QUARTERLY REPORT Project Name: Preventing the spread of EVD in Liberia through Community Engagement and Surveillance Country: Liberia Agreement Number: AID-OFDA-G-15-00016 Reporting Period: December 2014 - March 2015 Contact Person: HQ: Sue Gloor, Program Officer Field: CARE Liberia Office OVERVIEW Provide a general overview of the projects activities and some of the highlights of implementation. This should not be more than 2 paragraphs. (200 words maximum) In 2014, West Africa recorded the highest number of Ebola cases since its inception in the 1970s. In October 2014 the increasing number of Ebola cases and deaths was a growing concern in Liberia, one of the three countries hard-hit by the 2014 Ebola Virus Disease (EVD) outbreak. Humanitarian organizations supported government initiatives through the establishment of Ebola Treatment Units (ETUs) and Community Care Centers (CCCs) by providing human resources, particularly healthcare workers and technical support in Water, Sanitation and Hygiene (WASH) as well as supporting with construction and management of these facilities. However, an increasingly important component of the overall Ebola response is social mobilization through community engagement with emphasis on behavior change with the aim to cut transmission rates. CARE engaged communities through local networks and leadership structures to influence the will of the people to participate in the Ebola response process. CARE coordinated with county and district health teams and trained 600 (male: 443 and female: 157) local leaders to create buy- in and support to the development and implementation of the Ebola response plan in coordination with the Ministry of Health & Social Welfare (MOHSW) and other humanitarian agencies. In support of the Liberian Government’s request to reopen schools, CARE coordinated with the Ministry of Education and trained additionally 191 (male: 138 and female: 53) local teachers and decision makers who would lead the awareness exercises at school campuses and at business areas. In February and March 2015, CARE also trained 300 (male 244 and female 56) Community Health Workers (CHWs) and provided technical and logistical support in reaching more than 101,474 community dwellers (45,366- male and 56,108- female) with social mobilization and community health education in effort to cut transmission rates in the five counties of Grand Gedeh, River Gee, Grand Kru, Maryland and Sinoe. SECTOR 1 NAME: HEALTH Objective: To contain the spread of EVD through community health education and surveillance Subsector 1 Name: Community Health Education/ Behavior Change For each subsector, provide a more detailed description of the activities carried out over the reporting period. This should be about 150 words per subsector. Summary Description of Activities undertaken from December 2014 to March 2015 The following activities were undertaken: CARE hired and trained fifteen (15) staff (5 County Coordinators and 10 Social Mobilization Officers) in EVD awareness and prevention. They worked with 60 County and District Health members in the five counties of Grand Gedeh, Grand Kru, River Gee, Maryland and Sinoe to conduct training of Community Health Workers (CHWs) commonly called community volunteers or general community health volunteers (gCHVs) and local leaders (including town chiefs, religious leaders, businessmen, teachers, parents and other community decision makers). The training of CHWs and local leaders commenced in the latter of February 2015 due to some delays in the procurement and delivery of project inputs from abroad (e.g. vehicles, laptops) and the printing of approved Ministry of Health (MOH) messages (SBCC) used to trained CHWs. However, three hundred (56 female and 244 male) CHWs and six hundred (157 female and 443 male) local leaders were trained in household health education, hygiene, and behavior change practices using the Social and Behavior Change Communication (SBCC) approved by the Ministry of Health & Social Welfare of Liberia. The three hundred CHWs were engaged in holding 109 focus groups and training sessions on EVD prevention education. They led in community-based surveillance reporting using cell phones, bicycles and megaphones provided by CARE. The proposed target population was 399,646 people or 79, 929 households (HHs). Following the distribution of districts and communities to humanitarian organizations working with the local health authorities in the five targeted counties (Grand Gedeh, River Gee, Grand Kru, Maryland and Sinoe), CARE’s target population will be adjusted to reflect the actual population of new areas given to CARE by the local authorities. From the proposed 60 districts, 24 districts were given to CARE as actual target districts. CARE has reached all 24 