ACFFUNDING REQUEST FORM

XINITIAL REQUEST

AMENDMENT REQUEST

FINAL REPORT

MISSION: Zimbabwe

TITLE OF PROJECT TO BE FINANCED: WasH emergency response unit (WERU) extension

TOTAL REQUESTED (€):78037 €

TYPE OF ACF FUNDING: / Code / Comments / EXPLANATIONS
 / Forgotten Populations funds / H3
 / Emergency programme funds / H3 / Extension of the WERU project which has been responding to Cholera in the South East of Zimbabwe where 80% of the cases in 2010/11 have been. Co-funded by ECHO (A1L) and OCHA (D5A) grants
 / Applied Research funds / H3
 / Allocated funds generated by private donations / H0
 / Allocated funds generated by fund-raising events / H1
 / Allocated funds from corporate donations / H2
 / Allocated funds from foundations / H7
 / Allocated funds from local authorities / I9
 / Allocated funds from Water Agencies / I7
 / Allocation against collection of forecast funds / Z3

PERSON RESPONSIBLE FOR THE REQUEST: rupert leighton

PROJECT LAUNCH DATE: 1stJune 2011

PROJECT END DATE: 30th september 2011

  • Date FOR presentation OF THE REQUEST TO THE OPERATIONS commission: 4th of july 2011
  • Justification OF THE REQUEST FOR ACF FUNDING: three draft cost extension requests were submitted to echo to cover those additional costs generated by emergency situations in the area covered by acf, without success.
  • OTHER FINANCING CHANNELS ENVISAGED / EXAMINED: the h3 funds requests if granted will cofund an echo funded program.
  • OPINIONOF THE commission:

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PROJECT DEFINITION:

  • The context

Zimbabwe, following a massive outbreak of cholera in 2008/9, is suffering from a smaller, but not insignificant outbreak principally in the South East of the country. ACF Zimbabwe is a member of the WERU (WaSH Emergency Response Unit) which is fundamentally the coordinated ECHO response mechanism designed to ensure adequate WaSH response to emergencies across the country. This mechanism is uniquely financed by ECHO, although ACF Zimbabwe have co-funded this response work with funding from OCHA (notably ZI D5A).

Between the period of January 1st 2011 and June 12th 2011, 1134 cases of Cholera have been reported with 45 deaths. Of these cases, 697 have been reported in Chipinge and 198 in Chiredzi districts, both in the ACF WERU geographical coverage, representing together 79% of the caseload in the country over the period. ACF Zimbabwe’s response to this emergency has been through a response programme that has delivered NFIs to 10 times the originally stated beneficiaries, totalling 125,000 beneficiaries (with material support from UNICEF).

In designing the WERU model, there has been a ‘connected vessel’ approach where preparedness activities are supported through clinic rehabilitation and in the onset of any emergency response requirement, funds then shifted to emergency response. Unfortunately, this model (originally designed by ECHO) is somewhat flawed as clinic rehabilitations cannot be stopped mid-stream, nor can procurement planning be undone when, for example, contracts have been drafted and signed with suppliers. As such, ACF Zimbabwe under the model committed to both rehabilitation and response (due to ongoing emergency needs as stated above) on the understanding with the ECHO representative in country, would support ACF in providing a cost extension to support the efforts.

This however, was thrown into disarray when the ECHO representative in country, Mr. Francois Goemans, refused, after three drafts of the cost extension request, to fund based upon his opinion of poor quality work being undertaken on the project. This opinion being formed by a two key field reports that he received of poor implementation of emergency water supply to clinics in the Chipinge/Chiredzi area. Further to these complaints, meetings have been held between the CD and the Desk in planning to address these issues and actions have been taken and are ongoing in ensuring better quality of implementation. This includes a visit from Jean Lapegue, WaSH Technical Department Paris as well as a full review of the works needed to be completed under the current A1L in response to demands from Mr. Goemans.

  • The purpose(what is this about?)

This intervention serves four key purposes, notably:

  1. Responding to the ongoing (although diminishing) needs of Cholera affected communities in Chipinge/Chiredzi;
  2. Ensuring commitments to the rehabilitation of clinics (as part of the preparedness part of the WERU project) are honoured;
  3. To demonstrate capacity to undertake efficient and effective interventions to ECHO in the light of recent criticisms of the project as well as to demonstrate commitment to the response needs;
  4. To maintain ACF’s presence in a key operational area for WERU (positioning).

