National Health Cluster Meeting June 3rd, 2021 10:00 am to 12:00 noon

Agenda Discussions Action points

1 Update on State Level Coordination Structure 4. AoB 2 AWD Cholera Situation Update  SHF Q & A and Training Session 3 Health Cluster Information Management Update  PSEA Update

Introduction and The meeting was moderated by the Cluster Co-coordinator. Participants were encouraged to write in their name and organization name opening remarks in the comments box and to type in questions in the comments box as the meeting is ongoing; in order to respond as is possible and limit interruptions to the presentations. Partners were also invited to give any program updates n the chat box

1. Update on State An update on the coordination structure was provided by the Cluster Co-coordinator. Considering the scale and scope of humanitarian Level Coordination operations, the structure entails coordination levels at National, State and Regional levels. The objective of this structured coordination is Structure to serve the needs of the scattered nature of partners across the country. Also,several LNGOs, NNGOs and INGOs do not have presence in Mogadishu. The decentralized structure therefore ensures invlolvement of partners who may not have prescence in Mogadishu. Con- tinued limited access to the field locations, while some geographical areas face multiple and sudden crises. Decentralized coordination ensure information from these areas is captured in a timely manner, so as to ensure appropriate response. Further, the coordination structure allows for the need to keep response close to the affected population. This also ensures participation of LNGOs and NNGOs and builds their capacity, through information sharing and capacity building functions through the cluster. Local authorities play a key role in governance, monitoring and moderation of activities in the field. The decentralized cluster structure also helps to ensure coordination with the local authorities. The revised coordination structure has the Humanitarian Country Team(HCT) as the head, with the Intercluster Coordination Group (ICCG) reporting to the HCT, with the Clusters coordinating with the ICCG. The next level is the State level ICCG and sub-national working groups at state level, followed by coordination at Regional level both, formed based on need and established crite- ria. The criteria for establishing working groups at state level involve:  Areas frequently facing crisis – floods, drought, locust  Areas with high humanitarian response for the cluster  Number of partners  Regional capitals at state levels

The criteria for stablishing Focal Points at Regional Level includes:  Partners unable to access state level

1/3  Areas frequently facing crisis – floods, drought, locust  Areas with high humanitarian response for cluster  Number of partners Link to the presentation is below: Re-structuring Sub-national Coordination https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/restructioning_sub- national_coordinations.pdf 2. AWD Cholera In 2020, the cluster created a Chorea survey tool called the AWD surveillance offline dashboard whose objective was to moitor the Situation Update Cholera situation in the country. Data was also collected from 2018 and 2019 to be able to observe trends within this period. This data shows that a spike in AWD cholera was consequtively witnessed between April and June of each year.This therefore shows that there is a likelihood of an outbreak during this period in 2021, and partners are urged to be vigilant an dprepare to respond. Galmudug Update

In May 2021 , 717 suspected AWD cases were reported from Galkayo and Dhusamareb .280 people were admitted in Hanano hospital dhusamareb, while 437 were admitted in Galkayo south hospital which supported by IMC and MSF while Hanano Hospital is supported by IRC. 73% of these cases were under five years old. No death was reported at the time of reporting. In response to the situation, rapid response teams supported by WHO have conducted Cholera prevention community awareness. MoH with support of WHO collected 6 stool samples from Galkacyo and sent to National laboratory for further diagnosis and these samples tested negative for Cholera . Galmudug sub-national health cluster meeting was held where this issue was discussed and all partners were requested to increase cholera prevention awareness in their areas of operation.

Link to the presentation: https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/glm_awd_update.pdf

Update from District, by Medair In mid-April 2021, there were reports of increased number of suspected AWD cases seen and treated at the Buulo Karamo Primary Healthcare Facility in Cadale District of Middle Shabelle region supported by Medair. As of 29th April 2021, a total of 36 suspected AWD cases with two associated deaths had been recorded at the Medair supported HF. An alert was sent to CSR, district health team, and RMO for investigation and verification of the upsurge of cases of watery diarrhoea. On the same date (29th April 2021), a joint outbreak investigation and verification team led by the district surveillance officer was done and 10 stool samples were collected and sent to the National Public Health Laboratory (NPHL) in Mogadishu of which 9 of them tested positive for Vibrio Cholera as confirmed by CSR. Having confirmed the outbreak, Medair on the same day (29th April 2021) deployed an emergency response team composed of senior health and WASH officers to support both the MoH-district team and Medair field team in terms of surge capacity to mount and scale-up response activities aimed at reducing morbidity and mortality associated with AWD/Cholera and to control and contain the outbreak. The response has been integrated (intersectoral) and jointly carried out by the MoH team and Medair in partnership with local NGO- SAACID. The response activities included: case management, enhanced surveillance and case finding, intensified community sensitization

2/3 and awareness raising, WASH intervention such as hygiene kit distribution. A CTU was set up on 5 th May 2021 with 20 bed capacity and equipped with all the necessary provisions including staffing and medical supplies and was closed on 25th May following zero cases admission. The last case was admitted on 23rd May 2021. Since the beginning of the outbreak, a total of 181 cases with two associated deaths have been recorded at the Medair supported HF and CTU and thus a CFR of 1.1

