World VisioN Annual Report FOR EVERY CHILD:
LIFE
AND
FY 15 MOZAMBIQUE
HOPE
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
impact Report
2015
For every Child: Life and Hope THe present REPORT IS A PART OF world Vision-Mozambique’s COMMUNICATION STRATEGY AND EXERCISE OF ACCOUNTABILITY AND TRANSPARENCY. IT SEEKS TO REFLECT THE IMPACTS OF AND SUMMARIZE THE ACTIONS TAKEN IN THE COURSE OF THE FISCAL YEAR 2015
Do nothing out of selfish ambition or vain conceit. Rather, in humility value others above yourselves, not looking to your own interests but each of you to the interests of the others.
Philippians 2:3-4
III
IV
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
Contents Our contribution from 2013 to 2015
3
Introduction
5
Contribution to Child Well Being in 2015
9
Children grow safe from violence Children grow strong
12 18
Children grow healthy
22
Children grow learning
29
Disaster risk reduction and response
34
V
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
OUR CONTRIBUTION TO CHILD WELL-BEING FROM 2013 to 2015
2015 was a particularly important year for the World VisionMozambique. It marked the end of the national strategy and was, therefore, a year of much reflection and learning. It was a year in which we analyzed the past and we planned the future; in which we celebrated successes and we evaluated our ability to overcome challenges; and ultimatelly it was a year in which we reaffirmed the commitments established with our
185 000
218 592
3705
adolescent girls integrated savings groups
MORE CHILDREN WITH BIRTH CERTIFICATEs
12%
Savings groups formed. In FY15 these groups saved USD 544 499
8 212 346 82%
372 530
children reahbilited from severe malnutrition
92 904
We are proud of the journey we have done together.
people with access to mproved water sources
MORE CHILDREN who can read and write in the areas where WV has invested in Literacy Programming
thank all of those who have been by our side.
More households with at least one Mosquito NET
community members received messages and information about malaria preventin and treatment
people assisted during flood emergencies
communities and with them we outlined the following steps. We
people with improved sanitation facilities
VI
1400
1774
VII
VIII WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
Results that change lifes
Child Protection
OUR TARGETS World Vision is a Christian humanitarian aid, development and advocacy organisation dedicated to working with children, their families, and communities worldwide to reach their full potential by tackling the causes of poverty and injustice. World Vision serves all people, regardless of religion, race, ethnicity, or gender.
Children acknowledge improvement of the rates of wellbeing Increased number of well-nourished children
Nutrition
Education
WorldVision-Mozambique dreams of a Mozambique where children can enjoy their rights and live in Love and Peace. With the new strategy,World Vision-Mozambique intends to contribute, in significant and measurable way, to the well-being of 1 million vulnerable boys and girls (including registered children). The present report is a part of World VisionMozambique’s communication strategy and exercise of accountability and transparency. It seeks to reflect the impacts and summarize the actions taken in the course of 2015. However, it does not include the totally of World Vision’s activities during this year. for more information o our projects and activities, do not hesitate to contact us.
Health
Emergency Response
Increased number of children protected from diseases and infections Increased number of children who know how to read and write at the age of 11 The aspirations, the results of child well-being and the needs expressed by the communities guide the definition of World Vision-Mozambique strategy at national level by setting operative and programmatic options. Targets establishment allows World Vision-Mozambique to focus on, align, and evaluate the effectiveness of its strategies, programmes and resources investment, while providing evidence of World VisionMozambique’s contribution for the results of child well-being and ensuring clarity and transparency to the children, communities and donors that we serve. These targets, which reflect the priorities at national level, are integrated in the national strategy for the 2013-2015 period and are in force in the operational planning and in the corresponding monitoring and evaluation mechanisms through specific indicators.
IX
X
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
Education
371 616 children reached by
education activities
4% drop out rate 7 6 .2 % enrollement rate 81.4% increased
school attentiveness in result of Food For Education integrated approach
59 411
Children benefiting from literacy interventions
1124
teachers trained in literacy methodologies
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
Advocacy & Child Protection Economic Development 1774 new savings groups 29 299 active savers 544 499 usd saved/
mobilized by savings groups
Nutrition
2671 community volunteers trained
nutrition
33 380 pregnant women and mothers received nutrition and health counselling
745
children rehabilited from severe malnutrition
all children benefiting from the revised penal code
47 327
children reached by Child Protection activities
Emergency
112 500 households
received humanitarian assistance
6726 children issued with birth
certificate
70 girls savings groups formed 90 health agents trained in better
techniques to assist victims of sexual violence
XI
Health
127 195 people benefiting from improved sanitation facilities
60 600 people with access to improved water sources
3 577 104
long lasting mosquito nets distributed
6 338 461 members messages
reached
15 000
immunization
community by malaria
children received
16 639 people
reached with hygiene and sanitation education
XII WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORTXIII
children grow safe STOPING EARLY MARRIAGE IN MOZAMBIQUE In Mozambique, 48% of girls are married before the age of 18, and 18% before their 15th birthday (UNICEF). World Vision-Mozambique has taken strides to end Child Marriage both nationally and locally: by partnering with Girls Not Brides; by engaging faith leaders in a zero tolerance campaign for the adoption of the inter-religious code of conduct for all faith leaders; and by promoting local ownership to address the causes of child Marriage. Culture transformation and enhanced local ownership are at the core of WV-Mozambique’s investments in addressing negative initiation rites practices and promoting wider dialogue with Matrons, in order to prevent the increase of early marriages in ADP areas.
STRATEGIC OBJECTIVE CONTRIBUTE TO A CHILD FRIENDLY ENVIRONMENT AND IMPROVED CHILD PROTECTION
As WV-Mozambique, we are deeply committed to addressing this issue. Through Improved Wellbeing of Adolescent Girls (IWAG) project in Gaza, we are supporting adolescent girls by promoting their economic empowerment through savings group models, enabling girls to complete education and avoid early marriages.
