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Psychosocial and Medical Assistance to Urban Refugee Survivors and Those at Risk of Sexual and Gender Based Violence (SGBV) in Kampala, Uganda”

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Psychosocial and Medical Assistance to Urban Refugee Survivors and Those at Risk of Sexual and Gender Based Violence (SGBV) in Kampala, Uganda” Final Evaluation for the Project: “Psychosocial and Medical Assistance to Urban Refugee Survivors and those at Risk of Sexual and Gender Based Violence (SGBV) in Kampala, Uganda” A REVIEW OF OVERALL ACHIEVEMENTS: OCTOBER 2018-FEBRUARY 2020 EVALUATOR: ANGELINE WAMBANDA REGIONAL M&E OFFICER IOM REGIONAL OFFICE FOR EAST AND HORN OF AFRICA Table of Contents EXECUTIVE SUMMARY ................................................................................................................................ iv INTRODUCTION AND BACKGROUND ........................................................................................................... 1 EVALUATION PURPOSE, SCOPE AND METHODS ......................................................................................... 5 2.1. Evaluation Purpose ........................................................................................................................... 5 2.2. Evaluation Scope ............................................................................................................................... 6 2.3. Evaluation Criteria: ............................................................................................................................ 6 2.5. Evaluation methodology ................................................................................................................... 7 EVALUATION FINDINGS .............................................................................................................................. 10 Relevance................................................................................................................................................ 10 Efficiency ................................................................................................................................................. 22 Impact ..................................................................................................................................................... 23 Coherence ............................................................................................................................................... 26 Sustainability .......................................................................................................................................... 27 CONCLUSIONS AND RECOMMENDATIONS ............................................................................................... 30 Conclusions ............................................................................................................................................. 30 Recommendations ................................................................................................................................. 31 ANNEXES ..................................................................................................................................................... 34 List of persons interviewed ...................................................................................................................... 35 List of documents reviewed ..................................................................................................................... 35 i Acronyms ACTV African Centre for Torture Victims ARMP Africa Regional Migration Programme AVRR Assisted Voluntary Return and Reintegration BIA Best Interest Assessment BPRM Bureau of Population, Refugees, and Migration CRRF Comprehensive Refugee Response Framework DAC Development Assistance Committee of the Economic Cooperation and Development FGD Focus group Discussion GoU Government of Uganda HIAS Hebrew Immigrant Aid Society MiGoF Migration Governance Framework MSC Most Significant Change OECD The Organization for Economic Co-operation and Development OPM Office of the Prime Minister PDAEP Pan African Development PEP Post Exposure Prophylaxis PFA Psychological First Aid PSS Psychosocial Support RBA Rights –based approach SGBV Sexual and Gender Based Violence TiP Trafficking in Persons U-FE Utilization Focussed Evaluation TOC Theory of Change POC Persons of Concern ii LGBTI Lesbian, gay, bisexual, transgender and intersex Project Summary Project Title Psychosocial and Medical Assistance to Urban Refugee Survivors and those at Risk of Sexual and Gender Based Violence (SGBV) in Kampala, Uganda Project identification: IOM Project Code: MA.0436 Executing Organization: International Organization for Migration (IOM) Project Management Site and IOM Kampala, CO, UGANDA Relevant Regional Office IOM Regional Office, Nairobi, Kenya. Evaluation Commissioned by: IOM Uganda; AMRP Project Period and Overall