Annual Performance Report, FY2020 October 1, 2019 to September 30, 2020 Asili 2.0: Scaling for Sustainability in the Kivus USAID/ARC Cooperative Agreement No. 72066018CA00002

Annual Report, FY2020 Performance Period: October 1, 2019 to September 30, 2020 Submitted: August 15, 2020

Key Mission Staff: Submitted to AOR: Amy Stenoien Alternate AOR: Benjamin Skolnik

ARC Contacts: Country Director: Abraham Leno, [email protected] Business Specialist: Tad Lunden, [email protected] Field Operations Manager: Valery Namuto, [email protected] Global Support Coordinator: Jane Stockman, [email protected] Reporting Catalyst: Jonah M. Dister, [email protected]

2 TABLE OF CONTENTS

Program Overview Page 4 Summary of Activities Page 5 Monitoring and Evaluation Page 12 Implementation Challenges Page 13 Management and Administration Page 14 Upcoming Plans for Next Quarter Page 14

3 PROGRAM OVERVIEW Asili 2.0 is a co-creation of USAID, private sector partners, communities of eastern Congo, and ALIGHT, which strives to create empowered communities through the provisioning of meaningful, high-quality services. Asili was designed recognizing that state institutions cannot adequately address the needs of many communities within eastern Congo, nor is it desirable for the donor community to play the role of stopgap ad infinitum. The social enterprise model creates accountability to the communities in which we work, ensuring that Asili responds to their needs in a way that speaks to them with dignity and brings the value they deserve. This growth phase of Asili is a project funded by USAID with implementation beginning March 30, 2018 and running through March 29, 2023.

a. Project Purpose and Objectives

Goal: To scale a sustainable social enterprise platform to create healthier, more resilient, economically empowered, functional communities in .

Objective 1: Through co-creation with private partners, develop viable business models for the delivery of bundled social services through a platform at scale

Objective 2: Improved access to clean water and health services in target communities

Objective 3: Quality standards of clean water and health services maintained in target communities

b. Technical Approach

Asili is a member-driven hub of complementary social businesses that are located within zones of approximately 25,000 people. The initial businesses – agriculture, health care, and clean water – were selected due to their potential to immediately contribute to healthier, more resilient, and economically empowered communities. Asili will continue to expand and grow utilizing the frameworks and tools developed within the initial pilot phase. In addition to expansion of the current service package to six additional zones, Asili will capitalize on the opportunity to use the same proven platform to launch new businesses with similar values, such as sanitation and energy.

c. Zones Locations and Identification

Asili 2.0 is the second co-creation project with USAID, the community, and private sector partners, funded through a USAID Global Development Alliance (GDA) cooperative agreement. Under the first GDA, water, health, and agriculture business lines were built in four Zones: Buhanga, Cirunga, Mudaka, and Panzi. Under Asili 2.0, water and health business lines will be

4 built in six additional Zones, which we will refer to as numbers (Zone 1, Zone 2 . . . Zone 6) until a location has been identified for the Zone. To date, the Ciriri area has been selected for Zone 1 and the Camp TV area has been identified for Zone 2. We have identified and selected as the next site to implement Zone 3 and 4. Some characteristics of this city are listed below. Minova is a town in the of South Kivu Province in Eastern-DRC and is an important business center for farm and fishery products in Kivu Province. It is very close to Island in Masisi Territory and the northwest shore of Lake Kivu, and is only 45 km from the city of Goma. The development of this place is linked with important chapters in the history of displacement and migration in recent history. Refugees from Rwanda in 1994, displaced persons from Masisi in 1992–1997, and others migrating from surrounding areas have made Minova and Kalehe Territory their home in the last several decades. The migrations of refugees and associated humanitarian presence led to the relatively recent acceleration of growth and development of Minova. The discovery of and mining of minerals, such as columbite-tantalite, discovered in nearby mountain ranges (Rubaya, Numbi, Nyabibwe, and Kalungu Mountains) has also significantly contributed to the development of this area.