Specifically, a gap of WERU presence means that the region covered by ACF is potentially ‘unmanned’, meaning either:

  • Small-medium scale emergencies are not responded to in a timely manner, which could result in mortality, excess morbidity, or (likely) a small cholera outbreak could spread into a large outbreak
  • ACF risks loosing its position as the WERU partner in MasvingoProvince and Chipinge district, as other partners will be asked to come in to cover – If this happens, ECHO could suggest that there is less need for ACF for continuing WERU. This is of particular importance given the fact Chipinge district is under the ‘spotlight’ for an area that requires considerable WASH funding, and ACF should by all means ensure to maintain the lead WASH player in the district.

So, concretely, this proposal is requesting H3 funding support to cover:

  • The amount not covered by ECHO for the additional resources required to finish the clinics.
  • The low-cost extension of WERU program for 2 months, to maintain WERU response capacity, maintain ACF strategic positioning, and also allow ACF to focus on addressing issues for the future WERU program (staff development, proposal needs assessments..).
  • The stakes(why? Needs assessment and description of the issue)

During 2008-2009 Zimbabwe experienced a nationwide cholera epidemic of unprecedented proportions, with 97,799 cases reported, and causing 4,265 deaths. Action Contre la Faim (ACF), supported by ECHO, has been a major player in the response to WASH emergencies in Zimbabwe, with activities starting in 2007. Since 2008, ACF has been implementing 3 successive ECHO funded WASH Emergency Response projects, aimed at mitigating the emergencies and building preparedness in high risk areas.

The current intervention has been designed based on experience and consultation with key stakeholders, together with field data collection on clinic WASH facilities in the target districts. The project is based on:

Discussions with other WASH Emergency Response implementing actors in Zimbabwe (GAA, OXFAM, Mercy Corps), together with WASH Cluster leads and emergency response donors (ECHO country representative). A common program strategy was developed for 2010-2011

ACF’s accumulated experience implementing emergency WASH operations in the districts of intervention

Meetings with provincial and district authorities in the area of intervention taking advice, preferences and recommendations into consideration for project design

Discussions with Health Emergency Response (HERU) actors in the target areas

Data collection through the Provincial and District health authorities on WASH facilities in clinics:

For a rapid assessment of the functionality of WASH facilities of clinics in the 11 proposed districts of intervention, a data collection table (see annex A) was provided to all district health authorities, in addition to the Provincial Medical Director of Masvingo Province. This was complimented with ACF collated datasets from current and previous interventions in 5 of the districts to give an overview of the status of clinics in each district. There was insufficient time for comprehensive assessments by ACF staff on all clinics of the districts for the submission of this proposal.

  • The targets(what, how much, when?)
  • global:Contribute to the mitigation and response to WASH related emergencies
  • specific:Mitigating the impact of emergencies, improving WASH facilities at health institutions, responding to emergencies by improving access to safe water, appropriate sanitation and hygiene practices for affected populations.
  • Number and type of beneficiaries

Beneficiaries specifically being at risk populations in the Chipinge/Chiredzi districts through distribution of NFIs, hygiene education, catchment population of clinics scheduled for emergency rehabilitation. To date, this exceeds 125,000 recipients of hygiene education, NFI distribution as well as 15 clinic rehabilitations accounting for 2500 per clinic (catchment) totalling 37,500.

  • Principal results anticipated at the end of the project

During the course of the time extension period, the program would aim to achieve the following:

  • Completion of the outstanding works at the A1L clinics in Gutu
  • Maintaining minimal emergency response capacity until the next WERU funded program (emergency coordination/initial response, and maintain geographical positioning for the WERU)
  • Supervise the completion of D5A program
  • Complete detailed needs assessments for WERU 5 proposal
  • Undertake training and other measures to ensure quality future programming and address concerns raised by ECHO/recommendations raised by J.Lapegue’s field visit

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LFA:

[LFA + schedule to be included ]

