NIGERIA: COVID-19 Situation Report – #08 Reporting Period: May 9th -15th 2020

Situation Overview and Humanitarian Needs

Nigeria has witnessed an increase of an average of above one-thousand COVID-19 cases per 1 week, since the week of 18 April when testing across the country increased (see graph ). As of 15 Situation in Numbers May there are 5,162 recorded cases of COVID-19 across the country. Lagos, Kano, Federal Capital Territory, Borno, Gombe, Katsina, Bauchi and Jigawa are responsible for 60 per cent of confirmed cases in the country2. In addition 51 5162 COVID-19 per cent of the confirmed cases are confirmed 3 from 9 local government areas . Of cases (14 May) the total admitted, 1,180 cases have been discharged and 167 deaths have been recorded. 31,702 tests 167 deaths

have been carried out across the

country with 34 states and the 46,000,000 Federal capital Territory (FCT) Children having reported at least one confirmed case. affected by COVID-19 In Yobe a report of about 471 deaths within five weeks led to an investigation with initial reports revealing that most deaths were of elderly people with pre-existing medical conditions such as hypertension and diabetes. Bauchi state, on Monday announced a 10-day lockdown on three US$ 65 M areas that border Kano state in a bid to contain the increase in COVID-19 cases, curb rapid funding community transmission and allow for effective contact tracing and testing. In Sokoto state, the required Executive Governor inaugurated a 3,000 volunteer response team made up health workers and commenced distribution of two million face masks to the public. Borno state lifted its lockdown on 13 May stating that the lockdown period was successful in testing and tracing. In addition, 160 Nigerians in United States were repatriated to Nigeria on 10 May. This is part of government’s efforts in aiding stranded Nigerians in other countries. Similar returns have been done from the United Arab Emirates and United Kingdom. Returnees are quarantined in designated isolation centers for 14 days upon their return. SPOTLIGHT Prior to the COVID-19 outbreak, UNICEF, in partnership with the Borno State Agency for Mass Education (SAME), supported an EU-funded technical and vocational education and training (TVET) programme. This programme’ s aims were to equip 25,000 youths (15+) with skills and income opportunities through training on key skills including shoemaking, catering, sewing, painting and poultry farming. Target beneficiaries were heads of households, with an emphasis on female-headed households, across six conflict-affected LGAs - Hawal, Gwoza, MMC, Jere, Monguno and Mobbar. During the three-month training period, beneficiaries are provided with monthly stipends to cover their transportation costs. To date over 1,000 youths have been empowered through this programme.

Due to the COVID-19 outbreak and lockdown restrictions the commencement of the second phase of the project was delayed. However, recognizing the shortages in PPEs and other hygiene materials, the project begun production of 40,000 face masks and 12,000 bars of soaps in three TVET centres in Maiduguri. A total of 366 youth, 10 adolescent girls and 24 women head of households are involved in the production. Daily production capacity is 1,500 facemasks and 700 soaps. Safety is ensured at the centres with the provision of face masks, gloves, hand washing facilities as well as social distancing measures.

1 Data for graph from National Center for Diseases Control (NCDC) Sitreps Feb 28-May 14 2 National Center for Diseases Control (NCDC) Sitrep May 14th 2020 3 Presidential Task Force Briefing May 15th  The development of the ‘National Lab Scale up UNICEF’s COVID-19 response Strategy’ to optimize all molecular laboratories in the country, including Cobas machines in Abuja and RCCE/C4D Lagos, as well as optimizing one GeneXpert RCCE activities continue to intensify through the machine per statep; sensitization and capacity building of partners in all targeted  The coordination and integration of lab reporting states. A mobile messaging campaign was launched in through modeling, forecasting, quantification and communities; vid eo skits on diffe rent key practices distribution;  The procurement of test kits and nasopharyngeal including hand washing, tips for staying at home and other swabs. 10,000 Cobas kits have been delivered to key behaviours are actively disseminated through social NCDC; media. A ‘COVID-19 Talk’ radio talk show has been initiated  Analysis of a need-based deployment of surge staff in Enugu by all nine radio stations and it will continue for to states to strengthen human resources for eight weeks providing key information and call-in Persons Of Interest monitoring and contact tracing; opportunities. UNICEF in Kaduna supported weekly  The development of an inventory of clinical care scheduled talk shows with key resource persons on seven supplies on Google Drive, that is being updated Radio/TV stations and FM Stations. In Kano, UNICEF weekly. This drive also captures weekly updates of health care worker trainings; and supported the RCCE pillar to plan and implement  Developing an online self-reporting dashboard that engagement sessions with district heads on COVID-19 will also capture alerts from call centres. prevention and mitigate transmission and the use of public information vans to broadcast COVID-19 information in UNICEF is working with partners on data models for a mid- selected communities and neighbourhoods. COVID-19 level detailed analysis of the outbreak. 68 isolation- jingles continue to be aired on selected radio stations in treatment centers have been accredited in the country Kano, Katsina and Jigawa States. through UNICEF support to the case management pillar.

