MOZAMBIQUE Humanitarian

Situation Report No. 2

Situation in Numbers Beni Ali, mother of 2 children receiving mosquito net at the Nagua Reception Center, Metuge, in Cabo Delgado © UNICEF/UN0364846/Franco 363,120 Reporting Period: November 2020 children in need of

Highlights  Insecurity situation in Cabo Delgado prevails and led to displacement of 712,000 over 500,000 people of which over 90% living in host families and people in need nearly half of IDPs are children; (OCHA 2020)

 UNICEF has supported the screening of 38,544 children 6-59 months, and 582 cases of SAM were identified and referred for treatment; > 500,000  During November, 13,000 children were vaccinated against measles through Integrated Mobile brigades supported by UNICEF; bringing the Internally displaced people cumulative total of children vaccinated against measles to 73, 391 (IDPs) (since May)

 UNICEF completed drilling of 14 new boreholes and together with other 2,370 water supply initiatives enabled access to safe water to about 10,000 Reported fatalities people  9,239 children affected by the conflict received psychosocial support (ACCLED, November 20) through ten (10) open air child friendly spaces established  UNICEF supported the promotion of life saving messages, safe practices on hygiene, health, Nutrition, Child protection and its adoption reaching 233,716 people including children, adolescents and women; UNICEF’s Response and Funding Status UNICEF Appeal 2020 US$ 11 million Acute malnutrition & Vitamin A 110% Funding status 13% Funding Status (in US$) Measles vaccination 82% Funding status 109% Safe water access 156% Funding status 105% Funding gap PSS access 103% 4.6M Funding status 79% Funds received Education access 8% 6.5M Funding status 28% HH received cash transfer 14% Funding status 7% Life saving messages 137% Funding status 39% 0% 20% 40% 60% 80% 100%

* Table footnotes: Funding status is only measures ORE received against 2020 HAC requirements. For some sectors, regular resources were used to achieve results as per the 2020 HAC targets for Cabo Delgado. Some sectors have received multi-year funding for interventions that will carry over into 2021.

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Funding Overview and Partnerships For 2020, UNICEF has been appealing for US$ 11.1M to sustain provision of life-saving services for women and children in northern affected by the ongoing conflict. As of 30 November 2020, Central Emergency Response Fund (CERF), ECHO, FCDO, USAID and Thematic allocation from Headquarters have generously contributed a total of US$ 6.5 million to UNICEF Mozambique humanitarian response in Cabo Delgado. UNICEF HQ allocated $2.5 million (from its Emergency Programme Fund (EPF) to support the scale up of the response which $500,000 is assigned for PSEA). However, the 2020 HAC still has a funding gap of 41% and without sufficient funding over 100,000 people will not have access to safe water, adequate sanitation, and over 33,000 children will not have access to education, 27,000 pregnant and lactating women will not benefit from IYCF messages. These gaps are significant heading into 2021, where the HAC 2021 for Mozambique will require $52.8 M USD for the entire country, of which over $ 30M USD is for the Cabo Delgado Emergency.

