SOMALIA 2006 Consolidated Emergency Thematic Report

Transcription

1 SOMALIA 2006 Consolidated Emergency Thematic Report For every child Health, Education, Equality, Protection ADVANCE HUMANITY

2 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT EXECUTIVE SUMMARY On the heels of the tsunami and the outbreak of polio in 2005, the children and women of Somalia bore the brunt of a debilitating combination of natural disasters and conflict during By March, an estimated 1.7 million people, primarily in central and southern Somalia, were in a state of humanitarian emergency or acute food and livelihood crisis due to the drought in the Horn of Africa. While still recovering from the effects of the drought, many of the same families were plunged into some of the worst flooding of the past decade, which affected an initially estimated 455,000 people during the last months of the year. Overlapping with and exacerbating these natural calamities, were localized conflicts and displacement, as well as the broader political developments that created widespread insecurity, rivalling even Somalia s own dramatic past and threatening to draw the entire region into conflict. Only months after the nascent and fragile Transitional Federal Government (TFG) convened its first session of Parliament in Baidoa, the Islamic Courts Union (ICU) rose to power and took control of most of central and southern Somalia. While the ICU managed to bring stability to Mogadishu after decades of lawlessness at the hands of warlords, its rhetoric and actions regarding the rights of women raised concerns. The protracted stand off with the TFG, as well as the activities of the jihadist element within the ICU, created a worsening security situation in the south for humanitarian agencies attempting to access populations in urgent need of assistance. Following threats in September, all international staff had to be pulled out of southern Somalia for the remainder of the year, severely constraining both the implementation and monitoring of relief efforts on the ground. A faltering peace negotiation process was launched in August, but failed to keep both sides at the table. After months of reported build-up, Ethiopian troops backed the TFG in a war against the ICU during the final days of the year amid reports of increased recruitment of child soldiers. Against this volatile backdrop, UNICEF and partners continued to adjust strategies and response mechanisms to reach children and other vulnerable groups with lifesaving support, basic services and access to their rights within the framework of the Millennium Development Goals (MDGs). UNICEF s humanitarian assistance was delivered through five key programmes: Health; Nutrition; Water, Sanitation and Hygiene (WASH); Education; and Communication, Protection and Participation. All interventions were planned within the context of UNICEF s five-year Country Programme and prioritized in line with UNICEF s Medium Term Strategic Plan and achievement of the MDGs. The cluster coordination system was introduced to Somalia in 2006, with UNICEF taking the lead for the Nutrition, WASH and Education clusters, and playing a key supportive role to WHO in the leadership of the Health cluster and to UNHCR in the Protection cluster. In close partnership and coordination with numerous international and local agencies, and through engagement with local authority structures, community fora, women s and youth groups and other key stakeholders, a number of key achievements were made. The annual outbreak of cholera was prevented for the second year running and country-wide campaigns to vaccinate children against measles and polio were successful in reducing the burden of these diseases. At the most critical level, about 775,000 people received lifesaving support in the form of access to clean water during the drought and over 35,000 malnourished children were treated in selective feeding programmes. Despite the onslaught of emergencies, primary school enrolment rates continued to rise during 2006, even in the worst affected parts of the country, and local and regional child protection networks played an instrumental role in monitoring, reporting child protection violations to inform and trigger advocacy and response. As part of UNICEF s focus on convergence programming, about 75,000 internally displaced persons (IDPs) in 12 locations benefited from the provision of multi-sectoral services. In partnership with TFG and Somaliland and Puntland authorities, the UN and World Bank Joint Needs Assessment was completed in 2006 with strong involvement from UNICEF, both in terms of technical assistance and financial and administrative support. The resulting Reconstruction and Development Framework identifies national and sub-national priorities for the period of , based on which the UN is developing a Transition Plan for Another crucial step for monitoring the impact of UNICEF s work and better targeting future interventions was the completion of the Multiple Indicator Cluster Survey (MICS) It is widely acknowledged that Somalia is unlikely to meet the MDGs by However, building on a significant reduction in infant and under five mortality between the MICS 1999 and the MICS 2006, UNICEF and partners will continue to prioritize both humanitarian response and recovery and development interventions to improve child survival during 2007 through the convergence of health, nutrition, WASH, protection and education programming. Isdoorto, Somalia, January 2006, women and children wait in line for Unimix at a UNICEF-supported supplementary feeding programme. UNICEF/Bannon

3 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT PURPOSE The initial 2006 Consolidated Appeal Process (CAP) for Somalia, developed in late 2005, targeted one million chronically vulnerable people. As the drought situation worsened in early 2006 for the Horn of Africa, the UN and partners reviewed humanitarian response plans and in March, a revised appeal was issued. Under the newly established Inter-Agency Standing Committee (IASC) for Somalia, the revised CAP identified three strategic priorities: (1) increase access to basic humanitarian services for vulnerable populations, in particular 1.7 million in a state of Humanitarian Emergency or an Acute Food and Livelihood Crisis, 370, ,000 IDPs, and those living in areas of return and resettlement; (2) enhance the protection of and respect for the human rights and dignity of affected populations; and (3) strengthen local capacity for social service delivery and response to natural or conflictrelated disaster. Toward this end, UNICEF undertook a range of humanitarian interventions framed within the broader Country Programme and in conjuction with multiple partners including local authorities, sister UN agencies, international and local NGOs and civil society groups. UNICEF s operations inside Somalia fall under three zones: the Northeast Zone (NEZ), the Northwest Zone (NWZ)* and the Central and Southern Zone (CSZ). The vast majority of UNICEF s humanitarian response took place in CSZ during 2006, but the emergency programme also targeted vulnerable communities in the northern zones, particulary IDPs. In 2006, UNICEF s emergency Health and Nutrition interventions with partners aimed to reduce preventable mortality and morbidity from infectious and communicable diseases for 2.1 million people through provision of maternal and child health (MCH) care services, including the Expanded Programme on Immunization (EPI) and cholera preparedness and response; polio eradication campaigns targeting all children under five (approximately 1.4 million children); and provision of nutritional care for up to 62,000 malnourished children in CSZ with full rehabilitation of at least 80% of detected cases. It should be noted that the initial beneficiary target figure for nutritional response was later revised to prioritize 47,000 children in the five worst drought affected regions of CSZ. Emergency Water, Sanitation and Hygiene (WASH) interventions aimed to reach an estimated 2.5 million vulnerable or drought-affected people with improved access to safe drinking water, basic sanitation services and hygiene education. Within this overall target, UNICEF defined a priority goal of reaching 300,000 of the most critically affected in the CSZ and the NEZ. As part of the larger Education programme, emergency actions aimed to provide formal or alternative education to 220,000 Somali children and 30,000 youth/women, particularly girls and women from IDP and other *The NEZ and NWZ are roughly equivalent to Puntland and Somaliland, with the exception of the disputed Sool and Sanag regions. A girl and her mother at a camp in Wajid for persons displaced by the drought. UNICEF/Kamber vulnerable groups including those affected by drought. Targets also included ensuring that some 2,700 teachers in CSZ were able to continue providing education in drought affected areas despite the inability of parents to pay for school fees. Throughout Somalia, UNICEF works to strengthen the protective environment for children by preventing violence, abuse, exploitation and discrimination, particularly gender-based, and providing psycho-social support to vulnerable and marginalized children. Through a range of projects, the Communication, Protection and Participation programme aimed to build the individual, collective and institutional capacity of duty bearers at all levels of society to enable greater participation and protection of vulnerable groups, and to reduce HIV risks and vulnerabilities. During the drought, UNICEF s 2006 response plan also targeted pre-positioning of family shelter and relief supplies to enable response for 30,000 children and 10,000 women. These distribution targets were expanded in December for the flood response in the CSZ to 131,000 people, including 26,000 children. The external Real-Time Evaluation of the drought response provided positive feedback that UNICEF was effectively applying the cluster mechanism, SPHERE standards were recognised and largely applied, and that resources were mobilized in a timely manner. The ongoing tsunami response in the NEZ shifted in 2006 from emergency response towards longer-term recovery and development activities that focus on community participation and joint programming/programme convergence. Finally, in close coordination with UNICEF programming, UNICEF also manages the Global Funds for Malaria and for HIV/AIDS on behalf of all partners in Somalia, with carry-over impact on humanitarian interventions. Cover photo: A young student at the Hafun Primary School which was constructed as part of UNICEF s rehabilitation work in tsunami affected areas. UNICEF/Bannon

