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Semi-Annual Program Performance Report

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Semi-Annual Program Performance Report Semi-Annual Program Performance Report Headquarters Information Field Contact Information Coy Isaacs Allan Havers Acting Director, Crisis Response Response Coordinator, FHI 360 Yemen 1825 Connecticut Avenue Khormaksar (Opposite Lotus Hotel) Washington, D.C. 20009 Aden, Yemen [email protected] [email protected] Country/Region of Country: Yemen Submission Date: April 30, 2020 Program Title: Integrated Humanitarian Assistance to Yemen OFDA Award Number: 720FDA18CA00042 Award Period: July 2, 2018 – November 1, 2020 Reporting Period: October 1, 2019 – March 31, 2020 Al Ghaded deep clean and repair day, November 2019 CHV Training, Hudaydah Governorate, March 2020 Summary This report captures FHI 360’s progress against planned objectives, activities, and indicators from October 1, 2019 to March 31, 2020, for the “Integrated Humanitarian Assistance to Yemen” (IHAY) project, USAID/OFDA Award No. 720FDA18CA00042. FHI 360’s Health, Nutrition, WASH, and Humanitarian Coordination activities comprise an integrated package to promote comprehensive support to host communities and internally displaced persons (IDPs), thus reducing risks of morbidity and mortality and contributing to the improved well- being of displaced and conflict-affected individuals at the following sites along the Western Coast of Yemen: Al Ghaded Health Center (HC) in Dhubab district, Taiz Governorate; Al Mokha Maternal and Child Health (MCH) Center (through November 2019), Al Gharaffi HC, and Al Shatheliah HC in Mokha district, Taiz Governorate; and Al Khawkhah MCH and Al War’a Health Unit (HU) in Al Khawkhah district, Hudaydah Governorate. In this period, FHI 360 began support to additional facilities that were added as part of the cost modification of the award executed in July 2019. Originally, in the cost modification, the new health facilities proposed were Al Gharaffi and Al Hema, however, due to the lag time between receiving nomination letters for individual health facilities, MOUs with each governorate, and a revised subaward for the project and being able to start services, another NGO (ACF) was already operating in Al Hema. Therefore, FHI 360 asked the DHO to appoint another location and after consideration of multiple facilities, Al War’a HU was ultimately assessed and selected. Furthermore, in agreement with the DHO, in December 2019, FHI 360’s support to Al Mokha MCH was replaced by Al Shatheliah HC after Mokha MCH was assigned to another local NGO, DEEM, which would have resulted in a duplication of services if FHI 360 continued its work in that location. In addition to the static health facilities, a Mobile Health Team (MHT) was incorporated into the cost modification, which was originally intended to be launched in Al Khawkhah district but reassigned to Al Tuhayta district (also in Hudaydah Governorate), as per request of the GHO Hudaydah in order to cover an area in higher need of medical assistance. (Of note, Tuhayta district is the same one where the previously referenced Al Hema health facility is located.) Finally, a team of Community Health Volunteers (CHVs) was incorporated in the project whose aim is to support the work of the health facilities through community outreach and health promotion. During the reporting period, FHI 360 recorded progress on the following main activities: • Signed renewed sub-award agreement with Ministry of Public Health and Population (MoPHP) on the 12th December 2019, after submitting it initially in August 2019. • Following execution of the sub-award, signed MoUs with Hudaydah GHO on the 15th of January 2020 and Taiz GHO on the 4th of March 2020. • Renewed the Principal Agreement with the Ministry of Planning and International Cooperation (MoPIC) on the 1st of March 2020, valid until the 28th of February 2022. • Completed technical and security assessments in the newly assigned facilities: Al Gharaffi, Al Shatheliah, Al War’a. • Provided incentives and technical support to 65 frontline health workers in Al Ghaded HC, Al Mokha MCH (until the end of November 2019), and Al Khawkhah MCH. With regard to the new facilities and the MHT, incentivized staff will be operational starting from April 2020, while initial WASH interventions and procurements of medical supplies were completed during the reporting period. • Facilitated a six-day training for 50 Community Health Volunteers (CHVs) in Taiz and Hudaydah Governorates who will work as a link between the communities and the health facilities by conducting nutrition screening and awareness sessions on health and nutrition issues and improving the referral mechanism. • Completed an international procurement of pharmaceuticals; one shipment was received in November 2019 and the second one is pending (expected in April 2020). • Initiated the procurement process for the rehabilitation of Al Khawkhah MCH and Al Gharaffi HC, including upgrades to WASH facilities and health care waste management systems. Works will start in April 2020. • Initiated procurement for medical equipment for Al Gharaffi, Al