EP-2020-000012-CHN

Country epidemiological data and context The first cases of COVID-19 in were reported in March 2020, and as of 3 July, there were 8,904 confirmed cases and 26 deaths reported (WHO figures).

Real-time information on the development of the outbreak is available via the World Health Organization’s COVID-19 Dashboard.

Identified Needs In Uzbekistan there has been a 229% increase in confirmed cases reported over the past one month (between 30 May and 29 June). There is a critical need to implement a robust risk communication and community engagement strategy in Uzbekistan in order to reduce and prevent the spread of COVID-19.

The coronavirus pandemic has negatively affected the economy of Uzbekistan, as a result of which, GDP has decreased, peoples’ incomes have decreased, and inflation and unemployment have increased. The decline in the quality of life of the population is most reflected in socially vulnerable groups of the population: - lonely elderly people - persons with disabilities - large families (families with one breadwinner)

Role of National Society in Response The Red Crescent Society of Uzbekistan (RCSU) was established in 1925 and is the oldest humanitarian organization in the country. RCSU operates on the territory of the whole country and consists of branches in Republic, 12 regional branches, city, Railroad organizations, 195 urban and district branches, and over 3,000 primary grassroots units/organizations in the country. The RCSU has 1,365,000 members and 38,000 active volunteers. In 2004, the law on use and protection of the emblems of Red Cross and Red Crescent was adopted in Uzbekistan. It is the only non-government organization in the country which is included into the State coordination mechanisms for emergency preparedness and response. Among its many activities, it has a well-established service of visiting nurses providing nursing care to the most vulnerable. RCSU conducts its work in close cooperation with state structures, such as local authorities, Ministries of Justice, Health, Emergencies and other relevant ministries. With its strong community presence, it is uniquely placed to play an important role in COVID-19 preparedness and response activities.

In accordance with the Decree of the Cabinet of Ministers of the Republic of Uzbekistan dated August 24, 2011 No. 242, the RCSU is included in the State system of warning and emergency response of the Republic of Uzbekistan (link to document www.lex.uz/ru/docs/1857284). The main role of RCSU in the emergency preparedness and response system is the provision of humanitarian assistance to the population in emergency situations, as well as in teaching the skills of First Aid in emergency situations as an auxiliary structure.

A Decree of the President of the Republic of Uzbekistan No. R-5537 dated 29 January 2020 was established on the formation of a Special Republican Commission to prepare a Programme of Measures to prevent the spread of COVID- 19, headed by the Prime Minister, with the assistance of representatives of all Ministries and Departments responsible for implementing programmatic measures to protect against COVID-19. To combat the spread of coronavirus an Emergency Operations Centre was established at the Agency for Sanitary and Epidemiological Wellbeing under the Ministry of Health, and a Response Protocol and Operating Procedures have been developed. In order to ensure proper communication and cooperation with all key parties that respond to COVID-19 in the country and to ensure a coordinated response, RCSU regularly holds technical coordination meetings with representatives of the MoH, WHO and the Ministry of Emergencies at national level. At the request of the MoH, the National Society actively participates in meetings of the National Epidemic Committee, together with other partners. In accordance with the agreement on cooperation between the National Society and the MoH, activities are carried out at the regional and district level throughout the Republic of Uzbekistan. At the same time, the branches of the National Society work closely with local health authorities. National Society staff and volunteers of regional organizations and branches take part in similar coordination fora organized by regional government health departments.

RCSU coordinates with the MoH, WHO, ICRC and the Risk Communication and Community Engagement (RCCE) working group. RCSU supports WHO with translations of COVID-19 information, education and training (IEC) and other materials into Uzbek and Karakalpak languages. RCSU has delivered several thousand information materials related to COVID-19, self-protection, and proper use of PPE, and conducted workshop/information sessions. RCSU has an ongoing partnership with the MoH, providing social care to vulnerable households throughout the country (including people with disabilities, older people and families living below the poverty line). This allows direct access to some of the people most at-risk of mortality from COVID-19. Recognizing the strengths of the RCSU to work with and inside the communities, it will provide key educational messages to communities, especially living in remote areas of the country.