Situation Overview & Humanitarian Needs The month of November was described with the month of November, insecurity remained prevalent in some districts of , with some population movement triggered by insecurity and restricted access to northern districts. According to ACLED, during November 2020 over 201 violence events occurred and about 872 fatalities from these events were reported. Given the prevailing complex, volatile and unpredictable situation in Cabo Delgado, on 28 November, the UNICEF declared a Level 2 emergency for the Cabo Delgado crisis in Mozambique affecting Cabo Delgado and neighbouring provinces; with the level 2 designation, the crisis receives prioritized corporate-wide support for the scale-up of emergency response. From 6-15 November, there was signficant movement of people from Muidumbe (majority), Macomia and Mocimboa da Praia districts to Mueda, Montepuez and Pemba city totalizing 33,2933 people on the move during this period – nearly have of the of the reported IDPs are children; 310 children were identified as unacompanied. Main needs reported in priority order were food, shelter and non-food items (NFIs). The National Institute for Disaster Management (INGC) reported (as of 17 November) in November that due to Cabo Delgado crisis there are 554,3804 people displaced in five provinces which 515,966 are in Cabo Delgado and about 40,000 in Nampula. About 92% of the IDP population are living in host families, 45% are children, 6.6% of the IDP are living in accommodation centers and only 1.6% were already resettled mainly in Cabo Delgado and . Government and humanitarian partners continue to provide assistance to the population displaced through basic service provision (Food, Protection, WASH, health and Nutrition) in transit and reallocation sites, distribution of supplies and community engagement. Access to northern region of Cabo Delgado especially to Mocimboa da Praia, Quissanga, Muidumbe, Palma, Ibo and Macomia districts continue to be challenging given the insecurity and physical constraints. Hopefully, access to some of this areas will be improved with scaled-up UNHAS and logistics services facilitated by WFP and Logisitic cluster. Disease outbreaks are affecting Cabo Delgado too, mainly COVID-19 and acute watery diarrhea(AWD). As of 30 November, there were 390 cumulative cases5 of AWD in four districts and death toll of 3 (case fatality rate 0.8%). UNICEF has been providing additional assistance with safe water, sanitation materials, hygiene promotion, household water treatment products, medicines and other supplies for the treatment centers. For COVID-19, the province has reported since the onset of the pandemic 975 cases of which 576 (8%) cases are currently active and death toll of 2 people (case fatality rate 0.2%).

Summary Analysis of Programme Response Nutrition During November, UNICEF supported Health Provincial Directorate (DPS) in conducting district supervisions and identification of nutrition sites for implementation of integrated nutrition programs, online and in-person training and mentoring on inpatient treatment of acute malnutrition in all districts of Cabo Delgado province.

3 IOM Emergency Tracking Tool No 26: 06-15 November 2020 4 DTM Round 7 preliminary results are pending validation/release but preliminary findings indicate #IDPs are over 500K 5 Provincial health authorities data shared on 29 November 2020 6 https://covid19.ins.gov.mz/wp-content/uploads/2020/11/boletim-diario-258.pdf 2

Within the scope of partnership with Caritas, UNICEF supported active case finding and screening for possible acute malnutrition cases, that led to the screening of 3,156 children 6-59 months and identification of 42 cases of SAM and 5,576 mothers and caregivers of children 6-23 months received IYCF messages. Since the beginning of the response, the nutrition cluster has supported the screening of 42,498 children (38,544 children with UNICEF support) 6-59 months, and 624 cases (582 cases with UNICEF support) of SAM were identified and referred for treatment. A total of 65,129 caregivers received messages including IYCF counselling in the communities, 50,741 children 6-59 months were supplemented with vitamin A, and 36,339 children 12-59 months were dewormed. In addition, UNICEF supported the training of 159 community health workers (i.e. APEs) in Integrated Nutrition Program (PIN). Different equipment has been requested to respond to additional needs in the province and include portable stadiometer (25), Scale electronic (25), Scale springtype (300), inpatient kit supply/ equipment modules (10), outpatient kit equipment module (5), MUAC Child (200 PAC-50). The Nutrition cluster coordination meetings continue to take place every 2 weeks (bi-monthly), with latest discussions on prepositioning of materials to respond to the latest influx of IDPs arriving specially to Montepuez and capacity of partners to scale up in Montepuez and Meluco. Nutrition cluster partners have been also participating in different rapid needs assessments in Ancuabe, Palma, Montepuez and Meluco.