4 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT RESOURCES The CAP remains the major funding mechanism for humanitarian programming in Somalia. At an initial total of US $18,786,330, the 2006 UNICEF portion of the appeal was slightly higher than both 2004 and However, as the drought developed, a revised CAP for the Horn of Africa was issued in March 2006, with the UNICEF appeal jumping to US $33,838,862, more than double the 2005 appeal figure. By the end of the year, UNICEF had received 70% of the revised appeal, with over $25 million in receipts. In December, an updated Flood Response Plan was issued to supplement the CAP, highlighting US $ 5,150,000 of urgent funding needs to enable humanitarian response in the last weeks of 2006 and into early The Flood Response Plan highlighted UNICEF s most critical 2006 CAP funding gaps for Education ($550,000), Nutrition ($300,000), WASH ($1,900,000) and Child Protection (US$400,000). It also added an additional appeal figure of US $2 million for procurement of non-food items on top of the much smaller 2006 CAP appeal figure. An initial CERF grant for drought response arrived in April 2006 and accounted for 14% (US $660,000) of total WASH receipts for the year; smaller amounts were available for Health and Nutrition. The timing of release of CERF funds enabled acceleration of the WASH drought response and ensured procurement of polio vaccine and nutritional feeding supplies. A second CERF grant arrived in December for the provision of family shelter and relief items as part of the Flood Response Plan, allowing UNICEF to procure supplies for more than 150,000 people, including over 30,000 children in December. Table 1: 2006 Funding Status against Appeal by Sector (USD) Sector Appeal Target- March 06 CAP Revision Funded* % Funded Health 8,876,470 5,635,558 63% Nutrition 3,311,792 4,897, % Education 5,718,000 2,469,191 43% Water, Sanitation and Hygiene (WASH) 10,442,000 5,582,603 53% Protection 4,911,600 2,184,598 44% Coordination and Support Services (Emergency Preparedness and Response, cross-sectoral Planning, Monitoring and Evaluation and procurement/ transport of non food items) 2,579,000** 4,246, % TOTAL 35,838,862 25,015,319 70% *Funded column reflects total contribution amounts for non-thematic emergency funding (and programmable amounts for thematic humanitarian funding). ** including the December 2006 Flood Response Plan figure of US $2 million for non food items.

5 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT Table 2: Funding received and available by Donor and funding type (USD) Donor Name/Type of funding Programme Budget Allotment (PBA) reference Programmable Amount Contribution Amount a) Non-thematic Emergency Funds: Netherlands SM/06/0064, 0121, ,283,779 3,570,066 UK DFID SM/06/0216, ,544,989 2,745,735 USAID/OFDA SM/06/0149, 0353, 0280, 0256, ,353,905 2,550,000 Denmark SM/06/ , ,350 Ireland SM/06/ , ,595 Italy SM/06/ , ,103 New Zealand Committee for UNICEF SM/06/ ,726 64,975 b) Thematic Humanitarian Funds: SM/2003/ , SM/2003/ SM/2006/ ,896,030 c) Pooled Funding CERF Grants: SM/06/0377, SM/06/0084 2,894,688 3,128,026 d) Carry-overs of emergency funds from prior years: USAID/OFDA SM/05/ ,556 Italy SM/05/ , ,549 Norway KM/05/ ,101 German Committee for UNICEF SM/04/ ,365 d) Other sources In-kind assistance UK Committee for UNICEF* KC/06/ , KC/06/ ,765 Total Programmable Amount Available: 38,753,781 Table 3: Country-specific Thematic Humanitarian Donor Country-specific Thematic Humanitarian Funds (Contribution Amount in USD) Norway 7,376,840 Sweden 3,543,690 Danish Committee for UNICEF 344,240 US Fund for UNICEF 200,000 Luxembourg Committee for UNICEF 86,584 UK Committee for UNICEF 52,174 Netherlands Committee for UNICEF 30,681

6 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT KEY RESULTS FOR CHILDREN HEALTH Somalia presents amongst the worst infant, child and maternal mortality rates in the world. Children already weakened by malnutrition face a tragic menagerie of respiratory infections, malaria and diarrhoeal diseases - while the cycle often continues with illnesses exacerbating malnutrition. Public health services are fragmented, dependant on vertical aid support programmes and lack capacity at every level as a result of civil conflict. Only an estimated 25% of the population has access to basic primary health care. Private sector service delivery exits, but is totally unregulated, of questionable quality and excludes the poor due to high costs. In this context, UNICEF s Health programme is designed to contribute to a reduction in maternal and child morbidity and mortality by improving service delivery and combating disease, in line with the MDG targets and UNICEF s focus on child survival. Health and nutrition programming is dependent on cooperation with over 100 partners, including the Ministries of Health; international, national and community based organizations; and sister UN agencies including WHO, UNFPA, FAO, UNAIDS, UNDP. Positively, preliminary results of the MICS 2006 show significant decline in the estimated child and infant mortality rates, down from 224 and 133 per 1,000 live births respectively (for the period ) to 156 and 96 per 1,000 live births for Disaggregating the data by zone shows evidence of a peace dividend for the northern zones where the declines in mortality have been much higher. The explanation of the decline is not immediately apparent, given that many other indicators of access to social services show few dramatic improvements. Further analysis of the MICS 2006 results is underway to help UNICEF and partners identify the best strategies for reaching the MDG targets. Achieving MDG 4 would require a further reduction of under-five mortality to no more than 74 deaths per 1,000 live births and of infant mortality to no more than 44 deaths per 1,000 live births. The maternal mortality ratio in Somalia is also amongst the highest in the world at 1,013 per 100,000 live births during the period of , against an MDG target of no more than 275 maternal deaths per 100,000 live births. With an average number of 6.7 births per woman in her lifetime, this translates into the lifetime chance of 1 in 15 for a Somali woman to die as a result of pregnancy and childbirth complications due to poor access to quality antenatal, delivery, postnatal and emergency obstetric care. Anaemia and female genital mutilation also have a negative impact on maternal health. The MICS 2006 estimates that 33% of births are delivered by skilled personnel and educated woman are more likely to have delivered with the assistance of a skilled person. A nurse from partner agency World Vision attends to six-year-old Shubeb at a UNICEF-supported Mother and Child Health clinic in Wajid. UNICEF/Bannon Overall Assessment In 2006, the NEZ and NWZ remained sufficiently calm to allow recovery and development interventions on both service delivery and capacity building to support health sector reform. However, in the CSZ, routine activities were disrupted and significant human and financial resources were diverted to the emergency response. The health cluster response in CSZ, coordinated by WHO, consisted of measles and polio campaigns, cholera prevention activities, the provision of essential drugs/health kits and technical support to partner agencies providing primary health care services, and building synergies with the nutrition response. In spite of chaotic conditions and population displacement in both the drought and flood affected areas, a measles campaign vaccinated 2.2 million children, cholera outbreaks were prevented and polio cases were reduced by 80%. UNICEF provided sufficient supplies and technical assistance to ensure that some 2.7 million people in CSZ had access to basic primary health care services for a period of 12 months, exceeding initial targets. Main Activities and Results Maternal and Child Health Care: Over 400 health facilities supported by UNICEF (including hospitals, MCH centres and health posts) continued to provide the essential health package utilising regular supplies of drugs and basic medical equipment. During the year, UNICEF provided 1,419 MCH drug kits and 2,705 health post kits to facilities throughout the country. In the NEZ, the tsunami response continued to address the underlying problem of a lack of health facilities; 14 facilities have now been completed and outfitted with basic equipment as well as ambulances for community based emergency obstetric care (EmOC) services. Service delivery will begin in 2007.

