Medair - HAP International

2011 Annual Report for HAP 

ORGANISATION: Medair 

Introductory comments (history of accountability work in the organisation, HAP membership, accountability framework etc.): 

Medair is an international, faith-based NGO working with under-served populations in relief and rehabilitation situations after humanitarian 

crises, and has been operating out of Lausanne, Switzerland for the last 20 years. We are ZEWO registered, a founding member of the 

Humanitarian Accountability Partnership, contributors to the ECB Good Enough Guide, and certified under ISO 9001: 2008 for services to 

our ‗customers‘, the beneficiaries in our eight country programmes. 

Medair continues to champion its accountability to beneficiaries in all of its country programmes, and improve its quality of service delivery 

in terms of the on-going integration of participation and accountability in all stages of the project management cycle, in particular linked to 

monitoring activities. Each country programme team has a focal point for beneficiary accountability (BA), supported by a BA focal point at 

Medair‘s head office. 

1. Establishing and delivering on commitments 

Key goal for 2011 Achievements/ challenges/ lessons learned 2012 objectives 

1. BA is incorporated in new organisational 

strategy through an initiative on 

excellence in programme delivery 

2. Continued BA presentations in sector 

workshops/ Country Directors Workshop 

3. Explore potential of accounting software 

to positively impact Medair‘s ability to use 

resourcing with greater agility in order to 

serve beneficiaries more efficiently 

4. Attend HAP-I General Assembly 

5. Continue to distribute Good Enough 

Guide electronically; revise Medair BA 

guidelines 

6. Include beneficiary focus on Medair 

website & in Medair quarterly 

newsletters; send information for Medair 

affiliates to use 

7. Harmonise BA briefings at HQ for 

internationally recruited staff and in field 

8. Review field job descriptions to include 

some BA responsibilities as appropriate 

1. Excellence in programme delivery included 

in organisational strategy through a focus 

priority on quality by HQ sector advisors 

2. BA included in HQ sector advisors‘ 

presentation on programme quality to all 

country directors at Aug conference, and at 

annual WASH conference for field staff 

3. Introduction of Navigator software has 

allowed more precise tracking of 

expenditure and financial visibility, allowing 

for appropriate reallocation of resources 

4. HAP-I GA attended by the Programmes 

Manager; no revision undertaken to Medair 

BA guidelines 

5. Beneficiary focus has become a regular 

feature of Medair publicity 

6. BA presentation at HQ briefings for 

internationally recruited staff rationalised 

within project management session 

7. Field staff job descriptions reviewed with 

regard to BA to fit better with main role 

1 

1. Sector advisors to work with country 

programmes to develop appropriate 

programme quality indicators/ dashboard 

2. BA to remain a key cross-cutting issue 

within Medair and part of presentations 

3. To extend Navigator to other HQ/ Field 

departments will improve visibility in more 

programme support areas 

4. Medair to consider whether a parallel 

process to HAP certification is possible 

within Medair‘s quality system 

5. Country programmes to continue to 

explore how BA principles can be best 

contextualised in projects 

6. Medair HQ to develop a series of selflearning 

study modules for new field staff 

7. New HAP Work Plan to be developed

Afghanistan 

To incorporate beneficiary accountability 

into all project activities. 

D R Congo 

Streamlining of BA throughout project 

cycle 

BA activities currently required in Medair 

COD programmes to be implemented in 

all projects in 2011. 

By end of 2011, BA activities outlined in 

table 2 are systematically implemented in 

all Medair DRC projects. 

Afghanistan 

WASH/ CFW projects used surveys/ B 

feedback forms to obtain key information 

from Bs; helped direct implementation of 

programme activities, monitor staff 

behaviour/ performance 

Significant challenge: rumours/ false 

accusations undermined Badakhshan 

nutrition programme. Factions within v 

conservative area opposed M‘s work with 

vulnerable women; dialogue with mullahs/ 

Bs/ village elders/ community/ district leaders 

to resolve issue, but tensions remained 

between project & small part of B population 

D R Congo 

More communication with Bs and partners in 

all 3 sectors of activity 

Communications with Bs in local languages. 

M discussed with officials of relevant gov‘t 

ministries/ LAs: (local MoH office, Provincial 

Roads Office), before signed conventions/ 

agreements on nature of project 

implementation. Progress reports on work 

achieved & intended interventions regularly 

communicated in WASH/ rehab. projects 

M continued to inform LAs re project 

activities, ad hoc then more systematically 

throughout 2011, e.g. announced extension 

of WASH project from Sep to Dec. 

Contracts signed with health centres/ district 

health offices supported by Medair, 

indicating responsibilities of M/ HCs/ DHOs 

At start of projects, met with LAs to explain 

objectives, then mass communication (where 

Afghanistan 

Continue to develop and improve 

beneficiary feedback forms, to be utilised 

in all project activities. 

