OCTOBER 2017 INTERNATIONAL MEDICAL CORPS | MONITORING & EVALUATION DIVISION INTERNATIONAL MEDICAL CORPS NEEDS ASSESSMENT REPORT 2017 FAR NORTH REGION Contents Acknowledgments ........................................................................................................................................ 5 List of abbreviations and acronyms ........................................................................................................... 6 Executive summary ..................................................................................................................................... 7 Introduction ................................................................................................................................................. 8 I. Objectives of the evaluation ................................................................................................................ 9 II. Methodology ..................................................................................................................................... 9 II.1. Evaluation team ........................................................................................................................... 9 II.2. Selection of assessment areas ...................................................................................................... 9 II.3. Data collection and data analysis ............................................................................................. 10 II.3.1. Desk review ........................................................................................................................ 11 II.3.2. Key Informant Interview .................................................................................................. 11 II.3.3. Focus Group Discussions (FGDs). .................................................................................... 12 II.3.4. Community mapping......................................................................................................... 13 II.3.5. Protection LQAS KAP survey in Minawao camp .......................................................... 13 II.3.6. Direct observation ............................................................................................................. 13 II.3.7. Geospatial analysis ............................................................................................................ 13 II.4. Duration ..................................................................................................................................... 14 II.5. Limitations ................................................................................................................................. 14 III. Findings .......................................................................................................................................... 15 III.1. Health and Nutrition ............................................................................................................. 15 III.1.1. Health information system ................................................................................................ 15 III.1.2. Available health services in the areas assessed ............................................................... 16 III.1.3. Specific gaps in mental health .......................................................................................... 18 III.1.4. Health care staff ................................................................................................................. 19 III.1.5. Access to health services for communities ....................................................................... 22 III.1.6. Management of malnutrition ............................................................................................ 24 III.2. Protection ............................................................................................................................... 24 III.2.1. General protection issues .................................................................................................. 24 III.2.2. Gender-Based Violence ..................................................................................................... 29 III.2.3. Child Protection threats vulnerabilities and cope mechanisms .................................... 30 III.2.4. Protection needs in Minawao camp ................................................................................. 31 III.3. Water Sanitation and Hygiene ............................................................................................. 32 III.3.1. WASH in Health Facilities ................................................................................................ 32 Page 1 of 73 INTERNATIONAL MEDICAL CORPS NEEDS ASSESSMENT REPORT 2017 FAR NORTH REGION III.3.2. WASH in community ........................................................................................................ 34 III.3.3. WASH in School ................................................................................................................ 37 III.4. Community mapping............................................................................................................. 39 III.4.1. Health and nutrition actors in the assessed areas ........................................................... 39 III.4.2. Protection actors in the assessed areas ............................................................................ 41 III.4.3. WASH actors in the assessed areas .................................................................................. 42 IV. Recommendations ......................................................................................................................... 45 IV.1. Health and nutrition .............................................................................................................. 45 IV.2. Protection ............................................................................................................................... 46 IV.3. WASH ..................................................................................................................................... 46 Annex: ........................................................................................................................................................ 50 Page 2 of 73 INTERNATIONAL MEDICAL CORPS NEEDS ASSESSMENT REPORT 2017 FAR NORTH REGION List of tables Table 1: List of the areas assessed .............................................................................................................. 10 Table 2: List of key informant interviewed .................................................................................................. 12 Table 3: Timeframe of the needs assessment ............................................................................................. 14 Table 4: Availability of essential psychotropic in health facilities assessed ................................................ 19 Table 5: Summary of health staff in the health facilities assessed ............................................................. 19 Table 6: Health staff analysis in the sub-divisional medical centers assessed in Logone & Chari .............. 20 Table 7: Health staff analysis in Integrated Health Centers assessed in Logone & Chari ........................... 20 Table 8: Health staff Analysis in the sub-divisional medical center of Mozogo .......................................... 20 Table 9: Health staff analysis in integrated health centers assessed in Mayo Tsanaga .............................. 21 Table 10: Health staff analysis in the health district of Kolofata ................................................................ 21 Table 11: Health Staff Analysis in Integrated Health Centers Assessed in Mayo Sava ............................... 22 Table 12: Threats, vulnerabilities and cope mechanisms for general protection issues ............................ 27 Table 13: Gender-Based Violence threats vulnerabilities and cope mechanisms ...................................... 29 Table 14: Child protection threats, vulnerabilities and cope mechanisms ................................................. 30 Table 15: Results of LQAS GBV KAP survey in Minawao camp ................................................................... 31 Table 16: Results of LQAS Child Protection KAP survey in Minawao camp ................................................ 32 Table 17: Situation of excreta disposal indicators in the assessed facilities ............................................... 32 Table 18: Situation of hygiene indicator in the assessed facilities .............................................................. 33 Table 19: Situation of medical waste disposal indicators in the assessed facilities .................................... 33 Table 20: Situation of vector control indicator in the assessed facilities .................................................... 33 Table 21: Situation of training indicator in the assessed facilities .............................................................. 34 Table 22: Situation of water quality indicators in the assessed facilities.................................................... 34 Table 23: Distribution of prioritized water points per division and subdivision (Source: Country WASH cluster HRP 2018) ........................................................................................................................................ 35 Table 24: Coverage of community WASH practices