: COVID-19 Situation Report – #12 Reporting Period: June 8– June 21, 2020

Situation Overview and Humanitarian Needs

As of 21 June, there are 20,244 reported cases of COVID-19 in Nigeria. 115,760 people have been tested with 35 states and the Federal capital Territory (FCT) having reported at least one Situation in Numbers confirmed case. 20 local government areas are currently responsible for 60 percent of the COVID- 19 cases in the country. 1 They are concentrated in FCT, Lagos, Katsina, Jigawa, Ogun, Kano and Borno States. In addition, the Presendential Task Force stated that 80% of cases are not being 20,244 COVID- treated in isolation centres out of fear of stigmatization and the remaingin 20% present 19 confirmed 2 themselves quite late. The RCCE pillar is developing plans to addresss these challenges to reduce cases (June 21) stigma in the community. Of the total admitted cases, 6,879 have been discharged and 518 deaths 3 have been officially recorded. 518 deaths

Findings from an investigation on the multiple mysterious deaths that occurred in Kano few weeks ago, undertaken by the Irrua Infectious Diseases centre, suggested that between 50-60 percent of the deaths may be due to COVID-19, with most of the affected being over 65 years of age.4 This 46,000,000 further suggests that the death toll currently recorded might be much higher, as these numbers Children are not collated in the national figures. Also within the reporting period, the Federal government affected by signed a bilateral agreement with the Democratic People’s Republic of Korea on cooperation in the area of public health and medical sciences including visit and information exchanges. In their COVID-19

100 days review, the PTF highlighted the following achievements:

• Increase in the number of laboratories from 2 to 30 with at least one per State; • Over 80,000 tests have been conducted in the country; US$ 65 M • Over 13,000 health workers have been trained; funding • Increase in procurement of testing kits and Personal Protection Kits (PPE); • Over 5000 beds number available for isolation and case management nationwide; required • Developed guidelines for homecare and general case management; • Over 1000 Nigerians evacuated from different parts of the world; and • Gradual reopening the economy while balancing between lives and livelihoods.

UNICEF’s COVID-19 response

RCCE/C4D In ,live interactive radio programs on COVID 19 were Based on a gap analysis on community engagement as conducted by experts on Garkuwa FM and Rima FM. 40 identified by the Presidential task Force and joint UN team, stakeholders including religious and traditional leaders were UNICEF intensified technical support for the capacity sensitized on COVID-19 who in turn cascaded the messages building of state facilitators responsible for providing to another key 40 religious stakeholders at the LGA level. leadership at the local levels in 17 focus States.

Bauchi office continues RCCE through mobile messages and In Sokoto, the LGA facilitators supported the state health radio discussion forum and addressing stigmatization, workers training on COVID-19 organized by National Primary stereotyping and COVID-19 prevention awareness in Bauchi, Health Care Development Agency (NPHCDA), while 20 Taraba, Gombe, Plateau and Adamawa states. The number journalist were orientated on COVID-19 at state level. of religious institutions providing key messages to their Volunteer Community Mobilizer (VCMs) continued the followers on COVID-19 awareness and prevention were routine house to house sensitisation and mobilization in all increased to 1,101 Mosques and 1,000 churches in Bauchi, targeted states while promoting testing for COVID-19. Adamawa, Gombe, Plateau and Taraba states Additionally, 1000 community mobilizers were trained on raising awareness in non-VCM areas on prevention. The In Kaduna, UNICEF trained 70 persons from Civil Society community was sensitized on measles and COVID-19 Organization (CSOs), Inter Faith First Aid Groups, new RCCE prevention in markets, malls, car parks and sports venues as members from SMOH and other volunteers on COVID-19 including messaging on stigma and testing. LGA consultants supported the NPHCDA training for maintining PHC services

