UNICEF Somalia 2021-2022 thematic support health and protective environment

This contribution uses a thematic support modality which means that UNICEF is able to co-mingle the Swedish funds with other funds they have, both regular resources and other mobilised resources. Results attribution is therefore sometimes difficult, but in theory and with this flexibility the Swedish resources leverage the results UNICEF is able to generate in the thematic area. Some examples of results include: The Sida funds bridged a critical gap in procuring traditional routine immunization vaccines, with more than 630,000 children benefitting from these. In addition, an estimated 384,443 women have received their first dose of the tetanus vaccine, a first step to preventing maternal and neonatal tetanus in 2022. The Sida funds also supported delivering essential health services in critical locations where populations faced significant threats from the drought with limited resources to safeguard existing health service delivery. Through this support, UNICEF supported the MOH Puntland to maintain essential health service delivery to an estimated 1,017,640 population in Mudug region through 24 hospitals and 10 Mother and Baby Friendly Areas (MBAs). Approximately 303,698 people accessed outpatient services in 2022 in these facilities. Further to this, 25,949 pregnant women could attend their first antenatal visit, 14,629 completed the required four antenatal visits and 17,863 deliveries occurred in these facilities with support from a trained midwife in 2022. Sida funds were also instrumental in the rollout of the DHIS 2 system that is now fully transferred to and managed by FMoH and Somaliland MoHD. With this funding, UNICEF supported the training of districtlevelstaff on using the DHIS 2 system and, more importantly, the printing and distribution of revised reporting tools. At the end of 2022, 93.3 per cent of health facilities registered in the DHIS 2 platform submitted complete and timely reports. Sida funds contributed to making possible to invest in three-year partnerships with 19 local non-governmental organizations (NGOs) and establishing Annual Work Plans (AWPs) with 14 government ministries at both federal and federal member state level, Puntland, and Somaliland. This contribution was instrumental to strengthen child protection systems, legislation, and structures to ensure that Somalia fulfils its obligations as enshrined in the UNCRC and to continue to support the capacity enhancement and professionalization of the social service workforce and in CP/GBV service provision through the social work degree and diploma program, multi-sectoral GBV services and case management roll out. Sida funds contributed to the work on changing social norms harmful to the safety and development of children, especially in reducing the social acceptance of practices harmful to children and women in targeted locations with improved access to services for GBV survivors. Sida funds contributed to the successfully reintegration of 954 children associated with armed forces and groups' - CAAFAG - (794 boys, 160 girls) back into their communities.

The contribution is focused on two areas: health and protective environment Health: UNICEF states that the overall purpose of its support to Somalia’s health programming is to ensure that more children aged 0-18 years and women benefit from quality comprehensive health services and healthy life practices. Programming will, UNICEF informs, therefore focus on strengthening evidence-based planning, budgeting and monitoring for maternal, neonatal, child and adolescent health (MNCAH), improving quality MNCAH services as well as family care practices for health and nutrition and institutionalizing community health approaches. As part of Somalia’s strategy, to reduce neonatal mortality, UNICEF aims – with the contribution from Sida - to provide continued support to evidence-based low-cost high impact interventions to mothers and babies to reduce new-born mortality and still births. UNICEF support includes trainings of midwives, nurses and doctors on early essential new-born care, which UNICEF with Sida support seeks to roll out in two federal member states: Hirshabelle and South West States. Complemented with supplies and equipment, competency-based training will - according to UNICEF - target health professionals, primarily midwives, nurses and doctors from regional hospitals, health centres and peripheral health units (PHUs) to deliver quality interventions for pregnant and lactating women and their babies. In terms of actual activities, UNICEF states that these are derived from the essential package of health services (EPHS) with primary focus to establish quality care targeting pregnant and lactating women and their babies using community, health facility and mobile clinic platforms. This includes: -Cascade (already prepared) various forms of competency-based training to build skills and knowledge of health professionals (midwives/nurses/doctors) and other front-line health cadres (e.g. community health workers). -Provision of new-born care and other related mother and new-born supplies and materials. -Monthly performance monitoring meetings to review indicator trends. -Complementary resources to NGO partners in targeted