Biweekly health sector operational updates 1-15 March 2021

Ongoing activities, accomplishments, issues and challenges for the reported period and Name of organization upcoming plans (1-15 March 2021) ACF Not provided AICS Not provided CEFA Not provided Chemonics Not provided Common Feedback Please see a separate report. Mechanism (ETS sector) Emergenza Sorrisi Not provided Expertise France Not provided GIZ Ongoing: Improve functionality of 5 PHC centres (PHCCs) through IMC in Garabulli (Algarabouli Polyclinic) and Janzour (Abduljalil Martyrs PHCC), Nalut (Sidi Khalifa PHCC), Al Bawanis (Tamanhant PHCU), Zintan (Al Kawassim Western PHCC).

Based on an assessment on the functionality of PHCCs in Brega and Ajdabiya that was conducted by IMC in Feb 2021, MoH East selected Brega Eljadeda PHCC in Brega and Elshahid Mohammed Eldora PHCC in Ajdabia that will be supported to improve their functionality through IMC.

In cooperation with Health Information Centre, 9 DHIS2 trainings were conducted Zliten, Msallata and Nalut with a total of 71 participants (5 women). Trainings in Al Sharguia, Al Bawanis and Al Jufra will continue from the 20th of March until the 8th of April.

Support to National COVID-19 Response Plan:

Pillar 2: Risk Communication and Community Engagement - Preparations to introduce Municipal COVID-19 Emergency Committees in 16 partner municipalities* plus Brak and Tawergha to the revised national COVID-19 preparedness and response plan are underway – Workshops in Hay-Alandalus, Janzour and Misrata are scheduled for End of March and Beginning of April. - The MHPSS Focal Person network met to discuss the Promotion of MHPSS and Social Cohesion at municipality level. Pillar 3: Surveillance, RRTs and case investigation - Biosafety Level 2 containerized laboratories for Tarhuna, Tobruk und Brak Shate for COVID-19 testing are expected in April. Pillar 6: IPC: - Ongoing support to Women Training and Development Centres in production of PPEs Pillar 7: Case management: - Equipment and supplies for COVID-19 testing and treatment for hospitals in , Tobruk, Al Zintan, Brak Shate, Garabulli, Zliten and Nalut are expected to arrive in Libya in April. Pillar 9: Maintain Essential Services - 5 PHCCs (Al Qassabat PHCC Msallata , Hun and Wadan PHCC in Al Jufra, Western Rawajeh PHCC in Garabulli and Ghadamis PHCC) supported by IMC in the provision of essential services and IHEKs – online and face-to-face trainings on Family Practice Nursing continued.

* 16 municipalities: Nalut, Ghadamis, Al Zintan, Jadu, Hay-Alandalus, Garabulli, Msallata, Janzour, Zliten, Misurata, Tarhouna, Al Jufra, Al Bawanis, Al Shargia, Edri El Shati, Al Shweyrif ** 8 municipalities: Nalut, Ghadamis, Al Zintan, Garabulli, Msallata, Janzour, Al Jufra, Wadi Al Bawanis Handicap International Not provided Helpcode Within the framework of the EUTF/AICS funded project “Restoring quality health care services in Zawya and Ghat District in Libya” the following activities were implemented: • Rehabilitation work for the Health Centers in Tahala and Awainat in Ghat district reached 95% and the health facilities will be handed over to the Municipality and the communities by early April. • Rehabilitation work for the Health Center in Ghat were initiated. • Tender for medical equipment for selected health facilities in Zawya were awarded and delivery will take place during April. • Training on the Job Medical Team in Ghat conducted the last sessions in Tahala and Awainat Health Center. • Trainings for medical staff in Zawya and Ghat under organization and will be starting in late March.

Assessments were conducted on unsupported PHC facilities in Ghat and . ICRC PHCC: • Monthly donation of drugs and consumables to PHCCs: Agar PHCC, Al Jadid PHCC, Zuwilla PHCC, Bergen rural hospital, Al Ghurayfah rural hospital, Alkhoms Polyclinic. • Medical donation delivered to Sabha Diabetic Center.

Mobile Health Unit In coordination with the LRCS, the MHU activities Benghazi began on 1rst of March/2021.

Hospitals: • Finalizing Yefren in Nafusa mountain, ER assessment. • A remote health assessment was conducted for Wazen rural hospital/Nafusa mountain. • Field visit with Wat Hab FO to assess and estimate generator size for the Oxygen plant in Al Thanawiya isolation center- Sabha Ad Hoc Donation delivered to Al Wahda Hospital. Ad hoc donation of ER items delivered to Sabrathah teaching hospital.