Title of the Action / WASH Emergency Response and Preparedness in Southern Zimbabwe.
Principal Objective / Contribute to the mitigation and response to WASH related emergencies.
Intervention Logic / Objectively Verifiable Indicators / Sources of Verification / Risks and Assumptions
Specific Objective / Mitigating the impact of emergencies, improving WASH facilities at health institutions, responding to emergencies by improving access to safe water, appropriate sanitation and hygiene practices for affected populations. / WASH Disease case load stabilized or reduced within 1 week of intervention.
Minimum WASH access within 72 hours in affected communities and Health centers as per SPHERE standards.
15 clinics gain access to operational WASH infrastructure in target areas / MoHCW/WHO weekly Epidemiological bulletins
ACF Monthly monitoring reports
ACF WASH Rapid assessment and response reports
ACF Monthly monitoring reports / Government of Zimbabwe and other agencies provide support and cooperation.
The socio-political context allows operations to be implemented as planned.
Prices remain stable for program equipment and materials
Result 1 / Surveillance of WASH emergency needs is ensured and adequate rapid WASH response is ensured in affected populations. / 90% of reported WASH emergency alerts assessed in 48 hours
Affected populations have access to a minimum of 5 lppd of safe water, and SPHERE water standards met at emergency health institutions within 72 hours of alert
75% of households receiving NFIs use them properly and for intended use in target populations
80% of Environmental Health Technicians trained and pass knowledge tests on emergency WASH response / WERU Tracker updates
WASH rapid assessment and response reports (written during emergency intervention phase).
Water quality monitoring reports.
Post distribution monitoring reports.
Monthly ACF monitoring reports /

Risk

Restricted physical and administrative access to affected population.
Politicization of humanitarian aid
Delays in supply of program items (NFIs) from UNICEF

Assumption

Provincial & District Authorities interest and commitment in developing their emergency response capacity
Cooperation and collaboration of the relevant stakeholders to deliver services to affected population within the shortest time possible.
Sufficient water resources (quantity and quality) available for clinic water supply
Community and staff interest in WASH infrastructure improvements in clinics
Result 2 / Ensure adequate access to safe drinking water, sanitation and hygiene facilities in 15 health institutions. / Clinic water supply surveillance system established in all Masvingo province, and 80% of breakdowns identified at district level within 2 weeks
SPHERE standards achieved for water supply and sanitation in 100% of targeted clinics in program areas
100% of targeted clinics have ratified constitutions for WASH system management, and 80% of caretakers pass operation and maintenance knowledge test. / DistrictProvincialWASH monitoring reports (quarterly), District Water and Sanitation Sub-committee (DWSSC) and MoHCW updates.
ACF monthly Program monitoring reports, water quality monitoring reports
ACF Monthly Monitoring Reports
Activities contributing to Result 1 / Surveillance of WASH Epidemics and other WASH-related emergencies
  1. Reinforcement of the GIS mapping unit within Masvingo provincial authorities, and mapping of WASH-related epidemics and distribution of monthly maps to district authorities
  2. Distribution of emergency contact cards to authorities, and pro-active follow-up with district authorities to detect and anticipate WASH-related emergencies
Emergency Assessment & Response to WASH-Related Emergencies
  1. Undertaking joint assessments to emergency alerts with local authorities and health partners including water quality sampling
  2. Ensuring safe water supplies to affected populations and institutions through water trucking, water point rehabilitation/chlorination, bucket chlorination, provision of water system inputs (chemicals/fuel)
  3. Ensuring adequate sanitation in emergency institutions (clinics, MVP camps etc) through construction/rehabilitation of latrines and flush toilets, provision of cleaning kits, residual spraying contaminated areas, sewage rodding, drainage works and community clean-up campaigns
  4. Ensuring adequate handwashing facilities and soap in affected populations and institutions
  5. Distribution of hygiene kits and associated IEC materials to affected populations as required/appropriate
  6. Participatory Health & Hygiene Promotion to affected populations, and establishment of health clubs or committees as appropriate in affected populations and institutions
  7. Ad-Hoc training of local personnel on hygiene promotion, bucket chlorination, water quality sampling, latrine construction as required to assist the implementation of the response
  8. Post distribution monitoring and follow-up of activities
  9. Water quality testing and monitoring of water sources and domestic stored water
Joint Planning & Response Ability of District & Provincial Stakeholders
  1. Facilitating a joint planning workshop for provincial-level authorities on emergency response responsibilities, planning, coordination and surveillance in Masvingo province
  2. Facilitating joint planning workshops in all MasvingoProvince districts (7) on emergency response responsibilities, planning, emergency management and surveillance
  3. Implementing training courses in all MasvingoProvince districts (7) on emergency PHHP, NFI promotion/distribution, chlorination, and chlorine testing to 84 EHTs from the districts.