1 https://www.premiumtimesng.com/news/headlines/398606-ptf-reveals-20-local-govt-areas-with-60-of- covid-19-in-nigeria.html 2 https://thenationonlineng.net/80-of-infected-persons-not-in-isolation-centres-says-fed-govt/ 3 COVID-19 SitRep June 21st 4 National Briefing, June 8, 2020 – Remarks by Minister of Health in the context of COVID-19 for health personnel. 22 radio is supporting focused IPC interventions in high burden LGAs discussions, aried on four stations, were conducted with in four states (Kano, Jigawa, Oyo and Edo). religious leaders engaged as resource persons. Announcements were made during Jumat prayers in six The case management pillar is being supported to review central mosques across six LGAs reaching 480 people, while home-based care guidelines, and community testing scale 70 people were sensitized in two churches. up plan is also being reviewed. Support is being provided in piloting community sample collection and testing in 2 high UNICEF engaged representatives of ulani Associations and burden LGAs (KMC and Gwale) in . 450 religious leaders from 12 emirates across Kano, Katsina and Jigawa States for the dissemination of COVID-19 Bauchi FO supported the ward level training of 1200 ICCM messages. 1,938 religious leaders across 57 LGAs in Enugu, CORPs, 483 VCMs and 48 VWSs on COVID-19 response and Abia and Cross River states integrated COVID-19 messages preparedness and the Sokoto FO supported the training of on prevention, reporting and testing in their congregation over 9,000 PHC workers and community volunteers across sessions. “COVID-19 Talks”, the joint radio magazine Zamfara, Kebbi and Sokoto states. In , UNICEF programme by radio stations in Enugu is in its sixth week of supported the training of 61 health care workers from iso- airing and during the reporting period, the programme aired treatment centres and 657 health care workers from for 540 minutes at 30 minutes per episode per station. secondary and tertiary health facilities on Infection “COVID-19 Talk’ expressed the views and concerns of the Prevention and Control. community on the issues of fear/stigma that are associated with the outbreak of the COVID-19 pandemic. UNICEF supported to review the expected deliverables, terms of reference and scheduling the UNICEF in Lagos developed and disseminated short movement of ad-hoc technical team consisting of skilled messages on home-based care, existence of COVID-19, health workers to track Persons of Interest in 11 points of stigmatisation, proper use of face masks and proper hand- entry at the interstate borders. UNICEF provided logistics washing with soap. Market and community sensitisation support to the COVID-19 TWG/RRT to carry out supportive activities continue to feature as part of RCCE pillar initiatives. supervision activities in 17 LGAs of the state. The sensitization exercise conducted in Amu plank market addressed physical distancing, use of face masks and hand has expanded its COVID-19 testing capacity washing with soap. following the roll out of the mobile Wellness on Wheels mobile testing equipment. Selected wards of the active LGAs UNICEF in Akure developed 40 standing banners on are targeted for community level COVID-19 case search and prevention and fight against the spread of COVID-19 which testing. UNICEF is fully involved in the mobilization and risk were displayed in public places. used social media communication component of the community testing, with (WhatsApp and Facebook) to create awareness on COVID-19 the deployment of VCMs and other supported community prevention. The office continued to work with town platforms. UNICEF is supporting the training of 3200 PHC announcers to sensitize communities in 18 LGAs and in health care workers on IPC, risk communication, stigma and collaboration with National Orientation Agencies (NOA). discrimination, triaging, case identification, Notification and referral. UNICEF is also supporting the activation of the North-east RCCE/C4D response 4th COVID-19 diagnostic laboratory in Yusuf Dantsoho 796 religious leaders were sensitized resulting in 189 Memorial Hospital, with capacity to conduct both PCR and mosques/church announcements and 111 Tsangaya schools molecular test using GeneXpert. with 5,373 children taught measures to prevent COVID-19. In , UNICEF supported the development of the IAP for the state to cover the next three months. On case Health management, training of doctors and Nurses on ICU care for UNICEF continues to support the COVID-19 health response COVID-19 patients was conducted at General Hospital Lagos. under the different functional areas led by the Presidential Task Force. In the Epidemiology and Surveillance pillar, North-east Health response UNICEF, is supporting the DQIP (Data driven quality In the North-east, 49 health care workers in UNICEF improvement in primary care) process. UNICEF continues to supported health facilities and communities in Borno and support the Testing and Laboratory pillar of the PTF with Yobe States were provided with essential PPEs. 73 health testing capacity increasing with arrival of supplies (18,333 facility staff and community health workers were trained on Cobas tests, 42000 Thermo fisher tests, and 15000 VTMs). Infection Prevention and Control, of which 51 were also Specimen collection and submission to labs continues to trained on COVID-19 surveillance protocols. increase as more states continue to roll out community case finding activities. The provision of essential primary healthcare services continued with a new practice of starting every clinic session UNICEF supported the NPHCDA led COVID-19 response LGA with sensitization on COVID-19 issues. An estimated 1046 level step down training for an estimated 20,000 health care clients/patients at OPD consultation clinics were sensitized workers in PHCs and community volunteers across 35 states on COVID-19 symptoms and prevention, including the need from 11-15 June 2020. The IPC pillar is reviewing and for physical distancing, use of facemask, personal and enhancing IPC practices in communities and health facilities environmental hygiene practices. to prepare for treatment of patients with COVID-19 and prevent transmission to staff, patients and visitors. UNICEF