Beletwyne District During the month of may,Beletwyne District in Hiraan Region was affected by conflict and floods. The floods were caused by heavy rains Hiraan Conflict in Ethiopia. As much as the flooding was not as much as in the previous years,Houseohls along the Hirshabelle river were most affected and Floods Update after ther river banks bursted. On the other hand, armed conflict between local clan militias, which took place in Beletweyne district in May resulted in the displacement of civilians, 25 injuries and 15 deaths. Houses were burnt and farms destroyed. The fighting started in the north of Balat Weyne particularly in the villages of Baladulnuur, Dabeyl, Lugbari, Buulokaahin, Dharkeynta, Haaracadeey, Bacaadbuuke and Dhaaywabar. Most of these villages were burnt or destroyed by the fighting militiamen. According to the local authorities about 5,432 households were displaced with 32,592 people displaced or hosted by relatives in Balat Weyne town and other safe areas. Despite the fighting, the situation exasperated when floods hit the areas where the fighting occurred, and the displaced people were affected by a subsequent displacement. A rapid multicluster needs assessment has been done in this area and among other urgent needs, mobile health clinics are urgently needed to serve the affected population Link to Beletwyne District Hiran Conflict and Floods Update https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/multi- cluster_rapid_assessment_in_beletweyne_-_may_2021.pdf

IM Update Over the past year, the cluster has been working to improve reporting and has rolled out 3 reporting channels to include the 3W survey platform, Reporthub and HeRAMS, to capture different levels of partners activities. The cluster has carried out series of trainings for these platforms to enable partners to report in a correct and timely manner. The cluster has also introduced specific surveys to collect information on partners who are currently implementing SHF and CERF funds. So far, a total of 26 out of 45 HRP partners have reported on the 3w platform. While 23 partners have provided th 4w information. The HeRAMS on the other hand has a 20% reporting rate. Partners running helath facilities and have not registered are requested to do so, so as to effectively provide information on health service provision across the country. Link to IM update Presentation https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/im_update.pdf Health 3W Reporting Form: https://ee.humanitarianresponse.info/HK5gWRpx

SHF 1st allocation 3W Reporting form https://ee.humanitarianresponse.info/wLP49F7d

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HeRAMS recorded training session https://drive.google.com/file/d/17_7vX2SeZNkI4plIAE8q784IxETHheLN/view?usp=sharing

ReportHub recorded training session https://www.drive.google.com/file/d/180WRxVtG8sxyOTdBwX4_o7EP3HZM8FvQ/view The current Health Cluster 3Ws mapping dashboar; you can check if your organization is reporting or not: https://bit.ly/2Rqv14I

Partner Updates  PAC: Confirmed AWD cases in week 22 from Banadir CTC are 218 cumulative coming mainly from DayNile,Hodan, Dharnkale,Kaxhda,Wadajir.On May 2021 the Banadir Cholera treatment center facing increasing the referral cases of AWD/cholera from Dayniile, Hodan, Wadajir, Kahda and Dharkenyle District in Banadir region. The most of cases are newly displaced people from Jawhar and those affect the floods was reached in Banadir region especially above districts. PAC intervention: 1- PAC has provided ORS and Zinc tab. 2- PAC has provided essential drugs. 3- PAC has delivered PPE for frontline staff to prevent Covid 19. Challenges: -Shortage for essential supply in PAC warehouse -lack of hygiene kits from PAC warehouse.  IMC: AWD data in GAS Hospital show drastic increase of the cases up to an outbreak threshold in week 20 compared to the total of week 18 and 19 as per the WHO alert threshold.  Hawlwadaag HC and eljaale HC both have recorded 41 cases of AWD within a week and already shared to WHO through the weekly online communicable diseases Surveillance and response.  WARDI Organization is currently facing a funding gap at Howlwadaag and Eljaale HC at beledweyn regarding health services but due to availability of supply all our health facility are still on process to provide the required health services, similarly we are also implementing an active CMONC services at beledweyne hospital and MCHN program that is funded by UNFPA and WFB respectively. We also actively implemnt the regional Cold chain at Hiran  AYUUB: there are AWD/Cholera cases in Lowershabelle districts including Qoryoley,Marka and AFGOYE. Samples from respective districts including Qoryoley and Afgoye have been taken, and waiting results from NPHRL and MoH.  KARDO AID:- The breakage was opened 31 days and affected 41 villages which includes isolated and displaced more than 25,150 also destroyed their farmland about 49,313 Hectors which were various crops like Maize, Sesame Beans and Cow pea this leads lack of food with increasing of price and the people living along the river are mostly farmers and labors that were facing constraints towards their life so this can lead them to migrate or look for work in another place

4/3  Mercy-USA: There is an upsurge of AWD and Measles cases reported in and Galgaduud region, galmudug state. The cases are currently isolated and treated appropriately and reported to MOH at both regional and state for follow up and action.  KARDO AID has planned Hygiene Kits and Empty Sacks Distribution for Flood affected people in Moyko Village, Tawakal IDP Camp, Jilyale IDP Camp and Xudur Ciise Village of Jowhar and Mahaday Districts in Middle Shabelle region  CCC is implementing health emergency services , funded by UNICEF in Berdale and some surrounding villages.

Meeting Recording: https://who.zoom.us/rec/share/Nps-vpXZ6oaIHbvjQU9sQcDfd_O_p8rD0T2P6jJEpH- Mo0H4GPPqIGAGDNUpohJM.6UaJMG69KXi85qOV?startTime=1622703432000

Attendance: 55 Participants from the following organizations:

AAOF CCC FSA IMC MSF QRCS WARDI ALIGHT CISP GEWDO IOM NASDO RRP WARO AYUUB CoDHNet HIJRA Medair PAC SHO WHO BADEF DMO HIRDO Mercy-USA PDA SOS WRRS CARE SCI Health Cluster Team

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