In Sokoto and Bauchi, UNICEF worked with religious focal UNICEF is supporting the State level Training of Trainers on persons and traditional leaders as well as VCMs to sensitize ‘COVID-19 Preparedness and Response at PHC and people in communities and markets and other locations on Community Levels’ organized by the NPHCDA. Virtual TOTs effective handwashing, physical distancing, COVID-19 were conducted this week across the different states. These signs/symptoms, and referral practices. Planning for the master trainers will thereafter conduct step down face-to- Volunteer Ward Supervisor (VWS) and Voluntary face training for PHC teams at LGA level. UNICEF continues Community Mobilizers (VCMs) continues across several to provide ongoing technical support to the state EOCs on states this week. This included the construction of locally COVID-19 response. sponsored handwashing facilities in Taraba in 201  In Ekiti State, UNICEF supported the training of 400 settlements. State and LGA health workers from Public and Private health facilities on Infection, Prevention and

Control. North-east C4D response  UNICEF Akure is supporting active case search visits In Borno, 42 spots of jingles have been airing weekly in Hausa to health facilities and communities in Akure South and Kanuri languages while mobile announcements are and Owo LGAs noted to be high-risk LGAs. carried out twice a week in 10 LGAs reaching 6,344  Kano FO is supporting Rapid Response Team community members. 3,439 Volunteer Community activities in Kano, Katsina and Jigawa States. 88 LGA Mobilisers (VCMs) continued to sensitize small groups of Facilitators have been engaged for active case search in Kano. people and reached 58,221 caregivers in the past week in  UNICEF Lagos FO supported IPC assessment of two Borno and Yobe. During the lockdown, VCMs continued to sites as the State Government attempts to expand make wider use of the telephone tree in order to maintain isolation bed capacity. contact with their community families for COVID-19 surveillance; and follow-ups with caregivers on routine North-east Health response immunisation. Religious leaders in Borno and Yobe are In the north-east, UNICEF continues to support and actively actively engaged in the COVID-19 response and 819 religious participate in coordination meetings at the State and LGA leaders were sensitized on COVID-19. levels. UNICEF is also supporting IPC activities, including training of healthcare workers and community resource persons, in UNICEF supported health facilities and host Health communities in Borno and Yobe States. 33 VCMs were UNICEF continues to provide technical support to the sensitized on COVID-19 signs and symptoms and IPC Presidential Task Force and the NCDC. Guidelines on measures for strengthening community response approach. ‘community case definitions’ developed by epidemiology and surveillance pillar with UNICEF’s support have been disseminated to states. This is addition to support for: Nutrition North-east Nutrition response Anambra, Bauchi, Ebonyi, Enugu Gombe Imo, Kaduna, Kebbi, In April, integrated nutrition services were provided in 278 Nasarawa, Niger Sokoto and Zamfara states have continued health facilities and 30,738 SAM children were admitted in providing the community-based management of acute out-patient therapeutic programs (OTP) between March and malnutrition (CMAM) for children 6 -59 months with SAM, in April. 