Activities contributing to Result 2 / Surveillance of Water Supplies of Health Institutions Across Province
  1. Development of surveillance system for clinic water supply functionality within the provincial and district authorities, and GIS mapping of health centers
WASH Infrastructure Improvements in 15 Health Centers in Gutu, Chiredzi and Bikita Districts
  1. Technical Assessment of WASH facilities in Clinics, selection of clinics and design of works to be undertaken, involving health actors, local authorities, clinic staff and local residents
  2. Construction/Rehabilitation of water supply systems delivering safe water within clinics (boreholes, pump systems, plumbing network, storage tanks, stands etc)
  3. Water quality testing and analysis at rehabilitated, constructed and upgraded water points.
  4. Construction/Rehabilitation of sanitation facilities in health clinics and provision of basic clinic cleaning kits
  5. Installation of handwashing units (tippy taps) for inpatient and outpatient usage. Installation of information boards explaining the construction of tippy taps and other hygiene messages next to outpatient handwashing stations
  6. Mobilization of clinic staff, local residents and district stakeholders, establishing/refreshing and training committees on the management of the improved WASH facilities at the clinics (community based management)
  7. Training of clinic caretakers, and local stakeholders on technical aspects of operation and maintenance of the WASH facilities, water chlorination/testing and provision of spare parts kits

Pre-conditions

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Performance schedule

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ASSESSMENT OF THE projeCt AND ITS impact:

  • Assessment at the end of the project (who / how?)

Ongoing assessment is being undertaken by ECHO. This fundamentally around a key field visit by ECHO scheduled for the 1st, 2nd and 3rd August by Francois Goemans.

SUCCESS FACTORS / RISK ANALYSIS:

  • Key factors in the success of the project(skills, partners involved, information shared, etc. …)

Key in the successful implementation of this project is a change in quality particularly regarding the outputs. This have involved significant investment by ACF globally in the project from the visit of the desk in June 2011 to technical evaluation of the visit by Jean Lapegue in July 2011 (scheduled 3rd to 12th July 2011). The focus of the visit is to work on looking at ensuring quality in order to satisfy internal and external expectations of ACF interventions, as well as to be the basis for securing further ECHO WERU funding for the last round due to commence August 2011 (ACF recognise that both the validity of the application for ECHO funding will depend on the evaluation of the quality of implementation and also recognise that there will be a gap in ECHO support).

  • Risk management

Description of risks / Measures to be taken
  • Non approval of ECHO (A1L) NCE;
/ Possible termination of all ACF WERU response programme.
  • Interaction with other projects:

This action is a co-funding between ECHO funding (A1L with a NCE request applied for 30th June 2011) and OCHA (D5A).

Budget

  • Budget requested (Euros): 78037 €
  • Co-financing acquired (Euros): 537000 €
  • Potential co-financing or possible leverage

Conclusion / comments:

Due to a number of circumstances, ACF Zimbabwe has had to apply for funding from H3 in order to support the intervention, fundamentally as the cost extension request was turned down by ECHO due to questions raised regarding quality. In order to respond to the emergency, ACF merged OCHA and ECHO funding and relied upon the approval of the ECHO cost-extension to continue to respond to the emergency. Unfortunately and due to the refusal of the request, ACF Zimbabwe has no choice but to apply for H3 to support this action.

It is believed that whilst there are some quality issues that need to be addressed, the programme does support vulnerable populations and meet the objectives of the proposal. We hope that quality issues will be addressed during the visit of Jean Lapegue, but also that as well as an indication of areas for improvement, Jean might also highlight challenges as well as successes of the project which at the heart of the matter go to responding to preventing Cholera in the part of the country that has seen the lion’s share of the problem over the last months.