First Aid and prehospital Care: • A refresher FA TOT for the LRCS participants had been conducted in the LRCS HQ.

PRP: • A two-day training on the Multidisciplinary Approach and clinical assessment was conducted by PRP team to 10 BPRC staff. • Nomination of candidates from BPRC & JPRC management for ICRC Scholarship 2021 • Beneficiaries Feedback and Technical Assessment (BFTA) was completed at JPRC. IFRC Not provided IMC COVID -19 Preparedness Ongoing Activities and Updates Pillar 1: Country-level . Coordination with relevant authorities such as the NCDC, coordination, planning, and PCHI and MOH are ongoing monitoring Activities pertinent to COVID-19 preparedness and response are supported through the support of BHA, EUTF, GIZ and UNFPA. IMC continue to provide information dissemination with regard Pillar 2: Risk communication to C-19 in its target locations through community health workers and community engagement and mobile medical units. . IMC continue to participate in national disease surveillance Pillar 3: Surveillance, rapid system, submitting C-19 alerts through the EWARNs response teams, and case As of the last 2 weeks, 13 cases of suspected COVID-19 were investigation reported (3 - Misrata, 4 - , 6 – Benghazi) Pillar 4: Points of entry Not applicable Procurement of laboratory equipment and supplies are currently ongoing to support the Tripoli Central Hospital laboratory as well Pillar 5: National laboratories as the Tripoli NCDC central laboratory to increase their laboratory capacity . IMC continue to provide and ensure PPEs are available to supported health facilities Pillar 6: Infection prevention In each of the supported hospitals, IMC deploys an infection and control prevention and control nurse who assists in ensuring that universal precautions and additional infection prevention and control measures are adhered to Pillar 7: Case management . IMC is supporting 5 health care facilities with C-19 isolation and Therapeutics units, namely Tripoli Central Hospital and Ophthalmology Hospital (Tripoli), Oncology isolation center (Misrata), Respiratory Isolation center (Sabha), Alamal Benghazi Medical center (Benghazi) . Services supported within the health facilities include provision of additional clinical staff to conduct triage, case management and infection prevention and control The support for this pillar is largely provided by BHA and EUTF Pillar 8: Operational support IMC continue to rely on 2 sources for the procurement of PPEs – and logistics local pre-qualified vendors and international suppliers . IMC currently deploys 13 medical mobile teams covering 26 primary health care centers and 5 temporary locations offering primary health care services including C-19 screening. The operational areas for these mobile teams include Sabha, Tripoli, Benghazi and Misrata . As much as possible, mitigation measures to ensure the continuation of regular health care services such as provision Pillar 9: Essential Health of PPEs are supported by the donor of each project. Primary Systems and Services health care services are funded by BHA, EUTF and UNFPA Update – Services in Al Ghararat Primary Health Care Center is expected to be phased out as of April 1st due to funding constraints as UNFPA will not be supporting Reproductive Health Care Services beyond March 31st. IMC will be mobilizing other resources to cover current services for the PHCCs in Al st

Qadasiya (Tripoli) and Al Jadeed (Sabha) as of April 1 2021. Coordination

IMC have participated in the REACH MSNA Health Sector Kick off call on March 8th as well as the PHC Technical Working group call convened by the PHCI on March 9th

Primary Health Care Services

IMC is currently deploying 13 medical mobile teams to 26 primary health care centers and 5 temporary service delivery points in IDP and migrant locations. Services offered include general medical consultations, maternal and childcare, provision of essential medications as well as disease surveillance. Within the period reported, there were 2,098 medical consultations and 149 antenatal consultations conducted. In addition to facility-based services, community health activities are also provided by community health workers who conduct home visits and primary health care center awareness sessions. Within the period reported, there were 2,641 community members reached for key health messages.

***Group activities are limited to 10 -15 participants with mandatory wearing of face masks, physical distancing and frequent hand-sanitation***

IMC continue to support screening and active case finding for beneficiaries that may be suffering from tuberculosis through its partnership with the NCDC in Tripoli. In Misrata, these services have been initiated in two PHCs in Misrata (Al Aswak PJCC and Ras Freidekh PHCC). Within the period reported, there were 27 beneficiaries screened for Tuberculosis and 12 referred for laboratory confirmation and enrolled for treatment while 92 patients with provided with free laboratory services which includes liver profile, complete blood count as well as blood chemistry to facilitate further management.

Support to Secondary Health Care Facilities

Aside from the support for 5 COVID-19 isolation units described above, IMC is in the process of procuring medical equipment and supplies for Abu Seta Hospital (Tripoli) as part of the ongoing rehabilitation of the 6 isolation rooms for patients suffering from tuberculosis.