22,338 in Borno (male 3,735, female 18,603) all existing treatment sites per states with COVID-sensitive caregivers were sensitized on COVID-19 infection, modifications as described last week. They continued to prevention and control at OTP sites and communities. To provide SAM children with two weekly supplies and have minimize contact, a two-weeks’ ration of RUTF to all reached a total of 36,077 SAM children since January, beneficiaries was maintained and in support of this, 8444 including 9,195 from April to date. In Anambra, Ebonyi and cartons of RUTF were distributed in Borno (3,624 to UNICEF- Enugu the new SAM admissions was observed to be on the supported sites, 4,141 to partners) and 679 to UNICEF- increase, potientially associated with the COVID-19 supported sites in Yobe. 56,569 caregivers received IYCF outbreak. counselling since March. Mother to mother support group meetings of caregivers and sensitization on COVID 19 During lockdown in Kaduna, Nasarawa and Niger states, measures prevention were held in Yobe involving a total of caregivers of SAM children used OTP/ration cards as a pass 264 (male 12, female 252). to avoid movement restrictions by security personnel to enable caregivers visit the health facilities (HF), including WASH mothers with children who have been newly referred. Hygiene Promotion and Distribution of IEC materials 84,506 caregivers of children 0 - 23 months have been An additional 27,300 COVID-19 prevention posters were reached with Infant Young Child Feeding (IYCF) promotional distributed across several LGAs in Plateau, Niger, Nasarawa, messages since January, including 11,665 in April. Kaduna, and Kwara states and were used to complement hygiene Nasarawa and Niger states continued to provide key promotion campaigns and placed in critical places such as messages on optimum IYCF in context of COVID-19 alongside hospitals, markets, public offices and other public places. risk communication and community engagement. The The distribution and placement were carried out through the COVID-19 health messages are now integrated in the IYCF respective state Rural Water Supply and Sanitation Agencies sessions in the HFs. Mothers and caregivers are being (RUWASSAs), LGAs WASH units and rapid response teams. equipped with knowledge on COVID-19 and how to prevent it, while respecting physical distancing in all the facilities. In Plateau, Bauchi, Kaduna, Benue, Anambra, Ebonyi, Kano, Katsina, and Jigawa states, handwashing sensitization Enugu have begun mass communication of IYCF messages campaigns were carried out through small group discussions using jingles, video skits, picture cards and posters in indigenous languages (through the use of community and developed with the support of C4D last week. The messages religious leaders), house to house visits and the use of town are being disseminated via Coal City FM and they will run 50 announcers with motorized public address units while spots of jingles. Jigawa, Katsina and kano will commence observing appropriate safe distances and other COVID-19 weekly interactive radio and TV program and daily airing of prevention recommended best practices, reaching at least jingles on recommended IYCF practices in COVID-19 context 352,900 persons. including IPC measures by next week. Jingles on COVID-19 awareness and prevention developed in In Adamawa, Bauchi and Gombe, Health and C4D collaboration with C4D continue to be aired on a daily basis consultants were also trained on IYCF messages using Zoom in English, Pidgin, Hausa, Igbo, Kanuri and Yoruba languages and there will be a series of continuous weekly training’s for by various radio stations across 17 states continuously CMAM and MNP in collaboration with health and C4D team. reaching an estimated number of 8.5 M people.4 Nutrition teams been integrated into all the health COVID- 19 Training of Trainers (ToT) training’s in these states. In Ogun state, 108 frontline health workers from PHCs in nine LGAs were trained on hygiene promotion and Katsina and Jigawa States kick-started deworming tablets handwashing for prevention of COVID-19. 100 RUWASSA, distribution to children 12-59 and school-age- children WASH unit staff and WASHCOM federations were trained on through routine health services. Katsina has commenced the hygiene promotion, handwashing strategies and other integration of vitamin A supplementation to routine health COVID-19 IPC WASH measures in Benue and Anambra state. services for children 6-23 months.