WASH partners continue to conduct water chlorination in conflict Hygiene Promotion and Distribution of IEC materials affected LGAs with an estimated 4,554,328 litres of water chlorinated during the reporting period. An additional 6,593 COVID-19 prevention posters were distributed across several LGAs in Plateau (6,550), Bauchi In , 436 hygiene promoters were trained in MMC (28), Adamawa (15), and were used to complement hygiene LGA (155) Konduga LGA (40) Dikwa LGA (18) and Jere LGA promotion campaigns in ciritcal locations. The distribution (223). Up to 26,472 individuals were reached with key and placement were carried out through the respective state messages on COVID-19 prevention and control. 15 hand Rural Water Supply and Sanitation Agencies (RUWASSAs), pump boreholes were repaired in MMC (4), Konduga (4), LGAs WASH units, COVID-19 coordination teams and VHPs. Dikwa (2) and Jere (5) LGAs, benefitting 7,500 beneficiaries.

Meanwhile, UNICEF WASH partners continued to conduct at Awareness on COVID -19 prevention emphasizing on hand source water chlorination at 116 water points in Dikwa LGA washing, and COVID-19 preventive protocols was carried out (8), Jere LGA (25), Konduga LGA (12), Pulka LGA (13), MMC through ward officers, volunteer hygiene promoters, town LGA (6) and Rann LGA (54). An estimated 22,928,617 liters of announcers with motorized public address units at water were chlorinated at the 116 sources. community level with at least 93,873 people (46,519 female) reached during the week in different LGAs in Bauchi (22,945) 24 community clean up campaigns were conducted across and Plateau (70,956). The UNICEF-trained VHPS and six LGAs while 16 Hand washing facilities established in four WASHCOMs, traditional and religious leaders and COVID 19 LGAs serving an estimated 1,600 beneficiaries. To support Action Committees have continued to sensitize community hygiene practices to curb the spread of COVID-19 infection, members on preventive measures, signs and symptoms of 11,110 soaps were distributed in Muna Garage El Badawi COVID-19, WASH and NTDs in all eight UNICEF-supported Camp in Jere LGA and MMC LGA to benefit at least 300 LGAs in Benue and in the nine IDP camps. households (1,851 affected persons). Meanwhile, 29