FCO to report back to project managers 

with feedback from beneficiary community 

obtained through one-on-one interviews. 

D R Congo 

Continue to ensure that BA remains a 

fundamental part of all our projects. 

2

Use of ‗Most Significant Change‘ (MSC) 

methodology to monitor/ evaluate impact, 

without using indicators, in 2+ projects. 

Haïti 

Review field job descriptions to include 

some BA responsibilities as appropriate. 

media available) or oral/ written methods in 

other areas to reach targeted villages. 

Satisfaction surveys conducted at WASH 

project sites incl. survey at water points to 

evaluate frequency/ utilisation trend; e.g. a 

pump not open long enough during day 

addressed with well management committee 

Knowledge, Attitudes & Practice (KAP) 

surveys conducted at onset of WASH project 

re hygiene practices in communities. Survey 

at end to see if behaviour change achieved. 

Intended to use MSC methodology to 

measure impact of projects on Bs; not done 

Haïti 

Haiti - Website contributions: ‗Haiti: One 

Year Later: 11,622 Haitians Safely Housed‘ 1 . 

(10 Jan 2011); ‗Haiti: What Makes a House a 

Home?‘ 2 (11 Jan 2011); ‗Days Are Where 

We Live‘ 3 (15 Dec 2011) 

Job descriptions with BA responsibilities 4 

All proposals/ reports had community 

mobilizing & database/ M&E component/ 

section. 

B focus constantly repeated at meetings (i.e. 

carpenters encouraged to remember that 

building T-shelters for individual families). 

Treatment/ interaction by NRS to Bs also 

Haïti 

To increase capacity of local staff in M&E 

techniques to be performed at field level 

To complete assessment in new sections 

and incorporate this data into existing 

database. 

All data, including GPS coordinates and 

pre- and post-intervention photographs of 

each site, to be entered into a database 

and linked to Google Earth to allow visual 

representations and simplify tracking. 

To create labour database to track all work 

accomplished and to aid in attaining goal 

of gender equity. 

1 http://www.medair.org/nc/en/infochanel/news/detail/article/one_year_later_11622_haitians_safely_housed/ 

2 http://www.medair.org/nc/en/infochanel/news/detail/print/article/what_makes_a_house_a_home/ 

3 http://www.medair.org/nc/en/infochanel/news/detail/article/days_are_where_we_live/ 

4 Monitoring and Evaluation Assistant, Monitoring and Evaluation Assistant, Quality, Lead Community Mobilizer, Community Mobilizer, Field Communication 

Assistant, Shelter Program Manager Assistant, Technical Officer, Logistics Assistant, Warehouse Assistant, Carpenter and Master Carpenter, IT / Database 

Officer 

3

BA to be incorporated into all Medair 

AFG proposals/ projects. 

BA to be explored by CD at IRS 2011 

retreat. 

BA understanding/ practice to be 

included at staff training in early 2011. 

Design in-house M&E training course, pilot 

to increase M&E capacity of local staff. 

Integrate current database into GIS system 

to increase monitoring/ reporting capacity. 

Somalia/ Somaliland 

Where new activities are starting, or 

selection of new sites, Medair will engage 

with Local Authorities (LAs)/ committees 

to ensure appropriate site is selected, 

equally accessible to various 

beneficiaries. 

Medair will distribute BA leaflets on a 

quarterly basis detailing programme 

achievements, future plans, and specific 

issues for health and nutrition promotion. 

monitored, e.g. some Bs offered food/ coffee 

to carpenters/ CFW but cannot be requested 

At induction, all M staff read info sheet, 

signed document against exploitation of 

women/ children; integration of women in 

teams addressed in weekly meeting/ at each 

field visit during first months 

Key Prog & Logistics NRS received training 

on Management & Leadership (8 sessions). 

Office-based staff received IT training & key 

staff received ESL training 

2 IRS (M&E manager, HR manager) took 5- 

week online M&E training; later designed inhouse 

M&E training course for NRS 

IT/ Logs officer attended GIS training, then 

gave 3 NRS (Database Officer, IT Officer, 

LCMO) 2 intro sessions on GIS 

Jacmel: all GPS coordinates per B (3,112 

points) & per community (41 localities) put in 

database & maps created with information. 


Health & Nutrition (H&N) sites (Maternal & 

Child Health Centres (MCHs), nutrition 

distribution sites, mobile immunisation sites) 

selected in consultation with communities/ 

LAs; ensured equal accessibility & services 

met communities‘ needs. 

H&N BA leaflets not issued on Q basis, as 

many Bs illiterate (e.g. children under 5). 

H&N promoters/ maternal volunteers 

employed to promote H&N messages to B 

communities, communicate Medair‘s plans/ 

receive feedback. 

Burao: target populations more concentrated 


To continue community involvement while 

planning activities. 

To provide training for health and nutrition 

promoters in receiving beneficiary 

feedback. 

