ap17-21 samengevoegd final - rode kruis€¦ · 5 outcome 2 fa ..... 167

2

Inhoudsopgave Afkortingen ................................................................................................................................................................................. 9

Algemene fiche van het programma .............................................................................................................................. 12

Beschrijving van de Outcomes .......................................................................................................................................... 13

Budget van het programma ............................................................................................................................................... 14

T1 Algemeen budget ....................................................................................................................................................... 14

België........................................................................................................................................................................................... 20

Samenvatting ...................................................................................................................................................................... 21

Landenfiche .......................................................................................................................................................................... 23

Betrokken partijen ............................................................................................................................................................. 23

Theory of Change .............................................................................................................................................................. 24

Outcome 1 AIS ............................................................................................................................................................... 24

Outcome 2 IHR .............................................................................................................................................................. 29

Risicoanalyse ....................................................................................................................................................................... 36

Aanbevelingen gedaan in het kader van de Strategische dialoog ................................................................ 38

Geleerde lessen uit vorige programma’s ................................................................................................................. 38

Outcome 1 AIS ............................................................................................................................................................... 38

Outcome 2 IHR .............................................................................................................................................................. 39

Outcomes ............................................................................................................................................................................. 40

Fiche Outcome 1 AIS ................................................................................................................................................... 40

Fiche Outcome 2 IHR ................................................................................................................................................... 41

Logisch kader Outcome 1 AIS .................................................................................................................................. 42

Logisch kader Outcome 2 IHR ................................................................................................................................. 44

Operationeel Budget ................................................................................................................................................... 47

Relevantie ............................................................................................................................................................................. 49

Outcome 1 AIS ............................................................................................................................................................... 49

Outcome 2 IHR .............................................................................................................................................................. 51

Relevantie ten opzichte van de prioritaire thema’s van Belgische overheid ......................................... 52

Transversale thema’s ................................................................................................................................................... 53

Doeltreffendheid ................................................................................................................................................................ 56

Outcome 1 AIS ............................................................................................................................................................... 56

Outcome 2 IHR .............................................................................................................................................................. 57

Duurzaamheid ..................................................................................................................................................................... 58

Outcome 1 AIS ............................................................................................................................................................... 58

Outcome 2 IHR .............................................................................................................................................................. 59

Doelmatigheid .................................................................................................................................................................... 59

Outcome 1 AIS ............................................................................................................................................................... 60

Outcome 2 IHR .............................................................................................................................................................. 60

Partnerschap ........................................................................................................................................................................ 61

Betrokken partijen/partners ...................................................................................................................................... 61

Link met het Zuiden ..................................................................................................................................................... 61

Platformen ....................................................................................................................................................................... 62

Synergie & complementariteit ..................................................................................................................................... 63

Outcome 1 AIS ............................................................................................................................................................... 63

Outcome 2 IHR .............................................................................................................................................................. 64

Burundi ....................................................................................................................................................................................... 68

Samenvatting ...................................................................................................................................................................... 69

3

Fiche Pays ............................................................................................................................................................................. 71

Localisation de l’intervention ................................................................................................................................... 72

Liste des partenaires ......................................................................................................................................................... 72

Théorie de Changement ................................................................................................................................................. 73

Outcome 1 WASH ......................................................................................................................................................... 73

Outcome 2 Premiers Secours ................................................................................................................................... 78

Analyse des risques ........................................................................................................................................................... 82

Recommandations et expériences antérieures ...................................................................................................... 83

Recommandations du Dialogue Stratégique ..................................................................................................... 83

Leçons apprises par les expériences antérieures du CRB-Fl dans le pays .............................................. 83

Outcome 1 WASH ............................................................................................................................................................. 84

Fiche Outcome ............................................................................................................................................................... 84

Cadre Logique ................................................................................................................................................................ 85

Frais opérationnels ....................................................................................................................................................... 89

Outcome 2 PS ..................................................................................................................................................................... 90

Cadre Logique ................................................................................................................................................................ 91

Budget opérationnel .................................................................................................................................................... 94

Pertinence ............................................................................................................................................................................. 95

Outcome 1 WASH ......................................................................................................................................................... 95

Outcome 2 Premiers Secours ................................................................................................................................... 97

Pertinence selon d'autres thèmes prioritaires de DGD .................................................................................. 98

Efficacité ................................................................................................................................................................................ 99

Outcome 1 WASH ......................................................................................................................................................... 99

Outcome 2 PS .............................................................................................................................................................. 100

Durabilité ........................................................................................................................................................................... 100

Outcome 1 WASH ...................................................................................................................................................... 100

Outcome 2 PS .............................................................................................................................................................. 101

Efficience ............................................................................................................................................................................ 102

Délégation .................................................................................................................................................................... 102

Outcome 1 WASH ...................................................................................................................................................... 102

Outcome 2 PS .............................................................................................................................................................. 103

Partenariat ......................................................................................................................................................................... 104

CRB .................................................................................................................................................................................. 104

Renforcement de capacités ................................................................................................................................... 104

Synergies & complémentarités ................................................................................................................................. 105

Madagascar ........................................................................................................................................................................... 106

Samenvatting ................................................................................................................................................................... 107

Fiche Pays .......................................................................................................................................................................... 109

Localisation de l’intervention ................................................................................................................................ 110

Liste des partenaires ...................................................................................................................................................... 110

Théorie du Changement .............................................................................................................................................. 111

Analyse des Risques ...................................................................................................................................................... 118

Recommandations et leçons apprises .................................................................................................................... 120

Recommandations du Dialogue Stratégique .................................................................................................. 120

Leçons apprises........................................................................................................................................................... 120

Outcome 1 First Aid ....................................................................................................................................................... 121

Fiche outcome ............................................................................................................................................................. 121

4

Cadre Logique ............................................................................................................................................................. 122

Frais opérationnels .................................................................................................................................................... 124

Description de la Pertinence ................................................................................................................................. 125

Pertinence par rapport aux thèmes prioritaires de la DGD ....................................................................... 126

Description de l’Efficacité ....................................................................................................................................... 127

Description de la Durabilité ................................................................................................................................... 128

Description de l’Efficience ...................................................................................................................................... 129

Description de la stratégie de Partenariat ....................................................................................................... 130

Synergies & Complémentarités ........................................................................................................................... 131

Mozambique ......................................................................................................................................................................... 133

Samenvatting ................................................................................................................................................................... 134

Country Fiche ................................................................................................................................................................... 136

Area of intervention .................................................................................................................................................. 137

List of partners ................................................................................................................................................................. 137

Theory of Change ........................................................................................................................................................... 137

Outcome 1 WASH ...................................................................................................................................................... 137

Outcome 2 FA ............................................................................................................................................................. 141

Risk analysis ...................................................................................................................................................................... 145

Recommendations & lessons learned .................................................................................................................... 147

JSF Strategic Dialogue Recommendations ...................................................................................................... 147

Lessons learned from previous programs ........................................................................................................ 147

Outcome 1 WASH .......................................................................................................................................................... 148

Outcome Fiche ............................................................................................................................................................ 148

Logical Framework .................................................................................................................................................... 149

Operational Budget ................................................................................................................................................... 151

Outcome 2 FA .................................................................................................................................................................. 152

Outcome Fiche ............................................................................................................................................................ 152



Relevance ........................................................................................................................................................................... 156

Outcome 1 WASH ...................................................................................................................................................... 156

Outcome 2 FA ............................................................................................................................................................. 157

Relevance according to other DGD priorities ................................................................................................. 157

Effectiveness ..................................................................................................................................................................... 159

Outcome 1 WASH ...................................................................................................................................................... 160

Outcome 2 FA ............................................................................................................................................................. 161

Sustainability .................................................................................................................................................................... 161

Outcome 1 WASH ...................................................................................................................................................... 161

Outcome 2 FA ............................................................................................................................................................. 162

Efficiency ............................................................................................................................................................................ 162

Delegation .................................................................................................................................................................... 162

Outcome 1 WASH ...................................................................................................................................................... 163

Outcome 2 FA ............................................................................................................................................................. 164

Partnership ........................................................................................................................................................................ 164

Policy ............................................................................................................................................................................... 164

Cruz Vermelha de Moçambique (CVMO) ......................................................................................................... 164

Capacity building ....................................................................................................................................................... 165

Synergy & complementarity ...................................................................................................................................... 166

Outcome 1 WASH ...................................................................................................................................................... 167

5

Outcome 2 FA ............................................................................................................................................................. 167

Nepal ........................................................................................................................................................................................ 168

Samenvatting ................................................................................................................................................................... 169

Country Fiche ................................................................................................................................................................... 171


List of partners ................................................................................................................................................................. 172

Coherence with BRC-Fl Strategy ............................................................................................................................... 172

Vision .............................................................................................................................................................................. 172

Mission ........................................................................................................................................................................... 172

Medium & long-term objectives in Nepal ....................................................................................................... 172

Strategy .......................................................................................................................................................................... 173

Theory of Change ........................................................................................................................................................... 173

Outcome 1 WASH ...................................................................................................................................................... 173

Outcome 2 FA ............................................................................................................................................................. 177

Lessons learned ............................................................................................................................................................... 182

Risk analysis ...................................................................................................................................................................... 183

Outcome 1 WASH .......................................................................................................................................................... 184

Outcome Fiche ............................................................................................................................................................ 184



Outcome 2 FA .................................................................................................................................................................. 188

Outcome Fiche ............................................................................................................................................................ 188



Relevance ........................................................................................................................................................................... 192

Outcome 1 WASH ...................................................................................................................................................... 192

Outcome 2 FA ............................................................................................................................................................. 195

Relevance according other DGD priorities ...................................................................................................... 196

Effectiveness ..................................................................................................................................................................... 197

Outcome 1 WASH ...................................................................................................................................................... 198

Outcome 2 FA ............................................................................................................................................................. 198

Sustainability .................................................................................................................................................................... 199

Outcome 1 WASH ...................................................................................................................................................... 199

Outcome 2 FA ............................................................................................................................................................. 199

Efficiency ............................................................................................................................................................................ 200

Delegation .................................................................................................................................................................... 200

Outcome 1 WASH ...................................................................................................................................................... 200

Outcome 2 FA ............................................................................................................................................................. 201

Partnership ........................................................................................................................................................................ 201

Policy ............................................................................................................................................................................... 201

NRCS ............................................................................................................................................................................... 201



Outcome 1 WASH ...................................................................................................................................................... 203

Outcome 2 FA ............................................................................................................................................................. 203

Rwanda .................................................................................................................................................................................... 204

Samenvatting ................................................................................................................................................................... 205

Country Fiche ................................................................................................................................................................... 207

6


List of partners ................................................................................................................................................................. 208

Theory of Change ........................................................................................................................................................... 208

Outcome 1 WASH ...................................................................................................................................................... 209

Outcome 2 FA ............................................................................................................................................................. 213

Risk analysis ...................................................................................................................................................................... 217

Recommendations and Lessons Learned.............................................................................................................. 218

JSF Strategic Dialogue Recommendations ...................................................................................................... 218

Outcome 1 WASH .......................................................................................................................................................... 219

Outcome Fiche ............................................................................................................................................................ 219



Outcome 2 FA .................................................................................................................................................................. 223

Outcome Fiche ............................................................................................................................................................ 223



Relevance ........................................................................................................................................................................... 227

Outcome 1 WASH ...................................................................................................................................................... 227

Outcome 2 FA ............................................................................................................................................................. 228

Relevance according to other DGD priority themes .................................................................................... 229

Effectiveness ..................................................................................................................................................................... 230

Outcome 1 WASH ...................................................................................................................................................... 230

Outcome 2 FA ............................................................................................................................................................. 231

Sustainability .................................................................................................................................................................... 231

Outcome 1 WASH ...................................................................................................................................................... 231

Outcome 2 FA ............................................................................................................................................................. 232

Efficiency ............................................................................................................................................................................ 232

Outcome 2 FA ............................................................................................................................................................. 233

Partnership ........................................................................................................................................................................ 234

RRCS ................................................................................................................................................................................ 234



Tanzania .................................................................................................................................................................................. 236

Samenvatting ................................................................................................................................................................... 237

Country Fiche ................................................................................................................................................................... 239


List of partners ................................................................................................................................................................. 240

Theory of Change (ToC) ............................................................................................................................................... 240

Outcome 1: WASH ..................................................................................................................................................... 241

Outcome 2: FA ............................................................................................................................................................ 245

Risk Analysis ...................................................................................................................................................................... 250

Lessons learned and Recommendations ............................................................................................................... 251

Strategic Dialogue Recommendations .............................................................................................................. 251

Lessons Learned from previous in-country experiences in WASH and FA – programming ........ 251

Outcome 1 WASH .......................................................................................................................................................... 252

Outcome Fiche ............................................................................................................................................................ 252


7


Outcome 2 FA .................................................................................................................................................................. 256

Outcome Fiche ............................................................................................................................................................ 256



Relevance ........................................................................................................................................................................... 260

Outcome 1 WASH ...................................................................................................................................................... 260

Outcome 2 FA ............................................................................................................................................................. 261

Relevance according to DGD Priority themes ................................................................................................ 263

Effectiveness ..................................................................................................................................................................... 263

Outcome 1 WASH ...................................................................................................................................................... 264

Outcome 2 FA ............................................................................................................................................................. 265

Sustainability .................................................................................................................................................................... 265

Outcome 1 WASH ...................................................................................................................................................... 265

Outcome 2 FA ............................................................................................................................................................. 266

Efficiency ............................................................................................................................................................................ 266

Delegation .................................................................................................................................................................... 266

Outcome 1 WASH ...................................................................................................................................................... 267

Outcome 2 FA ............................................................................................................................................................. 267

Partnership ........................................................................................................................................................................ 268

Policy ............................................................................................................................................................................... 268

TRCS ................................................................................................................................................................................ 268



Zimbabwe ............................................................................................................................................................................... 271

Samenvatting ................................................................................................................................................................... 272

Country Fiche ................................................................................................................................................................... 274


List of partners ................................................................................................................................................................. 275

Theory of Change ........................................................................................................................................................... 275

Outcome 1 FA ............................................................................................................................................................. 275

Risk Analysis ...................................................................................................................................................................... 282

Lessons Learned & Recommendations.................................................................................................................. 283


Lessons learned from previous programs ........................................................................................................ 283

Outcome 1 FA .................................................................................................................................................................. 284

Outcome Fiche ............................................................................................................................................................ 284



Relevance ........................................................................................................................................................................... 288

Relevance according to priorities of the Belgian Development cooperation .................................... 289

Effectiveness ..................................................................................................................................................................... 290

Sustainability .................................................................................................................................................................... 291

Efficiency ............................................................................................................................................................................ 292

Results-based budgeting ........................................................................................................................................ 292

Delegation .................................................................................................................................................................... 292

Partnership ........................................................................................................................................................................ 293

8

Policy ............................................................................................................................................................................... 293

ZRCS ................................................................................................................................................................................ 293



South Africa ........................................................................................................................................................................... 296

Samenvatting ................................................................................................................................................................... 297

Country Fiche ................................................................................................................................................................... 299

Aria of intervention ................................................................................................................................................... 299

List of partners ................................................................................................................................................................. 300

Theory of Change ........................................................................................................................................................... 300

Outcome First Aid ...................................................................................................................................................... 300

Risk analysis ...................................................................................................................................................................... 306

Lessons learned & Recommendations ................................................................................................................... 307


Lessons learned .......................................................................................................................................................... 307

Outcome First Aid........................................................................................................................................................... 309

Outcome Fiche ............................................................................................................................................................ 309

Logical framework ..................................................................................................................................................... 310


Relevance ........................................................................................................................................................................... 312

General ........................................................................................................................................................................... 312

Relevance for local partner .................................................................................................................................... 313

Beneficiaries ................................................................................................................................................................. 313

Location ......................................................................................................................................................................... 314

Relevance related to the priorities of the Belgian Development Cooperation ................................. 314

Effectiveness ..................................................................................................................................................................... 315

JSF Contribution ......................................................................................................................................................... 316

Intervention strategy ................................................................................................................................................ 316

Sustainability .................................................................................................................................................................... 317

Efficiency ............................................................................................................................................................................ 318

Results-based budgeting ........................................................................................................................................ 318

Delegation .................................................................................................................................................................... 318

Partnership ........................................................................................................................................................................ 319

Policy ............................................................................................................................................................................... 319

SARCS ............................................................................................................................................................................. 319

First Aid .......................................................................................................................................................................... 320


Delegation .................................................................................................................................................................... 320


Annexes ................................................................................................................................................................................... 322

Annex 1: Explaining the Theory of Change approach ...................................................................................... 323

Annex 2: Example of detailed Risk Analysis (Nepal) ......................................................................................... 324

Annex 3: Explaining the link between Decent Work and First Aid. ............................................................. 327

Annex 4: Human Rights within the work of BRC-Fl ........................................................................................... 328

Annex 5: Partnership Agreement template .......................................................................................................... 329

Annex 6: Cooperation agreement (synergies) template ................................................................................. 336

9

Afkortingen International Initiative for Impact Evaluation 3ie

Analyse de contexte conjointe ACC

Acteur de la coopération non-gouvernementale ACNG

Automatic External Defibrillator AED

Accès à l’Eau Potable, Hygiène et Assainissement AEPHA

Advanced First Aid AFA

African First Aid Materials AFAM

Activités génératrices de revenus AGR

Agence Burundaise de l’Hydraulique et de l’Assainissement en Milieu Rural AHAMR

Action Plan AP

American Red Cross AmRC

Belgian Development Agent (BTC/CTB) BDA

Internationale Rode Kruis- en Rode Halve Maanbeweging Beweging

Belgian Red Cross-Flanders BRC-Fl

Big Results Now BRN

Belgian Development Agency BTC

Community Based Health and First Aid CBHFA

Convention for the Elimination of Discrimination Against Women CEDAW

Chief Executive Officer CEO

Centre for First Aid CFA

Centre de Formation Professionnelle CFP

Child Hygiene and Sanitation Training CHAST

Comité International de la Croix-Rouge CICR

Community Led Total Sanitation CLTS

Commercial First Aid CoFA

Community Owned Water Supply Organisations COWSOs

Comités Points d’Eau CPE

Croix Rouge Burundaise CRB

Croix-Rouge de Belgique – Communnauté francophone CRB-Cf

Croix-Rouge de Belgique – Flandres CRB-Fl

Croix Rouge Française CRF

Croix Rouge Malgache CRM

Cadre Stratégique Commun CSC

Cible Stratégique Commun CSC

Civil Society Organisation CSO

Cruz Vermelho de Moçambique CVMO

Disability-adjusted life year DALY

District Chapter DCh

District Development Committee DDC

Department for International Development DFID

Belgian Development Cooperation DGD

Disaster Management DM

Department of Roads DptR

Department of Transportation DoT

Disaster Risk Reduction DRR

District Water and Sanitation Hygiene Coordination Committee D-WASH-CC

District Water Engineer’s office DWE

Eidgenössische Anstalt für Wasserversorgung, Abwasserreinigung und Gewässerschutz (Swiss Federal Institute of Aquatic Science and Technology)

EAWAG

Evidence based practice EBP

Directorate-General for European Civil Protection and Humanitarian Aid Operations ECHO

Emergency First Aid EFA

Dienst Eerste Hulp EH

Equivalent Temps Plein ETP

First Aid FA

First Aid Response in Emergencies FARE

First Aid & Road Safety FARS

10

First Aid Simulation FAS

First Aid Training Curriculum Approval Board FATCAB

First Aid Training Standardization FATS

Formation des Formateurs FdF

Forum des acteurs belges FOBAC

Full Time Employees FTE

Gravity flow scheme GFS

Government of Mozambique GoM

Government of Nepal GoN

Good Samaritan Law GSL

Household HH

Humanitaire hulpverlening HHV

Headquarters HQ

Human Resources HR

Health Surveillance Assistant HSA

Health and Welfare Sector Education and Training Authority HSWETA

Institutional Actors IA

Interministeriële Commissie voor Humanitair Recht ICHR

International Committee of the Red Cross ICRC

Information, Education and Communication Materials IEC

International Federation of Red Cross and Red Crescent Societies IFRC

Income Generating IG

International Humanitarian Law IHL

Internationaal humanitair recht IHR

Instituto de Investigacao em Aguas IIA

International Non Governmental Organizations INGOs

Werkgroep Internationaal Actief IntAct

Joint Context Analysis JCA

Dienst Jeugd Rode Kruis JRK

Joint Strategic Framework JSF

Joint Strategic Goal JSG

Knowledge, Attitudes and Practices KAP

Local Government Authorities LGAs

Monitoring and Evaluation M&E

Malawi Blood Transfusion Service MBTS

Memorandum of Understanding MoU

Ministry of Water MoW

Non Communicable Diseases NCDs

Nepal First Aid Materials NeFAM

National Emergency Water, Sanitation, Hygiene Resource Team NEWASH-RT

Non Governmental Organizations NGOs

Network on Humanitarian Action NOHA

Nepal Red Cross Society NRCS

Nederlandse Rode Kruis NRK

National Society NS

National Strategy for Growth and Reduction of Poverty II NSGRP II

National Sanitation and Hygien Master Plan NSHMP

Operation and Maintenance O&M

Objectifs de Développement Durable ODD

Open Defecation Free ODF

Organizational Development & Institutional Development ODID

Open Data Kit ODK

L’Organisation internationale du Travail OiT

Organisation Mondiale de la Santé OMS

Occupational Safety & Health OSH

Programme Alimentaire Mondial PAM

Participatory Hygiene and Sanitation Transformation PHAST

Plateforme d’Intervention Régionale de l’Océan Indien PIROI

Planning, Monitoring, Evaluating and Reporting PMER

Prime Minister Officer - Office of Regional Administration and Local Government PMO-RALG

Partner National Society PNS

11

Promotion des Principes et Valeurs Humanitaires PPVH

Premiers secours PS

Premiers secours commerciaux PSCo

Premiers Secours en milieu Professionnel PSmP

Psychosocial Support PSS

Parents Teachers’ Association PTA

Risk, Attitudes, Norms, Abilities, Self-regulation (model of behavior change) RANAS

Results-Based Management RBM

Red Cross RC

Régies Communales de l’Eau RCE

Réanimation cardio-pulmonaire RCP

Rode Kruis RK

Rode Kruis-Vlaanderen RKV

Responsable National de Secourisme RNS

Réduction des Risques de Catastrophe RRC

Rwanda Red Cross Society RRCS

Road Safety (Nepal) RS

Regional Secretariats (Tanzania) RS

Regional Water and Sanitation Team RWST

Southern African Development Community SADC

South Africa Red Cross Society SARCS

Sustainable Development Goals SDG

Santé génésique maternelle néonatale et infantile SGMNI

Syndrome d’immunodéficience acquise SIDA

Société Nationale Partenaire SNP

Netherlands Development Organisation SNV

Siège Principale SP

Santé et Sécurité au Travail SST

Strategic Dialogue StDi

Théorie de Changement TdC

Tanzania Development Vision 2015 TDV

Theory of Change ToC

Training of Trainers ToT

Tanzania Red Cross Society TRCS

United Nations UN

United Nations Economic and Social Commission for Asia and the Pacific UNESCAP

United Nations Children’s Fund UNICEF

Urban Water Supply and Sewerage Authorities UWSAs

Village Development Committee VDC

Virus de l’immunodéficience humaine VIH

Vlaamse Vereniging voor Ontwikkelingssamenwerking en Technische Bijstand (Flemish As-sociation for Development Cooperation and Technical Assistance

VVOB

Village Water and Sanitation Hygiene Coordination Committee V-WASH-CC

Water, Sanitation & Hygiene WASH

Water And Sanitation Kigoma Region Project WASKIRP

World First Aid WFA

World Health Organization WHO

Water Point Committee WPC

Water and Sanitation Development Plan 2007-2020 WSDP

Water User Association WUA

Water User Committee WUC

Ward Water and Sanitation Hygiene Coordination Committee W-WASH-CC

Zimbabwe Red Cross Society ZRCS

12

Algemene fiche van het programma Algemene titel van het programma: Rode Kruis-Vlaanderen helpt helpen: duurzame impact door inzet op zelfredzaamheid

Landen opgenomen in het programma:: Lijst van GSK's waartoe het pro-gramma wil bijdragen:

België, Burundi, Madagascar, Mozambique, Rwanda, Zuid-Afrika, Tanzania, Zimbabwe

Lijst van de landen buiten de GSK's: Nepal

Startdatum van het programma: 1 januari 2017

Einddatum van het programma: 31 december 2021

De aanvragende erkende actor(en) Rode Kruis-Vlaanderen Internatio-naal vzw

IATI identifier: BE-BCE_KBO-0461634084

Status: Civiele Maat-schappij Organisatie (CMO)

Rekeningnummer:

KBC Bank

Iban: BE24 7310 1827 1438

Benaming rekening: vzw.

Rode Kruis-Vlaanderen Inter-nationaal * DGD

Budget: Totaal budget van de directe kosten van het programma (EUR):

11.350.435

Bedrag van de DGD subsidie (EUR) 9.080.348

Contacten Naam Telefoonnummer E-mail

Contactpersoon voor DGD voor het programma: Tiene Lievens, manager International Cooperation

+32 15 44 33 57 [email protected]

Mogelijke financiële uitzonderingen: Niet van toepassing

13

Beschrijving van de Outcomes Beschrijving van de verwachte resultaten (Outcomes) van het programma 2017-2022

Land Outcomes Operationele kosten

GSK België

Outcome 1: De vrijwilligers van RKV-Internationale Samenwerking zetten zich in om kwetsbaren

zelfredzaam te maken EUR 357.457

Outcome 2: Professionals en de Belgische beleidsmakers zijn versterkt in hun kennis over inter-

nationaal humanitair recht en dragen dit uit. EUR 715.168

GSK Burundi

Outcome 1: L’utilisation durable de suffisamment d’installations d’eau et d’assainissement sûres

ainsi que des attitudes et pratiques d’hygiène sûres et durables dans la population cible d’ici

2021.

EUR 959.697

Outcome 2: Les profanes, le personnel et les volontaires Croix-Rouge possèdent les attitudes, ca-

pacités et connaissances adéquates, à-jour et evidence-based pour donner les premiers secours à

ceux qui en ont besoin, et ce, d’ici 2021. De telle façon, ils augmentent le niveau de résilience de

la communauté et la capacité de soins d’urgence.

EUR 531.058

GSK Madagascar

Outcome: Les profanes, le personnel et les volontaires Croix-Rouge possèdent les attitudes, capa-

cités et connaissances adéquates, à-jour et evidence-based pour donner les premiers secours à

ceux qui en ont besoin, et ce, d’ici 2021. De telle façon, ils augmentent le niveau de résilience de

la communauté et la capacité de soins d’urgence.

EUR 633.876

GSK Mozambique

Outcome 1: Sustained use of sufficient safe water & sanitation facilities, as well as sustained safe

hygiene attitudes & practices by the target population by 2021. EUR 955.229

Outcome 2: Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence

based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhanc-

ing community level resilience and emergency care capacity.

EUR 505.659

Niet-GSK Nepal Outcome 1: Sustained use of sufficient safe water & sanitation facilities, as well as sustained

safe hygiene attitudes & practices by the target population by 2020. EUR 624.380



ing community level resilience and emergency care capacity

EUR 367.113

GSK Rwanda Outcome 1: Sustained use of sufficient safe water & sanitation facilities, as well as sustained





EUR 558.664

GSK Tanzania Outcome 1: Sustained use of sufficient safe water & sanitation facilities, as well as sustained





EUR 663.954

GSK Zimbabwe Outcome: Lay people, Zimbabwe Red Cross staff & volunteers have adequate, up-to-date and

evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such

enhancing community level resilience and emergency care capacity.