1
In Nacaroa, Child Protection and Advocacy (CPA) promotes conversations and community engagement with “Matrons”, brings social and cultural transformation on key aspects of initiation rites.
By engaging in conversations with “Matrons”, the facilitators and leaders of community initiation rites this project was able to bring up to debate some of the pratices envolved in rites which impact on child Marriage. Mozambique ranks 11th worldwide for Child Marriage; Girls Not Brides studies show that higher incidents occur in Nampula and Zambezia Provinces. Early pregnancy, cultural pratices and poverty constitute the major driver for child marriage in Mozambique, with more than 1 million girls becoming pregnant before the age of 18. Nationally, we have partnered with Girls Not Brides in advocacy for legal reformation and policy implementation, including faith leaders platforms to increase awareness about harmful practices and define the role of Faith Leaders in ending child marriage across all faiths. These colective efforts culminated in the approval of the National Strategy to End Child Marriage, as well as on the criminalization of Child Marriage Law, . On the other hand, FEC CP strengthens child protection systems to effectively respond to Child Protection Incidents. Graph 1: Percentage of girls who are married before 18 years
5.0%
STRATEGIC LINKAGES
GOAL 3: PROMOTE GENDER EQUALITY AND EMPOWER WOMEN.
Millenium Development Goals
INDICATOR 1 NUMBER OF CHILDREN AND YOUTH (0-8) WITH BIRTH CERTIFICATE
World Vision Child well-being aspirations
Govenment priorities
INDICATOR 2 NUMBER OF NATIONAL LEVEL INITIATIVES TOWARD CHILD MARRIGE
CHILD WELL-BEING OUTCOMES
World Vision Child Mozambique Strategic Objective 1 CONTRIBUTE TO CHILD FRIENDLY ENVIRONMENT AND IMPROVED CHILD PROTECTION
BIRTH REGISTRATION
VIOLENCE AGAINST CHILDREN
CHILD MARRIAGE
CWBA 4: ARE CARED FOR PROTECTED AND PARTICIPATING
Children cared for in a loving, safe, family and community environment with safe places to play
Children celebrated and registered at birth
Children are respescted participants in decisions that affect their lives
“Hi, my name is Ana Maria Aurélio Vilanculos, from P humulene in Chongoene. I’m 13 years and I’m in grade 8. One thing that I like about the Iwag Savings groups is that they encourage me to look towards future with hope. My dream is to become a teacher, and I don’t have plans to get married soon. I’m happy to be part of these groups because here I can keep my money for my future education”.
18.0% 9.0% 24.0% Gaza
Zambezia
Source: Girls Not Brides Statistical Analysis, UNICEF 2014, DHS 2011
Tete
Nampula
XIV WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
ACHIEVEMENTS WV-Mozambique’s attendance in the Girls Not Brides’ global conference on child marriage in Morroco created the opportunity to learn and exchange experience with other important actors actively engaged in ending child marriage. This resulted in the publication of WV-Mozambique authored articles on leading media bodies such as The Guardian Newspaper and Reuters increasing international awareness and information to this cause. A faith leaders’ platform on child marriage was established with a plan of action to address early marriage and birth registration in all areas were WVMozambique is operating. WV-Mozambique through collaborative efforts with UNICEF, Girls Not Brides, Inter-Religious Alliance for Advocacy and Social Development (AIRDES), Plan International and Pathfinder, supported the attendance and participation of 12 religious leaders from 4 provinces, on the National Inter-Religious Forum on Child Marriage, attended by the Mozambique 1st Lady Mrs Isaura Nyusi, Minister of Education and Human Development, Minister of Health and Don Denis Singulane. This convention reiterated the Matola Rio Declaration on Child Marriage.
Province. This promoted inclusion and participation of girls in leadership roles, influencing parents to allow girls to continue their education and delay early marriage.The project organized a child marriage learning event (November 2015) in which informarion on possible solutions and prevention suggestions on the reduction of child marriage practices was debated and later shared with partners key child marriage actors, financial institutions. This event was attended by project beneficiaries and stakeholders and hosted a panel discussion with various financial and community actors on the benefits and impacts of this project. The adolescent savings groups in Gaza are intersectional, covering financial literacy, Sexual Reproductive Health and child rights, amongst both girls and boys in a more participatory approach. Results show that more girls have taken leadership roles and parents are, therefore, willing to save for the girl’s education, thus delaying early marriage. In Nacaroa District, 99 women were engaged in discussions to understand the harms of negative initiation practices and the importance of girl’s education. These sessions involved mothers and “Matrons” developing the community guidelines, titled, “positive methods on engaging young girls on rites of passage”. Some communities have begun to adopt these alternative “friendly rites of passage” and others are discussing it with local leaders for its adoption.
CPA
1
IWAG Funded
Saving Groups
FDM, Community leaders, DDE, DDSAS, University of Kwazulu Natal & Direcção nacional de canto e dança.
1
127,283.66
90,860.03
WVUSA
WV Australia
WVUSA
this is how the representative of girls, during the national conference of girls, 16 years old Cátia Uamusse started her speech. World Vision Mozambique played an important role through its live testimonies to empower girl children and voice up their desires to continue with education.
100.0%
CPA Nacaroa Funded
DPS, DPMAS, PRM/GAFCVV, IPAJ, SDEJT, DPEC, Registration & Notary, Court and General Attorney, CDC, Community and Traditional Leaders.