To work with communities to ensure they 

can maintain WASH infrastructure after 

Medair leaves Somaliland. 

4

South Sudan 

In 2011 Medair SDS will continue to 

emphasise central importance of a BA 

approach in its country strategy. To 

implement its strategy a HAP focal point will 

continue to be responsible for promoting 

HAP principles/ appropriate HAP 

benchmarks among all staff across its 

programmes at all stages of project cycle, 

primarily through sector workshops/ new staff 

briefings. 

so held H&N promotion dramas (Jan 2012) 

Partner NGO CCBRS received feedback on 

Medair‘s H&N activities on our behalf 

through our promoters/ volunteers. 

WASH sites for latrines, berkad rehab‘n, 

shallow well rehab‘n selected in consultation 

with communities/ LAs; ensured equal 

accessibility, that facilities met communities‘ 

needs & able to take ownership of them. 

WASH BA leaflets issued on quarterly basis 

South Sudan 

2011 Achievements 

o Cross cutting to all projects: 

- Retained BA as priority in country strategy 

- Retained HAP focal point position 

- Presented BA principles in all sector 

workshops 

- Introduced BA to all new staff members 

- Required BA updates from project 

managers at quarterly meetings 

- Kept participatory approaches central to 

all projects 

o Highlights among projects: 

- Conducted post-distribution monitoring 

surveys to assess appropriateness of NFI 

kits received by Bs 

- Presented session on complaints 

handling/ message boards during H&N 

Workshop & WASH Conference 

- Baseline data taken from 2 programme 

sites using LQAS survey methodology 

- Training & follow-up assessments of 

Health & Hygiene Promoters at 

Emergency Response Team (ERT) & 

static programme sites 

5 

South Sudan 

Integrate BA principles using qualitative 

and quantitative methods in each of 2 

post-intervention assessments in WASH, 

Health, Nutrition & NFI/Shelter sectors as 

part of ERT 

Integrate message boards with suggestion 

boxes and complaint handling mechanism 

at programme sites for beneficiary 

feedback on programme activities 

Implement baseline assessments prior to 

all emergency interventions to include 

community involvement 

Strengthen curriculum of HHP and train 

national staff to ensure key hygiene 

messages are understood by trainees 

Integrate LQAS survey methodology into 

ERT interventions 

Continue to integrate LQAS within static 

programming for baseline and end of 

project report

Sudan ( formerly Northern States) 

Medair SDN to streamline LQAS 

monitoring timeframe to avoid rainy & 

harvesting seasons 

- Successful handover of Medair health & 

WASH programming in Melut & Manyo to 

NGO partner/ local gov‘t authorities 

2011 Challenges 

o Conflict between communities‘ 

expectations/ good practice 

o Lack of education among communities, 

limiting intended accountability processes 

o Need to be accountable also to poorly 

conceived gov‘t standards 

o Communicating essence of accountability 

to staff members 

o Limits of donor funding practices for BA 

o Striking balance between BA & 

participation/ empowerment 

o Deciding on appropriate trade-offs between 

BA & impartiality 

2011 Lessons Learned 

o Value of refreshing staff on BA at 

workshops 

o Persist in communicating BA‘s importance 


Achieved. LQAS monitoring timeframe 

planned for May & Nov, to avoid rainy & 

harvesting seasons as much as possible. 

2. Staff competency 


Afghanistan 

Staff training in beneficiary 

accountability. 

D R Congo 

Afghanistan 

Staff BA workshop before project activities 

began in 2011. Much discussion/ exchange 

of ideas regarding importance of treating 

Bs with dignity/ handling complaints/ 

involving them in project cycle. 

D R Congo 

6 


New objectives are not applicable. 

Medair will close its Sudan country 

programme in the first quarter of 2012. 

Afghanistan 

To further train national staff to include BA. 

At induction, to introduce all new staff to M‘s 

mission/ mandate/ values; importance of 

treating beneficiaries with dignity. 

To implement a staff code of conduct. 

D R Congo

All Medair projects incorporate a BA plan 

in their projects by June 2011 

Madagascar 

No specific objectives for staff 

competency were written for 2011. 


Maintain a training plan for all staff 

(support/ programme), volunteers, and 

other people integral to success of 

programme. 

BA session held with all PMs during annual 

Apr projects review meeting; need for BA 

plan in each project emphasised… 

Project launches held at onset of health 

projects; project staff discussed how to 

incorporate BA in project activities; 

included requirement of sending letters (in 

local languages) to partners (clinic staff, 

district health office, community health 

workers) informing them re scope of 

project. Letters submitted to health centres 

3 months before end of project to inform 

partners of project‘s intended termination. 

A plan to communicate services to Bs 

required from each programme. Key 

elements: use of radio broadcasts, 

information provided to community groups 

(e.g. churches), signs put in health centres. 

