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Executive Summary
The current OFDA and DFID funded Water and Sanitation, Nutrition, Health Promotion and
Environment activities are on track to achieve their objectives by the end of their respective
funding periods. Objectives where the project exercises greater controls such as water point
construction and cure rates are likely to be met, which is particularly noteworthy as project
staff were able to access the location for approximately 30% of the time. Other indicators
which are more contingent on the local population’s participation such as malnutrition
prevalence, and latrine adoption are not performing well and may not be met. These activities
are much more subject to local security conditions grounded in long-term change factors
rooted in local custom, tradition and context. Unexpectedly, attempts to provide services or
build communal assets to serve all communities involved in the conflict have positively
contributed to a local de-escalation of tensions.
Sectoral activities and methodologies were consistently shown to be appropriate and
competently implemented. Activity constraints varied by sector.
Water & Sanitation technologies were appropriate both in their design and by their ability
to redress both chronic and acute needs. They were constrained by the degree of
community engagement and cross-sectoral linkages in the project.
Health Promotion & Children’s Activities also demonstrated very strong methodologies
and cost-effective approaches. However the activities are not likely to fit within future
government priorities or budgetary capacities. Without project support, community
capacity or desire to sustain these activities is also weak.
Environmental Health & Livelihoods, supports valued and appropriate activities at the
household level. These activities are not critical for public health. Their impact and
sustainability are also premised on a local partner whose organisational capacity is weak.
Nutrition activities show very strong clinical, case and project management. Issues related
to the supplementary programming limit sectoral performance overall.
The mix of project activities was seen to be responding to the fluid security context. The
project is making a valued contribution in building household resilience and community
coping capacity (public health -water, hygiene and nutrition).
General Recommendations
Despite the current stable security conditions, the threat of insecurity strongly necessitates a
continued project presence. In this relatively stabilised environment, acute needs were
observed to be less pronounced than ones of recovery and development. Water, latrine,
HPCA coverage levels and nutrition centres of activity are met and established. Rather than
more capital investment in these sectors, activities to support local capacity to sustain
activities, increase their impact and respond to emergencies should be emphasised. While
continuing to provide services and making investments that de-escalate local tensions.
Recommendations for strategy
A new strategic plan should be developed for the final period based on the recommendation
above. The programmes approach to conflict sensitivity should be specifically articulated by
preparing a tension reduction strategy through equitable service provision based on the
conflict sensitivity report already produced. Each potential activity should be recognised as a
political act and balanced against explicit acknowledgement of how the activity could go
wrong and the cost to Tearfund or other communities of getting it wrong. Sustainability plans
for Nutrition should be reviewed, and capacity building efforts limited to stabilisation and
management of severe cases. This substantive change to the programme is currently being
planned and developed as part of the new nutrition strategy.
Other recommendations
Other recommendations included setting sectoral quality standards with which all activities
should comply in 2009 – 2010 (ie water installations, nutrition coverage and measurement).
In response to this Tearfund are establishing acceptable lowest quality standards for periods of
remote management, but will continue to monitor against external standards for each sector
during times of access.
It was suggested integration could be improved by appointing a single staff member to be the
point person for a community, and each sector to take responsibility for promoting positive
health behaviours not just Health Promotion. Tearfund have responded by focusing on
improving integration., one example is the Health Promotion sector have already conducted
joint training with nutrition and Watsan staff to promote better integration.
Sectoral plans should be made together with local partners to locally manage / continue
activities in case of future staff evacuations, and to respond to acute crisis, ie large
displacement. In response Beida projects have pre-positioned stock in place and are ready to
respond to new displacement in coordination with partners should this occur.