4 Edo, Ekiti, Ogun, Ondo, Osun, Oyo, Plateau, Bauchi, Kebbi, Sokoto, Zamfara, Ebonyi, Anambra, Benue, Cross River, Borno, Yobe (approx. 500,000 per state) Distribution of WASH NFIs, Provision of WASH services measure progress agasint the COVID-19 education response Soaps and liquid bleach were distributed to 400 households plan. (about 2,000 persons) in three LGAs in Plateau state. In Plateau and Bauchi state, 18,425 persons were provided North-east Education response access to safe water through 34 water facilities in In Borno sate, school radio programming successfully began communities. In collaboration with RUWASSA, 60 through Dandalkura FM Radio (98.9) Maiduguri. The handwashing stations with soap were provided in markets, implementation started with airing lessons in three subjects; motor parks, PHCs and public places in Kaduna state to English, mathematics, and basic science. It is estimated that enable at least 600 people to practice proper hand hygiene. approximately 120,000 (47% females) children tuned in for the lessons. Partnering with Street Child International, North-east WASH response UNICEF supported the distribution of hygiene kits to 330 At the Borno State isolation centre for COVID-19, UNICEF, children and 684 parents to promote good hygiene through RUWASSA, installed eight handwashing stations and practices. a solar powered water pump to support COVID-19 IPC measures. In three camps, UNICEF supported the installation With technical support from UNICEF, states of Borno, Yobe, of an additional 11 hand washing facilities to increase access Adamawa, Bauchi, Jigawa developed Education sector to 1,100 vulnerable people. COVID-19 contingency plan. In coherence with the education sector contigency plan, radio learning programme is In Borno state, An additional 65 Community Based Hygiene operationalised to reach over two million children including Promotion Volunteers were trained on COVID-19 risk children from IDP and host communities to engage them in communication in Rann and 885 COVID-19 IEC materials learning and academic activities. were distributed in Rann, Dikwa, Jere, Konduga and MMC LGAs during hygiene promotion campaigns where 10,345 Child Protection individuals were reached. UNICEF continued providing support to Almajiri children separated from their parents and affected by COVID-19. In In Adamawa state, 2,000 COVID-19 prevention posters were Kaduna, 12 out of the 55 children who tested positive to distributed to private health facilities, while 180 soap tablets were discharged having recovered from the disease, while were provided to a COVID-19 isolation center with an 210 out of a total 631 Almajiri children placed at the average of 20 person capacity in Adamawa state to support temporary shelter were reunited with their families. Another IPC measures 115 Almajiri children are receiving psychosocial support at a temporary shelter in Gombe while waiting to be reunited Education with their families, while an additional 331 children are With continued technical assistance from UNICEF, the expected to arrive from Adamawa. In Borno and Yobe, 64 Federal and State Ministries of Education provided children (32 girls, 32 boys) and 59 (31 girls, 28 boys) new opportunities to children to engage in learning through arrivals were provided with appropriate alternative care alternate home-based learning such as radio, television, arrangements. 18 out of 28 children (all boys) deprived of online and take-home learning resources. Thus far, over 10 their liberty were released from the remand home in Katsina million children are accessing learning and other academic State as part of the ongoing decongestion programme in the opportunities through alternate home based facilities in 22 face of the COVID-19 response. states.5 In accordance with COVID-19 safety protocols, UNICEF Continued support is also being provided in mapping, supported a step-down training of 35 community volunteers contextualising and development of educational scripts for in Ebonyi state as part of ongoing community sensitization radio and TV programmes. Support was provided in the of COVID-proofed integrated child protection messaging. development of communication and educative materials Inter-generational house to house community mobilization such as leaflets, audio and visual materials, kids books which sessions on ‘End FGM’ with integrated prevention of COVID- were disseminated to over 13 million children across 36 19 messages was conducted in three communities in Osun states and FCT. Small-scale assessment tools are being state with 484 persons reached in 39 households (287 girls, developed to measure the progress in learning to ensure 109 women and 88 men). 12 radio stations aired the End continuity and knowledge acquisition of children. Currently, FGM jingles and prevention of COVID-19 messages while remote monitoring tools such as U reports, WhatsApp’s #endcuttingirls messages were uploaded on six media groups, google forms are operational to monitor and platforms (Twitter, Instagram, Facebook, You Tube, Web site