hygiene kits were distributed reaching 174 beneficiaries. In Provision of Soap and Hand washing Facilities , 96 persons in an IDP camp and COVID-19 Through contributions from DFID/UNILEVER, UNICEF treatment centre in Yola South (58 female) were reached distributed 441,350 soap tablets to approximately 63,050 with 576 pieces of soaps to aid in promoting hand hygiene households (220,675 beneficiaries – 127,991 female) in measures to prevent the spread of COVID-19. communities, health care facilities, prisons and public places in and LGAs. Concurrently, 250 Nutrition handwashing stations were provided in markets, hospitals, motor parks and other public spaces in Sokoto’s main town, 308 health facilities in 16 states continued to provide serving an estimated 12,500 beneficiaries (7,500 female) treatment for children with severs acute malnutrition (SAM) beneficiaries. in line with the community-based management of acute 5 malnutrition (CMAM) guidelines. In total 103,017 children Provision of WASH Facilities aged 6 to 59 months with SAM were admitted since March 60 latrines were desludged in health care facilities in Kebbi 2020, including 42,946 in the last three weeks. All states state to provide renewed access to sanitation for 300 have adapted the implementation of treatment programme patients, staff and visitors. In Ekiti and , trained to the context of COVID -19 including the provision 2 weeks Local Area Mechanics (LAMs) were engaged to assess and instead of one-week ration of therapeutic food. rehabilitate broken-down water points across seven LGAs. On the prevention front, a total of 1,358,519 caregivers of A total of 16 hand pump boreholes have being rehabilitated children aged 0-23 months have been reached with (seven in and nine in Osun) in health care messages on Infant and young child feeding (IYCF) since facilities, schools, markets and within communities. A March 2020, including 457,185 caregivers reached in the last population of 5,663 persons are (1,502 females and 2,178 three weeks. These messages were delivered at health children U18) benefitting from these facilities. facility and community levels through interpersonal communication and aim to protect breastfeeding in the Coordination and Technical Support to Government context of COVID-19. In Katsina, weekly interactive radio and TV programme on IYCF in COVID-19 context commenced With UNICEF’s support, Sokoto state WASH Coordination since the last week in May and will continue for 10 weeks. platform was reactivated. The platform will enhance coordination of COVID-19 WASH response in the state, and meetings will hold every two weeks under the leadership of North-east Nutrition response the state commissioner for water resources and was Community sensitization on Mother MUAC screening of attended by relevant MDAs. children 6-59 months in the context of COVID-19 was conducted in Yobe covering a total of 95,847 males and North-east WASH response 116,436 females. Caregivers were sensitized on IYCF During the reporting week, 180 COVID-19 awareness and messages and COVID-19 prevention using IEC materials prevention posters were distributed and 8,897 persons were (posters) in IDP camps and UNICEF-supported reached with key messages on COVID-19 prevention and health/nutrition facilities in the communities by CNMs. control in Pulka and Rann LGAs of Borno. UNICEF WASH

5 Anambra, Bauchi, Bayelsa, Delta, Ebonyi, Edo, Enugu, Gombe, Imo, Nasarawa, , Kaduna, Kano, Jigawa, Ondo and Osun persons (7,254 girls, 3,277 men and 3,658 women) with integrated interpersonal communication (IPC) messages on Education ending violence against women and children, ending FGM, UNICEF is supporting the inclusion of psycho-social support increasing birth registration and preventing the transmission in Radio and TV platforms to bring hope and boost of COVID-19. emotional capacities of children to cope with various effect of COVID-19. The messaging also addresses fears of both The nationwide PSEA hotline received 32 calls and 12 learners and teachers with regards their safety after school messages from Adamawa, Borno, Kano, Yobe, Abuja and re-opens by providing information on precautionary measures each family is expected to put in place. Ogun States. Most of the callers sought for more information about PSEA, a few reported cases of GBV and were referred Support was also provided to ensure continuing learning for to GBV for professional survivor assistance, while others the children from Almajiri communities. A high-level inter- called regarding accessing humanitarian aid. sectoral meeting with four Kano State Commissioners (Education, Women Affairs, Religious Affairs, and Health) North-east Child Protection response was conducted to strengthen coordination on the 479 children and adults (62 girls, 61 boy, 192 women and 164 repatriation of the Almajiris and the abolishment of the men) were reached with COVID-19 awareness and Almajiri system of education in the State. sensitization messaging through community-based

engagement. The activity included, sensitization and North-east Education response awareness creation on hygiene promotion sessions including With support from UNICEF and the respective states practical demonstrations of hand washing and social governments, the broadcasting of home-based learning distancing in line with WHO and NCDC guidelines on COVID– programmes for Basic Education level through Radio and TV 19. in Bauchi, Borno and Adamawa States is reaching over 3 million of children. Additionally, 500 radio sets were Child protection and COVID-19 related messages were distributed to promote radio-based learning leading to the incorporated in four children’s radio programmes as well as formation of radio reading clubs with an estimated 500 clubs discussions on socio-economic reintegration for vulnerable to be formed across the LGAs in NE Nigerian states. and at-risk children were aired through Peace FM in both Hausa and Kanuri languages. More than 10,000 persons Child Protection were reached by these messages which focused on Since the start of the COVID-19 pandemic in Nigeria, state emphasizing the importance of using the masks and government social workers in Adamawa, Borno, Kaduna and observing strict hand hygiene as well as physical distancing. Yobe registered 2,858 Almajiri children (including 205 girls) using the CPIMS mobile application. Of this total, 84% are A total of 1,846 persons (453 boys, 517 girls, 578 women, children registered in Kaduna State and 4% tested positive and 298 men) in north-east Nigeria were reached with PSEA for COVID-19. 51% were between 13-17 years old, 40% were messages through the prevention of sexual exploitation and between 6-12 years old, 2% between 0-5 years old and, 7% abuse (PSEA) posters on how to access safe and secure were above 18 years. 31% had spent more than four years reporting channels for allegations of sexual exploitation and in the system, 31% between 2-3 years, 19% less or equal to abuse. At least 4,408 posters (1,160 in English, 1,392 in one year. While 19% could not recall how many years they Kanuri and 1,856 in Hausa) were distributed in Bama and have been in the Almajiri system. Gwoza LGAs.