7 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT The ongoing challenge is to ensure sustainability through improved training and staff recruitment. Access to MCH services for vulnerable IDP groups in NEZ also increased, reaching about 33,000 people in Bosasso and Gardho. Of particular note is the innovative Traditional Birth Attendant (TBA) project piloted in Bosasso (NEZ) which trained TBAs not only to screen pregnant women, but to generate community dialogue, consensus and action to reduce alarming maternal mortality rates. The new TBAs are the foundation of a community based EmOC referral system. An initial 90 TBAs were trained and within six months, were shown to have contributed significantly to increased deliveries in health facilities, increased MCH antenatal care service utilisation from 20% to 78%, and increased Maternal Neonatal Tetanus (MNT) coverage from 15% to 60% of women of childbearing age. A total of 602 TBAs were recruited and trained in 2006, covering all districts in NEZ. In the NWZ, together with partners, UNICEF trained a total of 125 TBAs, including 75 in all the IDP camps. Meanwhile, UNICEF and UNFPA jointly conducted an EmoC assessment in 120 health facilities in NWZ and NEZ. Based on key recommendations, UNICEF and UNFPA will finalize and implement a joint plan of action to standardize the EmOC package, train health service providers, and renovate and equip EmOC centres. A draft Prevention of Mother to Child Transmission of HIV/ AIDS (PMTCT) policy, guidelines and a training manual for Somalia were also produced as a new component of safe motherhood programming, in close cooperation with the GFATM programme. A training of PMTCT trainers was conducted in Uganda in late 2006 for 20 participants from the three zones. Disease Control efforts focused on malaria and cholera prevention and control activities. These activities were also reviewed regularly by the Communicable Disease Control Task Force of the Somalia Support Secretariat Health Sector Committee thereby ensuring ownership of preparedness and response plans annually revised by the zones. UNICEF s role as manager of the GFATM Malaria programme for Somalia, although technically not part of emergency programming, significantly enhanced humanitarian response in Effective malaria treatment (Artemisinin-based combination therapy) was introduced at health facilities, as well as a rapid diagnostic test to improve diagnosis. Through UNICEF s procurement system, more than 390,000 insecticide treated nets were provided to partners in 2006 for distributions targeting vulnerable groups such as pregnant women, children under five and families facing increased risk of malaria from riverine flooding. This shows significant increase from 2005 when only 132,000 treated nets were distributed. Immunization and Polio Eradication: Immunization services were strengthened through support for local authorities, national and international NGOs and community based organizations providing EPI services in 163 MCH facilities throughout Somalia. One of UNICEF s major contributions has been the establishment of a regular supply of vaccines through a complex logistical network of cold chain centres. Overall routine immunization coverage trends continue to stagnate since 2004, although there has been a steady increase for some antigens. Preliminary routine coverage figures for children under one in 2006 (with 90% reporting from partners) were 35% for BCG, 20% for DPT3/Polio3 and 22% for measles. In addition, 34% of pregnant women were reached with Tetanus Toxoid (TT2+) vaccination. To boost these routine EPI rates, UNICEF supported polio, measles and maternal neonatal tetanus campaigns during In the Lower Shabelle region of southern Somalia, 77,407 women of childbearing age out of a target population of 119,273 (65% coverage) received a protective dose of TT2+ through a campaign using TT-UNIJECT devices. A maternal neonatal tetanus campaign was also conducted in all three regions of NEZ during 2006, targeting 135,735 women and reaching 81,248 (60% coverage). The joint WHO/UNICEF Polio Eradication Programme conducted nine rounds of National Immunization Days (NIDs) in 2006, each round targeting over 1.4 million children under five with an average coverage of 90%. Innovations in 2006 included the implementation of synchronized NIDs with the Somali region of Ethiopia and in Northeast Kenya, as well as the introduction of a more aggressive community-based social mobilization strategy. Programme impact is evident in the epidemiological data: 185 cases were reported in 2005 compared to 36 in 2006, with the most recently reported cases localized in one district in the NWZ. This is evidence that the epidemic might be brought under control in Somalia, although suspicion and paranoia of polio vaccination still continues in some locations despite strong advocacy and communication initiatives. Meanwhile, the joint UNICEF/WHO measles catch-up campaign vaccinated over 2.2 million children aged nine months to 15 years in the NWZ and CSZ. Analysis of the disease surveillance report for January-December 2006 indicates a steady drop in measles incidence. Unfortunately, insecurity and flooding prevented access to some 291,755 targeted children in 14 districts of CSZ which will be prioritized in The campaign also strengthened routine EPI services by expanding the cold chain and improving injection safety/sharp wastes disposal, vaccine-preventable disease surveillance, capacity building and coordination mechanisms within the Ministries of Health. The integration of Vitamin A supplementation with the measles campaign was a critical component in the health and nutrition response to the drought; over 900,000 children received Vitamin A supplement alongside the measles campaign to strengthen their immune system.