5 Kano, Katsina, Jigawa, Borno, Yobe, Kaduna, Niger, Nasarawa, Adamawa, Bauchi, Gombe, Taraba, Zamfara, Sokoto, Ogun, Oyo, Osun, Ekiti, Ondo, Edo, Enugu and Bayelsa. and WhatsApp). The potential reach of the messages on including members of child protection committees, were Twitter between 8-13 May 2020 was 43,801 persons. taken through practical demonstration of hand handwashing, and social distancing in all UNICEF supported UNICEF also supported birth registrars to reach out to their CFS centers located within MMC/Jere and Konduga. communities and at the health centers to register births during the immunization process across the country. 42 personnel (21 women, 21 men) from UNICEF partners and Between 1-30 April 2020, at least 651,095 under-5 children child protection community volunteers were trained on GBV (330,874 girls, 320,2210 boys) were registered and out of the prevention, risk mitigation and case management, clear 651,095 under-5 registered during the COVID-19 lockdown, guidelines and referral mechanisms for survivors. In Bama, at least 55 % or 360,868 (181,122 girls, 179,746 boys) 31 survivors (17 girls, three boys and 11 women) who had newborn were registered.6 experienced violence were reached with support services including referrals for health, counselling, family mediation UNICEF supported the Federal Ministry of Women Affairs in integrated with COVID-19 preventive measures. convening the 10th Technical Working Group meeting on Ending Violence against Children (TWG EVAC). The virtual A total of 60,324 persons (3,898 boys, 3,556 girls, meeting deliberated on the process, structures, timeframe 19,215 women, 31,088 men, and 2,570 who indicated for the National Plan of Action on Ending Violence against neither their age nor gender) in Nigeria were reached with Children in Nigeria. The TWG deliberated on the protection against sexual exploitation and abuse (PSEA) ongoing response to COVID-19 pandemic as it affects messages through the U-Report platform and PSEA posters violence against children including validation of child on how to access safe and secure reporting channels for protection messages targeting children, parents and the allegations of sexual exploitation and abuse. Of this total, general public. Members further considered ongoing 19,765 persons (26%) were from conflict affected Borno, response to release children deprived of their liberty across Adamawa and Yobe states, while the remaining were the states, the prevailing challenges and proffered way reached across the nation. In addition, the PSEA reporting forward in accelerating actions to hasten their release. channels received 71 calls and 25 messages from the dedicated phone line and 14 email communications from the North-east Child Protection response dedicated email account from 19 states.7 Most of the callers A total of 2,265 children (1,703 girls, 562 boys) and sought for more information about PSEA, while a few adolescents; 512 community members (362 women, 150 reported cases of VAC and GBV and were referred to men) and three GBV survivors (all girls) received MHPSS and relevant services, while others called regarding accessing awareness on COVID-19 preventive measures including humanitarian aid. handwashing demonstrations across CFS and communities in over ten LGAs in Borno State. In Maiduguri, Bama and Biu Supply LGAs, the MHPSS services were provided via telephone. UNICEF provided 29,000 (60ml) hand sanitizers to the National Center for Disease Control (NCDC) as part of its UNICEF also reached 359 parents (151 women, 208 men) contribution to the COVID-19 response. and 58 children (33 girls, 25 boys) through community-based sensitization on hygiene promotion. The participants,

Adaptations to ongoing UNICEF programmes

UNICEF continues to support the federal and state governments in the delivery of essential services. Quantification of PPEs for community health workers under the CARAMAL project was done in Adamawa state. Discussions are ongoing at national and state level to explore ways to engage young people and youth in COVID-19 response involving generation unlimited (Gen-U), Innovation unit and NGOs. UNICEF in Akure adapted its programming to support state governments to continue provision of MNCH services and effectively monitor service delivery in the health facilities. In Ogun state, immunization sessions were conducted as planned. Furthermore, UNICEF Akure FO supported community sensitization in the state, which contributed to improved clients’ patronage for routine immunization during the month of April. In Ogun state, UNICEF supported the COVID-19 Command Center, which was launched to strengthen routine immunization (RI) services during lockdown so as to prevent post-pandemic outbreak of vaccine preventable diseases. The teams used an applied checklist to monitor coverage, vaccine availability, ante natal care (ANC) services, use of PPE and IPC compliance of Health workers.

6 See https://rapidsmsnigeria.org/br/2020/4. 7 Adamawa, Abuja, Lagos, Nasarawa, Ibadan, Borno, Delta, Benue, Kaduna, Akwa Ibom, Cross River, Yobe, Gombe, Ondo, Taraba, Kano, Ebonyi and Imo

The emergency procurement process for WASH projects reprogrammed for COVID-19 response has progressed rapidly with the opening of bids for facilities in eight states (Kano, Yobe, Jigawa, Bauchi, Benue, Katsina, Kaduna and Zamfara states). State and LGA supervisors have been mobilized to ensure quality supervision of works and contract management. In four UNICEF supported LGAs in Benue state, WASH units reviewed strategies and plans for community approaches to total sanitation to adjust tools to respond to COVID-19 prevention protocols.