House-to-house sensitization efforts by community volunteers in Ekiti, Osun and Oyo States reached 14,189

Adaptations to ongoing UNICEF programmes UNICEF successfully mobilized and engaged an estimated 150 HIV prevention national stakeholders to develop an AGYW HIV prevention operational framework. Ongoing support is being provided to national and state TWGs for coordination of HIV response and implementation of UNICEF supported work plans. UNICEF in Akure is working with field office State Primary Health Care Development Agencies/Boards to develop state specific strategies to improve routine immunization coverage in the states. In Kaduna state, UNICEF is supporting implementation of all routine services through the PHC MOU implementation.

Sustained advocacy to state governments has resulted in release of 125 million naira (80 million Naira from , 25 million from and 20 million from Bauchi) for the procurement of ready to use therapeutic food (RUTF) required for the treatment of children with SAM. Routine Vitamin A Supplementation have started in 2,040 Primay health facilities across seven states as an alternative to campaigns, which were suspended due to the pandemic.6 Data reported through DHIS2 indicate that a total of 272,888 children 6-11months and 636,598 children aged 12-59 months were reached with vitamin A and 402,798 children 12-59 months old received de-worming tablets from January to May 2020.

6 Akure, Ekiti, ogun, Ondo, Osun, Oyo states and UNICEF continues to support remote monitoring of planning, supply distributions, quality nutrition services delivery, data management and reporting through daily telephone calls, SMS, use of social media platforms, and virtual review meetings. In Jigawa State a cascade training of community mobilisers on screening, diagnosis and management of severe wasting took place in their respective communities.

During the reporting period, UNICEF, in collaboration with the Federal Ministry of Women Affairs commemorated the 2020 Day of the African Child (DAC) themed ‘access to child-friendly justice system’. Over 10,000 persons attended the high-level webinar with policymakers, child parliamentarians, Speaker of the House of Representatives, Attorney General of the Federation, Minister of Women Affairs, Executive Secretary of National Human Rights Commission and Nigeria Police Force. As an immediate follow up to the 2020 DAC, the Inspector General of Police signed the Standard Operational Procedure as a Force Order and approved the training manual on handling cases of children for in-service training of police officers.

UNICEF further leveraged the momentum of this event by holding a virtual meeting with the Presidential Committee on Correctional Service Reform and Decongestion immediately after the 2020 DAC and secured commitments by the Presidential Committee to collect relevant data from the Nigerian Correctional Service and the states government and conduct onsite hearing and release of the affected children. During the reporting period, nine children (all boys) were diverted to Grace Springs Rehabilitation Centre in Lagos State by other referral bodies including the police, social welfare and courts in the state, while in , another six children were released from correctional service facilities, bringing the total number of children released from Cross River State Correctional Service facilities to 32 (including two girls).

In Lagos State, 60 survivors of sexual violence accessed free services at the Mirabel Centre, a one-stop facility for victims of sexual violence. In addition, UNICEF supported the convening of a Survivors Forum with 50 survivors of sexual violence and their caregivers so they can receive psychosocial services and engage in peer-support activities. As part of efforts to raise awareness, mobilize and promote positive behavioural change, UNICEF supported the development and airing of radio jingles, reaching over 2,000 adults and 1,500 secondary school children in targeted LGAs; facilitated community dialogues on the importance of reporting of violence against women and children with at least 880 community members in Sokoto State. Also, in Sokoto State, as part of a joint Spotlight Initiative, UNICEF, UN Women and UNFPA conducted a training of 37 members of the Gender-Based Violence and Child Protection Response Team. The training focused on basic principles of child protection, case management and child protection information management system (CPIMS) to strengthen their capacity to provide prevention and response services for children and women. In addition, radio and television partners (Media Pim Pim Pim) focused on different aspects of ending FGM messages in English, Pidgin and Yoruba reaching estimated at least 405,897 persons in Ekiti (123,000), Osun (168,897) and Oyo (114,000) States.