Photo 1: Minova and its surroundings - In yellow: ASILI water and heath care services - In blue: ASILI/ECI grantee activities

Minova is a promising market for a community-run social enterprise in water services. There are existing gravity-fed piped water distribution systems in the area, most of them in various states of disrepair due to community-based management systems failing after the expiration of the humanitarian programs that started them. This area is also a home to small-hold coffee producers where water is in demand for both the household needs and agriculture.

5 We have identified and selected Minova as the next site to implement activities for Zones 3 and 4. All the new areas targeted during this GDA will include activities related to health care services as well as access to drinking water. During this reporting period, Asili conducted an assessment activity to determine Minova’s potential for various activities and approaches, and the process of cross-checking and verifying the assessment data is ongoing. Additional details from the assessment will be shared with USAID in the next quarterly report, but preliminary findings are described below. Six water sources (Nyamadwidwi, Kihata, Kishinji 2, Kitalima, Kinyamuheke/ Buhumba, Kalambairo) have been identified. The consistent water flow from the mountains will be able to supply clean water to the targeted population in the city. The existing water sources identified by the assessment pose an opportunity to implement the gravity-based water system. Minova has 19 health care Zones, and Asili has identified four areas in the city of Minova where the access to clean water is still the biggest challenge. The Asili network can be extended to other areas in the future, but the locations where cholera rates are highest will be prioritized for water services. The following table displays a list of the initially targeted areas withing Minova: AREAS WATER WATER POINTS OPERATIONAL WATER POPULATION SOURCES POINT A.S. BUHUMBA 7 3 0 10,401 A.S BULENGA 3 5 1 18,813 A.S. BWISHA 5 11 2 8,127 A.S. CHEA 1 1 1 11,861 Total 16 20 4 49,202 Asili has initiated the first activities for identification of Zone 5 and Zone 6. The planned primary location for these zones is the south of , which is Territory. Nothing has yet been done in the Uvira area, given the slowdown in activities linked to accessibility and mobility of people and the restrictions and protection of staff due to the COVID-19 pandemic. The submitted 2020-2021 work plan mentions that the site identification, assessment, and selection for Zone 5 and 6 will be completed in FY2021.

SUMMARY OF ACTIVITIES

1. Project Components/Objectives

Objective 1: Through co-creation with private partners, develop viable business models for the delivery of bundled social services through a platform of scale.

IR 1.1: Asili core business lines (health and water) demonstrating operational financial viability.

6 Description The five-year goal is to ensure that Asili’s core business lines of healthcare and clean water sales are generating $7,700/month of profit per zone. These combined revenues would then be able to effectively cover the central corporate management costs for shared services such as finance, supply-chain management, human resources, compliance, and executive services.