Project staff trained on importance of good 

communication with communities and on 

giving feedback from Bs 

Madagascar 

BA kept as a priority in M‘s country strategy 

BA included in all sector workshops 

BA introduced to all staff members 

Participatory approaches kept central to all 

projects. 


Medair provided regular training to national 

staff (NRS)/ volunteers/ local partners. 

NRS training policy enabled staff to apply 

for funds for personal studies o/s of work if 

relevant to role in Medair. 

22 NRS (c.50%) had specialised training to 

No objectives for 2012. 

Madagascar 

To continue to ensure that all Medair staff, 

especially new staff, know what BA is and 

how they should behave and act. 


To continue on-going staff training activities. 

To develop a staff development plan for SOM 

programme that encourages internal 

promotion of NRS to more senior positions. 

To provide ToT (training of trainer) training 

for Medair H&N staff, to allow them to train 

7

help them carry out duties/ improve 

education level to benefit DRC after M exits 

Total of 31 H&N promoters (21)/ maternal 

health volunteers (10) attended 2 refresher 

training courses in Apr & Nov; training 

provided to 6 infant & young child feeding 

promoters, so could train/ mentor 90 more 

volunteers at M sites in Burao IDP camps. 

20 WASH volunteers received training on 

promoting hygiene in community (Feb/ Jul). 

As well as hygiene knowledge to pass on 

to Bs, volunteers received BA training; they 

now pass on comments/ feedback to camp 

committees 

Our local partner NGO in WASH, IsRC, 

(carried out majority of construction work 

for WASH projects), also benefited from 

Medair-provided training; ensured highlyskilled 

construction workers will remain in 

Somaliland when Medair leaves. 

3. Sharing information 

Key goal for 2011 Achievements/challenges/lessons learned 2012 objectives 

Afghanistan 

Transparency with beneficiaries and other 

stake-holders. 

Afghanistan 

Signboards used for info sharing in WASH 

& food aid projects; due to high levels of 

illiteracy in B population, of limited benefit. 

Community mobilisers and field foreman 

continued to be M‘s most important 

resource for information-sharing within field 

across all project activities. 

PMs worked closely with community 

leaders/ representatives, plus shura 

leaders/ heads of CDCs/ district governors 

to exchange info re M, project activities, 

and future planning. 

8 

promoters and volunteers. 

To provide water quality testing training for 

WASH staff. 

Afghanistan 

Medair management team and project 

managers to continue ―hands on‖ approach 

to working with beneficiaries to ensure 

accurate information sharing and 

transparency.

D R Congo 

To keep beneficiaries and partners better 

informed on projects 

Sharing information with other agencies 

Haïti 

Internal project evaluation implemented in 

Jan 2011; will include FGDs with 

community leaders/ shelter beneficiaries/ 

CFW beneficiaries/ other community 

members (i.e. non-beneficiaries). Timed to 

gather information on programme‘s 

successes/ weaknesses for on-going 

programme & design of future proposals. 

Leaflets combining written/ pictorial 

representation of key details already 

designed; awaiting production before being 

delivered amongst community to aid 

D R Congo 

Posters re services on offer/ participating 

health centres/ targeted Bs/ duration of 

projects posted on clinics supported in 

health projects. 

Radio communication went beyond 

announcing availability of services: 

developed to include skits on thematic 

areas (sexual violence/ survivors to seek 

treatment/ educating communities against 

stigmatisation of survivors). Medical 

Coordinator participated in radio show, 

answered questions from Bs. 

Summary for BA activities implemented/ 

planned in malaria project presented at 

partners‘ workshop with donor SANRU in 

Kinshasa on how Medair engages with Bs. 

Increased efforts to send regular updates 

on project activities to Clusters plus other 

coordination mechanisms, e.g. OCHA 

weekly and monthly reports. 

Haïti 

Questionnaires for mid-term evaluation 

completed by: current and past M Haiti Int‘l 

& Nat‘l field staff, HQ staff, donors (USAID/ 

OFDA) & other NGOs as well as from 

secondary data from Shelter Cluster 

reports, Nat‘l/ Local assessments/ reports. 

Internal project evaluation completed. 

information for evaluation collected through 

individual HH surveys completed by 10% of 

randomly selected Bs; technical quality 

checks; FGDs held in each area with: Local 

community leaders (CASECs/ ASECs), Bs 

D R Congo 

Establish system to foster information sharing 

on good BA practices between projects. 

Haïti 

Lessons learnt documentation will be 

recorded throughout and shared in final 

report on the Côtes-de-Fer project. 

9

information provision. 

Madagascar 

We will continue with Radio programme 

about keeping beneficiaries updated on 

project progress and giving rooms for 

them to express and give feedback on 

how Medair can better improve its work. 


Ensure LAs receive monthly reports. 

Ensure government departments receive 

quarterly reports. 