targeted districts, which includes 231 communities (Grand Gedeh 2 districts and 39 communities; Grand Kru 5 districts and 50 communities; Maryland 5 districts and 60 communities; River Gee 6 districts and 60 communities; and Sinoe is 6 districts and 22 communities). Summary of Training Sessions and Gender Disaggregation of Persons Reached with Social Mobilization Theme Indicator By Location/Counties Total Grand Grand River Gedeh Maryland Kru Gee Sinoe Social # of awareness or 28 20 24 21 16 109 mobilization training sessions held # persons trained, by gender: Male 4,869 15,600 8,335 6,674 9,758 45236 Female 5,771 19,596 10,965 7,789 12,117 56238 # persons reached with social mobilization 10,640 35,196 19,300 14,463 21,875 101,474 CHALLENGES FACED Describe any implementation challenges faced over the reporting period. Mention anything that caused delays such as poor weather conditions, procurement issues, contracting issues, staffing changes etc. The following challenges were faced during training and community awareness and EVD prevention education: • During the training of CHWs and local leaders in all five counties, trainees and residents expressed concern about the lack of basic hygiene kits such as soap and water used to demonstrate household tidiness and hand washing exercises widely recommended by the Ministry of Health and practiced nationally as early prevention procedures. • Inaccessible communities due to limited or poor road network delayed CARE staff and CHWs in reaching households for training and social mobilization and behavior change communication, particularly communities in hard to reach locations. • Upon the Government’s pronouncement for the reopening of schools, CARE and other humanitarian organizations were asked to provide training on EVD awareness and prevention and good hygiene practices to teachers and students in effort to prevent the spread of EVD at schools. CARE had to include some teachers and students in the training schedule which was not part of the original plan. • School administrations in all targeted 5 counties are requesting CARE support to revitalize WASH infrastructures and water installation to facilitate hand washing stations and safe drinking water at community schools. • Delayed arrival of the procured 6 vehicles, 10 motorbikes, and 15 laptops (also including bicycles, cell phones and MOH-printed SBCC materials) delayed project startup by 2.5 months (December 2014 – February 2015). CARE had to hire vehicles for 3 months in all 5 counties of Grand Gedeh, Grand Kru, River Gee, Maryland and Sinoe to facilitate logistics and joint monitoring by CARE and County and District Health teams. • CARE has been requested to lead and support County and District Health Teams in facilitating disease campaigns and control such as whooping cough and measles in communities where CARE works. Although this exercise is more of an awareness education which is similar to CARE’s social mobilization and behavior change activities, this exercise is not planned for as part of CARE project deliverables. • Farmers association and community leaders continue to approach CARE for support in revitalization of farmers associations, VSLA and provision of farming tools to support recovery initiatives in Liberia’s southeastern region. MONITORING TRACKING TABLE Complete the table below providing quantitative data on targets. Be sure to use the exact indicator language and target numbers as in the approved proposal. Add extra rows for more sectors and subsectors and extra columns for more quarters. In the comments section, if necessary, explain why target numbers are not on track. Total number of Total beneficiaries Sector 1: Health 399,646 399,646 Total 399,646 399,646 Indicator Target Q1 Q2 Cumulative % of Comments target met Sector Name: Health Subsector Name: Community Health Indicator 1 Total: Total: 1091 - 1091 121% The target of 600 local Number of 900 Male: 825 Male: 825 leaders and 300 CHWs CHWs Male: 540 Female: 266 Female: 266 were met. However, trained and Female: based on the supported 360 government’s request (total and to support the back to per school initiatives, population within CARE trained project additional 191 (male area), by 138 and female 53) sex people which includes teachers. Indicator 2 300 Total: 300 - 300 100% All 300 CHWs were Number and Male: 244 trained and are percentage Female: 56 provided incentives of CHWs and logistics to also specifically lead in public health engaged in observation and public surveillance reporting. health The CHWs are living surveillance with the people within their communities and take the lead on reporting cases to the recommended health authority or focal person. However, in 4 of the 5 counties, there haven’t been any confirmed EVD cases. Indicator