EUR 542.743

GSK Zuid-Afrika Outcome : Lay people, Red Cross & volunteers staff with adequate, up-to-date and evidence



EUR 1.410.147

14

Budget van het programma

T1 Algemeen budget

Programma Rode Kruis Vlaanderen - Budget 2017-2021

Landen Outcome Jaren Investeringen Werking Personeel Algemeen Totaal

GSK België

Outcome 1: IAS 2017 3.000 10.355 71.831 85.186

2018 - 20.512 66.831 87.343

2019 - 15.262 46.831 62.093

2020 - 14.462 46.831 61.293

2021 - 14.712 46.831 61.543

Totaal 3.000 75.303 279.155 357.457

Outcome 2: IHR 2017 100 20.505 116.466 137.071

2018 100 22.755 118.795 141.650

2019 100 21.305 121.171 142.576

2020 100 24.555 123.594 148.249

2021 100 19.455 126.066 145.621

Totaal 500 108.575 606.093 715.168

Totaal GSK België 2017 3.100 30.860 188.297 222.257

2018 100 43.267 185.626 228.993

2019 100 36.567 168.002 204.669

2020 100 39.017 170.425 209.542

2021 100 34.167 172.897 207.164

Totaal 3.500 183.878 885.247 1.072.625

GSK Bu-rundi

Outcome 1: WASH 2017 20.777 119.372 62.150 202.299

2018 3.000 208.788 78.290 290.078

2019 - 141.112 77.428 218.540

2020 - 108.384 50.092 158.476

2021 - 56.581 33.723 90.304

Totaal 23.777 634.237 301.683 959.697

Outcome 2: FA 2017 3.882 46.364 33.936 84.182

2018 19.745 87.339 48.798 155.881

15

2019 - 68.232 50.326 118.558

2020 - 62.827 40.276 103.103

2021 - 39.106 30.227 69.333

Totaal 23.627 303.869 203.562 531.059

Totaal GSK Burundi 2017 24.659 165.736 96.085 286.481

2018 22.745 296.128 127.088 445.960

2019 - 209.344 127.754 337.098

2020 - 171.211 90.368 261.579

2021 - 95.687 63.950 159.638

Totaal 47.404 938.106 505.245 1.490.756

GSK Ma-dagascar

Outcome 1: FA 2017 24.186 33.489 20.669 78.344

2018 35.027 111.764 39.085 185.876

2019 29.803 98.680 39.085 167.568

2020 1.146 87.778 34.937 123.860

2021 1.146 60.561 16.521 78.228

Totaal 91.308 392.270 150.297 633.876

Totaal GSK Madagas-car

2017 24.186 33.489 20.669 78.344

2018 35.027 111.764 39.085 185.876

2019 29.803 98.680 39.085 167.568

2020 1.146 87.778 34.937 123.860

2021 1.146 60.561 16.521 78.228

Totaal 91.308 392.270 150.297 633.876

GSK Mo-zambique

Outcome 1: WASH 2017 29.135 70.630 55.061 154.825

2018 126.473 104.244 78.413 309.130

2019 19.960 95.869 78.413 194.242

2020 5.635 99.402 70.979 176.017

2021 1.260 55.170 64.585 121.015

Totaal 182.463 425.316 347.450 955.229

Outcome 2: FA 2017 19.150 35.448 31.094 85.692

2018 10.000 96.080 39.928 146.008

2019 - 65.933 37.552 103.485

2020 - 75.933 35.176 111.109

2021 - 24.190 35.176 59.366

Totaal 29.150 297.585 178.925 505.660

2017 48.285 106.078 86.155 240.517

16

Totaal GSK Mozambi-que

2018 136.473 200.325 118.340 455.138

2019 19.960 161.802 115.964 297.727

2020 5.635 175.335 106.155 287.126

2021 1.260 79.361 99.761 180.382

Totaal 211.613 722.901 526.375 1.460.889

GSK Rwanda

Outcome 1: WASH 2017 23.631 30.926 21.409 75.967

2018 151.357 66.085 47.439 264.881

2019 11.429 48.868 47.439 107.736

2020 - 41.587 47.439 89.026

2021 - 33.376 37.340 70.716

Totaal 186.417 220.841 201.068 608.326

Outcome 2: FA 2017 6.939 43.716 19.310 69.966

2018 44.762 92.607 45.324 182.694

2019 4.048 95.737 45.324 145.109

2020 - 43.289 44.241 87.530

2021 - 38.125 35.241 73.366

Totaal 55.749 313.474 189.441 558.664

Totaal GSK Rwanda 2017 30.570 74.643 40.720 145.932

2018 196.119 158.692 92.764 447.575

2019 15.476 144.605 92.764 252.845

2020 - 84.876 91.681 176.556

2021 - 71.501 72.581 144.082

Totaal 242.165 534.315 390.509 1.166.990

GSK Tan-zania

Outcome 1: WASH 2017 6.735 60.273 38.940 105.948

2018 104.858 98.974 62.757 266.589

2019 115.266 64.505 62.757 242.528

2020 - 62.192 62.757 124.949

2021 - 43.727 48.063 91.790

Totaal 226.858 329.672 275.274 831.804

Outcome 2: FA 2017 30.171 88.163 35.491 153.826

2018 - 141.535 56.859 198.394

2019 - 67.244 56.859 124.103

2020 - 47.703 56.859 104.562

2021 - 38.455 44.614 83.070

Totaal 30.171 383.101 250.682 663.954

17

Totaal GSK Tanzania 2017 36.906 148.437 74.431 259.774

2018 104.858 240.509 119.616 464.983

2019 115.266 131.749 119.616 366.631

2020 - 109.895 119.616 229.511

2021 - 82.182 92.677 174.860

Totaal 257.030 712.772 525.957 1.495.759

GSK Zim-babwe

Outcome 1: FA 2017 43.806 52.646 14.244 110.696

2018 14.352 110.310 28.488 153.150

2019 18.093 60.722 28.488 107.303

2020 - 74.804 28.488 103.292

2021 - 54.057 14.244 68.301

Totaal 76.250 352.540 113.953 542.743

Totaal GSK Zimbabwe 2017 43.806 52.646 14.244 110.696

2018 14.352 110.310 28.488 153.150

2019 18.093 60.722 28.488 107.303

2020 - 74.804 28.488 103.292

2021 - 54.057 14.244 68.301

Totaal 76.250 352.540 113.953 542.743

GSK Zuid-Afrika

Outcome 1: FA 2017 40.242 53.478 39.646 133.366

2018 33.750 222.957 135.584 392.291

2019 3.125 123.670 135.584 262.379

2020 3.125 109.280 146.474 258.878

2021 1.563 49.137 24.876 75.576

Totaal 81.805 558.522 482.163 1.122.489

Totaal GSK Zuid-Afrika 2017 40.242 53.478 39.646 133.366

2018 33.750 222.957 135.584 392.291

2019 3.125 123.670 135.584 262.379

2020 3.125 109.280 146.474 258.878

2021 1.563 49.137 24.876 75.576

Totaal 81.805 558.522 482.163 1.122.489

Totaal Luik GSK

2017 251.754 665.366 560.247 1.477.367

2018 543.423 1.383.951 846.591 2.773.965

2019 201.823 967.139 827.257 1.996.219

2020 10.006 852.195 788.144 1.650.345

2021 4.069 526.653 557.508 1.088.230

18

Totaal 1.011.075 4.395.304 3.579.747 8.986.125

Niet-GSK Nepal

Outcome 1: WASH 2017 49.379 80.263 64.918 194.561

2018 57.328 280.040 76.336 413.704

2019 - 3.947 12.168 16.115

2020 - - - -

2021 - - - -

Totaal 106.707 364.251 153.422 624.380

Outcome 2: FA 2017 2.586 137.543 53.840 193.970

2018 - 97.520 59.508 157.028

2019 - 3.947 12.168 16.115

2020 - - - -

2021 - - - -

Totaal 2.586 239.010 125.516 367.113

Totaal Niet-GSK Nepal 2017 51.966 217.807 118.758 388.530

2018 57.328 377.560 135.844 570.732

2019 - 7.894 24.336 32.230

2020 - - - -

2021 - - - -

Totaal 109.293 603.261 278.938 991.492

Totaal Luik Niet-GSK

2017 51.966 217.807 118.758 388.530

2018 57.328 377.560 135.844 570.732

2019 - 7.894 24.336 32.230

2020 - - - -

2021 - - - -

Totaal 109.293 603.261 278.938 991.492

Algemeen Totaal Niet-GSK en GSK

2017 303.720 883.172 679.005 1.865.897

2018 600.750 1.761.511 982.435 3.344.696

2019 201.823 975.033 851.593 2.028.449

2020 10.006 852.195 788.144 1.650.345

2021 4.069 526.653 557.508 1.088.230

Algemeen Totaal 1.120.368 4.998.565 3.858.685 9.977.618

Evaluatie of auditkosten

2017 -

2018 36.000

2019 31.500

2020 34.500

19

2021 138.421

Totaal 240.421

Percentage (min 1%) 2%

Andere beheerskosten

2017 0 7.500 265.444 213.646

2018 0 7.500 286.330 365.209

2019 0 7.500 296.646 235.664

2020 0 7.500 297.523 188.494

2021 0 7.500 291.248 129.384

Totaal 0 37.500 1.437.191 1.132.397

Percentage 10%

Beheerskosten Algemeen Totaal 1.372.818

Totaal Programma

2017 2.079.543,07

2018 3.745.904,93

2019 2.295.612,89

2020 1.873.338,94

2021 1.356.035,35

Eindtotaal 11.350.435,19

Verdeling GSK/Niet-GSK Totaal GSK Totaal buiten GSK

Verdeling % 90.06% 9.94%

Algemene

Samenvat-

ting

Jaren Totaal Pro-

gramma ANGS

(0% - 20%) DGD

(80% - 100%)

Structuurkos-ten

Admini-stratieko

sten

7,00%

2017 2.079.543 415.909 1.663.634 145.568 0 Schijf 1 1.500.000

2018 3.745.905 749.181 2.996.724 262.213 0 Schijf 2 3.258.937

2019 2.295.613 459.123 1.836.490 160.693 0 Schijf 3 1.997.183

2020 1.873.339 374.668 1.498.671 131.134 0 Schijf 4 1.629.805

2021 1.356.035 271.207 1.084.828 94.922 0 Schijf 5 1.488.953

Totaal 11.350.435 2.270.087 9.080.348 794.530 0 9.874.879

20

België

Outcome 1 AIS: De vrijwilligers van RKV-Internationale Samenwerking zetten zich in om kwetsbaren zelfred-zaam te maken. Outcome 2 IHR: Professionals en Bel-gische beleidsmakers zijn versterkt in hun kennis over internationaal huma-nitair recht en dragen dit uit.

2017-2021

21

Samenvatting

Rode Kruis-Vlaanderen (RKV) zal in de periode 2017-2021 in België een programma uitvoeren opgebouwd rond twee luiken: vrijwilligerswerking (Outcome 1) en internationaal humanitair recht (IHR) (Outcome 2). Er is een totaalbudget van 1.072.625 EUR voorzien.

De luiken dragen bij tot de SDG’s (4 en 16), de GSK doelstellingen (C1, C2, C3, C5, D1, D2 en D3) en onderschrijven de strate-gienota ontwikkelingseducatie. Beide interventies dragen verder ook bij tot de prioriteiten van de Belgische ontwikkelingssamenwerking: gender, milieu, mensenrechten en digitalisering.

Outcome 1: De vrijwilligers van RKV-Internationale Samenwerking zetten zich in om kwetsba-

ren zelfredzaam te maken.

RKV Advocacy Internationale Samenwerking (RKV AIS) versterkt vrijwilligers met een interesse voor internationale samenwer-king als wereldburger. Dit programma beoogt het bereiken van 16.921 directe begunstigden over vijf jaar. Wij kiezen ervoor om in te zetten op het activeren van Rode Kruisvrijwilligers. Dat doen we door hen mogelijkheden en ondersteuning te bieden en door hen toe te laten competenties te ontwikkelen die ze kunnen inzetten wanneer ze daadwerkelijk aan de slag gaan binnen het thema van internationale samenwerking. De hogere doelstelling van deze activering is om kwetsbaren zelfredzaam te maken. Om dit te bereiken wordt in de interventiestrategie ingezet op twee grote domeinen: communicatie en vrijwilligers-omkadering (waaronder opleidingen) en dit met aandacht voor enkele prioritaire thema’s die die we naar voor schuiven in dit programma.

Zoals beschreven in de Theory of Change informeren we om te sensibiliseren en te activeren. Bij de vernieuwing van het com-municatieplan ondernemen we actie om doelgerichter te informeren. Hiervoor zetten wij ook in op technologische vernieuwing, bijvoorbeeld door het opmaken van een e-learningmodule en het inschakelen van online ambassadeurs op sociale media.

RKV AIS zet in op een kwalitatieve ondersteuning van de vrijwilligers, aangepast aan hun specifiek profiel en (eerder verworven) competenties. Enerzijds wordt een aangepast opleidingsaanbod voorzien en begeleiding anderzijds opdat vrijwilligers binnen het uitgewerkte takenpakketten een taak vinden die aanleunt bij hun wensen, ervaringen en competenties. We streven een opbouw waarbij vrijwilligers in 5 jaar 431 activiteiten uitvoeren, die rechtstreeks bijdragen tot het helpen van kwetsbaren om hen meer zelfredzaam te maken.

Een van deze projecten is het inzetten van vrijwilligers in het zuiden. Op basis van de geleerde lessen van het vorige programma beslissen we om het partnerschap niet verder te zetten in haar huidige vorm, maar over te gaan naar expertisemissies waarbij vrijwilligers die een zekere expertise hebben worden ingezet in de projecten in het zuiden. RKV AIS voorziet in de nodige omkadering tijdens het voor- en natraject.

Met dit luik dragen we bij tot de benaderingen C1.1 en C2.1 van de GSK België.

Op het niveau van synergie en complementariteit gaan RKV en Croix-Rouge de Belgique-Communauté francophone (CRB-Cf) informatie (geleerde lessen, best practices) uitwisselen over hun vrijwilligerswerking (informationele synergie). Bovendien zal er doorheen het programma aandacht worden besteed aan andere synergiën. Zo bijvoorbeeld zal RKV AIS bekijken welke oplei-dingen er reeds bestaan binnen de sector die passen binnen de vrijwilligersomkadering.

Outcome 2: Professionals en Belgische beleidsmakers zijn versterkt in hun kennis over interna-

tionaal humanitair recht en dragen dit uit.

Het internationaal humanitair recht (IHR) is een levende rechtstak gelet op de toename in zowel aantal als complexiteit van gewapende conflicten. De nabijheid van conflicten, de betrokkenheid van België in gewapende conflicten en het feit dat het IHR ook verplichtingen kent die in vredestijd voldaan moeten worden, duiden het belang van IHR. Als helper van de overheid ondersteunt RKV de Belgische overheid in de verspreiding en het bevorderen van de naleving van het internationaal humanitair recht (IHR). Wij beschikken over de nodige expertise en kunnen rekenen op een internationaal netwerk voor expertise en actuele informatie. RKV kiest ervoor om te werken op twee domeinen: informatievoorziening en beleidsbeïnvloeding, waarbij enkele prioritaire thema’s naar voor worden geschoven.

In het vorige programma werd ingezet op een geconcentreerde aanpak van de doelgroepen, waarbij besloten werd de activi-teiten te richten op mensen die beroepsmatig in contact komen met IHR (‘professionals’) en beleidsmakers. Deze lijn trekken we door in dit nieuwe programma, waarbij we de focus van onze activiteiten nog meer zullen verbinden aan het multiplicator-effect. In dit programma leggen we wij bijvoorbeeld een grotere focus op beleidsmakers en verschuift de aandacht van studenten naar de universiteiten als multiplicator. Belangrijk om te benadrukken is dat de meeste activiteiten kennis- en ar-beidsintensief zijn, zoals bijvoorbeeld beleidsbeïnvloeding.

22

Informatie verspreiden doen we digitaal via onze website, nieuwsbrieven en publicaties. Verder organiseren wij verschillende types van vormingen, zoals lessenreeksen, studiedagen en een pleitwedstrijd. Wij nemen deel aan vormingen van derden waar wij als Rode Kruis (RK) een meerwaarde kunnen betekenen, zoals de deelname aan militaire oefeningen om de rol van het RK op het terrein toe te lichten. Aan professionals reiken wij vooral de kennis aan die rechtstreeks van toepassing is in hun vakge-bied. Vandaar ook de keuze om aangepaste vormingen aan te bieden gericht op de noden van de subdoelgroepen, zoals bv. een vorming voor journalisten, vormingen voor medisch personeel, vormingen voor militairen. RKV zet binnen beleidsbeïnvloeding vooral in op adviseren (bv. het aanleveren van input voor beleidsdocumenten, trainings, briefings), lobbying en (meer uitzonderlijk) advocacy (bv. interventies in het parlement). We zetten hier ook op in via een actieve participatie in de Interministeriële Commissie voor Humanitair Recht, aangepaste vormingen voor verschillende subdoelgroe-pen zoals parlementairen en diplomaten. Dit luik van het programma beoogt het bereiken van 4.988 directe begunstigden, waaronder 3.500professionals en 270 be-leidsmakers op 5 jaar tijd. Met dit luik dragen we bij tot de benaderingen C3.3, C3.5, C5.1, C5.2, D1.1, D1.2, D2.1, D3.1 en D3.2 van de GSK België. Voor het uitvoeren van het programma hebben wij twee belangrijke operationele partners: CRB-Cf en het Ministerie van De-fensie. Ondanks dat IHR een nichethema is waar geen andere organisaties in de sector rechtstreeks rond werken, zetten wij toch in op synergie en complementariteit (zowel buiten als binnen de ngo-sector). Zo hebben wij momenteel al een synergie en/of complementariteit met het Nederlandse Rode Kruis, ICRC Brussel en BTC. Naar aanleiding van dit programma hebben we nog enkele actoren geïdentificeerd waarbij we in de loop van het programma gaan bekijken of een hogere graad van synergie en complementariteit mogelijk is.

23

Landenfiche

Totaal Budget

Land (EUR)

1.072.625

Contactpersoon

in België

Naam:

Tiene

Lievens

Organisatie: Belgian Red Cross-

Flanders (BRC-Fl)/Rode Kruis-Vlaan-

deren (RKV)

Telefoonnummer:

015 44 35 19

E-mail: [email protected]

Samenvatting programma:

RKV Advocacy Internationale Samenwerking (RKV AIS) versterkt vrijwilligers met een interesse voor internationale samenwerking als we-reldburger. RKV AIS kiest ervoor om haar doelgroep van RK-vrijwilligers mogelijkheden en ondersteuning te bieden om haar competenties in te zetten en daadwerkelijk aan de slag te gaan binnen het thema van internationale samenwerking (zie benaderingen C1.1 en C2.1 van de GSK België). We zetten dus volop in op het activeren van vrijwilligers. De activiteiten die de vrijwilligers gaan uitvoeren dragen bij tot de hogere doelstelling van het zelfredzaam maken van kwetsbaren. Om dit te bereiken wordt in de interventiestrategie ingezet op twee grote domeinen: communicatie en vrijwilligersomkadering.

Als helper van de overheid ondersteunt RKV de Belgische overheid in de verspreiding van en in het bevorderen van de naleving van het internationaal humanitair recht (IHR). RKV beschikt over de nodige expertise en kan rekenen op de steun van een internationaal netwerk voor expertise en actuele informatie. RKV kiest ervoor om te werken op twee domeinen: informatievoorziening en beleidsbeïnvloeding en ook hier worden enkele prioritaire thema’s naar voor geschoven. RKV richt zich specifiek op professionals die in hun werkzaamheden met het IHR in aanraking komen en op beleidsmakers die een rechtstreekse invloed hebben op de naleving en verspreiding van het IHR.

Betrokken partijen

Betrokken partij

Volledige naam en afkorting: Croix-Rouge de Belgique - Communauté francophone (CRB-Cf)

Algemene informatie Adres: Tel. No : E-mail:

Stallestraat 96, 1180 Brussel 02 371 31 11 [email protected]

Contactpersoon Delphine De Bleeker

Outcome(s) Outcome 2 IHR : Professionals en Belgische beleidsmakers zijn versterkt in hun kennis over internatio-naal humanitair recht en dragen dit uit.

Budget by Outcome (EUR) Budget O2: 0 EUR

Samenvatting van de rol van elke betrokken partij/per outcome

O2: CRB-Cf en RKV organiseren gezamenlijke activiteiten naar bepaalde doelgroepen rond IHR (zowel professionals als beleidsmakers). De samenwerking behelst zowel het inhoudelijk als logistiek uitwer-ken van de activiteiten, uitwisselen van informatie en best practices. (zie hoofdstuk ‘Synergie en complementariteit’)

Startdatum Sinds 1997, ontstaan Rode Kruis-Vlaanderen Internationaal vzw.

24

Betrokken partij

Volledige naam en afkorting: Ministerie van Defensie (inclusief Koninklijke Militaire School (KMS) en Studiecentrum voor Militair Recht en Oorlogsrecht (SMRO))

Algemene informatie: Adres: Tel. No. : E-mail:

Ministerie van Defensie: Kwartier Koningin Elisabeth, Everelaan 1, 1140 Brussel KMS: Hobbemastraat 8, 1000 Brussel SMRO: Hobbemastraat 2, 1000 Brussel

02 441 43 99 [email protected]

Contactpersoon Jan De Loof, kapitein-commandant, DG Vorming1

Outcome(s) Outcome 2 IHR: Professionals en Belgische beleidsmakers zijn versterkt in hun kennis over interna-tionaal humanitair recht en dragen dit uit.

Budget by Outcome (EUR) Budget O2: 0 EUR

Samenvatting van de rol van elke be-trokken partij/per outcome

In 2012 werd een schriftelijk samenwerkingsakkoord afgesloten tussen het Belgische RK (beide ge-meenschappen) en het Ministerie van Defensie. Deze samenwerking werd over de jaren heen uitgebreid, in het bijzonder onder de vorm van IHR opleidingen en deelname aan militaire oefenin-gen. Het Ministerie van Defensie intervenieert regelmatig als spreker bij activiteiten van RKV. Nieuwe samenwerkingsmogelijkheden worden jaarlijks onderzocht in het Programmatiecomité, het overlegforum dat de samenwerking opvolgt.

Startdatum Het samenwerkingsakkoord werd ondertekend op 23 november 2012. Hiervoor bestond er al een minder structurele samenwerking inzake IHR activiteiten.

Theory of Change

De Theory of Change (ToC) is de basis van het logisch kader (zie verder). Het logisch kader is het opvolginstrument van RKV doorheen het programma. Annex 1 van het programma geeft ook een algemene uitleg hoe de ToC is opgebouwd.

Outcome 1 AIS

De schematische voorstelling wordt weergegeven op de volgende pagina.

1 RKV heeft verschillende andere contactpersonen bij het Ministerie van Defensie in het kader van haar activiteiten naar militairen en andere doelgroepen, deze gegevens zijn beschikbaar op aanvraag.

26

1. Assumpties

Assumptie Link naar

Logisch Ka-

der

Houdt de

assumptie

stand?

(ja/nee?)

Argumentatie / Bewijs

A De projecten van RKV Internationale Sa-menwerking dragen zowel in België als in onze partnerlanden2 bij tot het zelfred-zaam maken van kwetsbaren wereldwijd.

Impact Ja RKV Internationale Samenwerking ondersteunt haar partnerlanden bij het implementeren van WASH en EH programma’s. Een studie van het Britse Rode Kruis toont aan dat er een verband is tussen het volgen van eerstehulpopleidingen en de zelfredzaamheid binnen een gemeenschap.3 Daarnaast is de promotie van water, sanitatie en goede hygiënepraktijken een belangrijke component van het zelfredzaam en bestendig maken van een gemeenschap tegen de gevolgen van klimaatsverandering, en maakt het deel uit van de promotie van mensenrechten.4 Het Klimaatcentrum van het Rode Kruis onderstreept ook de link tussen de beschikbaarheid van WASH en de kwetsbaarheid van de gemeenschappen t.o.v. extreme weerselementen. M.a.w. het verbeteren van WASH infrastructuur en kennis wordt gezien als een cruciale bouw-steen voor zelfredzaamheid.5

B Doordat de vrijwilligers van RKV Interna-tionale Samenwerking zich inzetten voor onze organisatie, worden kwetsbaren ge-holpen om zelfredzaam te zijn.

Outcome Ja RKV AIS gebruikt de projecten van RKV Internationale Samenwerking als basis om bewustzijn te creëren bij vrijwilligers over internationale thema’s en om hen te activeren. Vrijwilligers dragen bij tot de projecten in het zuiden door expertisemissies, maar daarnaast zal RKV AIS ook kijken naar de noden hier in België, bijvoorbeeld bij het herstel van familiebanden (Tracing).

C Rode Kruisvrijwilligers krijgen de nodige omkadering zodat ze doelgericht geacti-veerd kunnen worden.

Outcome Output 1.1

Nee Uit bevragingen in functie van dit programma blijkt dat vrijwilligers en de bestaande werkgroepen waarin ze vertegenwoordigd worden, niet de nodige omkadering krijgen vanuit RKV AIS om zich ook effectief te kunnen inzetten, terwijl de vrijwilligers aangeven zich wel degelijk te willen inzetten indien ze de juiste omkadering krijgen. In het kader van dit programma zet RKV AIS sterk in op het ontwikkelen en aanbieden van activiteiten waar vrijwilligers zich actief kunnen inzetten (activering) ten voordele van kwetsbaren. Er wordt hierbij aandacht besteed aan de hiervoor noodzakelijke competenties en de opleidingen noodzakelijk om de vrijwilligers deze competenties bij te brengen. (Deze assumptie werd opgenomen in het hoofdstuk ‘Risicoanalyse‘)

D Informeren en sensibilisering van de vrij-willigers leidt tot activering van vrijwilligers.

Outcome Output 1.1

Ja Een globale benadering van ontwikkelingseducatie (OE) omvat verschillende stappen zoals sensibilisering, be-wustwording, inzicht, gedragsverandering en engagement. Om op individueel en collectief niveau veranderingen tot stand te brengen en het actief uitoefenen van rechten en verantwoordelijkheden aan te

2 Onze partnerlanden zijn, onder voorbehoud van wijzigingen, Burundi, Madagaskar, Malawi, Mozambique, Nepal, Rwanda, Tanzania, Zimbabwe en Zuid-Afrika. 3 British Red Cross. Assessing the links between first aid training and community resilience. Research Report, 2011, 1-48, http://www.redcross.org.uk/~/media/BritishRedCross/Documents/What%20we%20do/First%20aid/As-sessing%20the%20links%20between%20first%20aid%20training%20and%20community%20resilience.pdf 4 Hulland K, Martin N, Dreibelbis R, DeBruicker Valliant J, Winch P (2015) What factors affect sustained adoption of safe water, hygiene and sanitation technologies? A systematic review of literature. London: EPPI-Centre, Social Science Research Unit, UCL Institute of Education, 6 (2015), 1-169, http://eppi.ioe.ac.uk/cms/Default.aspx?tabid=3475 5 Nerlander L. Climate Change and health. Commission on the Climate Change & Development (CCCD), 3 (2009), 1-12, http://www.pacificdisaster.net/pdnadmin/data/original/CCCD_2009_CC_health.pdf

27

moedigen (cfr. definitie van OE) moet eenzelfde doelgroep idealiter toegang hebben tot de aanpak voor die verschillende stappen6.

E Een betere omkadering van vrijwilligers leidt tot meer betrokkenheid.

Outcome Ja De GCA Noord bevestigt dat een eigen achterban in stand houden een eigen professionaliteit en deskundig-heid vraagt. Een goede omkadering van vrijwilligers heeft aandacht voor de eigen realiteit van de vrijwilliger, zijn kennis en vaardigheden opdat meer individuele vormen van engagement mogelijk zijn.7

2. Stakeholdersanalyse8

Stakeholder Rol (Wat, wanneer, hoe, waar) Belang (BL)/ Kracht (K)

Opportuniteiten (O)/ (BD) Bedreigingen

1 CRB-Cf CRB-Cf en RKV hebben beiden een vrijwilligersomkadering en probe-ren maximaal gebruik te maken van vrijwilligers bij hun activiteiten. Hiervoor plegen ze onderling overleg om best practices en geleerde lessen uit te wisselen.

K: CRB-Cf, en dus ook hun vrijwilligers, behoren tot dezelfde Internationale Rode Kruis en Rode Halve Maanbeweging (Beweging) en werken volgens dezelfde 7 fundamentele princi-pes.9 O: CRB-Cf en RKV kunnen elkaars werking versterken door uitwisseling van best practices en geleerde lessen in de vrijwilligersomkadering in het kader van de internationale projecten.

2 Nationale Rode Kruisverenigingen in landen waar RKV ac-tief is

De vrijwilligers van RKV AIS zetten zich in onze partnerlanden in via expertisemissies. De vrijwilligers voeren er specifieke taken uit die rechtstreeks ondersteuning bieden aan de projecten. De nationale Rode Kruisverenigingen leveren informatie aan die RKV AIS gebruikt om haar doelgroep te informeren over andere culturen, humanitaire noden wereldwijd en de projecten van RKV Internationale Samenwerking.

K: De Nationale Rode Kruisverenigingen maken allemaal deel uit van de Beweging en werken volgens dezelfde principes. K: Door het inzetten van vrijwilligers, op vraag van de partnerlanden, draagt RKV AIS recht-streeks bij aan de projectwerking van onze partners. O: Vrijwilligers ervaren het als motiverend om een vrijwilligerstaak te kunnen uitvoeren in het buitenland.10 BD: RKV AIS is afhankelijk van haar partnerlanden voor het inzetten van vrijwilligers in de lokale projecten.

3 Gemeentelijke raden voor ontwikkelings-samenwerking

De meeste gemeentes hebben een adviesraad voor ontwikkelingssa-menwerking. Deze adviesraden ondersteunen het Noord-Zuidbeleid van de gemeente, en bestaan uit organisaties en afdelingen van nati-onale en niet-gouvernementele organisaties die zich inzetten voor het Zuiden. In de meeste adviesraden is de lokale RK-afdeling vertegen-woordigd.

K: Door deelname aan de gemeentelijke raad voor ontwikkelingssamenwerking dragen lo-kale RK-afdelingen bij aan de doelstellingen van deze adviesraden. BL: Door deelname aan de gemeentelijke raad voor ontwikkelingssamenwerking blijven de lokale RK-afdelingen op de hoogte van relevante informatie met betrekking tot onze wer-king.

6 Federale Overheidsdienst Buitenlandse Zaken, Buitenlandse Handel en Ontwikkelingssamenwerking (2011) ‘Ontwikkelingseducatie. Begrippen en concepten’, p.12. 7 GCA Noord, p. 76. 8 Onder stakeholders verstaan we mensen, groepen of organisaties die belang hebben bij de uitvoering van onze interventie. 9 Menselijkheid, onpartijdigheid, neutraliteit, onafhankelijkheid, vrijwilligheid, universaliteit en eenheid. 10 Zie hoofdstuk ‘ Aanbevelingen en geleerde lessen’.

28

4 Externe organisaties die relevante work-shops aanbieden

RKV AIS leidt haar vrijwilligers op met het oog op het verwerven van specifieke competenties. Hierbij houden we rekening met het aanbod van externe organisaties als we vrijwilligers opleiden met het oog op activering. We denken hier in de eerste plaats aan workshops rond duurzaamheid, communicatievaardigheden, het schrijven van project-dossiers, intercultureel leren en lesgeversopleidingen.

BL: Externe organisaties, zoals Vorming Plus, 4e pijlersteunpunt, 11.11.11, Mediaraven en Stichting Lodewijk de Raet bieden vormingen aan in open aanbod, die rechtstreeks relevant zijn voor het versterken van de competenties van de vrijwilligers van RKV AIS. O: RKV AIS maakt gebruik van reeds bestaande expertise bij andere gespecialiseerde orga-nisaties voor het uitbouwen van vormingen voor haar vrijwilligers.

5 Online fora voor het aanbieden van vrij-willigerswerk

De verschillende online fora zoals vrijwilligerswerk.be bieden een plat-form aan waar RKV AIS op zoek kan gaan naar geschikte competentieprofielen.

K: Door haar aanbod aan vrijwilligerswerk via de fora bekend te maken, draagt RKV AIS bij aan het activeren van hulpbereide mensen. BL: Via deze fora kan RKV AIS nieuwe instroom aan vrijwilligers verzekeren.

3. Contextanalyse

Context factor Invloed op ToC

Binnen een geglobaliseerde wereld waar de grenzen en verschillen tussen Noord en Zuid vervagen, is er een steeds veranderende focus aan thema’s.

RKV AIS kiest ervoor om thematisch te werken en kiest hierbij voor een flexibiliteit om te variëren doorheen het pro-gramma om zo in te spelen op nieuwe tendensen. De gekozen thema’s sluiten altijd rechtstreeks aan bij de werking van RKV AIS. In J1 (2017) kiest RKV AIS bijvoorbeeld om intensief te werken rond het thema migratie. Communicatie, opleidingen en vrijwilligerstaken zullen door de keuze van dit thema worden beïnvloed.

Vrijwilligers zetten zich niet minder in, maar anders. Vrijwilligers bepalen zelf hun inzet, kiezen hun engagement zeer bewust maar kiezen voor veel flexibiliteit. Geïndividualiseerd engagement staat hierbij centraal.11

RKV AIS kiest voor een variatie aan mogelijke engagementen voor vrijwilligers, met een focus op korte, duidelijke engagementen die inspelen op de kennis en competenties van vrijwilligers. In de omkadering die we onze vrijwilligers bieden spelen we hierop in en besteden we extra aandacht aan de levensloop van de vrijwilliger om hen op elk moment een engagement op maat te kunnen bieden.

De recente informatie- en communicatietechnologieën verruimen en ver-snellen de mogelijkheden tot engagement en zorgen voor nieuwe manieren om te leren.12

RKV AIS past haar activiteiten aan de toenemende digitalisering aan. Zo zetten we vrijwilligers onder andere in om via hun social media-accounts naar hun achterban te communiceren, ontwikkelen we een e-learningmodule om het pu-bliek te informeren en omschrijven we vrijwilligerstaken die niet locatie gebonden zijn.