areas to accelerate mother and new-born health service delivery, emergency referral and community accountability mechanisms (e.g., community health committees). -Develop an integrated health and nutrition “first pregnancy” strategy for UNICEF; and, conduct a detailed assessment and roadmap for gradually supporting the state MOHs to manage managing their own cold chain to enable deliver safe, effective vaccines. -Prepare contingency plans, capacity development and pre-positioning of supplies to enable the different state ministry of health to prepare and respond to regular cyclical shocks (floods, drought)- given chronic humanitarian needs (annual cyclical shocks) affecting the two states. Examples of indicators that will measure progress and results for Health: - Percentage of deliveries attended by skilled health personnel - Percentage of pregnant women who attended at least four times for antenatal care during their pregnancy - Percentage of children under 1 year receiving measles-containing vaccine Protective environment: The humanitarian crisis in Somalia is among the most complex and longstanding emergencies in the world. The protective environment for children has been weakened due to more than two decades of conflict resulting in the collapse of institutions at all levels. The perpetration of grave child rights violations including the recruitment and use of children by armed forces and groups remains a major concern in Somalia. Under the programme for protective environment UNICEF will provide technical support to the Ministry of Women and Human Rights Development and the Ministry of Justice to develop an effective child protection system. UNICEF will support the Government in accelerating the domestication of the Convention on the Rights of the Child through building a stronger legislative and policy environment. The Child Protection Information Management System will be rolled out nationwide, providing case management tools that reinforce accountable services and follow-up. UNICEF will furthermore in the area of child protection/protective environment: -Strengthen the protective environment for girls and boys in school. -Support children affected by armed conflict (including maintenance of the monitoring and reporting mechanism on grave child rights violations). More specifically, the contribution will help to support the retention of girls and boys in school by contributing to a wider safe schools initiative that is being developed between the UNICEF education and child protection teams. The broader program includes the development of school councils, teacher codes of conduct, improved pre- and in-service teacher training, higher female teacher ratios, as well as empowerment self-defence and "your moment of truth" violence prevention norm change programming for students. Examples of indicators that will measure progress and results for Protective Environment: - Outcome indicator: Number of schools and adolescent students (by sex) engaged in a safe schools’ programme incorporating adolescent empowerment - Outcome indicator: % of girls and boys recruited and used by armed forces and groups that have been released and reintegrated with their families and provided with adequate care and services For both Health and Protective Environment UNICEF has provided a results framework with indicators, baseline and targets allowing for a results oriented approach and close follow-up and dialogue on the progress of implementation. Examples of those is presented above under each thematic area.  COVAX vaccines and the roll out of Covid-19 vaccination campaign  The first batch of COVAX vaccines (300 000 doses) arrived to Somalia on March 15, 2021.  The Covid-19 vaccination campaign is of vital importance as a critical public health intervention to help contain further spread especially amongst the vulnerable populations. The COVAX facility will provide vaccines for 20% of Somalia's total population. In this regard, Somalia will receive vaccines to cover 3,134,106 individuals, taking into consideration the population of Somalia being approximately 15,670,529 persons. Each eligible individual will receive 2 doses of the vaccine so, meaning that 6,268,212 million doses are expected to be administrated.   In close collaboration with the Federal and State Ministries of Health, UNICEF and WHO developed a plan and budget to cover for the operational costs for the vaccination campaign. To cover the operational costs for the 6,2 million doses that are expected, it is calculated to cost approximately 25 MUSD, or per doses administrated 4 USD. The plan developed includes the following key activities planning and coordination, logistics and vaccine management; human resources; training and meetings; supplies and equipment; transportation; social mobilization and communication; and M&E tools and biometric data collection; intra- and post-campaign monitoring; AEFI (adverse events following immunization) surveillance; and other forms of necessary technical support.   The expected outcome of the Covid-19 campaign is vaccine induced immunity to protect against Covid-19, which will protect vulnerable groups and detain further spread of the virus. The proposed 5 million SEK will cover full vaccination (2 doses) of approximately 74 000 Somalis.