Health UNICEF has proceeded, during November 2020, with the support on the implementation of Cabo Delgado Rapid Response plan through strengthening of health system and capacity, participation in multi-sectoral rapid assessments in districts with influx of IDPs to identify immediate health care needs of IDPs and host populations. During the month of November, through UNICEF support for Integrated Mobile Brigades (IMB) 1,651 children under 5 years received consultation, 5,292 children received DTP3, 13,001 children were vaccinated against measles, and 461 pregnant HIV positive (HIV+) women received ART in Balama, Namuno, , Montepuez, Mecufi, Metuge, Meluco, Ancuabe, Ibo. Since the beginning of the response (May 2020), a cumulative total of 8,497 children under 5 years received consultations, 29,668 children received DTP3; 73,391 children vaccinated against measles, and 1,066 pregnant HIV+ women received ART. In order to improve the health of women and children, UNICEF supported the training on integrated management of newborn and child illness (IMNCI) for 18 district health professionals.

In November, an assessment was conducted to verify the continuity of the provision of services by the community health workers (i.e. APES) in the communities that receive the greatest number of IDPs (Montepuez and Ancuabe), considering the context of COVID-19. The province of Cabo Delgado began to be hit by an outbreak of acute diarrhoea from the month of November (week 45), mainly affecting the displaced population in the 4 districts: Namuno, Montepuez, Ancuabe and Metuge. UNICEF has collaborated with the government and other partners to respond, providing some medicines and equipment (20 basic unit IEHKs, 20 AWD Community Kit Drugs, 2 Tents 72m2 for CTCs, 52,200 sachets of ORS, and 200 Cholera treatment charts), to assist in equipping and case management in the CTCs of the affected districts and reinforcement of prevention and awareness-raising measures in the community.

WASH UNICEF started three new partnerships for IDP WASH response in Cabo Delgado in November. In UNICEF is responding to a large influx of IDPs after recent attacks and displaced persons from through a partnership with Joint Aid Management to support 12,700 people (2,738 men; 3,917 women; 3,022 boys; and 3,023 girls), including 8,700 IDPs with WASH services. Initial activities included the commencement of water trucking for the displacement sites and construction of emergency latrines at the temporary accommodation centre as the new borehole construction is underway for the permanent resettlement site. To date 2,550 people have been reached with safe water and sanitation through the water trucking and temporary latrines in the two resettlement camps in Montepuez (Nipacua and Mapupulo). In UNICEF in partnership with Instituto Oikos, has supported 33,582 people (9,640 men; 10,184 women; and 13,758 children), including 13,233 IDPs with WASH services. Ibo District continues with significant needs for the host population as IDPs transit from insecure areas to Pemba City. This partnership will increase access to WASH services for these populations that are now sharing water facilities and have limited sanitation facilities. Recent government planning has indicated plans for resettling a large number of IDP families in Ancuabe and Chiure Districts. UNICEF, through a partnership with Helvetas, is supporting 47,900 people (9,580 men, 9,580 women, 14,370 girls and 14,370 boys), including 36,450 IDPs with WASH services. UNICEF completed drilling of five new boreholes in Ancuabe District and nine new boreholes in Chiure District with the provincial public works department and private contractors. Helvetas will support the community mobilization and training of water committees associated with these water points and install solar powered piped systems for the larger IDP sites. In UNICEF continues support to the temporary accommodation centres which are hosting more than 40,000 IDPs with construction of an additional 200 emergency latrines and bathing units in partnership with Ayuda en

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Accion (AeA) and with supply provision to MSF for these overcrowded sites. Through the public works department and private contractors UNICEF installed new water point platforms in Ntokota, the new permanent resettlement site. In Ngalane, another resettlement site, UNICEF has an ongoing partnership with FIPAG to extend the piped network and construct six new permanent standpipes and sanitation partnerships with AeA and MSF for the construction of communal latrines. So far 10 boreholes equipped with handpumps were completed in the resettlement camps, and 27 boreholes were drilled just missing the pump installation. Additionality, 3 boreholes that will be used for solar water supply systems were already drilled also in the resettlement camps. In November, about 9,957 people in Cabo Delgado had access to safe water. Upon reports of AWD (Acute Watery Diarrhoea) cases in several districts, UNICEF distributed 10,000 bottles of household water treatment chemicals in Namuno and other districts to mitigate the spread. In addition, UNICEF is doing water trucking with AeA in the larger accommodation site (25 de Junho) to increase water supply for the increasing demand while the pump installation is being completed with FIPAG. Additional tap stands are being constructed in Nangua (site with most cholera cases) to reduce the number of people using the same water point and MSF and AeA are working on messaging. Additional emergency latrines are planned for the next month to address the growing demands and the acute watery diarrhoea outbreaks in these sites.