11 IDEA, Toekomstverkenning: de blik van sociaal-cultureel volwassenwerk, amateurkunsten en jeugdwerk, gericht op 2025, eindrapport, 20 december 2013, 1-105, https://ambrassade.be/sites/default/files/pagina/toekomstverken-ning_eindrapport.pdf 12 GCA Noord, p. 81-82-96

29

4. Activiteiten

Outcome 2 IHR

De schematische voorstelling wordt weergegeven op de volgende pagina.

1 Inzetten van vrijwilligers als expert in onze partnerlanden of ter ondersteuning bij onze tracingactiviteiten

2 Inzetten van vrijwilligers voor het creëren van visibiliteit en gedragenheid.

3 Verder uitbouwen en implementeren van een activerende vrijwilligersomkadering.

4 Opleidingen en bijscholingen organiseren voor vrijwilligers.

5 Ondersteunend materiaal ontwikkelen voor de vrijwilligers (draaiboeken, informatiedatabank, beeldmateriaal, infobrochures, e-learningmodule) Draaiboeken opmaken, up to date houden en actief verspreiden ter ondersteuning van de vrijwilligerswerking.

6 Publiceren van online nieuwsberichten en berichten op sociale media.

31

1. Assumpties

Assumptie Link naar

Logisch Ka-

der

Houdt

de as-

sumptie

stand?

(ja/nee?)

Argumentatie / Bewijs

A Naleving van IHR wordt bevorderd wanneer de impact-groep over de nodige kennis beschikt over IHR. Bovendien is kennis van het IHR belangrijk in de effecti-viteit van humanitaire hulpverlening. RKV draagt hiertoe bij door de verspreiding van kennis en info over IHR.

Outcome Ja De positieve invloed van vormingen over IHR op de naleving wordt benadrukt in verschillende Resoluties van de VN Veiligheidsraad. (Voorbeelden zijn Res. 2289 (2016); Res. 222(2015))13 Ook in de literatuur is hier ondersteuning voor te vinden: “Effective humanitarian responses depend as much on knowledge as they do on funding or logistics. Indeed, without knowledge, responses cannot hope to succeed: ‘The international humanitarian community’s ability to collect, analyse, disseminate and action key information is fundamental to effective response”14

B RKV is een relevante actor voor wat betreft internationaal humanitair recht

Output 2.1 Ja De Belgische overheid erkent het Rode Kruis (RK) als hoeder van het IHR.15 In de Statuten van de Beweging wordt aan de nationale Rode Kruis- en Rode Halve maanverenigingen de taak opgelegd om de overheden te ondersteunen in de verspreiding van IHR. Deze Statuten zijn door alle staten partij bij de Verdragen van Genève goedgekeurd.

C De Interministeriële Commissie voor Humanitair Recht (ICHR) is een belangrijk orgaan om aan beleidsbeïnvloe-ding te doen.

Outcome; Output 2.1

Ja Artikel 2 van het KB tot herinrichting van de ICHR bepaalt dat de opdracht van de ICHR erin bestaat om “vast te stellen en te onderzoeken welke nationale uitvoeringsmaatregelen nodig

zijn voor de uitvoering van de regels van het internationaal humanitair recht, de betrokken fe-

derale Ministers erover in te lichten en hun terzake voorstellen te doen, […], als permanent

adviesorgaan, de federale Regering, op eigen initiatief of op haar verzoek, bij te staan via studies,

verslagen, adviezen of voorstellen in verband met de toepassing en de ontwikkeling van het

internationaal humanitair recht […]”16 Als co-voorzitter van de werkgroepen Verspreiding en Internationale Conferenties bepaalt RKV mee de agenda van deze werkgroepen.

13 Res. 2289 (2016) UN Security Council: ‘Underlines the important role that education and training in international humanitarian law can play in supporting efforts to halt and prevent acts of violence, attacks and threats against the wounded and sick, medical personnel and humanitarian personnel exclusively engaged in medical duties, their means of transport and equipment, as well as hospitals and other medical facilities”; Res. 2222 (2015) UN Security Council “Recognizes the important role that education and training in international humanitarian law can play in supporting efforts to halt and prevent attacks against civilians affected by armed conflict, including journalists, media professionals and associated personnel”. 14 Mahmood et al. (2010) ‘Guidelines on Data Issues in Humanitarian Crisis Situations’. New York: UNFPA. 1-87, www.alnap.org/resource/9983.aspx 15 http://diplomatie.belgium.be/nl/Beleid/beleidsthemas/mensenrechten/specifieke_kwesties/internationaal_humanitair_recht 16 KB van 6 december 2000 tot herinrichting van de Interdepartementale Commissie voor humanitair recht, BS 12 december 2000, zoals gewijzigd door het KB van 22 juni 2016 tot wijziging van het Koninklijk Besluit van 6 decem-ber 2000 tot herinrichting van de Interdepartementale Commissie voor humanitair recht, BS 19 augustus 2016.

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D RKV beschikt over of kan de nodige methodologieën ontwikkelen om te kunnen inspelen op de verschillende niveaus van het educatief continuüm.

Output 2.1 Output 2.2 Output 2.3

Ja RKV heeft de afgelopen jaren geïnvesteerd in verschillende soorten activiteiten rekening hou-dende met de noden van de verschillende doelgroepen. RKV kan hierbij ook steunen op de ervaringen van andere componenten van de Beweging, bijvoorbeeld via platforms zoals de European Legal Support Group.

E Communicatie over IHR draagt bij tot erkenning van de expertise van RKV.

Output 2.2

Ja Reeds opgericht in 1864, is het Rode Kruis een gevestigde waarde. Kwaliteitsvolle communi-catie over haar expertisedomein kan de positie van RKV als expert inzake IHR versterken.

F Professionals beïnvloeden de Belgische beleidsmakers Outcome Ja Professionals in hun werkkader hebben een multiplicatoreffect.17 Door dat multiplicatoreffect kan er meer gewicht gegeven worden aan bepaalde problematieken, wat op zijn beurt als katalysator kan dienen voor het politieke en maatschappelijke debat.

2. Stakeholdersanalyse

Stakeholder Rol (Wat, wanneer, hoe, waar) Belang (BL)/ Kracht (K)

Opportuniteiten (O)/ Bedreigingen (BD)

1 CRB-Cf

CRB-Cf en RKV werken beiden rond het nichethema IHR. Hiervoor plegen ze onderling overleg om best practices uit te wisselen. Dit wordt ondersteund doordat beiden actief zijn in gezamenlijke platformen (bv. ELSG, zie hoofdstuk Partnerschap). De activiteiten naar bepaalde doelgroepen (militairen, beleidsmakers) worden door RKV en CRB-Cf gezamenlijk georganiseerd. Zowel het inhoudelijk als lo-gistiek uitwerken van deze activiteiten wordt door beiden voor de helft opgenomen.

K: CRB-Cf werkt volgens hetzelfde mandaat en volgens dezelfde princi-pes. O: Ervaringen uitwisselen op het vlak van vormingen naar dezelfde doel-groepen, zowel naar opzet, timing en evaluatiebeleid.

17 GCA Noord, p. 23

33

2 NRK RKV en het Nederlandse Rode Kruis (NRK) organiseren jaarlijks een pleitwed-strijd voor rechtenstudenten. De inhoudelijke en logistieke uitwerking wordt door beiden gedragen. NRK en RKV maken deel uit van enkele gezamenlijke platformen (bv. ELSG) waardoor ook informatie uitgewisseld wordt over bepaalde thema’s en best practices.

K: NRK is ook lid van de Rode Kruis- en Rode Halve Maanbeweging waardoor het volgens dezelfde principes werkt. K: RKV en NRK kennen een duurzame samenwerking waar beide partijen positief tegenover staan. O: Dit initiatief, waarbij zowel Nederlandse als Belgische universiteiten vertegenwoordigd worden bestendigt/vergroot het academische net-werk. O: NRK en RKV delen eenzelfde werktaal (Nederlands) waardoor de uit-wisseling van gegevens en ondersteunende documenten gemakkelijk kan.

3 ICRC Brussel Een opleiding voor medewerkers van de internationale instellingen in België wordt in samenwerking met NOHA18, CRB-Cf en RKV georganiseerd. (elk 1,5 jaar) Informatie uitwisseling.

K: Beide zijn componenten van de Beweging waardoor men volgens de-zelfde principes werkt en dezelfde doelstelling inzake de verspreiding van internationaal humanitair recht nastreeft. BL: ICRC Brussel is door haar nabijheid het eerste aanspreekpunt voor RKV bij het ICRC. O: RKV kan bij het verzamelen van informatie (bv. over de operaties van het Internationale Rode Kruiscomité (ICRC) in andere landen) en orga-niseren van vormingen (bv. uitnodigen als spreker) beroep doen op de expertise bij ICRC Brussel.

4 Ministerie van Defensie

Het Ministerie van Defensie werkt met RKV samen inzake de verspreiding van IHR. Deze samenwerking kan bestaan uit het ter beschikking stellen van exper-tise en materiële middelen.

K: IHR maakt de balans tussen militaire noodzaak en menselijkheid. Aangezien Defensie rechtstreeks betrokken is met de toepassing van het IHR, (bv. in buitenlandse operaties), is uitwisseling verrijkend om ook het militaire perspectief over IHR te begrijpen. BD: Besparingen en veranderingen van prioriteiten bij het Miniserie van Defensie kunnen als gevolg hebben dat het aantal gezamenlijke activi-teiten wordt verminderd.

5 BTC BTC organiseert op regelmatige tijdstippen een infocyclus over het begrijpen en aanpakken van mondiale uitdagingen waarin RKV een module IHR geeft (zo’n 6 keer per jaar).

O: BTC bereikt humanitaire actoren. Door deelname aan de BTC infocy-clus bereikt RKV een van haar doelgroepen, personen die werkzaam zijn in de humanitaire sector. K: Er is al een jarenlange samenwerking met BTC, waardoor deze samen-werking structureel kan worden beschouwd.

18 Network on Humanitarian Action

34

6 Universiteiten De Belgische universiteiten hebben een wisselend aanbod inzake IHR. RKV on-dersteunt dit aanbod door als spreker op te treden of door zelf aanvullende activiteiten te voorzien gericht aan universiteiten (academisch personeel en/of studenten), zoals bijvoorbeeld de Frits Kalshoven Competition on International Humanitarian Law. Op hun beurt ondersteunen de universiteiten RKV door sprekers aan te leveren, onderzoek naar IHR te ondersteunen, etc.

BL: Universiteiten hebben een multiplicatoreffect.19 K: Universiteiten hebben een groot (internationaal) netwerk. O: Universiteiten spelen een belangrijke rol in onderzoek over IHR.

7 Journalisten/ Media

RKV ontwikkelt een communicatiestrategie inzake IHR (om zowel proactief als reactief te reageren) en kan een gepaste vorming aanbieden.

BL: Journalisten/media hebben belang bij de kennis van de regels die van toepassing zijn in de gewapende conflicten waarover zij berichten. K: Beleidsmakers zijn gevoelig voor wat in de media verschijnt. O: Journalisten bereiken een groot publiek.20 BD: Media verwacht duidelijke standpunten en beoordelingen van con-crete situaties, wat gelet de neutraliteit van RKV een constante evenwichtsoefening is.

3. Contextanalyse

Contextuele factoren Invloed op ToC

Alle componenten van de Beweging werken volgens de 7 fundamentele principes: menselijkheid, onpartijdigheid, neutraliteit, onafhankelijkheid, vrijwilligheid, universaliteit en eenheid.

Deze principes moeten bij elke activiteit door RKV gerespecteerd worden. Voor de ver-spreiding van het internationaal humanitair recht zijn voornamelijk neutraliteit en onafhankelijkheid belangrijk.

RKV is, zoals bepaald in artikel 3, §2 (3) van de Statuten van de Internationale Rode Kruis- en Rode Halve Maanbeweging (de Statuten), verantwoordelijk voor de verspreiding van het internationaal humanitair recht (IHR). Als helper van de overheid, zoals erkend in artikel 2(3), 3 en 4(3) van de Statuten21, ondersteunt Rode Kruis-Vlaanderen de Belgische overheid in de verspreiding van en in het bevorderen van de naleving van deze rechtstak.

RKV heeft een mandaat om haar expertise over IHR te verspreiden en de naleving te be-vorderen.

De politieke context is variabel. De politieke context is constant aan veranderingen onderhevig (verkiezingen, besparingen, etc.). Op dergelijke omstandigheden kan RKV geen invloed uitoefenen, maar deze kunnen de werking van RKV wel bemoeilijken.

De recente informatie- en communicatietechnologieën verruimen en versnellen de mogelijkheden tot engagement en zorgen voor nieuwe manieren om te leren. 22

Communicatie gaat sneller en mensen krijgen steeds meer prikkels. RKV wilt hierop inspe-len door naast klassieke vormingen in te zetten op digitale modules (bv. e-learning).

19 GCA p. 18: Met de doelgroep ‘intermediairen’ (tweedelijnsactoren) verwijzen we naar specifieke organisaties en personen die een multiplicatoreffect hebben omdat ze boodschappen doorgeven. Door hun vaardigheden in OE te ondersteunen en te versterken (kennis, knowhow en sociale vaardigheden) ontstaat een multiplicatoreffect omdat zij op hun beurt invloed hebben op andere personen. Het gaat hier o.a. over […] journalisten en opiniema-

kers, […], professionelen in hun werkkader, onderzoekers/academici en onderzoeksinstellingen/universiteiten, […]. Door hen te versterken, bereiken de ANGS eveneens en onrechtstreeks een breder publiek. 20 GCA Noord, p. 18. 21 Herbevestigd in Resolutie A/RES/49/2 van 27 oktober 1994 van de Algemene Vergadering van de VN. 22 GCA Noord, p. 81-82-96.

Vormingen naar de specifieke doelgroepen (vb.: een jaarlijkse lessenreeks aangevuld met studiedagen, een vorming voor journalisten, ondersteuning opleidingen van Defensie, etc.)

Proactief en reactief communiceren over IHR

Actieve deelname aan nationale en internationale overlegfora

Advies geven over en input voor Belgische beleidsdocumenten Opleidingen aan beleidsmakers

36

Risicoanalyse

ToC Beschrijving van het risico en de impact

Impact

(1-6)

Probability

(1-6) Mitigation Verantwoordelijke

Land en partners

ToC IHR, korte termijn

doelstellingen

Outcome 2: Verandering van de politieke context (o.a. GCA

Noord, risico 1, p.100, risico 5, p.100): (1) Contactpersonen ne-

men een andere functie op, waardoor vertrouwensbanden met

nieuwe personen opnieuw opgebouwd moeten worden; (2) IHR

wordt door de regering niet meer als een prioritair thema be-

schouwd; (3) De regering neemt ontslag en komt in lopende

zaken te zitten, waardoor er geen nieuwe engagementen meer

worden aangegaan en/of de bestaande dossiers on hold wor-

den gezet.

4 2 (1) Na personeelswisseling contact opnemen met nieuw aanspreekpunt.

(2) RKV blijft het belang van aandacht voor de verspreiding van IHR benadrukken in haar dialoog met de overheid.

(3) Geen

Stafmedewerker

IHR

ToC IHR, S4

Outcome 2: Het samenwerkingsverband met het Ministerie van

Defensie wordt stopgezet (o.a. GCA Noord, risico 1, p. 97), waar-

door bepaalde vormingen niet meer kunnen doorgaan.

6 1 Verwijzen naar de goede dialoog die steeds ge-

voerd is in het kader van het Programmatiecomité

en de meerwaarde van het partnerschap om de

dialoog open te houden.

Stafmedewerker

IHR

ToC AIS, S2 activiteit 1 Outcome 1: Nationale Rode Kruisverenigingen in landen waar

RKV actief is zetten hun projecten stop.

5 2 RKV AIS bekijkt in welke andere/nieuwe projecten

de vrijwilligers actief kunnen zijn.

Stafmedewerker AIS

Project

ToC AIS, korte termijn

doelstelling

Outcome 1: Meer globalisering brengt een sterke focus op het

individu met zich mee. Onder invloed van individualisering kan

een dalende interesse voor internationale uitdagingen ontstaan

(GCA Noord, Risico 2, tabel pagina 81-82), met een daling in het

aantal vrijwilligers die actief willen zijn tot gevolg.

5 2 Het aanbod van vrijwilligerstaken en vormingen

wordt afgestemd op de wensen en noden van de

doelgroepen (cfr. evaluaties vormingen en con-

tactoverleggen met de vrijwilligersstructuur) en

wordt waar nodig bijgestuurd.

Stafmedewerker AIS

37

ToC AIS, lange termijn

doelstelling

Outcome 1: We concentreren de inzet van vrijwilligers op een

klein aantal (nieuwe) taken met een bepaalde verwachting van

aantal activiteiten op outputniveau (indicator 1.1). Indien de uit-

voering van één van de taken onvoorzien wordt belemmerd of

beperkt, dan heeft dit een significante impact op het aantal ac-

tiviteiten.

5 3 Bij de opzet van vrijwilligerspool en omkadering

van de nieuwe taken zoals bij de Tracingactivitei-

ten wordt rekening gehouden met ervaring en

lessons learned van andere nationale Rode Kruis-

en Rode Halve Maanverenigingen en andere

soortgelijke diensten binnen RKV om mogelijke

knelpunten vroegtijdig te signaleren en voorko-

men.

Stafmedewerker AIS

ToC AIS,

Assumptie C

Outcome 1: De Rode Kruisvrijwilligers krijgen niet de nodige

omkadering om te kunnen bijdragen aan het zelfredzaam ma-

ken van kwetsbaren.

6 1 Een belangrijk traject vooropgesteld voor het be-

reiken van Indicator 1.1 is het versterken van de

vrijwilligers-omkadering. Dat doen we onder

meer door het duidelijk stellen van de taken van

de verschillende werkgroepen en door het actief

ondersteunen van vrijwilligers.

Stafmedewerker AIS


doelstellingen, activi-

teit 2

Outcome 2: Onvoldoende media aandacht vanwege het niet uit-

spreken over bepaalde zaken zoals schendingen van het IHR

(o.a. GCA Noord: Risico's media 1 p. 98; Risico 's en opportunitei-

ten voor doelgroep media, risico 2, p. 103).

3 4 Evalueren waarom de communicatiestrategie het

beoogde resultaat (= proactief en reactief com-

municeren over IHR) niet haalt en op basis hiervan

de communicatiestrategie bijsturen.

Stafmedewerker

IHR

ToC IHR korte termijn

doelstellingen, activi-

teit 1

Outcome 2: Doelgroepen hebben geen tijd om vormingen te

volgen (o.a. GCA Noord, risico media 3, p.98).

4 2 Het aanbod van vormingen wordt afgestemd op

de wensen en noden van de doelgroepen (cfr.

evaluaties vormingen en eventuele documenten

vanuit de werkgroep verspreiding van de ICHR) en

eventueel bijgestuurd.

Stafmedewerker

IHR

ToC IHR, Assumptie C

Outcome 2: BRK is niet langer voorzitter van de werkgroepen

verspreiding en Internationale Conferentie in de ICHR

3 1 BRK blijft actief meewerken in de ICHR waardoor

wij erkend blijven voor onze meerwaarde.

Stafmedewerker

IHR


doelstellingen

Outcome 2: Er worden andere organisaties actief met vormingen

rond IHR, waardoor er een vermindering is het aantal professio-

nals en Belgische die IHR vormingen van RKV volgen.

3 1 In dialoog gaan met deze organisaties en de mo-

gelijkheid van synergiën en complementariteit

bekijken. De uitzonderlijke positie van RKV inzake

IHR belichten, op basis van ons mandaat.

Manager Internati-

onale

Samenwerking,

stafmedewerker IHR

ToC AIS, korte termijn

doelstellingen Toc IHR:

korte termijn doelstel-

lingen, activiteiten 3

en 5

Outcome 1 en 2: Personeelswissel waardoor kennis verloren

gaat. Vooral outcome 2 IHR is een kennis-intensieve rechtstak.

Verder is netwerken zeer belangrijk binnen deze positie.

5 1 Een personeelswissel kan gedeeltelijk worden op-

gevangen door een goede documentatie van

onze activiteiten.

Manager Internati-

onale

Samenwerking

38

Aanbevelingen gedaan in het kader van de Strategische

dialoog

Aanbevelingen van DGD over het Gemeenschap-

pelijk Strategisch Kader (GSK) België die relevant

zijn voor dit programma

Beschrijving over hoe deze aanbevelingen in rekening worden geno-

men in dit programma

Algemeen

Zuid-actoren en de Noord-Zuid benadering in de the-matieken

Zie ‘Link met het zuiden’ onder het hoofdstuk ‘Doeltreffendheid’ en ‘Part-nerschap’.

Gender en milieu Dit programma houdt rekening met de transversale thema’s gender en milieu. Zie hoofdstuk ‘Relevantie’.

Prioriteiten bepalen IHR is een duidelijke keuze in onze prioriteiten en gelinkt aan ons man-daat. Hoewel we ons richten op de gehele rechtstak die IHR is, kiezen we er toch ook voor om bepaalde prioritaire thema’s naar voor te schuiven voor de komende 5 jaar. Zie hoofdstukken ‘Duurzaamheid’ en ‘Doeltref-fendheid’. Ook voor AIS trekken we die lijn door om te werken via prioritaire thema’s. Zie hoofdstuk ‘Doeltreffendheid’.

Synergiën Zie hoofdstuk ‘Synergie en complementariteit’.

Invloed van het GSK werkproces op de keuzes in dit programma

Zie hoofdstukken, ‘Relevantie’, ‘Doeltreffendheid’ en ‘Synergie en com-plementariteit’.

Digitalisering Zie hoofdstuk ‘Geleerde lessen’ en hoofdstuk ‘Relevantie’.

A. 1ste en 2de lijn

Aandacht voor de formulering van C2 Zie hoofdstuk ‘Relevantie’.

Synergiën Zie hoofdstuk ‘Synergie en complementariteit’.

B. Plaidoyer

Meer reliëf in de thema’s (startsituatie en verwachte situatie). Verduidelijking van de platformen en rol.

Zie hoofdstuk ‘Relevantie’ en ‘Platformen’ onder het hoofdstuk Partner-schap.

Geleerde lessen uit vorige programma’s

Outcome 1 AIS

Van partnerschap naar expertisemissies In het vorige programma werd ingezet op het Partnerschap als methodiek voor draagvlakversterking en het verspreiden van humanitaire waarden onder de RK vrijwilligers. We leerden dat de vrijwilligers die deelnamen aan dit partnerschap een sterk multiplicatoreffect hebben en hun achterban kunnen motiveren. Anderzijds hebben we ondervonden dat het slagen van een partnerschap zeer gevoelig is aan factoren die buiten onze controle vallen, waaronder de capaciteit bij de nationale RK vereni-ging van het partnerland. De impact daarvan op het Partnerschap als methodiek is niet te onderschatten. Uit analyse van de verschillende evaluaties besluiten wij dat het bereikte resultaat niet in lijn ligt met de geleverde inspanningen. Daarnaast was de win-win voor beide partnerlanden in het partnerschap niet groot genoeg, onder andere omdat de verwachtingen naar inhoud van de samenwerking niet voldoende afgestemd waren op elkaar. Op basis van de geleerde lessen beslissen we daarom om het Partnerschap niet verder te zetten in haar huidige vorm, maar over te gaan naar een expertise-uitwisseling waarbij vrijwilligers die een zekere expertise hebben worden ingezet in de projecten in het zuiden. Deze uitwisselingen zullen worden georganiseerd op vraag en op basis van de verwachtingen van het partnerland. Dit houdt in dat RKV AIS de nodige omkadering biedt aan vrijwilligers om concrete taken uit te voeren die rechtstreeks betrekking hebben op, en gelanceerd zijn door de projecten in onze partnerlanden. De vrijwilligers worden inhoudelijk en logistiek ondersteund bij het uitvoeren van hun taak door RKV AIS in samenwerking met de stafmedewerkers van de humanitaire diensten van RKV. Uit de evaluaties van het part-nerschap en interne gesprekken besluiten wij dat een betere omkadering van deze vrijwilligers rechtstreeks zal leiden tot een hogere betrokkenheid van en een groter multiplicatoreffect door deze vrijwilligers. De ervaringen en geleerde lessen in het opzetten van een voor-en natraject van missies in het kader van het partnerschap worden meegenomen in de verdere uitbouw van deze component van de vrijwilligersomkadering.

39

Doelgericht en op een eigentijdse manier info verspreiden Vrijwilligers gaven in bevragingen meermaals aan dat ze graag meer informatie krijgen over de activiteiten van Internationale Samenwerking, voornamelijk over het luik Humanitaire Hulpverlening. In 2016 besteedden we al extra aandacht aan dit thema via de bestaande communicatiekanalen. In het nieuwe programma voorzien we om het communicatieplan grondig te herzien op basis van de feedback ontvangen tijdens het programma 14-16. Zoals beschreven in de ToC informeren we om te sensibi-liseren en te activeren. Bij de vernieuwing van het communicatieplan zullen we actie ondernemen om doelgerichter te informeren. Hiervoor zullen we ook inzetten op technologische vernieuwing, bijvoorbeeld door het opmaken van een e-lear-ning-module en het inschakelen van online ambassadeurs op sociale media.

Vrijwilligers activeren op basis van hun competenties en expertise In het kader van de opmaak van dit programma gaf de bestaande vrijwilligerspool aan meer te willen worden geactiveerd. Ze zijn bereid concrete taken uit te voeren en hun vrije tijd te investeren ten voordele van de doelstellingen van onze organisatie, waarmee ze zich sterk verbonden voelen. De vrijwilligers gaven daarbij aan dat ze meer gemotiveerd zouden zijn om vrijwilli-gerswerk uit te voeren als hun inzet nog meer gevraagd zou worden. Onder meer om deze lacune op te vangen kiezen we in dit programma om in te zetten op het activeren van vrijwilligers via concrete taken gebaseerd op hun competenties en exper-tise.

Outcome 2 IHR

In het vorige programma werd ingezet op een geconcentreerde aanpak van de doelgroepen, waarbij besloten werd de activi-teiten te richten op mensen die beroepsmatig in contact komen met IHR en beleidsmakers. Deze lijn trekken we door in dit nieuwe programma, maar waarbij we de focus van onze activiteiten nog meer gaan verbinden aan het multiplicatoreffect. In dit programma zullen wij bijvoorbeeld een grotere focus leggen op beleidsmakers en verschuift de aandacht van studenten naar de universiteiten als multiplicator. De samenwerking met de universiteiten verloopt goed maar blijft ad hoc, op enkele terugkerende projecten na. Zo kwam de duurzame relatie met Thomas More niet echt tot stand. In de voorbereiding van dit programma zijn wij daarom opnieuw de dialoog aangegaan met verschillende Vlaamse universiteiten, om te bekijken of en waar er noden zijn waaraan we kunnen beantwoorden. Uit de ervaringen van het vorige programma en deze dialoog blijkt dat er per universiteit verschillende noden zijn op vlak van IHR. Daarom besluiten wij dat het niet optimaal noch haalbaar is om in dit stadium een algemeen aanbod naar universiteiten aan te bieden, maar zullen wij wel verder inzetten op het uitbouwen van een duurzame relatie met de universi-teiten en dit met een wisselend aanbod per universiteit. In het vorige programma hebben wij verder ingezet op de uitbouw van een dialoog met de overheid over de implementatie van verplichtingen inzake internationaal humanitair recht. Beleidsmakers blijft een moeilijke doelgroep om te bereiken, maar door jaar na jaar de geleerde lessen mee te nemen, zoals bijvoorbeeld het rekening houden met de parlementaire agenda, kunnen we de dialoog verderzetten.

In het programma 14-16 is gebleken dat journalisten een belangrijke maar moeilijk te bereiken doelgroep is. In de voorberei-ding van het programma 17-21 hebben we daarom een nieuwe strategie naar deze doelgroep uitgedacht. Opvolgen van inschrijvingen, aanwezigheden en attesten was in het vorige programma voornamelijk een manuele taak. Hoewel de afgelopen jaren reeds de eerste stappen gezet zijn inzake verdere digitalisering, (bv. door voor inschrijvingen en evaluaties over te gaan naar een online tool), gaat RKV in het komende programma de stap naar digitalisering vervolledigen. Ook de financiële opvolging en de opvolging van de attesten zullen via een online tool gebeuren. In deze tool zullen de inschrijvingen en aanwezigheden ook geïntegreerd worden, wat de efficiëntie verhoogt (Zie hoofdstuk ‘Relevantie’).

40

Outcomes

Fiche Outcome 1 AIS

24 In het hoofdstuk ‘Relevantie’ vindt u hoe de directe en indirecte begunstigden gekwantificeerd zijn.

Outcome (Engels of Frans): The volunteers of RKV-International Cooperation are fully committed to make those that are vulnerable more resilient.

Outcome (Nederlands): De vrijwilligers van RKV-Internationale Samenwerking zetten zich in om kwetsbaren zelfredzaam te maken.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_02_BE_DGD

Land: België Is de Outcome gebonden aan een GSK? Ja

Regio/Provincies Vlaanderen en Brussel

Lokale partners of betrokken partijen n.v.t.

Doelgroep: Directe begunstigden:

- Vrijwilligers RKV Internationale Samenwerking - Mensen die we rechtstreeks bereiken met ons aanbod (tracingactiviteiten, expertisemissies, infosessies, opleidingen, activiteiten,

communicatie) Indirecte begunstigden:

Mensen met interesse voor internationale thema's die onrechtstreeks bereikt worden met de inhoud van activiteiten/infosessies/opleidin-gen/communicatie doordat de begunstigden dit verder verspreiden.

Begunstigden24: Totaal: 50.763 Directe begunstigden: 16.921 Indirecte begunstigden: 33.842

Hoofdsector: 99820, Promotion of development awareness

Operationele kosten van de Outcome (EUR): 357.457

Policy Marker

Onderwerp Score Onderwerp Score Onderwerp Score

Milieu 1 Gender 1 Woestijnvorming (Rio Marker) 0

Biodiversiteit (Rio-marker) 0 Klimaatsverandering – Adaptatie (Rio Marker) 1 Klimaatsverandering – Mitigatie (Rio Marker) 1

Trade Development 0 Goed Bestuur 0 Reproductive, maternal, newborn and child health (RMNCH) 0

HIV/AIDS 0 Kinderrechten 0 Totaal 4

41

Fiche Outcome 2 IHR

25 In het hoofdstuk ‘Relevantie’ vindt u hoe de directe en indirecte begunstigden gekwantificeerd zijn.

Outcome (Engels of Frans): Professionals and Belgian policy makers are reinforced in their knowledge of international humanitarian law and convey the respect for IHL towards the public.

Outcome (Nederlands): Professionals en Belgische beleidsmakers zijn versterkt in hun kennis over internationaal humanitair recht en dragen dit uit.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_01_BE_DGD Land: België Is de Outcome gebonden aan een GSK? Ja

Regio/Provincies Vlaanderen en Brussel

Lokale partners of betrokken partijen

Partner 1 CRB-Cf

Partner 2 Ministerie van Defensie

Andere plaats van de interventie: n.v.t.