With support from the Italian Agency for Development Cooperation, IMC has finalized the renovation of the medical warehouse of Zwara’s Al Marine Hospital. Renovation works included the addition of a generator, fire alarm system, intruder alarm system, cold chain space, and inventory system. The official handover ceremony of the warehouse will be on March 17th. Under this same support, IMC is in the process of finalizing its support to Janzour Village Hospital through the donation of medical equipment and supplies, including PPE.

Capacity Building

A GIZ -funded training on Family Practice targeting medical doctors from the municipalities of Ghadamis , Jufra-Hon , Jufra-Wadn , Misullata , Garaboulli was conducted in Tripoli with 25 participants in collaboration with PHCI.

Mental Health and Psychosocial Services

IMC MHPSS Counselors and Community Health Workers continue to provide twice-weekly support to the Suq Al-Tulataa COVID Isolation Center. The team provides support and health information to patients with suspected COVID, to their families, and to the staff working at the center. MoH has reported that other centers would benefit from similar intervention and any interested organization is encouraged to reach out to the ICO or to IMC directly to learn more about the activities and how to implement in other centers in Libya. IOM Primary Health Care Consultations and Referrals

IOM medical teams provided a total of 3,888 primary health care consultations to migrants, IDPs and host community members and referred 48 migrants to secondary and tertiary health facilities for further medical investigation, treatment and management.

DCs: IOM medical teams provided primary health care consultations for 806 migrants in detention (490 men and 65 women) in ten detention centres: namely, Abu Rashda, Tariq Alsikka, Abu Issa, Ganfouda, Tokra, Albayda, Shahat, Algubba and Kufra DCs. IOM also provided health consultations at Mabani, Batin Aljabal, Almarj and Ejdabya DC upon ad-hoc request. 12 migrants were referred from these detention centers to the secondary and tertiary hospitals for further clinical management. PHC clinics: Through its support in four primary health care centres (Shouhada Abduljalel PHC, 17 Feb Polyclinic, Alsiraj PHC and Al-Aoeanea PHC), IOM provided 443 primary health care consultations (212 men and 231 women) to the IDPs and host community members, along with supporting the centers with medicines, medical consumables and IEC materials on COVID-19.

Medical outreach: IOM mobile teams (Health program and Migrant Resource and Response Mechanism (MRRM) program) are providing primary health care services for migrants, IDPs and host communities in urban settings. Project locations cover Hai Al-Andalus, Ghot Alshaal, Ain Zara, Alsirraj, Souq Aljumaa, Abdulsalam, Tajoura, Zwara, Sabha, Qatroun, and Bani Waleed.

IOM medical outreach teams reached 1,428 migrants and IDPs (1,218 men and 210 women), out of which 34 migrants were referred to the secondary and tertiary health facilities for clinical management.

Rescue at Sea: IOM medical team responded to rescue at sea operations where 357 migrants (321 adult male, 24 adult females and 133 minors) from Abusitta disembarkation point. 44 migrants received the medical screening and triage upon arrival and 2 migrants were referred to the secondary health facility for clinical management.

Fitness to Travel Screening: IOM medical teams provided pre-departure medical screenings for 293 migrants to assess fitness to travel (FTT) under the Voluntary Humanitarian Return and Reintegration (VHR) program.

National Health System Strengthening

1. Capacity building training on TB contract tracing In close collaboration with the National Tuberculosis Program (NTP), the National Center for Disease Control (NCDC), IOM supported organizing a two-day workshop for “Contact tracing and follow up of TB cases” on 9-10 March 2021. The training facilitated by three experienced NTP/ NCDC staff aimed to enhance capacity of stakeholders in tuberculosis cases contact tracing and adherence to the treatment among the migrants.

A total of 20 health professionals participated in the training. The participants included eight medical doctors from the International Rescue Committee (IRC) and two doctors from Medecins Sans Frontieres (MSF) besides two doctors from NCDC and eight IOM staff working across Libya.

2. TB screening campaign in detention centre IOM also conducted a five-day tuberculosis screening campaign at Mabani detention centre on 8-15 March 2021. In close collaboration with the NCDC and Directorate of Combatting Illegal Migration (DCIM), the campaign screened 771 migrants and 13 staff members for the tuberculosis, out of which one case was confirmed positive and 102 suspected cases are currently under the laboratory investigation.

3. Prefabrication IOM donated the prefabricated medical isolation units to six medical hub hospitals in Zelten, Tajour, Alkhoms, Zliten, and Nalut. The donations included the necessary medical equipment, furniture and personal protective equipment (PPEs) to support national health system for maintaining continuity of essential health care services across the continuum of care while managing the COVID- 19 response.