Key Activities for Performance Period • Health care implementation in Zones 1 and 2 After receiving the confirmation that the SOS village clinic was no longer for sale, we decided to explore other alternatives to implement health care services in Zones 1 and 2. To better serve the community, Asili is considering other business lines that meet the needs of the population and can contribute to filling gaps in the DRC health system, especially within Asili’s implementation zones. Potential alternative health services being considered by the Asili team include a diagnostic center, and Asili dental health clinic, and a scaling up of health services to a health center level. These opportunities are further described below. 1.1.1. Diagnostic center Diagnosis plays a key role in improving the quality of health care. Confirmation of clinical diagnosis by additional testing is a given in most western countries. In underdeveloped countries, the diagnoses are often strictly clinical, as laboratory and imaging services are unavailable. Clinicians are obliged to treat patients using these limited resources, often with non-conforming prescriptions. The current situation in the region, amid the coronavirus pandemic, has further exposed the weaknesses of the region’s health system. One such gap is the need for additional screening capacity for COVID-19. The diagnostic capacity regarding COVID-19 is still very low with an average of 350 confirmation tests per day for the whole country. Asili has a network of health clinics providing primary health care focusing on providing quality health services. Expanding Asili clinics’ diagnostic capacity has consistently been one of the main demands of the community and will improve the quality of care provided to our customers. An Asili Diagnostic Center that would offer services of both high quality and adapted to the standard of living of the community we serve. A diagnostic lab would allow for provision of PCR testing and laboratory analysis for COVID-19, as well as imaging. A diagnostic center would also play a key role in epidemiological surveillance given the threat of zoonotic diseases and other epidemics in the region. 1.1.2. Asili dental health clinic Even as the technological aspects of dental practice in developed countries make rapid progress, people in rural areas of developing and underdeveloped countries continue to be deprived of basic oral health care. In the zones where Asili operates, most of the hospitals do not provide basic oral health services. 7 Oral health services are mostly offered by regional or central hospitals of urban centers and little, if any, priority is given to preventive or restorative dental care. Patients who need treatment for oral disease are referred for treatment in an urban area with all the transportation and other costs that come with that access solution. In addition, rates of addiction to unprocessed alcohol and tobacco among the region’s population create major risk factors for oral diseases. Attracted by low cost and easy access, people seek treatment at the nearest traditional healer for oral surgery like dental extraction despite the high risk for complications. Developing a specialist healthcare service such as a dental health clinic in Asili zones can build on the progress already made while filling healthcare gaps needed by the community. 1.1.3. Scaling up clinic services to the health center level A health center is a first-line facility responsible for health care activities at the primary care level. A health center must cover a sufficiently large population (10,000 inhabitants per 8km2) to warrant the development of the necessary infrastructure. One of the main functions of a health center is to ensure the care of the population of the area by offering a minimum package of care activities according to national standards. To be defined as offering the minimum package of care activities, a health center must have the following services: reception, consultation, treatment rooms, maternity services, overnight stays for inpatient treatment, laboratory services, and a maintenance room. Outcomes from the one Asili clinic piloting overnight stays for the first time have shown that this service can increase utilization and ensure minimum profitability necessary for the continuation of the basic activities. The end of the COVID-19 crisis, or changes in restrictions associated with the crisis allowing our customers and our staffs to move freely around the area, will present an opportunity to relaunch Asili’s surveys and research that will determine the best plan of action for service delivery. For Zones 3 and 4, which we currently locate in Minova, we have already carried out surveys for the existing services offered by different stakeholders, either government, international organizations or private organizations, to so that we can be able develop the best implementation strategy in the health domain, given to the experience we learned under our previous GDA ASILI 1.0

IR 1.2: Completed pilot clean energy business line running

Description Asili is a social enterprise platform with three core components: a unified brand, management tools and practices, and a business model that is designed with bottom-of-the-pyramid consumers. Therefore, the core of Asili is agnostic to the services that are provisioned and was designed to accommodate the introduction of new offerings to our customers. Customers within South Kivu have a hard time attaining affordable and continuously accessible electricity. Asili will develop and pilot a clean energy business line within the five-year cooperative

8 agreement. Key Activities for Performance Period Implementation of some energy activities was planned for FY2020. Unfortunately, the COVID-19 situation affected the implementation of all planned activities. Movement restrictions prevented travel and community engagement necessary for conducting household surveys and thorough community assessments. Nevertheless, certain activities were still conducted at the beginning of FY20. As Asili has always done for the other services currently offered, namely drinking water and health care, the Asili team is committed to the principle that a social service works well when it is designed with the community and for the community. It is with this design principle in mind that the Asili team organized sessions for experimentation with certain tools and equipment in the energy field, to understand what the community desires and finds interesting. Community experimentation has taken place pertaining to the usage of the following tools and equipment: • A complete kit of 4 bulbs and a solar panel • A gas stove • A solar stove with 2 bulbs, a radio and a socket to charge 2 telephones. A group of community members was selected to experience this green and renewable energy equipment in a hands-on experimental session. This session was guided by two main objectives: A) Explain and demonstrate the environmental issues (deforestation and air pollution) of using wood charcoal B) Demonstrate the new efficient, easy, and inexpensive energy technology systems. Twenty families were invited, represented by two persons each. During the questions and answers session, we received general questions from our future customers in green energy related to their biggest concerns such as: • Pricing system for equipment • Durability and functional lifespan of equipment • Supply chain of equipment and dependence on Asili’s presence • Maintenance and repair availability and access • Planned availability timing and duration from Asili

