed and every household received a free ceramic water filter for water purification. Despite all The SRC and the Red Crescent Kyrgyzstan support communities to improve water, these efforts, households using and maintaining sanitation and hygiene. Thanks to the project, Nurzat Shadykanova (14) has access clean latrines has hardly increased since project to running water. © SRC start (baseline 52 per cent to 54 per cent in 2017). Community Led Total Sanitation (CLTS), a different approach, was used in Togo and Haiti. In Haiti, clean latrines. Main hampering factor for the unsat- trained people promoted latrine construction in isfying result was the fact that the latrine holes were their communities and sold slabs for a reduced price not covered. If this criteria was removed from the to households that participated in latrine construc- indicator, 90 per cent of the households would ful- tion. With the income from the sold slabs, new slabs fil. In Bangladesh, the project developed a new so- were produced and sold to a reduced price. called “easy latrine” design, which fulfils all sanitation standards for families living on the river island. The diverse sanitation approaches have contributed These latrines are of low cost, and when washed to end open defecation in project areas in Bangla- away by flood, can be easily rebuilt in another place. desh, Togo, Malawi and Nepal. For example in Ma- However, when latrines are flooded or even the is- lawi where SRC and MRCS used the CLTS approach, land is washed away, the faeces will be washed into the project exceeded its target of 50 certified open the flood water since the pit below the concrete defecation free villages by 45. One year after pro- ring is only made of bamboo and plastic sheets. The ject end, 90 per cent of the villages declared open easy latrine, as well as other sanitation material, are defecation free could maintain this status. In Nepal, sold by sanitation marketing businesses fostered by 19 out of 20 districts where the project intervened, the SRC project in all intervention areas. Besides the achieved open defecation free status. “easy latrine”, the project developed further designs for “mainland” areas, changing from a contrac- Particularly in urban settings, waste management tor-based approach to a community-led approach, is an essential element of SRC WASH projects. In where community people decide on their own for Dhaka,s slums in Bangladesh, the project intro- the latrine design and get the parts from local san- duced a solid waste management system, increased itation business. Overall, community contribution access to community toilets and bathrooms, and to toilet construction had a great impact on ap- cleaned clogged drainage systems. Apart from propriate maintenance and use of toilet structures. community efforts, the ward councilor contributed Households that use and maintain clean latrines in 27 per cent of the total costs in kind as labor. In the the combined DRR and WASH project has increased SRC project in Naogaon district, communities emp- from 15 per cent (baseline) to 93 per cent in 2017. tied their pits in adherence with defined disposal standards. During the reporting period, 10 per cent In Pakistan, the use of latrines increased from 68 per of all toilet pits were emptied, utilising the services cent to 76 per cent, with an increase in water-sealed of trained sweepers. The proportion of households latrines from 23 per cent to 31 per cent. This is a par- disposing solid waste in compliance with agreed ticularly interesting result since the project did not procedures stagnated at 38 per cent because peo-

36 ple were unwilling to pay the agreed waste collec- with a hand washing station in 2017. In Ethiopia, tion fee. In El Salvador, 33 systems for the treatment 1,015 households installed hand-washing facilities of grey water were finalized and in use by the end by their own means. At the end of 2017, 91 per cent of 2017. Trained health committees conducted of targeted households had a hand washing facility home visits to monitor and train the beneficiaries with soap and water commonly used by the fam- in the use and maintenance of the grey water treat- ily members, which was an increase of 12 per cent ment systems. Waste management was also a pri- since mid-2016. Similarly, hand washing increased ority in Bhutan. As one of its first activities, Bhutan in SRC projects in Bangladesh (from 10 to 59 per RC started a stream-adoption cleaning campaign. cent), Cambodia (from 27 to 46 per cent), Nepal The SRC supported the government in its rural san- (from 32 to 66 per cent) and Togo (from 9 to 31 itation and hygiene promotion programme in two per cent). districts. The overall progress of the construction of partially subsidized improved toilets was impressive Beside community hygiene, SRC projects increas- with an increase from 26.9 per cent to 64.6 per cent ingly target hygiene at schools. In Nepal, 52 within one year. schools benefitted from WASH intervention packages that include safe drinking water, gender and disability friendly toilets and sanitation, hand wash- Hygiene ing with soap, waste management and menstrual hygiene management. However, despite several To promote improved hygiene behaviour in the workshops to sensitize and motivate the collec- communities and at school, SRC and its partner or- tion of funds, schools still are reluctant to invest in ganisations use and combine a variety of behaviour WASH activities from their own school budget. In change approaches, depending on the respective Sudan, 24,000 students were reached during child national guidelines, the local context, and the skills friendly health and hygiene events. The events fea- and qualifications of the partner organisation,s tured both theoretical and practical sessions and project staff. In 2017, SRC hygiene promotion in- included the provision of goodies like soap, tooth- terventions reached 648,308 people. In Haiti, for ex- brush, toothpaste, nail clipper and portable water ample, hand washing, household water treatment container to all students. The strong interest and and latrine construction and maintenance were good collaboration with the Ministry of Education promoted through a mixed approach of PHAST and was very helpful for the implementation of school the Community Sanitation Strategy. In Vietnam, the level activities. CBHFA volunteers in Ethiopia car- SRC project adopted a behaviour change communi- ried out hygiene promotion sessions in ten schools cation strategy in line with the methodology “risks, reaching 1,810 students. And in Malawi, 8,273 stu- attitudes, norms, abilities and self-regulation” (RA- dents were reached with WASH messages. NAS). Menstrual hygiene management has gained in- Hygiene promotion has not only contributed to la- creased attention across the SRC,s school WASH trine construction and end open defecation but has projects in Bangladesh, Nepal, Laos and Malawi. In also stimulated the construction and use of hand addition to menstrual hygiene education, 39 pri- washing facilities as well as hand washing at critical mary schools in Bangladesh have created a stock times. In Malawi, SRC and MRCS promoted so-called of sanitary pads, and toilets have been equipped tippy-taps. The tippy tap is a hands free way to wash with proper sanitary pad disposal facilities. In order hands that is especially appropriate for rural areas to improve girls, knowledge on menstrual health where there is no running water. It is operated by a issues, the program in Malawi established mother foot lever and thus reduces the chance for bacteria groups in each of the schools in the target area and transmission as the user touches only the soap. The more than 2,000 female students were oriented in used waste water can go to plants or back into the menstrual hygiene. In Nepal, the project has cre- water table. The project promoted hand washing ated a more profound awareness on menstrual at critical times at schools and in households, start- hygiene management in communities, schools ing with a baseline of 29 per cent of households and at regional level through various sensitiza-

37 tion and advocacy measures, such as trainings on national policy levels. As a result of these efforts, re-usable sanitary pads, menstrual hygiene man- a national committee was formed to draft a policy agement workshops, and sessions with the school on menstrual hygiene management and efforts are management committees and teachers. Within the under way to endorse the policy in 2018. At district Swiss Water Consortium, the SRC took the lead in level, menstrual hygiene was incorporated in the advocating menstrual hygiene at the regional and school curriculum.

Number of WASH beneficiaries

2016 2017

Access to improved water 355,040 390,829

Access to improved sanitation 197,253 170,695

Access to washing facilities 75,374 92,086

Hygiene promotion 1,104,299 648,308

38 Lessons learnt ––In areas with good drinking water coverage, some SRC ––Sludge management needs to be more explicitly integrat- projects moved from water system construction to im- ed into SRC sanitation projects, especially when flush toi- proving water quality. Water treatment at household lev- lets are used. Double pit or dry latrines may be sustainable el or community water treatment through water purifica- and accepted solutions. tion plants are crucial where people do not have access to ––Different and mixed participatory approaches were used safe drinking water. However, its sustainability remains to change the people,s WASH behavior. RC should explore questionable and more innovative and business oriented new ways to behavior change, such as the RANAS ap- solutions should be explored as it is done for example in proach. Cambodia. ––Whilst the SRC recognizes that washing hands with soap ––In many countries, local public water authorities are un- is the most important and effective means of preventing derresourced or understaffed. SRC projects need to invest diarrhea, changing hand-washing behavior requires a further in innovative approaches to hold water authori- long-term approach that addresses culturally rooted prac- ties accountable, and at the same time enable and em- tices. Gradual improvement of hand washing with soap power local water committees and water operation man- could be observed in several projects. However, safe water agers in the communities to do water testing on their own handling practices just started to be monitored in 2017 in and report the results to the authorities. some projects and require more emphasis in the future as ––All projects that installed water systems have functional secondary water contaminations remains problematic. water committees in place. Whilst this is a crucial element ––Menstrual hygiene management has become an integral not only for community-based management and mainte- module of WASH in school programs. The topic, touching nance, a better link and registration with the local water both girl,s rights to health and to education, has strong authorities is essential to further strengthen sustainabili- potential to be developed further towards advocacy and ty. In this respect, progress was made, and more SRC pro- policy influencing for the integration of menstrual hy- jects should follow. giene management in schools and school curriculums. ––Linkages between WASH, health and DRR interventions The blue school concept is a promising approach to foster were reinforced in disaster prone programme countries WASH at schools in a holistic manner. such as Bangladesh or Cambodia. Integrated WASH fos- ––Policy influence is gradually increasing, particularly in tered a more comprehensive health planning at local lev- those projects that have been doing health system el. In addition, beneficiaries that had gained trust into strengthening for some time. Influence in social health WASH projects easily built also trust on health projects in protection, health information management systems and the same region. Integrated health, WASH and DRR may quality of care have been observed. render greater impact and its feasibility should be further ––Combining health with disaster risk reduction and WASH explored. projects has increased in the past year, leveraging better ––“One household – one tap” is an innovative way to im- impact and benefitting from good reputation and de- prove access to water, as shown in Nepal. It needs to be mand in the community. closely monitored in terms of sustainability for its long- ––Using multiple channels and being innovative in health term outcome and should be explored whether such ini- promotion is likely to have more and a quicker impact on tiative could be expanded and may bring greater owner- behaviour change. ship to households towards their water source. ––Working with multiple stakeholders leverages the impact ––Whilst the availability and use of latrines has increased, on health outcomes, as seen in Honduras. the maintenance of latrines needs more attention. To achieve good results, it is not necessary to subsidize latrines, as the case of Pakistan has shown, where good maintenance of latrines was achieved thanks to community-led project design and implementation.

39 Ageing and health

Monitoring of selected outcome indicators AH1: % of organizations that adhere to quality standards As from 2017, the SRC monitors the following outcome indicators. SRC programme countries provide projectbased indicator data in accordance to their thematic priorities (see 100% details on methods in chapter 3 above). Note that projects have different durations so that the year of baselines and tar- 80% gets vary.

60%

40%

20%

0% Before 2017 Target

Kyrgyzstan

AH2: % increase in number of clients benefitting from AH3: % increase in members in active ageing groups service

600 1200

500 1000

+21% 400 800

300 600

200 +24% 400

100 200

+45% 0 0 2016 2017 2016 2017

Armenia Bosnia and Herzegovina Moldova Armenia Bosnia and Herzegovina Moldova

Contributes to the following SDG targets: 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being

40 3,724 elderly people were reached by the SRC ageing and health projects in Eastern Europe and CIS (Armenia, Belarus, Bosnia Herzegovina, Bulgaria, Moldova, and Kyrgyzstan), and 2,598 in the SRC health programme in Bolivia.

Home-based care

In Armenia, Belarus, Bosnia Herzegovina, Bulgaria, Moldova, Kyrgyzstan and Ukraine, the SRC supports the Red Cross and local NGOs to develop sustainable integrated medico-social home-based care (HBC) services to elderly and disabled people. The The home-based care service of the Armenian Red Cross visits Gevorg Danielyan (82). The SRC supports care for elderly in seven countries in Eastern Europe and the CIS. models vary from professional home care centres to © Nick Danziger volunteer-based visiting services. Across all the SRC home-based care projects, the number of clients increased between 24 and 49 per cent from 2016 to 2017. In total, 2,398 lonely elderly or disabled clients received social and medical care at home In April, the SDC mandate to the SRC and the Bul- through SRC projects and partnerships. garian Red Cross (BRC) ended. SRC decided to extend the project with the BRC with the aim to secure The licensing of the Armenian Red Cross Society the sustainability of the four HBC centres that pro- (ARCS) by the Ministry of Social Affairs contributed vide care to 411 clients. SRC support will bridge the to the sustainability of the newly established HBC gap until the new legal and funding framework for services providing medical and social care to 98 HBC in Bulgaria allows the partner to fully take over. lonely elderly clients. Thanks to the official recogni- To influence the respective policy development, the tion, the ARCS is now eligible to bid for upcoming BRC participated in the working group preparing national tenders in the sector of social and or med- the national action plan on long-term HBC and in ical care. During the year, the ARCS supported the the working group elaborating the new law on so- government in the development of national home cial assistance that includes public HBC services. care standards, participated in the inter-ministerial commission on elderly issues, and chaired the The SRC support to the HBC program of the Be- network of organizations implementing elderly larus Red Cross (BRC) entered in a new, decisive healthcare. phase in 2017. The main aim of BRC is to develop a sound financial basis for delivery HBC services to The Red Crescent Society of Kyrgyzstan (RCSK) be- elderly and disabled persons throughout the coun- came an important organization addressing elderly try. This entails the development of sound business issues at the national level. The RCSK was leading plans based on marketing strategies and enhanced the working group responsible for the develop- communication and fundraising. It also includes the ment of the plan of action on social issues includ- strengthening of the BRC,s policy dialogue with the ing elderly. Since November, the RCSK president is Health and social Ministries in order to strengthen chairing the Public Supervisory Council to the Min- its key position as public service partner of the gov- istry of Labour and Social Development. Another ernment. important pillar of the RCSK is domestic fundraising that will allow to sustain their assistance to the Upon request from the Ukrainian Red Cross Society 400 beneficiaries at home through 200 volunteers. (URCS) and ICRC the SRC started providing techni- Already, the RCSK has been successful in attracting cal support to the URCS for the reform of its ailing, business partners. traditional home care program, involving technical

41 experts as well as partner organizations from Swit- In Kyrgyzstan, the RCSK promoted the establish- zerland and Europe. Initial support allowed pilot- ment of six self-help groups among target elderly ing of reformed HBC approaches in areas controlled by identifying active and interested leaders. With by the Ukrainian Government (GCAs) of Donetzk the approval and launch of an active ageing con- and Lugansk regions, and learnings transferred cept, the Armenian Red Cross Society reached to Non-Government Controlled Areas (NGCA) of an important milestone. By the end of the year, Donetzk and Lugansk. The dire humanitarian needs ten IGs with 150 elderly members were initiated of lonely elderly people left behind in the Donbas in two regions of the country. In Moldova, seven are the main reasons for selecting these regions as new IGs made of active older people were created first pilot areas for the home care reform, in a close and seven existing IGs from the previous project cooperation with the ICRC. phase were mobilized and strengthened for the implementation of the project. At the beginning It is a strategic aim of the SRC to support Red Cross/ the IGs displayed low activism and skepticism about Red Crescent ageing and health interventions also participation in community life and in the decision beyond its own program countries in Eastern Eu- making process. A variety of tools and techniques rope and Common Wealth of Independent States were used to empower and encourage them to (CIS) and to expand it to other geographic regions. participate. By the end of the year, 273 elderly par- A thematic concept is in progress to pave the way ticipated in the IGs. In Bosnia and Herzegovina, for future ageing projects in Africa, Asia and the the 25 IGs with 1,016 members founded an active Americas. Bolivia is the first non-European country ageing network. A survey conducted among 916 programme that addresses elderly people: in 2017, IG members showed that over 50 per cent of them the SRC project enabled access to free medical participate in social activities on a weekly basis. 55 treatment at the health center and to social pen- per cent are very happy and satisfied with their life, sion for 2,589 vulnerable elderly by informing them 91 per cent are keen to help other people, 91 per about their rights and entitlements. cent know more people from the community, 89 per cent participate in community events, 83 per cent spend less time alone and 90 per cent men- Active ageing tioned that they make better use of their time since joining the IGs. Similar to the results in Bosnia and The SRC active ageing approach considers older Herzegovina, in Belarus the impact that the IGs people as agents of change for their lives. In Ar- have on the wellbeing of their members and com- menia, Belarus, Bosnia Herzegovina, Moldova and munity at large is widely noticed by regional and Kyrgyzstan, the SRC projects support the founda- district administrations. To sustain the existing IGs, tion of self-help and initiative groups (IGs) of elderly two in each project region were selected to become people. The IGs are supported through capacity resource persons for the training and mentoring of building, education and training, providing their new IGs. members with the skills and confidence to start small community projects that will bring benefit to them as well as to their community. An important aspect of active ageing is the creation of visibility for the needs of the ageing citizens. It is the basis of advocacy campaigns addressing issues of age-friendly environments and access to health and social services. The SRC active ageing projects in Eastern Europe supports 120 IGs involving more than 2,550 older people.

42 Number of beneficiaries in ageing and health

2016 2017

Elderly care 3,833 6,590

Lessons learnt ––Financial viability and sustainability remains a ––Also the SRC,s own traditional, project-based key challenge for home-based care services in working modality is challenged by the com- countries with weak social health protection plexities of supporting partners in the develop- mechanisms. Various alternatives to guaran- ing of relevant, effective and sustainable health teed donor funding practices have the poten- & social services. tial to lead to improved ownership and ––Exchange visits of SRC and partner organisa- co-funding opportunities of the implementing tions, project staff between the SRC programs partners and the concerned local authorities. . supported learning and innovation. ––Developing of potentially sustainable home- ––Supporting the partner organizations in build- based care services requires a wider health and ing up quality HBC services and activities for the social system strengthening approach and elderly fosters their profile and recognition in therefore a conscious shift in the working men- the country. talities and strategies of most National Red ––Working on empowerment of older people re- Cross/Red Crescent Societies. quires entering personal, cultural and structural levels and is a longer-term mission.

43 Blood safety

Monitoring of selected outcome indicators BS1: % of blood donations screened for TTIs As from 2017, the SRC monitors the following outcome indicators. SRC programme countries provide projectbased indicator data in accordance to their thematic priorities (see 100% details on methods in chapter 3 above). Note that projects have different durations so that the year of baselines and tar- 80% gets vary.

60%

40%

20%

Contribute to the following SDG targets: 3.3: By 2030, end the epidemics of AIDS, tuberculosis, ma- 0% Before 2017 Target laria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases Moldova

BS2: NBTS meets the % of needs of requested blood BS3: % of voluntary non-renumerated blood donations products

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Lebanon Malawi Moldova Kyrgyzstan Moldova

The total number of blood donations in the SRC in Moldova can meet 100 per cent of the needs, projects in Egypt, Lebanon, Moldova, Malawi, the Lebanese Red Cross as national provider only South Sudan, Kyrgyzstan, Haiti and Honduras could covers 15 per cent of the needed blood products in be further increased to 667,864 in 2017 whereas Lebanon. Private providers in Lebanon also produce nearly 80 per cent of donations are attributable to blood products and make up for part of the gap. a project in Egypt, which is also the most populated The objective of the SRC program is to strengthen country with a SRC blood safety project. The over- the national blood provider in better meeting the all increase could be achieved thanks to the joint national blood needs with safe blood products that efforts to promote and scale-up blood donation meet international standards. campaigns and thereby increase the number of voluntary donations. Looking back at nearly twenty years of collaboration in Egypt, the SRC continued to support the The above diagram BS2 shows to what extend Ministry of Health via the Egypt Swiss Project for the National Blood Services supported by the SRC Restructuring of the Blood Transfusion Services can meet the needs of requested blood products. with a mandate from SECO. In 2017, the last pro- The figures differ greatly from one country to -an ject phase reached a major milestone: the suc- other: whilst the public blood transfusion services cessful scaling-up of blood management system

44 soft- and hardware from Headquarters in Cairo to start of the intervention. As the graph BS3 shows, nine Regional Blood Transfusion Centres (RBTCs) the target is to reach a base of 50 % voluntary dona- across Egypt. This achievement was celebrated on tions by 2019 as increasing VNRBD is a key element the occasion of the visit of SECO State Secretary to a safe, equitable and accessible blood supply in Ms Ineichen-Fleisch on 12 December 2017. Seven Kyrgyzstan. The partnership between the Republi- remaining RBTCs are in the process of installation can Blood Centres (of the Ministry of Health) and and staff training. It is expected that in early 2018 the Kirgiz Red Crescent Society was formalized in all sites are connected to the centralized database, April 2017 and lays the ground for a sustainable co- ensuring seamless data exchanges and standard- operation. Trainings on “friendly attitude towards ized quality blood products for 82 million people. donors” was conducted for 74 Oblast Blood Center This will mark the end of the project and trigger a medical staff and 125 Red Crescent volunteers were phasing out process of the SRC in this field in Egypt. trained on VNRBD practice. Promotion activities reached more than 54,000 people with information As a national provider, the Lebanese Red Cross sessions. The number of voluntary blood donors (LRC) collected 23,000 units of blood in 2017 – out was already increased by 6,100 donations in 2017. of which one fourth was issued to Syrian refugees. Access to affordable health services is a major con- In Moldova, the SRC launched a second phase of cern for the over 1 million registered Syrian refu- the project “Strengthening the Transfusion Blood gees in the country. In 2017, the SRC concluded Services in the Republic of Moldova” on April 6th, the second phase of a blood safety project with the 2017 together with the Ministry of Health. In the LRC that increased voluntary donations, enforced course of 2017, 511 doctors were trained in “Trans- international quality standards and started an or- fusion therapy management and haemovigilance ganisational development process. A major game- in health care institutions”. Equipment for testing changer was a policy dialogue with the Ministry of donor blood for transfusion of transmissible infec- Health and other major stakeholders. Consequently, tions was received and installed. 50 per cent of the LRC will receive more funding from the Lebanese new information technology (IT) equipment was Government and has a clear mandate to increase purchased and the technical specifications for up- the number of voluntary regular blood donors and grading the Blood IT system was developed to meet improve blood safety in all parts of the country. In the criteria required for transfer to the governmen- August 2017, SRC and LRC signed a multilateral co- tal platform “MCloud”. 100 per cent of the blood operation agreement of the EU MADAD that will donations were screened for transfusion transmit- secure further 1.8 million US Dollar for blood units ted infections (TTI), as shown in diagram BS1. for refugees. A third phase of a technical assistance project with the SRC will start in 2018. The SRC has In South Sudan, the project “Blood donor recruit- also supported the Palestinian Red Crescent So- ment and First Aid” is being implemented with the ciety in Lebanon, which operates blood banks in South Sudan Red Cross. The constant insecurity five hospitals in the Palestinian refugee camps and and dramatic economic situation in the country provides services for Palestinian refugees, including had negatively influenced the availability of blood Palestinians Refugees from Syria. In the frame of a for those in need. People were reluctant to do- comprehensive quality management project, the nate blood. In addition, rumours and dangerous blood services were strengthened by implementing beliefs about donating blood made it difficult to urgently needed hard- and software and a capaci- achieve the project targets. Therefore, in 2017, the ty-building program. project focused on awareness raising and public campaigns. 12,276 households were reached with The project “Promotion of Voluntary Non-Remuner- blood donation messages, 95 outreach blood drives ated Blood Donation in Kyrgyzstan was launched were conducted and 1,879 blood units collected. In in January 2017. The project encompasses a com- addition, 13 staff members of NBTS were trained in prehensive program for the increase of voluntary pre and post donation counselling. (vs. family replacement) donations, which accounted for only 7 % of all donations prior to the

45 has been approved by the council of ministers but is pending to be published for political reasons. To counterbalance the slow progress to dialog with the Government, HRC reactivated the transfusion committees with the hospitals. Working towards financial sustainability, a costing system has been developed and is applied. Blood collection campaigns were conducted by HRC. The SRC funded the purchase of equipment (e.g. centrifuges, cold room, and a temperature monitoring system) at the blood transfusion centers to assure higher quality testing. A major achievement was the development of the e-learning tool to promote voluntary A Red Cross volunteer donates blood in the blood transfusion centre of the Red Cross in non-remunerated blood donation (VNRBD) which Léogâne, Haiti. ©Florian Kopp was launched on the IFRC e-learning platform. HRC is the first National Society to pilot such a tool. SRC is in discussion to finance a new building for the National Blood Program in Tegucigalpa. This future In Malawi, a blood donor recruitment project was project is fully coordinated with a second phase of launched as a joint project between the SRC, the a technical assistance project (to start in 2018) and Malawi Red Cross Society and the Malawi Blood shall ensure a long-term sustainability for the HRC. Transfusion Services (MBTS). The objective is to com- The start of this intervention depends on funding bat the chronic shortage of blood in the country by for the construction of the new building. recruiting more voluntary blood donors. Regular campaigning was established in order to promote In Haiti, the SRC has continued its efforts to increase and increase regular blood donations. 8 campaigns, blood safety in a joint effort with the Haitian Red reaching approximately 18,500 people, were real- Cross and the Ministry of Health. In 2017, major ized. With blood collection through mobile drives, achievements were the increase of voluntary blood the project met 85 per cent of the project collection donations by 12 per cent and an overall produc- target in Blantyre and 48 per cent in the Lilongwe tion of 28,018 blood units. Promotion of voluntary branch, achieving 66 per cent of the project target blood donations was reinforced through technical of 1,200 units. Regarding improved capacity of and financial support of campaigns at national MBTS and MRCS staff and volunteers, standard op- scale. 463 sensitization sessions were organized erational procedures are emerging, the acceptance by the HRC in several entities such as schools and built in traditional authorities is opening the door churches. All operational procedures were revised for more donor recruitment; and the youth Club and the staff skills were updated accordingly. All 25s was successfully established. MBTS drafted a support processes like human resources, logistics new donor recruitment strategy 2017–2020. Blood and communication were assessed and an action needs for Malawi have risen to 120,000 annually plan was put in place. To increase safe clinical trans- according to post baseline analysis of 2015. Cur- fusion practice, four Haemovigilance Committees rent blood units collected from Voluntary Non-Re- were strengthened and 312 medical staff were munerated Blood donation meets already 48.6 per trained. An external mid-term evaluation of the cent of the annual requirement. project was conducted which resulted in an adjust- ment of some project activities and approaches to In Honduras, the first phase of joint project be- be implemented. tween the SRC and the Honduras Red Cross (HRC) was finalized in 2017. On a policy level, the HRC In a complex and multidisciplinary field like blood and the Ministry of Health renewed their MoU safety, a good expert network and effective knowl- whereas the recommendations made by HRC for edge management are key. The SRC expert group the new blood policy were taken into account. It Blood Safety has 12 to 15 members, all IC Depart-

46 ment or Swiss Transfusion SRC staff members. The systems, the SRC co-founded and supports the Afri- group meets every three to four months to review can Society for Blood Transfusion (AfSBT) working new SRC blood safety projects and discuss evalua- group on IT systems. Following the AfSBT Congress tion outcomes, innovations and new approaches. in Rwanda in 2016, the AfSBT Board established a dedicated IT working group tasked with developing Fostering networking and exchanges is also im- tools and materials to assure more effective use of portant for the SRC,s partners. In 2017, SRC fund- IT in blood transfusion in Africa; the SRC is providing was made available to allow three people to ing the group with financial and technical inputs. attend the International Society for Blood Trans- The e-learning tool for voluntary non-remunerated fusion (ISBT) Congress in Copenhagen in June blood donation (VNRBD) developed in Honduras, 2017. Bringing innovations to partner countries will be translated into English and piloted in a sec- is another priority for the SRC. Having conducted ond SRC program country in 2018. multiple projects in the field of blood management

Number of blood donations

2016 2017

Blood donations 652,541 667,864

Lessons learnt ––National Red Cross and Red Crescent Societies ––The visibility and positioning of the SRC as a highly value the SRC,s cooperation in the field National Society is important and will be fur- of blood safety, specifically because the SRC ther strengthened through active participation provided not only funding, but also technical at international events and working groups. assistance and is linking up the partners to in- ––Stakeholder involvement was very important ternational network of resources. This ap- during the process of drawing up blood trans- proach should be maintained and the network fusion service legislation or any other form of further enlarged. policy making. Projects will continue to engage ––While introducing IT-supported blood man- in a policy dialogue where required to reach agement systems to improving blood safety and sustain the project objectives improve the and the efficiency of blood services, the pro- blood safety. jects are becoming increasingly complex and ––Political, institutional and financial challenges the results were not achieved in the timeframe in ministries and blood services can limit the originally planned. More capacity building is results of blood transfusion projects. A risk required and expert knowledge must be made analysis and a contingency plan must accompa- available at all stages of the project. ny every blood safety project.

47 Eye Care

Monitoring of selected outcome indicators EC1: % of eyes with good visual acuity after 6 weeks As from 2017, the SRC monitors the following outcome indi- of cataract surgery cators. SRC programme countries provide projectbased indicator data in accordance to their thematic priorities (see 100% details on methods in chapter 3 above). Note that projects have different durations so that the year of baselines and tar- 80% gets vary.

60%

EC2: % of increase of utilization of eye care facility from 40% previous year to current year 20% 45000

40000 0% Before 2017 Target

35000 +23% Ghana 30000

25000 Contribute to the following SDG targets: 3.8: Achieve universal health coverage, including financial 20000 risk protection, access to quality essential health-care ser- 15000 vices and access to safe, effective, quality and affordable essential medicines and vaccines for all 10000

5000

0 2016 2017

Ghana Mali

The total number of cataract operations in 2017 patients in Togo were not able to pay costs as part was 3,978 in the SRC supported facilities and out- of the cost recovery system. In Nepal, the absence reach camps in Ghana, Mali, Nepal and Kyrgyzstan. of an ophthalmologist reduced the days for opera- 439,834 clients were informed about eye care tions. And Kyrgyzstan just started their professional problems, which is an increase of almost 20 per staff in operation techniques. cent compared to 2016. In Ghana, SRC measured a 25 per cent increase of eye care patients, as shown Looking at selected outcomes of the projects (see in diagram EC2. In all countries fora for awareness diagram EC1), 84 per cent of patients had eyes with used were schools, screening camps, public events good visual acuity after 6 weeks of cataract sur- and of course educational sessions in the supported gery in Ghana, compared to a target of 85 per cent. health facilities. Training for traditional healers, for The project in Ghana also achieved an increase of example in Ghana, increased the access to new 23 per cent of utilization of eye care facilities from rural areas. Ghana, Nepal and Mali offered vision the previous year, compared to a targeted increase screening in schools and reached a total of 59,427 of 8 per cent per annum. students. Especially in Africa, the number of outpatients reached 97,407 patients, which is much Quality standards through regular checks of higher than in Nepal and Kyrgyzstan, where the post-operation visual acuity or application of support for eye care just started. The beneficiary biosecurity are integrated in all projects, but par- numbers increased in total, but curative interven- ticularly Ghana and Togo made visible progress in tions were lower than expected. This has to be at- 2017. In Togo, the success rate of cataract surgery tributed to several challenges at local level. Many (number of eyes with good visual acuity beyond 4

48 weeks after surgery) was 92 per cent. It is very ap- parent that the skills of the surgeon determines the acuity results. With regular patient satisfaction surveys in Nepal, the increase of outpatients (53 per cent in 2017) can be managed, services adjusted and customers kept. The diversity of services, a good building and equipment, regular availability of surgeons and technical staff were key points for the high satisfaction. However, financial sustainability is an ongoing challenge. In Nepal, the hospital was able to successfully recover operational cost of 70 per cent. The security situation in Mali continues to limit the opportunity to work around Timbuktu. Closer cooperation has been established A man recovers from an eye surgery in the SRC supported clinic in Surkhet, Nepal. © SRC with the Programme Nationale de Santé Oculaire. The young project in Kyrgyzstan established close links with the Ministry. A study conducted in 2017 confirms the high prevalence of eye problems in the southern regions of Kyrgyzstan. Especially Ghana and Nepal continued there networking with government and non-government actors to increase the effectiveness and visibility of the eye care activities. In Nepal, the collaboration with the local agencies to carry out outreach and sell hospital services increased due to contacts with the senior citizens forum, municipality, and the Social Security Health Insurance Board. In Ghana, the first ever national survey on blindness and visual impairment was conducted and co-funded by the project.