8 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT NUTRITION In Somalia, 35% of children under the age of five are moderately or severely underweight, an indicator of both chronic and acute malnutrition and 11.2% are classified as severely underweight in the MICS These rates are alarmingly high by international standards and consistent with the recurrent droughts and the poor health care status of Somali children. Malnutrition status is worst in rural and nomadic households, CSZ as a whole, amongst the relatively poor and among children whose mothers have not attended primary school. Rates of malnutrition in the NEZ and NWZ are largely unchanged from MICS 1999, but have worsened in CSZ following the drought. Rates of exclusive breastfeeding for infants 0-3 months of age (13%) and timely complementary feeding among infants 6-9 months (15%) are low, however breastfeeding is often sustained to 12 months and beyond (50%). To reach the MDG 1 targets for the elimination of extreme poverty and hunger will require reducing the percentage of underweight children under five to no more than 13%. Following poor rains in late 2005, Somalia entered 2006 facing a serious drought. Already high long-term malnutrition levels increased and in some regions of CSZ, global acute malnutrition rates were recorded above 20% among children under the age of five years (particularly in Gedo and Middle and Lower Juba). Nutrition programme interventions remained as planned for NEZ and NWZ, but UNICEF s focus in CSZ shifted to emergency response to reduce morbidity and mortality. This response was coordinated by the new UNICEF-led nutrition cluster. Main partners included the Ministries of Health, WFP, WHO, FAO s Food Security Analysis Unit (FSAU), MSF-Belgium, MSF-Holland, ACF, IMC, COSV, Muslim Aid UK, Mercy USA, Mercy International, AMA, SAF, InterSOS, SOS, International Islamic Relief Organization, UAE-RC, CISP, SC-UK, World Concern, World Vision, IFRC, Somalia Red Crescent Society, Gedo Health Consortium (GHC). With this team, UNICEF worked to rapidly expand the coverage of selective feeding centres to reach and rehabilitate an estimated 47,000 malnourished children in the five worst drought-affected regions, including up to 8,000 severely malnourished children. Overall Assessment Through strong cluster leadership from UNICEF and generous donor support, the number of operational selective feeding sites in CSZ increased from 14 to 75 during the year, including 19 new Supplemental Feeding Centres (SFCs), four new Therapeutic Feeding Centre (TFC) and 38 community-based therapeutic care (CTC) programmes. In addition to supporting partners to set up these new sites and coordinating to fill gaps in critical areas, UNICEF was able to utilise timely donor funding to provide sufficient supplies for the treatment of 32,761 severely and moderately malnourished children under five years of age with an overall cure rate of 77%, slightly above SPHERE standards of 75%. A young girl s arm circumference is measured as part of a nutrition survey in Central and Southern Somalia. UNICEF/Bannon The cluster as a whole reached about 36,000 children, with a few reports still outstanding. Over one million children also received Vitamin A supplement to strengthen their immune systems. Despite these successes, only about 57% of the estimated number of malnourished children in CSZ as a whole was reached through the cluster response. In part, this gap is a reflection of the difficulty in estimating the number of affected children in a context of insecurity and poor population data. However, the scale-up of feeding programmes was also delayed by lack of capacity among partners on the ground in CSZ. Several months were spent mobilizing and training new partners. Local agencies with access to insecure locations had to be identified and trained as new partners, before the selective feeding programmes could be launched. In addition, the supply pipeline for food and screening equipment was under-prepared to cope with such a rapid expansion of the programme in early Positively, generous donor funding allowed UNICEF to increase the stockpile of supplies in the field during the year. In combination with the work already done to establish more trained partners, this enabled immediate response during the flood emergency in late 2006 and early Lack of access continued to be the single greatest obstacle to implementation of the nutrition programme, both in terms of reaching vulnerable communities with supplies and for monitoring the impact of interventions. Conflict prevented the establishment of 19 planned SFCs and one additional TFC during 2006 in CSZ, although all of these sites began providing services in January As international staff members were relocated, this placed a heavy burden of managerial work on national staff and limited UNICEF s ability to provide technical support and oversight to partners on the ground.

9 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT Of particular note is the successfully introduction of the CTC approach to the Somali context. The approached was used to increase the coverage of feeding centres for severe malnourished children in drought affected areas with little coverage of medical services. UNICEF assisted five international NGOs (ACF, MSF-B, IMC, WVI, GHC) to set up 38 CTC outreach sites in the drought affected regions of Bakol, Gedo and Middle Juba. The use of mobile teams has improved the accessibility of services and the home-based treatment ensures that caretakers and patients remain in their families, resulting in better recovery rates, less disruption of family life and more active involvement of the caretaker in the recovery of the child. The limited cadre of qualified medical staff available in CSZ is now less burdened with the treatment of uncomplicated severe malnutrition cases and more children are being identified and treated in remote communities. The use of the CTC approach during the drought response revealed that good services with acceptable recovery rates can be achieved even by less qualified health workers in the field without the need for many highly-specialized inputs. The challenge now will be to further roll out the CTC approach to community based organizations and health post level to ensure that treatment of severe malnutrition is accessible to the majority of Somali families during emergencies, alongside routine interventions. Main Activities and Results Selective Feeding: In addition to the dramatic expansion of selective feeding programmes in CSZ, one additional TFC was established late in the year in close collaboration with the Ministry of Health in Hargeisa hospital and one SFP opened in Burao IDP camp treating 102 and 88 children respectively. Nutritional surveillance and monitoring: Throughout 2006 ongoing monitoring of the nutritional status of children and women was coordinated amongst local authorities, UN agencies and NGOs across Somalia, with FSAU publishing monthly updates. In total, UNICEF and FAO/FSAU, assisted by NGO partners, conducted 17 nutritional surveys in various high-risk areas. Results were used to adjust implementation strategies to improve the impact of interventions. Food diversity, frequency of meals and general feeding and caring practices were found to be poor and significantly contributing to the high long and short-term levels of global acute malnutrition and nutrition related morbidity and mortality. Feeding Practices: To address these underlying causes of malnutrition, participative approaches to train caregivers on improved feeding practices were used alongside selective feeding interventions. Focus group discussions on infant and young child feeding and practical demonstrations of cooking complementary food were carried out on a monthly basis at 83 MCHs and 38 SFCs in CSZ. During the World Breastfeeding Week in August 2006, partner agencies working in the major towns in CSZ recorded 68,000 women reached with awareness activities on exclusive breastfeeding and complementary feeding. The impact of these various demonstrations has proved difficult to measure and UNICEF continues to work to adapt strategies for improved child feeding practices in a context of very low female literacy and limited access to the worst-affected communities. Micro-nutrient supplementation: To reduce Vitamin A deficiency amongst young children, supplements were provided as part of the national measles vaccination campaign, reaching 74% of children aged 6-59 months with a single high dose. In total, more than one million children aged 6-59 months received Vitamin A during measles campaigns, routine EPI activities, the polio NIDs and as part of the routine selective feeding protocol. In addition, over 39,400 pregnant women received low dose Vitamin A supplementation as part of the antenatal care package. WATER, SANITATION & HYGIENE (WASH) Diarrhoeal disease-related dehydration, respiratory infections and malaria are the main killers of infants and young children, together accounting for more than half of all child deaths in Somalia. The major underlying causes of water-related diseases are the lack of access to safe water and poor food and domestic hygiene. Results of the MICS 2006 show that only 29% of Somalia s population has access to improved drinking water sources (up slightly from the MICS 1999 coverage of 23%); 58% in urban areas and 17% in rural areas. Just over 37% of the population has access to sanitation facilities (77% in urban areas and 17% in rural areas). It is widely acknowledged that given the severe political and security constraints of the past sixteen years, Somalia will not reach the MDG 7 targets, which would require achieving access to safe water for at least 64.5% of the population. However, intermediate targets have been agreed upon with partners and the TFG. UNICEF s regular country programme is having success both at scaling up public-private partnerships for water supply in the more stable northern zones and in boosting education and health care services by providing clean water and sanitation facilities at schools and health facilities alongside hygiene education. Underpinning these results is UNICEF s support to institutional strengthening and policy development in northern Somalia, which remains crucial for the sustainability of all investments in the sector. Given the failed 2005 Deyr rains, southern Somalia faced a severely worsened humanitarian situation in The worst hit regions were Gedo, Middle and Lower Juba, and areas of Bay and Bakol. At the onset of the emergency, water shortages were the most critical need to be addressed. As livestock died, pastoralist communities lost their livelihood. Between January and March, UNICEF participated in interagency assessments for Bakol, Bay, Gedo and Middle