Doelgroep: Directe begunstigden

Professionals: Militairen (inclusief de medische component), humanitaire actoren, medisch personeel, journalisten, universiteiten

Belgische Beleidsmakers: Politieke partijen/politici, ministers, parlementsleden etc. en hun medewerkers (op lokaal, regionaal, nationaal en inter-nationaal niveau), overheid en publieke instellingen/instanties (administraties, adviesraden) uitvoerings- organen, …) Indirecte begunstigden

Personen met een interesse voor internationaal humanitair recht die onrechtstreeks bereikt worden met de inhoud van activiteiten/infoses-sies/opleidingen/communicatie doordat de directe begunstigden dit verder verspreiden.

Aantal begunstigden:25 Totaal: Directe begunstigden: 4.988Indirecte begunstigden: 9.976

Hoofdsector: 99820, Promotion of development awareness

Operationele kosten van de Outcome (EUR): 715.168

Policy Marker

Onderwerp Score Onderwerp Score Onderwerp Score

Milieu 1 Gender 1 Woestijnvorming (Rio Marker) 0

Biodiversiteit (Rio-marker) 0 Klimaatsverandering – Adaptatie (Rio Marker) 0 Klimaatsverandering – Mitigatie (Rio Marker) 1

Trade Development 0 Goed Bestuur 1 Reproductive, maternal, newborn and child health (RMNCH) 1

HIV/AIDS 0 Kinderrechten 2 Totaal 7

42

Logisch kader Outcome 1 AIS

Baseline 2017 2018 2019 2020 2021 Bronnen

Proces indicator

Indicator 1: Aantal directe begunstigden be-reikt26

0 +12.46727 +13.541 +14.700 +15.780 +16.921 Lijst actieve vrijwilligers; Overzicht aantal personen geholpen via Tracing vrijwilligers; Algemeen bereik communicatie; Overzicht infosessies; Overzicht begunstigden exper-tisemissies; Lijst deelnemers opleidingen

Indicator 2: Aantal indirecte begunstigden be-reikt28

0 +24.93429 +27.082 +29.400 +31.560 +33.842 PMER- overzichtsdocument

Impact

� Verbreden en ondersteunen (informeren, sensibiliseren, bewust maken en/of mobiliseren ten gunste van een wereld die rechtvaardig, solidair, duurzaam en niet langer ongelijk

is) van sociale basis. (GSK 1ste en 2de lijns, doelstelling C.2)

� Inwoners van België informeren, sensibiliseren, bewust maken en/of mobiliseren ten gunste van een wereld die rechtvaardig, solidair, duurzaam en niet langer ongelijk is. (GSK

1ste en 2de lijns, doelstelling C.1)

Outcome 1 AIS: De vrijwilligers van RKV-Internationale Samenwerking zetten zich in om kwetsbaren zelfredzaam te maken.

Assumpties: Cfr. assumpties opgelijst onder sectie ‘Theory of Change’.

Indicator 1.1: Aantal activiteiten uitgevoerd door de vrijwilligers van RKV-Internatio-nale Samenwerking.30

0 n.v.t. n.v.t. +219 n.v.t. +431 Lijst met aantal activiteiten waarbij kwets-baren of andere vrijwilligers in partnerlanden direct worden stimuleert meer zelfredzaam te zijn. Concreet: tracing activiteiten (per dossier of vertaalde ge-sprek) en per expertisemissie.

26 Zie toelichting onder hoofdstuk ‘Relevantie’. 27 De targets werden bepaald op basis van het bereikte aantal begunstigden in 2015, zie toelichting onder hoofdstuk ‘Relevantie’. 28 Zie toelichting onder hoofdstuk ‘Relevantie’. 29 Voor het berekenen van de indirect begunstigden, hanteren wij een multiplicatoreffect van *2 van direct begunstigden. 30 Zie Risico-analyse met betrekking tot deze indicator.

43

Indicator 1.2: % actieve vrijwilligers RKV-Internati-onale Samenwerking dat aangeeft een voldoende aangepaste onder-steuning31 gekregen te hebben van de entiteit AIS.32

033 n.v.t. n.v.t. 75% n.v.t. 80% Survey J3 & J5

Output 1.1: RKV AIS informeert, rekruteert en activeert doelgericht haar (potentiële) vrijwilligers.


Indicator 1.1.1: aantal verstuurde be-richten door RKV AIS via interne en externe kanalen met aandacht voor milieu en gender.

0 +28 +64 +105 +150 +199 Lijst van berichten geplaatst op interne en externe kanalen

Indicator 1.1.2: aantal georgani-seerde infosessies34 door RKV AIS.

0 +11 +38 +68 +96 +125 Lijst van georganiseerde infosessies (incl. deelnemerslijsten)

Typologie van activiteiten Zie lijst van activiteiten onder sectie ‘Theory of Change’.

31 Onder ‘aangepaste ondersteuning’ verstaan we: o.a. het tijdig ter beschikking stellen van communicatiemateriaal, de vooropgestelde communicatiedoorstroom onderhouden, vergaderingen en voorbereidingen correct laten verlopen, geven van aangepaste workshops, ter beschikking stellen van nodige inhoudelijke informatie. 32 Bij het meten en rapporteren van deze indicator monitort RKV het transversale thema gender. 33 In jaar 1 wordt een baseline survey uitgevoerd 34 Infosessie: Een verzamelterm voor alle vormen van informatieoverdracht die niet voldoen aan de definitie van ‘kwaliteitsvolle opleiding’. Dat zijn onder meer briefings, lezingen, infostands …

44

Logisch kader Outcome 2 IHR

Baseline 2017 2018 2019 2020 2021 Bronnen

Proces indicator

Indicator 1: Aantal directe begunstigden bereikt35

0 +1.96836

+2.718

+3.473

+4.228

+4.988

PMER-overzichtsdocument

Indicator 2: Aantal indirecte begunstigden be-reikt37

0 +3.93638

+5.436

+6.946

+8.456

+9.976

PMER-overzichtsdocument

Impact:

Professionals:

� Versterken van (informeren, sensibiliseren, opleiden, bewust maken en/of mobiliseren) en/of samenwerken met intermediaire actoren met het oog op een wereld die recht-

vaardig en niet langer ongelijk is. (GSK 1ste en 2de lijns, doelstelling C.3)

� De CMO’s /IA’s die actief zijn in de ontwikkelingssamenwerking (ook op het vlak van WBE) versterken om de organisaties beter te laten bijdragen aan een wereld die rechtvaar-

dig, solidair, duurzaam en niet langer ongelijk is. (GSK 1ste en 2de lijns, doelstelling C.5)

Beleidsmakers:

� Onze expertise wordt door onze doelgroepen erkend. (GSK Beleid, doelstelling D.1)

� Het aangaan, versterken en/of beïnvloeden van allianties rond ontwikkelingsrelevante thema’s. (GSK Beleid, doelstelling D.2)

� Het beïnvloeden van nationale, Europese en internationale beleidsmakers en privé-actoren ten gunste van duurzame ontwikkeling en mensenrechten. (GSK beleid, doelstelling

D.3)


Outcome 2 IHR: Professionals en Belgische beleidsmakers zijn versterkt in hun kennis over IHR en dragen dit uit.


35 Zie toelichting onder hoofdstuk ‘Relevantie’. 36 De targets werden bepaald op basis van het bereikte aantal begunstigden in 2015, wat neerkwam op 2.093 personen, zie toelichting onder hoofdstuk ‘Relevantie’. 37 Zie toelichting onder hoofdstuk ‘Relevantie’. 38 Voor het berekenen van de indirect begunstigden, hanteren wij een multiplicatoreffect van *2 van directe begunstigden. Dit kan echter hoger liggen aangezien we ons richten tot actoren met een multiplicatoreffect, waarbij een van onze belangrijke doelgroepen de beleidsmakers zijn.

45

Indicator 2.1: Minstens 85% van de professionals en de Belgische beleidsmakers geven aan dat hun kennis over IHR is toege-nomen door RKV vormingen.39

85%40 n.v.t. n.v.t. 85%

n.v.t. 85%

Steekproef door evaluatieformu-lieren

Indicator 2.2: De Belgische overheid voert haar en-gagementen aangegaan tijdens de 32ste Internationale Conferentie van het Rode Kruis en de Rode Halve Maan (IC) uit en bereidt de 33ste IC voor.

Naar aanleiding van de 32ste IC nam de Belgi-sche overheid 26 engagemen-ten op en nam ze 10 resoluties aan.

n.v.t. n.v.t. De ICHR rappor-teert over de uitvoering van de engagementen en resoluties aan-genomen tijdens de 32ste IC opge-volgd en de ICHR bereidt de 33ste IC voor.

n.v.t. De ICHR heeft de uitvoering van de engagementen en resoluties aan-genomen tijdens de 33ste IC opge-volgd.

Verslagen werkgroep IC van de ICHR, halfjaarlijkse rapportering plenaire vergadering, mid-term report IC (2017).

Indicator 2.3: Aantal keer dat de Belgische overheid zich positioneert over IHR inzake hu-manitaire kwesties.41

Aantal positio-neringen42

n.v.t. n.v.t. + 3% n.v.t. + 5% Belgische beleidsdocumenten, toespraken door Belgische be-leidsmakers op nationale en internationale evenementen, pledges, resoluties, enz.

Output 2.1: RKV voorziet kwaliteitsvolle vormingen43 over IHR voor professionals en Belgische beleidsmakers, met aandacht voor gender en milieu gerelateerde thema’s. Assumpties: Cfr. assumpties opgelijst onder sectie ‘Theory of Change’. Indicator 2.1.1: Aantal Belgische beleidsmakers die gevormd zijn over IHR door RKV.44 45

0

Totaal: + 5046 Totaal vrouwen: +v Totaal man-nen:+v

Totaal: +100 Totaal vrouwen: +w Totaal man-nen:+w

Totaal: +155 Totaal vrouwen: +x Totaal man-nen:+x

Totaal: +210 Totaal vrouwen: +y Totaal man-nen:+y

Totaal: +270 Totaal vrouwen: +z Totaal man-nen:+z

Overzicht IHR vormingen in PMER- overzichtsdocument

Indicator 2.1.2: 0

Totaal: +70049 Totaal: +1.400 Totaal: +2.100 Totaal: +2.800 Totaal: +3.500 Overzicht IHR vormingen in PMER- overzichtsdocument

39 Dit percentage wordt berekend aan de hand van een steekproef uit de evaluaties van vormingen. Dit betreft niet alle vormingen aangezien wij niet bij elke vorming ons eigen evaluatiebeleid kunnen toepassen, bv. als de vorming wordt georganiseerd met een partner. 40 Dit percentage was ook het uitgangspunt voor het vorige programma en dient als kwaliteitstest voor onze vormingen. 41 Bij het meten en rapporteren van deze indicator monitort RKV de transversale thema’s gender en milieu. 42 Voor deze indicator voeren we een baselinemeting uit in jaar 1. De targets in J3 en J5 worden hier op afgestemd. 43 Onder vormingen verstaan we alle manieren van informatieoverdracht. Bv. lessen, colloquia, pleitwedstrijden, studiedagen, briefings, etc. 44 Bij het meten en rapporteren van deze indicator monitort RKV de transversale thema’s gender en milieu. 45 In het nieuwe actieplan zullen deze gegevens gender gedesaggregeerd worden bijgehouden. 46 Deze targets werden berekend op basis van het aantal bereikte beleidsmakers in 2015 (55 personen). 49 Deze targets werden berekend op basis van het aantal bereikte professionals in 2015 (838 personen).

46

Aantal professionals die gevormd zijn over IHR door RKV.47 48

Totaal vrouwen: +v Totaal man-nen:+v

Totaal vrouwen: +w Totaal man-nen:+w

Totaal vrouwen: +x Totaal man-nen:+x

Totaal vrouwen: +y Totaal man-nen:+y

Totaal vrouwen: +z Totaal man-nen:+z

Output 2.2: RKV communiceert over en positioneert zich inzake IHR, met aandacht voor gender en milieu gerelateerde thema’s.


Indicator 2.2.1: Aantal keer media-aandacht voor IHR dankzij input vanuit RKV.

0 +650 +14 +23 +33 +45 Strategie 2020 – communicatie-plan Overzicht media-aandacht IHR - RKV

Indicator 2.2.2: Aantal keer dat RKV actief een positie over IHR heeft gedeeld met Belgische beleidsmakers.51

0 +1052 +20 +32 +44 +58 Briefingmomenten, aantal voor-gestelde agendapunten voor de ICHR, position papers, enz.

Typology van activiteiten Zie lijst van activiteiten onder sectie ‘Theory of Change’.

47 Bij het meten en rapporteren van deze indicator monitort RKV de transversale thema’s gender en milieu. 48 In het nieuwe actieplan zullen deze gegevens gender gedesaggregeerd worden bijgehouden. 50 Deze target werd bepaald rekening houdende met het feit dat er in 2015 vijf keer media-aandacht was voor IHR dankzij input van RKV. 51 Bij het meten en rapporteren van deze indicator monitort RKV de transversale thema’s gender en milieu. 52 Deze target werd bepaald rekening houdende met het feit dat RKV in 2015 acht keer een positie heeft gedeeld met de Belgische beleidsmakers.

47

Operationeel Budget

Outcome 1: AIS 2017 2018 2019 2020 2021 Grand total

Operationele kosten

1. Partner 0 0 0 0 0 0

Investering 0 0 0 0 0 0

Werking 0 0 0 0 0 0

Personeel 0 0 0 0 0 0

2. Samenwerking 0 0 0 0 0 0


Werking 0 0 0 0 0 0


3. Lokaal kantoor 0 0 0 0 0 0


Werking 0 0 0 0 0 0


4. HQ 85.186 87.343 62.093 61.293 61.543 357.457

Investeringskosten 3.000 0 0 0 0 3.000

Werking 10.355 20.512 15.262 14.462 14.712 75.303

Personeel 71.831 66.831 46.831 46.831 46.831 279.155

Totaal 85.186 87.343 62.093 61.293 61.543 357.457

Investeringskosten 3.000 0 0 0 0 3.000

Werking 10.355 20.512 15.262 14.462 14.712 75.303

Personeel 71.831 66.831 46.831 46.831 46.831 279.155

Partners

Totaal partner 1 0 0 0 0 0 0

Totaal Partners: 0 0 0 0 0 0

Samenwerking

Samenwerking 1 0 0 0 0 0 0

Totaal Samenwerkingen 0 0 0 0 0 0

48

Outcome 2: IHR 2017 2018 2019 2020 2021 Grand total

Operationele kosten

1. Partner 0 0 0 0 0 0

Investeringskosten 0 0 0 0 0 0

Werking 0 0 0 0 0 0


2. Samenwerking 0 0 0 0 0 0


Werking 0 0 0 0 0 0


3. Lokaal kantoor 0 0 0 0 0 0


Werking 0 0 0 0 0 0


4. HQ 137.071 141.650 142.576 148.249 145.621 715.168


Werking 20.505 22.755 21.305 24.555 19.455 108.575

Personeel 116.466 118.795 121.171 123.595 126.066 606.093

Totaal 137.071 141.650 142.576 148.249 145.621 715.168


Werking 20.505 22.755 21.305 24.555 19.455 108.575

Personeel 116.466 118.795 121.171 123.595 126.066 606.093

Partners

Totaal partner 1 0 0 0 0 0 0

Totaal Partners: 0 0 0 0 0 0

Samenwerking

Samenwerking 1 0 0 0 0 0 0

Totaal Samenwerkingen 0 0 0 0 0 0

49

Relevantie

Outcome 1 AIS

Contextanalyse De zeven fundamentele principes (neutraliteit, vrijwilligheid, menselijkheid, onpartijdigheid, onafhankelijkheid, universaliteit en eenheid) vormen de basis van de werking van het Rode Kruis wereldwijd. Ook RKV draagt deze waarden hoog in het vaandel. Daarnaast nam RKV in 2015 een nieuwe baseline aan, namelijk ‘Rode Kruis-Vlaanderen helpt helpen’. Deze slogan duidt waar de organisatie voor staat: we zorgen ervoor dat zoveel mogelijk mensen op zoveel mogelijk verschillende manieren andere mensen kunnen helpen. Het ultieme doel bestaat eruit om zoveel mogelijk mensen zelfredzaam te maken. Deze denkwijze vormt ook de basis voor ‘Strategie 2020’, waar de organisatie nu haar schouders onder zet.

Als deel van RKV komt ook de entiteit AIS op voor kwetsbare mensen in binnen- en buitenland. Dat draagt bij tot het creëren van verantwoordelijke burgers, de essentie van ontwikkelingseducatie.53 Door vrijwilligers te versterken in hun competenties en hen de nodige omkadering te geven bij het uitvoeren van hun activiteiten worden zij in staat gesteld om kwetsbaren te helpen. Gezien de maatschappelijke tendensen (toenemende internationale migratie en racisme in Europa, impact van de eco-nomische crisis, etc.) is de nood aan enerzijds het versterken van het eigen individu en anderzijds het effectief kunnen helpen van anderen, niet te onderschatten. Door thematisch verschillende hedendaagse thema’s te belichten, kan AIS bovendien doel-gerichter inspringen op de huidige noden (zie hoofdstuk ‘Doeltreffendheid’, subtitel ‘Thematisch werken’).

Via haar werking draagt AIS bij aan het Sustainable Development Goal (SDG) 4.7: ‘By 2030, ensure that all learners acquire the

knowledge and skills needed to promote sustainable development, including, among others, through education for sustainable

development and sustainable lifestyles, human rights, gender equality, promotion of a culture of peace and non-violence, global

citizenship and appreciation of cultural diversity and of culture’s contribution to sustainable development’ en aan de doelstellingen C.1 en C.2 van het Gemeenschappelijk Strategisch Doel (GSD) 1ste en 2de lijns van de GSK België.

Selectie directe begunstigden/doelgroepen Als vrijwilligersorganisatie is de eigen achterban een belangrijke doelgroep van RKV. In de context van RKV AIS richten we ons meer specifiek op de vrijwilligers geïnteresseerd in internationale thematieken. Deze vrijwilligers bevinden zich breed binnen de organisatie: zowel binnen andere disciplines (Interventie, Jeugd Rode Kruis, Eerste Hulp, etc.), als op de verschillende niveaus (lokaal, provinciaal, nationaal). Wanneer deze vrijwilligers effectief een activiteit uitvoeren voor AIS worden ze beschouwd als AIS vrijwilliger.

Omdat we zoveel mogelijk mensen zelfredzaam willen maken is het belangrijk om te blijven investeren in nieuwe AIS vrijwil-ligers. Ook de context van het veranderende engagement van vrijwilligers (zie hoofdstuk ‘Risicoanalyse’) draagt bij aan deze nood. Daarom zetten we naast het versterken van de huidige vrijwilligersgroep ook in op het aantrekken van nieuwe vrijwilligers. Enerzijds worden geïnteresseerde vrijwilligers binnen andere diensten van Rode Kruis-Vlaanderen die interesse hebben in In-ternationale Samenwerking opgeleid om specifiek binnen RKV AIS aan de slag te gaan. Anderzijds gaan we concreet op zoek naar vrijwilligers met kennis en ervaring binnen bepaalde thematieken. Het aantrekken van deze nieuwe vrijwilligers zal worden afgestemd op de activiteiten die in het begin van het programma verder worden ontwikkeld. Mogelijke doelgroepen waaraan gedacht worden zijn studenten communicatie, studenten fotografie, ex-cliënten van Tracing, enz.

Zowel binnen de bestaande achterban, als bij nieuwe vrijwilligers, wordt rekening gehouden met de transversale thema’s, dit aan de hand van een thematische werking (rond o.a. gender- en milieuthema’s), als bij het aantrekken van nieuwe vrijwilligers (meer diversiteit binnen de organisatie).54

In de voorbereiding van dit programma werden verschillende kwantitatieve en kwalitatieve bevragingen gedaan. Zo werden diverse overlegmomenten met vrijwilligers(groepen) ingepland: Adviescommissie, Provinciale Teams, werkgroep IntAct55. Hier-naast werden ook de data uit de grote vrijwilligersbevraging die dit jaar plaatsvond meegenomen en vonden verschillende overlegmomenten plaats met CRB-Cf. Binnen RKV werd de expertise van verschillende collega’s in hun vakgebied meegeno-men; dit zowel binnen als buiten de dienst Internationale Samenwerking. Zo bijvoorbeeld werd bij de keuze van begunstigden rekening gehouden met een bevraging gedaan naar scholen door Jeugd Rode Kruis. De conclusies die uit deze bevragingen getrokken werden, steunen de gemaakte keuzes met betrekking tot begunstigden.

53 FOD Buitenlandse Zaken, Buitenlandse Handel en Ontwikkelingssamenwerking (2012), Strategienota Ontwikkelingseducatie, p. 4 (2012), 1-18, http://diplomatie.belgium.be/sites/default/files/downloads/strategienota_ontwikkelingseducatie.pdf (verder Strategienota Ontwikkelingsedu-catie). 54 Zie subtitel ‘Transversale thema’s’, onder hoofdstuk ‘Relevantie’. 55 IntAct = Internationaal Actief, een informele werkgroep opgericht binnen RKV om de krachten van AIS vrijwilligers te bundelen en ze op pro-jectmatige basis te laten samenwerken rond internationale thema’s.

50

Berekening directe begunstigden/doelgroepen Als basis voor de berekening van de directe begunstigden kijken we naar het aantal bereikte directe begunstigden in het jaar 2015. We houden hiermee rekening met het aantal actieve vrijwilligers van RKV Internationale Samenwerking in 2015 (30 per-sonen), het aantal personen die we rechtstreeks bereikt hebben door infosessies, activiteiten en opleidingen (580 personen56) en personen die we bereikten via onze communicatiekanalen.

Berekenen hoeveel unieke personen we bereiken via de diverse communicatiekanalen is niet mogelijk omwille van technische en financiële beperkingen. Dit counteren we echter door enkel onze e-nieuwsbrief in rekening te brengen bij het berekenen van de begunstigden. De e-nieuwsbrief wordt verstuurd naar onze 13.000 vrijwilligers. Daarnaast hebben we op het vlak van interne communicatie nog de e-nieuwsbrief Internationaal Digitaal, directe mailing naar Rode Kruisvrijwilligers met een over-koepelende functie op lokaal en/of provinciaal niveau, de sociale media kanalen van RKV (Facebook, Twitter, …) en de blogberichten waarbij we de thema's van Internationale Samenwerking in de verf zetten. Hiermee halen we een gemiddeld bereik van 3.000 personen per Facebookbericht, 2.000 via een Twitter bericht, 28 per blogbericht en 1.000 met de Internationaal digitaal. We nemen deze echter niet mee op om dubbeltellingen te vermijden. Niet alle 13.000 vrijwilligers zullen de e-nieuwsbrief lezen, maar dat wordt door het niet opnemen van de andere kanalen grotendeels gecounterd.

Daarnaast communiceren we ook nog naar externen via de algemene Rode Kruis-Vlaanderen website en via externe kanalen zoals 11.be. Hiermee behalen we zo’n 180 personen per bericht op de RKV-website en 1.600 via 11.be. Ook deze tellingen nemen we echter niet op omdat we niet kunnen garanderen dat bij de mensen die deze berichten lezen geen RK vrijwilligers zijn enerzijds en hoeveel unieke andere personen stilstaan bij onze berichtgeving anderzijds. Rekening houdende met de bud-getherziening maart 2017 en verschuiving in prioriteiten van communicatie naar vrijwilligersomkadering,57 lijkt ons daarom correct om het aantal begunstigden die we bereiken door onze communicatiekanalen in te schatten op 12.000.

Als basis voor de berekening van de directe begunstigden nemen we dus 12.610 (30+580+12.000) waarbij we op 5 jaar tijd willen stijgen tot 16.921. Dit betekent een stijging van 4.311 over vijf jaar. De personen die we bereiken via onze communica-tiekanalen rekenen we niet cumulatief over de vijf jaren. In ons totaal aantal directe begunstigden komen zij dus maar één keer voor.

Indirecte begunstigden/doelgroepen Indirect worden mensen met interesse voor internationale thema’s onder het algemene publiek bereikt via onder andere acti-viteiten die de vrijwilligers van RVK-Internationale Samenwerking zullen uitvoeren en nieuwsberichten die we verspreiden. Daarnaast kan een verdere verspreiding bewerkstelligd worden door media-actoren die bepaalde acties of campagnes oppik-ken. Voor het berekenen van de indirect begunstigden (zie proces indicator Logisch Kader AIS), hanteren wij een multiplicatoreffect van ‘directe begunstigden *2’.

Locatie RKV–AIS is actief binnen Vlaanderen en Brussel.

56 Ter voorkoming van dubbeltelling is het aantal actieve vrijwilligers die ook opleiding zullen genieten niet meegerekend. 57 Zie herziening van de indicator 1.1.1 in het hoofdstuk ‘Logisch Kader Output 1.1 AIS’

51

Outcome 2 IHR

Contextanalyse Het internationaal humanitair recht is een levende rechtstak gelet op de toename in zowel aantal als complexiteit van gewa-

pende conflicten.58 De nabijheid van conflicten, de betrokkenheid van België in gewapende conflicten, het feit dat het IHR ook

verplichtingen kent die in vredestijd voldaan moeten worden, duiden het belang van internationaal humanitair recht.

Op internationaal, regionaal en nationaal niveau wordt het belang van IHR erkend. In resoluties van de Veiligheidsraad van de

VN lezen we erkenning voor het belang van IHR en de noodzaak om de verplichtingen inzake IHR na te leven.59 Op regionaal

niveau heeft de Europese Unie o.a. richtsnoeren ontwikkeld ter bevordering van de naleving van het IHR.60 Recentelijk werd

IHR in de Belgian Position Paper naar aanleiding van de World Humanitarian Summit, ook op Belgisch niveau erkend als een

cruciale rechtstak om de komende jaren op in te zetten.61

In de GCA werd IHR als onderdeel van het prioritaire thema mensenrechten beschreven.62 RKV heeft een erkend mandaat inzake

IHR. Als helper van de overheid ondersteunt ze de overheid in de verspreiding en naleving van het IHR. De voorbije jaren heeft

RKV reeds veel expertise kunnen opbouwen, zowel inhoudelijk als in de verspreidingsmethoden naar de verschillende doel-

groepen.

De werking van IHR draagt bij tot de volgende SDG’s:

- SDG 4.7: ‘By 2030, ensure that all learners acquire the knowledge and skills needed to promote sustainable development,

including, among others, through education for sustainable development and sustainable lifestyles, human rights, gen-

der equality, promotion of a culture of peace and non-violence, global citizenship and appreciation of cultural diversity

and of culture’s contribution to sustainable development’,

- SDG 16.1: ‘Significantly reduce all forms of violence and related death rates everywhere’

- SDG 16.3: ‘Promote the rule of law at the national and international levels and ensure equal access to justice for all’

Daarnaast draagt dit IHR programma bij aan de GSK doelstellingen C.3, C.5 en D.1, D.2 en D.3.

In voorbereiding van dit programma deden we een elektronische bevraging bij onze partners uit het huidige programma 14-

16, aangevuld met enkele diepte interviews. In de bevraging richtten we ons op de rol die RKV speelt en kan spelen in het kader

van IHR, welke synergiën er mogelijk zijn en in welk opzicht RKV haar partners kan ondersteunen bij hun werking inzake IHR.

De conclusies ondersteunden de keuze van begunstigden. Als onderdeel van het GSK werkproces en de opvolging daarvan,

namen we contact op met verschillende andere ngo’s om de synergie en complementariteit te bespreken. Het resultaat hiervan

wordt weergegeven onder het hoofdstuk ‘Synergie en complementariteit’.

Selectie directe begunstigden/doelgroepen RKV zet voor haar luik IHR in eerste orde in op de Belgische beleidsmakers.63 Zij hebben een rechtstreekse invloed op de

naleving en verspreiding van het IHR onder andere door de implementatie van internationale verplichtingen in de nationale

wetgeving. Bovendien hebben beleidsmakers een belangrijk multiplicatoreffect. RKV zet in tweede orde in op informatievoor-

ziening naar professionals.64 Professionals worden hier gedefinieerd als personen die in hun werkzaamheden met het IHR in

aanraking (kunnen) komen en dus over een correcte kennis van de rechtsregels dienen te beschikken.65 Deze professionals

kunnen ook wegen op het publieke debat, wat op haar beurt de Belgische beleidsmakers kan beïnvloeden. Bij de uitwerking

van de activiteiten naar beide doelgroepen wordt rekening gehouden met de transversale thema’s.66

58 Annual Report ICRC 2014, p. 88 (614p.); 40 actieve conflicten wereldwijd, https://acd.iiss.org/ 59 UN Security Council Res. 2286 (2016); Res. 2250 (2015); Res. 2242 (2015); Res. 2222 (2015) 60 Richtsnoeren van de Europese Unie inzake de bevordering van de naleving van het internationale humanitaire recht, PB C 327, 23.12.2005, http://eur-lex.europa.eu/legal-content/NL/TXT/?uri=URISERV%3Al33605 61 World Humanitarian Summit, Plenary Session, Istanbul, 23/05/2016, Belgian Position Paper + Plenary statement,Minister Alexander De Croo. 62 GCA Noord, p. 26. 63 Zie ToC Outcome 2 IHR. 64 In de GCA Noord (p. 17) wordt een niet-exhaustieve definitie gegeven van ‘professionelen in een werkkader’: medisch en paramedisch perso-neel, advocaten, magistraten, militairen, studiebureaus, consultants, vormingswerkers, medewerkers van studie en beleid van sociale organisaties… 65 In de eerste plaats richten we ons op de professionals zoals neergeschreven in de ToC Outcome 2 IHR. 66 Zie subtitel ‘Transversale thema’s’ verder in dit hoofdstuk ‘Relevantie’.

52

Berekening directe begunstigden/doelgroep Als basis voor de berekening van de directe begunstigden kijken we naar de bereikte directe begunstigden in het jaar 2015,

waar we 838 professionals en 55 beleidsmakers hebben bereikt. Bijkomend zijn zo’n 1.200 personen ingeschreven op onze IHR-

berichten die we twee maal per maand uitsturen. Zo komen we op een basis van 2.093 personen. Rekening houdende met de

budgetherziening in maart 2017 voorzien we voor dit programma 4.988 directe begunstigden te bereiken over vijf jaar67.

De ingeschrevenen op onze IHR berichten rekenen we niet cumulatief over de vijf jaren. In ons totaal aantal directe begunstig-

den worden zij dus maar één keer geteld. Voor wat betreft de berekening van het aantal professionals/beleidsmakers die een

vorming hebben gevolgd nemen we een optelsom van de aanwezigen. Hierbij houden we geen rekening met het feit of die

personen al dan niet al een andere vorming hebben gevolgd.