Number of eye care beneficiaries

2016 2017

Cataract surgeries 5,300 3,978

Other eye surgeries 1,810 2,380

Eye care consultations (outpatient) 112,472 125,842

Eye care school screenings 71,761 59,427

Eye care awareness raising 330,856 439,834

49 Lessons learnt ––SRC eye care projects follow WHO standards, inclusive process which included consultations e.g. the threshold of prevalence in the country, with staff of the marketing department and measurement of visual acuity, calculation of the international cooperation as well as inter- CSO (cataract surgical outcome). national eye care specialists from NGOs and the ––Eye care programmes in the countries are in- IFRC was designed and stimulated discussions creasingly focusing on quality of care. This has across the units. direct effects on the performance standards for ––SRC contributed with country case studies from surgeons (e.g. in Togo) and shifts the focus Ghana and Kyrgyzstan to the first Swiss Inter- from many cataract operations to better cata- national Eye Care Conference in Geneva. More ract outcomes. advocacy and networking has to be done by ––The SRC Global Eye Care Evaluation was com- SRC in Switzerland and internationally to ex- missioned in August 2017. Results are expected pose staff and make the programme better by beginning of 2018. With the objective to known. determine the future strategy of the SRC, an

50 Disaster Risk Management

In 2017, SRC has further strengthened its integrated multi-sector approach to Disaster Risk Man- agement (DRM). SRC conceives DRM as a cyclical process linking the core phases of response, recovery and development. The nexus between the three phases does not simply consist in a smooth transition from one phase to the next. Linking relief with recovery and development (LRRD) also means that phases can overlap and occur simultaneously, as shown in the figure below. Event Hazardous Hazardous

SRC DRM Cycle

The SRC cycle of disaster risk management

51 Emergency response

Number of beneficiaries in emergency response

2016 2017

Total Emergency Response 805,598 549,561

Health in emergencies 408,097 446,329

Non-food (e.g. family kits) 156,543 201,856

WASH 468,128 112,082

Food Aid (e.g. seeds & tools) 132,236 110,246

Cash 20,033 61,373

Shelter 23,082 1,114

Emergency deployments 18 34

Refugees and internally displaced persons 164,288 190,854

According to the Global Humanitarian Overview The SRC implemented these response operations (GHO) of UNOCHA, 135.7 million people were in in close collaboration with its RCRC Movement need of humanitarian assistance by November partners. More specifically, in 2017, the SRC spent 2017, an increase of 7.1 million compared to the 58 per cent of the total of 8.5 million Swiss Francs previous year. Conflict and violence were the main bilaterally – i.e. in direct collaboration with the Red drivers of humanitarian needs – forcing people to Cross National Society of the country in which the leave their homes, worsening their access to food, disaster happened. The remaining 42 per cent were basic services and causing loss of income. For the channeled through the coordinated multilateral SRC, the suffering of the civilian population in Syria response system, namely through the IFRC, but and the displacement of millions to neighbouring occasionally also through other Partner National countries, namely to Lebanon, remained one of the Societies or the ICRC. most preoccupying humanitarian crises in 2017. The complex emergencies in Somalia, Ethiopia and In 2017, the SRC reached 549,561 people with its South Sudan required another series of response emergency response projects. The difference to interventions by the SRC and the Movement. The 2016 in the WASH in emergencies section orig- huge humanitarian needs of the refugees from My- inated after the end of the cholera response and anmar in Bangladesh in August 2017 triggered a preparedness project in Ghana. The deployment major response by SRC and the Movement. Almost of disaster management delegates increased sig- simultaneously, the SRC and its RCRC partners nificantly as the multilateral operations in the Car- mounted a significant relief operation to support ibbean and Bangladesh required a major surge of the people affected by the hurricanes Irma and Ma- technical experts in logistics and health, but also ria in the Caribbean, which focused on the heavily cash, shelter and relief. affected islands of Dominica and St. Marteen.

52 Conflicts causing population movement

The conflict in Syria entered its 7th year in 2017 and the situation deteriorated in many parts of the country. The humanitarian needs of the Syrian population continue to increase and there are millions of internally displaced people. The SRC continued to support the Syrian Arab Red Crescent (SARC) in strengthening its capacity to deliver psychosocial support through multifunctional centres and the health clinic in Suweida in a consortium with the Danish Red Cross. Furthermore, the SRC donated four ambulances to SARC to continue providing emergency health and first aid services throughout Community members unload sand for construction work in Dolakha, Nepal. In 2017, the SRC completed its earthquake recovery programme. © SRC the country. In addition, the SRC contributed to the memorial fund that SARC established in honour of the deceased volunteers to provide support to their families. The visit of the SRC director to Syria in April 2017 reconfirmed the commitment of the SRC to IFRC appeal and the SRC deployed 17 surge dele- establish a delegation in Damascus and to com- gates into the Red Cross response: three FACT dele- mit to a longer term collaboration with the SARC. gates (relief, shelter, cash), four logisticians and ten The arrival of the SRC representative is planned for health delegates who were operating in the field 2018. hospital of the Norwegian Red Cross. On WASH, the SRC worked together with the German Red Cross In Lebanon, the SRC continued its bilateral coop- and the Bangladeshi Red Crescent Society to ame- eration with the Lebanese Red Cross in support of liorate access to clean water, provide latrines and Syrian refugees. The SRC continued to support LRC improve the hygiene in the camps for 5,000 people. distributions of relief supplies in refugee camps. Im- Moreover, the SRC – in partnership with the BDRCS portantly, it took care to ensure that projects were – is planning to support the Ministry of Health in the “winterized”, readying people to face freezing win- establishment of three Public Health Care centres ter conditions. The SRC also continued to support with integrated protection services. the Lebanese Red Cross cash transfer program for Syrian refugees. It financed two additional day-shift teams of the Lebanese Red Cross Emergency Med- Complex emergencies ical Services, thanks to which an additional 4,000 rescue missions were carried out in the greater Bei- In Somaliland, repeated droughts have led to food rut area. security and acute risk outbreaks of water borne diseases such as cholera. Water shortage and lack In Greece, the SRC deployed cash transfer program- of fodder has led to an estimated 40 per cent of loss ming experts to support the IFRC respone in the ref- of livestock. Ongoing conflicts lead to internal dis- ugee camps. placements and limitations of access to remaining water sources. Supported by Swiss Solidarity, the In South-Eastern Bangladesh, a sharp increase of SRC has joined forces with the Somali Red Crescent refugees fleeing violence in the Rakhine state of and the IFRC to cover WASH and livelihood needs Myanmar has triggered urgent needs among the of 51,120 severely drought-affected people in three refugees and the host population. The Bangladesh regions of Somaliland: Togdheer, Sanag and Saahil. Red Crescent and the IFRC responded to the crises The focus lies on lowering the risk of waterborne dis- with a substantial emergency appeal and the de- eases through WASH activities and enabling the af- ployment of a large number of Global Surge units fected population to meet their basic needs through to Cox Bazar. The SRC and SDC contributed to the conditional and unconditional cash transfers.

53 In southern Ethiopia, food security severely deteri- for 50,000 people which included the distribution orated, now affecting 12.5 million people, after the of shelter items, food, water and hygiene kits and failure of both rainy seasons. In pastoralist Somali- school meal, food voucher and shelter programmes. land, livestock size was 70 per cent below average. Hurricane Maria hit the island of Dominica on 18 Moreover, ongoing clashes between Oromia and September as a category 5 storm and caused large Somali ethnicities lead to internal displacement. scale destruction of houses and critical infrastruc- The SRC reacted with a five-months emergency ture such as health facilities, power lines, roads, project in Moyale reaching 60,000 people. The SRC water supplies, etc. The SRC responded rapidly by and Ethiopian Red Cross provided supplementary supporting the shelter assessment of the IFRC with feeding for children, pregnant and breastfeeding a shelter expert and the relief operation with four mothers, emergency supply of potable water, im- members of the Logistics Emergency Response proved health and hygiene practices, and medical Unit (ERU). Moreover, a financial contribution to treatment for animals. the IFRC appeal was made to support the shelter response and recovery. In the complex context of South Sudan, fighting continued and humanitarian access remained very In August, South Asia experienced very strong challenging. The SRC joined forces with the ICRC by and long Monsoon rains, which affected around launching an integrated primary health care pro- 41 million people. Bangladesh, India and Nepal ject (2 years) in Maiwut state for 20,000 people. were the countries most affected. In Bangladesh, The project manages health facilities, provides cu- the entire Brahmaputra-Jamuna river basin across rative care, ante and post-natal care, psychosocial 27 districts in northern, north-eastern and central first aid and pathways for victims of sexual violence part of the country was inundated, 6.9 million peo- and emergency response in a very volatile security ple were affected. Most houses were damaged and environment. Moreover, the SRC seconded one of crops destroyed. Together with the Bangladesh Red its logisticians to the ICRC who was in charge of Crescent, the SRC launched a very rapid and effi- the main warehouse in Juba. In its bilateral, inte- cient response for 4,222 affected families in the grated health projects with the South Sudanese districts of Gaibandha and Sunamganj. The project Red Cross, the SRC continued to apply a develop- provided food for 2 weeks, fodder for the animals, ment approach, very much taking into account the seeds for crops and 5 medical camps, which treated fragility of the context. In Uganda, more specifically 5,950 patients. In a second phase, SRC and BDRCS in Adjumani district, the SRC continued to support focused on cash grants for 2,722 families in Gaib- the refugees from South Sudan through the relief andha district. project of the Uganda Red Cross and the German Red Cross in the Wash sector. Typhoon Haima (locally named Lawin) made land- fall in Peñablanca, Cagayan province, at 11p.m. on 19 October as a Category 4 typhoon with sustained Hurricanes and heavy rain winds of 225kph and gustiness of up to 315kph. It displaced over 200,000 people in Regions I, II, III The hurricane season of 2017 caused severe dam- and the Cordillera Administrative Region and left ages in many islands of the Caribbean. On 6 Sep- at least 15 dead and 4 people injured. The SRC tember, Hurricane Irma hit the region as a category provided cash grants to 250 affected households 5 storm. St. Marteen was one of the territories most to help reconstruct their damaged houses and pro- affected: most buildings and public infrastructure vided cash to support the restoring of livelihood were severely damaged and livelihoods destroyed. activities. The Netherlands Red Cross (which is the Host Na- tional Society on this island) requested the SRC to In Paraguay, recurrent storms and hail in Septem- deploy its Logistics Emergency Response Unit. In ber and October resulted in largescale damages three rotations, ten logisticians (team leader, ware- in houses, agricultural cultivations and livestock. housing, transport, airport, systems) supported The SRC responded through its partner organiza- the team of the Red Cross to mount the response tion Tesãi Reka Paraguay with food rations for 950

54 affected families and contributed to the resump- Disease outbreaks tion of their livelihoods trough provision with seeds. In Peru, heavy rainfalls between January and March In August 2017, Madagascar experienced an out- led to severe floods and mudslides. The SRC partic- break of the plague; the numbers of infections ipated in the emergency response of the German were increasing rapidly and most of the cases were Red Cross, which secured access to drinking water infected with the more dangerous, pneumonic and sanitary infrastructure and provided first aid form of the disease. The government reported 171 and relief supplies. deaths and 2,119 total cases of plague. The IFRC and the Malagasy Red Cross responded quickly, applying the ,no regret, approach, which had been developed after the Ebola crises. The SRC responded to the request of the IFRC Society with the deployment of two health delegates.

Lessons learnt ––As forced displacements in protracted crises ––The coordination among the members of the tend to lead to a prolonged stay in the recipient RCRC Movement partners in large response op- country or area, the nexus between relief and erations has to be strengthened and clarified in recovery has to be strengthened in those con- order to avoid duplications and further stretch- texts. The challenge being that most governing capacities of the local partner. ,Shared ments work on return (or resettlement) scenar- Leadership, and ,Strengthening Movement Co- ios and do not wish to perpetuate the staying ordination and Cooperation, (SMCC) might be of the displaced people. concepts that help to better engage partners ––The operation in Bangladesh highlighted – and build on their strengths. The SRC will capi- again – the need for a more rapid switch from talize from its experiences and contribute to an emergency (FACT/ERU) response to a more the ongoing movement discussions through sustainable set up building more on local re- i.e. the Global Tools Review process. sources. This, however, also needs local capaci- ––In the response operation after Irma and Maria, ties to be ready to fill the gap. The SRC will rein- the added value of pre-existing partnerships force the efforts of the BDRCS (and RCRC part- with other Partner National Societies (in this ners in other disaster prone countries) to case the Netherlands Red Cross) has been clear- improve preparedness for response. ly highlighted. The SRC will review the response together with its partners and in order to fine- tune the coordination and deepen (and for- malize) the partnership where indicated.

55 Recovery

Beneficiaries of reconstruction and rehabilitation projects

2016 2017

Total Recovery 69,832 55,498

Improved drinking water 63,063 15,500

Individual aid 2,150 13,662

Hygiene promotion 37,140 10,898

Housing 17,000 8,574

Improved sanitation 37,140 3,800

Houses repaired/reconstructed 2,921 1,518

Health facilities (re)constructed 36 22

Schools reconstructed 31 10

Other public facilities reconstructed 36 10

In 2017, the SRC supported recovery interventions nearly 50 per cent of the targeted water supply sys- such as housing, reconstruction of public infrastruc- tems were repaired or reconstructed, now handed ture and capacity development in five countries in over and being fully functional. (See the WASH sec- the aftermath of disasters, namely earthquakes tion in chapter 3.1 for details.) (Nepal), typhoons and hurricanes (Philippines, Haiti), floods (Pakistan), and conflict (Armenia). Housing situations in zones The SRC reached 55,498 people by engaging in DRR, at risk improved WASH, the repair and reconstruction of homes, and the rehabilitation of economic activities to vulnera- Shelter plays an essential role in reducing vulnerable people affected by disaster. 1,518 houses were bility and building communities, resilience. Most repaired or reconstructed with an owner-driven people who have lost their homes through a dis- approach, reaching 8,574 housing beneficiaries, aster want to repair or reconstruct their homes as predominantly in the Philippines and in Haiti. 22 soon as possible. Many start the reconstruction pro- health and 10 other public facilities were reha- cess immediately after a disaster, whenever circum- bilitated, as well as 10 schools, most of them in stances and resources permit. As defined by IFRC, the context of comprehensive community-based shelter is not just a matter of building a ,product, – DRM or Disaster Management (DM) programmes, but rather a ,process, whereby people can improve namely in Honduras, El Salvador, Laos, and South their own homes and engage to create a safe and Sudan. In keeping with the SRC,s integrated ap- secure environment. SRC attempts to support the proach, post-disaster projects usually have a WASH most vulnerable families in this process, by provid- component, as appropriate in the given context. ing cash and material, technical expertise and social In the Philippines, for example, 85 per cent of tar- assistance. Hereby, the SRC facilitates the affected geted households were using water from one of people in their self-recovery strategies, relaying on the 26 improved and sustainable sources. In Nepal, simple and culturally adapted house designs.

56 In 2017, the SRC mainly supported housing recovery in Haiti and the Philippines, with a few additional ones in Honduras. In total, 1,518 beneficiary households moved into their homes erected: 490 families now inhabit safe core shelters built to be typhoon-resistant, and 478 families now live in homes repaired using disaster-resistant building techniques. Due to special circumstances, 44 households affected by typhoon Haiyan and situ- ated in so-called no-build-zones were successfully relocated to government-owned land. 422 families use a repaired or reconstructed latrine supported by the projects. The SRC strongly emphasizes the A Swiss Red Cross technical expert oversees reconstruction works in Corail, Haiti. Using locally available material, the houses are built in such a way that they can resist a storm build-back-safer approach, focussing on trainings, of medium force. © Florian Kopp awareness rising, and technical advice. This aims at improving the living and housing conditions of the people concerned, and to bolster the resilience of systems and structures. building techniques. In Nepal, an overall increase of awareness in the municipalities for safe building Trainings of local construction workers effec- techniques could be accounted for; at least 90 per tively contributed to the disaster safety of homes. cent of the trained skilled and semi-skilled masons In 2017, in total 208 skilled or semi-skilled carpen- are now engaged in owner-driven reconstruction ters and masons in the Philippines and in Haiti have activities. been trained by specialised organisations in how to use disaster-resistant building techniques to re- In addition to trainings, 30 per cent of the house- pair and reconstruct private dwellings and public holds were made aware of safe settlement and infrastructure. All trainings emphasised practical disaster-resistant building techniques in the exercises, be it on the basis of model houses, model Philippines, through community orientations, cam- construction elements or through on-the-job train- paigns and/or the distribution of leaflets. Also in ings while carrying out repairs or reconstruction. Nepal, the project continued with public events at Model houses also served as future learning sites, the demo houses and the distribution of IEC ma- to raise awareness and disseminate guidance on terial. safe housing, including through Information Edu- cation Communication materials. In the Philippines, In Nepal, the project focused on providing techni- over 95 per cent of the trainees were certified after cal assistance to enable households affected by the training, whereas in Haiti 100 per cent of the the earthquake to rebuild their homes to last and training participants were provided a certificate. be safe. In 2017, 550 households sought technical The high standard of construction displayed by the instructions at the model houses or obtained direct core shelters in the Philippines was an indication on-site advice. In the Philippines, the project staff that the trained workers had put their newly ac- and villagers as well obtained valuable external quired knowledge into practice. In Haiti, as per ob- technical support by the professional organisation servations of the delegate, the homes repaired with Build Change, gaining a lot in terms of a standard- SRC support can clearly be distinguished from ordi- ized approach towards technical improvements in nary houses due to visibly applied disaster-resistant improved repairs.

57 Sustainable DRM structures in place and and tasks of various governmental institutions and DRM knowledge increased how they can approach them for emergency or development support. By the end of 2017, communi- In 2017, the housing projects in the Philippines and ties were better protected against natural hazards the recovery programme in Pakistan included DRR and have improved access to public facilities, due interventions to improve preparedness for future to structural and non-structural mitigation activities disasters. such as retaining walls and gabion walls, bridges, footpaths, as well as community emergency trans- In the Philippines, the six targeted communities portation plans. established functional and active DRR committees that are now linked to higher-level DRM systems. By the end of 2017, villagers knew their major disaster Living conditions improved and climate related risks and how to take concrete actions to reduce them. In five villages, small-scale Thanks to livelihood orientations, technical train- structural mitigation activities were implemented. ing and conditional cash grants, lost assets were Around 65 per cent of the households have pre- replaced and income security was improved for pared their own family contingency plans and 40 all targeted households in the Philippines. 10 per per cent of the households directly participated in cent had stable knowledge and 78 per cent gained DRM promotion activities. knowledge in regard to livelihoods. In Haiti, several small interventions in agriculture and fishery aimed 246 volunteers were recruited and trained in DRR at contributing to partly reestablish the subsistence and Vulnerability and Capacity Assessment (VCA) economy and income basis of households. The rein the six project villages, 60 per cent of the trainees plantation of banana trees, horticultural activities, completed all the training sessions and registered the replacement of canoes, trainings in Terra Preta, with the PRC for future engagement. Moreover, compost techniques and fish conservation as well the Red Cross Action Team (RCAT) in Ormoc Chap- as a cash for work project showed good results. In ter was reorganised, retrained and provided with Pakistan, 70 per cent of trainees in kitchen garden- the relevant equipment. Shortly after the training, tailoring/sewing and embroidery, crop produc- ings, they successfully proved their newly acquired tion and IT started using new techniques in 2017 to knowledge and skills during high level flooding in improve their earnings. 50 per cent of participants Ormoc City in the City Government,s search, res- reported positive improvements to household cue and evaluation operation. A number of first livelihoods. Contributing to livelihood opportuni- aid trainings, health and hygiene dissemination ties and healthier living conditions, in Nepal four sessions as well as search and rescue trainings for events of “off-seasonal vegetable farming” were representatives of all villages were also conducted organized. With this initiative the capacity of the in Cagayan for over 450 families. farmers to increase production and profitability of vegetables was enhanced, resulting in an increase In Pakistan, all three targeted community based of their income. For example, around 25 per cent organisations (CBOs) were formed and trained in of the participants currently apply their knowledge social mobilisation, project management and link- gained in the training by farming tomatoes all year age development. They are now aware of the roles around.

58 Lessons learnt ––The compliance with quality standards for re- ––A clear trend in 2017 was self-recovery with a pairs of private homes remains a challenge. If strong focus on the existing building culture, the SRC wants to have a say in the technical the use of local construction material and local- quality of repaired homes, minimum standards ly adapted building techniques, as the case of need to be agreed with the partner (ideally Haiti illustrates. This approach needs strong with HNS) and advocacy needs to be done to- technical as well as community engagement wards donors, partners and beneficiaries for skills as the population concerned is not always adopting those quality standards agreed for in favor of their local house designs, but rather the context. prefer designs imported from urban contexts, ––Project planning and implementation need to which promise higher social prestige. stay as flexible as possible; each recovery inter- ––What role the SRC will have in future recovery vention is unique. The work has to be done in interventions, especially in urban contexts, and phases, starting small and continuously ex- what the organisation with its partners can do panding so that lessons can be learnt from ex- to be better prepared in the shelter sector in periences and new findings integrated over future disasters are questions that were subject time. This was also shown in various evalua- of intensive strategic discussions in 2017. These tions after the earthquake in Haiti and the Tsu- discussions will continue in 2018. nami in Asia. ––The SRC benefits from strong internal and ex- ––More expertise and resources need to be internal knowledge management in reconstruc- vested in participatory processes in and in so- tion and rehabilitation. For the last five years, cio-cultural aspects of reconstruction pro- SRC has taken an active role in regular Swiss grammes. In Haiti valuable experience is made NGO learning events, newly started to coordi- with the position of an agent sociale in this re- nate its recovery strategy with other Partner gard. National Societies (PNSs), and internally mas- ––For beneficiary selection, a transparent and ters a shelter and reconstruction working well-structured process needs to be in place, group where experiences are exchanged, les- including a robust complaint mechanism. This sons learnt presented, and evaluations and goes not without direct and close involvement studies discussed. Current and new reconstruc- of SRC delegates to ensure a fair handling of tion and rehabilitation programmes benefit each individual case and to initiate adequate directly from these exchanges. adjustments, as experience showed in the Philippines.

59 Disaster risk reduction

Monitoring of selected outcome indicators DRM1: % of communities at risk with a functional* As from 2017, the SRC monitors the following outcome indi- emergency committee cators. SRC programme countries provide projectbased indicator data in accordance to their thematic priorities (see 100% details on methods in chapter 3 above). Note that projects have different durations so that the year of baselines and tar- 80% gets vary.

60%

40%

20%

0% Before 2017 Target

Bolivia Ecuador El Salvador Ghana Haiti Kyrgyzstan Nepal Paraguay

* In order to be “functional”, an emergency committee must comply with the following 5 criteria: 1) trained, 2) equipped, 3) recognized by the national DRM system, 4) linked to the superior level, and 5) active (emergency response and recovery, simulation exercises).

DRM2: % of community based structural protective measure DRM3: % of tested disaster response plans updated annually functioning and managed properly and linked to the provincial response mechanisms

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Honduras Vietnam

Contribute to the following SDG targets: 1.5 : By 2030, build the resilience of the poor and those in 11.B : By 2020, substantially increase the number of cities vulnerable situations and reduce their exposure and vulner- and human settlements adopting and implementing inte- ability to climate-related extreme events and other eco- grated policies and plans towards inclusion, resource effi- nomic, social and environmental shocks and disasters ciency, mitigation and adaptation to climate change, resil- 11.5 : By 2030, significantly reduce the number of deaths ience to disasters, and develop and implement, in line with and the number of people affected and substantially de- the Sendai Framework for Disaster Risk Reduction 2015- crease the direct economic losses relative to global gross 2030, holistic disaster risk management at all levels domestic product caused by disasters, including water-re- 13.1 : Strengthen resilience and adaptive capacity to cli- lated disasters, with a focus on protecting the poor and peo- mate-related hazards and natural disasters in all countries ple in vulnerable situations

60 In 2017, the SRC implemented 19 Community Based projects typically comprise disaster preparedness Disaster Risk Management (CBDRM) projects in 14 and disaster prevention/mitigation components. countries. Five projects apply a standalone CBDRM methodology; 11 have a broader approach with a The SRC reached a little more than 300,000 benefi- resilience-oriented focus, integrating health and/ ciaries with Disaster Risk Reduction (DRR) in 2017. or WASH components. The remaining three include This figure is lower than in the two previous years the recovery projects in the Philippines and Paki- mainly because two larger recovery programmes stan, described also in the recovery section above. with DRR elements ended in 2016. Furthermore, The SRC is increasingly supporting DRR in urban the SRC considerably reduced its funding contribu- contexts, 2017 in Honduras, Nepal, Bangladesh, tion to a CBDRM programme in Armenia and Geor- Kyrgyzstan and Bosnia and Herzegovina. CBDRM gia, implemented by the Austrian Red Cross.

Number of beneficiaries in disaster risk reduction

2016 2017

Total DRR beneficiaries 398,068 303,820

DRR awareness 282,060 167,486

Early warning systems 121,564 166,907

Risk mitigation 117,890 76,280

DRR education 65,679 28,156

DRR committees supported 532 563

Awareness raising and early warning systems were Disaster preparedness the main activities (54 per cent each), followed by risk mitigation (25 per cent). Key actors in DRR in- Disaster preparedness is an entry point of SRC sup- terventions were 563 committees, through which port in CBDRM programming. Capacity strengthen- partner organisations raised awareness of more ing of local level DRM structures, multi-stakeholder than 167,000 people. 28,000 schoolchildren bene- collaboration, early warning systems, contingency fitted from school-based DRR and Climate Change planning and evacuation systems are essential el- Adaptation (CCA) activities. Most of the beneficiar- ements. ies covered with DRR interventions in 2017 live in Asia (32 per cent), followed by Latin America & Car- Functional emergency committees in communities ibbean (26 per cent), Africa & MENA (24 per cent) at risk (see diagram DRM1) are a key element of and Europe & CIS (18 per cent). CBDRM and currently supported in eight SRC programme countries. Bolivia, Ecuador, Paraguay and Nepal only started project activities in 2017, including formation of committees, awareness raising of municipal authorities, capacity building and equipment of committees, vulnerability and capacity assessments, and hazard mapping.