The WASH Cluster is currently undergoing the cluster performance evaluation with partners to inform and improve cluster support.

Education In Cabo Delgado, the sector response, taking into account COVID 19 prevention and response, focuses on IDP’s in host families and in accommodation centres in Pemba, Meconta and Murrupula districts in Nampula. Partnerships with GVC We World in Cabo Delgado and Terre des Hommes in Nampula were established to support the internally displaced children and families with distance learning materials, information on prevention of COVID 19 infection and psychosocial support (PSS). These two specific responses are supported by the Global Partnership for Education (GPE) and aim to support the continuation of education for the most vulnerable children during the schools' closure.

A total of 23,832 children (11,837 girls, 11.995 boys) participated in distance learning, 714 children (338 girls, 376 boys) and 37 teachers (16 female and 21 male) received support and distance learning and teaching materials; 766 children/families and 100 teachers were reached with COVID 19 messages. Education partners including government are collecting lessons learned on how to best respond to the suspension of classes during epidemics. Temporary learning spaces (TLS) were provided at Nagalane accommodation centre where 39 children (IDP’s) of grade 7 will be attending the lessons.

The enrolment of the IDP’s students is ongoing in all districts and 70,000 students enrolled during November and the sector is in the process identifying the number of the tents and learning materials to be allocated to respond the demand of the children in the southern districts of the province. The collaboration with Provincial Directorate of Education (DPE) also aims to organize regular monitoring of the activities happening in all districts. Through financial support of Norway, UNICEF launched two new partnerships with AVSI and Helpo respectively to increase education support to children (including IDPs) and teachers in 7 districts (Pemba, Mecufi, Metuge, Chiure, Namuno, Balama and Ancuabe) to be enrolled in the nearest schools, including support for children with disabilities (as part of disability inclusion in education).

Child Protection The Child Protection sector has been focusing on ensuring an appropriate response for Unaccompanied and Separated Children (UASC). In November, 222 UASC were reported and are being followed up on by Child Protection Area of Responsibility (CP AoR) members. Community foster care modalities are being implemented with currently only 4 unaccompanied children, having been placed in institutional care, due to a lack of community-based care and the remainder are in community-based foster care; 54 registered UASC have been placed in appropriate interim or alternative care and UNICEF partners, in close collaboration with Government social services and ICRC and community structures have initiated family tracing activities. Through a new partnership with AIFO, UNICEF launched activities to build the capacity of child protection workers on disability inclusion and assist children with disabilities. As per the reported period (November), UNICEF and its partners have reached 9, 239 children affected by the conflict with psychosocial support through ten (10) open air child friendly spaces established in Ibo, Metuge, Montepuez and Pemba districts. A new guideline for safe reopening of CFS with regards to social distancing and COVID-19 mitigation measures was developed and will be validated by the government. Currently the CFS activities are being carried out in

4 open air, or through house to house means for individual support; 160 (69 men and 91 women) child protection Animators/Facilitators were trained in PSS methodology and approaches. Additionally, 27 members of community- based mechanism (9 men and 18 women) from Metuge, also received training on child protection in emergencies, psychosocial support and identification and referral of protection case, and important COVID19 related information.

During November, 928 (456 boys; 460 girls) children have been registered for case management services. The majority of the cases of referrals have been to health facilities and civil registration offices. The referrals relating to the education sector have not been closed yet due to the still ongoing closure of schools. In December, UNICEF will initiate a campaign aiming at re-issuing birth registration documents. The Child Protection AoR is continuously supporting assessments and community consultations being carried out in Cabo Delgado for the resettlement process.