Funding Overview and Partnerships

The Nigeria CO has developed an updated response plan outlining gaps and needs, COVID-19 proofing measures and response activities across all sections. USD 65 million is requested to support the government to respond to COVID-19 and reach an estimated 20 million Nigerians. ECHO Nigeria has provided UNICEF with 1.2 million Euros to support in risk communication and life-saving health and WASH supplies.

External Communication

UNICEF has aligned with global campaigns on COVID-19 and has been disseminating information through its social media network (Twitter: Facebook, Instagram).  A story highlighting the lifesaving work of health workers in saving newborns in hard-to-reach areas was published for International Day of the Midwife. The story was featured on UNICEF global channels as part of the “Every Child Alive” campaign.  Social media posts this week focused on eliminating stigma for COVID-19, the importance of children continuing education and how parents can help to create a sense of normalcy for children.  A press release highlighting the risks faced by displaced children in the COVID-19 crisis was issued to media and received widespread media coverage, including a television interview by the UNICEF Nigeria Rep on TVC.  A social media pack was created for the NCDC to assist in NCDC amplification of child rights messaging in its communications.

For more Peter Hawkins Claes Johansson Gillian Walker information Representative Deputy Representative a.i. Emergency Manager contact: UNICEF Nigeria UNICEF Nigeria UNICEF Nigeria Tel: +234 (0) 803 402 0870 Tel: +234 (0) 906 206 6637 Tel: +234 (0) 803 403 5235 Email: [email protected] Email: [email protected] Email: [email protected]

Annex A

Summary of Programme Results UNICEF and IPs Response

Sector 2020 target Total results8

Risk Communication and Community Engagement Number of people reached on COVID-19 through messaging on prevention and access to services 22,000,000 17,595,190 Number of people engaged on COVID-19 through RCCE actions 22,000 18,855 Number of people sharing their concerns and asking questions/ clarifications for available support services to address their needs through established feedback mechanisms” 2,020,000 601,586 WASH and IPC Number of people reached with critical WASH supplies (including hygiene items) and services 1,340,782 248,889 Health Number of children and women receiving essential healthcare, including prenatal, delivery and postnatal care, essential new-born care, immunization, treatment of childhood illnesses and HIV care in UNICEF supported facilities. 6,061,266 1,543,758 Number of healthcare workers within health facilities and communities provided with Personal Protective Equipment (PPE) 780,586 27,184 Number of healthcare facility staff and community health workers trained in Infection Prevention and Control (IPC) 20,000 24,718 Number of healthcare providers trained in detecting, referral and appropriate management of COVID-19 cases 8,548 18,712 Nutrition Number of children 6-59 months admitted for treatment of severe acute malnutrition (SAM).9 558,189 66,330 Number of caregivers of children aged 0-23 months reached with messages aiming to protect breastfeeding in the context of COVID through national communication campaigns. 656,000 180,676 Education Number of children supported with distance/homebased learning 17,500,000 10,014,940 Child Protection and GBV Number of children without parental or family care provided with appropriate 29,500 alternative care arrangements 1,573 Number of children, parents and primary caregivers provided with community 2,605,000 based mental health and psychosocial support10 102,219 Number of children and adults that have access to a safe and accessible channel 498,067 to report sexual exploitation and abuse 121,439 Number of UNICEF personnel and partners that have completed training on 1121 VAC/HP/GBV risk mitigation and referrals for survivors11 473 Social Protection Number of households (affected by COVID-19) receiving humanitarian multi- 120,000 - sector cash grant for basic needs

8 Results are cumulative from March 2020 9 Target is calculated as all children with SAM from March 2020 to December 2020 including HRP, HRP addendum and estimated caseloads 10 Indicator broken down to 5,000 CP and 2,000,000 Education and 100,000 CP and 500,000 Education (NE) 11 Indicator broken down to 250 CP and 500 Education and 221 CP and 150 Education (NE)