61 In Kyrgyzstan, the continued collaboration of longer required direct accompaniment. They devel- all major community structures, state bodies and oped, implemented and updated their respective partners at municipal and district levels in Talas plan of action autonomously, were linked to and province, mainly based on simulation exercises and requested support from their respective partner through joint small-scale projects, has a high poten- organisations at the municipal level, showed lead- tial for sustained disaster management. All 12 local ership and coordination capacities in their commu- disaster management committees have attained a nity, and proactively assumed their role as agents of good level of functionality. School-based disaster change. In coordination with the ministry of educa- management activities also increased disaster pre- tion, all schools with SRC collaboration have inte- paredness of teachers and schoolchildren, e.g. the grated DRR and CCA in their curricula. These schools winner of first aid competitions at Talas province have trained disaster management committees, took the second place at the national level compe- have their own security and evacuation plans and tition, a significant improvement to previous years. are involved in DRR activities in their respective communities. For example, in the intervention area In Haiti, hurricanes Irma and Maria provided an- of the departments of Valle and Choluteca, 91 per other opportunity for a reality check of the prepar- cent of the school children adequately named the edness structures at the local level. An awareness risks they are exposed to and the measures required raising campaign to prepare the communities for risk reduction and environment conservation. started two months ahead of the hurricane season, Families increasingly know the hazard risks and involving the “Comités Communaux de la Protec- consequences of climate change, they have their tion Civile“ (CCPC) and the local Red Cross branch. own family emergency plans and are aware of the The activities led to stronger coordination and in- early warning systems and evacuation routes. They tegration of the different involved actors and in- also have developed their own climate change ad- creased credibility of the local structures among the aptation plans. In the intervention area of Olancho population. While considerable progress has been for instance, 77 per cent of the families know the made regarding all criteria, none of the 26 commit- community preparedness and risk reduction plans, tees reached the functionality threshold yet. 100 per cent of the families developed family emergency plans and 82.5 per cent apply them, and 100 In Ghana, the community disaster preparedness per cent of the families know the family climate and response teams practiced the newly acquired change adaptation plans and 84 per cent apply at skills through regular environmental cleaning cam- least 5 measures. paigns and educating communities on environmental sanitation, firefighting, live saving and first In Bangladesh, the project created networks of aid. Community teams on three occasions helped interdependence that galvanize local governance to control fire outbreaks and on four occasions structures in fulfilling their development and dis- were called upon to rescue people from drowning aster management (DM) mandate more meaning- in the river. The 25 consolidated committees have fully. This was especially the case with the dedicated attained a good functionality level (44 per cent). DM committees at the Union (communal) level. Sub-national structures with DM mandates have In El Salvador, 2017 was characterised with the started working proactively around response, mit- start of a new phase with additional communities igation and preparedness plans, which was earlier and thereby a focus on forming, capacity building reactive, ad-hoc and fragmentary. Good linkages and equipping of community level civil protection have been built with early warning systems at the committees. For the communities in the consolida- subnational and national levels. In the Char region, tion phase, a further increase of the functionality which characterised by dispersed settlements, the of their committees could be noted, 13 out of 21 effectiveness of early warning is essentially a func- committees fulfilled all the criteria (62 per cent). tion of appropriate dissemination strategies. The endline survey revealed that flag hoisting and an- In Honduras, 100 per cent of the community level nouncement using megaphone are perceived as committees that were in a consolidating process no most effective mediums of early warning dissem-

62 ination. Evacuation plans with embedded route maps have been updated regularly. Mock drills were carried out in which more than 1,500 people participated with women being in majority. Floods in 2017 tested again the robustness of the preparedness measures and response capacity built by the project, with a similar success rate like the previous year. Community empowerment of the SRC CBDRM programming demonstrated impact beyond the scope of the programme: there is enhanced community connectedness within themselves and with the larger set of stakeholders touching their lives. The social capital and social cohesion that has been fostered allows the target communities to better Nurzat (14) and her mother Jamilya in Kyrgyzstan lost their entire cattle and harvest after a flood two years ago. Thanks to the SRC DRR project, the river bank was strength- engage with preparedness and mitigation actions. ened to prevent flooding of the family,s strawberry field.© SRC, Remo Nägeli Due to efforts both at awareness building and community mobilisation, the sub communal meetings (“Ward Shavas”) witnessed high levels of community participation. Subsequently, after compilation response mechanism, as shown in diagram DRM3. of Ward level plans, three Union level (communal) Improvements could be observed with regard to Councils called for open budget declaration events the clarification of the chain of command and roles and presented their annual budgets among the and responsibilities of involved agencies, identifica- common audience. tion of suitable evacuation points and clarification of the functioning of the communal early warning In Ethiopia, the disaster prevention and prepar- system. At the household level, awareness raising edness and Red Cross committees and trained vol- efforts show promising results: 94 per cent of sur- unteers could put their newly acquired skills into veyed households reported they would know what action, in responding to one of the worst droughts to do to prepare for a disaster, compared to 64 per affecting the area in decades. The local structures cent during the baseline (early 2016), and 82 per provided early warning information at a very early cent (2016: 50 per cent) indicated they would know stage, carried out emergency relief efficiently, man- where to go in the event of a disaster. The most aged to identify and refer malnourished children common preparedness actions mentioned included to treatment centres and successfully mobilised watching the news / weather forecasts, reinforcing resources for water trucking. houses, storing food and medicine and preparing useful equipment (e.g. flashlight, candle). In Bosnia and Herzegovina, increasingly complex simulation exercises were a valuable method to test skills and procedures at community and municipal Disaster prevention and mitigation levels. The involved stakeholders took over leading roles in the preparation and conduction of the ex- Reduced hazard exposure and vulnerability is the ercises. The collaboration between municipalities, second expected outcome of SRC CBDRM program- civil protection authorities and the Red Cross was ming. The key ingredients are hazard-proofing of further strengthened, leading to increased mutual critical sites at community and household level, and trust and recognition. protecting, rehabilitating and managing sustainable resources. In Vietnam, the programme focus was on contingency planning at the communal level. By the end In Honduras, communities and individuals con- of 2017, out of the total 13 targeted communes, tinued taking ownership with regard to better four (31 per cent) had established and tested disas- protecting their (micro) watersheds, applying a ter response plans that are linked to the provincial range of techniques for slope stabilisation, soil res-

63 toration and protection of water supply systems. 1) The “Protective and Productive System” doesn,t Protection measures for individual homesteads only produce fresh and good quality vegetables but were conducted with own funds. Many such criti- at the same time protects the homesteads against cal sites, formerly considered as areas of high risk, land and mud sliding as well as flooding (similarly converted into “zones of opportunity”. The families to the “zones of opportunities” in Honduras, see took advantage of the extra space for co-benefits above). 2) “Permaculture farms” at the household (medicinal plants, fruit trees, vegetable production, level also yield multiple benefits: apart from pro- partly for markets) and were thus motivated to pro- ducing fruits and vegetables, it increases the forest vide the necessary maintenance support. The use cover of the area and carbon storage in trees and of these sites is a perfect example showcasing the soil. 3) “Plants with soilless roots”, a technology for multiple benefits of linking DRR and CCA with nat- handling nursery plants without the need of plastic ural resource management and livelihoods for in- bags, is ecological, inexpensive and easy to under- creased sustainability. Community level protection stand. measures, e.g. reforestation, soil-bioengineering, check dams and dry barriers, are executed as micro In Bangladesh, in the Char region, characterised by projects under the leadership and management of small non-permanent islands at risk of river erosion the community level committees, but involving the during monsoon season, risk mitigation mainly fo- communities in the identification, prioritisation and cuses on raising household plinths for flood protec- implementation of measures. By the end of 2017, tion, building flood-proof tube wells to ensure year 96 percent (227 out of 236) measures complied round access to safe drinking water as well as con- with the set standard (diagram DRM2). All micro structing flood shelters and access infrastructure projects were integrated in the municipal devel- (wooden bridges, culverts, road repair) to facilitate opment plans, backed by the local authorities and communication and evacuation. Since the mitiga- co-financed by municipal budgets. Reforestation is tion options are based on local knowledge, have increasingly part of a larger micro watershed pro- been developed in consultation with users and tection scheme which also includes legal protection have an inbuilt element of community contribution of the area (“declaratoria”), provided by the Insti- (minimum of 10 per cent of investment costs), they tute for Forest Conservation (IFC). In the interven- are generally well accepted with a fair degree of tion area of the department of Olancho, reforest- ownership and involvement. The 2017 floods again ation has gained momentum, behaviour of the validated the appropriateness of the whole array of communities towards reforestation is changing as measures, as did the flood the year before. it is perceived not only as a resource protection and risk mitigation mechanism but additionally as part In Pakistan, the risk mitigation (foot tracks, bridges, of sustainable livelihoods. A big success is the in- gabion walls, retaining walls, check dams) and wa- volvement of the cattle-breeders who proved to be ter supply schemes that have been implemented very reluctant but due to ongoing dialogue are now in Manoor Valley as part of the 2010 flood recov- part of the solution, actively taking reforestation ini- ery programme, reduced the risk related to flood- tiatives. In the intervention area of the departments ing and landslides. The valley remained accessible of Valle and Choluteca, through increased coordi- throughout the monsoon seasons which wasn,t the nation and advocacy dialogue, the municipalities case before. increased their budgets for DRR measures by 10 per cent. In Kyrgyzstan, risk mitigation was an important component in 2017, carried out in form of locally In Haiti, in addition to the successfully ongoing soil led micro projects and included water works to conservation (e.g. reforestation, progressive terrac- reduce flood risks (metal-concrete trays, water ing, pile walls with plants) and organic agriculture reservoir / gate), reinforcement of riverbanks, con- measures (e.g. lombri-composting and terra preta struction or repair of bridges as well as cleaning of gardening), a series of newly introduced natural mudflow channels and drainage systems. resource management technologies are creating a similar level of ownership at community level:

64 DRR mainstreaming programmes, currently in the Philippines and Pakistan. In Kyrgyzstan, DRR elements are inte- Whilst the SRC practices DRR mainstreaming grated into several activities in the Elderly Care throughout International Cooperation, progress and Eye Care projects, such as capacity building still differs considerably and can be grouped into in first aid and earthquake preparedness in urban three categories: settings. Ghana demonstrates an increasingly programmatic and geographic focus including ––in the framework of a resilience approach, either WASH, health and DRR and includes prepared- at project or country programme level, Honduras, ness activities for health in emergencies. These Haiti, El Salvador, Vietnam and Ethiopia integrate programme countries have reached a good de- DRR with health and/or WASH. The integrated gree of DRR mainstreaming. projects demonstrate a range of DRR and health synergetic effects at the level of communities ––particularly in the African programme countries and project staff that go beyond mere DRR main- of Mali, Togo, Lebanon, Sudan, South Sudan and streaming. Malawi, as well as the European programme countries of Armenia, Moldova, Belarus and Bos- ––the disasterprone countries Nepal and Bang- nia and Herzegovina, mainstreaming efforts ladesh with large health or WASH programme are still at an early stage. Even though not all mainstream DRR by incorporating DRR out- programme countries are equally affected by comes or outputs. With the start of the new climate and hazard risk, a stronger SRC inhouse phase of their programmes, this is now also the support is needed to achieve an acceptable DRR case for Bolivia, Paraguay and Ecuador. The same mainstreaming level. accounts in general for the integrated recovery

Lessons learnt ––2017 again demonstrated that context and –– Contribution of communities and local author- hazards risks are dynamic. As a minimum stand- ities increases ownership and sustainability of ard, CBDRM programming must endeavour to measures. To ensure maintenance, focus must repeat context and risk assessments at regular be on affordable and environmentally sound intervals and adapt DRM and contingency solutions that are technically adapted to local planning accordingly. skills and based on locally available materials. ––Experience to date highlights the importance As a minimum standard, CBDRM programming of building on and working with existing struc- must insist on in-cash or in-kind contribution of tures for strengthening the DRM system. As a major stakeholders. minimum standard, CBDRM programming ––The current implementation status and the ex- must imply working at the community and lo- pressed needs of many SRC delegations re- cal authority level. quests for DRR mainstreaming guidelines to be elaborated as a high priority for 2018. As a minimum standard, all SRC (health, WASH, reconstruction etc.) programmes must ensure climate and disaster risk proofing of any structural measure.

65 Institutional preparedness

Monitoring of selected outcome indicators IP1: % of National Society branches with disaster As from 2017, the SRC monitors the following outcome indi- management capacities rated well-functioning cators. SRC programme countries provide projectbased indicator data in accordance to their thematic priorities (see 100% details on methods in chapter 3 above). Note that projects have different durations so that the year of baselines and tar- 80% gets vary.

60%

40%

20%

0% Before 2017 Target

Lebanon

Number of trained staff in institutional preparedness (IP)

2016 2017

RCRC employees trained in IP 959 1,191

In 2017, institutional preparedness – the capacities of National RCRC Societies to respond to disasters – increasingly gained attention across the SRC country programs. 14 projects in 13 countries have incorporated institutional preparedness elements, often embedded in an over-all National Society Develop- ment (NSD) approach, as shown in the overview table below. An indicator of this is also the increasing number of RC volunteers being trained in Disaster Management activities by SRC projects, as shown in the table above.

66 Overview of Institutional preparedness activities per country in 2017

Activities Country

Assess the actual capacities of the National Society branch Lebanon, Kyrgyzstan, Ghana in DM, i.e. through OCAC/BOCA or WPNS/DRCE

Establish or update Contingency Plan Lebanon, Kyrgyzstan

Link the National Society more closely to the DM system of the Ethiopia, Bhutan, Vietnam, Bangladesh, government Kyrgyzstan

Establish disaster response teams at the communal/district Ghana, Honduras, Kyrgyzstan level

Strengthen links with the Red Cross Movement Lebanon, Kyrgyzstan, El Salvador (training, response operations)

Conduct simulations exercises Kyrgyzstan, Bosnia and Herzegovina

Train and equip volunteers and National Society staff for disas- Ethiopia, El Salvador, Honduras, Kyrgyzstan, ter response (e.g. first aid, rapid assessment, firefighting, cash Bhutan, Ghana transfer programming, and beneficiary selection)

Apply knowledge by responding to an actual, Ethiopia, Bangladesh major emergency (assessment, relief, monitoring)

In Kyrgyzstan, SRC and the Kyrgyzstan Red Cres- ment. The SRC also facilitated the exposure of the cent Society (RCSK), have implemented a CBDRM RCSK to an actual international response: 2 DM staff project in Talas Oblast. The project contributed to participated in the relief operation in Bangladesh in strengthening the capacity of the RCSK at provincial the role of FACT relief and cash. and national levels, i.e. by training National Disas- ter Response Teams, updating Contingency Plans In Bhutan, in May 2017, the Bhutan Red Cross So- and participating in simulation exercises organized ciety (BRCS) was officially recognized as a National by the authorities. In 2017, the SRC and Kyrgyz RC Society of the Red Cross. In October 2017, the SRC have not only agreed to engage in a second phase and BRCS in collaboration with the Department of of the project, but also to deepen their collabora- Disaster Management of the government started a tion to include capacity development on various pilot project in disaster preparedness. The project organizational levels. This resulted in the signature will help to define the auxiliary role of the BRCS in of a Partnership Framework Agreement for 2017 emergency response. Moreover, BRCS volunteers – 2022. SRC supported RCSK to conduct Branch will be trained in Emergency First Aid together with Organizational Capacity Assessment (BOCA) in all Search and Rescue Teams. branches in order to assess the capacities at branch level. Based on the results and identified priorities, In Ethiopia, in 2017, the institutional preparedness SRC agreed to support RCSK in upgrading their activities were embedded into the ongoing Resil- volunteer management. In cash-transfer program- ience projects of the Ethiopian Red Cross and the ming, SRC supported the preparedness within the SRC in Gambella and Moyale districts. In Moyale, the RCSK, i.e. by contributing to updating the plan of role of the ERCS in the drought response was highly action or facilitating the participation of key staff in appreciated by the beneficiaries and strengthened specialized international courses of the RC move- the position of ERCS in Moyale. This, plus the fact

67 got heavily tested in 2017 as they responded to a cyclone, the floods and the Population Movement in Cox Bazar. The experience strengthened BDRCS capacities, but also highlighted the gaps in BDRCS capacity and accountability in disaster response. In 2018, the SRC aims at broadening its support to BDRCS preparedness for response at headquarters and Gaibandha branch level.

In Vietnam, the SRC and the Vietnamese Red Cross are implementing a DRR project in Ca Mau, into which the institutional preparedness of the local branch is integrated. The SRC supports the VNRC in Strengthening Emergency Medical Services and response capacities of the augmenting the quantity and quality of monitoring Lebanese Red Cross benefits Lebanese population and refugees. © SRC, René Schulthoff and in the application of participatory techniques. The VNRC chapter was also supported to engage more strongly with the local authorities (i.e. the Committee for Disaster Prevention and Control) in that ERCS is the only organization operating in dialogue and contingency planning. The SRC/VNRC both, Oromia and Somali regions, have motivated support in the response to the drought in 2016 con- ERCS headquarters to increase the status of Moyale, tributed to this significant progress. In 2018, insti- which improves the access to the local government tutional preparedness will be integrated also at the and to the ERCS headquarters. In Gambella, ERCS national level through the provision of support to has participated in 5 assessments in 2017 related VNRC HQ on Contingency Planning with the wider to conflict and floods in collaboration with the gov- humanitarian sector and the development of a spe- ernment and other agencies and the number of vol- cific project on Emergency Shelter and Cash Trans- unteers trained in first aid and CBHFA has signifi- fer Programming. cantly increased. Consequently, draft guidelines for volunteer and member recruitment and retention In Lebanon, – in parallel to supporting the ongoing have been developed jointly with ERCS headquar- response to the influx from Syrian refugees – the ters. Looking ahead, ERCS and SRC have agreed to SRC is working with the Lebanese RC in various as- strengthen their collaboration by entering into a pects of institutional preparedness at national and long-term strategic partnership which in addition branch level. The Contingency Planning Project, a to emergency and development projects will focus result of the earlier Logistics Capacity development on the Organizational Development of the ERCS project, aims at improving the response capacity branches in Gambella and Moyale. and contingency stocking of 14 branches. The project teamed up with the response preparedness (RP) In Bangladesh, the SRC aimed to strengthen the project of the Lebanese RC and the Netherlands capacities of the Bangladesh Red Crescent, notably RC which focuses on the requirements, roles and the team at the branch in Gaibandha district. On the responsibilities of the Emergency Medical Services level of the DRR project, the BDRCS team conducted during emergency situations. In that context, the a stakeholder mapping of Disaster Management SRC / LRC piloted an Institutional Preparedness indi- actors on District level, including public and private cator which was based on a survey derived from the partners as well as knowledge organisations. The IFRC,s well-prepared national society framework. team developed a stakeholder engagement plan The survey helped capturing the degree of prepar- with clearly defined responsibilities for the BDRCS edness on branch level and indicated where there branch, BDRCS headquarters as well as the SRC is some potential for improvement. As diagram IP1 team. The plan will be implemented in 2018 and shows, 40 per cent (4 out of 10) were considered will link the Red Cross systematically into the local “well-functioning”. DM system. The capacities of the BDRCS in response

68 In Ghana, the SRC supported the Ghana Red Cross The SRC also strengthened its collaboration with to establish Disaster Response Teams in 40 Districts the IFRC at global (Geneva) and regional level in 8 Regions. By 2017, 34 GRCS District Disaster (esp. in Asia and Europe) to coordinate the efforts Response teams were established, trained and of the RCRC partners in institutional preparedness equipped. GRCS headquarters has a data base of of the RC through: these response teams and is equipped to respond to emergencies. In the Northern Region, the vol- ––Harmonizing the RCRC tools for Institutional Pre- unteers had the opportunity to apply and increase paredness, notably the ,Well Prepared National their skills during the response to the meningitis Society, (WPNS) Tool (designed at IFRC Geneva out-break. The volunteers disseminated preventive level) and the ,Disaster Response Capacity Evalu- messages during home visits, community health ation, (DRCE) Tool (designed by the Canadian RC durbars and on interactive radio discussions. In and widely used in the Asia and Africa contexts). 2017, Ghana RC underwent the Organisational Capacity Assessment & Certification (OCAC) review ––Strengthening the efficiency of the RCRC -re facilitated by the IFRC. The SRC has offered its read- sponse by contributing to the review of the IFRC iness to support implementation where needed. Global Tools. The SRC actively contributes to the review process of the Disaster Management Tools In Bosnia and Herzegovina, the SRC supported the of the IFRC at global (and regional) levels, notably Red Cross from Bosnia and Herzegovina through in the reference groups ,leadership, and ,assess- the CBDRM project in Šamac, Orašje and Brčko ment and planning,. Districts. Red Cross staff and volunteers from the 3 districts were involved in complex simulation ex- ––Strengthening preparedness in Cash Transfer Pro- ercises with civil protection and communities. The gramming. The SRC is member of the global Cash exercises strengthened the network with the local Peer Working Group of the RC movement. At Eu- authorities and fostered a common understanding rope and Central Asia regional level, SRC co-funds of each other,s skills and procedures in the given the position of a regional Cash Coordinator based scenario. The SRC and the Bosnia Red Cross also in Kiev who works on the Capacity Development worked together on the next phase of the project, of the regional National Societies. which will focus more strongly on institutional preparedness. ––Strengthening preparedness for response in logistics. As member of the technical working group of In Honduras, the institutional preparedness com- the Logistic ERU,s and active partner of the IFRC ponents were embedded into the resilience pro- in logistics capacity development, the SRC con- jects of the SRC and the Honduras Red Cross in the tributes to better coordination and efficiency in Zona Sur and Olancho. In the Zona Sur, the project emergency logistics. supported the organization, planning, training and equipment of the Red Cross teams at sub-district The SRC also continued to strengthen the prepar- level. In 2017, progress was made in quantity and edness for response of its headquarters and the quality of functional local teams. They increasingly delegations. The delegation preparedness tool has worked according to the predefined operational been tested in Vietnam and Bangladesh. plan and reported on it. Progress was also achieved in the training of the volunteers according to the regional capacity building plan. In Olancho, the activities in 2017 focused on the capacity building of the volunteers in risk management and community health.

69 Lessons learnt and implications for next year: ––Whenever necessary or possible, the institu- ––Institutional preparedness activities have to be tional preparedness activities have to be tested ,owned, by the local partner. If the agenda is in ,real, when responding to disasters. Integrat- pushed by the international partner, chances ing lessons learned from response to prepared- for sustainability are lower. Therefore, the tim- ness and vice versa will not only strengthen the ing of the interventions is crucial and has to Nexus (or LRRD), but also the response and pre- follow the planning of the local partner. paredness activities as such. ––The impact of institutional preparedness activ- ––Institutional preparedness is located at the in- ities also depends on the coordination of the tersection between DRR projects and organiza- various (international) partners contributing to tional development & capacity building of the this end. SRC will increase its efforts to coordi- local partner. The synergies with NSD have nate and seek synergies with the activities of been taken more and more into account by the other partners, notably those within the RCRC programs. This process will be encouraged and Movement. This relates to coordination on lo- strengthened in 2018. cal, national, regional and global level.

70 71 72 Health education session in South Sudan. The SRC supports the South Sudanese Red Cross to prevent Cholera. © SRC 4. Continental programmes

Africa and the Middle East increase delegation security, mainstream conflict Head of Division participated at a coordination sensitive programme management and to learn conference in March. from the projects in Africa and Middle East. In Partnership and alliances addition, a field visit allowed the participants to Since 2016, the relationship with the Ecuadorian In 2017, the exchange with National RCRC Soci- see what Disaster Risk Reduction (DRR) con- Red Cross has improved. The reconstruction pro- eties in Africa was strengthened through the cretely means in Ghana and gave some practical jects after the 2016 earthquake are implemented participation of the SRC President and the Head ideas for the implementation of DRR programs by the Red Cross. SRC was monitoring the activi- of the Division Africa/Americas at the Red Cross as stand-alone projects or as components of ties of the Emergency Appeal and was involved Red Crescent Pan African Conference in Abidjan. WASH projects. in the reconstruction of four drinking water sys- SRC HQ staff also participated at the Coordina- tems. tion meeting with Red Cross Partners in Juba, In order to strengthen knowledge sharing in the South Sudan, and at the Partnership meeting of field of blood safety, SRC, as member of the Afri- The Paraguay Red Cross Society is under observa- IFRC in Nairobi, Kenia. can Society of Blood Transfusion, launched a tion of the international Red Cross movement working group for IT technology in Blood Trans- due to various issues that the organisation is re- In Ethiopia, Malawi, Togo and Ghana, SRC started fusion Services and SRC and SRC-Project mem- quested to solve in order to remain a member of to strategically link project implementation with bers participated at the conference of the above the International Federation (IFRC). So far, the organisational development of the National mentioned organisation. requested re-elections and the revision of stat- RCRC Society (see chapter 5). In Ethiopia, the utes has not been organised and therefore the partnership between SRC and Ethiopian Red Fragility, Risk Management and Security international Red Cross movement is reluctant to Cross Society was strengthened through a pro- Fragility and security remain major concerns in cooperate directly with Paraguay Red Cross. Bo- gram visit of the SRC Vice-President and ex- Ethiopia, Mali and South Sudan as well as in livia Red Cross is also in the process of renovation changes with the board members of the ERCS. In Syria. The security situation in all these countries and reorganisation. Similar to Paraguay, SRC is Malawi, SRC supported the National Society with has worsened during the year. Moreover, there awaiting the outcome of re-elections before de- an Organisational Development specialist to ad- were security concerns also in Togo which was ciding on further support and cooperation. In vise the Secretary General on how to improve affected by violent protests during the year. In Paraguay, Bolivia and Ecuador, the main partners organisational management and analyse poten- South Sudan, the delegation remains under the of the SRC are indigenous or community based tial organizational problem areas and to accom- security umbrella of the ICRC. The delegations in organisations including their umbrella organiza- pany the Red Cross management in a change Ethiopia and Mali were supported by the SRC tion, and a health foundation, formerly a self- process. Security Advisor who visited the country offices help-group of people living with HIV. during the year. As SRC did not have direct man- In Guinea Conakry and Syrian Arab Republic, SRC agement responsibility in Syria and Guinea dur- Knowledge sharing and networking continued to implement projects in a consortium ing the reporting period, the staff security was of In May, a regional SRC workshop on financial with the Danish Red Cross. In South Sudan, SRC less direct concern to SRC. management was held in Honduras. Every SRC continued to play an active role in the process to project-country was represented by at least one strengthen Movement coordination and cooper- representative of the Finance Department. The ation. The process is quite far advanced. There is participants shared their way of working and transparency and trust among partners and also there were inputs from the two finance officers ICRC is part of the wider cooperation. The Red Latin America and from the SRC HQ who facilitated the workshop. Cross Movement in South Sudan has accepted to With a good mix of theory and practical exer- follow the financial administration and reporting the Caribbean cises, the facilitators covered topics from budg- system of the National Society and there is a ets to accounting, procurement guidelines and common country plan informing about the roles field financial reports. and responsibilities of the movement partners. Partnership and alliances Five staff members of the SRC Program in Para- In addition to the regular coordination and co- The partnerships between SRC and the Red Cross guay visited the Community Resilience and operation within the movement, SRC remained Societies of Honduras, El Salvador and Haiti are Health Management project in Olancho, Hondu- actively engaged as a member of the Swiss Wa- well established. Whilst some of the projects are ras in July. The purpose was to learn about con- ter Consortium for the implementation of pro- implemented by the partners, the larger part of crete experiences of DRR and CCA and its link- jects in Togo. the project implementation is under direct re- ages with the health component. Some of the sponsibility of the SRC in the three mentioned topics addressed were good practices on DRR Knowledge sharing and networking countries. A common challenge of the men- and CCA and health systems issues. The visitors A regional workshop with the SRC delegations tioned countries is the development of decen- participated in community experiences (work- from Africa and the Middle East and from Swit- tralised entities within the country with delega- shops on grafting, home remedies, fertilizers) zerland took place in September in Ghana. The tion of responsibility. Haiti is one of the “country and social micro-projects. It was a fruitful and objectives of the workshop were to strengthen labs” for improved cooperation and coordina- reassuring exchange that gave the guests from delegation and partner disaster preparedness, tion among Red Cross partners. Therefore, the Paraguay new ideas for their own programme.

73 The 16th meeting of the Health Network SRC Asia toring, one of the key building blocks of develop- South America (named Red de Salud) was held ment programming in a OD perspective. The in October. The event was hosted by the SRC Bo- workshop participants also received an introduc- livia team and attended by delegations from Ec- Partnership and alliances tion into Conflict Sensitive Project Management uador, Haiti, Paraguay and Switzerland. The main Several years of partnership building in Bhutan (CSPM) and spent time on developing their strat- objective of the meeting was to identify success- resulted in an overwhelming success in 2017. On egies for integrating the topic usefully in their ful experiences to be replicated and the defini- the 8th of May 2017, the National Red Cross So- country programmes. The workshop concluded tion of concrete actions and strategies to achieve ciety of Bhutan was officially and formally with an overview on delegation preparedness, an efficient knowledge management. Important launched in a ceremony under the helm of Her security and overall risk management and each topics for the development and innovation of Majesty the Queen of Bhutan, in the presence of country office established its specific action plan the programmes were discussed such as political the President of the SRC and the regional repre- to enhance or introduce the latest versions of contexts of the countries, monitoring and evalu- sentatives of the ICRC and IFRC. these management tools. ation, conflict sensitive programme management, successful experiences related with com- The difficulties in trying to establish a better com- The Regional workshop also saw the launching munity health, risk management, information, mon understanding and way forward that had of the regional Asian community of practice on education and training methods. befallen the long-lasting relationship between Mother, Neonatal and Child Health (MNCH). The the Cambodian Red Cross and the SRC in the past aim of this group is to foster knowledge man- The 3rd DRR and Resilience Workshop supported two years, prompted the SRC to announce its agement between the health teams of the Laos, by the Swiss Re financed DRR regional program ending of bilateral cooperation in Cambodia by Nepal, Bangladesh and Pakistan country pro- “Strengthening resilience in Central America and the end of 2017. grams. the Caribbean” took place on the Salvadorian coast at the end of October. The workshop al- The regional Disaster Risk Management (DRM) SRC organized two regional SRC finance and ad- lowed participants to gain new knowledge, get advisory delegate based in Vietnam allowed the ministration workshops in 2017, one in Moldova clarity on approaches, seek ideas to pilot activi- SRC to intensify its dialogue and cooperation for all East-European country offices and one in ties, and most of all fostered a dynamic peer-to- with the IFRC Regional Delegation in Kuala Lum- Nepal for the Asian ones. The main focus of the peer exchange between countries on local adap- pur, Malaysia and regional delegates of other Nepal workshop was to strengthen regional ex- tation to climate change. During the week, Partner National Societies. The SRC provided change and cooperation between SRC offices, concrete examples and theory inputs were funding for the Regional Logistics Capacity De- finance managers and enhance capacities in the shared between experts and teams from El Sal- velopment delegate and supported the IFRC and areas of internal control system, budgeting, vador, Haiti and Honduras to reflect how to bet- the Red Cross of Indonesia with a regional shel- managing procurement, fraud, and corruption, ter implement community based climate moni- ter expert. These efforts shall be sustained in understanding and managing audits, and ana- toring systems and how to better make use of 2018 and aim at fortifying the SRC,s embedding lysing audit reports. the collected data. in and coordination with the RC Movement in Asia. Fragility, Risk Management and Security Fragility, Risk Management and Security The SRC Risk Management expert visited the To better deal with the issues of fragility and se- Positive developments regarding thematic alli- country offices of Nepal and Bangladesh to con- curity, the delegation in Honduras was sup- ance building occurred in Bangladesh where the duct in-depth assessments of the overall security ported by the SRC Security Advisor who visited Bangladesh Red Crescent Society, the German situation, the Movement-wide security manage- the country office during the year. Moreover, SRC and Swiss Red Cross plus a number of national ment system and supported the SRC offices in organized a training workshop on conflict sensi- NGOs joined forces to answer the European De- developing their delegation security and contin- tive programme management and security is- velopment Cooperation (DEVCO) call for propos- gency plans. All other country offices scheduled sues in October. Participants were the project als on strengthening nutrition in Bangladesh. the improving and updating of their security coordinators of El Salvador and Honduras Red The collaboration during the proposal develop- plans for 2018, based on the then available new Cross Societies, the two SRC country coordina- ment phase clearly showed the potential of unit- SRC IC security management framework. tors, the programme coordinator for Central ing complementary organisations to form a America and the head of the disaster division stronger alliance. In Bangladesh, the SRC delegation took the next from SRC HQ. After inputs and discussion of the step to mainstream CSPM into the programme. relevant concepts, the participants worked on Knowledge sharing and networking A five-day training was held for projects staff specific tools for context analysis and conflict The 2017 Asia-Europe Division Regional Work- with the result that the frontline teams can now sensitive project design. These exercises were shop took place in September in Laos. For the first apply the CSPM tools in their projects. based on actual projects in El Salvador and Hon- time ever, it united the programme coordinators duras. A one-day module was dedicated to the and country coordinators of SRC ICs European The new internal control assessment tool of the security of the staff. Based on the SRC security and Asian programme countries for a joint ex- department was tested in an extensive field framework the participants learnt in practical change, learning and coordination experience. study in the Laos country programme. The topic exercises, how to assess and manage security The key topic that linked all workshop elements of ICS was also central in the two regional SRC risks and behave in critical situations. together was the SRC,s new approach to partner- finance and administration workshops in 2017. ships and cooperation, organisational develop- The new delegation preparedness tool was ment and capacity building. After introducing an tested in Vietnam in March 2017 by the Delega- overview of the current partnership-building and tion, Program Coordinator and DM Department Organisational Development and Capacity Build- representatives. The tool is part of the SRC,s own ing (OD/CB) initiatives and potentials of SRC IC, disaster preparedness effort and supports dele- the workshop provided a course delivered by gations to work on its response preparedness MDF Vietnam on participatory planning & moni- regarding a specific natural disaster event.