Duration: 1 October 2018-31 March 2020 Geographical Coverage: Five Divisions of Kampala City Project Beneficiaries: Women, Children, Persons with Disabilities, Older Persons at Risk, Youth, survivors of Gender based violence Project Partner(s): Office of the Prime Minister –Community services, UN SGBV partners, UNHCR, InterAID, Office of the Prime Minister (OPM), ARC, African Centre for Torture Victims (ACTV), Refugee Law Project, Pan African Development (PDAEP); Nakasero Hospital Total Funding: USD 235,000 Evaluation Date (Month, year) January 2020 Angeline Wambanda Name, title & contact of Evaluator Regional Monitoring and Evaluation Officer IOM Regional Office for East and Horn of Africa Email: [email protected] iii EXECUTIVE SUMMARY Psychosocial and Medical Assistance PROJECT OBJECTIVE: to Urban Refugee Survivors and “Contribute to the successful integration of those at Risk of Sexual and Gender refugees in Uganda through improved physical, Based Violence (SGBV) in Kampala, mental and emotional well-being of refugee Uganda” SGBV survivors.” DONOR: U.S Department of State, Bureau of Population, Refugees, and Migration ($235,000) Project Location: Five Divisions of Kampala City Target: 1000 refugees sensitized on SGBV 150 refugee women and girls survivors of SGBV receive individual counseling 100 refugee women and girls survivors of SGBV receive first-line medical assistance Key Project Interventions: Individual counseling Medical Assistance Community sensitization on SGBV Psychological First Aid trainings Best Interest Assessments Referral for Livelihood, medical, Protection Assistance iv 78% of surveyed survivors are optimistic about rebuilding life after GBV incident as measured by those who reported being able to go back to normal life with no problem, or with some minor problems [Target, 80%] OUTCOME 1: 68 % of surveyed SGBV survivors assisted Kampala’s urban refugee survivors of reported to have reduced stress symptoms by the end of their counselling SGBV or those at heightened risk thereof have reduced stress sessions [Target 80%] symptoms and are assisted in healthy recovery Indicator Target Achieved Output 1: Kampala’s # of refugees who receive 1501 160 urban refugee survivors of individual counselling Women:120 Male: 37 (23%) (disaggregate by gender, age) Girl: 30 Female 123 SGBV or at heightened risk # of refugees who attended ***2 208 thereof have access to support groups (disaggregate by 75 Male: 40 medical and psychosocial gender) Female: 168 support # of refugees who receive first- 100 147 line medical assistance Women: 80 Male: 11 Girls : 20 Female: 136 # of refugees who benefit from 500 6003 psychological first aid (training) Male: 250 Male: 186 (74%) Female: 250 Female: 414 (160%) # of Best Interest Assessments 100 140 for refugee children survivors of Boys: 50 Boys: 53 (100%) SGBV or at risk Girls: 50 Girls: 87 (174 %) Output 2: Refugee Community members 995 refugees (Male: 368 and leaders have Female: 627) benefit increased awareness of from awareness raising SGBV concerns in the and sensitization community campaigns [target, 1000] 1 Data was not disaggregated by girls. The age range for girls was not defined in the project 2 No specified targets in initial proposal but included in subsequent project reports 3 Number trained on providing psychological first AID (PFA)…..the target was initially # beneficiaries that received PFA v LESSONS LEARNT & RECOMMENDATIONS IOM Project Design Contextualization of MHPSS: Re-define psychosocial support model, to transition from HIAS model to an IOM institutional model. IOM absorbed staff and mode of delivery from HIAS but there was no contextualization of tools to IOM institutional practice and guidelines. There is need for technical support from the relevant MHPSS unit. Design of the next phase of the project could consider a holistic approach that includes comprehensive health, livelihood and protection supports. This would ensure a two-pronged approach to MHPSS for prevention by addressing route causes; and response activities for survivors of SGBV when it occurs”. Tailor support package to address particular needs of men, women, adolescent girls and couples who are survivors of sexual violence. Couple counseling should be considered to ensure effective healing. The cost-effectiveness of specialized medical services could be further analyzed to compare the cost of improving existing services at designated public hospitals and private health facilities. Coherence and Partnerships There should be a strong internal synergy with other IOM programmes such as community stabilization, health, AVRR among others. Regarding SGBV services, there is need to increase awareness and collaboration with government facilities and other providers of HIV Post Exposure Prophylaxis (PEP) to SGBV survivors to ensure that survivors of rape receive services within the required 72 hours to minimize risk of pregnancy, HIV infection and other
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