Social Protection/Cash-based Programming UNICEF and INAS carried out a joint assessment of Chiure district during November (19th -20th November), following the selection of the district to expand social protection/emergency cash transfer support. The visit confirmed the number of displaced families hosted by the district, the situation and functioning of resettlement centres and the needs and voices of IDPs, as well as potential of emergency cash support to access basic services and non-food items (including shelter, working tools and hygiene goods). As per reported needs for integrated support in Chiure, UNICEF was able to coordinate with its partners involved in child protection services to leverage their support in cash transfer registrations; and assure identification and referrals of child headed households and cases requiring psychosocial support; and leverage its nutrition work with partners, to assess the possibility of complementing cash with key behaviour change communication and supplementary feeding. Preparations for enrolments of IDPs and host families (approximately 4,500 households) in Chiure are ongoing (payments expected to be done in January 2021), with specific social protection and prevention of sexual exploitation and abuse (PSEA) trainings to community workers (INAS’ permanentes), organized with UNICEF support (training programmed for 3 December) In parallel, the second (and final) payment to IDPs from Quissanga (originally enrolled for cyclone Kenneth recovery support and localized in resettlement areas in southern districts) was prepared and, following transfer, will be done (mid- December) - this will include the1,583 households paid in September and an additional 845 households localized since then amounting to 2,428 households planned for next round of payments in December (out of the 2,595 households with pregnant women and children 0-5 enrolled in Quissanga in December 2019).

Communications for Development (C4D), Community Engagement & Accountability During the month of November 2020, in partnership with Caritas, CUAMM and Instituto de Comunicação social (ICS), UNICEF supported the IDP’s response in Cabo Delgado promoting a package of life saving messages for the adoption of safe practices on Hygiene, health, Nutrition, Child protection achieving 233,716 people including children, adolescents and women living in resettlement camps, temporary sites and host families in Metuge and Pemba districts. CARITAS continues to promote the use of accountability to affected population mechanisms (Linha Verde and Complaints boxes) through public announcements during the Hygiene kits distribution and through Radio debates to ensure that the community uses the available mechanisms to address their concerns and questions related to the humanitarian response in Cabo Delgado (since launch of response 485 complaints/feedback received). In coordination with government counterparts, UNICEF supported partner CUAMM trained 40 community activists in Pemba, 20 in Metuge and 20 in Mecufi to reinforce the community engagement network for the transmission of life savings messages for Hygiene promotion, Nutrition, Child protection as well as referral of suspect COVID-19 positive cases targeting IDPs and the host communities in those districts.

Humanitarian Leadership, Coordination and Strategy The Government of Mozambique through Provincial authorities led by Secretary of State, supported by National Institute for Disaster Management continues to provide overall leadership and coordination of humanitarian interventions in the Cabo Delgado and neighbouring provinces. The Secretary of State of Cabo Delgado established a Technical Commission, to act as the main interlocutor with the humanitarian agencies which meets regularly with the humanitarian community under the joint chairmanship of the Secretary of State and Provincial Governor. OCHA is present in Cabo Delgado and provides overall coordination support to humanitarian agencies responding to Cabo Delgado crisis. All clusters/sectors are represented in the province (Cabo Delgado) and at national and provincial levels UNICEF is leading WASH, Education (co-lead), Nutrition and Child Protection Area of Responsibility.