For each project coordinator to include 

HAP/BAP portion in monthly sitreps 

& community groups 

Madagascar 

Medair continued with Radio programme 

through 65 emissions to keep Bs updated 

on project progress; People listen to radio, 

so good way to give them updates on 

projects or communicate any information. 


LAs receive monthly situation report, 

detailing progress on all on-going Medair 

projects, including BA steps if relevant. 

Gov‘t departments received quarterly 

reports re progress on on-going projects. 

Other INGOs active in H&N in country 

aware of M activities through participation 

in Health Cluster & Nutrition Cluster 

Somaliland meetings, augmented with 

bilateral meetings with selected INGOs. 


Partly achieved; not all project coordinators 

reported on HAP/BAP monthly. Sit reps 

often report on meetings with communities/ 

water user committees/ village health 

committees, considered to be important 

way for giving voice to communities. 

4. Participation 


Afghanistan 

To maintain a high level of beneficiary 

participation in project planning and 

implementation. 

Afghanistan 

Food aid project led by B community in 

selecting vulnerable HHs for special cash 

distribution. 

CFW activities chosen in partnership with 

local CDCs/ community representatives. 

All WASH projects began with 

10 

Madagascar 

Medair already has many ways to share 

information with beneficiaries, for example: 

flyers, radio emissions, workshops, field 

agents, posters. 

No specific 2012 objectives for this section. 


Continue distributing reports to LAs and 

government departments. 

Medair will participate in Somaliland Ministry 

of Health annual review meetings (partners 

meeting and UNICEF meeting) for 2011 

achievements and 2012 plans. 


N/A 

Afghanistan 

To maintain Medair‘s high standard of having 

beneficiaries actively participating in project 

planning and implementation.

D R Congo 

Encourage continuous exchange with 

partners and beneficiaries. 

Working with community members to 

better serve beneficiaries. 

communities/ Medair signing agreement 

outlining responsibilities of each to project. 

Bs actively participated in selecting WASH 

sites, involved in all construction work. 

D R Congo 

Communiqués with project intentions/areas 

of intervention sent to chiefs/ pastors/ other 

local leaders. Bridge rehabilitation: monthly 

communiqués had a feedback form from 

communities asking for comments/ 

reactions to intended/ already completeded 

work. WASH communiqués had table with 

all project areas, planned plus upcoming 

activities, within construction/ sensitisation 

themes of project, plus role of hygiene 

promoters in communities 

Communiqués in simple, easy-to-read 

French; before & after photos of project 

sites 

BA report also developed for bridge rehab 

project, submitted by project supervisors to 

LAs: summarised meetings, discussions, 

formal & informal exchanges conducted 

with direct/ indirect Bs throughout project. 

Medair continued to work with community 

health workers (CHWs), integral to health 

interventions as link project to communities 

by ensuring they receive project info & 

relate their concerns to clinic/ project staff. 

WASH project: hygiene promoters selected 

from communities where project worked; 

helped project staff to understand local 

cultures/ behaviours; enabled project‘s 

community mobilisers to plan appropriate 

behaviour change training and effective 

11

Haïti 

Community-wide training programme 

planned for Q1 of 2011 to increase 

community‘s awareness & capacity in 

effective construction techniques in 

earthquake & hurricane areas. 

Madagascar 

We will keep BA of central importance in 

participatory approach. 

communication channels to reach Bs; e.g. 

key messages during church services 

Haïti 

Medair prioritised employing women in 

construction teams (see HTI case study) 

Training in communities increased capacity 

& benefited those who had not received a 

house. 2 community-wide training 

programmes developed with support of 

locally-staffed team equipped with 

technical/ teaching/ language skills to 

implement in all communities where M 

worked: a) Mar – Jun: 5,185 participants 

(2,826 women/ 2,359 men) in 68 training 

sessions (39 sessions in Jacmel, 29 across 

La Montagne). Objective: raise awareness 

on DRR construction, motivate to work on 

own dwellings, correctly; b) Dec: second 

training had 414 participants (Bs/ non-Bs, 

193 women). Training: 3 hour theory, 2 

days‘ practice (masonry & carpentry work) 

BA setup included: Community meetings, 

Community Information Boards, B 

Satisfaction Questionnaires, & a Field 

Communication team. 

Côtes-de-Fer: initial assessments for new 

construction done for 3 of 4 sections using 

input of local leaders, & Bs selected. But 

some areas not mentioned by CASECs/ 

ASECs later identified by M as vulnerable 

Madagascar 

Medair continued to keep BA of central 

importance in participatory approach, by 

organising workshops with beneficiaries to 

Haïti 

To conduct comprehensive shelter repairs 

and WASH assessment of sections 1,2,5&6. 

Community Mobilisers (CMs) to be teamed 

with Shelter Technical Officer (STOs) & 

WASH officer for assessment. Homes to be 

assessed for damage from 2010 earthquake, 

availability of clean water, & access to a 

latrine. Families of each home will also be 

assessed for vulnerability/ eligibility for 

participation in repairs & WASH programme. 