Indirecte begunstigden/doelgroepen Indirect wordt het algemeen publiek bereikt, door het verder uitdragen door beleidsmakers en professionals, maar ook door

berichtgeving over IHR in de media. Het Belgische publiek kan gewicht geven aan de politieke eisen.68

Voor het berekenen van de indirecte begunstigden (zie proces indicator Logisch Kader Outcome 2 IHR), hanteren wij een

multiplicatoreffect ‘direct begunstigden *2’.

Locatie RKV is actief binnen Vlaanderen en Brussel. Op federaal niveau wordt er steeds samengewerkt met CRB-Cf.

Relevantie ten opzichte van de prioritaire thema’s van Belgische overheid

Digitalisering RKV gebruikt digitale technologieën om de impact van haar interventies te vergroten. Digitalisering wordt in ‘Strategie 2020. Iedereen Helpt’ van RKV duidelijk naar voor geschoven als doelstelling voor de komende jaren.

In België maken deze technologieën onderdeel uit van de strategie inzake ontwikkelingseducatie, meer bepaald worden ze ingezet voor de verspreiding van informatie. Zo maken we gebruik van een website, digitale nieuwsbrieven en sociale media om informatie over onze activiteiten te verspreiden.

Daarnaast werden in het vorige programma stappen gezet inzake meer digitalisering voor wat betreft het opvolgen van deel-nemersregistraties en het evalueren van vormingen. Voor dit nieuwe programma gaan we hier verdere stappen in zetten opdat ook de financieringsopvolging en het beheren van de attesten aan eenzelfde tool worden gekoppeld.

RKV zet ook in op interactieve hulpmiddelen zoals e-learningmodules. Een eerste nieuwe module wordt uitgeschreven voor de werking van IHR in 2016. Tijdens het nieuwe programma zal hier verder op worden ingezet, zowel voor Outcome 1 AIS als Outcome 2 IHR.

Mensenrechten In navolging van de Belgische wet op de ontwikkelingssamenwerking werd in de GCA Noord opgenomen dat mensenrechten een prioritair thema is.69 Hieronder wordt ook begrepen het IHR, waarbij wordt gesteld dat ‘opdat het Internationaal humanitair

recht gerespecteerd wordt en om bij te dragen aan de bescherming van personen tijdens gewapende conflicten, is het noodzakelijk

om te investeren in de capaciteit van de actoren, zowel in België als in het buitenland, die een belangrijke preventieve taak hebben

en die de regels moeten naleven’.70

Een op rechten gebaseerde benadering is altijd aanwezig geweest in het werk van de Rode Kruis- en Rode Halve Maanbewe-ging. Hoewel internationaal humanitair recht en mensenrechten zich apart van elkaar hebben ontwikkeld, delen zij hetzelfde uitgangspunt van menselijke waardigheid. Deze rechtstakken zijn niet alleen complementair maar groeien ook steeds meer naar elkaar toe. Door verspreiding van kennis en informatie en beleidsbeïnvloeding inzake IHR willen wij bijdragen tot een betere naleving van het IHR. Onze primaire benadering om deze gedachte te operationaliseren is humanitaire diplomatie, waarbij we Belgische beleidsma-kers overtuigen om te allen tijde te handelen in het belang van de kwetsbaren en met respect voor de fundamentele

67 Zie herziening van de indicator 2.1;2 in het hoofdstuk ‘Logisch Kader outcome 2 IHR’ 68 GCA Noord, p. 22. 69 Wet van 19 maart 2013 betreffende de Belgische Ontwikkelingssamenwerking, BS 12 april 2013; GCA Noord, p.25. 70 GCA Noord, p. 26.

53

humanitaire principes.71 Dit vertaalde RKV in haar Strategie 20-20: ‘iedereen helpt’, waarin een van de doelstellingen is: ‘een

sterkere maatschappelijke signaalfunctie uitoefenen in onze expertisedomeinen’. IHR wordt hierbij genoemd als een van de ge-bieden van expertise. Al onze activiteiten, waaronder humanitaire diplomatie, moeten steeds in overeenstemming zijn met onze zeven fundamentele beginselen, in het bijzonder neutraliteit. Onze bevoorrechte toegang tot de overheid en onze geloofwaardigheid als organisatie impliceert dat vaak een stille en discrete vorm van humanitaire diplomatie het meest effectief is om de humanitaire resultaten die we nastreven te bereiken. In het programma 17-21, zullen wij daarom verder inzetten op participatie in de ICHR waar wij zowel belangrijke standpunten inzake IHR kunnen delen als actief kunnen meewerken aan de opvolging en implementatie van internationale verplichtingen en engagementen inzake IHR. Verder zullen wij humanitaire diplomatie nastreven via briefings en informatiedeling aan verschillende niveaus van de overheid. Het verder uitbouwen van thematische expertise moet zich verder vertalen naar het actief delen van standpunten met beleidsmakers naar aanleiding van actuele maatschappelijke onderwerpen. Mensenrechten zoals onder andere migratie, humanitaire waarden, gezondheid en veilig drinkwater worden behandeld als prioritaire thema’s of als thema’s verbonden aan onze partnerprojecten binnen de werking van RKV AIS.72

Transversale thema’s

Gender Gender refereert naar de sociale geconstrueerde verschillen tussen personen gebaseerd op geslacht, maar ook seksuele oriën-tatie, genderidentiteit of genderexpressie. Hoewel deze verschillen in elke cultuur voorkomen, zijn ze veranderlijk over de tijd en verschillend zowel in als tussen culturen. Gender bepaalt de rollen, macht en middelen voor vrouwen en mannen in elke context.73

Outcome 1 AIS De projecten van RKV in onze partnerlanden hebben aandacht voor gender. Deze lijn trekken we door bij het communiceren en informeren over deze internationale projecten en thematieken hier bij ons. Zo zijn de projecten van RKV gendersensitief en houden we bij het plaatsen van latrines of het organiseren van een eerstehulpopleiding steeds rekening met specifiek vrouwe-lijke noden.

We zorgen ervoor dat deze inhoudelijke informatie ook onze vrijwilligers bereikt. Verder houden we in onze communicatie ook rekening met een evenwichtige verdeling tussen mannelijke en vrouwelijke getuigenissen. Ten slotte nemen we deze gender-gevoeligheid eveneens mee in onze vormingen over de internationale thema’s.

De 13.000 vrijwilligers van Rode Kruis-Vlaanderen moeten een afspiegeling zijn van de maatschappelijke samenstelling binnen België. Om dit beter te monitoren gaan we vanaf het huidige programma gender gedesaggregeerde data bijhouden bij onze vormingen. Deze data kunnen gebruikt worden bij het aantrekken van de nieuwe vrijwilligers.

Logisch kader

In het logisch kader wordt gender opgenomen als aandachtspunt op indicatorniveau. Zo zorgen we er onder andere voor dat de deelnemerslijsten van onze vormingen gender gedesaggregeerd bijgehouden worden.

Outcome 2 IHR Gewapende conflicten treffen mannen, vrouwen, jongens en meisjes op een andere manier. Bovendien versterken gewapende conflicten de bestaande genderongelijkheid in samenlevingen. Het internationaal humanitair recht van toepassing in gewa-pende conflicten moet daarom rekening houden met mogelijk verschillende noden van personen om het humanitair doel te bewaren. Een gender perspectief op IHR betekent dat er aandacht wordt besteed aan hoe gender de bescherming, rechten en verplichtingen, van individuen onder dit recht beïnvloedt. Bovendien draagt aandacht voor een genderperspectief op IHR ertoe bij dat de humanitaire respons passend en effectief is.74

Alle stakeholders, inclusief beleidsmakers, met verantwoordelijkheden binnen het IHR, moeten begrijpen hoe gender factoren een impact hebben op de toepassing van het recht en dit moet vertaald worden naar het operationeel optreden.

71 IRFC Humanitarian Diplomacy Policy, http://www.ifrc.org/Global/Governance/Policies/Humanitarian_Diplomacy_Policy.pdf. 72 GCA Noord p. 24. 73 IFRC Strategic Framework on gender and diversity issues 2013-2020, p.2; Swedish Red Cross, Study on the access to health care during armed

conflict and other emergencies: examining violence against health care form a gender perspective, 2015. 74 Annual Report ICRC 2014, p.34; Swedish Red Cross, Study on the access to health care during armed conflict and other emergencies: examining

violence against health care form a gender perspective, 2015, p. 7-9.

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De meeste bepalingen onder het IHR zijn gender-neutraal (bv. de bescherming van burgers) en bevatten een non-discrimina-tieprincipe. Enkele bepalingen verlenen extra bescherming voor vrouwen.75 In de studie van het internationaal humanitair recht is er een evolutie waar te nemen, waarbij er steeds meer aandacht wordt besteed aan de mogelijke interpretatie van de regels, rekening houdend met het genderperspectief. Artikel 27 van het Vierde Verdrag van Genève van 1949 rond seksueel geweld verwijst bijvoorbeeld enkel naar vrouwen, maar wanneer men kijkt naar de Aanvullende Protocollen van 1977 dan wordt er naar seksueel geweld gekeken in zijn geheel, dus ook t.a.v. mannen.

Logisch kader

In het logisch kader wordt gender opgenomen als aandachtspunt op output niveau. Elke output vraagt aandacht voor gender gerelateerde thema’s (zie outputs 2.1 en 2.2). Ook voor indicatoren 2.1.1 en 2.1.2 werken we met gender gedesaggregeerde data.

Actiepunten van RKV a. Gender perspectief bij vormingen: aandacht voor aan gender gerelateerde thema’s in eigen vormingen:

- onderscheid tussen seksueel en gender gerelateerd geweld, - weerleggen van enkele stereotypen zoals dat enkel vrouwen en meisjes het slachtoffer wor-

den van seksueel geweld, - de relevante bepalingen van IHR en mensenrechten inzake seksueel en gender gerelateerd

geweld toelichten. b. Gender gedesaggregeerde data bijhouden:

- systematisch bijhouden van de verhouding man – vrouw en leeftijdsschaal in het overzicht van onze vormingen (sex and age disaggregated data76),

- deze data bespreken in de jaarlijkse evaluatie van de vormingen en kijken of er bepaalde conclusies kunnen worden getrokken.

c. Overwegen om actief lid te worden van de volgende platformen: - Be Gender: http://www.11.be/item/alles-over-be-gender-belgisch-platform-voor-gender-

gelijkheid-en-vrouwenrechten - IFRC Gender platform.

In het bijzonder voor outcome 2 IHR worden bijkomend volgende actiepunten voorzien: d. Indien mogelijk gender gerelateerde thema’s op de agenda plaatsen van partners inzake vorming, in het

bijzonder het Studiecentrum voor Militair Recht en Oorlogsrecht en Ministerie van Defensie.77 e. Genderperspectief bij beleidsbeïnvloeding: aandacht voor aan gender gerelateerde thema’s bij beleidsbe-

invloeding. Een van de invalshoeken is hier de opvolging van resolutie 3 ‘Sexual and gender-based violence: joint action on prevention and response’, aangenomen tijdens de 32ste Internationale Conferentie van het Rode Kruis en de Rode Halve Maan in december 2015. Hierin staan meerdere bepalingen die nuttig kunnen zijn in de dialoog met de overheid over de implementatie van deze resolutie in België. In paragraaf 9 worden Staten opgeroepen om internationaal humanitair recht en de bepalingen inzake seksueel geweld in gewapende conflicten, zo wijd mogelijk te verspreiden, inclusief het opnemen in militaire programma’s. De opvolging van deze resolutie gebeurt in de eerste plaats binnen de Interministeriële Commissie voor Humanitair Recht, waarin het Belgische Rode Kruis vertegenwoordigd is.

Milieu Natuurrampen en gewapende conflicten hebben een negatieve impact op het milieu. Dat legt bijkomend een zware druk op het leven, de gezondheid en veiligheid van de getroffen bevolking. Een goede informatieverstrekking over IHR en humanitaire hulpverlening naar personen die vanuit hun beroep in aanraking komen met thema’s gerelateerd aan rampen en conflicten blijft dan ook onontbeerlijk. Rode Kruis-Vlaanderen geeft aandacht aan deze problematiek in haar berichtgeving en vormingen. Zoals uit de GCA Noord naar voor gekomen is, spelen onderwijs en vorming een cruciale rol om milieubewuste wereldburgers te vormen die zorg dragen voor het milieu, zodat iedereen op deze planeet kan leven in een kwaliteitsvolle leefomgeving met toegang tot alle basisvoorzieningen. 78

75 Waaronder artikel 14 van het Vierde Verdrag van Genève van 1949 (GC IV), artikel 38(5) van GC IV, artikel 50 GC IV, artikel 132 GC IV, artikel 27 GC IV, artikel 97 GC IV en artikel 124 GC IV, artikel 75 van het Eerste Aanvullende Protocol (AP I) en artikel 5(2)(a) van APII. 76 Wellicht zullen we deze data niet bij al de vormingen die we geven kunnen verzamelen, met name wanneer we beroep doen op of samen-werken met een externe partner. 77 Op 5 maart 2015 werd er door het Studiecentrum voor Militair Recht en Oorlogsrecht een studiedag georganiseerd over ‘Het geweld tegen vrouwen en de bescherming van vrouwen in gewapende conflicten en operatiezone’, dit met steun en interventie van het Belgische Rode Kruis. 78 GCA Noord, Oktober 2015, p. 29

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Outcome 1 AIS RKV zet in op enkele prioritaire thema’s waaronder klimaat en (stille) rampen. Dit zijn thema’s die kaderen binnen het overkoe-pelende thema ‘duurzaam leefmilieu’, dat een belangrijke invloedsfactor is voor kwetsbaarheid. Zo bestaat er binnen de internationale gemeenschap een consensus over het feit dat klimaat een van de grootste uitdagingen is voor de huidige en komende generaties. Het zijn de meest kwetsbaren die zich het moeilijkst kunnen wapenen tegen de negatieve gevolgen van klimaatverandering enerzijds en klimaatverandering creëert nieuwe kwetsbaren anderzijds.79

De projecten van RKV in het Zuiden hebben aandacht voor milieu. Deze lijn trekken we door bij het communiceren en infor-meren over deze internationale projecten en thematieken hier bij ons. Zo bijvoorbeeld hebben we met RKV waterprojecten in onder andere Burundi en Nepal. Het uitgangspunt van deze interventies is dat werken aan veilig en beschikbaar water, gelinkt is aan werken aan een veiliger en meer proper leefmilieu. Zoals uit de GCA Noord naar voor kwam zal tegen 2030 bijna de helft van de wereldbevolking onder omstandigheden van ernstige waterstress leven, wat nog wordt versterkt door de gevolgen van de klimaatsverandering.80 Dit is dan ook, met onze projecten als praktijkvoorbeelden, een belangrijke thematiek om mee te nemen in onze communicatie en vormingen. Logisch kader

Er is een verband met indicator 1.1: de activiteiten op een duurzame manier worden uitgevoerd en met aandacht voor milieu gerelateerde onderwerpen. Daarnaast kan ook bij indicator 1.1.2 aandacht worden besteed aan milieu gerelateerde onderwer-pen.

Outcome 2 IHR Milieu in het kader van internationaal humanitair recht wordt gedefinieerd als een focus op mensen en hun relaties met alle elementen, zowel natuurlijke als door de mens gecreëerde, die direct of indirect invloed hebben op hun leefomstandigheden. Deze omvatten fysieke elementen zoals lucht, water, bodem, natuurlijke hulpbronnen, flora, fauna, maar overwegen ook soci-aaleconomische factoren, overtuigingen, praktijken, politieke standpunten, recht en beleidsmaatregelen die de levensvoorziening beïnvloeden.81 Het gebruik van bepaalde soorten wapens, zoals chemische, biologische of nucleaire wapens, kunnen vervuiling van de leef-omgeving tot gevolg hebben en hebben mogelijk een bijkomende negatieve impact op de voedselvoorziening van de bevolking. Waterbevoorradingssystemen of irrigatiesystemen kunnen vernietigd worden, hierbij kunnen waterbronnen besmet raken door kruisbesmetting. Een gewapend conflict kan tot gevolg hebben dat mensen zich verplaatsen, waardoor op bepaalde plekken een concentratie van personen ontstaat. Ontbossing voor houtvuur, overexploitatie van water, overbevissing of overbegrazing kunnen dan leiden tot een verhoogde kwetsbaarheid of (de verspreiding van) ziekten.82 Het IHR besteedt aandacht aan deze problematiek om de schadelijke gevolgen van gewapende conflicten aan het milieu te beperken.83 Kennis over de regels is de eerste stap naar een goede naleving van de regels. Het is van belang om milieu gere-lateerde thema’s voldoende aan bod te laten komen in de activiteiten van Rode Kruis-Vlaanderen. RKV is de laatste jaren actief rond het thema van nucleaire wapens en blijft dit ook de volgende jaren als een prioritair thema behandelen.

Logisch kader

In het logisch kader wordt milieu opgenomen als aandachtspunt op output niveau. Elke output vraagt aandacht voor milieu gerelateerde thema’s (zie output 2.1; 2.2 en 2.3). Ook bij het meten en rapporteren over de indicatoren (2.3; 2.1.1; 2.1.2; 2.2.2) wordt ‘milieu’ gemonitord.

Actiepunten van RKV a) Aandacht voor milieu gerelateerde thema’s in de activiteiten. b) Bij het organiseren van activiteiten houden we milieu ook in het achterhoofd bij de logistieke uitwerking. Zo organi-

seren we onze activiteiten dicht bij een treinstation waardoor de deelnemers aangespoord worden om met het openbaar vervoer te komen. Verder proberen we materiaal, in de mate van het mogelijke, dubbelzijdig te printen. Verder wordt er bij het ontwikkelen van tools rekening gehouden met de verwachte gebruikstijd van dergelijke tools, opdat deze gebalanceerd is met de kost (financieel en voor het milieu) die ermee gepaard gaat. Bijvoorbeeld de

79 Plan d’action de la Fédération sur les changements climatiques pour 2013-2016, Fédération Internationale des Sociétés de la Croix-Rouge et du Croissant-Rouge, p. 14 80 GCA Noord, p. 29 81 ICRC Assistance Division, Framework for environmental management in assistance programmes, International Review of the Red Cross, Vol. 92 number 879 september 2010, p. 748 82 ICRC Assistance Division, Framework for environmental management in assistance programmes, International Review of the Red Cross, Vol. 92 number 879 september 2010, p. 748 83 https://www.icrc.org/eng/war-and-law/conduct-hostilities/environment-warfare/overview-environment-and-warfare.htm

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brochures: ‘IHR: antwoorden op je vragen’ en ‘Hulp bij rampen’ zijn op die manier opgesteld dat ze enkele jaren als informatiebron kunnen dienen en niet na een aantal maanden verouderd zijn.

c) Monitoren van het transversale thema milieu in relatie tot verscheidene indicatoren in het logisch kader van zowel Outcome 1 AIS als Outcome 2 IHR.

In het bijzonder voor Outcome 2 IHR worden bijkomend volgende actiepunten voorzien: d) Indien mogelijk milieu gerelateerde thema’s op de agenda plaatsen van partners inzake vorming, bij het Studiecen-

trum voor Militair Recht en Oorlogsrecht en het Ministerie van Defensie.84 e) Milieuperspectief bij beleidsbeïnvloeding: aandacht voor aan milieu gerelateerde thema’s bij beleidsbeïnvloeding.

Doeltreffendheid

Outcome 1 AIS

Link met GSK Als vrijwilligersorganisatie hecht RKV veel belang aan het betrekken van vrijwilligers op alle niveaus van de organisatie.85 RKV AIS draagt daartoe bij door het activeren van vrijwilligers binnen internationale thematieken. Deze achterban is een belangrijke multiplicator naar de algemene bevolking. Om deze redenen onderschrijft RKV de benaderingen C1.1 en C.2.1 van de GSK België.

Na afweging van tijd en middelen versus impact werd besloten om de GSK benaderingen B1.1, B1.2 en B2.2 uiteindelijk niet te onderschrijven, in tegenstelling tot wat vermeld staat in de GSK België. Een scholenwerking rond internationale thema’s met inzet van vrijwilligers werd overwogen maar uiteindelijk niet weerhouden na verdere analyse van de sector en noden. Ook de GSK benadering C3.1 wordt uiteindelijk niet onderschreven met dit programma vanwege de afweging van middelen en priori-teiten.

Interventiestrategie RKV AIS laat RK-vrijwilligers daadwerkelijk aan de slag gaan binnen het thema van internationale samenwerking. De activiteiten die de vrijwilligers zullen uitvoeren dragen bij tot de hogere doelstelling van het zelfredzaam maken van kwetsbaren. Belangrijk om te benadrukken is dat we in dit programma nog meer willen inzetten op de activering van onze vrijwilligers. De aandacht verschuift van informeren en sensibiliseren naar activeren, hoewel er op deze eerste niveaus ook nog ondersteunende activi-teiten zijn. Om dit te bereiken wordt in de interventiestrategie ingezet op twee grote domeinen: communicatie en vrijwilligersomkadering. We lichten hieronder ook het thematisch werken verder toe, verbonden aan de twee interventiedo-meinen.

Communicatie

Door in te zetten op communicatie naar de bovenvermelde doelgroepen, worden deze personen geïnformeerd en gesensibili-seerd over onze huidige maatschappij en haar (stille) rampen. Het aanreiken van informatie over andere culturen levert hen bovendien inzichten op over andere maatschappelijke contexten, wat bijdraagt tot het sensibiliseren van de doelgroep. Het verstrekken van informatie over de projecten van RKV leidt vervolgens tot kennis en inzicht in de verwezenlijkingen van onze organisatie en haar partnerorganisaties, en de maatschappelijke relevantie hiervan. Vrijwilligers die intrinsiek gemotiveerd zijn om aan de slag te gaan rond internationale thematieken en zich betrokken voelen bij de werking van RKV zullen op deze manier gemotiveerd zijn om zich daadwerkelijk in te zetten om kwetsbaren zelfredzaam te maken.

Het informeren en sensibiliseren zal via diverse kanalen verlopen: nieuwsbrieven, blogberichten, de Rode Kruiswebsite, concrete draaiboeken voor verantwoordelijken Internationale Samenwerking in lokale afdelingen, etc. De inhoud wordt telkens aange-past aan het beoogde publiek.

Vrijwilligersomkadering

RKV zet in op een kwalitatieve ondersteuning van de vrijwilligers, aangepast aan hun specifiek profiel en (eerder verworven) competenties. Binnen het uitgewerkte takenpakket zullen vrijwilligers begeleid worden om een zo aantrekkelijk mogelijke taak te vinden die aanleunt bij hun wensen, ervaringen en kennis. De vrijwilligers-omkadering wordt ook aangepast om zo efficiënt en slagkrachtig mogelijk overeen te stemmen met de noden van de organisatie en de vrijwilligers.

84 Op 7 december 2015 werd er door het Studiecentrum voor Militair Recht en Oorlogsrecht een studiedag georganiseerd over ‘Het recht van de gevechtsmiddelen: evolutie en status quaestionis’, dit met steun en interventie van het Belgische Rode Kruis die tijdens hun interventie een focus op nucleaire wapens hebben gelegd. 85 Zie Rode Kruis-Vlaanderen, Strategie 2020. Iedereen Helpt: “Rode Kruis-Vlaanderen is een vrijwilligersorganisatie en doet dus maximaal be-roep op vrijwilligers”, http://www.rodekruis.be/strategie2020/ .

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RKV AIS zal een competentiegericht opleidingsaanbod uitwerken op basis waarvan (nieuwe) vrijwilligers opgeleid worden bin-nen de thema’s van Internationale Samenwerking. RKV AIS gaat hiervoor bekijken welke actoren binnen de sector opleidingen of workshops aanbieden die deel kunnen uitmaken van dit opleidingsaanbod. Daarnaast kan RKV AIS ook rekenen op interne expertise, zoals onder andere van de diensten Eerste Hulp, Jeugd Rode Kruis en de vrijwilligerscoördinator om dit aanbod verder uit te bouwen. Via de opleidingen willen wij de vrijwilligers de kennis en skills aanbieden die verbonden zijn aan hun taken en de activiteiten die zij zullen uitvoeren, maar die ook bijdragen tot hun persoonlijke ontwikkeling als wereldburger. De taken en activiteiten die de vrijwilligers zullen uitvoeren, worden nog verder vorm gegeven aan de start van dit programma, maar er wordt vertrokken van de geleerde lessen in het vorige programma. Zo bijvoorbeeld zal RKV AIS expertisemissies door vrijwilligers organiseren. De thema’s van deze missies zullen voornamelijk gelinkt zijn aan eerste hulp (simulaties) en jeugd (opstellen van eerstehulprichtlijnen), waarbij de diensten Eerste Hulp en Jeugd Rode Kruis hun expertise aanleveren.

Naast het blijvend ondersteunen van de huidige vrijwilligersgroep is ook het uitbouwen van een nieuwe instroom een van de aandachtspunten in onze werking. Hierbinnen hebben we specifieke aandacht voor diversiteit en gender. Op basis van uitge-werkte competentieprofielen worden specifieke profielen aangetrokken.

Thematisch werken

Doorheen de bovenvermelde interventiedomeinen wordt een thematische werking aangewend, die de rode draad vormt door-heen de communicatie, het activiteitenaanbod, de opleidingen, enz.

In J1 zetten wij in op het prioritaire thema migratie. Tijdens de opleidingsdagen die gepland staan zullen getuigenissen aan bod komen en zullen de actuele uitdagingen verbonden aan migratie toegelicht worden. In de communicatie zetten we extra in op het belichten van dit thema, onder meer door een expertenblog op www.rodekruis.be en actieve communicatie rond de Internationale dag van de Vermisten. Bovendien willen wij met de vrijwilligerskern minstens één grote activiteit rond het thema migratie uitwerken, meer bepaald in het kader van het 80-jarig bestaan van de dienst Tracing op 30 augustus 2017. Door een onderzoek naar de effecten van migratie, verbonden aan de RK ervaringen, willen wij vrijwilligers beter kunnen sensibiliseren rond dit thema.

In de periode 2017-2021 schuiven we als thema’s de volgende opties naar voor: migratie, stille rampen, IHR, fundamentele principes, klimaatverandering, noodhulp, ontwikkelingshulp en duiding van het Rode Kruis-embleem. De keuze van de effec-tieve thema’s zal gemaakt worden op basis van de actualiteit en/of actuele noden, ervaring en expertise van het RK.

Outcome 2 IHR

Link met GSK Zoals beschreven in het hoofdstuk ‘Relevantie’, vormt IHR een onderdeel van het prioritaire thema Mensenrechten. RKV richt zich inzake op het versterken van de actoren met een multiplicatoreffect waaronder de intermediaire actoren, zoals erkend door de GSK België in de benaderingen C3.3 en C3.5. De doelgroepen die wij hieronder beschouwen zijn in de eerste plaats (maar niet exclusief): journalisten, medisch personeel en militairen. Ook de humanitaire actoren, zoals onderschreven in de benaderingen C5.1 en C5.2 van de GSK België spelen hier een rol. De GSK België erkent ook dat voor de volwaardige realisatie van mensenrechten een verbetering van het beleid op het Belgische, Europese en internationale niveau en de toepassing van internationale akkoorden cruciaal zijn.86 RKV onderschrijft daarom de benaderingen D1.1, D1.2, D2.1, D3.1, D3.2 van de GSK België en bouwt haar werking naar beleidsmakers verder uit in het kader van dit programma.

Na afweging van tijd en middelen versus impact werd besloten om de GSK benaderingen B1.1, B1.2 en B2.2 uiteindelijk niet op te nemen als engagement, in tegenstelling tot wat vermeld staat in de GSK België. In dit programma wordt nog ingezet op een werking naar universiteiten, maar vanuit het standpunt dat universiteiten actoren met een multiplicatoreffect zijn, zoals ze ook omschreven zijn in de GCA Noord.87 Voor de werking naar universiteiten verwijzen wij bijgevolg naar de GSK benadering C3.5.

Interventiestrategie We kiezen ervoor om in onze interventiestrategie in te zetten op twee grote domeinen om de expertise te versterken bij de doelgroepen: informatievoorziening en beleidsbeïnvloeding.

Informatievoorziening

Informatie en kennis verwerven over het IHR is een voorwaarde voor de doelgroepen om hun expertise inzake te versterken. In kader van de GSK benaderingen C3.3, C3.5 en D3.1 werken we in eerste orde samen met het CRB-Cf en ICRC Brussel maar ook het NRK, BTC, het Ministerie van Defensie en de universiteiten. RKV is, net als het CRB-Cf, het NRK en ICRC Brussel, lid van de Beweging en heeft onder andere via operaties van het ICRC toegang tot enorme kennis over het IHR. De Beweging is ook een motor in de ontwikkeling van het IHR.

86 GSK België, p.35. 87 Zie supra.

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Universiteiten vormen een netwerk van onderzoekers die een meer theoretische benadering van het IHR kunnen toelichten. Samenwerken met het Ministerie van Defensie laat ons toe om bij activiteiten ook het militaire aspect van IHR te belichten. Informatie verspreiden doen we digitaal via onze website, nieuwsbrieven en publicaties. Verder organiseren wij verschillende types van vormingen, zoals briefings, lessenreeksen, studiedagen en een pleitwedstrijd. Hierbij houden we telkens rekening met de noden en beschikbaarheden van de doelgroepen. Zo bijvoorbeeld houden we rekening met de politieke kalender wanneer we vormingen aanbieden aan beleidsmakers, zorgen we voor een erkenning van de opleidingen bij de balie opdat onze vormingen meetellen voor de permanente vorming van advocaten, we houden rekening met de beperkte tijd van de professionals en we focussen specifiek op thema’s die actueel zijn of waarmee de doelgroep actief aan de slag kan. Door zowel proactief als reactief te communiceren over IHR en in te spelen op vragen van de pers (een van onze doelgroepen), wordt bijgedragen tot een genuanceerde beeldvorming over en verduidelijking van de regels die van toepassing zijn in gewa-pende conflicten.88

Beleidsbeïnvloeding89

Belgische beleidsmakers hebben een rechtstreekse invloed op de naleving en verspreiding van het IHR, onder andere door de implementatie van internationale verplichtingen in de nationale wetgeving. Via de ICHR hebben wij als organisatie toegang tot de verschillende ministeries en departementen die betrokken zijn bij de verspreiding en implementatie van het internationaal humanitair recht. RKV zet voor beleidsbeïnvloeding vooral in op adviseren (bv. het aanleveren van input voor beleidsdocumenten, trainings), lobbying en (meer uitzonderlijk) advocacy, zoals blijkt uit de onderschreven benaderingen D2.1, D3.1, D3.2 in de GSK België.