74 The overall security situation in Asia,s SRC pro- attended the renowned International Confer- gram countries remained more or less stable, ence on Integrated Care. The SRC was able to with some improvements in Bangladesh. The risk present eight brief inputs on their programs and of destabilisation and program disruption was learning. The visit concluded with an exchange demonstrated in a series of events in Bangla- visit with the Council of Dublin in relation to Age desh, where the SRC office supported the -na Friendly Dublin. tional society in one natural disaster after the other, the string of events culminating with the SRC organized two regional SRC finance and ad- tragic events in neighbouring Myanmar and the ministration workshops in 2017, one in Moldova subsequent mass influx of refugees in the Cox,s for all East-European country offices and one in Bazar region. With its well-established position Nepal for the Asian ones. The main focus of the within the Movement wide multilateral disaster Moldova workshop was to strengthen regional management system, the SRC was able and exchange and cooperation between SRC offices, ready to respond quickly with cash contributions finance managers and enhance capacities in the and – more importantly, key personnel second- areas of internal control system, budgeting, ments to the IFRC field hospital and logistics managing procurement, fraud, and corruption, set-up. Bilateral response took shape in the understanding and managing audits, and ana- WASH sector with proven partner German Red lysing audit reports. Cross and health infrastructure planning was initiated based on the sound SRC partnership with Based on the Ageing and Health knowledge the Ministry of Health, the ICRC and Action Con- management groups exchanges and learning tre la Faim. work, individual capacity building and mentoring of key SRC and NS personnel in the region continued successfully. The aim of this professional development work is to enable national personnel to plan and conduct planning work- Eastern Europe and the CIS shops, midterm reviews and to organize peer-to- peer workshops regionally.

Partnership and alliances Fragility, Risk Management and Security The SRC pursues its gradual strengthening of co- Risk to human security and disaster remain mod- operative ties with the IFRC Regional structure in est in all five programme countries. Potential Budapest and through the inclusion of ex- threats due to political developments however changes with National Societies outside the SRC require constant close monitoring. Program dis- program. The main themes of this regional coop- ruption due to natural disasters cannot be ex- eration are Ageing and Health and disaster risk cluded in Bosnia Herzegovina, Kyrgyzstan and management. New partnerships on Ageing and Armenia. A specific risk to sustainable program- Health were initiated with the Red Cross Socie- ming remains the fragmentation and volatility of ties of Ukraine and the Former Yugoslav Republic the political systems. Successes are clearly possi- of Macedonia (FYROM). The latter also plays a ble in small to medium-sized administrative en- role in SRCs work on migration, together with tities, nation-wide integration may remain be- Greece. low expectation.

Partnership also continued with the Danish and Austrian Red Cross partners in the framework of disaster preparedness and risk reduction in the Southern Caucasus. In June, the SRC hosted the annual consortium workshop for the ECHO funded regional DRM programme in Wabern, attended by the representatives of the Red Cres- cent Society of Azerbaijan and the Red Crosses from Georgia, Armenia, Denmark and Austria. In order to support regional RCRC cash expertise the SRC financed the translation of the IFRC online Cash Toolbox into Russian language and contributed to the funding of the IFRC Regional Cash Coordinator position in Ukraine.

Knowledge sharing and networking The 2017 annual learning event of the Ageing & Health Knowledge Management Group Europe/ CIS united the programme and country coordinators of the SRC in Dublin in May. The group

75 SaifurFoundation Rahman ceremony Saffi, einof the Mitarbeiter Bhutan Red des Cross Bangladesch Society inRoten May 2017,Halbmondes with the hält presence einen Säugling,of Her Majesty während Jetsun seine Pema, MutterPrime Minister von76 der H.E. Krankenschwester Lyonchhen Tshering Francis Tobgay Duclos and in der SRC mobilen president medizinischen and IFRC Vice-President Klinik des Kanadischen Annemarie RotenHuber-Hotz. Kreuzes in© derRoyal Notunterkunft Office for Media, Kutupalong, Bhutan, GelayBangladesch Jamtsho untersucht wird. © IFRC, Victor Lacken 5. Learning process: Partnership and National Society Development

Number of volunteers and employees of partner organisations trained

2016 2017

Total employees and volunteers trained 25,688 23,738

RCRC employees trained 1,168 971

RCRC volunteers trained 7,564 8,779

NGO/CBO employees trained 446 858

NGO/CBO volunteers trained 11,444 7,756

Government employees trained 5,066 5,374

The SRC recognizes that powerful local partner or- joint learning process on NSD. The common interest ganisations are required for sustainable develop- in a strong Red Cross Movement is underlined in a ment in health and disaster management since they Memorandum of Understanding between SDC, IF- are increasingly a prerequisite for access to the ben- RC and SRC. SDC not only supports the IFRC through eficiaries and acceptance towards humanitarian the multilateral programmes of the Humanitarian interventions. Thus, in its Strategy 2020 for Interna- Aid, SDC also provides targeted OD support to the tional Cooperation (SRC 2013), the SRC stresses its Red Cross of Tunisia. At the annual conference role of strengthening Red Cross and Red Crescent 2017, SRC presented partnership experience with (RCRC) National Societies in their organisational ca- the National Societies (NSs) in Togo and Kyrgyzstan, pacity to deliver sustainable services to vulnerable and an SDC representative from SDC Tunisia shared people. In accordance with the IFRC framework for the experience with the Tunisian Red Crescent. The National Society Development (NSD), the SRC un- participants, among them the NSD adviser of the derstands the aim of NSD as increasing the rele- IFRC Secretariat in Geneva, discussed the role and vance, quality, reach and sustainability of National great potential of the Red Cross in the broader Society services and overcoming organizational global development and humanitarian agenda, deficits (IFRC 2013). NSD encompasses both Organ- particularly the Grand Bargain and the Localization izational Development (OD) and Capacity Building Agenda. (CB), which are complementary and take place at multiple organizational levels. Rather than being Also in 2017, Helvetas Swiss Intercooperation initi- limited to one department, it is an organiza- ated its learning process with SDC on the topic of tion-wide process led by leadership and govern- partnership. Towards the end of 2017, the SRC and ance defined as deliberate planned efforts that can Helvetas Swiss Intercooperation agreed to merge touch on every organizational aspect (IFRC 2013). their learning processes. A joint concept “Partner- With the declared aim to add a new partnership ship and Organisational Development” was pre- and cooperation model to the traditional modality sented to SDC and agreed upon between the three of project implementation, the SRC defined Nation- parties. The goal of the joint learning process is “to al Society Development a distinct objective of the IC learn how to shape effective partnerships for jointly Programme 2017–20. At their annual partner con- strengthening institutions and systems in their ference in June 2017, the SRC and SDC launched a countries, and to have a common understanding of

77 our respective roles and responsibilities”. SRC and funding of the CRT. Joint efforts between the CRT, Helvetas will generate evidence based on case stud- SRC, ICRC, and other partnering NSs contributed ies, promote learning events between the involved not only to the elaboration of the new Strategic De- partners, and develop a capitalization document velopment Plan 2018-22 but also to the improve- towards the end of the learning process. ment and harmonization of monitoring tools. SRC strongly supported the logistic service of the CRT. This chapter presents the results of an NSD mapping SRC conducted in 2017, the first year of the Capacity building elements have been entailed in learning process. The mapping identified SRC sup- all joint projects by the SRC and the Belarus Red port to NSD in all country programmes with regard Cross (BRC). Numerous training and information to the following key internal organizational aspects initiatives were implemented in 2017 in order to of any National Society, as defined by IFRC: opera- improve cooperation with the national home care tionalization, strategic outputs, leadership and gov- system and to upscale the application of the SRC ernance, and core organizational values (IFRC promoted participative community work. Organi- 2013). In 2017, SRC pursued an active partnership zational capacity and sustainability were fostered dialogue and provided NSD support to eight Na- through organisational development trainings of tional Societies: Kyrgyzstan, Togo, Belarus, Armenia, community groups. For the first time, the SRC Mar- South Sudan, Bhutan, Malawi and Ethiopia. keting and Communications Department and the International Cooperation Department jointly en- In Kyrgyzstan, the SRC and the Red Crescent Society gaged in an initiative strengthening marketing and of Kyrgyzstan (RCSK) entered into a long-term stra- fundraising activities of the BRC, in order to estab- tegic partnership. A Partnership Framework Agree- lish a sustainable funding base for its home based ment was signed, acknowledging the mutual inter- care program. This included the development of est to strengthen the existing bilateral cooperation marketing and fundraising strategies as well as the and alignment of both National Societies, strategic joint development of the business plan for provi- priorities. As part of organizational development, sion of paid home-based care and trainings. Pro- the SRC technically supported Branch Organization- gramme development and stronger positioning of al Capacity Assessments (BOCAs) in all RCSK branch- the BRC in the national health system and social es. Representatives of different levels of the RCSK services provision was fostered through surveys and participated and analysed the branches, strengths external reviews supported by the SRC. and areas for improvement. As a result of the assessment, the SRC aims to strengthen the RCSK,s capac- In Armenia, the leadership of the Red Cross Society ity in volunteer management by improving the re- (ARCS) is determined to strengthen its organisa- spective system, building up the capacities of volun- tional capacities. In addition to the project support teers, upgrading the existing recruitment & retention on healthy ageing with the ARCS (see chapter 3.1), mechanisms, resource mobilization, and institution- the SRC established collaboration with and has al preparedness. An independent expert trained strengthened ARCS, OD department to ensure that RCSK branches and project team members on in- it has adequate capacities to manage the imple- come generation in order to prepare business-plans mentation of its Action Plan. Moreover, the SRC of three branches for 2018. aims to ensure good coordination of external OD support between the Partner National Societies In Togo, the National Red Cross Society (CRT) ap- (PNSs). An SRC funded market study, assessing the proached the SRC to support their efforts to rein- domestic fundraising potentials, mitigates the part- force their preparedness to epidemics, such as Ebo- ner risk of the ARCS related to inexistent access and la, and other hazards. Responding to this request, experience in fundraising. To support the branches, the SRC committed to strengthen the capacities of organisational development, BOCA was conducted the CRT in order to ensure its leadership in human- in two regions. To overcome the difficulties identi- itarian action. The SRC and CRT jointly launched a fied and to help the branches to come up with de- long-term initiative that aims to improve the organ- velopment plans, an OD/BD working group was isational capacities, managerial capacities, and the formed at the ARCS Headquarters. ARCS, branches

78 in four districts were provided with adequate or- was supported in its establishment and develop- ganizational and human resources to implement ment, and will gradually position itself as an auxil- their projects, recruit volunteers, improve reporting iary to the public authority. In line with this ap- and to build their community image. proach, the SRC and the BRCS in collaboration with the Ministry of Health started a community health Given the complex fragile environment in project in two districts. Meetings with key stake- South Sudan, the coordination of programmes be- holders including authority representatives pro- tween the South Sudanese Red Cross Society (SS- moted the importance and value added of volun- RC), the eight involved PNSs, the IFRC, and the ICRC teerism and the unique auxiliary role of National is of paramount importance. Experience shows that Societies. The SRC has also been advisory in a pro- major humanitarian operations can severely weak- ject that supports and funds the BRCS National So- en the Host National Society. For this reason, the ciety Development plan 2018-2020. This four-year Movement partners in South Sudan launched the development plan encompasses the development Strengthening Movement Coordination and Col- of services in disaster management, health, and so- laboration approach (SMCC) in 2017. The SRC plays cial care, the establishment of a volunteer and an active role in this initiative that aims to strength- membership base, governance and secretariat en the SSRC with functioning governance struc- structures and systems, and the mobilization of tures, an effective and efficient management and funds. A partnership MoU between the SRC and leadership team, robust accountability mecha- BRCS was signed and serves as an umbrella agree- nisms, and the capability to mobilise the volunteers ment to subsequent project agreements, laying out and resources required to systematically support the guiding principles of the partnership. vulnerable communities. An OD delegate of IFRC who is financially supported by the SRC coordinates In 2017, the Ethiopian Red Cross Society (ERCS) and these activities. The process of organizational SRC have agreed to enter into a long-term strategic change and development, in order to make the SS- partnership that, in addition to emergency and de- RC the leading humanitarian organization in the velopment projects, also includes support for the country, began with the harmonization of ap- organisational development of the ERCS. The Pres- proaches towards NSD. This resulted in an assess- ident and Secretary General of the ERCS visited the ment for a joint Emergency Response Plan and the SRC HQ for strategic discussions and SRC staff and harmonization of an aligned finance reporting sys- officials visited the ERCS several times to support its tem that eases the workload of the SSRC. The SRC delegation and to strengthen the partnership. In its seconded a delegate for organisational develop- efforts to support the NSD of the ERCS, the SRC co- ment, who is mainly involved in development and ordinates with the Netherland Red Cross (NLRC), coordination of the response plan. Additionally, which also committed to strengthen the ERCS. In SRC staff is part of the steering committee for NSD 2017, all RCRC members involved in the SRC pro- for the SSCR. The SRC also assisted in the develop- jects received a refresher training on the roles and ment process of the National Health Strategy and responsibilities of the RC including its mandate, vi- its support allowed the SSRC to engage with au- sion, missions, principles, and how to link with oth- thorities at national level concerning their projects. er community organizations and structures. A vol- Branch capacity was strengthened in accountabili- unteer and member recruitment and retention plan ty, accurate, timely procurement and financial man- workshop was conducted for the ERCS and resulted agement. Several volunteer and staff trainings took in draft recruitment and retention plan guidelines place on finance and logistic policies of the SSRC, at HQ and branch level, contributing to engage basic International Humanitarian Law, and PCM. more volunteers and members and to improve the community,s perception of the Red Cross. Lessons The Bhutan Red Cross Society (BRCS) was founded learnt from capacity building and branch develop- in May 2017 under close guidance and support of ment let the SRC and ERCS develop a separate pro- the SRC. In 2014, the SRC had proposed a plan of ject on branch development in the conflict- and action to the authorities of Bhutan in order to es- drought-affected fragile regions of Gambella and tablish a National Red Cross Society. Thus, the BRCS Moyale.

79 In Malawi the newly appointed Secretary General of the Malawi Red Cross Society (MRCS) analysed the challenging situation of the MRCS regarding funding, transparency and management. He developed an action plan for improvement of the organization, called “turn- around plan” and asked SRC to place an expert in OD advisory at his side. Towards the end of the year, SRC therefore deployed an OD advisor to assist the Secretary General of the MRCS.

Number of countries with SRC support to National Society Development by area of activity (2017)

22 Operationalization

20 Strategic outputs

Leadership & Governance 18 Core organizational values 16

Leaders

Volunteering Technical skills Management Human resources Image & positioning Resource mobilisation Fundamental principles Assets & material resources Operational model & Relationshipspolicies & partnerships Strategic/ OD assessment & plan Branch development & management Community engagement and ownership

80 Lessons learnt The NSD mapping illustrates that NSD activities of the SRC conducted in 2017 took mainly place at the levels of operationalization and strategic outputs. The table above illustrates that the SRC trained almost 24,000 volunteers and NS employees in 2017. The strong role of the SRC in strengthening and coordinating partnerships and relationships of NS stakeholders, its participation in policy dialogues, provision of capacity building support, and involvement in strategic dialogue were main benefits for the National Societies. With the exception of Malawi, leadership and governance and core organizational values were no primary areas of NSD activity in 2017. Particularly, leadership being among the least supported areas of NSD is contradictory since it is the most crucial resource of NSD. NSD can never be an entirely external process/ support to an NS and has to be promoted and executed by an NS itself (IFRC, 2013). Therefore, strengthening leadership can strongly contribute to a sustainable and integral development of an NS, fewer need of capacity building activities, and to the use of synergies concerning operational activities.

Heavy dependency of NSs on PNSs and further external funding can force NSs into the role of a service deliverer instead of an independent and strong humanitarian actor. The NSD support in domestic fundraising provided by SRC,s marketing and communication department to the Belarus RC illustrates the importance of actions taken in order to ensure NSs, financial sustainability and independence from external funders. In its future NSD engagement, the SRC will thus increasingly focus on strengthening fundraising capacities of NSs.

Effective NSD has to be based on the alignment of the SRC,s NSD support activities with the PNSs, and the IFRC,s support activities. Such an alignment helps to coordinate activities in the Movement, to make use of synergies, to strengthen the Movement and allows for cross-country learning. To ensure integral and sustainable NSD, the SRC will continue to provide NSD activities both on the level of Headquarters and branches, based on systematically conducted BOCA. Partnership agreements with Host National Societies (HNSs) are of great importance concerning the definition of roles and expec- tations and the foundation for an equal partner dialogue with regard to NSD. Moreover, when implementing NSD activities and to omit conflicts with operational programmes, it needs to be considered that the partnership on NSD follows its own management cycle in terms of time and approaches. Additionally, since large humanitarian catastrophes can weaken HNSs, NSD needs to be part of institutional preparedness in order to ensure the functioning of NSs in the long-term. The demand for institutional preparedness is found as a key issue of NSs.

Missing will of NSs to invest in the development of their organizational capacities is one of the main obstacles for an SRC engagement in NSD. However, this should not lead necessarily to a stop of NSD activities. Partnering with other PNSs to lobby for sustainable NSD in the respective NS can be one approach to deal with this challenge. Nevertheless, one-fits-all approaches to external NSD support do not exist, which requires flexibility and innovation from the side of the SRC.

81 The Red82 Cross Around The World exhibition at the Swiss Museum of Transport lasted from November 2015 through September 2017. In 2018, the exhibition moves to Geneva.© SRC 6. Awareness-raising in Switzerland

In 2017, the SRC focused on raising the general its online communication, taking advantage of public,s awareness to its international coopera- social media to reach a broader and often tion, placing special emphasis on younger audi- younger audience. With reference to the hurri- ences. The Red Cross Around The World exhi- cane disaster in the Caribbean, the crisis in Bang- bition at the Swiss Museum of Transport was ladesh (floods and refugees from Myanmar) and extended to 30 September. It introduced devel- the outbreak of plague in Madagascar, the tar- opment cooperation topics related to disasters get groups were easier to reach and made aware and health to a broad audience through attrac- of the various challenges through updated con- tive, easy-to-understand examples. The exhibi- tent. tion proved very popular among museum,s primary target groups, families and school classes. There was also widespread coverage of those Teaching packs prepared by the museum,s disasters in the media. Once again, we saw that schools office enabled teachers to expand on the the staff providing relief in the field are the best exhibition in the classroom before and after the ambassadors when it comes to the SRC,s human- visit. itarian work.

The pre-visit pack included a documentary film and various dossiers about hurricanes, focusing on Haiti as an example. The exhibition also provided visitors with a more cultural approach, with lively drum workshops run by the Ayekoo Drummers from Ghana.

After Lucerne, the exhibition was translated and moved to the French-speaking region of Switzer- land, where it will be hosted by the Maison du Futur in Les Berges de Vessy, near Geneva. It will open on 8 March 2018 and last for eight months.

A new migration module was added to the Red Cross Adventure online educational por- tal of the SRC Competence Centre for Youth Work. The interactive exhibition provides visitors with a comparison between the lives of a young Syrian woman living as a refugee in Lebanon and a Syrian youngster who has fled to Switzerland. This module will be launched in the spring this year.

Six months after hurricane Matthew devastated Haiti, the SRC organized a media trip to Haiti in March 2017, resulting in various detailed articles in Luzerner Zeitung (including a first-page head- line), La Liberté, and Coop Zeitung. The main subject of the trip was how the severe devasta- tion left by the hurricane was being managed along with the long-term disaster risk reduction projects that had proved effective against this disaster where the SRC is working in Léogâne.

In a media partnership with Ringier, other detailed reports were published about disease prevention in Paraguay, disaster preparedness in Kyrgyzstan, and the plight of Syrian refugee families in Lebanon.

Restructuring in the SRC,s Marketing & Commu- nication Department made it possible to step up

83 Hurrican84 Irma destroyed 70 per cent of the houses and infrastructure of the island St. Maarten in the Carribean. The Red Cross distributed water to the affected communities.© Netherlands Red Cross, Arie Kievi 7. Financial Report

Financial overview

The IC Department,s total turnover for 2017 was Expenditures of the IC Department 2016 –17 59.3 million Swiss Francs out of which 46.9 million was spent for implementing projects and 2016 2017 12.4 million to cover the Department,s operating Direct IC Department project expenditure 51,048,000 46,901,000 expenses. The IC Department raised 49.6 million Swiss Francs from private donations, founda- IC Department indirect & operating expenditure 12,466,000 12,438,000 tions, institutions, and public authorities to cover Total Expenditure 63,514,000 59,339,000 its project implementation expenses. The SRC HQ contributed 9.6 million Swiss Francs from its own funds to narrow the department,s operat- IC Department Income ing deficit. Donations 8,105,000 7,442,000 Foundations and Institutions 3,181,000 2,186,000 The statutory external financial audit of the Swiss Canton and Commune 1,505,000 1,947,000 Red Cross Headquarters in 2017 represents the following financial operating results for the In- Sponsoring 1,731,000 2,118,000 ternational Cooperation Department. (The fig- Legacy and Bequest 311,000 98,000 ures were rounded to the nearest thousand Income – Sales and service delivery 2,345,000 2,388,000 CHF). SDC Programme Contr., HA and mandates 19,122,000 16,682,000 Contribution – SECO for IC Department projects 72,000 59,000 Humanitarian Foundation SRC – (HS-SRK) 6,239,000 9,434,000 Lindenhof Foundation (FGL) 627,000 555,000 Swiss Solidarity 6,645,000 5,880,000 Red Cross Organizations & NGOs Contributions 1,518,000 865,000 Total Income 51,401,000 49,654,000

Total Operating Deficit 12,113,000 9,685,000 SRC Internal Revenue (544,000) (407,000) SRC Own Funds Contribution (3,694,000) (1,980,000) Net Operating Deficit 7,875,000 7,298,000

85 Financial results of the International Cooperation Department

The SRC,s development and cooperation pro- Financial project volume of the IC Department by sector 2016–17 (in million CHF) jects in particular in Ethiopia, Mali, and Sudan could not be implemented as planned due to 2016 2017 conflicts and movement restrictions in the pro- Budget Actual Budget Actual ject locations. This resulted in lower project turn- Emergency Relief and Humanitarian Aid over. Furthermore, SRC had to withdraw from its 9.20 12.43 9.20 10.71 reconstruction project in Nepal prematurely due (including value of goods in kind for 2 x Christmas) to the administrative complexities laid down by Reconstruction and Rehabilitation 7.00 8.43 7.00 4.81 the National Reconstruction Authority of Nepal. Development and Cooperation 31.00 30.19 31.00 31.38 This contributed to lower investment turnover in reconstruction and rehabilitation projects in Total IC Department Project Volume 47.20 51.05 47.20 46.90 2017. 2017 was marked by several natural disasters in the Caribbean and different conflicts resulting in major population movements. The SRC deployed its humanitarian aid workers supporting the vulnerable beneficiaries with relief supplies, medical care and transitional shelters in the Caribbean and Bangladesh. The SDC,s emergency and humanitarian aid allows the SRC to intervene rapidly in such disaster settings. The figures below represent the IC Department,s sectoral investments. The expenses presented comprise of project implementation expenses only (excluding the department,s operating expenses).

The project volume figures from 2013–2017 as Project volume 2013–17 and budget 2018 shown in the figure below reveal how sectoral turnover can fluctuate based on natural disas- 60000000 ters, country specific conflicts and population movements. From 2018 onwards, the IC Depart- ment will no longer administer the 2xChristmas 50,000,000 initiative and therefore no project volume is budgeted. 40,000,000

30,000,000

20,000,000

10,000,000

0 Actual 2013 Actual 2014 Actual 2015 Actual 2016 Actual 2017 Budget 2018

Development Cooperation Reconstruction Emergency Relief Value of 2×Christmas

86 SDC contribution to the IC Department projects

The contributions of SDC for humanitarian aid SDC and SECO contribution for IC Department projects 2016–17 (in CHF) and development cooperation allow the SRC to flexibly and quickly react and respond to disas- 2016 2017 ters, conflicts and crises. This allows timely re- Programme Contribution for Development Cooperation sponse to the needs of the most vulnerable pop- 11,100,000 10,100,000 projects ulation and fosters the linkage of emergency relief, rehabilitation and reconstruction (LRRD). Contribution to Emergency Relief & Humanitarian Aid 2,500,000 2,500,000 Independent auditors in the SRC project coun- projects tries apply the international standards on audit- Emergency Relief and Humanitarian Aid Mandated projects 80,000 0 ing when auditing SRC as well as the SDC funded SDC Mandated projects 3,971,000 2,841,000 projects. These audit reports are further re- viewed by the SDC Group Audit in June each SDC Mandated Water Consortium projects 754000 509,000 year. The Group Audit Report includes both the Total SDC Contribution for IC Department projects 18,405,000 15,950,000 Financial Report and the Management Letter, which will be submitted to SDC by the end of July Contracted Services for SDC (SHA) 717,000 732,000 2018. Total SDC Contribution including SHA Mandate 19,122,000 16,682,000

SECO contribution for Development Cooperation projects 72,000 59,000 Total Swiss Government contribution for IC Department 19,194,000 16,741,000

IC Department Project Expenditure and SDC Programme Contribution

The IC Department had an annual project turnover of 46.9 million Swiss Francs in 2017. The SDC contributed 16 million Swiss Francs through various sources, representing 34 % of the total IC Department project expenditure. The SDC,s Insti- tutional Partnership Programme Contribution (10.1 million) covered 37 % of the development cooperation programme expenditure (27.6 million). Similarly, the SDC,s Humanitarian Aid contribution (2.5 million) covered 23 % of SRC,s Emergency Relief and Humanitarian Aid project expenditure (10.7 million). Annex 3 and 4 show the IC Department,s expenses and SCD contribution by countries.

87 Programme Budget 2018

The tables below show the programme budget 2018 and the projected allocation of funds of SDC and the Humanitarian Foundation.

IC Department Programme budget projection 2017–20

Actual 2017 Budget 2018 Budget 2019 Budget 2020 Emergency Relief & Humanitarian Aid 10,714,000 9,000,000 9,000,000 9,000,000 Reconstruction & Rehabilitation 4,808,000 6,000,000 8,000,000 8,000,000 Development Cooperation 31,379,000 32,200,000 32,000,000 32,000,000 Total IC Department Projects 46,901,000 47,200,000 49,000,000 49,000,000

Project SDC HF SRC Volume Contribution Contribution Country CHF CHF % CHF % Egypt 250,000 125,000 50 % – 0 % Lebanon 228,000 200,000 88 % – 0 % Ghana 1,530,000 450,000 29 % 364,000 24 % Togo 985,000 340,000 35 % 534,000 54 % Mali 1,050,000 350,000 33 % – 0 % South Sudan 1,245,000 365,000 29 % 350,000 28 % Sudan 860,000 400,000 47 % 182,000 21 % Ethiopia 615,000 300,000 49 % 138,000 22 % Malawi 1,000,000 600,000 60 % 384,000 38 % TOTAL Africa 7,763,000 3,130,000 40 % 1,952,000 25 % Bolivia 910,000 400,000 44 % 289,000 32 % Paraguay 985,000 520,000 53 % 345,000 35 % Ecuador 800,000 380,000 48 % 227,000 28 % Honduras 2,695,000 600,000 22 % 202,000 7 % El Salvador 2,030,000 800,000 39 % 595,000 29 % Haiti 2,345,000 200,000 9 % 848,000 36 % TOTAL Latin America 9,765,000 2,900,000 30 % 2,506,000 26 % Bangladesh 2,365,000 1,235,000 52 % – 0 % Nepal 1,400,000 730,000 52 % 182,000 13 % Bhutan 775,000 – 0 % 248,000 32 % Pakistan 565,000 – 0 % – 0 % Laos 2,400,000 950,000 40 % 91,000 4 % Vietnam 1,350,000 520,000 39 % – 0 % TOTAL Asia 8,855,000 3,435,000 39 % 521,000 6 % Bosnia and Herzegowina 850,000 147,000 17 % 217,000 26 % →

88 Project SDC HF SRC Volume Contribution Contribution Country CHF CHF % CHF % Moldova 775,000 147,000 19 % 478,000 62 % Belarus 350,000 147,000 42 % 182,000 52 % Bulgaria 130,000 – 0 % – 0 % Kyrgyzstan 1,020,000 146,000 14 % 383,000 38 % Armenia 650,000 146,000 22 % 300,000 46 % TOTAL Europe 3,775,000 733,000 19 % 1,560,000 41 % Quality, Innovation & Sensitization 500,000 285,000 57 % – 0 % Worldwide Specific Sector Support 242,000 – 0 % – 0 % TOTAL Strategy & Conceptual Development 742,000 285,000 38 % – 0 % Development Cooperation without SDC Mandate 30,900,000 10,483,000 34 % 6,539,000 21 %

Development Cooperation Programmes SDC Mandated Projects 1,300,000 1,790,000 0 % – Total Development Cooperation Projects 32,200,000 12,273,000 38 % 6,539,000 20 %

IC Sector Programmes Total Emergency Relief 9,000,000 2,500,000 28 % – 0 % Total Reconstruction/Rehabilitation 6,000,000 – 0 % – 0 % Total International Cooperation Projects 47,200,000 14,773,000 31 % 6,539,000 14 %

Projected IC funding sources 2018

Funding 2018 Public Fundraising 10,184,000 Sponsoring 4,000,000 SDC Programme Contribution 10,483,000 SDC Emergency Relief and Humanitarian Aid Contribution 2,500,000 SDC Contributions for Mandated Projects 1,790,000 Swiss Solidarity 6,400,000 Humanitarian Foundation (HF) SRC 6,539,000 Other NGOs Contribution 4,031,000 SRC Undesignated Fund 1,273,000 Total International Cooperation 47,200,000

89 A health90 worker of the eye clinic in Nepal, Surkhet, assesses the eye sight of a client. The clinic is part of the multi- country eye care programme of SRC. © SRC Annex 1: Result framework of the SRC Programme 2017–20

Thematic area Programme Outcome Selected Outcome Indicator (SOCI) SDG target

Communities have improved access to % of births attended by skilled health personnel 3.1 quality services and change their behav- % of pregnant women having received four or more ante-natal care check-ups 3.1 iour in reproductive health. during the last pregnancy

% of women of reproductive age (15-49) currently using any kind of family plan- 3.7, 5.6 Reproductive ning method Health % of children 12-23 months vaccinated 3 times for DTP and other additional 3.2 vaccine (national guidelines)

Communities change their behaviour to % of population sleeping under insecticide-treated nets* prevent infectious and non-communicable diseases, and have improved access to care % of patients whose blood pressure was taken by health facility admission* and treatment. Disease Control

Households have increased access to % of households/schools using and maintaining clean latrines 6.2, 6.3, 4.a improved water and sanitation facilities % of households/schools using an improved drinking water source 6.1, 6.a, 6.b and change their hygiene behaviour. % of households/schools using safely managed sanitation facilities (incl. sludge 6.2, 6.3 management) WASH % of households/schools with soap and water at hand washing station used by 6.2, 6.3 the family members

% of population adopting safe water handling practices 6.1 Communities have access to nutrition % of severely malnourished children under 5 correctly identified and referred to 2.2, 3.2 services and have improved the nutrition therapeutic feeding centre of particularly vulnerable groups. % of children from 0–59 months that appear for regular check ups and growth 2.2, 3.2 monitoring Nutrition % of infants under 6 months of age received only breast milk on the previous day 2.2, 3.2 Elderly, disabled and chronically ill people % of organizations that adhere to quality standards 3.4 have access to quality integrated home- based care services and enjoy living in an age-friendly environment. % increase in number of clients benefitting from the service 3.4 Ageing % increase in members in active aging groups 3.4 Patients in need receive blood products National blood transfusion service meets x % of the needs of requested 3.3 through improved, well-organized and blood products financially viable blood blood transfusion % of blood donations screened for TTIs 3.3 services. % of voluntary non-remunerated blood donations 3.3 Blood safety % of VNR low-risk blood donors who donate blood more than one time per year 3.3 Communities have access to comprehen- % of increase of utilization of the eye care facility from previous year to current 3.8 sive and quality eye care services. year

% of eyes with good visual acuity after 6 weeks of cataract surgery 3.8 Eye Care

Communities have improved capacities to % of tested disaster response plans updated annually and linked to the provincial 1.5, 11.5, 11.B, identify and reduce exposure and vulnera- response mechanisms 13.1 bility to hazards and to act with appropriate preparedness measures. % of communities at risk with a functional emergency committee 1.5, 11.5, 11.B, Community- 13.1 based disaster risk manage- % of community based structural protective measure functioning and managed 1.5, 11.5, 11.B, ment properly 13.1

Red Cross and Red Crescent Societies in % National Society branches with disaster management capacities rated 1.5, 11.5, 11.B, disaster-prone area prepared to engage in “well-functioning” 13.1 emergency relief operations.