In accordance with the statutory tasks of the RCSU, with the participation of 298 full-time employees and 976 volunteers, together with authorized state bodies, active work is being carried out among the population to prevent the spread of COVID-19 and mitigate its effects as follows:

In crowded places - in markets, on public transport, in car parks, in enterprises and mahallas (local communities), employees and volunteers of the Society have conducted health education and personal hygiene discussions, distributed masks and information materials (received from the IFRC, ICRC, WHO and the MoH) as follows: - organized actions (events) - 3608; - the population reached to date is 107,170 people; - distributed masks – 100,902 pcs; - sanitary and hygiene products distributed - 39,289 pcs; - distributed information materials – 33,870 pcs; - the number of posts/mentions in the media (local TV and radio, print media, social networks) - 279 The care for the wards and vulnerable groups of the population, in particular, the lonely, older people, the disabled and others, is increasing: - provided medical and social services - 13,123 people; - persons who received financial or food assistance - 12,901 people; For the implementation of the above activities, funds of the Society and sponsors were spent totaling an amount of more than CHF 35,800.

Overall objective: To contribute to the effective containment of the COVID-19 outbreak in Uzbekistan

The operational objective is to fulfil the auxiliary role and mandate of the National Society and contribute to reducing illness and loss of life, while protecting the health, safety, wellbeing and livelihoods of the most vulnerable people, by supporting efforts to contain, slow or suppress transmission of the virus, treating cases, and helping affected communities maintain access to essential health and social services. By responding to the secondary socio-economic impacts, the strategy also looks ahead to early recovery from the crisis.

As the outbreak evolves, the National Society will: - Prepare for cases imported to the country or new communities in order to be able to respond quickly, appropriately and effectively. - Support rapid containment of localized outbreaks when they occur. - Mitigate the health and social impacts of large-scale outbreaks.

The COVID-19 response strategy will be based on the phase of the epidemic and the National Society’s role to support the local response. These may change over time, sometimes rapidly. The RCSU works in all regions of the country.

Health

Risk Communications and Community Engagement (RCCE): The priority is COVID-19 risk communication and community engagement activities, so that people understand how COVID-19 spreads, how to prevent infection, follow good hygiene practices and how to seek help if someone is affected. The RSCU, as a trusted and established organization with a network of branches and volunteers throughout the country and strong community presence, is uniquely placed to undertake this role.

COVID-19 is a rapidly evolving crisis and thrives on misinformation, or misunderstanding, around transmission and prevention; as such, understanding communities’ beliefs and fears, and working with them to share safe practices, warn of risks and dispel false information, is a critical component in this response.

Campaigns will be devised in partnership with affected people and communities and adapted for specific audiences. Campaigns will be tested and co-developed with communities as much as possible, to ensure relevance and sensitivity to local culture.

Face-to-face community engagement events and information sessions will be conducted safely with limited numbers of people to allow physical distancing. Personal protective equipment will be used during all in-person community engagement activities and attendees trained on how to keep safe while away from home.

Whilst RCSU works across all regions, at community level activities will rely on the existing network of community mahalla groups, and the following 1,000 mahallas have been selected for RCCE activities: Republic of Karakalpakstan (103 mahallas), Andijan (130), Bukhara (76) and Namangan (119) regions/oblasts, (167), (111), (153), Xorazm region (77) and Tashkent city (63). The mahallas will be selected based on criteria such as remoteness of location, COVID-19 outbreak situation, local health facilities’ pandemic readiness level and socio-economic indicators. Mahalla committees will support branches to target people without regular access to TV and social media.

Understanding people’s beliefs around COVID-19 and their levels of trust in those working in the response, including RCSU, IFRC and partners, is critical to addressing people’s most pressing concerns and fears, and ensuring that we remain a trusted source of information and community partner. Perception and rumour monitoring will be carried out through media monitoring (including digital), surveys and other engagement activities, such as focus groups or interviews.

A review of existing COVID-19 information available at local and national levels will be conducted in collaboration with WHO. A knowledge, attitudes and practices survey, to determine communities’ awareness of COVID-19, risks, prevention and control measures will be conducted along with an information needs assessment to understand communities’ preferred communications and feedback channels, and identify networks of trusted key influencers who can assist in promoting community understanding of COVID-19 and mitigation strategies.