1,103,270.60
90.0%
2
Gaza
80.0%
IPAJ, LEA/POLICE. Education, Welfare Service, Forensic Medicine/Health Sector, General Attorney
SOURCE OF FUNDING
“Dear mom and dad, we are very much aware of the tough society that we are living in lately, the though struggles you have to go through to make ends meet among other needs you may have to look after for the sake of your children, particular ours, as girl children but we must remind you that marrying us off shouldn’t even be a solution to consider. As girl children we face a number of challenges, out there we have to hide from those that seeking to do us harm, it wouldn’t be fair to do same at home only to escape early marriage”
70.0%
CPA
FY15 EXPENDITURE
Graph 2: Proportion of children with a birth certificate
60.0%
TECHNICAL STAFF
Although the collective efforts to improve child registration rates in Mozambique have showned progress in the past years, multiple factors still need to be addressed. Some of these factores include the lack of sufficient capable staff alocated to birth registration campaigns to assist in the most vulnerable location. On
WV-Mozambique is curbing these obstacles through local Government collaboration (District registration and notary services) were it is operating. This includes facilitating awareness sessions and supporting registration and vaccination campaigns, as well as building technical staff’s capacity on efficient ways to register children.
50.0%
FEC Child protection
KEY PROJECT PARTNERS FUNDING SOURCE
Since the majority of Registry Offices are located in (semi-)urban areas, rural families do not always have immediate access to the service, adding to the often under-staffed and lack of resources that strain the officer’s work.
40.0%
KEY PROJECT MODELS
For Every Child (FEC) CP project, together with the Ministry of Justice and the Religious affairs at Provincial and District levels, ensures that all children aged 0-5 are registered in Zambezia and Gaza ADPs.
The non-existent registration of children is problematic, as only 10% of Mozambican children get registered at birth, with the highest rates of children (0-5) without birth certificates in Tete and Zambezia. (31.4% & 21.3%) Even though Civil Registration was introduced in 2004, registration is still low, since communities do not have access to the facilities, due to the distance as well as costs implied in the process, 50mts paid after 120 days.
30.0%
NAME OF PROJECT/ PROGRAM
In Mozambique, only 48% of children aged 0-5 have a birth certificate (Demographic Health Survey).
the other hand, single parents (particularly mothers) are faced with more obstacles when registering children whose male parents are absent or deny paternity.
20.0%
The IWAG project formed 70 savings groups with 1,400 members of which 80% belong to Gaza
INCREASING BIRTH REGISTRATION rates
10.0%
Furthermore, the FEC CP project provided 90 health agents in Zambezia with training in techniques to assist victims of sexual violence and 299 police officers with skills to carry out face to face interviews and use appropriate response mechanisms to the incidents.
children grow safe
0.0%
In Gaza province, WV-Mozambique, together with the Governor spouse cabinet, ensured efforts in promoting a faith leaders provincial forum (November 2015), aiming to understand and implement Matola Rio with the participation of 22 religious leaders, from 10 Districts and resulting in a 1-year congregational Provincial action plan to be monitored by District managers.
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
72.0% 15.4% 59.0%
Zambezia 5.5% Tete Nampula WVM Overeall
47.0% 44.9% 45.1%
67.0%
61.3% 49.0% WWTARGET
DHS 2011 (Didnt Baseline these hence Proxy)
WV threshold: Critical
National Strategy Baseline FY15
WV threshold: Acceptable
WV threshold: Attention Required
Source: NO Strategy Baseline report 2015
XV
XVI WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
ACHIEVEMENTS UNICEF 2014’s children report shows that only 48% of children aged 0-5 have a birth certificate. Our FY15’s research shows that our Zambezia and Gaza development program areas rank highest with registered children without birth certificates: Zambezia with 23,550 out of 34,278 and Gaza with 18,190 out of 19,446. Progress reports shows significant changes in Zambezia and Gaza in terms of children with a Birth Certificate. This change can be attributed to the significant efforts made by FEC CP project in Zambezia & Gaza where birth registration percentages are currently 59.0% & 72% respectively as shown on the graph on page XV. The FEC CP creates a unique space for regular interaction with Senior Government officials, a panel of Provincial Justice and Religious Affairs department, National directory of Notary and Registration & District notary services, to discuss project plans and monitoring visits and other mutual interests. In addition, the project undertook in coordination with Disaster Risk Reduction project several interventions during the heavy floods between February to March 2015 which affected almost 180 000 people in Zambezia of which about 4500 lost their civil identification. Thanks to successful coordination with Provincial Justice and Religious Affairs department, as well as the National Directory of Notary and Registration, the massive awareness sessions, in collaboration with community leaders on the importance of birth registration, have significantly led to the registration of 4,576 children, of which 3,038 are in Gaza, and 1,538 in Zambezia. The successful mobile campaign led in coordination with Provincial Justice and Religious affairs department & District notary services in Zambezia resulted in the registration of 2,150 displaced children during the floods that affected Mocuba, Morrumbala, Namacurra and Nicuadala Districts.
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WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORTXIX
CHILDREN GROW STRONG REDUCING THE NUMBER UNDERWEIGHT CHILDREN
OF
Malnutrition is one of the biggest health problems in Mozambique. The effects of chronic malnutrition are irreversible, reducing child productivity through impaired mental and physical capacity. Not only are children less likely to enroll in school, malnutrition also makes children prone to diseases and cause up to 54% child deaths in Mozambique, and 60% in Sub-Saharan Africa. WV-Mozambique has aligned with Mozambican Government’s priority to ensure that “Children are well nourished”, through the PAMRDC (Multisectoral Plan for the Reduction of Chronic Malnutrition), approved in 2010, when Mozambique joined the Global Scaling Up Nutrition (SUN) Movement to fight malnutrition.
STRATEGIC OBJECTIVE CONTRIBUTE TO IMPROVED NUTRITIONAL STATUS OF CHILDREN
2
PAMRDC is a partnership involving WV-Mozambique, the Government and stakeholders who are working together to implement actions and activities targeting the child’s first 1000 days by promoting pregnant women nutrition, exclusive breastfeeding, and complementary feeding for children under two. By investing to improve nutrition, WVMozambique is helping families boost productivity for a lifecycle and across generations, based on the principles of MDG1,which deals with eradicating extreme poverty and hunger, MDG 2, looking at universal primary education by improving under five nutrition through the enhancement of school readiness, enrolment and retention rates and school performance and, finally, MDG 4, which aims at educing child mortality, by reducing the incidence and severity of morbidity and reducing case-fatality.