To be undertaken using participatory 

methods, e.g. feedback from community 

leaders, FGDs, community meetings, & B 

surveys plus evaluation through quantitative 

methods, e.g. shelter data reports. To occur 

during on-site & off-site supervision visits. 

Community leaders (CASECs & ASECs) with 

CMs to make initial & final B selection lists 

Community boards to be placed in all project 

areas 

To work with local communities/ community 

leaders in each zone during comprehensive 

assessment & for duration of repairs/ WASH 

activities. At project close, these 

relationships to be used to distribute tools 

from programme for community members to 

borrow for home repair/ latrine construction 

Madagascar 

To continue to keep BA of central importance 

in participatory approach, by organising 20 

workshops with Bs to listen to needs/ 

12


Medair SDN will encourage and involve their 

listen to their suggestions and complaints, to 

explain what M was doing and future actions. 

Dec: workshop heard beneficiaries‘ feedback 

on last project/ suggestions on next one. 


All M nutrition distributions carried out with 

unskilled community members; then trained 

to aid with distributing supplies to Bs. 

Health & nutrition (H&N) promoters/ 

maternal health volunteers recruited from 

communities they work in. Short list of 

potential promoters/ volunteers (Ps/Vs) 

drawn up by community leaders; final 

selection by M; ensured that communities 

M worked with received relevant training 

themselves, skills remained in community 

after M leaves, community leaders more 

responsible for Ps/Vs active in community. 

Mar 2011: M trained camp committees of 

14 Burao IDP camps plus 7 rural Toghdeer 

villages with WASH activities. 5 members 

of each camp/ village committee drawn 

together for training so communities could 

collaborate better with M, by assisting in 

WASH activities/ providing relevant feedbk. 

WASH activities: M facilitated community 

participation, specifically communities 

provided materials (sand, aggregate) & 

unskilled labour; participation varied from 

site to site, depending on local conditions. 


Achieved. Medair‘s local partner NGO DRA 

suggestions/ complaints. For ER, to develop 

simple template to collect Bs‘ needs/ 

suggestions. At end of response, requests to 

be compared with actions taken to give Bs 

feedback by radio on what M did, & why some 

needs previously expressed not responded to. 


To continue to recruit unskilled community 

members to take part in distribution activities. 

To continue to engage with community 

leaders to enable local recruitment of health 

& nutrition promoters/ maternal health 

volunteers. 

To continue to seek community feedback and 

involvement in design/ execution of WASH 

projects. 

To encourage communities to provide 

relevant feedback regarding need for major 

repairs of WASH infrastructure. 

To promote project sustainability by gradually 

increasing community contribution to WASH 

projects; specifically for communities to take 

responsibility for on-going maintenance/ 

cleaning/ minor repairs. 


N/A 

13

national NGO partner in new BA activities. 

was central to training of WUCs/ VHCs in Um 

Shalaya area of W Darfur. Also, DRA 

continually engaged in discussions with B 

communities re programme quality. 

SOS Sahel, Medair‘s local partner NGO in S 

Kordofan: 

5. Handling complaints 


Afghanistan 

Develop complaint handling procedures. 

D R Congo 

Establish and continuously monitor a 

feedback handling mechanism in all 

projects 

Afghanistan 

Challenge to establish effective mechanism 

to receive complaints due to high rates of 

illiteracy within B population. 

Communities often reluctant to complain to 

Medair directly; instead, locally-recruited 

staff told senior staff of rumours/ concerns 

being discussed in local community; e.g. 

nutrition team worked hard to investigate 

rumours & address underlying B concerns 

D R Congo 

Suggestion boxes placed strategically, 

including at health centres/ in communities 

with WASH installations. Comments recvd 

were collated, letter sent to relevant 

communities/ health centres/ LAs detailing 

what M offered within respective projects 

Most comments received not related to 

Medair‘s project work, or were complaints 

re rate of pay for day labourers etc. 

Some letters received written in languages 

unknown to Medair‘s national staff. 

However, comments directly involving 

projects (e.g. attitude of health 

professionals in HCs) discussed with Ango 

project staff, feedback communicated to 

Afghanistan 

Maintain and develop confidence with 

beneficiaries/ community representatives so 

concerns/ complaints can be openly 

expressed. 

D R Congo 

Where possible factor in stakeholder 

feedback to future projects. 

Projects to plan for more time to explain to 

communities what is described in the 

communiqués. 

14

Haïti 

Internal project evaluation implemented 

in Jan 2011; will include FGDs with 

community leaders/ shelter Bs/ CFW Bs/ 

other community members (i.e. non-Bs). 

Timed to gather information on 

programme‘s successes/ weaknesses to 

influence on-going programme & design 

of future proposals. 