Institutional Preparedness

* not measured in 2017

91 Annex 2: Beneficiary statistics 2017

Beneficiaries by intervention type and continent

Africa & MENA Latin America & Asia and Pacific Europe & CIS Total Caribbean Number of projects 39 22 29 21 111 Number of countries 12 9 9 8 38 Development 1,339,442 303,679 1,782,105 566,066 3,991,292 Reconstruction & rehabilitation 10,200 11,750 33,292 256 55,498 Emergency Aid 465,383 46,246 33,809 4,123 549,561 Total 1,815,025 361,675 1,849,206 570,445 4,596,351

Beneficiaries in health by continent

Africa & MENA Latin America & Asia and Pacific Europe & CIS Total Caribbean Total Health 1,505,673 295,679 1,812,411 532,037 4,145,800 Total WASH 221,161 133,677 293,470 - 648,308 Total Health in Emergencies 430,930 15,399 446,329 Access to improved water 168,946 28,157 193,726 390,829 Access to improved sanitation 37,297 3,235 130,163 170,695 Access to washing facilities 32,918 128 59,040 92,086 Hygiene promotion 221,161 133,677 293,470 648,308 Blood donations 526,005 66,018 75,841 667,864 Primary health care services used 84,217 124,287 1,259,520 31,762 1,499,786 Health education & promotion 210,995 108,409 361,753 17,126 698,283 Child health 15,873 7,596 245,960 269,429 Maternal health deliveries 2,633 8,590 539 11,762 Maternal health ANC 3,774 433 15,999 20,206 Elderly care 2,598 3,992 6,590 Social health protection 2,940 132,502 283,000 418,442 Infectious diseases 33,870 10,540 16,772 61,182 NCD service 9,012 928 526 15,037 25,503 NCD promotion 11,308 7,282 18,590 Nutrition 26,119 35,723 32,596 480 94,918 Eye care 311,950 81,542 46,342 439,834 Cataract surgeries 2,702 1,053 223 3,978 Other eye surgeries 1,593 248 539 2,380 Eye care consultations (outpatient) 97,407 10,117 18,318 125,842 Eye care school screenings 46,530 12,897 59,427 Eye care awareness raising 311,950 81,542 46,342 439,834 Community Health Workers involved 4,475 2,603 1,199 158 8,435 Health committees / groups 347 395 653 583 1,978 Social Inclusion 10,873 2,189 13,062 Sexually and Gender-Based Violence 6,523 6,523

92 DRR beneficiaries by intervention and continent

Africa & MENA Latin America & Asia and Pacific Europe & CIS Total Caribbean Total DRR and CCA beneficiaries 72,650 78,341 98,388 54,441 303,820 DRR committees 70 316 152 25 563 DRR and CCA Awareness 68,620 51,901 22,137 24,828 167,486 DRR and CCA Education 13,794 6,517 7,845 28,156 Early Warning Systems 72,620 27,679 54,630 11,978 166,907 Risk Mitigation 6,349 50,643 19,288 76,280 Insitutional Preparedness of RCRC Partner 887 146 125 33 1,191

Beneficiaires of reconstruction and rehabilitation projects by continent

Africa & MENA Latin America & Asia and Pacific Europe & CIS Total Caribbean Total reconstruction beneficiaries 10,200 11,750 30,542 256 52,748 Housing 556 8,018 8,574 Improved drinking water 15,500 15,500 Improved sanitation 3,800 3,800 Hygiene promotion 10,898 10,898 Direct aid (non-food items, cash, etc.) 12,030 1,632 13,662 Disaster Risk Reduction 22,312 22,312 Houses reconstructed 90 1,428 1,518 Health facilities reconstructed 2 18 2 22 Schools reconstructed 10 10 Other public facilities reconstructed 10 10

Emergency aid by continent

Africa & MENA Latin America & Asia and Pacific Europe & CIS Total Caribbean Total Emergency Aid 465,383 46,246 33,809 4,123 549,561 Emergency deployments 13 21 34 Cash 39,428 16,672 5,273 61,373 Health in emergencies 430,930 15,399 446,329 Non-food (including family kits) 126,921 53,891 21,044 201,856 Shelter 932 182 1,114 Food Aid (incl. Water, seeds and tools) 49,655 39,603 20,988 110,246 WASH in emergencies 107,082 5,000 112,082 Refugees and internally displaced 169,412 8,342 13,100 190,854

Capacity building beneficiaries by partner type and continent

Africa & MENA Latin America & Asia and Pacific Europe & CIS Total Caribbean Total capacity building beneficiaries 6,282 4,570 10,328 2,575 23,755 RCRC employees trained 132 274 405 160 971 RCRC volunteers trained 5,934 1,269 982 594 8,779 RCRC volunteers in action 6,062 628 479 541 7,710 NGO employees trained 521 187 167 875 NGO volunteers trained 853 6,437 466 7,756 Government employees trained 216 1653 2317 1188 5,374

93 Annex 3: Expenditures and SDC contribution 2017 by country

Budget 2017 Expenditure 2017 Country SDC Contract Budget for the Reporting SDC Contribution Plan for Annual Project Expendi- SDC Contribution against Number Period in CHF the Reporting Period in % ture in CHF Project,s Annual Expendi- and CHF ture Statement in % and CHF Egypt 7F-03945.15.01 550,000 36% 200,000 67,013.75 0% - Ethiopia 7F-03945.15.01 1,349,000 0% - 720,057.30 56% 400,000 Ghana 7F-03945.15.01 1,450,000 28% 400,000 1,349,298.83 29% 385,000 Lebanon 7F-03945.15.01 1,050,000 29% 300,000 1,103,131.92 34% 375,000 Malawi 7F-03945.15.01 550,000 55% 300,000 826,318.02 44% 360,000 Mali 7F-03945.15.01 906,000 33% 300,000 253,269.54 39% 100,000 South Sudan 7F-03945.15.01 765,000 70% 535,000 1,486,502.02 10% 155,000 Sudan 7F-03945.15.01 1,000,000 35% 350,000 424,408.52 45% 190,000 Togo 7F-03945.15.01 600,000 67% 400,000 546,015.66 75% 410,000 Total Development Cooperation Africa and Middle East – Programme Contribu- 8,220,000 34% 2,785,000 6,776,015.56 35% 2,375,000 tion South

Bolivia 7F-03945.15.01 875,000 57% 495,000 741,090.01 37% 271,000 Central America 7F-03945.15.01 320,000 0% - 44,172.46 0% - Ecuador 7F-03945.15.01 730,000 49% 360,000 809,582.81 48% 390,000 El Salvador 7F-03945.15.01 1,450,000 48% 700,000 1,190,204.48 49% 588,000 Haiti 7F-03945.15.01 1,757,000 0% - 2,466,045.39 22% 544,000 Honduras 7F-03945.15.01 1,627,000 49% 800,000 2,028,743.54 49% 992,000 Paraguay 7F-03945.15.01 1,068,000 54% 575,000 916,926.16 61% 555,000 Total Development Cooperation Latin America and the Caribbean – Programme 7,827,000 37% 2,930,000 8,196,764.85 41% 3,340,000 Contribution South

Bangladesh 7F-03945.15.01 1,980,000 40% 790,000 1,966,209.91 79% 1,550,000 Bhutan 7F-03945.15.01 400,000 69% 275,000 313,232.89 32% 100,000 Cambodia 7F-03945.15.01 726,000 83% 600,000 745,747.09 0% - Laos 7F-03945.15.01 2,000,000 48% 960,000 2,656,650.37 18% 470,000 Nepal 7F-03945.15.01 878,000 16% 140,000 738,389.26 0% - Pakistan 7F-03945.15.01 400,000 0% - 478,883.16 98% 470,000 Vietnam 7F-03945.15.01 951,000 56% 535,000 713,997.30 99% 710,000 Total Development Cooperation Asia – 7,335,000 45% 3,300,000 7,613,109.98 43% 3,300,000 Programme Contribution South

Armenia 7F-08544.03.01 550,000 24% 130,000 609,680.44 20% 120,000 Belarus 7F-08544.03.01 734,000 22% 160,000 796,150.65 7% 54,000 Bosnia and Herze- 7F-08544.03.01 807,000 21% 170,000 919,144.98 18% 168,000 gowina Bulgaria 7F-08544.03.01 - - 301,183.00 0% - Kyrgyzstan 7F-08544.03.01 840,000 20% 170,000 941,479.81 31% 290,000 Macedonia 7F-08544.03.01 - - 119,392.61 0% - Moldova 7F-08544.03.01 800,000 21% 170,000 585,472.47 29% 168,000 Ukraine 7F-08544.03.01 - - 1,104.85 0% - Europe 7F-08544.03.01 - - 25,396.10 0% - Total Development Cooperation Europe 3,731,000 21% 800,000 4,299,004.91 19% 800,000 - Programme Contribution East → 94 Budget 2017 Expenditure 2017 Country SDC Contract Budget for the Reporting SDC Contribution Plan for Annual Project Expendi- SDC Contribution against Number Period in CHF the Reporting Period in % ture in CHF Project,s Annual Expendi- and CHF ture Statement in % and CHF Quality, Innovation 7F-03945.15.01 685,000 42% 285,000 330,295.00 86% 285,000 & Sensitization IFRC Support 7F-03945.15.01 300,000 0% - 385,000.00 0% - Health & DRR Worldwide 7F-03945.15.01 - - 39,847.39 0% - Total Strategy & Conceptional Develop- 985,000 29% 285,000 755,142.39 38% 285,000 ment

Total Development Cooperation 28,098,000 36% 10,100,000 27,640,037.69 37% 10,100,000 Projects Süd/ Transition Ost

SDC Mandate Projects 2,500,000 100% 2,500,000 2,819,488.83 101% 2,841,049 Total SDC Mandated Projects 2,500,000 2,500,000 2,819,488.83 101% 2,841,049 Water Consortiums Projects 402,000 75% 301,500 850,084.38 60% 509,000 Total SDC Water Consortium Mandate 402,000 75% 301,500 850,084.38 60% 509,000

Total International Cooperation Projects 31,000,000 42% 12,901,500 31,309,610.90 43% 13,450,049 including SDC Mandate

SECO Mandate - 69,726.94 85% 59,148 Total SECO Mandate - - 69,726.94 59,148

Total Development Cooperation Projects 31,000,000 42% 12,901,500 31,379,337.84 43% 13,509,197

Reconstruction & Rehabilitation 7,000,000 0% - 4,805,289.33 Total Reconstruction & Rehabilitation 7,000,000 0% - 4,805,289.33 0% -

Emergency Relief and Humanitarian Aid 9,200,000 27% 2,500,000 10,716,729.69 23% 2,500,000 Total Emergency Relief and Humanitar- 9,200,000 27% 2,500,000 10,716,729.69 23% 2,500,000 ian Aid with SDC & SRC Funds

Total SRC Development Cooperation 47,200,000 33% 15,401,500 46,901,356.86 34% 16,009,197 Programme

SRC Contractual service for SDC SKH 732,411.53 100% 732,412 Total SRC contractual service for SDC SKH - - 732,411.53 100% 732,412

Total SRC Development Cooperation 47,200,000 33% 15,401,500 47,633,768.39 35% 16,741,608 Programme including SDC SKH Mandate

Annex 4: Deviations budget versus expenditures 2017 by country (if > 10%)

Country Budget CHF Expenditures CHF Deviation % Comment (if deviation more than -/+10%) Egypt 550,000 67,013.75 -88% The foreseen project in support of refugees, co-financed through the EU MADAD Fund, started substantially later than foreseen due to administrative reasons between the EU MADAD fund and the project. Ethiopia 1,349,000 720,057.30 -47% Due to the repeatedly difficult security situations, and due to weak partner capacities, the project could not advance at the pace foreseen. Malawi 550,000 826,318 50% At the time of budgeting, it had not been decided to what extent a new phase would be added to the ending health and WASH project. Mali 906,000 253,270 -72% The fragile situation in Northern Mali, where SRC is implementing its project, required a longer planning phase with less possibilities of implementation in 2017. South Sudan 765,000 1,486,502 94% The hunger crisis and a Cholera outbreak led to additional SRC interventions, amongst them a cooperation project with the ICRC for public health. Sudan 1,000,000 424,409 -58% The main reason for the deviation is the very slow start of the new project in Sennar State due to a protracted project staff recruitment process. As a result, hardly any project activities could be implemented and thus only 3% of the budgeted funds were used. Total Africa/MENA 8,220,000 6,776,016 -18%

Bolivia 875,000 741,090 -15% The planned project with the Bolivian Red Cross did not materialize due to major shortages in operational capacities of the partner. Central America 320,000 44,172 -86% The transfer of 300,000 to a project in El Salvador occurs in 2018 instead of 2017. Ecuador 730,000 809,583 11% Overspending is mainly due to a vehicle accident: The insurance paid their contribution, but this was only about one third of the cost of the new vehicle. El Salvador 1,450,000 1,190,204 -18% Underspending is mostly due to some delays taken in two projects which started in 2017, the inception phase was longer than foreseen. Haiti 1,757,000 2,466,045 40% Overspending is due to the extension of the recovery project in the southern area of Haïti, affected by a hurricane. Honduras 1,627,000 2,028,744 25% Overspending is firstly due to the closure of two projects in 2017, which managed to catch up some underspending from previous years, and secondly due to the purchase of equipment in the blood project. Paraguay 1,068,000 916,926 -14% The planned project with the Paraguay Red Cross was not implemented due to integrity issues of the partner and a respective sanction procedure by the IFRC. Total Americas 7,827,000 8,196,765 5%

Bhutan 400,000 313,233 -22% The Disaster Risk Management project with the governmental Directorate for Disas- ter Management started much later than anticipated, due to lengthy and complex institutional planning mechanisms. Laos 2,000,000 2,656,650 33% The Social Health Protection component was able to perform much better than initially planned, allowing to reach higher service delivery. Nepal 878,000 738,389 -16% Both the Eye Care Hospital and Urban DRR components experienced delays in their initial phases, which resulted in underspending. The Community Health component however performed better than expected. Pakistan 400,000 478,883 20% The planning phase budget of the Mother and Child project with Aga Khan university had been revised at the beginning of the year to accommodate for additional activities. Vietnam 951,000 713,997 -25% The resilience and WASH component experienced serious delays in the start-up phase due to administrative obstacles. Total Asia 7,335,000 7,613,110 4%

Armenia 550,000 609,680 11% In the course of the year, two additional projects were added to the portfolio. Bosnia and Herzegowina 807,000 919,145 14% The transition between the first and second phases of the Home Based Care program as well as the no-cost extension of the CBDRM component allowed for additional activities to be completed. Kyrgyzstan 840,000 941,480 12% The final year of the CBDRM component allowed for catching up on some of the under-spending from previous years. Moldova 800,000 585,472 -27% Procurement of blood transfusion services material was covered by the government of Moldova. Total Europe 3,731,000 4,299,005 15%

Quality/Innovation 685,000 330,295 -52% Regional expertise not required as foreseen. IFRC Support Health/DRR 300,000 385,000 28% Additional support to migration task force of IFRC. Total Strategy/Concepts 985,000 755,142 -23%

Total Development 28,098,000 27,640,038 -2%

96 Annex 5: Evaluations 2017

Country Thematic area Project number Type of evaluation Haiti Blood Transfusion 432358 External, Mid Term Honduras CBDRM and Health 430066 External, End of phase Togo WASH 424752 External, Final Malawi Food Security in Schools 422608 External, Final Bosnia CBDRM 412980 External, Mid Term Sri Lanka Reconstruction 444670 External, Final, multi-agency Belarus Ageing / Visiting Nurses 415485 External, Ex-post Nepal Community Empowerment for Health Promotion 443214 External, Mid Term Nepal WASH in Schools 443213 External, Final Nepal Community Action for WASH – technical assessment infrastructure 443212 External, Midterm El Salvador Social Inclusion and Health 431693 External, Final El Salvador Social Inclusion 431694 External, Final Laos Maternal Child Health - Endline assessment 442589 Internal, Final Laos Universal Health Coverage 442591 External, Final Pakistan Community based DRR 443656 External, Final

Annex 6: Publications and presentations at conferences 2017

Publications – Literature References

Thomé J., Christofori-Khadka M., Sekeun D. 2017: Social Health Protection for all - Leaving no one behind? In: Medicus Mundi Bulletin 144. December 2017

Wieland V. 2017: Do no harm or do good? Health programmes in fragile contexts. In: Medicus Mundi Bulletin 141. May 2017

Bukania F., Wieland V. 2017: Building resilience in the face of unrelenting trauma. In: Medicus Mundi Bulletin 142. June 2017

Harari, N., Gavilano, A., Liniger, HP. 2017: Where people and their land are safer: a Compendium of Good Practices in Disaster Risk Reduction. Bern and Lucerne, Swit- zerland: Centre for Development and Environment (CDE), University of Bern, and Swiss NGO Disaster Risk Reduction (DRR) Platform, with Bern Open Publishing, November 2017

Conferences

Conference Poster or oral presentation Title of the presentation/poster Authors

Medicus Mundi Symposium Presentation Addressing social determinants of NCDs through Tatyana Haplichnik community mobilisation: Swiss Red Cross experience in Belarus

Medicus Mundi Symposium Presentation Integrated Patient Centered Care. Examples of Monika Christofori-Khadka the SRC home based care work with older people in Europe and CIS

Global Platform DRR, Mexico Presentation Soil Bio-engineering for DRR Anton Joehr

International Conference Presentation Practicality Index: Communities assess the viability Eva Syfrig on Research for Development, Bern and impact of water interventions

International Conference Presentation Terra Preta Hugelculture - modern raised-bed Harald Bier on Research for Development, Bern horticulture to enhance soil quality, water hold- ing capacity and raise people,s resilience

International Conference Poster Community based Climate Change Observatory Grégoire Labhardt on Research for Development, Bern with Bio-indicators

WOCAT Symposium and 18th Presentation Soil Bio-engineering for DRR Carlos Montes WOCAT Networking Meeting, Colombia

SDC DRR and CCE Network Annual Event Presentation DRR and CCA Mainstreaming – SRC Practice in Anton Joehr Nepal Projects

98 99 Annex 7: Country Summaries

Armenia

Objectives of the country programme Thematic priorities 2017 – 2020

Ageing and Health: Health and well-being of elderly, chronically ill and disabled persons is improved through a focus on active ageing and better access to well-functioning integrated medical and social services. Disaster Risk Management: DRM capacity of SRC and partners are strengthened through relevant and adequate preparedness measures for emergency preparedness and response. Capacity development of partner organizations: The ARCS as well as selected non-RC partner organisations have improved organizational and operational capacities to implement and sustain relevant programs in favour of the most vulnerable.

Selected Outcome Indicators

AH2: % increase in number of clients benefitting from service AH3: % increase in members in active ageing groups

300 400

350

225 300

250

150 200

150

75 100 target: annual increase of 10 per cent target: annual increase of 10 per cent +145% 50

0 0 2016 2017 2016 2017

100 Summary results 2017

Integrated community-based home care ser- nity based Integrated Medical-Social Care of El- vice provision and active/healthy ageing derly, PWD and chronically ill, currently (445600) implemented in the region in cooperation with The SRC in cooperation with the ARCS finalized the Republic of Armenia Ministries of Health and the establishment of the Home Care Centres in Social issues and Armenian Red Cross Society Lori and Shirak regions of Armenia with the full and developing systems in integrated health and team of employees (2 nurse managers, 4 nurses, social care. 12 home helpers and 16 volunteers). The Centres are fully equipped and the documentation and guidance ready to be used with beneficiaries. 98 Food support to four regions of Armenia elderly and PWD clients (21 male, 77 female) (445603) were served. The Project implementation started in May 2017 The project started in the area of Active/Healthy in Ararat, Armavir, Lori and Shirak regions of Ar- Ageing in the Lori and Shirak marzes. The out- menia. puts are as follows: 1) the concept of Active Age- 56 imbedded elderly and PWD in Lori and Shirak ing through Participatory Community Work was regions were supported with food parcels on finalized and presented to the stakeholders; 2) monthly basis. ARCS staff in HQ and branches was trained on 200 elderly and PWD of Ararat and Armavir re- Active and Healthy ageing issues and main prin- gions were provided with a daily hot meal ciples of participatory community work. 3) 10 through Soup kitchens established in Masis and Community initiative groups of elderly people Armavir towns. were established in Lori and Shirak Regions of Staff of the ARCS HQ and Branches in Ararat, Ar- Armenia. 150 persons (87 male, 63 female) are mavir, Lori and Shirak regions of Armenia partic- participating in the IGs. ipated in a series of specialized trainings and in- The SRC supported ARCS,s organizational devel- creased its capacities in participatory community opment issues, especially volunteer manage- work and issues of elderly people and PWD. ment and delegation of authorities to the regional branches, elderly care and active ageing. 27 staff members were trained on participatory DRR Mainstreaming community work and 6 on VCA plus issues. 18 The activities are coordinated and synergized nurses and home helpers were trained by SRC with other projects implemented by the ARCS experts. 18 volunteers benefited from the train- and other PNSs active in the same region: Aus- ing on elderly care and were recruited for home trian and Danish RC. The main attention is paid care services to be provided to elderly and PWD to the DRR activities. Due to this program, the people in Lori and Shirak marzes. ARCS staff in- VCA conducted by ARCS in 2017 included infor- volved into the program implementation is also mation (capacities, risks, historical profile, prob- provided with the opportunity to participate in lem tree) gathered from elderly population as different training and capacity building pro- well. Elderly, disabled and lonely persons were grams, conferences as well as SRC Europe/CIS provided with a chance to speak about problems knowledge management platform. The ARCS in the community, which disasters are frequent started the renovation/ reconstruction of its fa- in their communities, how can be reduced their cilities in Yerevan as well as regional branches vulnerability level, and also regarding their so- with SRC support. cial, economic and health situation as well as accessibility to public services. The SRC extended its cooperation with Austrian Red Cross within Support to Gyumri Elderly House (445602) the framework of the “Building safe and resilient The project was implemented within 3 months communities” as well as Danish RC within the of 2017. All the activities set forth in the project framework of the Improved Emergency Prepar- document were fulfilled. edness & Coordinated Response in South Cauca- The project addressed the problems of 160 in- sus (EMPREP) with co-funding and technical habitants of the Gyumri Elderly Boarding House backstopping based on SRC Disaster Manage- by renovation/ reconstructing of the main build- ment Policy. ing of GEH. Within the framework of the project, the SRC supported the renovation and re-equipment of the kitchen and canteen area, as well as the renovation of the restroom. Project implementation allowed to renovate the mechanism and the cabin of the elevator as well as to build/ reconstruct the ramps and to make all floors accessible for PWDs and others with movement difficulties. As a result of the project, GEH increases its potential to be integrated into the Model of Commu-

101 Bangladesh

Objectives of the country programme Thematic priorities 2017 – 2020

Health: Health of communities in Rajshahi dis- strengthened through relevant preparedness trict and selected neighboring Upazilas as well as measures for emergency response and disaster Dhaka slum, with a special focus on vulnerable risk prevention groups, is improved through access to health ser- Capacity development of partner organiza- vices that meet national minimum standards and tions: The SRC,s partnership approach is re- through addressing health determinants. viewed and responds to the capacity needs of Disaster Risk Management: The resilience of our partners in order to enhance their capability/ communities and the operational DM capacity of performance to sustainably contribute to shared partner organizations and governmental institu- thematic objectives. tions in two Upazilas of Gaibandha district is

Selected Outcome Indicators

WH3: % of households using an improved drinking water source WH4: % of population using safely managed sanitation facilities

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

WH6: % of housholds with soap and water at the hand washing station commonly used

100%

80%

60%

40%

20%

0% Before 2017 Target

102 Summary results 2017

Strengthening Community Capacity on DRR Water, Sanitation and Hygiene for Vulnerable from Rakhine State (GRC WASH project): During and WASH for Sustainable Development in Barind Tract Communities in Naogaon, the reporting period ending December 2017, Gaibandha (440450) Phase-II (440458) 500 people had access to sufficient and safe -wa The project achievements transcended the initial In Porsha households are now equipped with ter through one Deep Tube Well (DTW) as well as goal of vulnerability reduction through improved hygienic latrines regardless of their socio-eco- access to washing/laundry areas in the makeshift disaster preparedness and risk mitigation, and nomic back ground. Compared to this 76% of camp of Burma Para block C. Furthermore 4 hand led to realization of broader resilience objectives. households in Sapahar are equipped with wash facilities were established. There is enhanced community connectedness hygienic latrines. Swiss Red Cross deployed 18 expatriate profes- within themselves and with the larger set of The project transformed the object of monitor- sionals to the Cox,s Bazar area (RCRC Population stakeholders touching their lives. The social cap- ing from things to people, from supply- to de- Movement Operation) in 2017 with professional ital and social cohesion that has been fostered mand-led monitoring; creating institutional backgrounds in Medicine, Cash, Shelter, Logistics allows the target communities to better engage structures that directly measure lack of access and Relief. with preparedness and mitigation actions. instead of merely what was done. Consequently, The project created networks of interdepend- the project has developed a water resource in- ence that galvanize local governance structures- ventory so that accurate information is available especially the dedicated DM Committees at the to establish demand led monitoring. Union level - in fulfilling their development and With the installation of 2 tubewells and 1 piped DM mandate more meaningfully. Sub-national water supply system in Porsha, it is reported that structures with DM mandates have started work- all Adivasi villages have adequate and secure wa- ing proactively around response, mitigation and ter supply. preparedness plans, which was earlier reactive, ad-hoc and fragmentary. All the targeted 26 Public Health Improvement Initiative communities now also have access to basic Rajshahi (PHIIR) II (440459) health services in the Chars. All indicators related to the improvement of quality of health services at the primary health Urban Empowerment Project, Dhaka care structures show a positive trend. The house- (440455) hold survey shows, that pregnant women who The Community Management Committees, have have received four or more ANC,s during their emerged as institutions which can implement whole pregnancy has increased from 17% in community-led projects and are capable to uti- 2016 to 59% by the end of this year. lize their capacity to address stakeholders with- The MNCH knowledge of health service provid- out project support. The mass cleaning of Puku- ers at the Community Clinic and Upazila Health rpar, including the removal of siltation and waste & Family Welfare Complex level increased signif- blocking the drainage, was successful. For the icantly from 3% (baseline) to 81% (2017), due to first time in years the houses were not troubled theoretical training and regular technical super- by water logging. Apart from community efforts, vision and mentorship. the ward councilor contributed 27% of the costs The formation of joint core teams at Upazila and in form of labor. The first birth registration and District level was completed as per plan this year. child labor campaigns have started having ef- In this reporting period, 5 joint core teams were fects, significant results are though not expected active and fully motivated to carry out their du- before 2018. ties according to their roles and responsibilities

Integrated Water Resource Management in Bi- and multilateral Emergency Response Op- the Barind Tracts (440456) erations for flood and cyclone affected com- 994 Water Resource Management Committees munities and displaced people from Rakhine development plans identified a series of activi- state (440500, 503, 504, 505, 506, 507, 508) ties that were submitted to the 39 WRM Associ- Cyclone Roanu: the activities entailed cash grant ations established within each local government to 700 households for undertaking shelter repair institution (LGI). and a cash grant to landless families to support LGIs responded to the demand of citizens & land acquisition in safe place followed by shelter training from the project by financing a range of construction. The SRC support was utilised for IWRM options that include pond excavations, earmarked purposes benefitting 2,700 people. earthen canals; the installation of drinking and Regarding Haor flood, SRC responded to the na- irrigation pipelines; check dams; managed aqui- tional appeal of BDRCS by pledging support in fer recharge and rain water harvesting systems the form of multi-purpose cash grant to 2,000 etc. families. The project has supported the consultation with Flood victims in Gaibandha und Sunamganj re- various ministries and drafting of the Bangladesh ceived a standard food package and seeds along Water Rules which were approved by the Execu- with non-food items to cover the food needs for tive Committee for the National Water Resources 2 weeks for each family for 4,222 flood affected Council (ECNWRC) in September 2017 and for- families. In a second round cash grants were dis- warded to the Law Ministry for vetting. tributed for recovery to the displaced population

103 Belarus

Objectives of the country programme Thematic priorities 2017 – 2020

Health and ageing: Health and well-being of elderly, chronically ill and disabled persons is improved through a focus on active ageing and better access to well-functioning integrated medical and social services. Public health: The health of people living in dis- advantaged communities is improved through community empowerment, health promotion and better access to health services Disaster Risk Management: Disaster risk management capacity of SRC and partners are strengthened through relevant and adequate preparedness measures for emergency preparedness and response.

Summary results 2017

Community action for health (415491) Twice Christmas The project end-line survey, conducted using a 5,458 beneficiaries got parcels covering their im- quasi-experimental design, has confirmed effec- mediate needs. 77,681 kg net of food and non- tiveness of the NCD prevention and healthy life food items were delivered to 4 regions of Bela- style promotion approaches and methods used rus. by the project and identified positive attitudes and behavior change by not only members and volunteers of the IGs, but by a broader cycle of community members covered by the IGs work. IGs worked within two campaigns on NCD prevention and HLS promotion directly – face-to- face – covering in total 8,664 people. 50 representatives of health organizations from 13 districts not covered by the project were trained by the BRC. Using interactive training methods they covered 929 people with NCD promotion (trainings, information sessions, master classes).