9

Photo 1: Demonstration solar stove with 2 bulbs, a radio, and a socket to charge 2 telephones

Photo 2: Demonstration of gas stove

10 A cooking competition session was an important component of community experimentation and feedback. One group prepared food with the gas stove and another with the solar panel stove. In this competition, we gathered the appreciation of women regarding the ease of lighting the stove, the ease of use, the preparation time, the level of heat produced by the equipment, and their perceptions of the functionality of the two stove types. It was concluded that customers appreciate the solar stove, especially because it does not require a resource re-supply like gas, and because the solar stove has an integrated radio to listen to during food preparation. Customers also expressed enthusiasm for the affordable pricing of the equipment. Photo 3: Cooking competition The development of this service requires a follow-up step consisting of co-designing the product with the community members and determining from these customers how this service should work. Unfortunately, the coronavirus pandemic prevented the planning of such follow-up meetings with the community members. The Asili team has been working on innovating means to conduct project activities within the coronavirus pandemic context. During the next fiscal year (FY2021), the Asili team plans to develop a model that will allow services to be fully operational while observing the measures necessary for the protection of our staff and the community we serve. Asili’s model for service delivery in the COVID-19 context will also have to be aligned with the government's health plan. IR 1.3 Completed pilot sanitation business lines running Description A social enterprise platform like Asili draws its strength from its capacity to evolve new business lines to meet pressing social needs. For example, eastern Congo faces recurring epidemics of waterborne illnesses such as cholera. The provision of clean water can go a long way to decreasing the incidence of cholera, but there are more steps along the sanitation safety chain that are not accessible to all citizens. Asili will use human-centered-design to develop and pilot a sanitation service within the five-year agreement to improve the lives of our customers. Key Activities for Performance Period During this reporting period (FY2020), due to restrictions caused by the coronavirus pandemic we did not conduct this activity as planned. This activity is still in the Human-Centered creation/prototype conception stage. As reported during the last reporting period, Asili is a proponent of the waste-to-value approach. Asili

11 regards sanitation as a service that transforms waste into useful products in the contexts of the peri urban and urban informal settlement areas where massive, piped sewage infrastructure is unrealistic at this time. Asili’s research on the applicability of the “Sanivation” and “Sanergy” approaches provided insights on the opinions of the potential customers on these solutions in which provide serviced toilets with or without mobile receptacles. Customers find these solutions attractive as they do not involve depositing waste in pits and do not produce odor or attract flies. Given the complexity of waste treatment upon removal, Asili is currently more inclined to test a model in which waste is transformed into fertilizer (“Sanergy” and similar models). Mudaka market has been identified as a potential prototype location for this model. In this likely prototype site, a humanitarian donor has already produced gender-segregated dischargeable latrines from permanent materials, which are currently not in use. Mudaka is the biggest market in the region, and Asili already provides health and water services in the vicinity. The Asili team has already engaged the market management committee to gain understanding as to why the existing permanent latrines are not presently functioning. Asili is currently defining the specifics of the service model and requirements for a composting site. A prototype for this new sanitation service was previously planned for this year. The restrictions caused by the coronavirus situation have significantly reduced the Asili team’s movements in the field since March thus preventing this planned prototype process. IR 1.4: Partnerships developed for further agricultural and economic development opportunities Description The overall goal is to grow the demand for complementary social services/goods such as healthcare and water, through increasing the economic output of each Asili zone. This will be achieved through site-specific strategies that fall into three broad categories: growth through partnership, integration of tools and services that have a wide scope/appeal, and incubation of public- private partnerships that meet a market need. Key Activities for Performance Period • Asili did not conduct any activities in this quarter for this IR; these activities will begin in FY2021 as described in our initial work plan and M&E plan.