Celebration of International Women’s Day

On International Women’s Day, IOM health teams, including a gynecologist, midwife and social mobilizers organized health checks and group discussions with migrant women in detention centres in Tripoli and Benghazi. The sessions related to women’s health, coping mechanisms, the importance of antenatal care and prenatal care, breast self-examination and a Q&A on women’s health.

IOM also conducted an immunization campaign (polio, tuberculosis and hepatitis) for nine migrant children under the age of five, in collaboration with the National Centre for Disease Control (NCDC) Zwara branch. The campaign supported migrant mothers and children who have limited access to legal documents, including birth certificates, health information and health-care services.

COVID-19 response

Risk Communication and Community Engagement (RCCE): IOM medical team conducted 122 outreach campaigns and awareness raising sessions in Sebha, Ubari, Tripoli, Zwara, Bani Waleed and Benghazi. A total of 4,703 migrants improved their awareness and knowledge of the COVID-19 prevention methods and health seeking behaviors when having the suspected symptoms.

Local NGO Women’s Union and IOM organized a day of celebration for International Women’s Day at the public theatre in Sabha where IOM team provided COVID-19 awareness information and distributed flyers on preventative measures for more than 100 women and children from migrant, displaced and host communities.

Points of Entry (PoEs): IOM Medical teams supported the NCDC staff at Misurata airport, Ras Jedir and Wasen PoEs by providing medical check up to all passengers returning to Libya as part of IOM COVID-19 response plan. A total of 53,186 cross-border travelers (47,406 men, 2,915 women, 1,430 boys and 1,435 girls below 18 years old) were screened by checking temperature and general condition.

Mental Health and Psychosocial Support (MHPSS) services

Mental Health and Psychosocial Support (MHPSS) services were provided to 143 migrants (91 men, 21 women, 23 boys, 8 girls) in IOM center in Hay Alandalus and urban locations in Tripoli and Zwara, including shelters, collective houses, labor migrants gathering points, IOM mobile clinics, detention centers, health facilities, and at disembarkation points following interception/rescue at sea operations in Tripoli.

During the reporting period, the MHPSS teams accompanied IOM medical teams to different locations and conducted a varied set of activities, including individual basic counselling and psychological first aid, psychosocial awareness sessions, art-based psychosocial activities, group readings of IASC MHPSS COVID 19 storybook for children and their families, facilitation of recreational activities for children, psychoeducation sessions, psychosocial assessments and referrals to protection and specialized mental health care services.

Also, the MHPSS teams conducted 10 follow up psychosocial support sessions throughout the month, including sessions for migrants with mental health conditions and their caregivers and migrants following distressful events in Tripoli and Zwara. Concurrently, the MHPSS teams conducted 21 referrals to other IOM teams for migrants in need of assistance in different locations in Tripoli.

Through the MHPSS helpline, and as a response to COVID 19 mobility restrictions, migrants living remotely continued to access mental health and psychosocial support services. The MHPSS helpline received 9 calls from Jadu, Tripoli and Zwara, where migrants from the Gambia, Nigeria and Sudan were provided with remote counselling and psychosocial support services.

Moreover, IOM continues supporting the national coordination mechanism through chairing the MHPSS technical working group (MHPSS TWG) with IMC (International Medical Corps) and in close coordination with the Ministry of Health and providing technical support and guidance to MHPSS actors in Libya.

IRC IRC- Mobile medical teams: During the period of 1st to 15th of March 2021, the International Rescue Committee (IRC) has provided beneficiaries (Migrants, refugees, Internal Displaced People (IDP) and local host communities) with primary healthcare services and conducted about 1,391 consultations in eight locations. Six locations in Tripoli, one in Azzawya and one in Misrata.

Tripoli: With support from RDPP, IRC mobile medical team supported Elmgarief, Alnosb Altedkari and Zawit Aldahmani PHCCs and have conducted about 521 consultation with 57 medical referrals to secondary and tertiary private and public hospitals during the reporting period. The consultations included general, gynecological and mental health. We plan to improve the quality of our mental health services and have provided our medical staff with additional mhGAP training.

With support from SIDA, activities at Sikka DC and AL Harat PHCC continue with IRC medical team conducting a total of 320 consultations with 28 medical referrals. Renovation is currently being done at Sikka DC and Al Harat PHCC. Additionally, a 40KVA generator and one container are being installed at Al Harat PHCC.

With support from UNHCR, one IRC medical team in Tripoli operates daily at the CDC in Gurji and have conducted over 498 consultations which include General, Reproductive and Mental health services, along with more than 147 referrals to public and private clinics. In addition to following the Covid-19 prevention protocols, we continue relying on appointments and phone consultations while making exceptions for emergencies.