Training for trainers in Kinaesthetics (415489) By the end of 2017, 134 BRC nurses or 72% use kinaesthetics in their work with 483 beneficiaries (19% of all VNS beneficiaries). Kinaesthetics is included into the coding system of the main types of activities of the visiting nurses, which allows to collect data and monitor kinaesthetics application in home care within the VNS. The trainers conducted 24 basic courses, as well as 80 master classes.

Implementation of the PCW approach: con- solidation and capitalization (415485B) PCW Concept has been prepared and submitted for the BRC Board approval in early 2018. 8 resource initiative groups became operational and conducted training sessions/problem solving meetings with 24 groups.12 new initiative groups of older people have started their activities in 2017.

104 Bhutan

Objectives of the country programme Thematic priorities 2017 – 2020

National Society Development: The Bhutan Red Cross Society is founded. Health: Quality of life of the people living in the project area in Bhutan is improved. Disaster Risk Management: The Department for Disaster Management enhances the National preparedness for disasters in cooperation with the Bhutan Red Cross Society.

Summary results 2017

Founding of the Bhutan red Cross Society (BRCS) (440700) A Red Cross Law had been launched by the Royal Government of Bhutan. In the beginning of 2017, the Upper and the Lower House of the Royal Government of Bhutan passed the Red Cross Act and provided herewith legality to the Bhutan Red Cross as an auxiliary to the Govern- ment. The BRCS was founded in May 2017. The official launch of BRCS was celebrated in the presence of her Royal Highness the Queen, the Premier minister and other dignitaries. The Red Cross Move- ment showed presence through ICRC and IFRC from Delhi and SC from Switzerland. A first public health event provided publicity to the young BRCS. The stream cleaning campaign encourages young and old volunteers and was the first public appearance of the Red Cross.

Community Health Pilot Project (440702) By Successful collaboration between departments in the Ministry of Health has been fostered. ,Traditionally, the different departments in the MoH seldom collaborate with each other in one project. This project brought the WASH and MNCH Department together. All staff confirmed that this was a new experience. Under the WASH component, a successful fair, especially in the remote district of Trashiyantse, provided access for villagers to equipment.

Disaster Preparedness Pilot Project (440703) As the project started in October 2017, no results as of yet can be reported. After a lengthy but fruitful process of consultations and assessments, first activities have been implemented regarding establishment of Emergency Opera- tions Centers, system and infrastructure as well as training of Search and Rescue Teams and Emergency First Aid Volunteers. 105 Bolivia

Objetivos del programa de país Prioridades temáticas 2017 – 2020

Mejorar la situación de salud: Se apoya y forta- cios seguros y saludables de tiempo libre para lece la implementación de la política SAFCI, la niños, niñas y jóvenes, y se promueven formas de que incluye la atención primaria de salud mediación de conflictos. Disminuir riesgos, salvar vidas y proteger me- Fortalecer organizaciones contrapartes: Se dios de vida: Se fortalece el potencial comunita- fortalece la capacidad de sus contrapartes y la rio e institucional a escala local y municipal, en la SNA, en coordinación con otros actores, respe- prevención, mitigación, preparación, respuesta y tando las estructuras y tradiciones, ofreciendo recuperación ante desastres, así como en la aporte conceptual, herramientas, asesoría, fi- adaptación al cambio climático. nanciamiento y capacitación. Proteger el bienestar de poblaciones en riesgo social: Para fortalecer la inclusión social, se fomenta la integración laboral, se crean espa-

Indicadores de efecto seleccionados

DRM1: % of communities at risk with a functional emergency NU2: % of children from 0-59 months of age who receive foods committee from 4 or more food groups on the previous day

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

RH5: % of women having received four or more ante-natal care RH6: % of children between 12 – 23 months vaccinated three check-ups during the last pregnancy times for DTP and other additional vaccine (local guidelines)

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

106 RH7 : % of women of reproductive age (15-49 years) using any kind of family planning method

100%

80%

60%

40%

20%

0% Before 2017 Target

Resumen de los resultados de 2017

Sub-Proyecto Poco Poco lla, e implementación de capacitaciones nutricio- Se han conformado comités locales de GRD en De las 25 comunidades, 23 realizaron el CAI co- nales). Para trabajar en la temática de GRD se las 7 comunidades, formando sus integrantes munal de forma mensual. El 100 por ciento de los logró una excelente coordinación con la Alcaldía con primeras capacitaciones. Se ha realizado la adolescentes han participado en eventos de de El Villar (a través de la Unidad de GRD del Mu- encuesta productiva a nivel familiar (360 fami- educación y promoción de SSR. A lo largo de año, nicipio). Se pudieron conformar 11 comités loca- lias), que es base para la elaboración del Plan toda la población ha sido capacitada en temas les de gestión de riesgo y primeras capacitacio- Estratégico Comunitario y familiar. de promoción de la SSR. El 100 por ciento de las nes son realizadas. Se han realizado 12 análisis comunidades (todas en riesgo) cuentan con un físico químico y 12 análisis micro biológico para Sub-Proyecto San Pedro comité local de GRD. Primeras capacitaciones ver la calidad del agua que se tiene en las comu- Se ha logrado cobertura total del 4to control pre- son realizadas, a nivel inicial existen funciones de nidades. natal, más control posparto dentro de 48 horas. sistemas de alerta temprana. Se ha iniciado el CAI comunal en las 7 comunida- Sub-Proyecto Pampa Huasi des y se han “carpetizado” y sistematizado a 341 Sub-Proyecto Nuevo Mundo Se han capacitado 2,137 personas en diferentes familias de las 7 comunidades. Se ha logrado la consolidación del CAI comunal. temáticas de salud (higiene, embarazo adoles- Se han conformado comités locales de GRD en El personal de salud utiliza los sistemas de moni- centes, parasitosis, lactancia materna, nutrición, las 7 comunidades, formando sus integrantes toreo del sistema de salud. Se han conformado 3 vacunas, Chagas) en las 5 comunidades. Han par- con primeras capacitaciones (con el apoyo de los comités locales de GRD y se ha iniciado la elabo- ticipado las madres embarazadas, madres con estudiantes de UEs). Se ha realizado la encuesta ración de 6 mapas de riesgo (de las 10 comuni- niños <5 años, estudiantes de 5to y 6to de secun- productiva a nivel familiar (347 familias), que es dades). daria. Se han “carpetizado” (carpetas familiares) base para la elaboración del Plan Estratégico Co- La organización, el personal de salud, la estruc- y sistematizado a 473 familias de las 5 comunida- munitario y familiar. tura social de salud y el municipio trabajan coor- des. dinadamente fortaleciendo el sistema de salud. El centro de salud de Pampa Huasi ha adoptado Sub-Proyecto Tarvita prácticas amigables para la atención de adoles- Las Autoridades de salud del Municipio han asu- Sub-Proyecto Pampas de Leque centes con orientación y atención en SSR. 2 capa- mido plenamente el compromiso para el desa- Se han realizado 55 CAI Comunales (en 5 comu- citaciones para los adolescentes en educación rrollo del proyecto a nivel municipal. nidades), dando un resultado alcanzado de 92 integral de la sexualidad, específicamente sobre Se han capacitado 1,571 personas en diferentes por ciento. La población fue capacitada por me- embarazo adolescente y prevención de ITS. temáticas de salud (higiene, embarazo adoles- dio de 50 charlas educativas de manera mensual centes, parasitosis, lactancia materna, nutrición, sobre los temas de higiene, embarazo adoles- Sub-Proyecto Cruz Ck,asa vacunas, Chagas) en las 5 comunidades. Han par- cente, parasitosis, lactancia materna, nutrición, Se han “carpetizado” y sistematizado a 367 fami- ticipado las madres embarazadas, madres con vacunas, Chagas e higiene de agua. El 100 por lias de las 7 comunidades. Se ha logrado cober- niños <5 años y estudiantes de 5to y 6to de se- ciento de las comunidades (todas en riesgo) tura total del 4to control prenatal y la prueba cundaria. Se han “carpetizado” y sistematizado a cuentan con un comité local de gestión de rápida de VIH. De 401 adolescentes, 169 adoles- 1,664 familias de las 29 comunidades. Se ha lo- riesgo. Los comités han sido elegidos en cada centes han recibido asesoramiento en contra- grado una cobertura de 97.6 por ciento (201 de comunidad con el apoyo de los estudiantes de la cepción y planificación familiar (a través de aten- 209 mujeres) del cuarto control prenatal, más UE. Las capacitaciones han sido coordinadas con ción y charlas individuales). Los centros de salud control posparto dentro de 48 horas. técnicos de la Gobernación. han adoptado prácticas amigables para la aten- ción de adolescentes con orientación y atención Sub-Proyecto El Villar en SSR. La estructura social de salud ha recibido Se ha iniciado la implementación del CAI Comu- capacitación con respecto a sus roles y funciones nal en 8 comunidades (con control de peso y ta- para que ejerzan plenamente sus derechos.

107 Bosnia and Herzegovina

Objectives of the country programme Thematic priorities 2017 – 2020

Ageing and Health: The health and wellbeing of elderly, chronically ill and disabled persons is increased by living in an age-friendly environment and increased access to integrated community-based medical and social services. Disaster Risk Management: Local communities in the North-East of BIH are better prepared to respond to disasters. Capacity Development of partner organisations: The implementing partners (RC and others) have improved management structures and mechanisms to implement and sustain programs and projects.

Selected Outcome Indicators

AH2: % increase in number of clients benefitting from service AH3: % increase in members in active ageing groups

400 100%

350 80% 300

250 +24% 60% target: annual increase of 10 per cent 200 40% 150

100 20%

50 0% 0 2016 2017 Before 2017 Target

108 Summary results 2017

Ageing and Health, BiH (412945) CBDRM, Possavina Region (412980) The number of visits successfully almost doubled More than 75 per cent of local DM actors, includ- comparing to 2016: In the period of six months, ing DM committees in communities, know their 2 nurses, 17 auxiliary nurses and 36 volunteers roles and responsibilities during emergencies, provided services (in total 14,276 visits and which was demonstrated during simulations and 12,647 working hours) for 282 clients in Tuzla follow up meetings on municipal level. Commu- City and Lukavac municipality. The agreements nication and coordination between DM actors with the local administration for co-financing of became more effective and clear. They are well services were signed. Local administrations cover connected with local authorities, but their mu- 20 per cent of costs for HBC services in Tuzla and tual collaboration exists still only on an informal Lukavac, and 10 per cent for Šamac, Doboj and level due to different political and administrative Živinice. In existing HBC Centres, clients are cov- structures. ering 15 per cent in Lukavac and 20 per cent of RC capacities in DM were also further developed. costs in Tuzla. Expected clients contribution in Three DM Officers and at least 12 trained volun- new HBC Centres is 20 per cent. teers per branch are fully familiar with their roles 5 new Active Ageing (AA) IGs were formed with and responsibilities and with the equipment 75 new members, currently making a total of 25 used during emergencies. This indicates that RC IGs with 1,016 members. Following the estab- branches apply increased DRM capacities and lishment of the groups, and getting necessary instruments which was confirmed during three support from the local authorities, all new simulation exercises and lessons learned work- groups initiated activities relating to creating shops. better working conditions. In relation to this ac- 22 preparedness projects, implemented in 13 tivity, all groups approached the local communi- local communities, have contributed to better ty,s authorities and secured a written consent for disaster preparedness in communities most the allocation of space and covering running prone to disasters. The simulation exercises costs for the AA. showed that the DM committees know proce- AA network mechanisms are formally in place dures and communication lines well in case of (Statute). The AA network has defined its vision emergency. Very basic early warning systems and mission statements, including the general were set up in each target community. goal of the network. Twice Christmas, Winter support Home Based Care, Tuzla Canton (412968) Winter Assistance for Posavina region aimed to Community groups successfully took a full own- mitigate the effects of extreme winter conditions ership in the activities and independently made through the distribution of cash vouchers for the decisions related to their further development. most vulnerable population. It was implemented Their focus on community development issues in three municipalities, Brcko, Orasje and Samac triggered the inclusion of an increasing number by the Local Red Cross Branches. The support was of Active Ageing (AA) IG members, reaching a given to 814 families in total - Brcko 305 families, 250 per cent increase of members. Orasje 255 families and Samac 254 families. Participation of the older people in the AA IGs Twice Christmas in Tuzla Canton region allevi- was reflected through satisfaction measuring in ated suffering of socially vulnerable families for the groups which marked significant improve- at least one month through the distribution of ments to the overall health and wellbeing, espe- cash vouchers. Implemented in three municipal- cially in the field of preventing depression. The ities, Lukavac, Gradacac and Tuzla by their local project worked closely with the Public Health Red Cross Branches, support was provided to 687 Institute of the Tuzla Canton in collecting infor- families (Lukavac 200, Gradacac 87 and Tuzla mation among IG members. 400 families). Over the period of six months, 2 nurses, 17 auxiliary nurses and 36 volunteers provided 11,396 service hours for 258 clients in Tuzla City and Lukavac municipality. Multi-sources mechanisms for covering costs of HBC services are in place and local administrations in both localities started to participate in co-financing the services.

Kinaesthetics, Tuzla Canton (412979) Kinaesthetics were identified. They worked out the plan of action and plan to monitor application of Kinaesthetic skills by HBC staff. The on-job-training that included 12 auxiliary nurses, 11 clients and 10 family members, showed significant improvement in clients, health but also improvement in caring capacities of HBC staff and clients, family members. 109 Cambodia

Objectives of the country programme Thematic priorities 2017 – 2020

Health: The beneficiary community and DRD Capacity development of partner organiza- jointly ensure WASH security in the project area. tions: Through the support of the Organiza- Adolescents have access to appropriate sanita- tional Development process, the target tion facilities and are familiar with Menstrual Branches/ Sub-branches will be enabled to more Hygiene Management (MHM). Implemented effectively and efficiently run their offices. intervention contributed to improved nutritional In March 2017, it was decided to close the SRC status of the target population. operation in Cambodia for the foreseeable fu- Disaster Risk Management: CRC Branches/ ture. The objectives listed above are therefore no Sub-Branches are familiar with and trained in longer relevant as the work in 2017 did aim to implementing Risk Reduction measures. phasing out.

Summary results 2017

Enhanced Environmental Public Health Phase There has therefore been a significant improve- 3, Cambodia (442023) ment in access to safe drinking water and sanita- The final project assessment carried out - using tion for the targeted households. an MSC methodology - found significantly positive results achieved by the project in the area of During 2017, the SRC entered a new partnership its impact (health status of target population with the INGO Teuk Saat 1001 in order to estab- improved) and its related outcomes 1 and 2. lish two water kiosks. Teuk Saat is committed to Work on outcomes 3 and 4 was stopped in early improve access to safe drinking water through 2017 when the decision was taken to close the the establishment of water filtration plants pro- programme. viding safe water, run as local businesses. Two As the project was closed early, it has not been plants were opened in the programme area with possible to assess the long-term health impact the support of SRC. In December 2017, the plants using any medical data. However, the final as- had recruited 227 families in Trapaing Krosaing sessment report includes feedback from the tar- commune and 190 families in Kraing Leave com- get populations and stakeholders stating their mune. It is expected that the number of families opinion that the health of the population had using the plants will grow over time. With an been improved considerably by the project. average of 6 people per household this means Regarding outcome 1 (hygiene behaviour im- that a total of 2,502 people are already benefit- proved), the final assessment report concluded ing from the plants. that a holistic approach to hygiene, covering many aspects from sanitation to cooking, hand washing, drinking water, and community clean- liness proved significantly effective. Thus, most significant changes reported by beneficiaries -in clude improvements in personal hygiene and use of clean water for hand washing, drinking and cooking. Good practices for cleaning facilities and the home were also appreciated by beneficiaries. Outcome 2 aims to improve access to safe drinking water and sanitation infrastructure. During the first quarter of the year, a revised plan for 2017 was agreed to reflect the decision to end all SRC operations in Cambodia. In this plan the three most important indicators were: – Construction of 306 household latrines – Actual result 961. – Construction of 612 HWBs – Actual result 2,013. – Distribution of 490 CWPs- Actual result 2,300.

110 Ecuador

Objetivos del programa de país Prioridades temáticas 2017 – 2020

Salud: Se apoya y fortalece la reducción de ries- Fortalecimiento organizativo: Se fortalece a las gos de morbilidad y mortalidad por diferentes organizaciones co-partes en sus estructuras in- causas. ternas, su capacidad de participación y negocia- Gestión de riesgo: Se contribuye en la preven- ción para favorecer el acercamiento de las visio- ción y mitigación de riesgos de desastre. nes de la medicina occidental con la medicina ancestral.

Indicadores de efecto seleccionados

DRM1: % of communities at risk with a functional emergency RH5: % of women having received four or more ante-natal care committee check-ups during the last pregnancy

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Resumen de los resultados de 2017

Ukllay OCKIL RIOS (431519) mayo. El trabajo intersectorial resultó en la Abrazo, REDDESC RIOS (431519) El modelo de trabajo intersectorial se mantuvo y mejora de un bote que facilita el traslado de las El mayor reconocimiento de la institucionalidad se llegó al 100 por ciento del cumplimiento en emergencias (> coordinación con UNFPA). Las de REDDESC en la coordinación Intersectorial dio firma de convenios y elaboración de planes op- capacitaciones (acciones de IEC) en VIH, TB, SSR el resultado del 100 por ciento del cumplimiento erativos. y Violencia se dieron en 62 comunidades con en firma de convenios y elaboración de planes Con la Unidad de Salud de Puerto Murialdo se 1,520 personas. operativos. Se logró también conseguir Acuer- activaron las redes CONE. La Integración del dos con los Distritos de Salud para trabajar con comité de gestión de riesgos de OCKIL en la Yangoe, NAWE RIOS (431519) adolescentes y jóvenes en el tema de GRD. respuesta cantonal a desastres fue exitosa. Otros Se ha mantenido la relación intersectorial con el Se han conformado 10 comités de gestión de aspectos importantes han sido las capacitac- Distrito de Salud, ilustrado por el 100 por ciento riesgo comunitarios en comunidades de vulner- iones (acciones de IEC) en VIH, TB, SSR y Violencia del cumplimiento en firma de convenios y elab- abilidad, y se ha empezado con la formación de en 42 comunidades con 2,100 personas y la asist- oración de planes operativos. Importantes ac- sus integrantes. encia de emergencia en dos eventos suscitados ciones de respuesta a los brotes de Leishmaniasis Otros aspectos importantes han sido las capac- en comunidades vulnerables. y Conjuntivitis se han implementado, logrando itaciones (acciones de IEC) en VIH, TB, SSR y Vio- controlar las epidemias. lencia en 34 comunidades con 1,050 personas y Ukllay FONAKISE RIOS (431519) En 13 comunidades (de 10 comunidades planifi- el apoyo a las entradas de brigadas médicas inte- Se ha logrado la firma del acuerdo de cooper- cadas) se realizó el ingreso de las brigadas médi- grales de salud a 13 comunidades. ación con el Distrito de Salud Putumayo y se llegó cas integrales de salud y acciones de IEC a las al 100 por ciento del cumplimiento en firma de comunidades. 10 de las comunidades han tenido convenios y elaboración de planes operativos. 2 o más ingresos de las brigadas. Se ha cumplido con los ingresos previstos, en co- A pesar de dificultades internas y de sus cambios munidades de acceso difícil, con brigadas médi- políticos se mantuvo una buena coordinación cas integrales de salud y acciones de IEC. con la NAWE. Se apoyó a realizar una rendición La implementación de un plan intersectorial de de cuentas (social accountability) con la presen- GRD ha llegado a conformar 8 comités en comu- cia de más de 120 personas, con buenos resulta- nidades vulnerables, logrando una buena coor- dos para el proyecto. dinación entre varios actores en el cantón Putu-

111 El Salvador

Objetivos del programa de país Prioridades temáticas 2017 – 2020

Gestión de riesgo: Las capacidades de gestión de desastres y de adaptación al cambio climático a nivel comunitario y regional están fortalecidos. Salud: La situación de salud y el acceso a servicios de salud de calidad adecuada están mejorados para la población en las comunidades más vulnerables. Inclusión social: Los factores de exclusión y de riesgo social de jóvenes y sus familias están reducidos a través de la promoción de oportunidades que favorecen la inclusión social. Fortalecimiento institucional: Las capacidades organizativas y estructurales de la Cruz Roja Sal- vadoreña se han fortalecido.

Indicadores de efecto seleccionados

WH3: % of households using an improved drinking water source DRM1: % of communities at risk with a functional emergency committee

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

112 Resumen de los resultados de 2017

Creando Oportunidades para la Inclusión Fortalecimiento de la resiliencia en comunida- Social, OIS, II, Ciudad Delgado/San Salvador des vulnerables del Municipio de Jiquilisco, (431694) Municipio de Jiquilisco (431698) El objetivo de impacto es de fortalecer capacida- Este proyecto iniciado en enero tiene el objetivo des de resiliencia de la población juvenil en code generar vidas más saludables y seguras en las munidades urbanas, disminuyendo los factores comunidades vulnerables del Delta Lempa. Esta de exclusión y riesgo social y generando entor- fase prevé la salida de 48 comunidades y una nos seguros y saludables. nueva intervención en 40 comunidades. El pri- Al fin del proyecto, se disminuyeron los factores mer año el trabajo se enfocó en zona de consoli- de exclusión y riesgo social de forma cumulativa dación en donde todas las comunidades tienen para 778 jóvenes que han recibido servicios y ca- un comité de salud y el 46 por ciento de las fami- pacitación de salud de 7 comunidades interveni- lias implementan al menos 4 medidas y practicas das. Igualmente para 1,436 alumnos de 5 cen- saludables (1,486 familias), participando en cam- tros escolares en los cuales el número de casos de pañas junto con los centros de salud. Igual- violencia bajo de un 64 por ciento y para más de mente, se inició el proceso de formación de los 230 familias que participaron en talleres de promotores psicosociales. orientación familiar. 21 Comisiones Comunales de Protección Civil 4 espacios para la formación vocacional han sido cubren la totalidad de la zona de consolidación rehabilitados y 109 jóvenes generan ingreso en- en donde se están instalando Sistemas de Alerta tre empleo (52) e iniciativas productivas que ge- Temprana (SAT). Así mismo se sigue con la imple- neran ingreso (57). 86 jóvenes participan y están mentación de los planes familiares y de las medi- activos en 5 organizaciones comunitarias y 4 or- das de mitigación y/ o adaptación implementa- ganizaciones juveniles están articuladas en redes das a escala familiar. Se optó por un proceso muy trabajando por sus comunidades. Igualmente se participativo para la selección de los micro-pro- han recuperado 10 espacios de integración co- yectos con el fin de favorecer a lo máximo el em- munitaria con la participación activa de la pobla- poderamiento de las comunidades y el mejora- ción. Se cuenta con 30 voluntarios de la Seccional miento de sus capacidades de gestión. En zona de Apopa, apoyando la conformación de las Uni- de consolidación se está preparando no solo a las dades Comunitarias y proceso de apoyo psicoso- estructuras comunitarias pero también a los cen- cial y saneamiento en las comunidades. tros escolares e instituciones locales a retomar su liderazgo y colaborar juntos. Salud e Integración social en San Vicente y Tecoluca, Municipios de San Vicente y Teco- luca (431695) Iniciado en julio de 2017, esta segunda fase del proyecto con el objetivo de mejorar el estado de salud y la inclusión social de la población, amplió la zona de trabajo, pasando de 3 a 14 comunidades. En estos 6 meses se finalizaron 33 sistemas para el tratamiento de aguas grises en la comunidad El Milagro y se diseñó la herramienta para realizar diagnóstico para la construcción de sistema de agua potable nueva y rehabilitación en 4 comunidades. Se conformaron 9 comités de salud en las nuevas comunidades y se fortalecieron los 3 existentes. Igualmente se realizaron los diagnósticos de 3 de los 4 centros de salud. Se ha trabajado juntos para promover medidas de prevención en salud e higiene en las familias. Igualmente iniciaron los procesos de conformación y fortalecimientos de las organizaciones comunitarias, y de diagnós- tico de riesgos comunitarios a nivel de salud y organización social. Se elaboró un plan de trabajo con la seccional de la Cruz Roja Salvadoreña para promover el invo- lucramiento de los voluntarios en los proyectos.

113 Ethiopia

Objectives of the country programme Thematic priorities 2017 – 2020

Health: Better water, sanitation and hygiene is ensured in rural villages. Disaster Risk Management: Villagers get stronger at dealing with droughts, floods and conflicts. Organizational Development: The Ethiopian Red Cross Society gets better at supporting community resilience.

Selected Outcome Indicators

WH2: % of households using and maintaining clean latrines WH6: % of housholds with soap and water at the hand washing station commonly used

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

114 Summary results 2017

Integrated and Community Managed Resil- monitoring changes. Following the master train- ience, Gambella (420565) ing, trained participants cascaded both ap- The ERCS has now 319 trained and active volun- proaches to community volunteers. teers in the project area. This is more than a twenty-fold increase since the beginning of the Moyale Emergency Drought Response 2017 project. Moreover, the branch trained 210 volun- (420574) teers for the already completed population Hygiene and health promotion to reduce water movement project. This includes 141 trained and born disease including diarrhoea as well as ma- equipped First Aid volunteers. Moreover, 6,311 laria, reached 61,482 persons of drought af- ERCS members had been recruited. Driven by an fected villages in Moyale Somali and Moyale increase of volunteers recruited and trained in Oromia districts. Trained volunteers conducted first aid and CBHFA, the ERCS has become better household visits and identified 2,643 malnour- at supporting community resilience. ished children under 5 and 319 pregnant and All 6 project villages have active DRR committees lactating mothers in need of supplementary which carry out their action plan. They were food. Those 2,962 women and children were trained, sketched risk maps and prepared action then provided with supplementary food during plans for 2017 to act on DRR. During 2017, DPP 3 months (blended cereal, soya, and beans and committees have consolidated their roles after oil). In total, 15,858 beneficiaries received sup- the understanding of their structures and re- plementary food and 32,850 people benefitted sponsibilities. from 3,407,000 l of water. Moreover, to protect 70 new CBHFA volunteers were trained which the livelihoods of the mainly pastoralist and results in a total of 96 CBHFA volunteers trained agro-pastoralist beneficiaries, medicine was pro- for 1,308 households. This indicates that 1 volun- vided for the treatment of 115,478 livestock. teer serves for 13 households (as an average based on their geographic location).

Community Resilience, Moyale / Somali and Oromia woredas (420569) The survey conducted on the use of latrines and on handwashing showed that by the end of 2017, 90 per cent of the households in the project area were using and maintaining clean latrines. However, the survey also showed that only 30 per cent of the latrine holes were sealed. The survey also revealed that 90 per cent of the households have a hand washing facility with soap. This is a positive increase from the finding in the MTR of December 2016, when 79 per cent of the households had a hand washing station. Moreover, it is a rewarding result of the work done by the project team and the 286 trained Community Based Health and First Aid (CBHFA) volunteers that reached 6,150 households (about 30,750 people) with hygiene and sanitation promotion. It is them who managed to motivate the houeholds in their villages to build latrines with hand washing stations, to keep the latrines clean and wash their hands.

WASH Shalla (420573) The project supports 8,000 people in the Shalla area of West Arsi Zone in Oromia region. It aims to increase resilience to drought through increased access to water and sanitation as well as capacity building of communities, local artisans and officials. 11 participants from local authority sector offices i.e., Health Office Water Office, Women and Children Affairs and Education Of- fice received master training on CBHFA and hygiene promotion and sanitation training. The trained participants play a key role in disseminating the knowledge to community volunteers and

115 Ghana

Objectives of the country programme Thematic priorities 2017 – 2020

Health: The prevalence of avoidable blindness is Disaster Risk Management: The population,s reduced by improving the quantity and quality of resilience to disasters is strengthened through Eye Care Services and enabling the population to improving the communities, capacity, knowl- access the service and get effective treatment. edge and behavior to cope with disasters and to The population,s resilience to health challenges mitigate their effect, as well as to improve risk is strengthened through improving the commu- management structures in the districts. nities, capacity, knowledge and behavior to enhance their well-being as well as by reinforcing the Public Health Care facilities within the communities.

Selected Outcome Indicators

EC1: % of eyes with good visual acuity after 6 weeks of cataract EC2: % of increase of utilization of eye care facility from previous surgery year to current year

100% 45000 40000

80% 35000 +23% target: annual increase of 8 per cent 30000 60% 25000

20000 40% 15000

20% 10000

5000

0% 0 Before 2017 Target 2016 2017

DRM1: % of communities at risk with a functional emergency committee

100%

80%

60%

40%

20%

0% Before 2017 Target

116 Summary results 2017

Disaster Risk Reduction (421464) benchmark upon which the performance of eye Community Disaster Preparedness and Response health would be measured. Teams (CDPRT) were created in 25 communities The Eye Care Services project achieved the high- and trained 500 volunteers in the Northern Re- est cataract surgery rate of 1,074 in the country, gion. The creation and training of the CDPRTs based on 2,363 cataract surgeries performed on was expected to enhance the communities, abil- an estimated population of 2.2m. The project ity to prepare the community and respond to also expanded to 4 additional health facilities in disasters with the communities. Tamale Metropolis, Savelugu, East Gonja and Sa- To facilitate their work effectively, the 25 CDPRTs boba/ Chereponi districts. were equipped with working tools for fire extinc- The project contributed towards improved qual- tion, lifebuoys, cutlasses, first aid kits, nylon ity of health care in Ghana through increased ropes, cleaning toll, visibility materials and bicy- investment in training of eye health personnel cles. Over 6,000 seedling were planted across the and provision of state of the art eye care equip- 25 communities in the Northern Region to pre- ment. 16 ophthalmic nurses were sponsored vent damages during rain and windstorms. through training, 180 volunteers trained on eye care matters and eye care equipment provided Maternal, Newborn & Child Health (421489) to facilitate ophthalmic staff work (e.g. biometry Community Sensitization through songs re- equipment etc.). The project also introduced ca- sulted in 24 MNCH-related songs composed and pacity building trainings in biosafety and other recorded by the Mothers, Clubs. The songs were quality control measures in service provision. Of played on the local radio stations in the 4 project the 2,363 patients operated, 1,990 (84.2 per districts with a multiplier effect on the geograph- cent) had VA between 6/6 and 6/18, recorded ical areas covered by the messages and en- 6-weeks post-surgery. The collection and man- hanced sustainability of the Clubs. GHS adopted agement of eye health data was also improved the initiative and invited the Mothers, Clubs to through the project. 77 government staff (DHIOs, perform at the launch of their MNCH-related in- HHIOs, ONs, and optometrists) drawn from 26 terventions and community organised durbars in hospitals/ facilities in 26 districts were trained on other areas. There was increased access to data entry in DHIMS II and in a new eye care re- healthcare and improved referral system in the porting form. This was expected to improve the reporting period. Access to health facilities was quality and integrity of eye health data in Ghana. facilitated for 221 patients with different MNCH-related conditions, through the services of the 10 tricycles. Out of the 1,326 pregnancies successfully delivered within the year, only 5 (0.4 per cent) cases of cord infection were reported within the first half of the year. No cases were recorded in the last half of the year. This was attributed to increased health literacy and adoption of positive behaviour by pregnant mothers in the project areas.