Duurzaamheid

Outcome 1 AIS

Duurzaamheid vinden we terug op drie niveaus: het programma algemeen, in het thematisch werken en in de ontwikkeling van het ondersteunend materiaal. Algemeen

Voortbouwend op onze vorige programma’s werken we naar onze achterban waarbij we concreet vertrekken van hun leefwe-reld als vrijwilliger om Internationale Samenwerking dichterbij te brengen (individualisering van het engagement). We gaan verder op het idee dat het belangrijk is om de betrokkenheid voor ontwikkelingssamenwerking te vergroten via ontwikkelings-educatie, waarbij een kritische meningsvorming wordt gestimuleerd en wordt gestreefd naar een verandering van waarden, attitudes en gedrag.90 Op deze manier worden verantwoordelijke burgers gevormd; een kaart die we met de RK strategie ‘Ie-dereen Helpt’91 ook duidelijk trekken. Op deze manier dragen we bij tot het streven naar een meer rechtvaardige wereld.92 Duurzaamheid wordt verder beoogd door doelgericht in te zetten op vrijwilligersomkadering. Een goed voorbeeld waar we verder op bouwen is het idee rond de discipline overschrijdende groep IntAct93. De vrijwilligersomkadering moet de nodige flexibiliteit en ondersteuning bieden om vrijwilligers actief in te zetten rond de thema’s van internationale samenwerking. We gaan hier bekijken welke synergiën op termijn mogelijk zijn met andere vrijwilligersorganisaties voor het uitwisselen van best practices en geleerde lessen om vrijwilligers te activeren (Zie ook hoofdstuk ‘Synergie en complementariteit’). Zo zetten wij verder in op de ontwikkeling van een duurzame ondersteuning waarbij de focus ligt op het duurzaam activeren van de vrijwil-ligers. Thematisch werken

Zoals in het hoofdstuk ‘Doeltreffendheid’ naar voor kwam, wordt ervoor gekozen om thematisch te werken rond onder andere klimaatverandering en rampen, zoals bijvoorbeeld overstromingen. Dit zijn thema’s die kaderen binnen het overkoepelende thema: duurzaam leefmilieu.

88 Rode Kruis-Vlaanderen, ‘Strategie 2020. Iedereen Helpt’, zie supra. 89 Beleidsbeïnvloeding wordt door IOB gedefinieerd als “Policy influencing, lobbying and advocacy covers a wide range of activities conducted to influence decision-makers in the public and private sectors at international, national or local levels towards the overall aim of combating the structural causes of poverty and injustice and contributing to sustainable inclusive development”, Nederlandse Ministerie van Buitenlandse Zaken, Evaluation of Policy influencing, Lobbying & Advocacy, Terms of reference, 31 juli 2014, http://www.iob-evaluatie.nl/sites/iob-evalu-atie.nl/files/Terms%20of%20Reference%20evaluation%20of%20Policy%20Influencing,%20Lobbying%20%26%20Advocacy.pdf 90 Strategienota Ontwikkelingseducatie, zie supra. 91 Strategie 2020 van Rode Kruis-Vlaanderen, zie supra. 92 Strategienota Ontwikkelingseducatie, p.7 zie supra en hernomen in de GCA Noord, 2015. 93 Zie supra.

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Ondersteunend materiaal

Bij het ontwikkelen van ondersteunend materiaal zoals brochures en e-learningmodules houdt RKV rekening met de verander-lijke context en richten wij ons op de ontwikkeling van duurzaam materiaal, dat niet onmiddellijk verouderd is. Waar vroeger ingezet werd op papieren flyers en brochures om uit te delen op evenementen kiest RKV resoluut voor digitali-sering. Digitale nieuwsbrieven, een up-to-date website, elektronische opvolging van inschrijvingen, aanwezigheden en evaluaties van de activiteiten (zie ook de subtitel ‘Digitalisering’ onder het hoofdstuk ‘Relevantie’). Indien toch gekozen wordt voor gedrukte publicaties worden deze dubbelzijdig geprint. Door deze ook online aan te bieden kan de geprinte oplage bovendien beperkt worden.

Exit strategie De betrokkenheid van vrijwilligers ligt aan de basis van onze organisatie. Daarom wordt er geen exitstrategie voorzien voor wat de omkadering van vrijwilligers betreft.

Outcome 2 IHR

RKV is, zoals bepaald in artikel 3, §2 (3) van de Statuten van de Internationale Rode Kruis- en Rode Halve Maanbeweging, verantwoordelijk voor de verspreiding van het IHR. Als helper van de overheid ondersteunt RKV de Belgische overheid in de verspreiding van en in het bevorderen van de naleving van deze rechtstak. Het ontstaan en de evolutie van het IHR zijn ver-bonden met de Beweging waar RKV onderdeel van uitmaakt. Dit maakt dat RKV over de nodige expertise beschikt om in te staan voor deze verspreiding. Het internationale netwerk waarop zij kan rekenen voor actuele informatie versterkt deze positie.

RKV is dan ook al vele jaren actief rond IHR. In het vorige programma werd reeds gekozen om in te zetten op de verspreiding van humanitaire waarden, waaronder de principes van het IHR, naar professionals en beleidsmakers. Deze twee doelgroepen blijven behouden, waardoor we in de komende jaren verder bouwen op de realisaties en geleerde lessen op niveau van inter-venties in het kader van het vorige programma, bv. het organiseren van vormingen naar beleidsmakers. Netwerken en expertise die zijn opgebouwd ondersteunen mee de constante verfijning die we doorvoeren in onze werking.

Net zoals bij Outcome 1 AIS houdt RKV bij het ontwikkelen van materiaal zoals brochures en e-learnings rekening met de veranderlijke context en probeert ze materiaal te ontwikkelen dat herbruikbaar is. Verder wordt er ingezet op digitalisering door elektronische opvolging van inschrijvingen, aanwezigheden en attesten, maar ook voor de evaluatie van onze activiteiten gebruiken we een online tool. Er is een IHR website waarin permanent geïnvesteerd wordt om de nodige informatie over IHR online aan te bieden aan geïnteresseerden (Zie ook de subtitel ‘Digitalisering’ in het hoofdstuk ‘Relevantie’).

Exit strategie Zoals vermeld onder relevantie is er een toename in zowel aantal als complexiteit van gewapende conflicten, waardoor het belang van IHR blijvend is.94 Daarnaast zijn er ook verplichtingen onder het IHR waaraan in vredestijd voldaan moet worden. IHR is een kerntaak van elke nationale Rode Kruis- en Rode Halve Maanvereniging, en dus ook van RKV. Onze organisatie zal blijven inzetten op verspreiding en naleving van IHR. Een exit strategie wordt hier dus niet voorzien.

Doelmatigheid

In kader van haar Result-Based Management policy, werkt RKV bij het begroten van haar programma als volgt: • opstellen van het budget vertrekt vanuit de vooraf gedefinieerde outcomes en verwachte outputs. • de verwachte outcomes rechtvaardigen de vereiste middelen, die op hun beurt worden afgeleid van en verbon-

den aan de outputs en • waarvan de uitvoering van de verwachte outputs wordt gemeten door objectieve en smart indicators.

Bovendien is het budget gebaseerd op reële spenderingscijfers van het vorige programma 14-16 voor dezelfde activiteiten.

94 Zie supra

60

Outcome 1 AIS

1. Werking

De investeringskosten zijn beperkt tot 3.000 EUR (eenmalige aankoop laptop vrijwilligersomkadering en eenmalige aankoop fototoestel). De algemene werkingskosten bevatten de kosten voor bijscholingen van het personeel (2.400 EUR) en verplaatsingskosten van het perso-neel (2.500 EUR). Van de kosten voor activiteiten wordt een aanzienlijk bedrag geïnvesteerd in de expertisemissies door vrijwilligers (33.750 EUR). Reden daarvoor is de relatief hoge verplaatsings- en verblijfskosten. Ze hebben echter ook de grootste impact, die bovendien tweeledig is. Een expert draagt rechtstreeks bij aan het versterken van onze partners ter plaatse en helpen van kwetsbaren. Daarnaast heeft het inzetten van deze vrijwilligers ook in eigen land een grote impact. Door het delen van hun persoonlijke ervaringen bereiken we een bredere groep van RK vrijwilligers en andere geïnteresseerden. Daarnaast ontwikkelen we activiteiten ter ondersteuning van het bereiken van de vooropgestelde veranderingen. Deze activiteiten delen we op in drie grote groepen: opleidingen (14.237,50 EUR), communicatie (7.750 EUR) en het ontwikkelen van materiaal zoals een e-learning (6.000 (EUR). Daarnaast voorzien we nog vergader- en verplaatsingskosten van onze vrijwilligers in kader van de activiteiten (6.915 EUR).

2. Personeel

Zoals eerder aangegeven in dit programma zetten we volop in op het activeren van onze vrijwilligers. Dat doen we onder andere door het uitwerken van een coherente vrijwilligersomkadering, waarbij we inzetten op het uitschrijven van duidelijke taken met bijhorende competen-tieprofielen. Deze vrijwilligersomkadering vraagt in de eerste plaats een personeelsinzet. Zeker in de eerste jaren van het programma is een intensieve ondersteuning van een stafmedewerker noodzakelijk, net om rekening te houden met de uitbouw van de taken inzake activering en nieuwe tendensen in individueel engagement. Daarna zal de ondersteuning stilaan kunnen afnemen ten voordele van zelfstandige inzet van vrijwilligers, op voorwaarde dat het takenpakket van vrijwilligers niet verder wordt uitgebreid. We kiezen hier voor 1,5 FTE voor J1 en J2 en 1FTE vanaf J3. Dit verklaart de verhouding tussen de personeelskosten (78 %) en werkingskosten (21%).

Outcome 2 IHR

1. Werking

De investeringskosten zijn beperkt tot de aankoop van de nodige vakliteratuur om onze interventies te ondersteunen (500 EUR). De algemene werkingskosten bevatten de bijscholingen van het personeel (3.450 EUR) en overige binnenlandse verplaatsingskosten (1.500 EUR). De werkingskosten van onze activiteiten kunnen onderverdeeld worden in drie grote groepen. In de eerste plaats organiseren we vormingen (62.225 EUR)95. We zorgen ervoor dat deze kwaliteitsvol zijn door in te spelen op actuele tendensen van IHR en door zowel qua thema als qua methodologie rekening te houden met de noden van onze doelgroepen. Ten tweede ontwikkelen we materiaal om die vormingen te ondersteunen (15.500 EUR). Het gaat hierbij onder andere om interactieve modules en ondersteunende brochures. Ten derde hebben we activiteiten die gericht zijn op communicatie (7.500 EUR). Daarnaast voorzien we buitenlandse verplaatsingskosten verbonden aan kennisopbouw en beleidsvoorbereidend werk zoals de voorberei-ding en opvolging van de Internationale Conferenties (2.000 EUR), deelname aan internationale overlegfora over onze prioritaire thema’s (6.000 EUR) en uitwisseling van expertise via de overlegfora van de RK Beweging (7.500 EUR).

2. Personeel

Onze activiteiten over IHR zijn zeer kennis- en arbeidsintensief en vragen voornamelijk inzet van personeel (2 FTE) doordat wij onze expertise delen met de doelgroepen door bv. beleidsbeïnvloeding, briefings, actieve communicatie enz. Er wordt ingezet op kennisintensieve activitei-ten zoals het opvolgen van nationale en internationale vraagstukken over IHR en grondige thematische kennis. Dit verklaart de verhouding tussen de personeelskosten (85 %) en werkingskosten (15%).

95 Definitie vormingen zie supra.

61

Partnerschap

Betrokken partijen/partners

CRB-Cf en RKV werken beiden rond het nichethema IHR. Als helpers van de overheid hebben zij een uitzonderlijk mandaat, gefundeerd op dezelfde fundamentele beginselen. In het kader van dit programma werken wij naar dezelfde doelgroepen, namelijk professionals en beleidsmakers. Op federaal niveau worden onze inspanningen bovendien gecombineerd, waardoor wij bv. beleidsmakers en militairen een tweetalige vorming kunnen aanbieden. Het samenwerkingsakkoord met Defensie zorgt voor een duurzame samenwerking inzake IHR. Bovendien behoren militairen, als personen die het IHR rechtstreeks toepassen, tot een van onze belangrijkste doelgroepen. Het programmatiecomité, sa-mengesteld uit vertegenwoordigers van de betrokken partijen, bespreekt elk jaar de vooruitgang van het voorbije jaar en actieplan voor het komende jaar. Wat betreft de activiteiten varieert dit van het samen organiseren van studiedagen (bv. met het Studiecentrum voor Militair Recht en Oorlogsrecht), bijdragen aan elkaars vormingen (bv. de IHR lessenreeks van RKV of de cursus raadgevers recht der gewapende conflicten van de KMS), het aanbieden van specifieke vormingen aan de verschil-lende componenten (zoals civiele-militaire samenwerking (CIMIC) of de medische component) enz. Zie ook onder de hoofdstukken (‘Betrokken Partijen’, ‘ToC’ en ‘Synergie en complementariteit’ voor meer details inzake de rol- en taakbeschrijving van deze betrokken partijen.

Link met het Zuiden

In het Zuiden is het programma van RKV opgebouwd rond een structurele samenwerking met 9 Nationale Rode Kruisvereni-gingen.96 Hier werken we steeds binnen de 2 thematische specialisaties van RKV: Eerste Hulp (FA) en Water, Sanitatie, Hygiëne (WASH). Dit samenwerkingsmodel is geënt op het uitdragen van expertise en uitwisseling van ervaring. RKV AIS draagt hier in belangrijke mate aan bij door vrijwilligers met welbepaalde expertises in te zetten binnen de programma’s in het Zuiden. Ervaren vrijwilligers van de dienst Eerste Hulp worden bijvoorbeeld uitgestuurd om de kwaliteit rond simulatie-trainingen voor lesgevers in het Zuiden te garanderen en capaciteit te versterken.

Vanuit RKV AIS zal de nodige vrijwilligersomkadering worden aangeboden, wat zowel het voor- als natraject betreft. We ver-wijzen hiervoor ook naar de geleerde lessen in het kader van het partnerschap in het programma 14-16 (Zie hoofdstuk ‘Aanbevelingen en geleerde lessen’). Bovendien neemt RKV deel aan het Be-cause Health Platform waar uitwisselingen en kennisopbouw rond onze FA en WASH programma’s in het Zuiden wordt gedeeld en gevoed. De uitwisseling van expertise onderbouwt zowel onze projecten in het Zuiden als de ontwikkelingseducatie vervat in dit programma.

Via de thematische workshops en platformen (zoals bv. over Health Care in Danger) en de jaarlijkse ICRC legal advisors meeting, worden kennis en informatie met betrekking tot IHR en diverse subthema’s gedeeld binnen de hele Beweging. Dit is een we-derzijdse kans om expertise over internationaal humanitair recht wereldwijd, en dus inclusief het Zuiden, te leren kennen, om hier vervolgens uit te putten voor de activiteiten in België.

96 In de respectievelijke landhoofdstukken van het programma wordt deze doelstellingen gedetailleerd beschreven.

62

Platformen

Platform: Interministeriële Commissie voor Humanitair Recht

Link met GSK België Deze synergie kadert in de GSK doelstellingen C.3, C.5 D.1, D.2 en D.3 zoals door RKV onderschreven.

Objectief

Sinds 1994 is de Interministeriële Commissie voor Humanitair Recht (ICHR) erkend als vast adviesorgaan van de federale regering op het vlak van de toepassing en de ontwikkeling van het IHR. Deze Commissie is belast met het vaststellen en bestuderen van nationale uitvoeringsmaatregelen van het IHR, met het formuleren van voorstellen voor de overheden die bevoegd zijn om deze maatregelen te nemen en, ten slotte met het opvolgen en coördineren van de genomen maatregelen. De ICHR wordt ook erkend als nationaal adviescomité zoals bedoeld in Resolutie II van het Verdrag van 's Gravenhage van 1954 inzake de bescherming van culturele goederen in geval van een gewapend conflict.

Rol- en taakverdeling

RKV is covoorzitter samen met CRB-Cf van de werkgroepen ‘Verspreiding’ en ‘ Internationale Conferen-ties’. Ze deelt haar expertise over het IHR en de standpunten van de Beweging. RKV heeft dus een actieve en coördinerende rol.

Platform: ICRC legal advisors Meeting

Link met GSK België Deze synergie kadert in de GSK doelstellingen C.3, C.5, D.1, D.2 en D.3 zoals door RKV onderschreven.

Objectief

De ICRC Legal Advisors Meeting is een informeel overlegforum binnen de Beweging en bestaat uit de juridisch adviseurs en IHR-medewerkers van alle componenten van de Beweging. Het platform promoot het uitwisselen van informatie en het samenwerken over IHR, IHR gerelateerde thema’s en over internati-onale thema’s van belang voor de Beweging. Dit forum komt één keer per jaar samen en RKV is al vele jaren een actieve deelnemer.

Rol- en taakverdeling RKV neemt actief deel aan de vergaderingen van de ICRC Legal Advisors Meeting. Hier worden actuele thema’s binnen het IHR en ontwikkelingen binnen de Beweging gedeeld.

Platform: European Legal Support Group (ELSG)


Objectief

De European Legal Support Group (ELSG) is een informeel overlegforum binnen de Beweging en bestaat uit de juridisch adviseurs en IHR-medewerkers van alle Europese nationale verenigingen. Het platform promoot het uitwisselen van informatie en het samenwerken over IHR, IHR gerelateerde thema’s en over internationale thema’s van belang voor de Beweging. Dit forum komt één tot tweemaal per jaar samen en RKV is al vele jaren een actieve deelnemer.

Rol- en taakverdeling RKV neemt actief deel aan de vergaderingen van de ELSG. Zo deelt zij informatie over activiteiten en in-formeert zij over de positie van België inzake IHR gerelateerde thema’s.

Platform: Health Care in Danger Movement Reference Group (MRG)


Objectief

De Movement Reference Group (MRG) is opgericht in 2012. Momenteel zijn zo’n 30 nationale Rode Kruis-verenigingen, de Internationale Federatie van het Rode Kruis- en de Rode Halve Maanverenigingen (IFRC) en het Internationale Rode Kruiscomité (ICRC) lid van deze groep. De MRG heeft als doel om feedback en advies te geven aan het Health Care in Danger-team van het ICRC over activiteiten en uitdagingen verbonden aan de sensibilisering over dit thema. Health Care in Danger beoogt het mobiliseren van staten en de Community of Concern voor een betere toegang tot de gezond-heidszorg. Dit heeft onder andere als doel om tot een betere implementatie van de regels van het internationaal humanitair recht op nationaal niveau te komen.

Rol-en taakverdeling RKV is een actieve deelnemer aan de MRG. Zij deelt informatie over de Health Care in Danger gerela-teerde activiteiten in België, levert thema’s aan voor de webinars, etc.

63

Synergie & complementariteit

Outcome 1 AIS

Synergie/complementariteit met CRB-cf

Soort Informationele synergie

Link met GSK België RKV en CRB-Cf onderschrijven de GSK doelstelling C2.1.

Objectief van de syner-

gie/complementariteit

Uitwisseling van geleerde lessen inzake vrijwilligerswerking

Betrokken actoren RKV CRB-Cf


RKV en CRB-Cf gaan informatie (geleerde lessen, best practices) uitwisselen over hun vrijwilligerswer-king. Verder willen RKV en CRB-Cf in de loop van het komende programma bekijken of een kennismaking tussen de vrijwilligers van beide organisaties het gevoel van verbondenheid tussen de eigen leefwereld en de internationale thema’s kan vergroten.

Meerwaarde van de syner-


Inzake vrijwilligerswerking onderscheiden RKV en CRB-Cf zich van andere, vaak meer militante vrijwil-ligersorganisaties, waardoor het niet altijd evident is om synergiën aan te gaan. Met CRB-Cf deelt RKV dezelfde fundamentele principes waaronder neutraliteit, onpartijdigheid en vrijwilligheid. Hoewel de inzet van vrijwilligers naar het soort activiteiten kan verschillen, beogen beiden het optimaal be-trekken van vrijwilligers bij de activiteiten van onze organisatie.

Logistieke bijdrage Bilateraal overleg: ter beschikking stellen van lo-catie

Bilateraal overleg: ter beschikking stellen van lo-catie

Financiële bijdrage Elke actor staat in voor de eigen kosten verbonden aan deze synergie.

Budget 0 EUR

Mogelijke toekomstige Synergieën/complementariteiten

Soort

In het kader van de voorbereidingen van dit programma werd er onderzocht welke mogelijke synergiën een meer-waarde kunnen betekenen bij de uitvoering van dit programma. In de loop van dit programma zullen we verder onderzoeken of een hogere graad van synergie en complementariteit mogelijk is met de volgende actoren en eventu-eel stappen zetten richting samenwerking.

NRK

Objectief van syner-


Het NRK heeft op haar tracing dienst een vrijwilligerswerking uitgebouwd. We gaan met hen bekijken wat de voor- en nadelen zijn van deze werking en welke taken de vrijwil-ligers precies uitvoeren. Verder gaat er bekeken worden of het uitwisselen van best practices en geleerde lessen mogelijk is.

Link met GSK België Deze synergie is gelinkt aan de GSK doelstelling C.2.1.

Minderhe-

denforum

Objectief van synergie /

complementariteit

Informatie delen over migratie. Het minderhedenforum heeft als belangrijkste doelstel-ling om mensen met een migratie-achtergrond een stem te geven. RKV AIS heeft migratie als prioritair thema opgenomen.

Link met GSK België Deze synergie is gelinkt aan de GSK doelstellingen C1.1 en C.2.1.

Red Cross EU

Office



Red Cross EU Office vertegenwoordigt 29 Nationale Rode Kruisverenigingen in de Euro-pese Unie, Noorwegen en de Internationale Federatie van de Rode Kruis- en Rode Halve Maanverenigingen. Een van de onderwerpen waar zij actief in zijn is asiel en migratie. Migratie zal een van de prioritaire thema’s zijn in de werking van AIS en informatie-uitwisseling met Red Cross EU office en kan dus een meerwaarde betekenen voor de uitbouw van de activiteiten in het kader van de vrijwilligerswerking. Als deel van de Beweging werken beiden volgens dezelfde fundamentele principes.

Link met GSK België Deze synergie is gelinkt aan de GSK doelstellingen C1.1 en C.2.1.

64

Outcome 2 IHR

Synergie/complementariteit met CRB-Cf

Soort Operationele en informationele synergie en complementariteit (zie ook hierboven bij ‘Betrokken par-tijen’ en ‘Partnerschap’).

Link met GSK België CRB-Cf en RKV onderschrijven de GSK doelstellingen C.3, C.5, D.1, D.2 en D.3.



Verspreiden van het IHR naar professionals en het versterken van de samenwerking met de Belgische autoriteiten om de naleving van IHR te bevorderen (in de rol van ‘helper van de overheid’ zoals bepaald in de Statuten van de Beweging en de respectievelijke statuten van CRB-Cf en RKV).

Betrokken actoren RKV CRB-Cf


RKV staat in voor de verspreiding van het IHR voor de Nederlandstalige gemeenschap. CRB-Cf staat in voor de verspreiding van het IHR voor de Franstalige gemeenschap. De twee gemeenschappen organiseren gezamenlijke activiteiten naar het tweetalige publiek (bv. mili-tairen) of Engelstalige publiek (bv. Introductory seminar on IHL). Hierbij werken ze samen zowel voor de inhoudelijke als logistieke uitwerking. CRB-Cf en RKV werken gezamenlijk naar de Belgische autoriteiten ter bevordering van de naleving van het IHR (bv. bilaterale overlegmomenten met beleidsmakers, input geven voor beleidsdocumenten, informeren over de positie van de Beweging, vormingen, de ontwikkeling van ondersteunend materi-aal) Jaarlijks vindt een overleg plaats tussen het CBR-Cf en RKV waarbij de samenwerking wordt besproken en de actiepunten voor het komende jaar worden opgelijst.



De beide gemeenschappen spreken in één stem over de positie van de Beweging op nationaal niveau en positioneren zich coherent. De principes van het IHR, de kernboodschappen en aanbevelingen die gedaan worden, zijn uniform. CRB-Cf en RKV werken volgens dezelfde fundamentele principes.

Logistieke bijdrage Bilateraal overleg: ter beschikking stellen van locatie

Financiële bijdrage

RKV en CRB-Cf staan elk in voor hun eigen verplaatsingskosten in het kader van overlegmomenten. RKV en CRB-Cf dragen elk 50% van de kosten verbonden aan de ontwikkeling en druk van ondersteu-nend materiaal naar gemeenschappelijke doelgroepen (bv. brochure voor beleidsmakers). In J3 en J5 wordt er een evaluatie gepland van de gezamenlijke activiteiten naar beleidsmakers, waarbij RKV en CRB-Cf elk 50% van de kosten dragen.

Budget97 21.100 EUR

97 Het budget dat in dit hoofdstuk wordt opgenomen betreft enkel de kosten voor RKV.

65

Synergie/complementariteit met het Ministerie van Defensie

Soort Operationele synergie (zie ook hierboven bij ‘Betrokken partijen’ en ‘Partnerschap’)




Zoals in de GCA Noord vermeld, heeft het Belgische RK (beide gemeenschappen) een samenwerkings-akkoord met het Ministerie van Defensie op het gebied van vorming en internationaal humanitair recht. De doelstelling: In 2012 werd een schriftelijk samenwerkingsakkoord afgesloten tussen het Belgische RK en het Minis-terie van Defensie. Dit akkoord streeft naar de verwezenlijking van synergie tussen gelijksoortige activiteiten in het internationaal humanitair recht en logistieke ondersteuning als het gaat over vor-mingen.

Betrokken actoren RKV Ministerie van Defensie


RKV ondersteunt het Ministerie van Defensie door als expert, spreker of observator op te treden in activiteiten van het Ministerie van Defensie (bv. spreker bij de opleiding Raadgevers Recht der Ge-wapende conflicten). Verder neemt RKV deel aan trainingsactiviteiten en voorziet hierbij in praktijkoefeningen (over o.a. de positie van het ICRC, het embleem). RKV werkt mee aan de studiedagen van het Stu-diecentrum voor militair recht en Oorlogsrecht (voorstellen van onderwerpen, contacteren van sprekers, zelf optreden als spreker) en is vertegen-woordigd in het bestuur. Jaarlijks wordt het samenwerkingsakkoord geëva-lueerd op een vergadering van het Programmatiecomité, met aandacht voor nieuwe samenwerkingsmogelijkheden.

Het Ministerie van Defensie ondersteunt activitei-ten van RKV als expert, spreker of observator bij activiteiten van het RKV (bv. jurylid bij de Frits Kalshoven Competitie). Het Studiecentrum voor militair recht en Oorlogs-recht organiseert studiedagen en krijgt hiervoor onderwerpen aangereikt door RKV via haar aan-wezigheid in het Wetenschappelijk comité. Jaarlijks wordt het samenwerkingsakkoord geëva-lueerd op een vergadering van het Programmatiecomité, met aandacht voor nieuwe samenwerkingsmogelijkheden.



Activiteiten naar militairen: Samenwerking inzake vormingen naar militairen zorgt ervoor dat militairen van alle rangen en van de verschillende componenten worden gevormd en gesensibiliseerd inzake IHR. RKV kan haar expertise over bepaalde onderwerpen binnen het IHR (bescherming van beschermde personen, humanitaire hulpverlening, civiel-militaire relaties) of onderwerpen verbonden aan de operationele activiteiten van de RK-Beweging (de positie van het ICRC op terrein) delen. Dit is essentieel voor de militairen die op terrein in aanraking komen met een of meerdere componenten van de Beweging. Activiteiten georganiseerd door RKV naar andere doelgroepen dan militairen: Het Ministerie van Defensie beschikt over de nodige praktijkervaring en kan een militaire interpretatie van de regels van het IHR geven. Dit zorgt ervoor dat onze vormingen niet alleen een RK perspectief over IHR inhouden maar dat ook andere standpunten inzake IHR aan bod kunnen komen.

Logistieke bijdrage

RKV neemt de kosten voor de eigen activiteiten voor eigen rekening. Ook de eigen vervoerskos-ten voor activiteiten in samenwerking met het Ministerie van Defensie neemt RKV voor eigen re-kening. Bilateraal overleg: ter beschikking stellen van lo-catie

Het Ministerie van Defensie voorziet de infra-structuur voor de eigen activiteiten. Bilateraal overleg: ter beschikking stellen van lo-catie


Budget 0 EUR

66

Synergie/complementariteit met ICRC Brussel

Soort Operationele en informationele synergie/complementariteit




Het versterken van de kennis over IHR bij specifieke doelgroepen. De positie van de Beweging over IHR gerelateerde thema’s op nationaal en internationaal niveau delen en verspreiden.

Betrokken actoren RKV ICRC Brussel


RKV organiseert samen met het ICRC Brussel, CRB-cf en het Network on Humanitarian Action (NOHA) een Engelstalige opleiding rond internationaal humanitair recht, gericht op Europese en Belgische be-leidsmakers. Specifiek werkt RKV mee aan de uitwerking van het programma en het promotiemateriaal en ondersteunt zij tijdens de opleidingsdagen zelf, dit zowel logistiek als als spreker. RKV en ICRC wisselen informatie uit over hun respectievelijke inspanningen in het verspreiden en be-vorderen van de naleving van IHR. Daarnaast beschikt het ICRC Brussel over terreininformatie die RKV gebruikt in haar activiteiten. Het ICRC levert inhoudelijke informatie en treedt op bij RKV activiteiten als spreker (bv. spreker tijdens de Frits Kalshoven Competitie). Wat de doelgroepen betreft, richt ICRC Brussel zich in de eerste plaats op de Europese en internationale instellingen en organisaties, waaronder de NAVO. Dit betreft dus een complementariteit met de acti-viteiten van RKV. Enkel wat betreft Belgische beleidsmakers is er een gedeeltelijke overlapping inzake werking, maar dit wordt goed op elkaar afgestemd door middel van een regelmatig overleg.



De uitwisseling van informatie over de respectievelijke inspanningen in het kader van de verspreiding en het bevorderen van de naleving van het IHR zorgt voor een complementariteit en coherentie in-zake het verspreiden en delen van de positie van de Beweging. Het ICRC deelt haar ervaring over de toepassing van het IHR op het terrein, RKV deelt haar ervaring over de implementatie van IHR op na-tionaal niveau en identificeert de noden van de doelgroepen.

Logistieke bijdrage n.v.t.


Budget 0 EUR

Synergie/complementariteit met het NRK

Soort Operationele en informationele synergie

Link met GSK België Deze synergie kadert in de GSK doelstellingen C.3 en C.5 zoals door RKV onderschreven.



Sinds 2011 organiseert RKV jaarlijks in samenwerking met het NRK een Engelstalige pleitwedstrijd: de Frits Kalshoven Competition on International Humanitarian Law. Beide organisaties zijn als ‘helper van respectievelijk de Belgische en de Nederlandse overheid’ gehouden tot het ondersteunen van hun overheid in de verspreiding van het IHR.

Betrokken actoren RKV NRK


Het gemeenschappelijk mandaat inzake IHR maakt samenwerking in het kader van de Frits Kalshoven Competitie mogelijk. Deze samenwerking omvat zowel de logistieke uitwerking (bv. regelen van ver-voer, locatie) als de inhoudelijke uitwerking (bv. programma uitwerken, promotiemateriaal ontwikkelen, casus uitschrijven, sprekers kiezen en contacteren). Een samenwerkingsovereenkomst wordt jaarlijks afgesloten om de financiële verdeling tussen beide partijen inzake te bepalen.98



Het kunnen steunen op de wederzijdse contacten maakt dat beide organisaties hun netwerk verder kunnen uitbouwen, wat leidt tot meer uitwisseling van ervaringen en expertise. De samenwerking zorgt ervoor dat het te bereiken doelpubliek groter is dan wanneer de activiteit gedragen zou worden door RKV alleen.