Graph 3: Underweight in Children under 5
Children REACHED
World Vision Child Mozambique Strategic Objective 4 CONTRIBUTE TO IMPROVED NUTRITIONAL STATUS OF CHILDREN
% OF CHILDREN 0-59 MONTHS ENROLLED IN GROWTH MONITORING PROGRAMS WITH INADEQUATE GROWTH IN THE LAST 2 MONTHS
33,380 pregnant women and mothers of children under 2 received nutrition counselling.
80.0%
% OF CHILDREN 0-59 MONTHS WHO ARE UNDERWEIGHT IN THE PAST 6 MONTHS
INDICATOR 2
program after 3 months;
70.0%
INDICATOR 1
CHILDREN ARE WELL NOURISHED
GOAL 2: REDUCE CHILD MORTALITY
Tete 23.4% 24.2% Gaza Nampula
24.3% 10.6% 33.2% 18.9% 31.3% 40.9%
Zambezia
745 children graduated from the PDH
60.0%
CHILD WELL-BEING OUTCOMES
GOAL 1: ERADICATE EXTREME POVERTY AND HUNGER
50.0%
CWBA 1: ENJOY GOOD HEALTH
1,665 children entered PDH program;
40.0%
MULTISECTORAL PLAN FOR THE REDUCTION OF CHRONIC MALNURITIONS
Millenium Development Goals
rehabilitation programs;
30.0%
Govenment priorities
World Vision Child well-being aspirations
20.0%
0.0%
1,722 children referred to
10.0%
STRATEGIC LINKAGES
WVM Overeall
27.9% 24.5%
FY15 Strategy measurement data
WWTARGET WV threshold: Acceptable
FY13 Strategy measurement data
WV threshold: Critical WV threshold: Attention Required
Source: NO Strategy Baseline 2013 & 2015
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WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORTXXI
ACHIEVEMENTS
and evaluation group for the SUN Civil Society platform, supporting the national food fortification program as well as implementing nutrition specific activities in the areas where WV-Mozambique is present, promoting infant and young children feeding (IYCF – 1000 days) using the Positive Deviance and Health (PDHealth) approach and Growth Monitoring and Promotion (GMP), by actively supporting volunteers in conducting community mobilization for the referral of malnourished children to health facilities as well as providing logistical support to the Ministry of Health (MoH) immunization and deworming campaigns.
Mozambique is one of 22 African countries with the highest burden of child malnutrition, resulting in significant threats to human development and reduced economic productivity. In Mozambique, inadequate dietary intake is a major cause for under nutrition. Diets are usually monotonous and low in micronutrients, with an estimated of 27% of households reporting poor or borderline food consumption. While only 43% of Mozambican infants are exclusively breastfed for the first six months and 30% of children aged 6-23 months have a diverse diet, the Government of Mozambique (GoM) has established several nutrition and health programs in primary healthcare that address the immediate determinants of malnutrition in both women and children. These programs range from growth monitoring and promotion of under 5 children, micronutrient programs, promotion of infant and young child feeding (IYCF) and management of malnourished children. In order to support the Scaling Up Nutrition (SUN) movement, actors such as the Government, UN agencies, Civil Society (CS), Private and donor have contributed. The government, together with partners, has been working towards the decentralization and contextualization of the PAMRDC within the provincial level. Currently, all 4 provinces in which WVMozambique operates, namely Gaza, Zambezia, Tete and Nampula, have their own localized PAMRDC. WVMozambique has taken the lead on the monitoring
Underweight rate has dropped from 27.9% to 24.5% by 3.4%. This shows a real reduction of underweight levels in provinces Nampula and Gaza, where World Vision-Mozambique has been investing in nutrition projects with two Maternal, Newborn and Child Health projects in and 3 ADPs implementing PDHealth, GMP and IYCF models, respectively. However, Tete and Zambezia experienced a slight increase in underweight rates, which can be attributed to the major floods that affected Zambezia, in January and February 2015, destroying all the crops and creating food insecurity. In Tete, the increase is explained by the reduction on the budget for nutrition activities exacerbated by the regional droughts, had a negative impact. To support the underweight figures, the analysis of data by age groups shows that the weaning phase (611 months) remains the critical phase to fight under nutrition, as 30.8% children are underweight. From this
Table 2: Resources for SO: Contribute to improved nutritional status of children PROJECT OR PROGRAM
KEY PROJECT MODELS
KEY PARTNERS
SOURCE OF FUNDING
NUMBER OF TECHNICAL STAFF
FY15 EXPENDITURE
Sponsorship funded ADPs
IYCF, PDH, GMP
MoH
Sponsorship
1 community health and nutrition assistant per ADP. Total of 28 staff
1,466,256.58
SCIP project Nutrition, WASH, HIV and health
IYCF, GMP
MoH Health Committees
USAID
10 nutrition trainers, 16 MCH nurses
5, 248,250.55
Nacaroa Community Health Project
GMP, IYCF
MoH
AusAID
2 Nurses
512,586.71
Muecate MNCH project
IYCF, PDH, GMP
MoH
WV Australia
3 Nurses
292,627.53
study, special attention should be focused on infants aged 0 to 5 months, especially when it comes to exclusive breastfeeding, the frequency of breastfeeding and feeding practices for lactating women. WV-Mozambique continues to partner with the MoH at provincial and district levels to support the GMP programs, as well as provide logistical support to immunization and deworming campaigns. The focus has been on strengthening mobile health brigades which target communities far from health facilities. These mobile health brigades are effective in delivering services like growth monitoring, antenatal care, immunization and deworming for these communities. Additionally, WV-Mozambique has trained 2,671 community health nutrition volunteers, from Nampula, Zambezia, Gaza and Tete, in IYCF – 1000 days. Trained volunteers were able to provide household education about exclusive breastfeeding, adequate complementary feeding as well as pregnant women and lactating women feeding. Lead mothers and volunteers organized cooking demonstration sessions, showing how best to incorporate locally available nutritious foods to diversify the dietary needs for children. All in all, 33 380 pregnant women and mothers of under 2 children benefited from nutrition counselling. Volunteers, through WV-Mozambique training sessions, also enhanced their skills on how to use Mid Upper
“One thing I noticed is that my last pregnant was less painful than to two I had before and my baby was born strong and healthy compared to others, which I believe as has to do with the trainings I had since I was pregnant.” Alzinha Rosário, 25 years old mother of three who is now aware of the importance of pre-natal care and nutrituion.