Livelihoods and Basic Needs

To support the most vulnerable groups of population, due to the socio-economic impact of the COVID-19 pandemic, the RCSU, jointly with the MoH and the Ministry for Mahalla and Family Affairs, is planning to implement cash transfer assistance and engage the unemployed vulnerable population in production activities, aiming to increase their family budget revenues and provide one-time financial assistance to more than 3,000 people by means of cash-transfers. It is backed-up by the legal framework as follows: - Decree of the President of the Republic of Uzbekistan No. UP-3706 dated 5 January 2006 “On measures to stimulate the expansion of cooperation between large industrial enterprises and the production of services based on the development of home-based labour” (link to document: https://lex.uz/docs/ 965124); - Decree of the Cabinet of Ministers of the Republic of Uzbekistan No. 4 dated 11 January 2006 “On the implementation of the Decree of the President of the Republic of Uzbekistan dated 5 January 2006 No. UP-3706“ On measures to stimulate the expansion of cooperation between large industrial enterprises and the production of services based on the development of home-based labour "(Link to document: https://lex.uz/docs/967575).

Identification of beneficiaries will be implemented according to the list of recipients, who under current law cannot be accepted for full state support and guardianship. Depending on the financial condition of the district (city) department of the RCSU and the population, each district (200 districts) will provide support to 10-15 people and several low- income large families (or families with children with disabilities), who will be among the targeted groups, to be provided with financial, medical and social services.

Given the above, and in order to support socially vulnerable groups of the population of Uzbekistan the following is proposed: 1. Payment of one-time financial assistance to more than 3,000 people of the amount of US$50 (commensurate with approximately 2 times the basic amount of calculating the pension - 477220 soʻm (or $US47) per month (from 01.02.2020), in total: US$150,000. Payments will be made to existing bank cards of individuals, which will ensure transparency and minimize human factor interference. 2. Providing 500 low-income families (mainly large families or single-breadwinner families) with an additional means of income – a sewing machine (average market value of US$200), in total: $100,000.

To implement the above activities jointly with the Ministry of Health, the Ministry of Mahalla and Family Affairs, as well as the local authorities, after studying the social and living conditions and assessing the state of health, detailed lists of recipients of these benefits will be compiled.

Institutional strengthening

Institutional area Rationale National Society Database for easier data exchange between the local branches and headquarters - to have readiness unified data ready to be used and shared at any time National Society Make the best use of newly established partnerships with different stakeholders so as to financial secure their support in the future sustainability Volunteer support Organize additional trainings for new volunteers, facilitate easier recruitment process, provide necessary personal protective equipment

Operational and Institutional Risk Assessment

Risk area Controls Personnel health: risk of • Staff and volunteers receive the necessary information and receive contracting COVID-19 through appropriate training clinical or community events • Staff and volunteers are provided with the necessary personal protective equipment • Almost all personnel switched to remote working The provision of services is • A strict quarantine was declared in the country, all activities were sharply violated due to restrictions on limited in the regional centres, but as far as possible and taking into account movement or illness of staff the epidemiological situation, activities are carried out at the district level • The above activities will be continued taking into account the quarantine measures introduced in the country • Depending on the epidemiological situation, all regions and districts of the republic are divided and indicated by different levels of risk, which determine the level of restrictive measures Financial sustainability • The core costs budget of the National Society is mainly covered by resources in-country - membership fees, brand sales and donations • The socio-economic situation in the country indirectly affects the formation of the National Society's budget Depending on the phase (preparedness, containment, mitigation) and the National Society’s role, the following activities will be carried out:

Health AP Activities planned Est. Comments code Start Date Indicators Output 1: Risk Communication and Community Engagement March • Knowledge, Attitudes and Practices survey on understanding of 2020 COVID-19, information needs and communications preferences # surveys conducted • Translation of information materials into Uzbek and Karakalpak # responses languages • Publishing and distribution of printed information education communication materials, including psychosocial support, on COVID-19 and other infectious viral diseases, for target population including school children