Logistieke bijdrage Bilateraal overleg: ter beschikking stellen van loca-tie

Bilateraal overleg: ter beschikking stellen van locatie

Financiële bijdrage Jaarlijks wordt een overeenkomst afgesloten die de financiële verdeling tussen beide partijen inzake bepaalt.

Budget 22.800 euro

98 Dit was ook het geval in het programma 14-16.

67

Synergie/complementariteit met BTC

Soort Operationele synergie

Link met GSK België Deze synergie kadert in de doelstellingen C.3 en C.5 van de GSK zoals door RKV onderschreven.

Objectief van de synergie/

complementariteit

Via de samenwerking met BTC kunnen we (potentiële) ngo-medewerkers vormen over IHR. In 2014-2015 is de basisopleiding door BTC grondig herzien, waardoor de module van IHR niet meer in elke cyclus is opgenomen. Ondanks deze hervorming behouden we een goede samenwerking met BTC en behalen we een aanzienlijk bereik van zo’n 150 personen per jaar.

Betrokken actoren RKV BTC


RKV geeft een module over het IHR in de infocy-clus.

BTC organiseert Infocyclussen over mondiale uit-dagingen. Zij neemt de logistieke en inhoudelijke uitwerking van deze cyclussen voor eigen reke-ning (locatie, zoeken en contacteren sprekers).

Meerwaarde van de

synergie/complementari-

teit

Verschillende thema’s rond ontwikkelingseducatie worden in één aanbod gegroepeerd. BTC richt zich op toekomstige en huidige humanitaire medewerkers. RKV heeft een forum waar ze haar doelgroep kan bereiken.

Logistieke bijdrage

RKV voorziet in een presentatie en ondersteunend materiaal (bv de brochure: ’IHR: Antwoorden op je vragen’).

BTC voorziet in de locatie.

Financiële bijdrage n.v.t.

Budget Aan deze synergie verbinden we geen budget. We beschrijven deze synergie hier ter volledigheid, maar vragen voor de activiteiten met BTC geen financiering in het kader van dit programma.

Mogelijke toekomstige Synergieën/complementariteiten

Soort

In het kader van de voorbereidingen van dit programma werd er contact genomen met verschillende organisaties om te bekijken welke synergiën/complementariteit mogelijk zijn. Er werd besloten dat er op dit moment geen syner-gie/complementariteit mogelijk is met Oxfam, Advocaten zonder Grenzen en Handicap International.

Met volgende organisaties zien we die mogelijkheid wel en zullen we doorheen het programma verder onderzoeken of een hogere graad van synergie en complementariteit mogelijk is met de volgende actoren en mogelijk stappen zetten richting samenwerking.

RCN Justice

et Démocra-

tie



RKV en RCN Justice et Démocratie werken complementair. RKV werkt rond de rechtsre-gels van toepassing tijdens gewapende conflicten terwijl RCN Justice et Démocratie focust op de impact van massageweld, waaronder gewapende conflicten, op perso-nen/de samenleving. Beide actoren kennen een overlapping in doelgroepen die de thematische complementariteit versterkt (bv. magistraten, journalisten, diplomaten). Deze complementariteit kan in het komende programma verder uitgewerkt/onderzocht worden, waarbij aandacht gaat naar het onderzoeken hoe we beter op elkaars expertise beroep kunnen doen.

Link met GSK België RCN Justice et Démocratie en RKV onderschrijven elk de volgende gemeenschappelijke GSK doelstellingen: C.3, C.5 D.1, D.2 en D.3.

Plan België



Plan België en RKV werken complementair op het vlak van de implementatie van inter-nationale verdragen. De focus van Plan België ligt op het thema van kinderrechten, terwijl de aandacht van RKV uitgaat naar het IHR. Toch zien de organisaties een mogelijke the-matische overlapping, wanneer het bijvoorbeeld gaat over het seksueel en gender-gebaseerd geweld. Een informatie-uitwisseling over elkaars activiteiten rond dit thema wordt dus van meerwaarde geacht.

Link met GSK België Plan België en RKV onderschrijven elk de volgende gemeenschappelijke GSK doelstellin-gen: C.3, C.5, D.1, D.2 en D.3.

Unicef



Inzake het waken over het respect voor Internationale Verdragen werken Unicef België, RKV en CRB-Cf complementair. Het Verdrag voor de Rechten van het kind vormt de basis voor de werking van UNICEF België. Voor RKV/CRB-Cf zijn de verdragen gelinkt aan IHR. Unicef België, RKV en CRB-Cf kunnen samenwerken rond bepaalde thema’s die zich op de kruising bevinden tussen het IHR en de rechten van het kind (bijvoorbeeld: gebruik van ziekenhuizen door gewapende groepen, kindsoldaten, seksueel geweld). Deze even-tuele samenwerkingen kunnen zich op ad hoc basis voordoen.

Link met GSK België Deze complementariteit is gelinkt aan de GSK doelstellingen C.3, C.5, D.1, D.2 en D.3.

68

Burundi

Outcome 1 WASH L’utilisation durable de suffisamment d’installations d’eau et d’assainisse-ment sûres ainsi que des attitudes et pratiques d’hygiène sûres et durables dans la population cible d’ici 2021.

Outcome 2 Premiers Secours Les profanes, le personnel et les volontaires Croix-Rouge possèdent les attitudes, capacités et connaissances adéquates, à-jour et evidence-ba-sed pour donner les premiers secours à ceux qui en ont besoin, et ce, d’ici 2021. De telle façon, ils augmentent le niveau de résilience de la communauté et la capacité de soins d’urgences.

2017-2021

69

Samenvatting

‘Rode Kruis-Vlaanderen (RKV) helpt helpen’ is de slogan die het 17-21 programma in Burundi samenvat. Enerzijds verwijst dit naar de focus op zelfredzaamheid, anderzijds naar de focus op impact. Mensen zelfredzaam maken is de manier bij uitstek om een duurzame impact te hebben. Zowel RKV’s interventiestrategie als de keuze van activiteiten in Burundi zijn gebaseerd op het idee van zelfredzaamheid. RKV’s interventiestrategie heeft als kernprincipe dat de implementatie van het programma geleid en gedragen wordt door de lokale Rode Kruis vereniging en haar vrijwilligers. RKV neemt een ondersteunende rol op zich maar zal zelf geen directe imple-mentatie doen. Het 17-21 programma, met een totaalbudget van 1.490.756 EUR wordt dan ook getrokken door het Croix-Rouge Burundaise (CRB). Het programma is op vraag van en in nauwe samenwerking met CRB opgesteld. CRB is ook de groot-ste nationale humanitaire organisatie van Burundi en is actief in het hele land. Het programma in Burundi is opgebouwd uit de twee thematische specialisaties van RKV: water, sanitatie & hygiëne (WASH) en eerstehulponderricht. Beide interventies houden rekening met de prioriteiten van de Belgische ontwikkelingssamenwerking rond gender, milieu en klimaat, mensenrechten, digitale innovatie en waardig werk.

WASH Volgens cijfers die bekomen werden na een spot check in augustus 2016, heeft slechts 51% van de bevolking uit onze inter-ventiezone (Ngozi provincie) toegang tot drinkbaar water en beschikt slechts 14% over sanitaire voorzieningen. Vrouwen, die vaak verantwoordelijk zijn voor taken rond water in het huishouden, worden bijzonder hard getroffen. Het programma van RKV beoogt daarom om 32.344 mensen (direct) en 161.720 (indirect) in de gemeente Nyamurenza te voorzien van voldoende en veilige water- en sanitatie-voorzieningen. Dit doen we door het bouwen en rehabiliteren van 100 waterpunten en 1.000 mili-euvriendelijke ecosan-toiletten. Daarnaast worden 4 scholen uitgerust met latrineblokken die tegemoet komen aan de noden van meisjes rond privacy en hygiëne, vooral tijdens hun maandelijkse menstruatieperiode. Hoewel adequate en toegankelijke infrastructuur essentieel is, is de impact beperkt wanneer toegang niet gekoppeld wordt aan gedragsverandering. Naast het opleiden van Comités Points d’Eau (CPE) die instaan voor een correct gebruik en onderhoud van het waterpunt, zullen elementen uit onder andere de nationale MénagesModeles aanpak worden aangewend om het be-wustzijn van de lokale bevolking rond toiletgebruik te verhogen. Rode Kruis-Vlaanderen heeft via haar “Center for Evidence-Based Practice” (CEBaP) de nodige expertise in huis rond methodes die leiden tot effectieve gedragsverandering. CRB-vrijwil-ligers zullen dan ook worden opgeleid in deze sensibilisatiemethodes alvorens te worden ingezet in de volledige interventiezone: niet enkel in Nyamurenza maar ook in de twee gemeenten Busiga en Mwumba waar RKV in synergie werkt met Protos. Het economisch rendement van een WASH-interventie is groot: de Wereldgezondheidsorganisatie berekende dat er voor elke US$ geïnvesteerd in WASH, een economisch rendement van 4 US$ wordt gegenereerd99. Daarnaast verklaart ook de Wereld-bank dat hygiënepromotie een van de meest kosteneffectieve interventies is, en zelfs leidt tot een negatieve kost per DALY100: de kosten voor het bevorderen van hygiëne liggen lager dan de kosten voor de behandeling van water-gerelateerde ziektes zoals diarree. Deze interventie gebeurt in sterke coördinatie met Protos die binnen Busiga en Mwumba het bouwen/rehabiliteren van WASH-infrastructuur op zich zal nemen. De capaciteitsopbouw, voortgebracht door deze synergie; is groot. De ervaring die Protos heeft in het bouwen van Ecosan-toiletten, zal gedeeld worden met CRB-vrijwilligers die binnen Nyamurenza op hun beurt toiletten zullen bouwen via de Ecosan techniek.

Eerste hulp Door CRB personeelsleden, CRB vrijwilligers en leken op te leiden in eerste hulp wordt de bevolking van Burundi zelfredzaam gemaakt. Bovendien is er een duurzaam multiplicator effect door het opleiden van de ‘master trainers101’ (11.787 directe be-gunstigden en 66.135 indirecte begunstigden). De aanwezigheid van dergelijke ‘First Responders’ is van groot belang in een land dat kampt met een systemisch gebrek aan basisgezondheidsinfrastructuur, zeker in tijden waarin de kans op politiek geweld een reële dreiging is. De slechte staat van de wegen en het gebrek aan tijdige hulp na een ongeval, verhogen daarnaast de menselijke tol van verkeersongevallen. Deze interventie richt zich in de eerste plaats op de CRB hoofdzetel in Bujumbura, die in staat zal worden gesteld om een kwalitatieve ondersteuning te bieden aan de die plaats vinden verspreid over het hele land. De trainingscapaciteit van CRB zal

99 Hutton G (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal cov-erage, p4. WHO, Geneva, Switzerland. 100DALY is een maatstaf die werd ontwikkeld door de Wereldgezondheidsorganisatie. De DALY meet niet alleen het aantal mensen dat vroegtijdig sterft door ziekte, maar meet ook het aantal jaren dat mensen leven met beperkingen door ziekte. In maatschappelijke kosten-batenanalyses worden DALY's ook toegepast om de kosteneffectiviteit van gezondheidsinterventies te bepalen. Laxminarayan et al. (2006). Intervention Cost-

Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2. 101 Trainers die andere trainers kunnen opleiden.

70

worden versterkt met 91 eerstehulptrainers waaronder 6 master trainers. Ook wordt een opleiding eerste hulp en verkeersvei-ligheid ontwikkeld. Naast het opleiden in eerste hulp, wil RKV de zelfredzaamheid van CRB versterken door hen in staat te stellen financieel auto-noom te investeren in eerstehulpactiviteiten. Hierdoor garanderen we een grotere duurzaamheid van de activiteiten. RKV wil dit doen door CRB te ondersteunen in het uitbouwen van bedrijfseerstehulp. Dit doen we in de eerste plaats via kennisover-dracht (workshops rond marketing en het opzetten van een kostenmodel). De uitbouw van bedrijfseerstehulp ligt in lijn met de ‘Waardig Werk’ prioriteiten van Burundi rond veiligheid en preventie op de werkvloer. Naast zelfredzaamheid is impact een belangrijke focus van het RKV programma in Burundi. Een studie van de Wereldbank toont aan dat het investeren in de opleiding van eerstehulp vrijwilligers één van de meest kosteneffectieve interventies is met een kost van slechts 8 US$ per vermeden DALY102. Bovendien investeert RKV via het CEBaP continu in onderzoek naar inter-ventiestrategieën met de meeste impact. Zo onderzoeken we onder andere het effect van simulaties in eerstehulpopleidingen of welke eerstehulpkennis op welke leeftijd kan onthouden worden. De resultaten van deze onderzoeken zijn geïntegreerd in RKV’seerstehulp-ondersteuning aan CRB. Daarnaast heeft het CEBaP evidence-based eerstehulprichtlijnen uitgewerkt die vol-ledig aangepast zijn aan de Afrikaanse context. Het eerstehulpopleidingsmateriaal van CRB zal op basis hiervan herzien worden zodat steeds de meest doeltreffende eerstehulppraktijken worden aangeleerd. Gedurende alle fases van de interventie, wordt een gender-sensitieve benadering gehanteerd: in de eerstehulptrainingen wordt aandacht geschonken aan situaties die specifiek van toepassing zijn op vrouwen, zoals bevallingen zonder medische assistentie. Aan de hand van gender-gedesaggregeerde indicatoren zullen verwezenlijkingen in kaart worden gebracht. Daarnaast zullen inspanningen worden gedaan om de impact van onze interventie op het milieu te beperken, door onder andere de aankoop van lokale materialen. Door beide interventies heen wordt een synergie aangegaan met het Croix-Rouge de Belgique – Communauté francophone (CRB-Cf). RKV zal ook in de interventiegebieden van CRB-CF CRB-vrijwilligers opleiden in eerstehulp, terwijl CRB-Cf de vrijwil-ligers in Ngozi dan weer de aanpak rond ‘income generating activities’ zal bijbrengen. RKV gelooft ten stelligste dat het 17-21 programma in Burundi rond WASH enerzijds en eerstehulponderricht anderzijds door zijn focus op zelfredzaamheid en duurzame impact sterk bijdraagt tot een verhoogde toegang tot eerstelijns gezondheidszorg en WASH voorzieningen. Op die manier komt het programma tegemoet aan de Gemeenschappelijke Strategische Doelstelling 4103 en 6104 van het Gemeenschappelijk Strategisch Kader Burundi en aan de Sustainable Development Goals 1, 3, 5, 6, 8 & 13.

102Laxminarayan et al. (2006). ibid. 103 De toegang tot en kwaliteit en beschikbaarheid van gezondheidszorg voor allen verzekeren en verbeteren (preventief, curatief, re-adaptief en gezondheidspromotie). 104 De toegang tot water en sanitatie verbeteren voor allen en een duurzaam en participatief beheer van watervoorzieningen verzekeren.

71

Fiche Pays

Frais opérationnels totaux

pour le pays (EUR) 1.490.756

Personne de contact qui

représente l'ACNG dans le

pays :

Nom : Jan Van der

Zwalmen

Organisation : Croix-

Rouge de Belgique -

Flandres (CRB-Fl)

Téléphone :

00257 71 961 382

E-mail : jan.vanderzwal-

[email protected]

Résumé narratif du pays du programme

La CRB-FL travaille au Burundi depuis 2007, principalement dans les domaines Premiers Secours et WASH, et toujours avec son partenaire préférentiel, la Société Nationale de Croix-Rouge du Burundi (CRB).

Entre 2017 et 2021, la coopération continuera à se concentrer sur les formations aux Premiers Secours et prestations de services (eau et assainissement). La CRB-FL se concentre sur ces deux domaines d’intervention afin d’être capable de donner une valeur ajoutée réelle au partenariat. Les PS constituent une activité prioritaire dans toutes les sociétés Croix-Rouge au monde et est particulièrement pertinente au Burundi pour plusieurs raisons. Une de ces raisons est la vulnérabilité aux catas-trophes liées au changement climatique (sécheresse, érosion…) qui menacent la population et surtout la population la plus vulnérable. D’autres raisons sont la défaillance des soins de santé primaires et la violence politique liée à l’instabilité politique continuelle. Ces éléments soulignent le besoin de volontaires Premiers Secours compétents. L’éducation aux PS forme une intervention très efficace, avec un coût de 8 $ par ‘DALY’105. évité (disability-adjusted life year, c’est-à-dire : AVCI, nombre d’années de vie corrigé du facteur d’incapacité). Ceci rend la formation aux PS un des moyens les moins chers pour améliorer la santé publique dans les pays en cours de développement. La CRB-FLa une vaste expérience en formation aux PS qui assure que ce qui est enseigné est conforme aux données scientifiques probantes les plus récentes. Ainsi 11.787 personnes bénéfi-cieront directement de l’intervention PS et grâce au grand effet de cascade, 66.135 bénéficiaires indirects seront atteints.

Deuxièmement, un accès suffisant à de l’eau potable et à l’assainissement est un important contributeur à la santé générale et à la réduction de pauvreté. Avec ce programme, 32.344 personnes seront atteintes dans la province de Ngozi, où plus spécialement 3 communautés (Busiga, Mwumba et Nyamurenza) bénéficieront directement et 161.720 personnes indirecte-ment des sources d’eau protégées et des systèmes de distribution d’eau. Outre l’accès, le comportement est un facteur clé pour la santé. Pour cette raison, le programme se concentre sur le changement comportemental envers l’hygiène. Ceci sera réalisé en utilisant des approches scientifiques de changement de comportement. Beaucoup de volontaires de la CRB jouent un rôle important tant en transmettant le message, qu’en assistant les bénéficiaires à changer leur comportement pour le mieux.

105Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2.

72

Localisation de l’intervention

Liste des partenaires

Partenaire Local

Nom complète & abréviation : Croix-Rouge du Burundi (CRB)

Détails de contact :

Adresse : Avenue de l’Etats Unis, Bujumbura, Burundi

Téléphone: +257 22.21.88.71 E-mail : [email protected]

Site web: www.croixrougeburundi.org

Personne de contact : Anselme Katiyunguruza

Outcome(s) :

O1: L’utilisation durable de suffi-samment d’eau propre et d’installations d’assainissement, ainsi que de bonnes attitudes et pratiques d’hygiène par la popu-lation cible d’ici 2021.

O2:Les profanes, les membres de personnel et les volontaires Croix-Rouge possèdent les attitudes, capacités et connaissances adéquates, à-jour et evidence-based pour donner les premiers secours à ceux qui en ont besoin, et ce, d’ici 2021. De telle sorte, le niveau de résilience et la capacité de soins d’urgences des communautés s’amélioreront.

Budget par Outcome (EUR) : Budget O1 : 727.142 Budget O2 : 306.837

Sommaire du rôle des parte-naires pour chaque Outcome :

La CRB, avec son réseau de branches et de volontaires dans le pays tout entier, est le princi-pal partenaire d’implémentation pour ces outcomes. Avec le soutien du siège principal (SP) et de la délégation de la CRB-Fl , la CRB est responsable pour le planning, l’implémentation, le monitoring et le reporting de ce programme.

Date de début du partenariat : 2007

73

Théorie de Changement

Les TdC’s servent de base de réflexion pour le cadre logique. A travers toutes les phases du déroulement du programme, la CRB-Fl utilisera le cadre logique comme base pour l’implémentation, le suivi et le monitoring. Une description narrative de la stratégie d’intervention peut être lue dans le chapitre ‘Efficacité’. En outre, une explication générale de la façon dont la CRB-Fl a structuré son modèle de TdC se trouve à l’Annexe 1.

En raison des limitations de page, les références scientifiques qui soutiennent les hypothèses ne sont pas incluses ici mais sont disponibles sur demande.

Les parties prenantes et les facteurs contextuels sont brièvement énumérés ici. Une description élaborée de leur rôle et influence sur la TdC est également disponible sur demande.

Outcome 1 WASH

La représentation schématique se trouve à la page suivante.

75

1. Parties prenantes 2. Facteurs contextuels 3. Activités

1. Protos 2. Avedec 3. Régies communales de l’eau 4. Ministère de l’énergie et des

mines 5. Directions d’écoles locales 6. Agence Burundaise de l’Hy-

draulique et de l’Assainissement en Milieu Rural (AHAMR)

7. Ministère de la Santé et struc-tures décentralisées

8. Comité Point d’Eau (CPE) 9. Comité d’Hygiène

1. Législation: CRB est reconnue par un décret comme partenaire auxiliaire du gouvernement pour les activités WASH

2. La politique de genre du gouvernement a une influence positive dans ce sens que la présence de femmes dans les comités de points eau est de 3/5

3. Crise politique et crise économique du à la crise politique: inflation, déva-luation du Franc Burundais

4. Densité démographique élevée (2,6%/an) qui résulte en une pression sur les ouvrages hydrauliques (cfr. Analyse de Contexte Conjointe (ACC) p23)

5. Exiguïté des terrains qui influence les familles à adhérer à la stratégie de Ménages Modèles

6. Organisation administrative et communautaire en «unités collinaires»

1. Construction Ecosan individuelle 2. Construction Ecosan institutionnelle (toilettes collectives dans une école qui offrent un as-

sainissement efficace et écologique) 3. Fabrication des sanplats 4. Aménagement des sources 5. Installation de systèmes de récupération de l’eau de pluie 6. Formation comité d’hygiène 7. Formation en gestion des infrastructures hydrauliques pour les fontainiers/maçons 8. Formation PHAST (Participatory Hygiène And Sanitation Transformation) 9. Production kit PHAST complets 10. Production kit PHAST de base 11. Journée promotionnelle dans les écoles 12. Formation CHAST (Child Hygiene and Sanitation Training) + kits dans une école 13. Formation en gestion et entretien des CPE’s 14. Formation utilisation et entretien latrines et Ecosan institutionnelles 15. Formation utilisation Ecosan familial 16. Formation traitement (filtrage et stockage) d’eau 17. Formation des Unités Collinaires (UC) en Activités génératrices de revenus (AGR) 18. Appui aux AGR des UC 19. Appui aux structures déconcentrées de la CRB (provinces, communes et Unités Collinaires)

4. Hypothèses (En raison des limitations de page, les références scientifiques qui soutiennent les hypothèses ne sont pas incluses ici mais sont disponibles sur demande.)

Hypothèse Lien avec

cadre logique

Cela tient-il ?

(Oui/non) Argumentation/preuve

A • Les interventions WASH ont un effet positif sur l’état de santé.

• Moins de pathogènes hydriques.

Outcome 1 • Oui • Oui

• L’effet positif d’interventions WASH sur l’état de santé a été démontré dans beaucoup d’études et revues systé-matiques. De plus, les données d’évaluation de DFID (Department for International Development) rapportent un impact plus large de programmes WASH sous la forme d’une réduction de morbidité (le fardeau de la maladie) et d’une augmentation de la fréquentation scolaire. Il y a de bonnes preuves que l’impact sur la santé implique beaucoup d’autres maladies importantes que seulement la diarrhée.

• Vu que les maladies hydriques sont causées par des pathogènes hydriques, il est évident que la réduction de ces infections mènera à moins de maladies hydriques et un état de santé général amélioré.

B Une meilleure hygiène mène à une réduction des infections par des pathogènes hydriques.

Outcome 1 Oui

L’assainissement et l’hygiène sont essentiels pour la santé, la survie et le développement. Donner accès à de l’eau potable et des installations d’assainissement et promouvoir un comportement hygiénique adéquat sont impor-tants pour réduire la morbidité due à des maladies causée par un manque d’assainissement et d’hygiène.

C L’accès à suffisamment d’eau propre /potable mène à une meilleure hygiène.

Outcome 1 Oui Une évaluation des données probantes qui sous-tendent l’impact sur la diarrhée des quatre interventions WASH principales (qualité de l’eau, accès à l’eau, évacuation des excréments, promotion de l’hygiène) montre que la dis-ponibilité d’eau est l’intervention la plus favorable, et ce, sur base d’un ensemble de facteurs d’évaluation spécifiques.

76

D L’accès à suffisamment d’installations d’assai-nissement améliorées mène à une meilleure hygiène et à une réduction des maladies hy-driques.

Outcome 1 Oui, mais plus de recherches nécessaires

Une évaluation d’impact au Bangladesh a démontré que l’amélioration des installations d’assainissement avait mené à une réduction des maladies hydriques. Quelques revues systématiques seulement ont étudié l’effet des installations d’assainissement sur l’état de santé ou la réduction de maladies. De plus amples recherches sont nécessaires.

E • Les gens pratiquent une meilleure hygiène s’ils ont les connaissances, capacités et atti-tudes nécessaires. La promotion sur l’hygiène via différentes méthodologies mène à un changement comportemental envers l’hygiène.

• La population cible a les capacités/moyens financiers d’effectuer des pratiques d’hy-giène et une utilisation appropriée de matériel de distribution d’eau et d’assainis-sement.

Outcome 1 Output 1.3

• Une étude de la CRB-FL est en cours

• Oui

• La CRB-Fl conduit une revue systématique pour déterminer quelles approches promotionnelles sont efficaces pour changer le comportement du lavage des mains et de l’assainissement dans des pays à revenus faibles ou intermédiaires. Ce projet est une collaboration du Centre for Evidence-Based Practice de la CRB-Fl et du Centre for Evidence-BasedHealth Care de la StellenboschUniversity en Afrique du Sud. Supervision et encadrement sont fournis par 3ie (International Initiative for Impact Evaluation).

• Lors d’un programme précèdent, la CRB a soutenu plus de 8.000 familles modèles qui ont répondu à la plupart des critères pour obtenir le certificat de Ménage Modèle. Ceci implique que les critères contenant des exigences de comportement hygiénique ne sont pas contraignant financièrement. Pour les familles les plus pauvres, les uni-tés collinaires CRB prévoient des moyens financiers. Les AGR peuvent soutenir les ménages le plus vulnérables.

F La Croix-Rouge est un acteur pertinent dans le secteur WASH.

Outputs 1.1-1.3

Oui Les données probantes suggèrent qu’un des facteurs les plus influents associés à une adoption durable est le con-tact fréquent avec un promoteur de santé pendant une certaine période. Un suivi personnel peut contribuer plus amplement à une adoption durable. Le vaste réseau de volontaires Croix-Rouge peut jouer exactement le rôle de promoteur de santé puisque ces volontaires font partie des communautés cibles et qu’ils restent présents après la durée de l’intervention. La CRB est couverte par plusieurs conventions légales avec différents ministères qui reconnaissent la CRB en tant qu’organisation auxiliaire dans entre autres le secteur WASH.

G Des sources d’eau sont disponibles dans la zone cible.

Output 1.1 Output 1.3

Oui Des sondages ont prouvés la présence de sources.

H Le temps que les femmes épargnent pour la collecte d’eau mène à plus de possibilités pour le développement personnel/ l’autonomisation des femmes (travail, éducation loisirs) ainsi qu’à une réduction des risques de violence et de blessures.

Impact Outcome 1 Output 1.1

Oui Des études ont démontré que des interventions WASH réduisent de façon significative le temps que les femmes doivent passer à aller chercher de l’eau et à s’occuper d’enfants malades. De plus, la peine en temps et en énergie associés à l’activité d’aller chercher de l’eau peut réduire le risque de violence et de blessures pour les femmes.

I • Des installations d’assainissement adéquates réduisent l’exposition des femmes au risque de violence et font gagner du temps.

• Des toilettes séparées et adaptées aux filles mènent à une augmentation de fréquenta-tion scolaire des filles.

Impact Outcome 1 Output 1.2 Output 1.3

•Oui •plus re-cherches nécessaires

• L’article WASH de données probantes de DFID fait part de l’impact d’une approche eau et assainissement inadé-quate particulièrement prononcé pour les femmes et les filles. Des installations d’assainissement inadéquates peuvent exposer les femmes à un risque de violence, et trouver des emplacements adéquats pour la défécation en plein air peut prendre significativement plus de temps.

• Un recherche qualitative indique que certaines filles peuvent être découragées de fréquenter une école sans facili-tés de toilettes adéquates. Cependant, il n’y a pas de preuve disponible concernant le lien direct entre des toilettes séparées et la fréquentation scolaires par des filles.

J • Les approches/méthodologies choisies pour promouvoir le changement comportemental WASH sont efficaces.


• Recherche CRB-FL en cours

• Voir hypothèse E et revue systématique en cours par la CRB-Fl en coopération avec 3ie. En plus, la CRB-Fl conduit actuellement une étude concernant les techniques de changement comportemental efficaces, plus particulièrement pour l’aire d’intervention à Malawi en coopération avec le professeur Hans-Joa-chim Mosler of EAWAG université de Zurich (SwissFederal Institute of Aquatic Science and Technology).

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• Les volontaires Croix-Rouge sont des agents efficaces pour un comportement WASH durable.

• Oui • Voir hypothèse F

K Les interventions WASH contribuent à une adaptation au changement de climat et à la ré-silience.

Impact Oui La promotion de technologies et de comportements WASH est une composante de première importance à une adaptation à un changement de climat et à la promotion des droits de l’homme. Le Centre du changement clima-tique de la Croix-Rouge et du Croissant-Rouge souligne le lien entre la disponibilité d’infrastructures d’eau et d’assainissement et l’augmentation de la prise de conscience sur le plan de l’hygiène, et la vulnérabilité des communautés face à des événements climatiques extrêmes.

L Les interventions WASH ont un effet positif sur la réduction de la pauvreté.

Impact Oui L’évidence paper de DFID’s sur WASH déclare qu’améliorer la qualité de l’eau, l’assainissement et l’hygiène atténue également la pauvreté.

M Réduire la distance à l’eau potable mènera à l’utilisation de l’eau pour des buts hygiéniques, et pas seulement pour boire et cuisiner.


Oui Cette intervention travaillera sur ce point. Les données probantes suggèrent que l’état de santé s’améliore lorsque la source d’eau est plus proche du ménage, avec l’implication que les stratégies de distribution d’eau devraient tenir compte de la distance à la source et planifier et investir en prenant ces données en cause.

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Outcome 2 Premiers Secours

La représentation se trouve sur la page suivante.

1. Parties prenantes 2. Facteurscontextuels 3. Activités

1. Gouvernement Burundais

2. Ministère du transport

3. Ministère de l’éduca-tion + Diocèses

4. Directions des entre-prises ou institutions publiques ou privées

5. Ministère de Santé et structures déconcen-trés

6. Organisations bilaté-rales et multilatérales

7. Protection Civile 8. CICR (Comité Interna-

tional de la Croix-Rouge)

1. Législation: CRB est reconnue par un décret comme partenaire auxiliaire du gouvernement pour les activités PS.

2. La politique de genre du gouvernement a une in-fluence positive dans ce sens que l’aspect genre est maintenant intégré dans toute action de la CRB.