Arm Circumference (MUAC) tapes to measure and visually assess bilateral pitting edema, so as to identify children with acute malnutrition during their home visits, PDH sessions and monthly growth monitoring sessions conducted through the mobile brigades. This resulted in 1,665 children referred to either PDH at community level, or health facility for malnutrition rehabilitation program. SCIP Ogumaniha’s project trained 44 MoH staff on IYCF to ensure the quality of continuum care for the children once they are referred to HF for nutritional care rehabilitation. The PDHealth model has been designed and implemented to target the most vulnerable families in the community. PDHealth uses locally available foods, such as Moringa leaves, which display high nutritional value at little or no additional cost. Through GMP programs and supporting monthly mobile brigades campaign, WV-Mozambique is improving the delivery of basic health services such as immunization and deworming to the most remote and farthest areas from health facilities, where vulnerable families are located. After evaluating the two Maternal, Newborn and Child Health projects, focus group discussion participants concluded that the knowledge and skills gained by health volunteers and mothers will be retained and sustained, as they proved to be efficient in supporting them towards improving their children’s health and nutritional status with no additional costs.
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WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORTXXIII
CHILDREN GROW HEALTHY Health is at the centre of the development agenda and relates directly to four MDGs: To reduce child mortality by two thirds (MDG 4); To reduce maternal deaths by three quarters and achieve universal access to reproductive health (MDG 5); To halt and reverse the spread of HIV/AIDS and the incidence of malaria and other major diseases (MDG 6). To reduce by half the proportion of the population without sustainable access to safe drinking water and basic sanitation has an indirect influence on health (MDG 7). WV-Mozambique Health and WASH programming is designed to deliver a set of effective health interventions to achieve better health outcomes, thus contribute to MDGs, country-level health objectives as well as CWB target “Children are protected from infection and diseases especially malaria and diarrhoea”.
STRATEGIC OBJECTIVE CONTRIBUTE TO IMPROVED HEALTH STATUS OF CHILDREN
3
STRATEGIC LINKAGES
Millenium Development Goals
Govenment priorities
World Vision Child well-being aspirations
GOAL 4: REDUCE CHILD MORTALITY
Interventions around malaria and WASH are grouped into areas: counselling & education; case management; protective interventions; and enabling environment.
INDICATOR 1 PERCENTAGE OF HOUSEHOLDS WITH ACCESS TO IMPROVED DRINKING WATER
CONTRIBUTE TO IMPROVED NUTRITIONAL STATUS OF CHILDREN
INDICATOR 2
INDICATOR 3
PERCENTAGE OF HOUSEHOLDS WITH ACCESS TO IMPROVED SANITATION FACILITIES
PERCENTAGE OF HOUSEHOLDS WITH AT LEAST ONE LLIN IN THE LAST 12 MONTHS
CHILD WELL-BEING OUTCOMES
CHILDREN PROTECTED FROM INFECTION DISEASE AND INJURY
CHILDREN AND THEIR CAREGIVERS ACCESS ESSENTIAL HEALTH SERVICES
The second leading cause of death in under 5 children is Diarrhoea diseases, which stem from limited access to potable water and sanitation, part of the health and disease burden in Mozambique. Table 3: Resources for Health
KEY PARTNERS
Sponsorship funded ADPs (including MOZWASH)
7-11 strategy - timed targeted Counseling CLTS in schools and communities; WASH and disabilities;
Sponsorship DPS, SDSMAS WVUS, charity: water, Health Committees Gov. Support Offices Dir. of WASH Communities
Global Fund Malaria project
Coordination with NMCP District supervision visits LLIN distribution SBCC: malaria prevention and treatment Refresher training of CHWs
NMCP DPS, SDMAS Malaria Consortium FH, FDC HCs, schools
10, 311,389.53 1 community trainer/district Global Fund 1 capacity building coordinator $7,904,765 from per province Oct´14 to June´15 (R9 phase 2) + $5,095,930 for July to Sept 2015 (NFM)
SCIP project Nutrition, WASH, HIV and health
MCH/Malaria Nutrition/WASH SBCC&IEC
DPS, SDSMAS FGH, IRD, JHU, CVM, HCs
USAID
35 health trainers, 16 MCH nurses, 1 capacity building coordinator,
5, 248,250.55
FFE project Literacy, school feeding, health interventions
PHAST SBCC/IEC on better health practices
DPS, SDSMAS DPEC, SDJET
FAS
1 Health Coordinator 4 Health Trainers
3,901,940.21
Muecate and Nacaroa projects
Timed targeted Counselling CLTS/PHAST
DPS SDSMAS
AusAID
2 community trainers per project, 1 ttc supervisor
805,214.24
CWBA 3: ENJOY GOOD HEALTH
World Vision Child Mozambique Strategic Objective 3
Life expectancy in Africa ( 55 years old), remains highly affected by Malaria epidemic, HIV and non-communicable diseases. Malaria, with 3.9 million reported cases in 2013, contributes to 29% of deaths, included in the maternal mortality rate, and is responsible for 44% of all outpatient consultations and 57% of paediatric admissions.