Leaflets combining written/ pictorial 

representation of key details already 

designed; awaiting production before 

being delivered amongst community to 

aid information provision. 

Community-wide training programme 

planned for Q1 of 2011 to increase 

community‘s awareness & capacity in 

effective construction techniques in 

earthquake & hurricane areas. 

Strategy being implemented to increase 

effectiveness of community messaging/ 

training. 

Madagascar 

We will install additional signboards and 

suggestion box in 4 other villages. 

clinics. Comments re gaps in delivery of 

medicine helped project staff to develop 

better system to monitor/ distribute this 

Some feedback received could not be 

factored into current project but offered 

valuable lessons for future projects. 

FGDs held with CHWs for health projects/ 

hygiene promoters/ B groups in WASH 

project to receive feedback on relevant 

issues concerning projects. 

Haïti 

Mid-term internal evaluation in Feb 2011. 

Most recommendations implemented in 

current programme at time of data 

collection, used to plan next programme. 

M&E data fed directly to programme 

management, any required changes made 

Complaints mechanism: CMs in active 

project areas trained in communication 

skills/ conflict resolution/ handling 

complaints; if unable to provide appropriate 

response to B/ community member, liaised 

with LCMO, M&E Assistant, PMA or PM. 

One key senior staff appointed as focal 

point for all complaints; Bs could directly 

approach this person, who carried a 

―Complaints Mobile‖ phone (no. on 

Community boards). ―Complaints forms‖ 

filled out at field level, if someone came to 

office/ called mobile; M&E/ Programs then 

responded before complaint filed. 

Madagascar 

Not achieved: experience showed this way 

of getting feed-back from beneficiaries was 

Haïti 

Create a database for all complaints and 

measure importance of each to respond 

better to beneficiary needs before complaints 

arise. 

Develop system to encourage beneficiary 

feedback in the early stages of all 

programme activities to register and seek 

resolution of complaints. 

Make information on complaint mechanisms 

for programmes a standard component of all 

community meetings/ training sessions. 

Madagascar 

Through field agents visits, open channel 

radio emissions and focus groups, we will 

15


To conduct appropriate surveys on a 

monthly basis. 

Sudan Northern States 

1. Explore option of incorporating complaint 

boxes/ new channels for beneficiaries to 

provide feedback 

not efficient in this area. 


‗Smiley‘ surveys attempted to measure 

health project Bs‘ feedback at MCHs 

supported, but ineffectual: high % of Bs 

unwilling to complete survey forms. 

Local partner NGO, CCBRS, received 

complaints re H&N activities on Medair‘s 

behalf/ gave feedback to M/ liaised with 

communities to resolve problems. 

M maintained complaints box in all Burao 

MCHs; allowed anonymity. 

Efforts to conduct surveys of Bs‘ opinions 

of WASH projects hampered by continual 

receipt of irrelevant commentary. 

As alternative to monthly surveys, WASH 

projects developed reporting system 

whereby WASH hygiene volunteers/ IDP 

camp & village leadership committees were 

trained in receiving feedback regarding 

Medair WASH activities in communities; 

recorded in committees‘ site minutes book 

Monthly meetings to discuss WASH 

activities held at each site. 


1. Partly achieved. Complaint boxes not 

installed, no trial done. In S Kordofan, 

WASH activities managed remotely when 

fighting erupted, so phone calls with key 

locals in inaccessible locations to obtain 

feedback on work by contracted parties. In 

encourage the beneficiaries to express their 

complaints and suggestions. We will keep a 

file with all feedback received and give 

answers twice per year though radio channel. 


To hold monthly focus group meetings at 

sites where we have H&N activities. 

To revise/ improve complaints box system at 

Burao MCHs. To incorporate all MCHs 

supported in Somaliland into revised system. 

For community committees to continue 

recording feedback at each WASH site. 

To introduce a standardised form of 

recording and evaluating all feedback at a 

central point (ie Medair Somaliland HQ). 

Village Committee trainings in BA 


N/A 

16

W Darfur, health staff collected feedback 

during supervisory visits re level of B 

satisfaction with services provided. 

2. Include BA—addressing complaints in 2. Partly achieved: work plan changed several 

workplan for WASH/ Health activities times during 2011, after Jul had strong 

focus on exiting. Communities informed in 

time re exit/ handover procedures, but 

limited space to adjust exit plans. When 

implementing sanitation programme in 

Ardamata IDP camp (only for Extremely 

Vulnerable Individuals), sheiks consulted, 

who conducted own survey (disagreed with 

M‘s initial results). Survey verified, then 

used for programme implementation. For 

writing proposals, health dep‘t collected B 

input during meetings with VHCs 

3. Train national staff on conducting proper 3. Not achieved. No additional WASH/ health 

Focus Group Discussions (FGDs) in national staff received FGD training in 

communities 

2011. In past, WASH team used FGDs 

mainly for quantitative data gathering, but 

inaccurate; to date no transition to more 

qualitative data gathering through FGDs. 