Objective 2: Improved access to clean water and health services in target communities IR 2.1: Access to health services improved Description Increasing access to affordable, high-quality health services is a principal driver of creating thriving, resilient communities. Over the course of the five-year cooperative agreement, Asili will create and operate six health services in six zones. The anticipated cadence will be to create two facilities/services per project year for three years and then have a two-year period of operating those facilities.

12 Key Activities for Performance Period • New electronic medical record (EMR) minimum viable product (MVP) deployment • After conducting the test for MVP for our new Electronic Medical Record, the Asili health team, with the Vecna Cares team, were working on organizing the MVP deployment which is centered around users. The aim of the deployment was to create: o Seamless and secure installation of ClinikPAK hardware and associated peripherals o Centralized training with focus on core aspects of the solution and gauging of user comfort levels. o Identification of super and potentially struggling users among the nurses. o Dedicated training of technical super users including shadowing during the installation process. o Provision of elbow support to users with the aim to observe usability and collect feedback. o Seamless transition of tier 1 app support to super users, and clear articulation of the escalation process. Adapting existing services to the COVID-19 pandemic context During this reporting period, a suspected COVID-19 patient received a consultation in an Asili clinic. The fact that our nurses were trained and prepared served us well. In collaboration with the government COVID-19 response team and with the support of civil society, our nurses and managers acted quickly and effectively to protect the patient, other customers, and the community. The nurses followed our COVID-19 guidelines: • The nurses who treated the patient used appropriate personal protective equipment. • The patient was isolated overnight in a room prepared for this purpose. • The health management team alerted the COVID-19 response team, and an investigation team came to the Asili clinic. The patient was validated by the investigation team which sent his sample for testing and transferred the patient to the quarantine facility selected by the government through the Ministry of Health. Due to the large community Asili serves, from the beginning of the COVID-19 outbreak, Asili has taken important steps to participate in the prevention of the spread of the virus by setting up a contingency plan. We approached that plan in a way that ensured that each health activity (specially on the clinic side) can continue, and our clinics will stay open regardless of the level of the outbreak. We began by meeting with the provincial MOH (Ministry of Health) and other partners to get feedback on implementation during the ongoing pandemic. Below are some steps we followed to keep us working during a COVID-19 outbreak: • Pre-positioned supplies in clinics to cover a longer period and avoid frequent trips for re- supplying • Organized the training of staff and partners • Increased the awareness of staff and clients in Asili clinics and water points. We designed and produced key health messages for our clients regarding COVID-19 prevention. • Positioned key personnel in clinic areas with provisions to support their capacity to stay on-site and to ensure that supervision and coverage of activities would continue • Recommended and followed the hygiene protocols that have been put in place since the COVID-19 announcement by placing hand washing stations at every entrance to every 13 clinic, water point, and office. • Prohibited physical contact as much as possible • A sitrep on COVID-19 was organized on a weekly basis and shared with USAID. Staff protection: • Staff have been provided with protective gear and trained on how to protect themselves during this period. • At the office level, we are currently conducting screening for all staff and visitors coming to the offices. • To manage social distancing, we have created a rotational schedule. Staff work in shifts; those that work this week stay home the following week to manage numbers in the office. • Managers have been facilitated with internet to enable them work from home. • Staff are also provided with transport from home to office and back from office.