KEY PROJECT MODELS & INTERVENTIONS
PROJECT/PROGRAM
GOAL 5: IMPROVE MATERIAL HEALTH GOAL 6: COMBATE HIV/AIDS, MALARIA AND OTHER DISEASES
Though improvements in health status has not been uniform, <5 mortality rate has substantially decreased, almost achieving the MDG targets. Other areas, such as neonatal and maternal mortality demonstrate slow progress and high rates, which compromise the achievement of relevant MDGs.
FUNDING SOURCE
NUMBER OF TECHNICAL STAFF
FY15 EXPENDITURE
1 community health assistant per ADP 23 WASH technicians at ADP level and 03 Provincial WASH Coordinators
3, 480,358.18
XXIV WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT HOUSEHOLDS HAVE ACCESS TO CLEAN WATER AND IMPROVED SANITATION WV-Mozambique is partnering with the relevant Ministries at all levels and community partners to deliver effective health and WASH interventions. Approaches across programmes and projects include mobilization and training of communities through Health Committees (HCs) and WASH Committees to be fully involved for community-based services delivery. Community activists and volunteers are trained and mentored to deliver health sensitization and behavior change messages (Social behavior Change and Communication – SBCC) on various topics to the target population, including promotion of bed net use for malaria prevention, good sanitation and hygiene using the Participatory Health and Hygiene Transformation (PHAST) and Community-Led Total sanitation (CLTS) methodologies. Besides SBCC activities, MozWASH program interventions also focus on building and rehabilitation of latrines and water access points to increase access. WV-Mozambique has extensive experience in building the capacity of communities and empowering them in order to build ownership and have a strong participation in project activities. The trained committees are critical partners to ensure community engagement, participation and ownership and sustainability. Gender issues and integration of vulnerable groups in decision-making and use of services are also considered within these processes through the use of participatory approaches.
ACHIEVEMENTS According to FY15 measurements, 48.29% of the population now has access to improved drinking water, an increase from FY13’s 46.37%. Tete (53.40%), Zambezia (51.10%), and Gaza (49.02%) provinces demonstrated highest growth in households with access to improved drinking water, while Nampula shows the lowest, at 37.06%. Nampula, the most populated province, requires more investments in order to reach its potential. MozWASH, in FY15, built 156 boreholes, 02 water systems with six taps each, as well as rehabilitated 38 boreholes and 01 water system, providing safe water to additional 60,600 people. Since water provision itself is not enough to maintain good heath, WV has trained 314 communities in safe water handling, storage, and use, which, if well implemented, prevents waterrelated diseases.
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORTXXV
27,270 children have now safe and
clean water from new or rehabilitated water points
57,238
from 0 to 14 years of age are benefiting from improved sanitation facilities built either by the community members or subsidized by WV-Mozambique
61,677
students of the 150 target primary schools have access to hygiene and sanitation facilities
Through MozWASH-conducted sessions such as CLTS and PHAST, 23,401 improved sanitation facilities were constructed by community members, across all ADPs in Mozambique. In addition, this program subsidized the construction of other 2,038 sanitation facilities for the most vulnerable people. In total, these facilities benefited 127,195 people and will contribute towards the prevention of fecaloral route of transmission. Though the efforts of the CLTS approach amount to sanitation coverage at 9%, in FY15, compared to 5.3% in FY13, the increase is even more significant after considerable testing. The reason is that community members are mainly using traditional latrines, in 56% of households. These usage of these latrines show progress in behavior change and elimination of open defecation, but they are not counted as coverage since they do not follow the technical standards on improved latrines. The integration of WASH on SCIP’s nutrition programming reached households through BCC messages on nutrition. These messages promoted hand-washing after the use of latrines, before food preparation as well as water purification for personal use. The Food for Education project also played a role in contributing to WASH’s indicators achievement, as 150 target schools, trained in PHAST methodology, are now using tippy-taps and clear water systems, with the construction and rehabilitation of 150 latrines. The FFE project baseline showed that 96.5% of the 147 schools had all year round access to water, and 62.5% had access to latrines. At the midterm evaluation, 100% of the schools had access to clear and safe water sources, while 87% had wellfunctioning latrines.
3,577,104
Long Lasting Impregnated Net distributed
12,645 Volunteers and teachers trained
6,338,461 community members reached by malaria preventation messages
Households are protected from Malaria
The Global Fund (GF) project and SCIP malaria interventions contribute to the Malaria Control Program (NMCP) objective, which states that by 2016, 100% of the population should have access to at least one malaria prevention method.
Long Lasting Impregnated Net (LLIN) distributing campaigns have been implemented countrywide, reaching beyond pregnant women and children under 5. Still, this and other prevention methods are not yet fully applied in vulnerable communities.
Table 4: Ownership of Mosquito nets indicator status CWB INDICATOR
THRESHOLD/ NATIONAL AVERAGE
FY13
FY14
FY15
ACHIEVEMENTS
ACHIEVEMENTS
ACHIEVEMENTS
22.3%
38.7%
57.4 %
65.4% *
MONITORING: # of households with at least one LLIN in the last 12 months
* The distribution in 12 out of 17 districts planned for this year are still ongoing and will be finished by December 2015. They were delayed due to various reasons such as rains, overlapping other programs, preparation delays at districts etc. Approximately about another 1 million nets are still to be distributed by December leading to overall 83% coverage rate.
ACHIEVEMENTS From 2013 to 2015 more than 10 million nets were distributed by WV Mozambique and partners through the GF malaria project, which covers the entire country giving this actual high ownership rate, which exceeds the WV target of 80%. Data from final health project evaluations in Nampula also revealed an increased rate of mosquito nets available in the household for children (88% against 71% at baseline) and mothers (86% against 73% at baseline).
Global Fund (GF) malaria project´s major achievement was the completion of the 2014-15 bed net campaign in 36 districts with more than 5.2 million nets planned for distribution by July’15 . Of the 2015 distribution plan, about 3.5 million nets were distributed. Another major achievement was the satisfactory target coverage for the volunteer and teacher training while the expected outcome of these trainings, the number of people reached messages exceeded the target of 100% during FY15.