10 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT and Lower Juba to identify immediate WASH needs. The major water-related problems were the lack of generators, damaged borehole pumps, and the dropping water level in shallow wells. People were forced to queue for water for several hours each day. In some areas of Bakol, families reported spending between 70-80% of their income on water. Overall Assessment Provision of safe water was the main drought mitigation factor used to avert impending disaster. Strong emergency response was achieved in 2006, thanks to the success of the WASH cluster approach under UNICEF leadership and commensurate with funding levels. UNICEF s emergency response appeal targeted over two million people with safe water throughout Somalia, although this figure was revised downwards as more detailed information about affected populations became available. While fewer people required immediate assistance, the cost of reaching the most vulnerable communities mounted dramatically as lifesaving water trucking became necessary. In total, approximately 295,000 people worst-affected by the drought and 36,000 people affected by flooding (by end December) received emergency access to safe water through the UNICEF programme. Sustainable access to safe water was created for some 100,000 people during 2006 through the regular country programme. Notably, although Somalia is well known for annual cholera epidemics, an outbreak was once again avoided in Because of the increased risk of diarrhoeal disease outbreaks following flooding, UNICEF and partners scaled up hygiene awareness activities in CSZ, reaching about 45% of the floodaffected population with key messages before the end of the year. The introduction of the cluster coordination system was a key element of 2006 humanitarian response. Despite access and security constraints in the second half of the year, the WASH cluster as whole was able to extend safe water and sanitation services to 775,000 people affected by drought and about 40,000 people affected by flooding by the end of the year; thousands of additional families benefited from ongoing distribution of water treatment supplies, rehabilitation of water points and scaling up of hygiene and sanitation services in early Through frequent information sharing at national level and in the field, gaps in implementation and coverage were identified and addressed. In areas affected by insecurity and inaccessible to UN staff, UNICEF enabled international NGOs, such as World Vision, ADRA, COOPI and NCA, to revive and expand their WASH operations during the drought. Small scale funding agreements with local NGOs in limited-access areas also enabled the cluster to reach to the most vulnerable populations. In both cases, these efforts had a positive carry-over impact on flood response in insecure locations later in the year. Water trucking and well rehabilitation provide access to safe water in Huddur, April 2006 UNICEF/Kamber In an end-2006 analysis, UNICEF estimated that the cluster coordination system applied during the drought increased coverage of safe water and sanitation services by an average of 14% in all areas. Major cluster actors included WHO, ACF, Solidarité, World Vision, COOPI, World Concern, Concern Worldwide, ADRA, Horn Relief, COSV, CEFA, NCA, Intersos, Care Int., Oxfam GB, Save the Children UK, local NGOs and government partners. Main Activities and Results The 2006 WASH emergency programme concentrated primarily on drought and flood response in CSZ, and to a lesser extent on humanitarian response in IDP communities in NEZ. Interventions (either directly by UNICEF or through funding to partners) included emergency water trucking to 40 locations for 80,000 people for a period of three months, as well as the rehabilitation of 41 boreholes, installation of 43 rain water catchments, and deepening of 59 shallow wells as a sustainable exit strategy. Hygiene and sanitation campaigns took place in 60 drought affected communities and over 480 latrines were constructed with community labour to improve sanitation in seven IDP settlements. UNICEF integrates training for community level WASH management committees and operational maintenance in all its water supply project activities. Late in the year, UNICEF s initial flood response activities included the distribution of water treatment supplies, soap and jerry cans, as well as water trucking for the communities hardest hit by flooding and extensive hygiene promotion. Over 1,500 trainers were trained on hygiene education and reached 113,600 people with key messages on how to protect themselves and their children from water-borne and diarrhoeal disease. All flood response efforts were ongoing into early 2007.

11 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT Based on lessons learned during the drought response, the WASH cluster coordination system was integrated into the normative sector coordination mechanism as a dormant structure to be mobilized in times of emergency. This arrangement was designed to avoid overlapping coordination mechanisms and proved effective during the flood response experience also revealed the need to recognize the critical role/ ownership of relevant Somali water institutions in emergency response and procedures were adjusted to reflect this wherever possible (primarily in NEZ and NWZ). To involve all stakeholders and avoid an UNcentric system, cluster coordination will be decentralized to field level through the establishment of WASH task forces in This system should improve early warning systems, ensure field based contingency planning, and strengthen field coordination, data collection, monitoring and evaluation. EDUCATION Persistent insecurity, economic collapse and lack of governance, especially in the southern regions, have greatly hampered the development of the education sector in Somalia. Currently, only one Somali child out of every three receives basic education. There are considerable disparities in quality and access to education in all parts of Somalia due to prevailing socioeconomic, cultural and political realities. The majority of schools are concentrated in urban areas, effectively excluding rural children, especially nomadic children, whose enrolment is estimated at only 1%. Gender disparities are significant, with girls enrolment recorded at 35% and female teachers constituting only 13% of the teaching force. Currently, there are 1,867 operational primary schools in Somalia with a total of 393,856 pupils, representing a Gross Enrolment Ratio (GER) of 27.9%. Although this remains one of the lowest enrolment ratios in the world, incremental progress is being made each year to draw more children into school and to improve the quality of education, in line with the Education for All and the MDG goals of achieving universal primary education, promoting gender equality and empowering women. New initiatives for offering primary alternative education and non-formal education are successfully extending access to basic education to thousands of additional children and youth. However the national drought emergency, combined with flooding and escalating conflict in the CSZ during 2006, adversely affected children s right to education as family livelihoods collapsed, as well as the ability of the TFG to focus on policy development and reconstruction of the sector. Programming in the northern zones took a holistic approach in 2006 with recovery and development activities under the regular country programme. UNICEF focused on increasing access to and improving the quality of basic education within the broad framework of the Back to School campaign. In CSZ, programme emphasis for 2006 shifted to emergency response, feeding into the wider programme but with a particular focus on increasing access to quality basic education and using schools as a protective strategy for vulnerable children and youth, including those in remote rural areas, IDPs and girls. Overall Assessment A total of 45,444 (13,104 in CSZ) more Somali children had access to basic formal primary education in 2006, bringing the total number of children enrolled in formal primary school to 393,856, of which 205,506 are in CSZ. The primary school GER increased by 6%, up from 21.9% in 2005 to 27.9% in Girls GER also recorded a modest improvement from 15.9% to 22.1%, with 20,353 additional girls enrolled in school in 2006 (including 6,058 in CSZ). Both the increase in total enrolment and the increase in girls enrolment were about 50% of the planned target for the year, due mainly to increased poverty, conflict and the drought emergency. Meanwhile, 15,839 more children were registered in Primary Alternative Education learning centres, for a total of 70,343 children between ages six and 13 who are benefiting from primary/basic education. Non-formal education opportunities were extended to an additional 16,000 youth aged of whom 65% are girls. With only 43% funding against the CAP appeal, the programme was not able to target women with basic literacy and life skills education as planned. In summary, through support from all funding sources, both regular and emergency, over 77,000 out-of-school children and youth gained access to some form of basic education, alongside efforts to improve the quality of learning for about 348,412 already enrolled in formal primary school in In particular, emergency response strategies were used to keep the drop out rate in drought-affected areas of CSZ to a minimum. As the drought destroyed family livelihoods, it began to adversely affect the attendance of both boys and girls at schools in Bay, Bakol, Gedo, Lower and Middle Juba and Hiran. UNICEF led the new cluster response system, working with field-based national and international partners, community based organizations such as Community Education Committees (CECs) and District Education Boards, as well as the Ministries of Education and Youth and Sports. Key cluster partners included ADRA, NRC, InterSOS, Save the Children-UK, CISP, DIAL, COSV, SONYO, SACCID, World Vision, WFP, UNOPS and UNESCO. The response included school feeding, teacher training on pedagogy and psychosocial/trauma counselling, provision of teacher incentives, and advocacy and social mobilization to enrol and retain children. Within the cluster, UNICEF focused on the establishment of temporary learning spaces, distribution of learning materials, teacher training and mobilizing resources for partners.

