ZIKA RESPONSE IN ECUADOR AND PERU ANNUAL PROGRESS REPORT USAID ZIKA PROGRAM Period: Y2 – October 1, 2017 to September 30, 2018 Submission Date: December 26, 2018 (DELETE THIS BLANK PAGE AFTER CREATING PDF. HERE MAKE FACING PAGES AND LEFT/RIGHT PAGE NUMBERS SEQUENCE CORRECTLY IN WORD. BE CAREFUL TO NOT DELETE THIS SECTION BREAK EITHER UNTIL AFTER YOU HAVE GENERATED A FINAL PDF. IT WILL THROW OFF THE LEFT/RIGHT PAGE LAYOUT Contents ACRONYMS AND ABBREVIATIONS II ACTIVITY OVERVIEW V ZIKA PROGRAM ACTIVITY DETAILS V ANNUAL HIGHLIGHTS/EXECUTIVE SUMMARY VI ACTIVITY IMPLEMENTATION IXIX PROGRESS NARRATIVE X COLLABORATION XVIII COLLABORATION WITH OTHER USAID OR USG ACTIVITIES XVIII COLLABORATION AND/OR KNOWLEDGE SHARING WITH PARTNER ENTITIES IN HOST GOVERNMENT AND OTHER DONOR AGENCIES XX LEARNING XXII LIST MAJOR ASSESSMENTS / INTERNAL EVALUATIONS AND LESSONS LEARNED XXII RESEARCH AND PUBLICATIONS XXV ACTIONS AND WAY FORWARD XXV PLANNED ACTIVITIES FOR NEXT REPORTING PERIOD XXVI COMMUNICATIONS AND DISSEMINATION XXVIII KEY COMMUNICATION ACTIVITIES - PROJECT PROMOTION, PUBLIC OR MEDIA EVENTS/ENGAGEMENTS FOR THE PAST YEAR XXVIII CALENDAR OF PLANNED PROJECT PROMOTION SUSTAINABILITY AND EXIT STRATEGY XXXII ANNEXES XXXIV ANNEX IA. PERFORMANCE INDICATOR REPORTING SHEET XXXIV ANNEX 1B. OTHER ZIKA ACTIVITY INDICATORS XL ANNEX II SUCCESS STORIES – ECUADOR AND PERU XLV ANNEX III TRAINING REPORT LV ANNEX IV PICTURES (EVENTS, TRAININGS ETC.) LXIV ANNEX V SUB-GRANTS UNDER THE ACTIVITY LXVI ANNEX VI INTEGRATION OF CROSS-CUTTING ISSUES LXX A. GENDER EQUALITY AND FEMALE EMPOWERMENT LXX B. ENVIRONMENTAL COMPLIANCE LXXIII C. INSTITUTIONAL STRENGTHENING AND LOCAL CAPACITY BUILDING LXXIII D. YOUTH (IF APPLICABLE) LXXIV E. DISABILITY (IF APPLICABLE) LXXIV F. SCIENCE, TECHNOLOGY, AND INNOVATION (IF APPLICABLE) LXXIV G. POLICY AND REGULATORY REFORM (IF APPLICABLE) LXXV ANNEX VII RESEARCH AND PUBLICATION TRACKER LXXVI ANNEX VIII MANAGEMENT AND ADMINISTRATIVE ISSUES LXXX A. MODIFICATIONS AND AMENDMENTS LXXX ANNEX IX ENVIRONMENTAL MITIGATION AND MONITORING REPORT LXXXI ACRONYMS AND ABBREVIATIONS AMELP Activity Monitoring, Evaluation, and Learning Plan AOR Agreement Officer Representative COR Contract Officer Representative IP Implementing Partner M&E Monitoring and Evaluation MEL Monitoring, Evaluation, and Learning USAID United States Agency for International Development CARE Cooperative for Assistance & Relief Everywhere CBSS Community-Based Surveillance System C4D Communication for development DRR Disaster Risk and Recovery EW Epidemiological Week EBA Evidence-Based Analysis (ABE) EMMR Environmental Mitigation and Monitoring Report EMMP Environmental Mitigation and Monitoring Plan FY Fiscal Year HC3 Information, communication, education and health (USAID) KAP Knowledge, Attitudes and Practices (KAP) MoH Ministry of Health (MINSA- Peru, MSP – Ecuador) PAHO Pan-American Health Organization SBCC Social and behavior change communication SRMH Sexual, Reproductive and Maternal Health SRH Sexual and Reproductive Health USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | II WHO World Health Organization UNFPA United Nations Populations Fund UNICEF United Nations International Children’s Fund USAID United States Agency for International Development MC Community monitors CBSS (Monitores comunitarios) ECUADOR DDS Dirección Distrital de Salud (District Health Department) DDE Dirección Distrital de Educación (District Education Department) GADM Gobierno Autónomo Descentralizado Municipal (Decentralized Autonomous Municipal Government) MIES Ministry of Economic and Social Inclusion MINEDU Ministry of Education MSP Ministry of Public Health UTM Universidad Técnica de Manabi UTMACH Universidad Técnica de Machala ULEAM Universidad Laica Eloy Alfaro (Manta) US Unidad de Salud (Health Unit) PERU ACS Agentes Comunitarios de Salud (Community Health Agents) CAD Ciudadanos al Día (Citizens Informed, Peruvian Non-Governmental Organization) COEL Centro de Operaciones de Emergencia Local (Local Emergency Operations Center) COER Centro de Operaciones de Emergencia Regional (Regional Emergency Operations Center) C.S Centro de Salud (Health Center) CUNA MAS Social program of the Ministry of Development and Social Inclusion III | USAID ZIKA ANNUAL REPORT USAID.GOV DIRESA Dirección Regional de Salud (Regional Health Department) DISA Dirección de Salud (Health Department) GERESA Gerencia Regional de Salud (Regional Health Agency) HCE Health Care Establishment IEF Individuos en edad fértil (Individuals of Childbearing Age) MIDIS: Ministry of Development and Social Inclusion MIMP: Ministry of Women and Vulnerable Populations MINSA: Ministery of Health PREVAED: Programa Presupuestal Estratégico Reducción de la Vulnerabilidad y Atención de Emergencias por Desastres - PREVAED - 068. (Strategic Budget Program: Vulnerability Reduction and Disaster Response – PREVAED-068) PPR Programa Presupuestal por Resultados (Budgeting Result Program), P.S: Puesto de Salud (Health Post) UGEL: Unidad de Gestión Educativa Local (Local Education Management Unit) UPCH: Universidad Peruana Cayetano Heredia SAT-C Sistema de alerta temprano comunitario (Community early warning system) USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | IV ACTIVITY OVERVIEW ZIKA PROGRAM ACTIVITY DETAILS The project seeks to contribute by strengthening local actors and communities in the control and prevention of the Zika Virus by influencing the knowledge, attitudes and practices of communities, agents, and community health workers. It recovers the best practices and experiences to strengthen and or develop communal mechanisms of monitoring and control. The project has emphasis on pregnant women, women in reproductive ages and adolescents. It proposes to involve communities in an active manner, recovering or strengthening the population’s participation on their own health care and empowerment. To this end, it promotes the generation of alliances with competent local and regional government organizations (Peru) and Municipalities. Objectives to achieve in two phases over three years: 1. To increase community, local and national capacities to deliver efficient and timely response to the Zika virus outbreak and other vector prone diseases through Disaster Risk Reduction (DRR) and Human Rights approaches based on CARE’s experience in SRMH (Sexual, Reproductive and Maternal Health), sustainable community health systems and empowerment to strengthen the direct involvement of communities, by community health agents, in Zika priority areas (prevention, and vector control). 2. To enhance regional and national efforts to help decrease the rates of Zika transmission by sharing findings, impact results and influencing bi-national policy making through a deep and rigorous evidence-based approach of best practices and lessons learned in community mobilization and participation, to allow fast track, gender sensitive implementation strategies in diverse social and cultural contexts, increase coordination and planning capacities, refine an accurate monitoring system and a well-developed communication and dissemination strategy. Geographic Focus: Ecuador: 10 cantons belonging to 3 provinces in the coastal region of the country, two of which suffered from varying degrees of damage from the April 2016 earthquake: Esmeraldas (1), Manabi (6) and El Oro (3) Peru: 20 districts in the northern section of the country: Tumbes (4); Piura (11); Lambayeque (3) and Cajamarca (2) Beneficiaries: The following chart details beneficiaries taking part of CARE’s monitoring platform: V | USAID ZIKA ANNUAL REPORT USAID.GOV Table 1. Beneficiaries Y1-Y2 Reached Y1 Reached Y2 Total Country Total project Total Women Men Total Women Men Ecuador 128,944 5,969 3,520 2,449 30,037 19,161 10,876 36,000 Peru 263,009 33,606 21,844 11,762 24,234 15,745 8,489 57,840 Total 391,953 41,026 25,364 14,211 54,271 34,906 19,365 93,840 Source: CARE ZIKA monitoring platform, 2018 Additionally, 186,000 individuals of reproductive age in project areas received Zika messages in Peru and 109,000 in Ecuador. ANNUAL HIGHLIGHTS/EXECUTIVE SUMMARY Highlights • Increased knowledge about Zika prevention in people of reproductive age, adolescents and pregnant women. • In Peru, the Good Practices on Zika prevention and control Award, allowed to identify and implement the best practices in the project areas. • The Community Based Surveillance System (CBSS) developed, implemented and evaluated a pilot study in Tumbes, Peru, and four pilots in Esmeraldas, Manabi and El Oro in Ecuador. The project scaled the experience to 12 districts in Peru. • The project developed the communication strategy for social and behavior change (SBC) with intercultural and gender approaches. The work developed with adolescents in educational institutions is relevant in the second year. • Sensitization and involvement of the regional governments (Peru) and municipalities (Ecuador and Peru) in the actions of the Zika response, was achieved through the budget program in Peru, and health municipalities strategy in Ecuador. • The Project developed the Edu communication strategy with gender and intercultural approaches, and implemented it through methodologies and messages appropriate to the age of the people. USAID.GOV ZIKA RESPONSE IN ECUADOR AND PERU. ANNUAL PROGRESS REPORT | VI • The project led community participation strengthening on Zika prevention and vector control with different actors, activities and spaces. Project worked jointly with leaders, families, communities, and community monitors