IRD BSF-IA Proposal - Basic Services Fund SOUTH SUDAN

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6. Justification: Maximum 40 pts Maximum 2 pages, Category 2: 6.1 Relevance of the project to BSF’s overall objectives. IRD will support BSF’s objective through the improved coverage of, access to and use of basic primary health and associated water and sanitation services in Duk County, Jonglei State. This is an essential part of the county’s rebuilding of community and basic support services. The project will engage local authorities, and, through project design, implementation, monitoring and evaluation, build their capacity to deliver sustainable services. With a focus on sustainability, the project will continue to support the function of the county, CHD and communities in providing the continuation of basic services currently supported by BSF in Duk to the most vulnerable groups. The project will link these sectors and services through community and local authority involvement to improve overall health status. 6.2 What GoSS sector priorities as described in the application guidelines will the project address? In designing the proposed project, IRD collaborated with representatives from the Duk County Commissioner’s Office, the CHD, Jonglei State MoH office in Bor, Ministry of Water Resources and Irrigation, and other local stakeholders. Project activities in health and water and sanitation were designed to meet both community and GoSS priorities, while building on lessons from implementation of the CHESS project. Of the targets identified as supported by the BSF-IA and GoSS in the health sector, this project will address the continued provision of the BPHS within Duk County, supported by BSF under CHESS, including support for inservice and formal trainings of health care workers, and support for the MoH in strengthening the CHD and community capacities to supervise and manage health services. The project will raise community awareness of basic health issues through hygiene campaigns and increase demand for health services, while strengthening the performance and involvement of BHCs, the CHD, and other traditional governance structures including chiefs and local leaders. As Jonglei state is one of the four states with a Lead Agent under the Umbrella Program for Health Systems Development (UPHSD), IRD will continue to support the provision of health services in Duk with UPHSD support and cooperation. All health related activities have been designed to cover 10 of the 13 MoH-identified high-level impact indicators. Planned health activities will align with the Health Policy for the Government of Southern Sudan 2006-2011 and policy statements on community participation, primary healthcare and implementation of basic service package, facility infrastructure development, pharmaceuticals and medical supplies, institutional and human resource development, and coordination. The associated water and sanitation activities, while linked to health facility improvements, are also designed to meet priorities of the GoSS Infrastructure sector. IRD’s project will provide clean water to the PHCUs and surrounding communities through the rehabilitation of 15 boreholes. IRD, in close coordination with the MWRI and the Jonglei State Directorate, will plan and report on water quality testing for these sites. IRD will provide training consistent with GoSS policy on rural hygiene and sanitation, and water management to 30 VWCs (15 already organized under CHESS project). IRD will train 30 pump mechanics with a target of 30 percent female. As Duk does not currently have a county water department, IRD will work closely with the local authorities to establish systems and procedures and create a supply of county spare parts. IRD will construct one PHCU (Pagaak) and one institutional latrine block. 6.3 What underserved / priority counties as identified by GoSS and described in the application guidelines are targeted? IRD will continue to support health and water and sanitation services in underserved Duk County. The county continues to experience population growth from returning war-displaced populations and from neighboring counties. Due to the uncertainty surrounding the April elections, the movement of people, the reduction of services, and possibly IRD’s current BSFfunded CHESS project, even more individuals have been accessing services in Duk, particularly at the DLBC whose monthly average consultations jumped from 1,210 in January to 2,457 in March 2010. IRD is one of the only INGOs operating in Duk County; while Catholic International Relief and Development US Basic Services Fund and Mott MacDonald 3
Relief Services has provided funds through local NGO Sudan Medical Care (SMC) to cover the salaries of health personnel, but is not providing direct support in Duk at present. 6.4 The different target groups and beneficiaries of the project and the specific needs and constraints of these groups. Project activities will target all eight payams including Mareng, the Duk County headquarters. Direct beneficiaries of trainings and direct outreach services are estimated to be 7,500. Under the program approximately 10,000 children under 5 and 31,000 women of reproductive age will benefit directly from improved health care services. Additional targeted beneficiaries will include the elderly, returnees, IDPs, health care service providers, county health teams, local government authorities, and community workers. Through the project interventions all 65,588 1 Duk County residents will benefit indirectly from improved services and health education and hygiene campaigns, as well as EPI interventions which will be conducted in all eight payams. According to the JDF, the MoH, and the County Commissioner, communicable diseases such as malaria, acute upper respiratory infections, acute watery diarrhea, anemia, malnutrition, measles and mumps, cases of guinea worm, and imported cases of Kala-zar (leshmaniasis) remain a threat to children and families. There are also many cases of pelvic inflammatory disease and urinary tract infections, indicating that sexually transmitted infections (STIs) are common. HIV/AIDS has made an appearance among returnees and outbreaks of cholera and polio were identified at the DLBC. Duk County has a high level of war-displaced returns, and is vulnerable due to its lack of health, water and sanitation services, and infrastructure. State and County government understand the needs, and are motivated to progress. The County Commissioner and State level MoH officials cite training for BHCs, EPI coverage, and rehabilitation of boreholes and trained mechanics as the most pressing needs in the county. Regular support of the PHCCs and PHCUs has been intermittent over the last several decades however some health care workers have continued on a voluntary basis. SMC supports 5 PHCUs and 1 PHCC through CRS support, however, this is primarily for salaries and we are not aware of any trainings taking place. SMC has begun rehabilitation of the nonfunctioning PHCC in Poktab in March of this year. In the county there is at present no functional PHCC as per BPSH standards, only the aforementioned non-functional PHCC in Poktab and the JDF DLBC that currently surpasses the BPSH criteria for a PHCU, but falls short of meeting the standards specified for PHCCs. ASCOM also runs a hospital in Padiet, which is the next level of referral for the DLBC. There are 15 PHCUs; and outside of the three constructed by IRD under CHESS, all facilities are little more than tukuls and face severe shortages of health supplies, and an unreliable supply chain of medicines with no cold chain. 6.5 The extent to which women and girls are specifically targeted. IRD and JDF are committed to ensuring the inclusion of women and girls in all project activities. The project’s health component will address general health problems and include curative, preventive and promotional services which will target children under 5 and women of reproductive age. The project will specifically focus on child immunization, reproductive health, ANC, nutrition, and HIV/AIDS awareness and prevention. Services will be brought closer to women and children through the increased number of trained health providers, community health campaigns, vaccination, Vitamin A and de-worming campaigns, and provision of medicines and health supplies, as well as the construction of a PHCU. Also, JDF under CHESS, has begun a youth theatre group to raise HIV awareness and has trained 10 girl participants who will continue activity under the proposed project. Further, IRD has trained 16 AES teachers (2 female) who will provide health and hygiene education to adult students, whose enrolment rate is 62 percent female under CHESS. IRD will work to include women in the BHCs and VWCs and achieve a target of 30 percent female trained pump mechanics. This project will continue to include women and girls in community meetings with community member, local leaders, and paramount chiefs as it has under CHESS. 1 The 5 th Sudan Housing and Population Census 2008 International Relief and Development US Basic Services Fund and Mott MacDonald 4
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Page 8 and 9: e 100 percent supported by the MoH.
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IRD BSF-IA Proposal - Basic Services Fund SOUTH SUDAN

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