12 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT Increased access to education: Over 10,000 children benefited from the establishment of tents to serve as temporary learning spaces during late 2005 and 2006 for both formal and non-formal education opportunities. This included IDP children in all three zones and those from remote rural areas, marginalized riverine communities, and tsunami-affected areas. UNICEF also supported the rehabilitation of 15 schools during seven in NWZ, 12 in NEZ (including four in tsunamiaffected areas) and two in CSZ - benefiting 3,140 learners of whom 36% are girls. Each of the schools was rehabilitated to a capacity of four furnished classrooms with a staff office, school store, latrines and water supply. Improved quality of teaching in primary schools: Building on successes of previous years, UNICEF continued training of lower primary teachers and training of head teachers through the mentorship programme. Following extensive training in 2005 on the new curriculum and textbooks, 775 teachers (258 females) from Jowhar, Mogadishu, Lower Juba, Bakool and Hiran received the second phase of training in 2006 on learner-centred pedagogy, life skills, classroom management, and participatory teaching/ learning methods. This brings the total pool of trained teachers in CSZ to 7,108. Temporary classrooms increase access to education in Merca. UNICEF/Howgego The cluster defined a priority of ensuring continued schooling for about 30,000 children in the drought affected areas and was able to reach 79% of that target, with some 23,700 children participating in basic education. A study of 75 schools targeted by the cluster showed that despite initial alarming drop out rates in late 2005, enrolment had increased by about 25% over pre-drought figures by July Main Activities and Results Distribution of essential learning materials: Alongside extensive advocacy with stakeholders and social mobilization with communities on the importance of education, all operational schools in Somalia received education supplies during the 2005/6 academic year, including kits for newly constructed or rehabilitated schools and schools affected by drought and floods. UNICEF provides essential materials including exercise books, pens, pencils, chalk, blackboards and school bags. About 350,000 school children were reached nationwide, including over 200,000 children in CSZ. The distribution effort also reached schools in the tsunami affected areas of NEZ. In addition, all schools in Somalia benefited from the distribution of 170,000 lower primary textbooks and teacher guides, including schools in flood and drought affected areas of CSZ, tsunamiaffected areas and IDP camps in NWZ and NEZ. This textbook distribution assisted schools to recover from losses and cater for increased enrolment. In addition, the skills of 3,601 IDP teachers (in existing schools in Mogadishu, Bossaso, Hargeisa and new IDP schools that were set up for displaced communities as a result of the various emergencies) from all zones of Somalia were trained on emergency preparedness and life skills such as HIV/ AIDS, peace and conflict resolution, gender and development, adolescent sexuality and psychosocial/ trauma counselling. In drought affected areas, this training reached 1,325 primary school teachers with a special focus on retaining and recruiting female teachers. To ensure the continuation of classes despite the inability of parents to pay school fees, UNICEF partnered with NGOs and WFP on a school feeding programme for IDP communities in drought affected regions and to provide incentives for 1,325 teachers for a period of approximately 9 months. Data collection, planning and monitoring: Basic Education Management Information System (EMIS) tools, including registers and pupil cards, were distributed to all schools in Somalia during 2006 to allow for record keeping, data collection, aggregation management and monitoring of education activities. Once the EMIS is operational it will take over from the annual school survey which is currently the most reliable source of school based data. The data will enable stakeholders to improve planning, monitoring and general oversight of the educational sector, including emergency response. COMMUNICATION, PROTECTION AND PARTICIPATION Most adolescents in Somalia have known nothing but conflict and hardship, are out of school and illiterate or semi-literate, have suffered displacement and have observed, experienced and sometimes participated in violence, use of weapons, drugs and other social ills. Violence against children, child labour and recruitment, and harmful traditional practices such as early marriage and Female Genital Mutilation (FGM/C) all feature in Somalia s landscape of child protection violations. Compounding these issues is the diminished