4. Increase no. of formal FGDs conducted by 4. Not achieved: No overall increase in no. of 

national staff 

FDGs: no. of formal FGDs by WASH staff 

reduced to zero; slight increase for health. 

Previously only VHCs targeted in FGDs; 

but in 2011 health promotion team also 

conducted FGDs with women addressing 

their specific issues. FGDs in VHCs utilised 

to indicate what messaging was needed, 

get input on assistance needed, motivate 

them to take ownership of health situation 

in own community by supporting voluntary 

health promotion programmes, providing 

incentives for clinic guards/ cleaners etc. 

17

6. Learning and continual improvement 


Afghanistan 

Attend HAP training to develop better 

beneficiary accountability practice. 

D R Congo 

Enhancing knowledge on behaviours 

and practices within communities where 

we work 

Training communities on cross cutting 

themes 

Haïti 

Full internal project evaluation Jan 2011. 

Afghanistan 

Medair‘s BA focal point attended 3-day BA 

training course: informed development of 

BA strategy for country. 

D R Congo 

Hygiene promoters from each location 

targeted in WASH project trained on 

behaviour change, to ensure sensitizing 

communities continues after project ends. 

Post-training session, participants gave 

feedback, suggested poss. improvements. 

1,200+ day labourers (23% women) hired 

from communities to work on rehab project; 

trained on preventing sleeping sickness/ 

HIV/ equality/ respect for gender, so could 

extend knowledge to others in community. 

Haïti 

Internal evaluation 1 year after earthquake 

reviewed ER programme quality to date cf 

DAC criteria (relevance, effectiveness, 

efficiency, impact, sustainability); 

suggested improvements for design/ 

planning of future proposals for working in 

communities in SE Haiti/ future shelter ER 

programmes; evaluation included HH 

surveys; FGDs in each area (Bs, non-Bs, 

local community leaders); questionnaires 

completed by current/ ex- M Haiti 

International/ National field staff, HQ staff, 

USAID/OFDA (Donor), other NGOs; data 

from Shelter Cluster reports, National/ 

Local assessments and reports. 

Afghanistan 

Further develop a team culture where 

beneficiary accountability is inherent in our 

work and interaction with beneficiaries. 

D R Congo 

None 

Haïti 

To conduct a comprehensive shelter repairs 

and WASH assessment of sections 1, 2, 5 & 

6 (Phases 2 & 3). CMs to be teamed with a 

Shelter & WASH Officer for assessment. 

Each home in these sections to be assessed 

for damage from 12 Jan 2010 earthquake/ 

availability of clean water/ access to latrine. 

Families to be assessed for vulnerability/ 

eligibility before participating in repairs/ 

WASH programme. 

STOs supervising repair crews to provide onthe-job 

training for carpenters/ masons/ 

casual labour assistants; to also provide 

briefings/ short trainings for Bs in 

earthquake- & hurricane-resistant repair 

18

Madagascar 

No objectives for 2011 in this section. 


Increase CATS (Community Approach to 

Total Sanitation) intervention in 

communities ready to take sanitation 

approach 

Beneficiary satisfaction survey with 10% of 

all Bs undertaken by end of project. 

Madagascar 

Recognised need to better understand Bs‘ 

culture, taboos, and common ways to 

communicate for effective B accountability. 


Jan 2012: External consultant to evaluate 

nutrition activities through B FGDs & other 

methods; report to be used to improve 

services in 2012. 

Throughout 2011 WASH team trained 

communities in use of new facilities & 

equipment, e.g. ceramic water filters, dome 

slab latrines 


Achieved. M successfully expanded CATS 

activities from 1 province (S Kordofan) to 2 (+ 

W Darfur). More villages now ‗open 

defecation free‘; experiences shared with 

WASH Cluster (i.e. gov‘t line ministries, UN, 

(I)NGOs) in W Darfur. 

Case study/example: Good practice in accountability and quality management 

Refer to separate case studies annexed to this report. 

Plans with regard to HAP services: baseline analysis or certification? 

techniques/ personal safety. 

Madagascar 

To study local culture, taboos and ways to 

communicate with 30 local families; capitalise 

all information into a study file; then set up 

accurate way to ensure BA in future. 


To implement changes to nutrition activities 

advised in January 2012 evaluation report 

To continue training beneficiaries in use of 

new WASH facilities and equipment 

To develop with B communities indigenous 

funding mechanisms for maintaining their 

WASH facilities (incl. high-cost facilities e.g. 

berkads) after Medair has left country 


N/A 

Not at this stage; Medair is considering how a similar baseline analysis process to HAP could be incorporated into our activities. 

Progress/highlights from programme sites (if not covered elsewhere in report): 

Refer to separate case studies annexed to this report. 

Summary and any other comments: 

None 

19

Medair - HAP International

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