With support from UNHCR, one IRC MMT conducted regular visits to Abu Essaa DC in Azzawya every Monday and Thursday. About 44 consultations have been conducted during the reporting period.

24/7 Hotline: During the period of March 1st to 15th; through the 24/7 hotline, the medical team assisted a total of 15 PoCs (9 females and 6 males) of which 2 were assisted with medical referrals both males.

Rescue At Sea: The IRC continues to conduct Rescue At Sea (RAS) visits and have responded to one rescue operations on the 1st of March at Tripoli Naval Base. There was a total of 100 (94 Male and 6 Female) people rescued during this rescue and the medical team made a total of 7 consultations (4 male and 3 female).

Misrata: During the reporting period, the IRC MMT with support from UNHCR, continued to support beneficiaries in LRC shelter in Misrata. 28 POCs are hosted at the Misrata-LRC shelter and provided with essential needs, accommodation, food, and primary and specialized health care and referral of cases as needed and are staying in the shelter under our responsibility waiting to be evacuated. In addition, Covid-19 precautions are taken to ensure shelter inhabitants are safe. The MMT provided a total of 8 consultations along with providing 2 cases with medical referral to secondary and tertiary public and private hospitals.

AICS 2: IRC conducted a two days leadership and management training for the targeted health facilities at Lamah Company, during 7th and 8th of March. Eleven employees attended the training from MMC, DOH, Blood bank, Central dental OPD and LAMSA which covered the following: (Leadership and management, Role of leader, Team development and Team management)

Infection prevention and control “IPC” cascade training for DOH was conducted on 15th of March and will cover Hand hygiene, donning and doffing PPE, Nosocomial infection, and injection safety.

The COVs remain active and have delivered 16 health education sessions reaching 176 beneficiaries (55 males and 121 females). COVs have also begun distributing awareness flyers and posters related to COVID-19, Diabetes, mellitus etc. in order to raise the awareness among the targeted beneficiaries.

AICS 3: Official meeting with Municipality\ targeting health facilities managers: The team in Alkhoms continued conducting meeting with the Managers of the selected health facilities. One of these meeting was with the Manager of Souq-Alkhamese Hospital, Dr, Yusef Alremali where the plan of action for the health awareness sessions in the selected health facilities for this month was discussed. Additionally, the managers of health facilities received information about the upcoming IPC TOT under AICS3 project, which is planned to be conducted on the 27th, 28th and 29th of March in Tripoli.

The leader of the medical team in Bani Walid attended the monthly periodic meeting with the municipality in the presence of the Mayor of the municipality, Dr. Younes Al-Azouzi, where idea of the project was discussed.

Trainings: • On 3rd March, one basic life support cascade training in Souq-Alkhamese hospital was conducted. 13 females of medical staff attended. • On 4th March, one basic life support cascade training in Alkhoms Polyclinic hospital was conducted. 10 medical staff attended ( 6 males and 4 females)

These cascade training were provided by the IRC Clinical Mentors with support from trainers from the medical staff who attended the BLS TOT in January 2021.

Activities in Bani Waleed: Assess the capacities of facility staff and develop a training plan: • Several meetings have been held with the coordinator of the Consortium, Mrs. Aruroa, regarding preparations for a number of TOT training and look forward to being ready at the end of March. • The work is well under way in preparation for the Basic life support TOT, which is one of needed training from the targeted health facilities and scheduled on 25th of March.

Conduct awareness sessions in the communities: • The CHWs and CoVs in Alkhoms continued delivering awareness sessions for the targeted communities by conducting visits to the health facilities, immigration residential housing and workplaces in addition to schools. About 80 health education sessions were provided, reaching directly 549 beneficiaries, (293 Females and 256 males). During these sessions, the CHWs ensured preventative measures for COVID-19. • Community health workers at Bani waleed began conducting health awareness sessions in public and private locations within the municipality and have reached approximately 371 people (190 males and 181 females). • In cooperation with the volunteers, a map of target communities and a weekly plan was drawn up to visit a number of them.

Achievements: • Increase in numbers of reached community after joining of COVs. • Broadening of local networks, as many managers of the schools in the city have requested health awareness sessions be provided to their students.

IRC- Health system strengthening: Under IRC’s EU-funded program, the IRC has prioritized continuity of essential health services at the PHCCs in a system building approach including care of patients with NCDs as well as supporting the MoH to address the impact of the COVID-19 pandemic.