XXVI WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORTXXVI
Children grow learning
CONTRIBUTE TO IMPROVED ACCESS AND QUALITY OF PRIMARY EDUCATION
According to WV-Mozambique Child Wellbeing Reports (2013 & 2014), only 25% of children in grades 6&7 were able to read and answer comprehension questions correctly, using the Functional Literacy Assessment Tool. Primary school enrolment rates were below the national rates (estimate 70% for both boys and girls), and learning outcomes were poor, especially in the northern provinces of the country. Over the past year, WV-Mozambique has been active in an “Education Transition Initiative”, which redirects the focus of sponsorship funded education from infrastructure and service delivery to literacy and learning outcomes.
The inclusion of previously disadvantaged population with no access to education has posed some challenges, namely the flux of new students causing schools to often function on shifts, which drastically reduces the children’s learning opportunities. At the same time, the educational system had to rapidly hire more teachers, who are not always prepared to teach reading to children whose main language is a local one. Directors often lack adequate managerial and instructional leadership skills to run a school focused on learning improvement. (Raupp et al, 2013)
The combination of effective literacy training for teachers and active participation of children in literacy activities, in and out of the school environment, is part of WV-Mozambique’s operations, thus facilitating improved access and quality of primary education, achieving the Child well-being target, “children are educated for life”.
Graph 4: Percentage of children enrolled by province
CHILDREN REACHED
Adolescents ready for encomic opportunity
Children access and complete basic education
impacted through infrastructure and other education intervention on literacy promotion
80.5% 83.8%
Gaza
60.0%
Zambezia
81.5% 66.5% 63.8%
Tete
70.8% 74.4%
Nampula
70.0%
National
76.2% WWTARGET FY 2013
FY 2014
90.0%
CONTRIBUTE TO IMPROVED ACCESS AND QUALITY OF PRIMARY EDUCATION
Children read, write and use numeracy skills
80.0%
PERCENTAGE OF CHILDREN ENROLLED AND ATTENDING A STRUCTURED LEARNING INSTITUTION.
World Vision Child Mozambique Strategic Objective 4
371,616 children (6-18) have been
70.0%
CHILD WELL-BEING OUTCOMES
PERCENTAGE OF CHILDREN WHO CAN READ WITH COMPREHENSION AT FUNCTIONAL LEVELS NEAR COMPLETION OF A BASIC EDUCATION PROGRAMME
60.0%
INDICATOR 2
211,222
indirectly reached through school feeding and Literacy Programming
50.0%
CWBA 2: GIRLS AND BOYS ARE EDUCATED FOR LIFE
40.0%
GOAL 2: ACHIEVE UNIVERSAL PRIMARY EDUCATION
INDICATOR 2
school feeding
30.0%
Govenment priorities
20.0%
Millenium Development Goals
59,411 directly beneffiting from
World Vision Child well-being aspirations
10.0%
0.0%
STRATEGIC LINKAGES
100.0%
4
STRATEGIC OBJECTIVE
This strategic objective is linked with MDG2, which aims to achieve universal primary education, and SDG 4, which aims to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. Education has been declared a fundamental right to all Mozambican citizens since the country’s Independence, and it serves as an instrument for the affirmation and integration of individuals in social, economic and political life. Despite 16 years of civil war, the educational system has been rebuilt and improved, expanding access to primary education. (Plano Estratégico da Educação 2012-2016)
XXVI WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORT In order to achieve the Child well-being target, “children are educated for life”, World Vision Mozambique, together with the government of Mozambique, has been promoting and advocating for improved quality of primary education through improving teacher trainings, promoting community participation in literacy activities for girls and boys so as to improve it. In the WV-Mozambique operation areas, about 69.96% of boys and 68.85% of girls were enrolled and attending a structured learning institution, in 2013. However, important challenges remain, rooted in the poor quality of teaching and adverse learning environments in many rural primary schools. The education system is, thus, characterized by inadequate reading materials, large classes and under-qualified teachers who lack access to inservice teaching. Though Portuguese is used as a medium of instruction, in some areas, Mozambican children start school without knowing how to speak the language.This poses challenge for children who try to learn and read in the early grades of primary school.
ACHIEVEMENTS
WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORTX XIX
enrolment rates by gender nationally, there were no major differences. Boys’ enrolment stood at 70%, while girls stood at 69%. Provincially, however, girls in Zambezia showed the lowest enrolment rates, at 56%, and in Gaza and Nampula, girls’ rates stood higher than the boys’. (Gaza, 82% girls and 79% boys; Nampula, 72% girls and 69% boys) On a national level, from 2013 to 2015, the average percentage of children enrolled in primary schools has risen from 70% in 2013, to 76% in 2015. This shows that WV-Mozambique’s continuous efforts in contributing to improved access and quality of primary education for children, through community mobilization. The FEE project indicates that 8.15% of children demonstrated the ability to read and understand the meaning of grade level text by the end of two grades of schooling. Though the holistic intervention of the Food for Education project (FFE), integrating education, health and nutritious interventions, the rate of attentiveness improved from 20% in 2013 to 81.4% in 2015, according to the FFE Final Evaluation Report 2015. This was achieved through the provision and production of supplementary reading materials and teacher training, which increased the motivation of both students and parents. Together with the Ministry of Education and FCD (Foundation for Community Development), WV-Mozambique improved access and quality of education through pedagogical capacity building for teachers and school management committees. Communities were sensitized to understand the value of their children’s education, and creating a reading culture in the community in order to improve literacy skills.