Shatheliah, and Al War’a to make them fully functioning per Minimum Service Package (MSP) guidelines. • Conducted water system extension in Al Ghaded, Al Khawkhah, Al Gharaffi and Al Shatheliah health facilities. • Completed rehabilitation of latrines in Al Shatheliah and provided latrine cleaning tools and consumables at Al Ghaded, Al Khawkhah, Al Shatheliah, and Al Gharaffi health facilities. FHI 360 made significant progress on overall target achievement during the reporting period, despite various factors that challenged implementation. The delays in approval of the sub-agreement by MoPHP and MoPIC and MoUs by GHOs, as well as the substitution of facilities due to an overlap of planned intervention by FHI 360 and other NGOs, which is partially symptomatic of the delays in sub-agreement approval, had an impact on target achievement. Other contributing factors include weak performance and commitment of some health facility staff, and the end of activities in Mokha MCH, since it was contributing high consultation numbers. The delay in the setting up the MHT and the CHV activities in the community—again a consequence of the delayed sub-agreement— also had an impact, especially on the on the Nutrition sector targets. FHI 360 foresees an increase in progress on these indicators in the next reporting period when all the facilities and the MHT will be operational and the CHVs will start their community outreach. However, one unpredictable element that might slow the implementation in the coming months is the COVID-19 pandemic, whose impact is yet to be determined. Although Yemen did not report COVID-19 cases during the reporting period (the first case having been registered in April 2020), all regional and neighboring countries reported cases with some of them reporting local transmission. The impending threat of COVID-19 infection and its potential impact in Yemen will overburden the already extremely fragile and depleted health system. As part of preparedness, the South of Yemen has activated multi-sectoral, multi-partner coordination mechanism to support preparedness and response, coordinated by the Health Cluster as described in further detail in sub-sector 2.1. On the 17th of March, a circular from MoPIC required all organizations to suspend trainings and gatherings for two weeks unless strictly related to COVID-19 and on the 25th of March a circular from MoPHP required all MHT services to be put on hold until further notice. Sector Cumulative Targeted1 Reporting Period Cumulative Reached Reached Health 54,913 (43,159 IDPs) 10,188 (6,825 IDPs) 64,898 (15,579 IDPs) Humanitarian Coordination N/A N/A N/A and Information Management Nutrition 18,143 (11,578 IDPs) 428 (287 IDPs) 3,041 (704 IDPs) Water, Sanitation, and 8,196 (1,865 IDPs) 10,417 (6,979 IDPs) 20,547 (6,979 IDPs) Hygiene OVERALL 100,403 (56, 312 IDPs)2 21,033 (14,091 IDPs) 88,486 (23,262 IDPs) Sector 1: Health Objective: To improve access to critical healthcare services in conflict-affected and displaced communities in Yemen Number of Beneficiaries Targeted: 54,913 including 43,159 IDPs FHI 360 continued to provide primary health care and reproductive health services as part of the MSP in three supported health facilities including the provision of medicines, medical supplies, and payment of incentives targeting frontline health workers. FHI 360 also took steps to expand service delivery to three more facilities, one a replacement for one of the original three, and one MHT. Final confirmation of the new facilities and the location of the MHT were obtained during the reporting period after extensive coordination and negotiations with the GHOs of Al Hudaydah and Taiz and the MoPHP. In addition, the selection and training of 50 CHVs was completed. Sub-Sector 1.1: Health Systems and Clinical Support 1.1.1 : Support health service delivery points and provide clinical care FHI 360 continued to provide primary healthcare services, including reproductive health (antenatal care, delivery, postnatal care and family planning), Expanded Program of Immunization (EPI)3, Integrated 1Sector-level targets reflect those in FHI 360’s cost modification proposal. 2 As further detailed in FHI 360’s cost modification proposal, based on information received from the local health authorities verified against cluster data, FHI 360 estimated the catchment population of the targeted facilities (Al Mokha MCH, Al Ghaded Health Facility, Al Khawkhah MCH, Al Hema Health Facility, Al Garaffi Health Facility) and IDPs in the catchment areas to be 100,403 and thus the overall cumulative targeted. FHI 360 notes that there have been changes to two of the targeted health facilities in this reporting period, effectively changing the overall number of people in FHI 360’s intervention areas. 3 Vaccines are provided in-kind by the GHO. Management of Childhood Illness (IMCI) and emergency outpatient care (OPD) at supported health facilities. A total of 29,2574 (11,440 M, 17,817 F) consultations were recorded over the six-month period. Acute respiratory infection, malaria, injuries, and acute watery diarrhea were the top morbidities in the reporting period.
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