In a situation of a complete lockdown we have planned to: • Seek authorization from the government for key staff to continue working • Use mobile money as a way of collecting cash at water points The fact that we referred a patient for quarantine raised questions first from those who were close to the patient, but also in the community. This inspired us to design another communication tool (flyers) in the form of questions and answers linked to COVID-19 basic information, isolation procedures, and treatment. We collected a group of questions frequently being asked by the community. After printing we made those flyers and poster available at the clinic and water points (flyer shared as annex in previous Q3 report submission). IR 2.2: Access to potable water source(s) improved Description The multi-sectoral approach of Asili relies upon complementary supply-side businesses to increase the social outcomes. So just as there will be six new health services over the course of the five-year cooperative agreement, Asili will also create and operate six new water retail systems. The anticipated cadence will be to create two systems per project year for three years and then have a two-year period of operating those facilities. Key Activities for Performance Period During this reporting period (FY2020), Asilit worked to improve control of the water system at the technical and management levels. To deal with the variations in daily consumption, especially during the dry season when the water requirements are very high, we have increased the water supply from the Ferme Agricole Pilote source. This source allowed us to stabilize the production of water, reduce the waiting time at the tap, and predict the stability of the water source during the dry season.

14

Photo 4: Water source Ferme Agricole Pilote; 4 L/s supply Expansion - New Zones 3 and 4: Asili has developed the Zone 3 implementation program located in Kalehe Territory, specifically in Minova. Minova is a city which has suffered for a long time from many water shortage-related problems, including a very high rate of cholera. The amount of water available at Minova is not sufficient for its population, and the gap to cover is significant. There are some existing water points where water is present two or three times a week, but these water availability times are often marked by poor quality because the sources are not protected; the water pipes are sometimes contaminated or broken.

Photo 5: Existing water point in Minova

15

Photos 6 & 7: Existing Minova water point (Nyamadwidwi)

Photo 8: Minova existing water point (Kashinji) The Asili team has already identified some possibilities for implementation in Minova, such as a source of drinking water, and we have identified the few points where it is possible to associate the Asili brand with quality and availability of service. The Asili team planned several activities during this period: among other things the chemical and bacteriological analysis of the spring waters that we identified in the Minova area. In addition to that activity, certification of the water sources, beginning the preliminary work of development of the water sources, issuing the purchase order of the pipes, and the identification of locations of potential places to build the water points were all planned. It is also necessary to conduct an environmental analysis for the respect of the environment and to safeguard ecology. Given that this site is located more than 60 kilometers from Bukavu, and because the government had placed restrictive measures due to COVID-19, the Asili team was unable to carry out these activities during this pandemic period. However, Asili is positioned to identify the ways and means to conduct these activities in FY2021.

16 To date, Asili has developed and strengthened its relationship with Nespresso. • Nespresso officially launched the Congo single origin coffee for the US market on August 18th and will be including Asili/ECI in all of their press materials. • The Swiss market has chosen Asili as a recipient of a new program that they are running where each purchase comes with the opportunity for the consumer to choose where a donation is being made. This program will be launched in 2021. • In partnership with TechnoServe, OLAM and Conservation International, Nespresso has submitted a concept to USAID to expand their sourcing to the area surrounding Kahuzi- Biega, spanning from Kalehe down to Kabare. In different conversation Nespresso would like ASILI/ECI to be part of the consortium. • Asili has been selected as one of five finalists for an award for innovation in Public-Private- Partnerships. There will be a large virtual conference and programming that will be a great opportunity to promote social entrepreneurship and potentially highlight our partnership with USAID/Nespresso about transforming aid into capital, a concept developed by ASILI/ECI Objective 3: Quality standards of clean water and health services maintained in target communities IR 3.1: Quality of health services improved Description Healthcare is an evolving field, and many health structures and organizations within the Democratic Republic of Congo have not kept up with the advances in the field. There has been a lack of adequate investment in human capital across the healthcare industry. Since all Asili healthcare practitioners are Congolese, and the majority were trained within the local health system, it is necessary to work to bring their methods and practice in-line with 21st century international standards.