• RCSU will assist the government with dissemination of public awareness education messages, including at schools, to better inform affected people, reduce stigma, discrimination and combatting misinformation. Campaigns will be adapted according to audience, based on research into target audiences’ communications preferences and community # people reached with RCCE committees will support branches to reach people without activities regular access to media • Equipping 242 schools (2 schools in each city of Uzbekistan # and % people with improved (220) and 2 schools in each district of Tashkent (22) schools) understanding of COVID-19 with information stands and posters for the prevention of prevention and mitigation COVID-19 (and/or, depending on the quarantine situation, behaviours dissemination of information online, with video clips etc for # of feedback (including school children) questions, complaints, • Risk communications and community engagement activities to rumours) collected be designed for wider population across Uzbekistan, including vulnerable groups (older people, disabled, people with TB, HIV % of feedback responded to etc), adapting materials from IFRC and WHO, including video clips, digital and social media, television, radio, press. Target: 1,242 ‘mahallas’ (local community groups) in each city of Uzbekistan including Tashkent, the Republic of Karakalpakstan, and 7 other regions

Livelihoods and Basic Needs AP Activities planned Est. Start Comments code Date Indicators Output 1: Cash transfers September Indicator: 3,000 most vulnerable persons nationwide will be assisted through 2020 # of vulnerable persons multipurpose cash transfers to address their immediate basic needs receiving multipurpose cash transfers Output 2: Livelihood support (means of income) September Indicator: 500 low-income families (mainly large families or single-breadwinner 2020 # of vulnerable households families) to be provided with an additional means of income - sewing assisted through tools machines provision

Strengthen National Societies AP Activities planned Est. Comments code Start Indicators Date National Society preparedness and volunteer mobilization April • Training of National Society staff and volunteers on prevention 2020 of COVID-19, sanitation and hygiene, raising awareness of # RCSU staff and volunteers trained protection of staff/volunteers, also provision of psychosocial

support for staff and volunteers during stressful situations • Risk Communications and Community Engagement and # RCCE trainings held Accountability training (ToT) for RCSU staff • Equipping staff and volunteers with basic hygiene products, including personal protective equipment, masks, medical gloves etc (provided by the government of Uzbekistan) Partnership for pandemic prevention and response April • Participate in joint planning and action with Ministry of Health, 2020 WHO and other partners to maximize impact • Support translation of medical guidelines, policies, protocols into local languages (Uzbek and Karakalpak) • Administrative and logistic support for trainings for medical personnel of the Ministry of Health • Support Government with equipping multi-purpose facilities, with beds and bed linen - for patients in isolation waiting for test results and waiting to be discharged, as well as for medical staff to rest – provision of 50 beds and sets of bed linen for each of 14 infectious disease hospitals, one in each region of Uzbekistan National Society in-country costs April • Support for 3 staff members, translation costs, 2020 communications costs etc

Health Risk communications and community engagement 370,000 USD 96,130 from USAID € 265,890 included in DG ECHO proposal Livelihoods and Basic Needs Payment of one-time financial assistance of US$50 to 3,000 vulnerable 142,000 Funding required persons – total US$150,000 Providing 500 low-income families (mainly large families or single- 94,000 Funding required breadwinner families) with an additional mean of income - sewing machines (cost $200 each), total US$100,000 Strengthen National Society National Society preparedness and volunteer mobilization 12,000 USD13,720 from USAID Partnership for pandemic prevention and response - training for MoH 240,000 USD253,232 from USAID staff, and including 50 beds and bedlinen for each of 14 hospitals National Society costs (staff, translation costs etc) 24,000 Funding required Total budget 882,000 Elvira Amiralieva Executive Director [email protected] Sanjar Umarov Head of the Medical and Social [email protected] Assistance Department

Name Role Contact details Bayarmaa Luntan Head of IFRC Country Cluster Support [email protected] Team (CCST) in Central Asia Oyungerel Amgaa Health & Care Delegate for Central Asia [email protected]

Jamie Sport Risk Communication, Community [email protected] Engagement and Accountability Surge Yagshimyrat Annamyradov Disaster Risk Reduction Coordinator for [email protected] Central Asia