Cholera Intervention (421454) House to house cholera prevention messages were disseminated to the affected communities where 421,050 beneficiaries were reached with cholera prevention messages through multiple IEC approaches. This helped in containing the disease and managed to curtail the spread during its outbreak. Improved sanitation and hygiene practices were promoted in the critically-at-risk communities where handwashing kits were provided to the 21,600 people, 34 schools and 16 public latrines. Moreover, boxes of water purification tabs were distributed to communities at risk.

Eye Care Service (421488) Eye Health Service (421457) The first national survey on blindness and visual impairment was conducted in Ghana, and co- funded by the project. This provided a baseline/

117 Haiti

Objetivos del programa de país Prioridades temáticas 2017 – 2020

Santé: Améliorer la situation de santé de la population vulnérable dans la région rurale de Léo- gâne. Sécurité sanguine: Renforcer le service haïtien de transfusion sanguine au niveau national. Gestion de risques: Développer et améliorer les capacités au niveau communal et régional en gestion communautaire des risques et désastres (GRD communautaire), notamment dans la pré- paration et la mitigation, et les lier avec le sys- tème national de GRD Développement organisationnel: Renforcer la CRH et les partenaires du programme au niveau local et communal.

Indicadores de efecto seleccionados

NU3: % of infants < 6 months of age received only breast milk DRM1: % of communities at risk with a functional emergency on the previous day committee

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

118 Resumen de los resultados de 2017

WASH Cormier (432356) Gestion des Risques des Désastres (432362) Les activités visant le changement de comporte- Dix nouveaux équipes d'intervention commu- ment ont été continuées tout au cours de l'an- nautaire (EIC) sont créées et ont reçu des forma- née. Quatre évènements communautaires ont tions dans les six premiers modules de formation été réalisés grâce au support des EIC et des struc- de GRD (introduction à la GRD, les PSC, le sys- tures communautaires organisées, un total de tème d'alerte précoce, la gestion d'abris provi- 8,029 personnes a été touché. 420 chefs de fa- soires, le système national de GRD, le PUF et la mille ont été formés en CTED et 1,299 élèves Prise en charge choléra). Au-delà de la formation dans 13 écoles ont été directement touchés par à la préparation et intervention en cas de catas- les activités de promotion à l'hygiène. Concer- trophe, également les activités de mitigation de nant l'infrastructure, la construction de 630 la- risques se sont poursuivies: La couverture boisée trines par les ménages a été réalisée (selon la des sous bassins versants est augmentée par 17 méthode «Assainissement total piloté par la pépinières additionnelles et 50,090 arbres communauté») et l'installation de 7 systèmes transplantés; les sols sont stabilisés par la mise en hydrauliques communautaires. En synergie avec place de 21,297 mètres linéaires de rampes pour le projet GRD, 19 nouvelles équipes d'interven- la plantation de 123,175 boutures de vétivers, tion communautaire (EIC) ont été formées en 2,722 boutures de roseau et 1,064 de boutures prise en charge communautaire du choléra. de canne à sucre. Egalement 12.5 kilomètres de routes ont été aménagées, et 100 panneaux de Renforcement du Système National de Sécu- sensibilisation confectionnés, distribués et instal- rité Transfusionnelle (432358) lés dans les communautés. En dépit des nombreux défis auxquels le SNTS reste confronté, la production globale du SNTS Recouvrement rapide Corail (432366) ainsi que le nombre de dons volontaires pour l'an- Le projet fut lancé suite aux activités d'urgence née 2017 ont augmenté grâce à l'action concer- avec l'objectif de supporter les besoins immé- tée de tous les acteurs du système. diats dans trois secteurs: Abris, WASH et relance Les activités de promotion via le renforcement du économique. Club 25 ont été renforcées, en plus se sont réalisés A la fin de l'année 2017, 85 maisons étaient déjà des campagnes et la production de 2 Matériels IEC finies, 83 étaient en cours de réparation et 112 sur le don de sang et le SNTS avec la collaboration étaient en cours de préparation. 120 jardins terra de la CRH, impliquée dans la promotion. preta et 90 avec technique compost ont été réa- La production annuelle a pu être augmentée lisés et 4 systèmes hydrauliques communau- d'environ 4 pour cent par rapport à la ligne de taires sont mises en place. base. Un objective important atteint était l'élaboration de procédures manquantes et la révision de la to- talité des procédures allant de l'accueil au 'testing' immuno-hématologique. La formation de cadres du SNTS à l'utilisation des dites procédures en- trées en vigueur et le renforcement de 4 comités d'hémovigilance hospitalière s'est poursuivi.

Santé Communautaire et nutrition (432360) Après une première année 2016 avec des grands défis comme le début tardif du projet et le pas- sage de l'ouragan Matthew, l'équipe du projet a pu avancer sur tous les axes du projet en 2017. Avec une stratégie visant à adresser l'ensemble de la population, a travers des grandes campagnes de sensibilisations, des réplications en groupe, des formations et discussions des paires et des accompagnements familiales (visites do- miciliaires), des grandes marches de sensibilisations et des animations culturelles, 15,000 personnes ont été touchées et sensibilisées sur les bonnes pratiques nutritionnelles. 55 formateurs communautaires et 28 professeurs ont été for- més et sont maintenant opérationnels dans les thématiques nutritionnelles. Les activités agro-écologiques ont pu être renforcées, 124 familles ont établi un jardin potager et 283 structures terra preta sont établis.

119 Honduras

Objetivos del programa de país Prioridades temáticas 2017 – 2020

Salud: Se mejora el acceso a servicios de salud de calidad y se fortalecen las capacidades. Gestión de riesgos: Se fortalecen sistemas y capacidades de gestión de riesgo y adaptación al cambio climático. Inclusión social: Se reducen factores de riesgo social y de exclusión. Fortalecimiento organizativo: Se fortalecen capacidades organizativas y estructuras de contrapartes.

Indicadores de efecto seleccionados

DRM2: % of community based structural protective measure RH4: % of births attended by skilled health personnel functioning and managed properly

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

120 Resumen de los resultados de 2017

PAO – Ampliando oportunidades para el for- PRODESUR – Fortalecimiento de la resiliencia talecimiento de la salud urbana y la preven- comunitaria a través de gestión de riesgos de ción de la violencia con poblaciones en riesgo desastres y de salud, Valle / Choluteca social de la colonia San Francisco y zonas ale- (430065) dañas / Tegucigalpa (430065) Durante el tercer de los cuatros años se firmaron Durante este año de cierre se logró la transferen- varios acuerdos junto con las alcaldías e institu- cia de los procesos para que fueron asumidos por ciones locales con las 86 comunidades de salida socios estratégicos e instituciones gubernamen- para asegurar la sostenibilidad de los procesos. tales. Los 2 establecimientos de salud han mejo- Se logró una implementación del 100 por ciento rado su cumplimiento con la mayor parte de los de los planes de acción por parte de los actores estándares mínimos de calidad de la SESAL y los involucrados en las 153 comunidades del pro- servicios de atención psicosocial han sido asumi- yecto: comités de salud, emergencia, y escolar, dos por el Colegio de Psicólogos de Honduras. Se alcaldías, Manorcho, entre otros. En zona de con- logró la sostenibilidad de la oferta del programa solidación y de salida se realizó en mayor parte de educación alternativa y de la formación ocu- de manera autónoma con una fuerte coordina- pacional mediante la transferencia a ONG locales ción entre los actores comunitarios e institucio- y la firma de convenios con instituciones guber- nales. En salud reproductiva se logró que la tasa namentales. Igualmente, 16 estructuras comuni- de embarazo adolescente en dos municipios este tarias cuentan con la acreditación y el reconoci- un 5 por ciento debajo del promedio nacional y miento legal de parte de sus instituciones que el número de estos embarazos disminuyo de referentes, funcionan de manera autónoma, y más del 60 por ciento en relación al 2013. El 96 realizan gestiones con instituciones guberna- por ciento de embarazadas cumplen las normas mentales y ONG. del Ministerio de Salud. En gestión de riesgo se están cumpliendo las metas de intervención de Resiliencia mediante la reducción de riesgos, los sitios críticos identificados en los estudios de Olancho (430066) amenaza gracias a la integración de las interven- La resiliencia en las comunidades rurales se for- ciones en los planes de inversión de las alcaldías talece a través de 3 ejes: capacidades locales y y de la Manorcho. comunitarias fortalecidas, exposición frente a riesgos físicamente reducidos y capacidades de Fortalecimiento del Programa Nacional de actores institucionales fortalecidas y coordina- Sangre de la Cruz Roja Hondureña, Teguci- das. A finales de esta fase, las capacidades locales galpa / San Pedro Sula (430071) a nivel individual – hasta 6,038 hogares visitados El proyecto apoya el Programa Nacional de San- implementando en un 82 a 87 por ciento medi- gre de la Cruz Roja Hondureña en el estableci- das de GRD-ACC y salud - están fortalecidas me- miento de una estructura de gobierno y de ges- diante el empoderamiento y la buena autono- tión de riesgos fortalecida, en el fortalecimiento mía de Comités de salud, Codel y centros de capacidades técnicas y en el fortalecimiento escolares en cada una de las 75 comunidades de la donación voluntaria. Durante esta primera atendidas. La exposición local de infraestructura prorroga entró en pleno funcionamiento el sis- y de bienes a nivel familiar y público frente a ries- tema de costeo de los productos sanguíneos. Se gos ambientales esta reducida, se estabilizaron elaboró el plan de implementación de la nueva en total 157 sitios críticos mediante acciones de política nacional de sangre y se activaron 6 comi- bioingeniería. Estos sitios se conservan adecua- tés de seguridad sanguínea a nivel hospitalario. damente y sirven para sembrar árboles frutales y Durante la crisis electoral a finales de 2017 se huertos bajo un enfoque agroecológico. En total activó con éxito el plan de contingencias lo- se reforestaron 325 hectáreas en coordinación grando abastecer satisfactoriamente las necesi- con las comunidades y los actores locales, y se dades. La compra de equipamiento está en pro- mejoró la protección y la gestión de los sistemas ceso tal como la formación del personal, el de abastecimiento de agua potable. Mediante el diseño de un nuevo edificio para el banco de mejoramiento de los 25 puestos de salud y la ca- sangre en Tegucigalpa, y el equipamiento de la pacitación al personal se alcanzó que el 95.8 por nueva unidad móvil. Se completó el programa en ciento de la población está satisfecha con los línea para la formación de promotores de la do- servicios. 326 écofogones reducen en un rango nación de sangre voluntaria y no remunerada, el del 60 al 70 por ciento el consumo de leña. Los cual se encuentra actualmente en la plataforma actores institucionales y miembros del Sistema virtual de la FICR. nacional de gestión de riesgos (SINAGER) han incrementado su capacidad de coordinación y acción. Las 3 alcaldías y sus CODEM han participado activamente junto con las comunidades a la ejecución de 63 micro-proyectos beneficiando a 130 comunidades.

121 Kyrgyzstan

Objectives of the country programme Thematic priorities 2017 – 2020

Health: The RCSK runs a successful programme Disaster Risk Management: Communities in where older people have opportunities to solve Talas Oblast are more resilient to hazards due to their problems. The civil society (and the popula- sustainable DRM measures. The RCSK and the tion involved) remains visible and vocal to act on SRC delegation are better prepared for emer- public health topics. The population in selected gency response and risk mitigation. areas of Kyrgyzstan have improved access to Organizational Development: The RCSK is quality services of the national health system. strengthened to secure and run its core tasks.

Selected Outcome Indicators

AH1: % of organizations that adhere to quality standards DRM1: % of communities at risk with a functional emergency committee

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

BS3: % of voluntary non-renumerated blood donations

100%

80%

60%

40%

20%

0% Before 2017 Target

122 Summary results 2017

CBDRM Phase 1 (445987) 12 Local Disaster Management Committees are fully functional at the end of Phase 1; refresher trainings are ongoing. 6 small-scale structural mitigation projects were completed, mitigating flood and mudflow risk reduction and benefiting over 17,000 people with this reduction of exposure. School-based preparedness activities benefited 7,160 children, focusing on simulation exercises and drills, but also non-structural measures for risk mitigation in and around school buildings. While the finalization of the Community-Based Disaster Risk Management Phase 1 was under- way, the organizations elaborated the next phase of the project in mid-2017, with the needed funds mobilized.

Elderly Care Phase 2 (445991) The RCSK demonstrated good examples of play- ing an increased role in advocating for elderly in Kyrgyzstan and demonstrated significant improvements in mobilizing additional resources locally for supporting key elderly care services. The project continued providing assistance to 400 beneficiaries through 200 volunteers in target areas and facilitated creation of self-help groups among elderly. Over the past year, the project reached over 5,000 beneficiaries.

Eye Care in Batken (445993) The project demonstrated solid progress and tangible results, in developing a functional eye care unit at the Batken Oblast Hospital and en- hancing the capacity of Kyzyl-Kiya Hospital in eye care services provision. 198 surgeries were provided at the newly established Eye Care Unit in Batken and 80 cataract surgeries successfully performed. Over 6,900 outpatients received services at the Eye Care Unit in Batken.

Promotion of VNRBD (445994) The new three-year project – Promotion of Vol- untary Non-Remunerated Blood Donation – was successfully launched across the country in Janu- ary 2017, with steady implementation throughout the year. The number of general donations already increased by 14.7 per cent in 2017, and the number of voluntary donations increased even by 71 per cent. With information sessions, regular public awareness raising events, collaboration with the blood centers, building up partnerships with various organizations and initiat- ing blood drives, over 54,000 people were reached with information, which was an important contribution to the increase of donations.

123 Lao PDR

Objectives of the country programme Thematic priorities 2017 – 2020

Health: The population in selected areas of Laos Capacity development of partner organiza- have access to quality services of the national tions: Capacity of LRC Branch staff in Luang Pra- health system. Target population in selected ar- bang and/ or Oudomxay is enhanced eas in Laos are empowered to act on the determinants of health. Disaster Risk Management: The SRC country delegation is empowered to play a strong role in case of disasters.

Selected Outcome Indicators

RH4 (Luang Prabang): % of births attended by skilled health RH5 (Luang Prabang): % of women having received four or personnel more ante-natal care check-ups during the last pregnancy 100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

RH6 (Luang Prabang): % of children between 12–23 months RH7: % of women of reproductive age (15–49 years) vaccinated three times for DTP and other using any kind of family planning method additional vaccine (local guidelines) 100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

124 RH4 (Sekong): % of births attended by skilled health personnel RH5 (Sekong): % of women having received four or more ante- natal care check-ups during the last pregnancy

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

RH6 (Sekong): % of children between 12 – 23 months vacci- WH4school: % of schools using safely managed sanitation facilities nated three times for DTP and other additional vaccine (local guidelines) 100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

WH5school: % of schools adopting safe water handling practices WH6school: % of schools with soap and water at the hand washing station commonly used

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

125 Summary results 2017

Strengthening MNCH Services, Chomphet The project has made a substantial contribution and Phonxay districts, Luang Prabang Prov- to the advancement of social health protection ince (442589) mechanisms, resulting in achievement of 5 out of Regarding the practical training results, skills and 6 outcome indicators. In Sekong, the HEF and knowledge of Master Trainers and District Train- Free MNCH schemes continued without inter- ers have improved significantly. Already 2 health ruption and with effective co-funding from the centres have been handed over to the District Government of Laos (GOL). With support of the Health Office which implies that DTs are fully re- project, Sekong has been the only province in the sponsible for supervision with only minimal sup- country where more than half of the population port from the project. has received free medical care with effective ex- HMIS data are submitted completely and in time emption at health facilities (more than 90 per and the accuracy has been improved. cent according to the endline survey). Addition- Regarding access to MNCH services, service up- ally, half of its population has been correctly pro- take and health indicators have improved im- vided with non-medical benefits such as food mensely. In July 2017, the household survey and transportation allowances, free referral ar- showed that 92 per cent of pregnant women rangement, and use of Maternity Waiting Homes have been attending at least one ANC visit (base- (MWH). An effective and continuous implemen- line 56 per cent). 60 per cent of pregnant women tation of the two schemes have significantly con- attended four or more ANC visits (baseline 30 per tributed to much higher utilization by beneficiar- cent). In 2017, 63 per cent of all pregnant women ies in Sekong than in other provinces (utilization delivered their baby in a health facility (2014: 34 by poor and children is 5 and 3 times higher than per cent). The coverage of fully immunized chil- the national average, respectively). dren < 1 year old has increased from 46 to 63 per A financial protection mechanism to cover the cent. The women,s satisfaction with the health remaining non-poor population in informal sec- services increased over the project period. tor (HII) has also been progressively piloted in The project contributed significantly through Sekong and has provided decisive lessons to the – Construction, extension and renovation of HCs MOH/NHIB in designing, developing and ex- and provision of medical equipment which panding its new National Health Insurance lead to an enabling environment both for the scheme for the whole informal sector popula- health workforce and for the women. tion. As of mid-June 2017, the whole population – Strengthening of the free MNCH system in or- in Sekong has been protected from a theoretical der to provide maternal and child health ser- 100 per cent financial health protection cover- vices free of cost age, and can access services for free or by paying – Capacity building at all levels of the health low co-payment at health facility. work force including formal trainings and mentoring which increased skills, confidence and WASH in Schools, Luang Prabang and Ou- motivation and in return contributed to attract domxay Province (442594) women. In Luang Prabang the High LRC and Stakeholder engagement made solid progress: The commu- Contribution towards Universal Health Cover- nication, coordination and support have signifi- age, Central (MoH) and Sekong Province cantly improved between the project staff, LRC (442591) staff, the Provincial Education, the District educa- With support of the project, the HSM capacity tion, the school authorities and communities. has substantially improved and strengthened at Regarding establishing RCY clubs in schools, both Sekong and central level which resulted in there have been positive and encouraging re- achievement of 3 out of 5 outcome indicators. In sponses from the students and the RCY members Sekong, at the end of 2017, both Provincial and are active. 4 District Health Insurance Bureaus are reasona- MHM capacity building for LRC and project staff bly staffed and equipped, and all social health is a relatively new program dimension and the protection schemes of the informal sector are project team has gained a fair understanding of integrated and co-managed by the PHIB/ SRC. At the conceptual and implementation details. central level, the SRC sub-office at the NHIB has In Oudomxay, the completion of Water and San- been fully operational and provided continuous itation projects is successfully ahead of schedule policy and technical support to the NHIB and (7 accomplished, while the target was 6). The DOF. Lessons learned from Sekong have been engagement with the provincial and district au- extensively shared and have been pivotal in thorities for coordination and technical support shaping the challenging MOH/ NHIB reformed was strengthened. Capacity building of LRC staff policies and launching of a heavily tax-based has been realized and advancement of their ca- non-contributory NHI scheme for the whole in- pacities can be seen. formal sector (linked to output 2.3). The project has also contributed to progressive capacity building of the NHIB in monitoring/ audit, data management and analysis at central level.

126 Lebanon

Objectives of the country programme Thematic priorities 2017 – 2020

Relief: SRC assists its partners in Lebanon during Organizational Development: SRC helps its times of humanitarian emergencies with finan- partners in Lebanon in their organizational de- cial and technical support – delivering relief as- velopment, with a specific focus on the areas of sistance in its different forms. resource mobilization/ fundraising and HR. Health: SRC supports its partners in Lebanon in the long term with specific know-how and capacity building in the blood transfusion sector – improving thus the overall availability of safe blood.

Selected Outcome Indicators

IP1: % of National Society branches with disaster management BS2: NBTS meets the % of needs of requested blood products capacities rated “well-functioning“

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Summary results 2017

Safe Blood for the General Public and Refu- BTS for Syrian Refugees (EU MADAD Fund) gees in Lebanon II (442663) (442665) A new and more realistic BTS strategy was cre- A quality manager, 3 technicians and driver ated and subsequently approved by the key were recruited. SOPs for organizing/ managing stakeholders. As a result of a Deloitte manage- blood donations were prepared and approved. ment consultancy, a new HR structure adapted A first order for medical consumables and rea- to the new strategic objectives was finalized and gents submitted. approved by the President and SG of LRC. The new structure forms a key pillar in the operating PRCS-L Safe Blood for Palestinian Refugees plan for the next two years. Six BTCs were totally QM II (442642) renovated (Tyre, Rashaya, Jounieh, Spears, The new QM software eDelphyn was installed in Chouf, Tripoli) with one (Saida) to be finished in all five blood banks. SOPs & technical manuals Q1 2018. The MoH pledged an annual contribu- were revised and the clinical guidelines com- tion to LRC BTS to be trebled to approximately pleted. The curriculum and schedule for BTS QM 1.5 million in 2018. trainings for Blood Bank technicians and semi- nars for all relevant hospital staff were established.

127 Improving Access to Pre-Hospital Care in sidered. 450 households were supported with Lebanon, Beirut (442659) fuel cards of USD 100 monthly in Akkar and A steady increase has been visible with regard to Hermel between January and March. the total missions performed. Emergency Medi- cal Services missions across Lebanon have more Winterization Assistance 2017–2018, Arsal than doubled, reaching 272,764 missions in (442667) 2017. 3,103 beneficiaries were reached by the The findings of the post-distribution monitoring two ambulance teams during the project period. activities of previous projects and the current winter strategy of LRC indicated that: an ex- Capacity Building EMS Equipment Manage- tended support in winter is crucial during the five ment, Hazmieh (442660) months between November and March, temper- The Enterprise Resource System is fully imple- ature maps are a useful tool for targeting, and mented. A Supply Chain System has been piloted fuel cards are an excellent tool. Fuel cards are and will be evaluated in 2018. easy to distribute and to monitor as transparency The quality of the logistics improved as there is is given at all time, 100 USD cover approximately not only a clearly defined process between the 70 per cent of the heating fuel expenses, and stations and the HQ combined with transparent there is no need for distributions of core relief stock reports, but also a good out-of-stock man- items. Therefore 625 HH received fuel vouchers agement in the stations. of USD 100 in Arsal in December.

Cash Assistance for Syrian Refugees in Contingency Planning Process, Beirut and 14 Lebanon, North and Bekaa (442661) DM teams (442643) Unconditional cash grants of USD 175 were dis- The CPP is the result of a former logistics capacity tributed monthly in Akkar between April and building project supported by the SRC, highlight- November, USD 250 in December. 460 families ing the need for creating and developing a con- received monthly cash assistance during 12 tingency warehouse stocks and plans. The re- months. The SRC HQ Communications depart- sponse of the DMU teams in 2015 to a population ment visited the project and created a case-study movement has shed additional light on the need with CTP-related photos to create an e-learning of the DMU to be more prepared in order to re- program for schools in Switzerland. spond properly to an emergency, displacement or disaster. 9 DM branches underwent and suc- Cash Assistance for Syrian Refugees in cessfully completed the roll-out of the CPP hav- Lebanon Phase II, Akkar (442666) ing their intervention plans in place and being With continued high vulnerability among refu- ready to support 200 families. 442 volunteers gees and host communities, continued support were trained in 12 branches (5 workshops, 1 sim- of the cash assistance project was prepared. The ulation and 1 drill). A first batch of response cash assistance project was part of a wider pro- equipment and contingency stocks was programme of the LRC. Besides the SRC, the Danish, cured (satellite phones, VHF radio kits and 550 German Red Cross and – new, the Austrian and SRC family kits (kitchen sets, blankets, etc.) as a Swedish – were giving financial support. 450 contingency. families (358 Syrian and 92 Lebanese families) were supported on a monthly basis between April and September.

Relief for Syrian Refugees, in-kind, Hermel (442658) With the Syrian crisis unresolved and the respective demand for basic items (including food) in Lebanon remaining high, the SRC extended its funding for in-kind assistance until the end of 2017. In accordance with the new BA strategy of the LRC, this in-kind support was provided only in areas where cash was not feasible. 599 families were supported on a monthly basis with food parcels between January and December: 480 Syrian and 119 Lebanese families.

Winterization Assistance 2016-2017, Akkar and Hermel (442664) In accordance to the new strategy, the DMU winterization assistance gives priority to cash assistance-based modalities. Only in case of high vulnerability, or if beneficiaries cannot be reached by such activities, in-kind is being con-

128 Malawi

Objectives of the country programme Thematic priorities 2017 – 2020

Health: Improve health and hygiene behavior. Increase Access to safe water and sanitation and primary health care services. Improve the quality and quantity of safe blood transfusion services. Organizational Development: Capacity building of Malawi Red Cross Society.

Selected Outcome Indicators

RH5: % of women having received four or more ante-natal care BS2: NBTS meets the % of needs of requested blood products check-ups during the last pregnancy

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

WH2: % of households using and maintaining clean latrines WH6: % of housholds with soap and water at the hand washing station commonly used

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

129 Summary results 2017

Integrated Community Based Health Pro- Hygiene promotion was reaching more school gram, Phase 1 (422603) children than targeted, potentially providing a The project has certainly increased access to valuable re-enforcer to the messages distributed good quality and sustainable water sources. 48 at household and community level. As baseline water points have been constructed or rehabili- data for this new area regarding the indicator “% tated providing access to safe water for 65,058 of households with soap and water at the hand- people. 48 water committees were trained, are washing station commonly used by the family active and sustained with maintenance funds in members”, 29 per cent of surveyed households a bank account following Water policy of Ma- fulfill this indicator (the End of Project target is to lawi. reach 80 per cent). The hygiene promotion led to Monitoring of improved health behavior and ac- the correct usage and maintenance of clean la- cess to health services shows that the number of trines by 50 per cent, the objective is to reach 75 women of reproductive age knowing at least 3 per cent. methods of contraception increased by more The outreach clinics were successfully reaching than 15 per cent. The number of blood donors far more than the targeted number of pregnant increased more than expected (over 2,500). women, mothers and children under 5, each month: instead of 100, in total 669 have been Food Security in Schools (422608) reached, also because mothers are coming from In order to improve access to food in schools, 9 outside the catchment area. 13 per cent of the primary schools and 2 CBCC have established pregnant women have received 4 or more times vegetable gardens and consume products (122 antenatal care, see figure RH5. per cent achievement of the target). 11,896 children attended school (24 per cent more than the Warehousing and Logistics support targeted 9,585) and received porridge each day. (422611) 5 permanent kitchens and all 13 schools built In order to address immediate issues of the temporary kitchen and all schools received uten- MRCS, SRC sent a warehouse expert to support sils: buckets with taps, soap, plates, spoons, and MRCS in its effort to improve logistics and ware- kitchen utensils. School feeding started in No- housing management to address shortfalls iden- vember 2016 and ran through the end of May tified by the SG. Logistics/ warehousing was as- with support of the project. However, all the sessed and recommendations for practical schools are still providing meals without the sup- changes listed. Stock reporting templates were port of the project. introduced, facilitating a clear out of the ware- houses and sale of unused items. Also, a tem- Blood Donor Recruitment Project (422607) plate for a Procurement Status Report was intro- Regular campaigning is established in order to duced. promote and increase regular blood donations. 8 campaigns, reaching approximately 18,500 people, were realized. With blood collection through mobile drives, the project met 85 per cent of the project collection target in Blantyre and 48 per cent in the Lilongwe branch, achieving 66 per cent of the project target of 1,200 units. The NBTS in general meets 50 per cent of requested blood products, see figure BS2. Regarding improved capacity of MBTS and MRCS staff and volunteers, SOPs are emerging, the acceptance built in T.A.s is opening the door for more donor recruitment. Additionally, the youth Club 25s was successfully established. MBTS drafted a new donor recruitment strategy 2017– 2020. Blood needs for Malawi has risen to 120,000 annually according to post baseline analysis of 2015. Current blood units collected from Volun- tary Non- Remunerated Blood donation meets already 48.6 per cent of the annual requirement.

Integrated Community Based Health Pro- gram, Phase 2 (422609) Starting in May 2017, the project is a continuation of phase 1 with expansion to new villages. 7 boreholes were drilled and 12 boreholes rehabilitated, adding access to safe water for 11,608 people.

130 Mali

Objectifs du Programme Pays 2017 – 2020 Priorités thématiques

Santé: Améliorer la santé et le bien-être des nouveau-né et de l'enfant (RMNCH) au niveau communautés et de leurs groupes les plus vulné- des communautés et les soins oculaires. rables par des conditions de vie saines et sûres. Renforcement de capacités institutionnelles: Améliorer les conditions déterminant la santé Renforcer les capacités des partenaires-clé afin par un meilleur accès à des soins de qualité, la de pouvoir gérer des initiatives durables de ma- santé reproductive et la santé de la mère, du nière autonome.