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Sector coordination is in place in Nampula province; WFP is the focal point for the provincial coordination among the partners and UNICEF is the co-chair. UNICEF has physical presence Cabo Delgado and Nampula – with 20 staff present on the ground in Cabo Delgado (projected to be 30 persons in the coming months) and 13 staff in Nampula. The field presences of UNICEF are strongly supported by the main office in . UNICEF’s key priorities for the response is to provide lifesaving interventions to IDPs, treatment and prevention of cholera/disease outbreaks and provisional of basic services (water supply, sanitation, Education, health, protection, community awareness) in transit/accommodation centers, resettlement sites and communities in general has most of IDPs are living with host families. However, there are some districts that are hard to reach due to physical and security constraints and humanitarian agencies are looking for alternative safe options and modalities to deliver assistance to affected populations. UNICEF continues to play a key role within the PSEA network, serving as Co-Chair with Oxfam since 2019 at national level and supporting the newly established PSEA network at subnational level in Cabo Delgado to strengthen accountability by humanitarian workers including government, prevention and risk mitigation of PSEA and survivor support.

Next SitRep: January 2021

Who to contact for Maria Luisa Fornara Katarina Johansson Claudio Julaia further information: Representative Deputy Representative. Emergency/DRR Specialist, Mozambique Mozambique Mozambique Tel: (258) 21481104 Tel: (258) 21481104 Tel : +258 21 481 150 Email : [email protected] Mobile : (258) 845215618 Mobile : +258 82 333 9250 Email : [email protected] Email : [email protected]

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Annex A

Summary of Programme Results Cluster UNICEF

UNICEF Cluster Cluster Change since Change since last UNICEF target Results target Results (2020) last report▲▼ report▲▼ (2020)

WASH Number of people with access to sufficient quantity of safe water 90,000 86,957 9,957 ▲ 50,000 77,957 9,957▲ Number of people with access to

appropriate sanitation facilities 180,000 152,876 and receiving hygiene messages 22,876▲ 180,000 152,876 22,876▲ Number of families receiving

point-of-use water treatment & 30,000 29,088 purification materials / products 3,088 ▲ 30,000 29,088 3,088 ▲ Health Children aged 6 months to 15 years vaccinated (Meales) 90,000 73,391 13,001▲ Number of children vaccinnated DPT3 4,150 29,668 5,292▲ Pregnant women 15-49 living with HIV receiving ART 950 1,066 461▲ Children under-five receiving a consultation 6,630 8,497 1,651▲ Nutrition Children 6-59 months screened for acute malnutrition and receiving Vitamin A 57,000 50,741 3,156 ▲ 46,000 50,741 - Pregnant and lactating women reached with IYCF services 87,000 65,129 5,576▲ 87,000 59,163 - Number of children 6-59 months admitted for treatment of SAM 480 624 42▲ 480 582 - Education Children aged 6-15 years old in humanitarian situations accessing education 41,694 13,680 - 36,500 3,000 - Children aged 3-5 years old in humanitarian situations accessing play-based learning 7,300 - - Child Protection

Children receiving psychosocial support through Safe Spaces 12,000 9,239 280▲ 9,000 9,239 280 ▲ Number of children who receive case management services 800 1,600 280 ▲ 600 1,600 280▲ Social Protection Number of households reached

with humanitarian cash transfers 11,000 1,583 - Communications for

Development Number of people reached with key lifesaving and behavior change messages on health,

nutrition and safe and appropriate sanitation and hygiene practices. 467,000 640,084 233,716 ▲

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PSEA % of humanitarian partner (including government) trained

on PSEA skill Number of children and adults that have a safe and accessible

reporting channel to report Sexual Exploitation and Abuse 164, 488 119,213 -

Annex B

Funding Status*

Funding Funds received Funding Gap Funding Gap Sector requirements7 (US$) (US$) (US$) (%)

Nutrition 1,143,072 151,217 991,855 87%

Health 1,376,352 1,506,490 (130,138) 0%

WASH 2,533,607 2,656,738 (123,131) 0%

Child Protection 1,813,752 1,425,713 388,039 21%

Education 1,573,822 447,145 1,126,677 72%

Social Protection 2,239,488 150,343 2,089,145 93%

C4D 373,248 145,133 228,115 61%

Total 11,053,341 6,482,779 4,570,562 41%

7 As per HAC 2020 8