Meetings and participations: • Primary health care technical sub working group coordination meeting hosted by PHCI/MoH. • Meeting with ICO/ MOH regarding the discussion of potential COVID-19 data management support. • Meeting with PHCI regarding CHW training. Activities: • Service utilization data collection for February is done and monitored by HIMS mentors. • Continued mentoring activities to all pilot PHCs by our mentors, • Continuing to sponsor vulnerable referrals from the targeted facilities to private clinics. • Medical teams deployed in Ghat, Ubari, Murzug, Tsawa and Bent Baya continued to provide PHC and emergency services in the main hospitals and the nearby PHC centers. • A new medical team deployed to Edry hospital in Ashatie Trainings: • Emergency Obstetric and Newborn Care (EmNOC) training for 3 days, 16 gynecologists attended the training. • Psychological First Aid training for the nursing staff, 66 Females, 4 Males attended, in Souq Aljomma, Zlitan and, Gharyan. • Ultrasound training for the GPs, 9 females 1 male attended. • CHW training for Ghat district, held in Tripoli, 22 Females and 2 males attended. • Family planning training for 3 days, 10 gynecologists attended the training. • Nurses NCDs training for 4 days, 16 Females and 4 males attended. • DHIS2 PHCs Managers Training. The training hosted by IRC in Tripoli from 2nd to 4th of March 2021, number of participants 22, 7 Females and 15 Male. Donations: • Medication and medical supplies donation to Arada polyclinic in Souq Aljomma district. • Some IPC and COVID-19 triage related supplies were donated to the 12 targeted health facilities. • Insulin was donated to Souq Aljomma municipality. LPFM Not provided. LRC Not provided. MSF France Not provided. MSF Holland Detention Centers Activities:

Regular distribution of Hygiene kits, diapers and milk formula for non-breast-feeding babies to all DCs

Abu Salim DC: Migrants still being brought in from Disembarkation points and checkpoints. Access is very difficult and multiple violence incidents were reported, including gunshot wounds and reports of severe injuries and/or deaths as a result.

Shara Al zawiya DC: 200+ new arrivals from Disembarkations, Hygiene situation is very poor in addition to overcrowding, migrants are majority females and children, multiple escape attempts have happened during the past weeks

Gathering & Return (Al mabani) DC: The DC opened up on December receiving migrants from new disembarkations, a huge influx of more than 1200 new arrivals during the reporting period, Systematic mass violence is reported to control the anxious and stressed migrants in the DC, the living conditions are miserable, no hygiene , no ventilation , unacceptable overcrowding, no sunlight in the cells and no available drinking water , MSF is conducting an emergency ad hoc drinking water distribution every 3rd day of 7L bottles

Total number of Consultations done in the DCs in the reporting period are 1261 medical consultation, 48 ANC/PNC consultation, and 98 Mental health group sessions with 908 participants and 105 Mental health individual sessions and 93 referrals from DCs to secondary care clinics.

Challenges in all DCs: Poor living conditions Overcrowding. Violence. Access and patients flow. Anxiety and stress among migrants Restrictions on MH activities and recreational activities

Community Activities: MSF-H started conducting mobile clinics in the migrant’s community in Gergaresh, two visits per week; the situation in Gergaresh is very poor in regard to hygiene, health awareness and medical needs.

We have conducted 177 consultations and 2 referrals from Gergaresh during the reporting period. We also started delivering Health education services in the community of Gergaresh COVID-19: cases testing positive rate is declining in the triage sites (due to shortage of testing reagents at NCDC), some even traveling from a far to be attended to in Tripoli. Continuation to conduct psychosocial education at Dahmani triage area and ensuring proper hand hygiene and general IPC measures are properly in place during our presence in the polyclinic. We stopped activities at Tripoli University Hospital triage unit due to its suspension of activities,

The numbers of clients (individual/ groups) in the reporting period has reached 729 beneficiaries.

TB activities (Abusetta Hospital):

Activities still continue in the facilities, Renovation process in Abusetta Hospital is still ongoing. The main building is still empty. Work on the MDR-Unit by MoH is still suspended since August 2020 The work by MSF-H on the AFB laboratory is done, a donation of Lab equipment was delivered to the lab, including Microscope, reagents and slides A GeneXpert maschine was also delivered with cartidges and installed with its PC, and printer and is fully functioning. Training for Abusitta lab techs will start next week. Abusitta hospital now has a fully functioning AFB & GeneXpert TB lab. MSF still support by providing investigations through private labs. (6 patients were supported). MSF-H MDs & Nurses conducted 104 OPD consultations in Abusetta hospital and 12 ward rounds.