13 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT community capacity to protect the rights of women and children as a result of prolonged civil unrest. The monitoring of human rights abuses remained a key concern during 2006 due to poor access, particularly in the CSZ. Preliminary results of the MICS 2006 show that only 3% of births are registered. Marriage occurs relatively early in Somalia; almost 8% of women were married before they reached the age of 15 and 25% of all females aged are married. While HIV prevalence remains low in Somalia (<1% among antenatal care attendees in 2003), evidence suggests transmission is on the increase and misconceptions about HIV are common, hindering prevention efforts. Only 4% of young Somali women aged have comprehensive correct knowledge of HIV. In this context, the Communication, Protection and Participation programme makes contributions across the MDGs and the Millennium Declaration with particular relevance to combating HIV/AIDS (MDG 6), promoting gender equality and empowering women (MDG 3) and protecting the vulnerable (Millennium Declaration). UNICEF works in collaboration with a number of sister agencies under joint programming initiatives including UNDP, UNFPA, UN Habitat, World Bank and UNAIDS. Key international NGO partners include Oxfam NOVIB, Transcultural Psychosocial Organisation (TPO), Tostan, Support to Tropical Initiatives in Poverty Alleviation (STIPA) and Action Africa Help International. Strategic partnerships with national NGO partners include CCBRS, TASS, Greengates, COGWO, Wawa, CCS, HornAfrik, and SDT. Key government counterparts amongst the subnational authorities include the Ministries of Justice, Social Welfare and Family Affairs and of Religion, and the AIDS Commissions. Overall Assessment In 2006, progress was most notable in the areas of community capacity development, prevention of HIV among adolescents and women, and enhancing child participation in policy development processes. Given the increasing insecurity in Somalia, recruitment of consultants and staff proved challenging during 2006, particularly for duty stations inside Somalia. This resulted in slower implementation rates for the programme, which is by nature a human resourceintensive undertaking. A pool of 25 trainers was created in 2006 to train partners, local authorities and service providers on child protection in emergencies with the aim of mainstreaming awareness on core child protection issues into sectoral emergency preparedness and response. Other key achievements include the joint Community Driven Recovery programme and the youth poll which underpins policy development processes by ensuring child/youth participation from the earliest stages. In 2005, UNICEF introduced a process aimed at strengthening community capacity to fulfil, respect and protect women s and children s rights through a participatory dialogue on rights. In 2006, this has evolved into a full-fledged approach to a rights-based Community Driven Recovery initiative. In partnership with the World Bank, DFID and UNHABITAT, UNICEF is spearheading community capacity development through Participatory Integrated Community Development and leveraging connectivity and local government capacity development in relation to children and women. Members from 15 Community Development Committees in seven districts (3 CSZ, 2 NEZ, 2 NWZ) contributed an estimated 5% of the inputs indicated in Community Action Plans that were developed in late 2005 and early Seven of the 15 communities now have access to basic social services including MCH care and primary education. In addition, 48 drought and tsunami-affected communities have gone through a process to enhance community participation during emergency response by harnessing community based resources to mitigate the effects of natural disasters. As the first of its kind in Somalia, the youth poll in 2006 provided a unique opportunity to listen to children s voices on topics that are rarely addressed. The survey sampled both urban and rural school children, collecting the views of 530 children and youth from age Key findings include that nearly half of respondents were not aware of any mechanism in their community for consulting children on matters that affect them, while 57% consider FGM/C a harmful cultural practice. The poll is being used as a vital component of a youth policy development process that began in 2006 and emphasizes youth participation. Consultations including both young people and government authorities in NWZ and NEZ resulted in an endorsement of the policy formulation process. Main Activities and Results Leadership Advocacy and Community Mobilization on Child Protection: UNICEF s strategy on child protection includes advocacy with leaders in society, as well as mobilizing community child protection committees. Progress was not as rapid in 2006 as UNICEF had hoped, but significant steps were made. Approximately 1,950 duty bearers were reached through 59 workshops on child protection advocacy in Somalia. Participants included policemen and women, district authorities, teachers and religious leaders. Examples of behaviour change in the home as a result of advocacy on child protection include reports of reduced domestic violence and child labour, as well as improved approaches to children in contact with the law in police stations and in the identification of alternative measures for dealing with child offenders. Meanwhile, a total of 5,240 community members in 143 communities across Somalia were mobilized by 44 trained child protection advocates and began referring cases of emergency protection to social service providers. Key accomplishments include access to prosthetics and to specialised schooling for children with disability; referral to medical services for victims of sexual violence; and family reunification for street children or children displaced from their families. The establishment of child protection focal points in five IDP communities offers a permanent child protection presence in these communities.

14 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT Child Protection Monitoring and Reporting: UNICEF established a child protection monitoring and reporting system in 2006 as a mechanism for monitoring and reporting on six egregious violations established by the Security Council Resolution 1612 to improve and guide UNICEF programming. As a result of capacity building work with international and local NGOs, 30 trained monitors investigated and reported on violations ranging from sexual violence and rape of children to armed attacks on schools and hospitals. Joint advocacy and response by the newly established interagency task force covered recruitment of children into militias, risk of mines and unexploded ordnance, and genderbased violence. Psychosocial care and support: Building on a strategy finalized in 2005, UNICEF took clear steps in 2006 to establish a system of psychosocial care and support in Somalia by integrating the topic into teacher and health worker training; building the institutional capacity of government counterparts in NEZ and NWZ to deliver psychosocial care and support services; and mobilizing partners to provide the service to vulnerable populations and during acute emergencies. The project successfully oriented 90 health workers and 112 teacher trainers from all three regions, who in turn trained more than 400 teachers. Following extensive training in 2005, seven local NGOs also provided these services to vulnerable populations including IDPs during HIV Prevention and Awareness: To strengthen staff capacity to respond to HIV in emergencies, 27 UNICEF staff members from CSZ and 23 partners were trained on the Interagency Standing Committee guidelines for HIV interventions in emergencies, the Core Commitments for Children, and in using multi-sectoral approaches to prepare and respond to emergencies. Capacity development of six regional HIV/AIDS working groups in CSZ continued, resulting in increased coverage and access to vulnerable and hard-to-reach groups in areas affected by natural disasters and conflict. These groups included truck drivers, female khat vendors and militia men. UNICEF also provided 160 women and men living in IDP camps in the Mogadishu area with HIV prevention, care and support information. As part of UNICEF s larger youth participation programme, 55 youth peer educators/mentors reached 5,600 youth group members with life skills training in HIV/AIDS (including 160 marginalized young people in IDP camps in CSZ). The project s mid-term review showed that youth peer educators were already much more comfortable discussing issues related to HIV prevention and gender equality. To complement this, an intensive one-week advocacy campaign was launched in six regions of NEZ, four in NWZ and eight in CSZ. Youth organizations arranged youth forums, dialogues with community leaders, games and sports events reaching several thousand young people and community members with critical information on HIV prevention, care and support. Meanwhile, the Woman-to-Woman Initiative on HIV and AIDS builds on existing women s development programmes in literacy and micro-finance, to also strengthen women s participation in HIV response and reduce their risks and vulnerability. Following a training of trainers for 90 women, new trainers used a Somali language took kit developed and translated by UNICEF in late 2005 to conduct peer education sessions and home visits with vulnerable women, particularly female IDPs, female-headed households, widows, adolescent girls, and female khat vendors. Many participants highlighted this as their first opportunity to discuss such sensitive issues among peers without restriction. Complementing leadership advocacy forums convened through the regular country programme in NEZ and NWZ, UNICEF supported 56 HIV forums in CSZ specifically targeting women, IDPs, teachers, young people, and community and religious leaders. These forums were facilitated by trained advocates using the Somali language toolkit to address stigma and discrimination of people living with HIV; modes of transmission and prevention methods; advocacy; and the benefits of voluntary counselling and testing. To complement the toolkit, the 16-minute Somalis on HIV and AIDS - Taking Action, Making a Difference video was developed and launched on World AIDS Day. Youth development and participation: More than 5,600 members of youth groups acquired leadership and organisational development skills in 2006 (including 160 marginalized youth living in IDP camps in CSZ). Youth demonstrated increased capacity for active participation in community development activities such as immunization campaigns, peer education on HIV and gender, mobilization to increase school enrolment, hygiene and sanitation campaigns and organizing sporting events. The rehabilitation of three sports/ playgrounds (Jowhar, Gabiley, Hargeisa) has provided children and youth with a sporting chance. One, at a girls centre in Hargeisa will allow girls to play basketball as they learn both life and practical skills. The rehabilitation of the Gabiley sports ground in NWZ came as result of training provided to youth on local governance. Youth then successfully advocated with the district municipal council to contribute to the cost. Communication Initiatives: Somalia has a rapidly growing media environment that has provided an additional channel for behaviour change strategies during Youth contributed 300 articles in Somali language to the KOOR Magazine by youth for youth, for a total of six issues and a nationwide distribution of 18,200 copies through UNICEF supported youth groups (7,200 in NWZ, 8,000 in CSZ, and 3,000 NEZ). Topics included HIV/AIDS (45%), FGM/C, youth leadership, education, conflict resolution/peace building, child rights, khat chewing, smoking and hygiene. A multi-media initiative on HIV and AIDS prevention, care and support in Somaliland produced 32 informative features and live panel TV discussions with call-ins, 29 radio broadcasts over five months, public service announcements for 120 days, and 66 feature articles in three newspapers.