Indicateurs d,effet sélectionnés

EC2: % of increase of utilization of eye care facility from previous RH4: % of births attended by skilled health personnel year to current year

6000 100%

5000 80%

4000 60%

3000 40% 2000 target: annual increase of 10 per cent 20% 1000

0 0% 2016 2017 Before 2017 Target

Aperçu des résultats 2017

422731 Projet Santé Communautaire et Ocu- dans la région avec une dissociation de la gou- dans le taux d'utilisation. La ligne de base pour laire – Phase préparatoire vernance régionale de l'exécutif en charge de la concernant l'indicateur «taux d'accouchements Le résultat le plus important de cette phase pré- conduite des projets CRM. assistés par du personnel qualifié» montre un paratoire a été de parvenir à élaborer un projet chiffre actuel de 9 pour cent; par voie des inter- dont la construction a été menée de façon très 422732 Projet Santé Communautaire et Ocu- ventions du projet, le taux devrait être augmenté participative et du local (Goundam) au Central laire à minimum 50 pour cent à la fin du projet. (Bamako) en passant par le régional (Tombouc- Le résultat le plus important pour le projet en Le projet intervenant dans une zone à sécurité tou). Cette approche participative a permis 2017 a été la restauration du système de re- très fragile, le personnel reste en quasi constante d'identifier les problèmes prioritaires, de réaliser couvrement des coûts dans tous les CSCom du exposition aux risques sécuritaires. En l'absence une planification détaillée et très orientée vers District Sanitaire de Goundam. Etant donné le de règles claires de sécurité au niveau de la so- les besoins identifiés et aussi aux bénéficiaires contexte ambiguë de la gratuité des soins et mé- ciété nationale partenaire pour les travailleurs, principaux de s'approprier du projet tant dans sa dicaments instaurée dans les régions du nord élaborer un plan local de sécurité pour les agents forme que dans son fond. Mali (bien qu'insuffisamment couverte) dont du projet s'avérait indispensable. La CRS a éla- Pendant cette phase, la CRS a participé avec la l'approvisionnement en médicaments est essen- boré et mis à disposition de la société nationale Croix Rouge Malienne à l'Atelier d'élaboration tiellement assuré par des ONG internationales, CRM et ses partenaires une grille d'évaluation du Plan Stratégique National de Santé du Mali. rétablir le système de recouvrement constituait des risques de sécurité qui a fait l'unanimité des Cette participation a permis à la CRS de maîtriser un défis majeur bien que les autorités régionales partenaires mouvement CR/CR présents au Mali. la politique nationale en matière de santé ocu- et locales le désiraient. Le fait pouvoir rendre dis- Cela a été un vrai succès pour l'année 2017. laire du Mali et aussi de partager son programme ponible le médicament de qualité et à moindre avec les différents partenaires de la santé ocu- pour les populations et restaurer l'ownership des laire. représentants des communautés pour l'offre des La CRS a apporté un appui dans le renforcement soins de santé et la gestion des structures de institutionnel de la CRM en apportant un soutien santé est très positivement salué par tous à com- financier pour le recrutement d'un Secrétaire mencer par les élus communaux. Général pour la Branche CRM de la région Tom- En ce que concerne l'utilisation des services ocu- bouctou. Cet appui renforce les capacités de la laires, la ligne de base a été relevée, l'objective branche pour la conduite des activités du projet est de réussir une croissance de 10 pour cent

131 Moldova

Objectives of the country programme Thematic priorities 2017 – 2020

Ageing and Health: Elderly, chronically ill and Blood Safety: The quality of the blood products disabled persons have improved access to inte- produced by the National Blood Transfusion Pro- grated, community-based medical and social gramme is improved through training of medical services and live in an age-friendly environment. and paramedical staff, upgrading the IT system Disease control: NCD information and health and increasing voluntary non-remunerable education are continued in the existing project blood donations. communities and extended to new municipali- Institutional Preparedness: The institutional ties in the North of Moldova with the support of preparedness of the delegation is strengthened the SRC implementing partners. by sending the country coordinator to selected trainings.

Selected Outcome Indicators

AH3: % increase in members in active ageing groups BS1: % of blood donations screened for TTIs

1200 100%

1000 80%

800 60%

600 40% 400

target: annual increase of 10 per cent 20% 200 0% 0 2016 2017 Before 2017 Target

BS2: NBTS meets the % of needs of requested blood products BS4: % of VNR low-risk blood donors who donate blood more than one time per year

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

132 Summary results 2017

Ageing and Health (415928) In order to help to improve their social and The project provided integrated care services at health condition and reduce social isolation, home to 626 elderly in need (493 female and 134 warm house activities were conducted for 11 male clients). The monitoring of beneficiaries, older people. Intergenerational support was level of satisfaction was done and 79 per cent of provided to 13 older people, home visits to 124 beneficiaries expressed satisfaction for the pro- elderly were done by the IG volunteers and 20 vided services. 23,377 HBC visits (18,486 social older people benefitted from free hair-dresser and 4,891 medical) were conducted. services. About 2,000 people in the project communities were acquainted with the concept of age- friendly community. The VCA on age friendliness was conducted in 9 project communities. 7 project communities developed age-friendly strategies; 2 of them were approved by the local council to be included in the community plan. 187 representatives from the 13 partner Local Public Authorities improved their knowledge in community development, writing project pro- posals and fundraising topics. 7 new IGs were created and 14 IGs have 273 members. IGs conducted vision building activities, their vision for the next years and an annually activity plan. 181 IGs members enhanced their capacities and knowledge on project writing and reporting.

Strengthening the Transfusions Blood Service in the Republic of Moldova – stage II (415929) The equipment for testing donor blood for transfusion transmissible infections using automatic technologies (ECLIA) and PCR is received and installed at the NBTC in Chisinau with the support of the MHLSP as a direct contributor to the project. 50 per cent of the new IT equipment was purchased and the repeated tendering for IT equipment launched. The technical specifications for upgrading the blood IT system were developed and additional adjustments made to meet the criteria required for the transfer to the governmental platform MCloud. 511 health professionals who use transfusion therapy were trained in the use of rational blood products and hemovigilance. The quality management indicators of transfusion therapy were approved. 24 public health care institutions benefitted from external audits of transfusion activity.

Winter assistance for the most vulnerable people in the Republic of Moldova (415930) The project benefitted 224 older persons, persons with disabilities and children from 7 communities (6 villages and 1 town) with Social Can- teen services during 4 months. Hot lunches were provided 5 days per week, once a day in the value of 24 lei / day / person. During the weekends, the beneficiaries received a food package of the value of 170 lei monthly. In total, 18,460 warm meals and 896 food packages were offered.

133 Nepal

Objectives of the country programme Thematic priorities 2017 – 2020

Health: Improve the health and well-being sta- Organizational Development: Include capacity tus of the target population by Community Em- building into projects and focus on district chap- powerment for Health Promotion, Community ters (and possible provincial chapters) support Action for WASH and Community Eye Care. including NRCS staff below headquarters level. Disaster Risk Management: Strengthen the operational Disaster Risk Management capacity through relevant and adequate preparedness measures for emergency response and risk mitigation.

Selected Outcome Indicators

DRM1: % of communities at risk with a functional emergency RH4: % of births attended by skilled health personnel committee

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

RH5: % of women having received four or more ante-natal RH7: % of women of reproductive age (15-49 years) using any care check-ups during the last pregnancy kind of family planning method

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

134 Summary results 2017

Community Action for WASH (443212) Community Empowerment for Health Promo- sified services, and improved patient,s satisfaction Regarding “One house one tap”, the project suc- tion (443214) and business attitude without excluding poor and cessfully implemented private tap connections The HFOMCs were made more responsible for HF needy people. The team is perfectly moving into with meter system in rural settings. Improvement management. The project is successful to develop this direction and it was successful to reduce op- in water supply (i.e. piped safe water supply) has good governance at the peripheral health facili- eration costs up to 70 per cent in the second year increased access to safe drinking water at families, ties in project VDCs fostered through the active of the project. premises and has reduced roundtrip time to 100 engagement and capacity building of 15 HFO- The hospital is increasingly collaborating with lo- per cent against the baseline of average 40 min- MCs. Fund collection worth NPR 1,402,000 (CHF cal agencies, like senior citizens forum, municipal- utes. Time taken for roundtrip is now utilized for 14,020) and land contributions by HFOMCs to ities, Social Security Health Insurance Board etc., productive works and increment in kitchen gar- maintain basic infrastructure at health facilities to carry out outreach and sell hospital services. dening practices utilizing waste water. Further- shows their active involvement. Now, 12 HFs are This indicates the popularity of the hospital in sell- more, government (WSSDO, Dang) as well as well maintained with basic infrastructure and ing its products to important collaborators. This is non-governmental organizations are influenced equipment. As per the self-evaluation data of an important indicator to sustain outreach and by this model and are replicating. 2017, 86.67 per cent (13) of HFOMCs were func- hospital services in the future with local resources. Collection of monthly tariff is key to sustainability tional against 40 per cent in 2016. and functionality of water systems. Every water Mother groups became more meaningful to help Earthquake Recovery in Dolakha (443217) project collects a monthly tariff to cover the cost mother,s in need. Health mother,s group partici- The rehabilitation of water supply schemes and for operation and maintenance (O&M) due to pation to conduct awareness campaigns espe- sanitation facilities was not met in terms of hard- which 100 per cent of water schemes are func- cially on importance of health care services during ware construction. In contrast, the targets of the tional, as they use these resources for O&M and pregnancy, like ,Meet the mother campaign,, accompanying software components such as provide incentives for care takers. shows the result of project activities. Realizing health and hygiene promotion were slightly ex- The project has made the significant changes on that not only awareness improves their utilization ceeded, and meaningful additional activities have access to sanitation and hygiene, applying various of health services, mother groups have estab- been successfully implemented in terms of win- tools and techniques (WASH learning games, inter- lished the Safe Motherhood Revolving Fund terization as well as menstrual hygiene manage- action sessions) to sensitize and change behavior, (SMRF), so as to decrease common delays in ser- ment. These activities allowed to respond to addi- that contributed to achieve ODF in all (100 per cent) vice utilization. This year, 451 mothers were sup- tional needs identified in the communities during project districts (baseline 20 per cent). Moreover, ported with SMRF funds. Besides, mother groups project implementation. the practices of proper hand washing have also in- are actively disseminating the health-related in- In the end, the resulting delays led to an undera- creased to 66.27 per cent (baseline 32 per cent). formation in community. chievement in the construction component, in The project has created profound sensitivity on The NRCS started to gain recognition as a health that only two out of the originally planned six san- Menstrual Hygiene Management in the commu- care strengthening agency. The project has in- itation and hand-washing facilities at schools nities, schools and on the regional level through creased governance of HFOMCs over manage- were rehabilitated. In these two and two other advocacy and by facilitating interaction sessions, ment of health facilities and to implement gov- schools in the target VDCs, the project provided training on re-usable sanitary pads, MHM work- ernment guidelines to improve quality care, like accompanying measures such as waste manage- shops, and orientations to the school manage- self-evaluation of HFOMCs, patient satisfaction ment and hygiene orientations, along with re- ment committee and teachers. Gender friendly survey, complaint handling mechanisms etc. lated items such as rubbish bins, drinking water toilets, having incinerators as well, were sup- Based on need assessment, essential health filters, water plastic-buckets, sanitary pads and ported in 17 schools. The introduction of a supple- equipment was supported to 12 HFs as well as first aid kits. mentary school curriculum for 4th-10th grade is maintenance of basic infrastructure. Assessment an exceptional achievement of a milestone. shows that 94.33 per cent of patients shared their Urban Disaster Risk Management (443218) satisfaction over the services received from health In this project, it is early to elaborate results. How- WASH in School (443213) facilities. Further, to increase the interest and re- ever, it gained a very positive start having 3 part- The project was successful to improve water ac- sponsibility of DPHOs to evaluate the perfor- ners, commitment to jointly invest and work to cessibility in each and every public school of the mance of HFOMCs and health facilities, joint mon- strengthen the capacity of the local government municipality by improving its infrastructure, water itoring visits (10 visits in 2017) and performance and community at risk for disaster response and storage and treatment (filtering) for around 9,000 assessments are supported by the project. This has mitigation. students, teachers and staff of the schools. Water supported in strengthening the health care, assur- It is an aim to become a part of the governmental quality was ensured with the support of a filter in ing the continuity of service delivery. system to ensure continuity. The project will sup- each classroom, training of the students and port the maintenance of the government regula- teachers on how to handle the water to maintain Mid-west Eye Care Project (443215) tions during its implementation in order that the hygiene, and the promotion of regular demon- A significant increase in the patient flow ensured continuity is maintained by the local government stration activities to attain spillover effects. that the project was extremely successful to earn after phase out. The project also ensured having functional toilets trust among the patients. As per data of the hos- Positive collaboration is presented by other stake- in 32 schools and Madrasas reached a student/ pital, the number of patients this year was 53 per holders as well: The District Disaster Management toilet room ratio of 1:33, which is even better than cent higher than the baseline of 2015. This is also Committee, District Coordination Committee, the national standard (1:50). All schools made validated by the patient satisfaction survey carried District Emergency Operation Centre, DEO, Dis- gender friendly toilets. out in 2017. This result was achieved due to di- trict Forestry Office, Department of Hydrology Reaching Muslim schools (Madrasas) is usually verse services, good building and equipment, and Meteorology, Soil Conservation Office and Water challenging as they worry about violation of their regular availability of surgeon and technical staff Induced Disaster Control Office have also pre- social and religious values by the outsiders. Unlike, members. sented their interest. the Red Cross was very successful to collaborate The project was successful to promote a financial with all (16) Madrasas to carry out all the WASH independence attitude right from the beginning. activities. This requirement enhanced quality of care, diver-

135 Pakistan

Objectives of the country programme Thematic priorities 2017 – 2020

Disaster Risk Management: Resilience of com- Health: Health and well-being of particularly vul- munities and the operational Disaster Manage- nerable and deprived people and communities is ment (DM) capacities of the PRCS, its partner improved through equitable access to health organisations and concerned governmental in- services that meet national minimum standards stitutions are strengthened through prepared- and through addressing health determinants. ness for emergency response and disaster risk prevention/ mitigation.

Selected Outcome Indicators

NU3: % of infants < 6 months of age received only breast milk on RH4: % of births attended by skilled health personnel the previous day

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

RH5: % of women having received four or more ante-natal RH6: % of children between 12 – 23 months vaccinated three times care check-ups during the last pregnancy for DTP and other additional vaccine (local guidelines)

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

136 RH7: % of women of reproductive age (15-49 years) using any kind of family planning method

100%

80%

60%

40%

20%

0% Before 2017 Target

Summary results 2017

The Manoor Valley Flood Recovery Program supervised and monitored the performance of (CBDRM) (443656) LHVs working at the facilities and provided on- Mobilization and organization of women of the the-job coaching and feedback to improve their community to form Female Focus Groups (FFGs) clinical skills. is a major achievement of this project. 6 female Access of mothers and babies to better health Mohallah Committees (MCs) were formed dur- services was improved. The percentage of births ing 2017 and they have become aware of their attended by skilled birth attendants increased challenges and ways to address them. The Pro- from 45.9 to 67.7 per cent. The number of preg- gramme was successful in forming 23 female nant women having received 4 or more ANC community institutions (FFGs), exceeding the visits during the whole pregnancy increased to planned target of 18. 17.6 per cent and nearly doubled. Similarly, the Community,s access to safe drinking water has proportions of fully immunized children and increased. Clean drinking water is available to 80 women reaching the health facility, have im- per cent of the population at their doorstep. proved. A functional referral and back referral Almost 71.3 per cent of the population has system was established through which women been served through 15 drinking water supply were referred to a higher healthcare facility. schemes. 32 OMCs were formed and trained to maintain these water supply schemes. The civil dispensary at Badal Giraan was reconstructed and is expected to benefit the majority of the population in the Valley.

Strengthening Mother, Neonatal and Child Health (MNCH) Services (443658) Health facilities in the project area were made functional and supplies sustained, and thus improved quality of health services. All targeted health facilities were renovated along with the provision of equipment and trained staff. The capacity of the staff in the target health facilities has improved through training and on-the- job coaching. 100 per cent of the staff participated in the initial training workshop and on-going refresher trainings on essential package of MNCH care by the end of 2017. Almost 100 per cent of healthcare providers including government Medical Officers and health Super- visors attended MNCH care training including training on common childhood illnesses and integrated management of neonatal and childhood illnesses (IMNCI). Trained LHV supervisors

137 Paraguay

Objetivos del programa de país Prioridades temáticas 2017 – 2020

Mejorar la situación de salud: Se apoya y fortalece el acceso de poblaciones vulnerables a salud de calidad, lo que contribuya a una vida saluda- ble y segura de la población más vulnerable. Disminuir riesgos, salvar vidas y proteger medios de vida: Se fortalece el potencial comunitario e institucional en la prevención, mitigación, preparación, respuesta y recuperación ante situ- aciones de desastres. Fortalecer organizaciones contrapartes: Se fortalece la capacidad de las contrapartes de la CRP, en coordinación con otros actores, res- petando las estructuras y tradiciones, ofreciendo aporte conceptual, herramientas, asesoría, fi- nanciamiento y capacitación.

Indicadores de efecto seleccionados

DRM1: % of communities at risk with a functional emergency RH7: % of women of reproductive age (15-49 years) using any kind of committee family planning method

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

138 Resumen de los resultados de 2017

Salud Familiar Comunitaria (433562) de las PVV alcanzadas, mediante los distintos La Línea de Base del proyecto revela que el 63 espacios y medios de acción del área de Salud, la por ciento de las mujeres encuestadas en edad consejería de pares y los grupos de autoayuda. reproductiva (15–49 años) casadas o en unión 448 personas han tenido acceso a servicios socia- utilizan cualquier método de planificación fami- les derivados y gestionados por la Fundación liar. Se ha logrado un aumento del 27 por ciento Vencer. en el acceso a servicios de Planificación Familiar, Se han elaborado 4 herramientas y mecanismos comparando datos de 2016–2017. A este obje- de gestión y el organigrama de la Fundación tivo contribuyeron la conformación/ reactiva- Vencer se ha incluido el Área de Voluntariado. El ción de 7 Mesas de Diálogo Multisectorial (MDM) reconocimiento de la referencialidad y liderazgo con participación de varias instituciones y acto- de Vencer en la temática, a nivel nacional y regio- res claves de los territorios y la formación de 361 nal, es notorio. voluntarios de la Asociación Tesãi Reka Paraguay (TRP) en la promoción en SSR y MI a nivel comu- Ayuda en emergencia para familias afectadas nitario. Los Sub-Consejos de salud se han confor- por tormentas y granizadas (433564) mado como instancias de participación comuni- Se han beneficiado 951 familias de 26 comunitaria. La dotación de equipamientos y mobiliarios dades de 3 Departamentos desde el comienzo a 10 USF permitió mejorar las condiciones de las del proyecto en la mitad de noviembre 2017. mismas y del servicio ofrecido. Como paliativo al déficit alimenticio que produjo Se ha iniciado a sentar las bases y generar condi- el desastre, se entregaron kits de alimentos a las ciones para iniciar la conformación de los comi- familias afectadas, conforme a los estándares de tés de emergencia en el segundo año del pro- Esfera. En pos de la reactivación de sus medios de yecto para mejorar la preparación de vida se entregaron kits de semillas de rubros que comunidades rurales ante desastres. Se sensibi- forman parte habitual de su producción, que lizó y concientizó a autoridades Municipales en fueron seleccionados en base al diagnóstico rea- la temática de GRD a partir de la socialización de lizado. los resultados de la Línea de Base. Se han for- mado 361 voluntarios de TRP en temas relacio- nados con la GRD y con el Análisis de Vulnerabi- lidades y Capacidades (AVC) que resultó en la elaboración de mapas de riesgos de 192 micro-territorios. Se han fortalecido las capacidades organizativas y técnicas de TRP y sus organizaciones miembros. La visibilidad y presencia institucional de TRP fue reforzada y elevada mediante el plan comunica- cional implementado. Se ha logrado la firma del Convenio Marco Interinstitucional entre el Minis- terio de Salud Pública y Bienestar Social y TRP para desarrollar acciones conjuntas, apoyar y acompañar todas las actividades organizadas y planificadas en el marco del proyecto.

Hacia la inclusión social, el acceso universal a la prevención y atención integral en VIH/sida en el Paraguay (433559) Se han capacitado 1,047 adolescentes y jóvenes de instituciones educativas para identificar su condición de riesgo a la trasmisión del VIH. El proyecto ha apoyado a 5 instituciones educativas. 55 docentes y directivos se han incluido en acciones pedagógicas el abordaje de la preven- ción y no estigmatización del VIH. Las estrategias implementadas en las instituciones educativas, talleres, ferias educativas, campañas comunica- cionales de promoción y difusión de las temáti- cas del proyecto fueron desarrolladas con apoyo de toda la comunidad educativa, directivos, docentes y padres de familia, lo que contribuye al logro de este resultado. Se fortaleció la adherencia al tratamiento por disminuir el desarrollo de enfermedades oportu- nistas, los vínculos interpersonales, la autoestima

139 Philippines

Objectives of the country programme Thematic priorities 2017 – 2020

Post-disaster rehabilitation and reconstruction: Humanitarian aid in the aftermath of Ty- phoon Haiyan is provided to contribute to strengthening the resilience of affected communities. Health: WASH projects are run that have an environmental sanitation component as a minimum and include environmental health where feasible.

Summary results 2017

Typhoon Haiyan: Ormoc Recovery Project rangays in order to improve housing conditions Phase 2 (443819) in targeted households in 5 barangays. 200 Core shelter construction provides a permanent households received the safe shelter and build- solution to the most vulnerable households af- ing back better orientation, cash grants and ma- fected by the Typhoon. A household level assess- terials to repair their houses. ment identified 681 core shelter beneficiaries 272 identified households attended a livelihood and 537 beneficiaries of shelter repair assistance. orientation, received cash grants, received tech- All new households and beneficiaries of shelter nical support and were able to restore their lost repair assistance, which had none, received la- livelihood. trines. The project contributed to the construc- Awareness raising and training efforts (such as tion of 490 new core shelters in 6 barangays. building back, hygiene promotion, Disaster Pre- Cash transfer was provided to 537 households to paredness, First Aid, Search and Water Rescue, repair their shelters according to disaster resist- etc.) involved over 450 families and strength- ant building techniques. ened their resilience and preparedness for future Access to water sources and increased knowl- disasters. In addition, 26 participants attended edge of hygiene was improved for the most vul- the Surface Water Search and Rescue (SWSR) nerable households and neighbouring popula- Basic Collapse Structure Search and Rescue tion in the targeted barangays. 85 per cent of the (CSSR) training. households identified as the most vulnerable in 6 barangays used water from safe sources and had access to water. 50 per cent of the households (10,156 people) attended the Hygiene orientation and PHAST activities and are now aware of the recommended practices related to hygiene, safe storage of water and solid waste disposal. The understanding of disaster risks was enhanced and appropriate measures were taken to mitigate the risks within vulnerable households and Ormoc and Barangay chapter levels. Vulner- ability and capacity assessment was conducted in all 6 barangays and 2,554 households prepared individual family contingency plans. Pro- ject staff and volunteers of the PRC were trained on DRR related topics.

Typhoon Haima: Early Recovery Project, Ca- gayan (443820) The project identified 26 carpenters and trained them on Build Back and PASSA tools. They provided support to repair 200 houses in 5 ba-

140 South Sudan

Objectives of the country programme Thematic priorities 2017 – 2020

Health: Strengthening community based health Organizational Development: Organizational care and health systems as part of the SRC,s over- and program management capacity of the South all goal for South Sudan “Health Status for South Sudan Red Cross is strengthened. Sudanese improved”. Access and utilization of safe water and sanitation (WASH) are improved. Blood safety: Recruitment and retention of voluntary non-remunerated blood donors are improved.

Selected Outcome Indicators

NU2: % of children from 0-59 months of age who receive foods NU3: % of infants < 6 months of age received only breast milk from 4 or more food groups on the previous day on the previous day

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

WH2: % of households using and maintaining clean latrines

100%

80%

60%

40%

20%

0% Before 2017 Target

141 Summary results 2017

Improving health status of crises affected Integrated Partnership of primary health people in Pageri County (424478) care in Maiwut (424475) The project started in 2017, preparation and This joint project with ICRC started in January approval being in time. An inception workshop 2017 and will end by the end of December was conducted for all stakeholders including 2018. board members of the SSRC Torit Branch. 120 The project reached 14,724 individuals with pa- volunteers were trained on RCRC law & code of tient consultation and 1,566 ANC consultations conduct, and all newly recruited staff was were given to pregnant women. 3,618 children trained on finance and logistic policies of the under 5 years were vaccinated and the access to SSRC. IEC material for psychosocial support health care was improved. Additionally, a TBA (PSS) was printed and 6 sessions on PSS were network was established and 63 TBAs trained conducted focusing on proper awareness of on danger signs of pregnancy, new born and psychological problems. The project start in- postpartum care. In Maiwut, a local psychoso- cluded an assessment of 54 boreholes. As a con- cial counselor identified the need for help to sequence, 2 boreholes were repaired. council victims. In Udier, in addition to proper MHPSS assessment, training was conducted for Health Improvement in Ikwotos (424476) 63 TBAs and staff of PHCU on the provision of A total of 145 staff and volunteers were trained proper PSS and SGBV services. on CBHFA, first aid, mid upper arm circumfer- ence (MUAC), psychological first aid and basic counselling. Additionally, 30,215 beneficiaries were reached with education on safe water, hygiene and sanitation. At Ikwotos and Torit, cholera items were prepositioned as a preparedness stock for cholera response in case of epidemics. The project contributed to the reparation/ rehabilitation of 3 water points and the establishment of 8 water management committees. In order to strengthen the SSRC branch organizational capacity, financial management training and a baseline survey took place in Ikwotos.

Blood donor recruitment and First Aid (424472) By the end of 2017, 2,060 blood donors were registered and 64 education sessions on the promotion of blood donation conducted. These numbers are above the targeted 1,600 registered blood donors and 40 promotion sessions. A total of 12,276 households was reached with blood donation messages, 1,879 blood units collected, and 95 outreach blood drives conducted. 13 staff of National Blood Transfusion Service benefitted from training in pre and post donation counselling. A group of 120 volunteers and traffic police officers was trained on first aid.

142 Sudan

Objectives of the country programme Thematic priorities 2017 – 2020

Health: Health knowledge, attitude and prac- Disaster Risk Management: The SRCS is sup- tices of beneficiaries and their capacity to ad- ported in disaster response capacities. dress health issues are strengthened. Access to Organizational Development: Capacity is built quality health services and water and sanitation on the SRCS Branch staff through the support of (WASH) are improved. the Organizational Development process.

Selected Outcome Indicators

NU1: % of severly malnourished children < 5 years of age correctly WH2school: % of schools using and maintaining clean latrines identifies and referred to therapeutic feeding centre 100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

Summary results 2017

Community based WASH Sennar (424439) School Health Sennar (424444) The project ended in 2017. The external evalua- As the project started in September 2017, most tion conducted in July 2016 suggested an overall of the activities are scheduled for 2018 and 2019. positive impact of the project. As part of the project, a school baseline survey Access to water and sanitation was improved for was completed at the end of 2017 (380 students 60,000 people. This outcome was achieved with interviewed and 20 schools assessed). Addition- the construction and rehabilitation of 20 bore- ally, 9 out of 13 project staff were recruited and holes/ handpumps, which are maintained by a project agreement was signed between the trained and equipped pump technicians. SRCS and SRC by the end of 2017. Related activ- Thousands of community members and school- ities to SOCI results are scheduled for 2018. children were sensitised in WASH issues through a variety of social marketing approaches. 20,800 participants were sensitised during health education sessions and community theatres; another 24,000 schoolchildren during child-friendly health/ hygiene events carried out in 13 schools. The project contributed to improvement of the PMER capacities of the SRCS through continuous on-the-job training and the INIBB project. The steady increase of the implementation rate from 2014 to 2017 and the improvement in the quality of reporting over the years, bear testimony to the improved PMER skills.

143 Togo

Objectifs du Programme Pays 2017 – 2020 Priorités thématiques

Santé: Améliorer l'accès aux services et soins de Gestion de risques: Développer et améliorer les qualité à base communautaire, spécialement capacités de la population pour faire face aux dans le domaine de la santé maternelle et infan- défis de santé et aux désastres. tile (SMI), le VIH/Sida, et l'eau et l'assainisse- Développement organisationnel: Renforcer ment. Améliorer l'accès aux services de soins les capacités de la CRT pour permettre à la SN de oculaires et de transfusion sanguine de qualité. maintenir son leadership dans le domaine huma- nitaire.

Selected Outcome Indicators

NU3: % of infants < 6 months of age received only breast milk on the previous day

100%

80%

60%

40%

20%

0% Before 2017 Target

Aperçu des résultats 2017

Eau et Assainissement (424752) tion) qui est de 92 pour cent. De plus, le projet a tion des outils de rapportage et des modules de Presque toutes les activités du projet ont été exé- réussi un pourcentage de cataracte dépistée en formations de la CRT et la formation des forma- cutées, notamment: la production et la distribu- stratégie avancée de 59 pour cent. La mobilisa- teurs polyvalents et des volontaires. 1,556 tion de chlore grâce au WATA, la vente des com- tion sociale a permis de toucher 36,000 per- femmes membres de CM et 123 de SASC ont été primés de chlore, l'introduction avec succès du sonnes avec 6,083 séances de prise d'acuité vi- formées pour la promotion des PFE dans les vil- concept «Ecoles Bleues» dans 8 établissements suelle par les volontaires. lages. primaires, la formation des Comités Eau, et les actions de sensibilisation des Comités d'Hygiène Appui à la Transfusion Sanguine (424757) et d'Assainissement (CHA) et des Clubs des Le projet a pour ambition d'améliorer l'accès aux Mères (CM) sur les Bonnes Pratiques d'Hygiène produits sanguins de qualité dans les Régions (BPH). Centrale et de la Kara. A la fin de l'année 2017, La proportion de ménages ayant accès à l'eau de 360 Leaders d'opinion communautaire dans le meilleure qualité a pu être augmentée de 27 à 76 cadre de la mobilisation sociale ont été formés pour cent. En tout, 1,745 latrines sanplats ont été dans tous les districts d'intervention du projet. Le construites dans 2,889 ménages pour plus de taux de demande satisfaite en produits san- 15,000 personnes. En plus, 21 localités ont at- guines labiles est de 90.23 contre 85 pour cent teint l'état FDAL dont 12 ont été certifiées par la attendus en 2017. Le pourcentage de poches de Direction de l'Hygiène et de l'Assainissement de sang utilisables est de 90.34 contre 90 pour cent Base du MSPS. attendus en 2017.

Togo santé oculaire (424756) Survie de la mère et de l'enfant SME (424760) A la fin de l'année 2017, le cataract surgical rate Le projet a démarré avec les actions prépara- (CSR) est estimé à 900 (contre 300 au démarrage toires. Une étude de base a été conduite en juillet du projet). Un objective important atteint par ce 2017 pour déterminer les valeurs de référence projet était le taux de succès de la chirurgie de avant le démarrage effective des activités. De cataracte (nombre de yeux avec une acuité vi- plus, la préparation a contenu l'achat du matériel suelle > 3/10 au-delà de 4 semaines après opéra- roulant et informatique, l'atelier d'harmonisa-

144 Vietnam

Objectives of the country programme Thematic priorities 2017 – 2020

Community Based Disaster Risk Manage- Organizational Development: Institutional ca- ment: Resilience of vulnerable communes to pacity of the VNRC and local government is de- natural disasters and climate change is improved veloped to identify and respond to disaster and through an integrated DRR programming ap- climate risk through effective and participatory proach that addresses disaster and climate planning and implementation of activities aimed change related risks, including those related to at reducing risk or providing relief and support to health. the recovery of affected populations.

Selected Outcome Indicators

DRM3: % of tested disaster response plans updated annually WH2: % of households using and maintaining clean latrines and linked to the provincial response mechanisms

100% 100%

80% 80%

60% 60%

40% 40%

20% 20%

0% 0% Before 2017 Target Before 2017 Target

WH3: % of households using an improved drinking water source

100%

80%

60%

40%

20%

0% Before 2017 Target

145 146 147 Schweizerisches Rotes Kreuz Rainmattstrasse 10 CH-3001 Bern Telefon +41 (0)58 400 41 11 [email protected] www.redcross.ch