Key Activities for Performance Period COVID-19 Pandemic Response 1. Effectiveness of new EMR MVP deployment. The Asili medical team and the VecnaCares team launched the new Medical Record Minimum Variable product. The deployment consisted of: • Setting up the new EMR with credentials for all end users in each clinic • Training session to build capacity on the use of the EMR. A user manual was provided to all the nurses. • Provision of end-user support to the nurses for their first week of use • Going live with the EMR the second week with the nurses being able to register patients in the EMR system.

17 • Collecting feedback from the end-users and preparing upgrades to be downloaded in future iterations of the EMR. The next action to take in our EMR development plan are to add a new tool in the EMR: The National System of Health information (SNIS) 2. COVID-19 Pandemic Response In early March, the DRC confirmed its first case of COVID-19 in Kinshasa, and soon after, the president announced a state of emergency covering the whole territory of the DRC. The North and South Kivu provinces were vulnerable to the disease spreading from Kinshasa in the west and from the neighboring countries in the east (Rwanda, Uganda). To help the country and our community respond to the COVID-19 pandemic, the Asili team took action on two priorities: 1) Protecting the safety of our staff, our customers and communities we serve 2) Maintaining uninterrupted services at Asili healthcare services and water points To protect our staff and customers: • We procured additional protective equipment, and additional hand washing stations were installed in our clinics. • Nurses were trained on prevention and control of infection focused on how to use the protective equipment. • Nursing staff at Asili clinics have been asked to remain in place for two-week shifts. To maintain Asili services: • Medical supplies covering at least 4 months were purchased from our pharmaceutical distributor. • Asili’s health care team created posters and brochures about COVID-19 in French and Swahili to help spread the word. • The Asili team is also providing weekly updates on public health and social impact in South and North Kivu to help our partners respond to the COVID-19 pandemic. • We collect daily feedback from the community, which allows us to design proper communication tools. IR 3.2 Quality and safety of water supply service improved Description The Asili difference in clean water is not due to the gravity-based system or the retail infrastructure – those are enablers, in service to the business model. The revenue collection and financial management is a means to continue to offer a managed service. Asili systems are built under grant funding but operable for decades to come. The continued testing, analysis, and remediation of Asili water sources and systems creates a durable life-saving service that communities can continue to count on. Key Activities for Performance Period • Asili has put into place a program to inject chlorine into the water storage tank. Now

18 this process is permanently in place to ensure the consistent quality of the water. Every morning, plumbers check the level of the water in the reservoir, and according to the Asili chlorination manual, they apply chlorine to the water to maintain safety. The residual chlorine level is always ensured by measurement of free residual chlorine using the comparator test and DPD tablets as a reagent. • Asili is working with other organizations to develop a system for automating the chlorination process with remote sensing and control technology to ensure a consistent quality of the water using free residual chlorine to prevent contamination over the subsequent 12-24 hour period between manual water treatment and water consumption by the customer.

Photo 9: Designs for possible automated chlorination system

Photo 10: Hand washing station at Asili water point Photo 11: Water chlorination for handwashing

19

Despite the coronavirus situation, the Asili team has not tolerated any negligence on the protection of the Asili brand and the quality of its services. It is true that the team works under reduced service conditions at this time, but we continue to retain a strong control of our services and maintain our commitment towards the community, especially since we offer a vital social service. In order to respect hand washing during this coronavirus pandemic, we have placed hand washing stations in the Asili water points so that each customer, before accessing to the water point, will have to wash his or her hands properly with chlorinated water and soap. IR 3.3: Improved knowledge and behaviors related to safe treatment, storage, and use of potable water at the household level. Description Asili retail points represent a distribution network that will reach 125,000 customers by the end of the five-year cooperative agreement. Furthermore, the water retail point serves as a daily interaction for customers – sometimes several times per day. Asili will capitalize on this interaction and brand affinity to market to our customers regarding water safety and storage and the risks and prevention strategies for cholera and other water-borne illnesses. Key Activities for Performance Period In the sensitization program, due to the presence of COVID-19, we organized only one type of activity in the final quarter of the award: • Sensitization of women at the Asili Clinic during vaccination and prenatal care