15 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT For the Youth Radio Programme, 64 youth were trained on radio broadcasting and produced 38 radio features and a drama series; 16 programmes were aired twice by local radio stations, addressing drug abuse, unemployment, peace building, malaria prevention, FGM/C, early marriage and HIV/AIDS. Finally, trained youth webmasters (two girls and four boys) managed the website to give Somalia s youth a forum to discuss sports, education, drug abuse, conflict and militia, among other topics; 35 articles were submitted for posting and 450 users have registered. PLANNING, MONITORING AND EVALUATION Across each of the five core programmes, UNICEF works to ensure that data is collected to analyze the situation of children and women, that cross-cutting strategies and lessons learned are effectively integrated into a systematic planning process, and that the monitoring and evaluation capacity of UNICEF and local authorities is strengthened. Main partners are the UN Country Team (Working Group on Statistics), UNOCHA, the Somalia Support Secretariat (Health Information System Working Group), SIMAC (interagency spatial data workgroup), FAO/FSAU and the Ministries of Planning. UNICEF s Mid-term Review in June 2006 was a key process in the current country programme cycle ( ), providing an opportunity to assess performance to date, adjust the programme to the evolving situation in Somalia, and update Emergency Preparedness and Response Plans for each zone. Review processes were strengthened in 2006 by decentralization to the zones where the authorities were formally engaged in the process. The Ministry of National Planning and Cooperation in Somaliland hailed this as a best practice among UN agencies. To strengthen emergency preparedness capacity at zone level, UNICEF also seconded a staff member into Somaliland s National Environment Research and Disaster Management Authority (NERAD); this will be rolled out to Puntland s Humanitarian and Disaster Management Authority (HADMA) in Cluster Survey (MICS) combined with modules from PAPFAM Reproductive Health Survey. The survey sampled 6,000 households across all regions of Somalia to provide updated national and zone-level estimates for a spectrum of social sector/mdg indicators since the last MICS in 1999, including infant and child mortality, access to services and some selected standard behavioural indicators. For the first time in Somalia, maternal mortality ratios were estimated from birth history data for women of reproductive age. A wide range of partners were engaged in the field work. A preliminary report was prepared in November and a full technical report is scheduled for review in March In 2006, the group issued a consensus estimate of Somalia s population size, location and structure for use by all UN partners, including the Joint Needs Assessment and the emergency flood response. Finally, an initial database for Somalia has been established in DevInfo. Key data from the drought response has been entered into a Horn of Africa database, but mechanisms to routinely update this have yet to be established. FAMILY SHELTER & RELIEF Although initial UN estimates of the flood-affected population in CSZ (455,000 people in November 2006) were revised down to 255,000 people by February 2007, UNICEF responded immediately in November to procure additional non-food items and to distribute prepositioned family relief kits to vulnerable households. By the end of the year, more than 17,300 households or more than 100,000 people had received critical survival supplies such as blankets, plastic sheeting, mosquito nets, jerry cans and cooking sets. More than 20,000 additional family relief kits were also in the pipeline for distribution in early The Joint Needs Assessment and companion Reconstruction and Development Framework for Somalia were completed in 2006 with active UNICEF leadership of the Social Services and Protection of Vulnerable Groups cluster. Despite the dynamic political context, the process was able to ensure that all the major authorities (TFG, Puntland, Somaliland and ICU) were engaged in prioritizing and costing needs for Once cleared by the JNA Secretariat, these reports will be published and available at In partnership with UNFPA, UNDP, the League of Arab States and the Ministries of Planning of TFG, Puntland and Somaliland, UNICEF undertook a Multiple Indicator Families displaced by flooding in Bulo Shiek village receive insecticide treated nets along with other non food items in December UNICEF/Yalahow

16 SOMALIA CONSOLIDATED EMERGENCY THEMATIC REPORT FUTURE WORKPLAN In 2007, UNICEF is seeking to strengthen and expand its emergency health response through the provision of basic primary health care services for 1.4 million people affected by conflict and drought/flood in CSZ and to reach a further 400,000 displaced people dispersed across the country. Since nutritional recovery takes time, the children who experienced the severe drought situation in 2006 are expected to be more vulnerable to infectious diseases and complications that will increase morbidity and mortality. Priority interventions will focus on the provision of expanded primary health care services to combat the main communicable diseases and to promote safe motherhood. The nutrition programme will aim to support up to 60,000 malnourished children to prevent excess mortality and promote their nutritional well-being. UNICEF will work with partners to expand life-saving selective feeding coverage and address the underlying causes of malnutrition that were identified in the 2006 drought response. To ensure nutrition response in remote or insecure areas, the community-based therapeutic care approach will be expanded. UNICEF will target up to 300,000 people with emergency water and sanitation services, particularly those affected by flooding and conflict in late A key concern is the spread of water-borne diseases in early 2007 following widespread flooding and contamination of water sources. UNICEF will focus on partnerships with international and local NGOs to reach the most remote areas. Capacity building of local partners will be central in the response, as well as convergence with health, nutrition and education interventions. To help children realize their right to education, UNICEF will set up temporary learning spaces and provide educational materials, together with appropriate incentives and training to ensure quality education and to retain students and teachers. These activities will be integrated into the Go to School campaign that will cover all areas of Somalia, with particular focus on girls and hard-to-reach groups such as IDPs. The capacitybuilding components aim to support the development of local and national institutions to assess the situation, provide educational opportunities, coordinate the response and monitor the impact of emergency education interventions. The impact of drought, floods and conflict on livelihoods and on the availability and access to food and water exposes children and women to increased risk of violence, exploitation and HIV transmission. UNICEF is tackling these issues by focusing on community-based programmes to build a rights-based culture amongst vulnerable groups, such as IDPs and their host communities. Key targets in 2007 include expanding the coverage and capacity of partners and community based groups to monitor and respond to child protection violations; train and deploy psychosocial workers and establish peer support mechanisms to respond to abuses, particularly gender-based violence; and develop mine-risk education materials for community mobilization and for use in schools. Across all programmes, UNICEF will maintain family shelter and relief supply stocks for rapid response in emergencies in support of the Core Commitments for Children. This will include the provision of non-food items to flood and conflict-affected communities in early 2007, as well as pre-positioning of supplies for additional response to newly displaced populations or vulnerable IDP families during the year. Finally, early recovery is a cross-cutting programme in the 2007 CAP and UNICEF s projects in this area are aimed to support the link between relief and development, with special emphasis on rebuilding sustainable livelihoods. The programme emphasizes capacity development to ensure that both authorities and communities retain and build upon the benefits of humanitarian interventions. This will include supporting community-driven development to integrate a human rights-based approach, and support the participation and political inclusion of women, minorities and youth as new local government structures are established. Eager students at an IDP school in Hargeisa, August 2006 UNICEF/Howgego EXPRESSION OF THANKS On behalf of the children and women in Somalia who have benefited greatly from your generosity, UNICEF thanks all our donors for your support and commitment during the multiple emergencies faced in 2006.