In collaboration with the Borno State Ministry of Women Affairs and Social Development (BSWASD), UNICEF supported the family tracing and reunification of 65 children (all boys) formerly associated with non-state armed groups (NSAGs). The children were released from Giwa military barracks and had been staying at the Bulumkutu Interim-Care Centre where they received child protection services including PSS and skills training as well as basic hygiene promotion activities to prepare their social and economic community reintegration. A total of 2,226 children (1,099 girls, 1,127 boys) and 685 community members (337 women, 348 men) received community-based MHPSS through house-to-house visitation in IDP camps and host communities. The activities aimed at maintaining PSS services to the most vulnerable and at-risk children in north-east conflict-affected Nigeria as well as to get consult caregivers and chidlren on accessing access centre-based PSS using the COVID-19 standard operating procedures and guidelines on social distancing and remote programming.

Funding Overview and Partnerships

The Nigeria CO has developed an updated response plan outlining gaps and needs, COVID-19 proofing measures and response activities across all sections. USD 65 million is requested to support the government to respond to COVID-19 and reach an estimated 20 million Nigerians.

External Communication

UNICEF has aligned with global campaigns on COVID-19 and has been disseminating information through its social media network (Twitter: Facebook, Instagram).

For more Peter Hawkins Claes Johansson Gillian Walker information Representative Deputy Representative a.i. Emergency Manager contact: UNICEF Nigeria UNICEF Nigeria UNICEF Nigeria Tel: +234 (0) 803 402 0870 Tel: +234 (0) 906 206 6637 Tel: +234 (0) 803 403 5235 Email: [email protected] Email: [email protected] Email: [email protected]

Annex A

Summary of Programme Results

Sector 2020 target Total results7

Risk Communication and Community Engagement

Number of people reached on COVID-19 through messaging on 22,000,000 20,921,478 prevention and access to services

Number of people engaged on COVID-19 through RCCE actions 22,000 23,738 Number of people sharing their concerns and asking questions/ clarifications for available support services to address their needs 2,020,000 601,586 through established feedback mechanisms” WASH and IPC Number of people reached with critical WASH supplies (including 1,340,782 601,9078 hygiene items) and services Health Number of children and women receiving essential healthcare, including prenatal, delivery and postnatal care, essential new-born 6,061,266 3,952,363 care, immunization, treatment of childhood illnesses and HIV care in UNICEF supported facilities. Number of healthcare workers within health facilities and 780,586 112,758 communities provided with Personal Protective Equipment (PPE) Number of healthcare facility staff and community health workers 20,000 73,011 trained in Infection Prevention and Control (IPC) Number of healthcare providers trained in detecting, referral and 8,548 48,226 appropriate management of COVID-19 cases Nutrition Number of children 6-59 months admitted for treatment of severe 558,189 143,169 acute malnutrition (SAM).9 Number of caregivers of children aged 0-23 months reached with messages aiming to protect breastfeeding in the context of COVID 656,000 1,432,512 through national communication campaigns. Education Number of children supported with distance/homebased learning 17,500,000 20,115,974 Child Protection and GBV Number of children without parental or family care provided with 29,500 5,294 appropriate alternative care arrangements Number of children, parents and primary caregivers provided with 2,605,000 629,331 community based mental health and psychosocial support10 Number of children and adults that have access to a safe and 498,067 152,408 accessible channel to report sexual exploitation and abuse Number of UNICEF personnel and partners that have completed 1121 642 training on VAC/HP/GBV risk mitigation and referrals for survivors11 Social Protection Number of households (affected by COVID-19) receiving 120,000 - humanitarian multi-sector cash grant for basic needs

7 Results are cumulative from March 2020 8 68,200 persons reached through UNICEF advocacy/technical/mobilization support, using government funds 9 Target is calculated as all children with SAM from March 2020 to December 2020 including HRP, HRP addendum and estimated caseloads 10 Indicator broken down to 5,000 CP and 2,000,000 Education and 100,000 CP and 500,000 Education (NE) 11 Indicator broken down to 250 CP and 500 Education and 221 CP and 150 Education (NE)