Challenges: - construction work on the TB MDR Unit from MoH has stopped since August 2020 - Refusal of the Hospital administration to admit undocumented migrants, even if someone is ready to cover all the patient’s needs (Admission fees, investigations …. etc) - MH support to Abusetta hospital was interrupted by the Hospital administration

TB activities at NCDC/NTP:

Number of patient consultations in NTP 200 patients during the reporting period. MSF MDs and nurses support NTP MDs and nurses in the patients’ management.

13 Lab Techs from NTP were trained on the following subjects: 1. ZN-AFB Microscopy 2. Quality control in AFB Microscopy 3. Biosafety (Introduction, Laboratory Layout and infrastructure, PPE) 4. Biosafety (Biosafety cabinet, Contamination) 5. Biosafety (Managing Laboratory waste, managing infectious spill, Use of disinfectants) 6. GeneXpert MTB Rif 7. GeneXpert MTB Rif Ultra

Challenges: No Approved TB Guidelines yet, this has been a very slow process! 2nd line TB drugs are not available. No admission facility for MDR-TB patients in Tripoli.

Referrals to a Secondary Care center: Many calls from DCs and community especially during the weekends looking for assistance from MSF and 95 cases were referred to a Private clinic from both DCs and Community PUI Not provided. TdH The procurement selection process deliveries are being planned with the suppliers with all materials expected to be delivered before Ramadan 2021.

6 Training packages have been prepared after site consultations, and the training packages have been delivered in October 2020, November 2020, December 2020, January 2021 and February 2021 with 2 additional training for 2 different sites scheduled to be delivered on March/April:

• COVID-19 Basics • Infection Prevention Control • PSS Risks to Health and Safety • Arterial Blood Gas Interpretation and Acid-Base Disorders • Collection, Storage, and Transportation of Specimens for COVID-19 Diagnosis • PPE for Suspected and Confirmed Cases of COVID-19 To date

Training has reached eleven of the fifteen health sites which will be supplied under the CERF project in Aljabal Algharbi, Tripoli and Misurata. Training packages have been delivered in-person and via remote Zoom presentations to staff from the following sites:

• Tawergha General Hospital • National Cancer Institute • Early Detection Center • Misurata Hospital for Tuberculosis and Chest Disease • Misurata Medical Center • General Hospital of Zintan • Zintan Isolation Center • Gharyan Rapid Response Centre • Rejban Rapid Response Centre • Tripoli Children’s Hospital • Tripoli University Hospital

Static online training materials have started to be released - December 2020 (COVID-19 Basics) and January 2021 (Infection Prevention Control). Sites not yet reached will continue to be engaged, but alternative delivery mechanisms aside from posting of materials are being prepared, including video recordings and printed materials for an accelerated, training briefing modality. The other four training packages are still scheduled to be released in March/April. RCCE activities launched in the second half of December 2020 and to date have reached over 1,243 individuals on social media and 3,737 individuals at in-person info sessions organized in the community. Continuing activities planned for 2021 will include social media posts and promoted ads, distribution of printed materials, possible television/radio spots, and in-person sessions with students and caregivers returning to school, community groups, etc.

TdH-It is planning to integrate these RCCE activities with hygiene promotion activities in schools starting in March/April 2021. The World Bank Not provided. UNDP START Project Ghadamos Youth Organization in Ghadamos received 37,300 LYD to produce 5,000 face masks, 1,900 face shields, and 500 gowns to distribute around 4,000 vulnerable people in the community. During the process, the organization provided 6 new jobs for women.

You and Giving Association in Sabha received 13,600 LYD to produce 3,000 face masks and 700 gowns to distribute to the local hospitals. During the process, the association provided 4 new jobs for women.

SFL Health Sector Biweekly Operational Updates Ongoing activities: 1. Supply of Refrigeration for vaccines, cold chain for Health Directorate and Rehabilitation of Cold Chain refrigerator Building, Sirte 2. Rehabilitation of Bani Walid General Hospital (Support the rehabilitation of diabetes healthcare facility and convert it to fully equipped isolation facility), Bani Walid 3. Rehabilitation + Supply and installation of (1) Portable Sewage Treatment Plant at Tajoura Cardiology Hospital, Tripoli 4. Supply, installation and commissioning of vertical multi-stage centrifugal pump and Air Conditioner (HVAC) in Abo Salim Hospital-Accident Department, Tripoli 5. Rehabilitation of ICU and newborn ward and patient's room at Benghazi Children Hospital, Benghazi 6. Rehabilitation of Tadamon Emergency Clinic, Sebha