The following table details the number of individuals sensitized during the reporting period (FY2020): Children Adults Age TOTAL Male Females Male Females range 2,130 1,586 559 4,356 8,631 6-8 690 296 0 0 986 9-11 734 482 0 0 1,216 12-14 532 512 0 0 1,044 15- 18 174 296 0 0 470 19-40 0 0 227 2,713 2,940 40 + 0 0 332 1,643 1,975

Months before the coronavirus situation was declared a pandemic at the global level and country-wide within DRC, the Asili team carried out education and prevention activities on the

20 disease risks related to poor hand hygiene such as cholera, other forms of acute watery diarrhea, typhoid fever, and others. The following photos depict these sensitization activities

Photos 12 & 13: Sensitization at Majirane primary school

Photo 14: After hand washing sensitization session at Mavuno primary school MONITORING AND EVALUATION

21 The following indicators were reported in the standard template and submitted to the USAID/DRC Online Data Portal for FY2020.

1. # of people gaining access to basic sanitation services as a result of USG assistance

- Reporting period indicator target FY20: 13,000 - Reporting period indicator progress realized FY20: 0 - FY21 target: 24,000

Note: We had planned to launch this activity at the same time with the health care service in Zones 1 and 2. This activity is planned to be prototyped in FY21

2. # of farmers & others who applied improved technologies or mgmt practices w/USG assistance

- Reporting period indicator target FY20: 8 - Reporting period indicator progress realized FY20: 0 - FY21 target: 55

3. # of people gaining access to safe drinking water services as a result of USG assistance

- Reporting period indicator target FY20: 130,000 - Reporting period indicator progress realized (FY20, Q3): 122,486 - FY21 target: 168,000

Note: This is the customer base. Unfortunately, accurate gender disaggregation was not possible this quarter. Gender-disaggregated data provided in the DRC Performance Data online portal is an approximation based on the estimated population ratio of 50% male, 50% female.

4. # of people sensitized in cholera risks, prevention/response, and treatment

- Reporting period indicator target FY20: 12,800 - Reporting period indicator progress realized FY20: 8,631(5,942F, 2,689M) - FY21 target: 18,400

Note: We did not reach the target due to the situation of various government restrictions to avoid the spread of COVID-19. Given that gatherings were forbidden in this period, we decided to use the sensitization activities during prenatal consultations as an opportunity to provide individualized sensitization on cholera risks, the safe use of drinking water, and proper hand washing. The presence of men in these figures is due to their presence accompanying their wives to pre-natal care appointments. This awareness-raising took place with strict respect for social distancing.

22 IMPLEMENTATION CHALLENGES We will be starting the implementation activities of the new Zones 3 and 4, which are outside the city of Bukavu, about 142 km away, and 47 km from Goma. This distance is one of the challenges that we intend to manage via a new management structure. Minova is a city where humanitarian services have been promoted without contribution from the community, leading to unsustainability. We have initiated an approach with community leaders to address this challenge. The coronavirus situation has been a challenge because of different measures in place that have restricted activity implementation. We have reduced the number of visits to the Zones, changed our working system to rotate staff, and certain activities have been suspended to avoid the spread of the virus. MANAGEMENT AND ADMINISTRATION We are pleased to announce that Eastern Congo Initiative (ECI) has joined with Alight as a part of the Asili alliance. ECI brings nearly 10 years of experience in amplifying Congolese solutions and voices, as well as a strong network of supporters interested in building a stronger Congo together.

UPCOMING PLANS FOR FY2021 Below are some key activities planned for FY2021: - Health care implementations in Zones 1 and 2 - Zone 3 and 4 implementations and launch - Energy sector o Co-creation session with stakeholders to map areas for assessment o Identification of potential area of implementation - Sanitation sector: o Co-creation session with stakeholders to map areas for assessment o Identification of potential area of implementation - Zone 5 and 6 surveys and assessment

23