WV-Mozambique’s contributions were manifested in the construction of schools and purchase of schools supplies and materials, which has increased access. Mozambique, nationally, has reached a WV-Mozambique enrolment target of 69%, with Gaza and Nampula at 80.5% and 70.5%, respectively, even despite regional disparities in the central provinces of Zambezia and Tete, in which the enrolment rates fell below the WV targets, at 60% and 66.5%, respectively. Looking at
Table 5: Resources for Education NAME OF PROJECT OR PROGRAMME
KEY PROJECT MODELS BEING IMPLEMENTED
KEY PARTNERS IN THIS PROJECT
SOURCE OF FUNDING
NUMBER OF TECHNICAL STAFF
1 Sub grantee 3,901,940.21 Education Specialist
FFE (Literacy Boost)
School feeding Literacy boost School infrastructure improvement Advocacy and awareness raising
FDC DPEC SDJET
FAS
Sponsorship funded ADPs
School infrastructure improvement Advocacy and awareness raising Literacy boost
DPEC SDJET
Sponsorship 1 (National fund Level)
FY15 EXPENDITURE
1,925,650.52
“Let´s suppose we are learning how to use a compass and the teacher doesn’t have one to show how to use, how will you understand the lessons? It was such difficult for us. So, when I learned about the possibility of producing our own teaching materials, I was so trilled and I volunteered to join the group. Today, I feel that I understand better the lessons and I have improved quite a lot because I can see what the teacher is saying rather than only listening.” Paulo Marinho is a 15 years old student supported by Food For Education Project, whose dream is to became President of Mozambique
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WORLD VISION-MOZAMBIQUE • CHILD WELL-BEING REPORTX XXI
Funding Details
Non Food Items (NFIS) CHILDREN IN EMERGENCY
13%
WASH
PEOPLE REACHED BY SECTOR
EMERGENCY RESPONSE
15 people affected in zambezia
Mozambique issued a red alert on January 12, 2015 after heavy and persistent rains resulted in severe flooding in northern and central parts of Mozambique. The worst affected provinces in the north and central areas included Zambezia (notably around the Lucingo and Chire rivers); Niassa, Nampula and Cabo Delgado and affected at least 37,090 families (over 160,000 people), of which around 50,000 people were displaced and 127 lost their lives in Zambezia alone. The floods caused power cuts, downed bridges, restricted access and food insecurity, especially since the disaster occurred during the planting season. As a result of this situation, WV-Mozambique declared a Category II emergency with a response to address challenges, focalizing the interventions on strategic sectors namely WASH, Food Aid, NFIs and Children in Emergency (protection and education). To do so, WV-Mozambique mobilized resources from multiple donors including WFP, UNICEF, USAID, the STARTFund and multiple private donors. In only 71.5 hours, funds reached the field and projects began implementation immediately in 8 affected districts. The activities included Non Food Items (NFI) distribution (emergency hygiene and shelter), supplying accommodation centres and establishing child friendly spaces, as well as providing latrines, water tanks, mosquito nets hygiene promotion messages to improve sanitation and prevent diseases. World Vision-Mozambique worked alongside the local government and community leaders, notably at the beginning of NFI distributions and for preventative health services. High waters and lack of boats significantly hampered access to the most isolated communities and affected initial assessments and distribution. Proactive
Over 50 000 People displaced in Zambezia
134 People died in Zambezia
160 000
25%
65,792 total people reached
NFIS
27,792
DFID WV KOREA USAID
people assisted from Jannuary to September in Food Security
144,279
Food Security
ZAMBEZIA FOOD AID PROJECT WFP
48% WASH
14%
UNICEF WV US
Children in emergency
25,718
people reached from Jannuary to July in WASH
7500
FOOD SECURITY
CHILD PROTECTION AND EDUCATION
students reached in Child In Emergency
WV AUSTRALIA WV TAIWAN WV UK
$1.035.745
4600
kits distributed including family shelter and hygiene items
Estimated number of people affected by flooding
coordination with implementing partners and external actors provided quick solutions to enable greater coverage. Women and children headed households, orphans, elderly and people with disabilities were targeted specifically, and the response reached 65,792 people. Specific on Food Aid in partnership with WFP, WVMozambique was responsible to provide support to 27,000 direct beneficiaries with general food distributions and food for asset over an eightmonth period to support recovery of vulnerable people resettled across 5 districts. In parallel to food interventions, WV-Mozambique provided improved water, sanitation and hygiene conditions for almost 40,000 direct beneficiaries during six months, and support education and protection actions in temporary relocation camps for almost 7,500 students. 4,600 NFI kits were distributed combining family shelter and hygiene items to the affected people. To successfully implement the response, WVMozambique worked closely with several partners (Government, UN and NGOs) through coordination technical meetings.
DISASTER REDUCTION As a part of the Disaster Risk reduction, WVMozambique implemented the GERANDO (Gestão de Risco ao Nivel da Comunidade) holistic approach aiming to build resilience of the communities on management of risks and mitigation of disasters. Simulation exercises to test the operationalization of the Community Disaster Preparation Plans developed was prioritized on key program areas. Under the Climate Change efforts to minimize in country impacts, WV-Mozambique in partnership with Oxfam and Save the Children (ACCRA - Africa Climate Change Resilience Alliance), provided capacity to the district governments on adaptation practices and was responsible to develop three Local Adaptations Plans for the districts of Guíja, Mopeia and Morrumbala (ADPs areas included), as a part of the Mozambique Government priority to mainstream CC aspects into the Districts Development Planning processes.
On the news: CNN World Vision staff struggle to get aid to flood victims in Mozambique STV World Vision supports Government food aid World Vision boat helps safe passage of people across the Licungo river World Vision committed to improving sanitation conditions in temporary accommodation centers Radio Mocambique World Vision provides assistance to flood stricken communities TVM World Vision provides shelter materials for flood victims
XXXI WORLD VISION-MOZAMBIQUE â&#x20AC;¢ CHILD WELL-BEING REPORT
In memory of Alda Manjate
World Vision staff since 2006, Alda passed away as a victim of floods while trying to reach the communities isolated in result of the destruction caused by the heavy rains in 2015.
You wil always be remembered
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