Planned activities: 1. Supply and Installation of Medical Oxygen Generator Facility, Benghazi 2. Rehabilitation of Abdelkafy Physical Therapy Center, Sebha 3. Rehabilitation of Mental Health & Psychosocial Support Center, Tawergha 4. Supply and installation of Medical Oxygen Generator Facility for Tajoura Cardiology Hospital, Tripoli UNFPA Through its partners International Medical Corps (IMC) and Libyan Red Crescent (LRC), UNFPA continued supporting the provision of essential reproductive health services in Tripoli, Sabha and Ghat; mobile medical units assisted 469 women and 118 men and supported 19 deliveries. The medical teams also supported the triage of 591 cases according to NCDC guidelines and conducted two follow-ups and 11 MHPSS consultations. The community health workers further reached 290 individuals in Tripoli,137 individuals in Sabha, and 130 in Ghat with awareness sessions on COVID-19 and pregnancy, as well as reproductive health. Through its implementing partner Alsafwa charity organisation, UNFPA conducted 1training for health care workers under the title (HIV Prevention testing and counselling) targeting 14 healthcare providers from Abu Saleem hospital. UNHCR Not provided. UNICEF Meetings and participations: • During the reporting period UNICEF health team continued participation with the national scientific and advisory committee for combatting COVID-19 pandemic, and Ministry of health meetings to provide technical and logistic assistance for the introduction COVID-19 vaccine. • A three-day scientific conference was organized by the COVID-19 scientific committee in coordination with NCDC. UNICEF was invited for a presentation on COVID-19 vaccination update on the 13th March 2021.

Dispatching medical supplies and equipment: • As part of US department of state dispatching of the remaining part of the MNCH supplies has been completed. This supply included IEHKs (10 basic unit) which is sufficient for 10,000 beneficiaries for 3 months. • To respond to the demanding needs UNICEF provided supplies including PPEs (goggles, hand sanitizers, masks), thermometers and sphygmomanometers to Baniwalid COVID 19 isolation center. These will ensure availability of responsive quality and safe service.

Capacity buildings: • In coordination with NCDC and cooperation of WHO, UNICEF facilitated Training for 90 vaccine supervisors from all across the country, the training took place on the 11th March 2021. The vaccinators were trained on cold chain and provided with tablets for training purpose and data collection. additionally, 1000 copies of COVID-19 vaccine technical field guide were distributed. • As part from France project a training of health officers from three health facilities from Almenshia , Samno and Ghodo health facilities on Integrated Management of Neonatal and Childhood Illnesses (IMNCI) has been conducted during the reporting period. Voluntas Policy Advisory Not provided. WeWorld-GVC Southern Libya As stated in previous reports, WW-GVC is implementing an integrated Health (funded by AICS), WASH (funded by CERF) and protection (funded by SDC) response to COVID-19 in Sebha, in close collaboration with its local partner, MIGRACE, and other relevant stakeholders. As the ongoing projects continue, over the past two weeks: - Under CERF, WW-GVC carried out the distribution of 833 PPE kits composed of surgical masks, gloves and hand sanitizer to the following primary health care facilities: New Hajarah Health Center, Jadeed Health Care Center, Mahdia Health Center, Mansheya Health Center, Tahrir Health Care Center, Al-Qardah Health Center, Tayouri Health Care Center. 21 additional kits have been distributed to the MIGRACE staff and 57 PPE kits have been stocked in WW- GVC warehouse for potential emergency distributions. - Under CERF, necessary material to ensure proper environmental cleaning (consumable hygiene products, cleaning supplies and tools) have been distributed to the abovementioned HCFs and to 7 schools. - Under CERF, the 7 abovementioned HCFs also received segregated garbage bins for different type of waste (infectious, sharp, and general) to ensure proper solid waste management. - Under CERF, posters with key messages on solid waste management, handwashing, COVID-19, and disinfection have been hung in all the targeted HCF. - Under both CERF and AICS, 62 additional staff members from the targeted HCFs received a training on referral mechanisms, proper use of PPE and waste management process. - Under AICS, Al Ghorda Polyclinic Isolation Center has been provided with oxygen delivery devices, airway management devices, intubation tools and other general consumables, including 41 oxygen concentrators. A training on the proper use of those equipment accompanied the distribution.

Western Libya Based on the capacity building need assessment conducted during the last four months, WW-GVC shared the final topics for the ToT, with its consortium partners and is currently finalizing the list of the participants from the HCFs and the DoH of the targeted municipalities. The ToT will start at the end of March and will cover mainly: − Health Management Information Systems (HMIS) − Infection Prevention and Control (IPC) − Supply Chain (pharmaceutical stock management) − Working with Migrants and Refugees - humanitarian principles and right to health Furthermore, WW-GVC identified the main public health topics for the awareness-raising campaign, planned to start in April. Topics included are: NCD such us Diabetes, Blood Pressure and Reproductive Health; COVID-19 Prevention and Awareness. WHO Please see a separate report.