3. Existence d’un programme de «Genderbased vio-lence» de la CRB.

4. Crise politique et crise économique du à la crise politique : inflation, dévaluation du Franc Burun-dais

5. Menace de catastrophes naturelles et climatiques 6. Dégradation et destruction du réseau routier 7. La démographie s’accroit de plus de 2,5%. Jeune

population. 8. Concertation de l’industrie autour de Bujumbura,

mis à part quelques sites en province. 9. Organisation administrative et communautaire en

«unités collinaires»

1 à 5. Développement et remplacement du matériel AFAM d'entrainement de base, du manuel pour les formateurs, mise à jour des recommandations 2016 et du guide pratique pour les formateurs (100) (35 pages photocopiées). 6 et 7. Développement et production du matériel AFAM d'entrainement PS jeunesse (y compris le test du matériel au Burundi) et pour les groupes spécifiques (jeunesse, sécurité routière, etc.) 8 et 9. Apport de matériel didactique pour formations (matériel de PS mannequins, brancards, attelles, flip chart, etc.) 10 à 12. Formations de (Master) formateurs (médical & didactique, Recyclage et Master Jeunesse inclus) 13. Réunion de suivi pour les formateurs 1x ans: 1 ou 2 jours par province, facilitée par les Formateurs Master 14. Développement du plan de formations + révision annuelle 15 à 18. Premiers Secours de base + recyclage pour le personnel de la CRB, les volontaires et les équipes d’urgences, pour sécurité routière, pour jeunesse 19. Atelier pour standardisation et certification des profils de compétences - curriculum de recyclage PS - procédures - mise en place d’un système de directives de qualité et comité de qualité - développement d'une procédure d'entretien de matériaux de PS, etc. 20. Installation du comité de qualité de PS (réunion 2X/an) pour approuver les curriculums, procédures, système de suivi de PS 21 et 22. Mise en place d’un système de suivi pour les formateurs et les formations 23. Elaboration d’une étude de référence (données de base) 24 et 25. Installation d'une équipe de PS: recrutement coordinateur PS, coordinateur de formations + formations du personnel - visite d'échange et atelier d’institutionnalisation de PS 26. Développement du plan opérationnel et révision annuelle du plan opérationnel - réunion de planification et de suivi 27. Mise en place d’un système d’enregistrement pour les formations de premiers secours: base de données des personnes formées 28. Atelier/réunion de coordination interdépartemental avec le conseil /niveau interdépartemental avec les départements pertinents (appui des volontaires, jeunesse, DM …) 1x/an 29. Matériaux promotionnels (Journée mondiale de PS) T-shirts, banderoles… 30 et 31. Appui de la gestion des volontaires PS (base de données volontaires) et Equipment des équipes volontaires. 32. Matériaux promotionnels pour PS Commerciaux (T-shirts, dépliants) 33 et 34. Formations du personnel PS Commerciaux en marketing et gestion (y inclus un atelier de 5 jours)

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4. Hypothèses (En raison des limitations de page, les références scientifiques qui soutiennent les hypothèses ne sont pas incluses ici mais sont disponibles sur demande.)

Hypothèses Lien avec

cadre lo-

gique

Cela tient-il ?

(Oui/non))

Argumentation/preuve

A • Les personnes deviennent plus résilientes quand elles sont capables d’appliquer des techniques de PS.

• L’impact négatif sur la santé en cas de bles-sure/maladie est plus petit parce que les personnes sont aidées par des techniques PS evidence-based.

• La formation aux PS est une intervention de développement très rentable pour améliorer sa santé publique.

Impact Oui Oui

• Oui

• Une étude de la Croix-Rouge Britannique montre un lien entre des éléments de résilience de communautés et la formation aux premiers secours.

• Il est démontré que les techniques PS evidence-based sont plus efficaces sur le plan du rétablissement après des blessures/maladies. Le Centre for Evidence-Based Practice (CEBaP) de la CRB-Fl est spécialisé dans la méthodo-logie evidence-based pour le développement de recommandations en matière de premiers secours: le centre utilise les données probantes disponibles dans la littérature scientifique, qui sont ensuite complétées par le sa-voir-faire d’experts et d’informations acquises lors de l’expérience pratique

• La formation aux PS a un coût de 8US$ par année de vie corrigé du facteur d’incapacité(DALY), ce qui rend cette approche un des moyens les moins chers d’améliorer la santé publique dans les pays en voie de développe-ment.

B • Un impact négatif sur la santé en cas de bles-sures/maladies diminué parce que des personnes sont aidées avec des premiers secours.

• L’assistance avec des premiers secours par la Croix-Rouge a un impact positif sur le traite-ment et le rétablissement de blessures/ maladies (uniquement Népal et Burundi).

Impact Oui, plus de recherche est en cours

• Une revue systématique est en cours concernant les effets sur la santé de former des profanes pour prodiguer les soins d’urgence dans des populations mal desservies. Les résultats seront disponibles en 2017. Une étude de cas en Iraq démontre qu’une réduction de la mortalité était causée par des profanes formés en tant que premiers intervenants dans un environnement où les délais d’évacuation pré-hospitaliers sont longs.

• Les unités collinaires de la CRB se composent souvent entre autre d’infirmiers des centres de santés locaux. Ils assurent ainsi le référence et contre référence entre les centres de santés et les familles sur les collines, ce qui améliore la santé primaire. Il y a donc un impact positif entre les unités collinaires de la CRB et la santé publique.

C • Des profanes, des membres de personnel et des volontaires Croix-Rouge interviennent pour donner des premiers secours, s’ils disposent des connaissances, capacités et attitudes re-quises.

• Des profanes ont accès à du matériel de PS de base pour exécuter des techniques de premiers secours.

• Des profanes premiers intervenants en premiers secours aussi bien que des membres de personnel et volontaires Croix-Rouge, peu-vent intervenir et prodiguer des PS dans un cadre légal sécurisé (responsabilité légale).

Outcome 2 Oui, mais plus de recherche est nécessaire. Oui

Non

• Une revue systématique rapporte une augmentation significative en connaissances et capacités de premiers se-cours et une amélioration du comportement d’aide suite à la formation aux premiers secours d’enfants et de profanes. Une étude de cas en Uganda démontre que les groupes de personnes qui doivent régulièrement appli-quer des PS ont une plus grande rétention en connaissances PS. Une structure Croix-Rouge pourrait être considérée comme une situation similaire.

• La sensibilisation sur l’importance d’avoir du matériel de PS adapté et l’utilisation de matériel local, fera partie de l’intervention. Les formations PS sont également adaptées au matériel disponible localement. En plus, des trousses avec du matériel de PS sont inclues dans les formations de PS pour les profanes.

• Dans aucun des pays d’intervention, la loi ne prévoit une protection pour des passants qui prodiguent des pre-miers secours. La 32ième Conférence des Sociétés Croix-Rouge et Croissant-Rouge a cependant adopté une résolution concernant le renforcement du cadre légal de réponse aux catastrophes : réduction de risques et pre-miers secours.

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D Des volontaires CR formés et équipés restent vo-lontaires.

Output 2.1, 2.2 et 2.3

Oui La CRB connait peu de perte de volontaires et seulement en cas de déplacements ou déménagement.

E La Croix-Rouge est capable de recruter les volon-taires et membres de personnel nécessaires pour donner des PS.

Output 2.1, 2.2 et 2.3

Oui La CRB a déjà recruté le personnel et les volontaires nécessaires. Les rapports annuels et les rapports trimestriels font part d’un recrutement continu de ressources humaines.

F Il y a un suivi et un coaching adéquats des volon-taires du personnel CR.

Output 2.1, 2.2 et 2.3

Oui La CRB réalise déjà un monitoring et coaching des volontaires et du personnel.

G • Les PS commerciaux génèrent des revenus. • La Société Croix-Rouge est désireuse d’investir

les revenus générés par les PS commerciaux au moins partiellement dans le service PS.

Output 2.2, Output 2.3

Oui mais une analyse plus profonde est nécessaire Oui

• En 2016, la CRB-Fl a entrepris une étude en coopération avec Vlerick Business School qui analyse le coût de for-mations PS au Népal en utilisant un modèle de coût basé sur la durée d’une activité. Vu qu’il s’agit d’une étude pilote, la CRB-FL vise à utiliser ce modèle pour améliorer les activités de PS commerciaux dans d’autres pays.

• La CRB a déjà investi le gain obtenu par des sessions PS commerciaux, circa 25MK en 2015 et 16MK en 2016.

H Les personnes qui décident de devenir volontaire ou membre de personnel Croix-Rouge, recon-naissent et apprécient l’importance des PS.

Output 2.2 Oui Au sein des organisations CR, les PS sont considérés comme une activité de base et chaque volontaire nouvelle-ment recruté fait connaissance avec la vision, la mission et la politique de l’organisation. Depuis une vingtaine d’années, la CRM mène des activités de PS. Vu la situation précoce des services de santé au Burundi, l’importance est largement reconnue.

I Les méthodes didactiques utilisées sont efficaces. Output 2.1 Recherche prévue par la CRB-Fl

L’utilisation de la simulation en tant qu’outil didactique sera étudiée durant la période d’implémentation.

J Les profanes (y compris les membres de person-nel en volontaires Croix-Rouge) retiennent suffisamment les connaissances et capacités ac-quises durant une formation (de recyclage) de premiers secours.

Outcome 2, Output 2.1

Recherche en cours par la CRB-Fl

La CRB-Fl conduit une étude pour évaluer le degré de rétention de connaissances et de capacités au cours d’un lapse de temps et pour déterminer l’impact de cours de recyclage et de pratique de premiers secours sur le niveau de rétention. Ces informations seront utilisées pour déterminer la fréquence optimale de cours de recyclage et pour évaluer la nécessité de réviser la validité de brevets de premiers secours. Une étude de cas a démontré que les con-naissances en premiers secours acquises durant les formations de premiers secours commerciaux, ne diminue pas significativement avec le temps. Par contre, les capacités liées à la RCP se détériorent rapidement au cours des pre-miers 90 jour, ce qui suggère qu’un recyclage fréquent des capacités est nécessaire.

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Analyse des risques

CRB-Fl utilise un système de gestion des risques étendu et dispose d'outils pour l'évaluation, la réponse et le suivi adéquats des risques. L’évaluation des risques effectuée à ce stade de programme, est trop vaste pour entrer dans les propositions de programme selon le modèle de DGD. Nous référons à l’Annexe 2 pour un exemple d’une matrice de risque comme celle faite également pour le Burundi.

TDC réfé-

rence Description des risques et

impact

Impact

(1-6)

Proba-

bilité

(1-6)

Mitigation Responsable pour

le monitoring

Risques au niveau du pays et du partenaire

Contexte

La situation socio-économique et/ou politique (voir ACC cha-pitre 9) pourrait donner lieu à un risque de retard significatif ou une interruption de l’implé-mentation.

4 6 La stratégie d’implémentation, le planning et le bud-get seront révisés si nécessaire. Le management à distance sera appliqué pour assurer la sécurité de personnel local et international. La CRB sera soute-nue dans l’atténuation des risques et effets, en concordance avec le programme de préparation aux catastrophes financé par le DGD. Un fait très impor-tant est que l’image de la CRB en tant qu’organisation humanitaire neutre continuera à être promue, afin d’assurer la continuité durant la période de crise.

CRB programme staff et manage-ment, délégué CRB-Fl et groupe de contact ONG belge de l'ambassade Belge FOBAC (Forum des acteurs belges)

Contexte

Catastrophes naturelles (voir ACC chapitre 3.5)

5 3 La stratégie d’implémentation, le planning et le bud-get seront révisés si nécessaire. La CRB sera soutenue dans l’atténuation des risque, en concor-dance avec le programme de préparation aux catastrophes financé par le DGD.

CRB programme staff et délégué CRB-Fl

Contexte

Fluctuations de prix causées par le changement du taux d’échange, l’inflation, … (voir ACC point 3.3)

3 5 Le budget est surveillé de façon permanente et des rapports trimestriels permettent une révision de budget quand nécessaire. De grandes fluctuations de prix peuvent requérir un ajustement des objectif et indicateurs.

Personnel CRB du programme staff et délégué CRB-Fl

Risque au niveau du programme

Output

2.3

La demande de formations PS et de services d’augmente pas. Chute des revenus générés par la CRB

4 1 La CRB génère des moyens financiers même en temps de crise. Une stratégie de marché a des chances de générer des moyens financiers substan-tiels, excepté dans le cas d’une crise politique et d’une crise d’insécurité. Aussi, la situation de crise amplifie la demande en sécurité et en formations PS, cependant souvent sans compensation financière

Personnel CRB du programme

Output

1.1

Les Comités d’eau ne fonction-nent pas comme ils devraient et le fonctionnement et l’en-tretien son compromis, ce qui résulte dans le mal fonctionne-ment des points d’eau.

4 2 la CRB, de par sa structure provinciale et communale, fait le suivi et exerce un contrôle sur les Unités colli-naires et les comités d'eau ou d'hygiène. L’encadrement et le soutien seront augmenté là où nécessaire.

Personnel CRB du programme et leadership des branches

Outcome

1 and 2

Manque de continuité dans les activités après la fin du projet

4 2 La CRB appuie des AGR des unités collinaires afin de les pérenniser. Le programme vise une autonomisa-tion des comités d’eau par un recouvrement des frais d’exploitation via la redevance eau. Finalement les activités générées par le Premiers Secours profes-sionnel accrue l’autonomie et la pérennisation du contenu du programme PS communaux.

Personnel CRB du programme, direction et délégué CRB-Fl

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Recommandations et expériences antérieures

Recommandations du Dialogue Stratégique

Le Dialogue Stratégique du CSC (Cadre Stratégique Commun) Burundi entre la DGD et les participants du CSC avait lieu le 15/06/2016 au sein du Service public fédéral Affaires Etrangères à Bruxelles.

Trois recommandations et points d’attention pour l’introduction des programmes 17-21 ont été formulés dans l’Avis Définitif de DGD :

1. La concrétisation de l’opérationnalisation des synergies et complémentarités. Nous référons à la section «Synergies et complémentarités».

2. La prise en compte des thèmes transversaux genre et environnement. Nous référons à la section «Pertinence».

3. La prise en compte de la qualité des médicaments chez les ACNG (Acteurs de la Coopération non-gouvernemen-tale) actifs dans le domaine de la santé. CRB-Fl n’est pas actif sur le plan des soins directs et donc pas concernée par l’achat des médicaments.

Leçons apprises par les expériences antérieures du CRB-Fl dans le pays

a) Au niveau du WASH - Besoin de concentrer les moyens limités sur une zone plus réduite afin d’augmenter l’impact.

Suite: la CRB-Fl a réduit son intervention à 3 communes dans lesquelles elle interviendra intensivement.

- Nécessité d’opérer en synergie avec d’autres organisations expérimentées en WASH afin de mieux couvrir les be-soins de la population. Nécessité d’échanger des expériences et de renforcer les capacités de la CRB via la synergie. Suite: la CRB-Fl a élaboré une synergie opérationnelle avec Protos.

- L’aménagement des sources est un modèle d’intervention indiqué pour des populations enclavées. Pour des com-munautés des petits centres urbains la construction des adductions est cependant plus efficace. Suite: CRB-Fl a peu d’expérience avec les systèmes d’adductions, ce qui mène à la synergie avec Protos, qui a une vaste expérience en infrastructures WASH, une valeur ajoutée à notre intervention.

- Afin d’augmenter l’impact des activités et de pérenniser l’organisation de la CRB, la nécessité se présente de trou-ver des pistes pour augmenter les revenus des unités collinaires. Suite: la CRB-Fl appuie des initiatives génératrices de revenus et préconise des toilettes du type «Ecosan» qui com-bine un assainissement efficace et écologique avec la possibilité de rentabiliser les excréments.

b) Au niveau Premiers Secours - Si bien que les formations en PS ont été fructueuses et que la plupart des volontaires des unités collinaires sont

formés en gestes qui sauvent, la CRB veut cadrer ses formations communautaires mais aussi les formations com-merciales (formations payantes par les clients) dans une stratégie globale afin d’assurer un développement logique et d’assurer la pérennisation de la CRB. Suite : un atelier stratégique en 2017 sera organisé avec toutes les parties prenantes au Burundi où ces questions seront discutées.

- Les formations en PS visaient jusqu’à présent la communauté mais de plus en plus une approche s’impose par groupe cible spécifique (jeunes - usagers des routes - ambulanciers etc.). Suite : la CRB organisera des formations spécifiques par groupe cible avec des approches et matériel adaptés.

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Outcome 1 WASH

Fiche Outcome

Outcome (English or French) : L’utilisation durable de suffisamment d’installations d’eau et d’assainissement sûres ainsi que des attitudes et pratiques d’hygiène sûres et durables dans la population cible d’ici 2021.

Outcome (Nederlands) : De doelgroep maakt tegen 2021 gebruik van duurzame water -en sanitaire voorzieningen die toereikend en veilig zijn, en houdt er veilige attitudes en prak-tijken op na omtrent hygiëne.

IATI identificateur d’activité IIAT : BE-BCE_KBO-0461634084-2017_03_BI_DGD

Pays : Burundi Cet Outcome est-il couvert par un CSC ? Oui

Niveau d’intervention : Niveau administratif infranational 1 Niveau administratif infranational 2 Niveau administratif infranational 3

Partenaires locaux ou partenaires de programme

Partenaire 1 CRB Province de Ngozi Busiga et Mwumba (en synergie avec PROTOS) et Nyamurenza

Coordonnées GPS : Longitude (Ngozi) : 29° 49’ 35.577’’

Latitude (Ngozi) : 2° 54’ 30.068 ‘’

Population cible : Habitants des communes Busiga et Mwumba (par la synergie avec Protos) et de Nyamurenza (CRB-Fl seule)

Nombre de bénéficiaires : Total : 194.064 Directs : 32.344 Indirects : 161.720

Secteur principal : 1430 approvisionnements en eau potable et assainissement de base

Autres organisations impliquées : N/A

Frais opérationnels totaux pour cet Outcome (EUR) : 959.697

Indicateur stratégique

Sujet Score Sujet Score Sujet Score

Environnement 1 Genre 2 Désertification (Marqueur de Rio) 1

Biodiversité (Marqueur de Rio) 1 Changement Climatique – Adoption (Marqueur de Rio) 2 Changement Climatique – Mitigation/Prévention (Marqueur de Rio) 1

Développement du commerce 1 Bonne Gouvernance 1 Santé Génésique maternelle néonatale et infantile (SGMNI) 1

VIH/SIDA 0 Droits des enfants 1 Total 12

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Cadre Logique

Un exercice complet de collecte valeurs de base sera mené après approbation du programme pour déterminer et mettre à jour strictement les valeurs de base et les valeurs cibles pour chaque indica-teur. Les objectifs numériques sont présentés de manière cumulative vis-à-vis de la valeur de base.

Référence 2017 2018 2019 2020 2021 Moyens de vérification

Indicateurs de processus

Indicateur 1 : Nombre de bénéfi-ciaires directs atteints.106

0

Total: +2880 Female: +1469 Male: +1411

Total: +16,048 Female: +8184 Male: +7864

Total: +23,356 Female: +11,912 Male: +11,444



Formulaires de suivi et de rapport

Indicateur 2 : Nombre de bénéfi-ciaires indirects atteints.107

0 Total: +14,400 Female: +7344 Male: +7056


Total: +116,780 Female: +59558 Male: +57,222


Total: 161,720 Female: +82,477 Male: +79,243

Formulaires de suivi et de rapport

Impact :

CSC Burundi

CSC 1 Contribuer à l’émergence d’une société civile indépendante, forte, compétente et redevable.

CSC 6 Améliorer l’accès de tous à l’eau et à l’assainissement et assurer une gestion participative et durable des ressources en eau;

Hypothèses : - cfr. Hypothèses TdC

Résultat 1 :

Utilisation108 soutenue109 de suffisamment110 d’eau potable et d’installations sanitaires, ainsi que des attitudes et pratiques d’hygiène durables dans la population cible en 2021.


106 Nous définissons les bénéficiaires directs comme les personnes bénéficiaires d’infrastructures nouvellement construites et des sessions de sensibilisation. Un total de 32.344 bénéficiaires directs sera atteint dans les trois communes Nyamurenza, Busiga et Mwumba. CRB réalisera le programme complet à Nyamurenza et effectuera des activités du type ‘soft’ en synergie avec Protos à Busiga et Mwumba. Le dossier présentera des moyennes pour les trois communes en ce qui concerne le ‘soft’. Mais dans le courant de l’exécution du programme un suivi et monitoring sera réalisé sur chaque commune distincte. 107 Nous avons considéré un facteur x5 pour le calcul des bénéficiaires indirects. Cette façon de calculer est plus précise qu’un calcul basé sur la différence de la population totale moins les bénéficiaires directs. Le chiffre de la population étant trop imprécis et estimé. Ceci porte le nombre de bénéficiaires indirects à 161.720. 108 Utilisation implique ‘accès’, et ‘accès’ est défini en tant que ‘suffisamment d’eau pour satisfaire aux besoins domestiques, disponible près de la maison. (source : SDG métadonnées http ://unstats.un.org/sdgs/files/metadata-compilation/Metadata-Goal-6.pdf 109‘Soutenue durable’ concerne la conception etl’implémentation de facilités : conception de telle sorte que la facilité elle-même soit durable et implémentation de sorte à ce que la facilité durable soit soutenue par la communauté bénéficiaire. Si les bénéficiaires choisissent de ne pas soutenir une facilité, aussi durable soit elle, cette facilité ne sera pas durable. 110Cfr. Note, n° 5 concernant suffisamment.

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Indicateur 1.1111: % de ménages dans la région cible utilisant suffi-samment 112 d’eau potable113 d’un point d’eau amélioré 114 pour boire.115

45%116

P/A (pas d’appli-cation)

P/A +15% P/A +25% Sondage des ménages / vérifications ponctuelles/ observation117, rapport de suivi de volontaires

Indicateur 1.2118 : % de ménages dans la région cible utilisant une latrine amélio-rée119.

18 % P/A P/A +7 % P/A +10 % Sondage des ménages/ vérifications ponctuelles/ observation, rapport de suivi de volontaires

Indicateur 1.3120 : % des ménages dans la région cible dont les membres se lavent les mains avec de l’eau et du savon (ou alterna-tive locale acceptable) à des moments critiques.

5 % P/A P/A +17 % P/A +28 % Sondage des ménages/ vérifications ponctuelles/ observation, rapport de suivi de volontaires

Indicateur 1.4121 : Nombre d’heures par jour requises à la collecte d’eau par un collecteur d’eau (temps de faire la queue com-pris).122

1h30

P/A P/A 1h10

P/A 1h

Sondage des ménages, rapport de suivi de volontaires

111 Le dossier présentera des moyennes pour les trois communes en ce qui concerne le ‘soft’. Mais dans le courant de l’exécution du programme un suivi et monitoring sera réalisé sur chaque commune distincte. 112 Suffisamment = il n’y a pas de recommandations evidence-based concernant le nombre de litres nécessaire pour usage domestique (boire, cuisiner, bain, hygiène). Le Coordinateur Scientifique de la CRB-FL se charge de chercher des preuves. En attendant que des preuves soient disponibles, le critère quantitatif du standard SPHERE de 15L/personne/jourpour boire, cuire et hygiène personnelle peut être utilisé. Un autre aspect qui influence le concept ‘suffisamment’ d’eau est le nombre de personnes / ménages desservis par point d’eau ainsi que la fonctionnalité de ce point d’eau. Ces aspects doivent également être pris en considération (référence Y3 et Y5). 113 JMP a développé l’indicateur sources eau ‘améliorées’, qui fut utilisé comme indicateur pour de l’eau potable http ://unstats.un.org/sdgs/files/metadata-compilation/Metadata-Goal-6.pdf. Suivant les métadonnées ODD ‘potable’ suppose sans pathogènes et sans niveau élevé d’éléments toxiques à tout moment. La CRB-FL par contre, mesure et définit la potabilité de l’eau uniquement lors de la remise officielle d’un point d’eau nouvellement construit ou réhabilité. 114 A définir sur base de la politique nationale et de l’échelle de l’eau potable (eaux de surface /points d’eau non améliorés / améliorés /branchements domestiques). http ://www.wssinfo.org/definitions-methods/watsan-ladder/. Suivant les métadonnées ODD de JMP ‘amélioré’ signifie : robinets publics ou bornes fontaines, puits tubulaires ou forages, puits protégés, sources protégées, collecte des eaux de pluie. 115 ‘Utilisation’ consiste en plusieurs phases : prise en charge, adhérence et utilisation à long terme (c.-à-d. plus de 12 mois). Pour cet indicateur, seul l’aspect ‘prise en charge’ est mesuré. (Cfr. article x Axel). 116 Sport check CRB/RKV Nyamurenza août 2016 117 Il sera vu avec le Coordinateur Scientifique / CEBaP de CRB-FL quelle méthode de mesure est la plus appropriée et envisagé si des méthodes innovatrices peuvent être utilisées. 118 Le dossier présentera des moyennes pour les trois communes en ce qui concerne le ‘soft’. Mais dans le courant de l’exécution du programme un suivi et monitoring sera réalisé sur chaque commune distincte. 119 Fosse supérieur ou égal à 3m ; dalle propre( sec) et nettoyable avec couvercle ; superstructure avec porte ; toiture http://www.wssinfo.org/fileadmin/user_upload/resources/JMP2013-French_web.pdf 120 Le dossier présentera des moyennes pour les trois communes en ce qui concerne le ‘soft’. Mais dans le courant de l’exécution du programme un suivi et monitoring sera réalisé sur chaque commune distincte 121 Le dossier présentera des moyennes pour les trois communes en ce qui concerne le ‘soft’. Mais dans le courant de l’exécution du programme un suivi et monitoring sera réalisé sur chaque commune distincte 122 On retient le temps pour un collecteur d'eau par voyage. Le nombre de voyages étant dépendant du nombre de collecteurs dans la famille.

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Output 1.1 :

Disponibilité accrue de sources d’eau potable durables pour la population cible d’ici 2021.


Indicateur 1.1.1 : Nombre de points d’eau construits suivant les standards na-tionaux.123

0 +20 +40 +60 +90 +100 Compte-rendu d’enquête hydrologiques, documents de conception (plans et devis), log de forage, log de pompage test, rapport d’achève-ment avec données GPS, rapport de remise / certificat de donation

Indicateur 1.1.2 : Nombre de points d’eau construits avec un comité de gestion d’eau établi.124

x +20 +40 +60 +90 +100 Outils d’évaluation SNH, contrat avec le prestataire de service, dossiers d’adhésion, contrat entre comité et fournisseur de pièce de rechange, dossier des fonds collectés

Output 1.2 : Disponibilité accrue d’installations sanitaires sûres et durables pour la population cible d’ici 2021.


Indicateur 1.2.1 : Nombre de latrines améliorées par population cible / par CRB

CRB: 0 Commu-nautés: 0

CRB: +433 Commu-nautés: 0

CRB: +333 Commu-nautés +10

CRB: +836 Commu-nautés: +25



Rapport de suivi de volontaires

Indicateur 1.2.2 : Nombre de latrines adaptées aux filles/femmes 125 cons-truites dans des écoles dans la région cible.

0 +1 +4 +4 +4 +4 Rapport de suivi de volontaires

Output 1.3 :

Les connaissances et la compétence en matière de pratiques d’hygiène de la population cible sont accrues d’ici 2021.


Indicateur 1.3.1 : Nombre de personnes formées à la méthodologie du compor-tement hygiénique126

Total: 0 Femmes : 0 Hommes: 0

Total: +2000 Female: +1020





Outils de suivi des volontaires

123 sources ouvertes aménagées avec clôture, terrain protégé de 30 m des habitations ou champs, canvas en béton, canal d'évacuation 124 ‘établi’= reconnu par la Régie Communale de l’Eau 125 Critères : toilette séparée, porte avec clef, boite de déchets pour linges menstruelles 126La méthodologie spécifique propre au pays doit être mentionnée ici. (P.ex. PHAST).

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Male: +980

Male: +2940

Male: +4998

Male: +7056

Male: 8036

Indicateur 1.3.2 : Nombre de techniques de change-ment de comportement hygiénique127 implémen-tées

0 +3 +3 +3 +4 +4 Outils de suivi des volontaires

Output 1.4 :

La SNH a une capacité accrue pour implémenter des interventions WASH d’ici 2021.


Indicateur 1.4.1 : Nombre d’activités relatées à l’evi-

dence-based practice (EBP) que la SNH entreprend.


Indicateur 1.4.2 : Nombre de AGR au niveau UC.


Typologie d’activités • Voir activités TdC.

127Techniques de changement de comportement (p. ex. spots radio, spots TV, posters, etc.) sont des outils spécifiques et ne sont pas la même chose que les méthodologies de changement de comportement (p.ex. PHAST, CLTS, etc.). Les techniques peuvent faire partie d’une certaine méthodologie.

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Frais opérationnels

Partenaires

Collaboration CRB 172.614 236.749 165.211 105.146 47.423 727.142

Total Partenaire CRB: 172.614 236.749 165.211 105.146 47.422 727.142

Collaboration

Collaboration 0 0 0 0 0 0

Total Collaborations 0 0 0 0 0 0

2017 2018 2019 2020 2021 Grand total


1. Partenaire 172.614 236.749 165.211 105.146 47.423 727.142

Frais d’investissement 20.527 3.000 0 0 0 23.527

Frais de fonctionnement 108.384 187.353 119.676 86.948 45.593 547.953

Frais de personnel 43.703 46.396 45.535 18.198 1.830 155.662

2. Collaboration 0 0 0 0 0 0

Frais d’investissement 0 0 0 0 0 0

Frais de fonctionnement 0 0 0 0 0 0

Frais de personnel 0 0 0 0 0 0

3. Bureau local 0 0 0 0 0 0




4. SP 29.685 53.329 53.329 53.329 42.882 232.555



Frais de personnel HQ 5.000 5.000 5.000 5.000 5.000 25.000

Frais de personnel terrain 13.447 26.894 26.894 26.894 26.894 121.021

Total 202.299 290.078 218.540 158.475 90.305 959.697




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Outcome 2 PS

Outcome (English or French) :

Les profanes, le personnel et les volontaires Croix-Rouge possèdent les attitudes, capacités et connaissances adéquates, à-jour et evidence-based pour

donner les premiers secours à ceux qui en ont besoin, et ce, d’ici 2021. De telle façon, ils augmentent le niveau de résilience de la communauté et la

capacité de soins d’urgences.

Outcome (Nederlands) : Leken, Rode Kruispersoneel- en vrijwilligers beschikken tegen 2021 over doeltreffende, meest recente en evidence-based kennis, vaardigheden en atti-

tudes om eerste hulp te verlenen aan zij die het nodig hebben en verhogen op die manier de zelfredzaamheid van gemeenschappen.

Identificateur d’activité IIAT : BE-BCE_KBO-0461634084-2017_04_BI_DGD

Pays : Burundi Cet outcome est-il couvert par un CSC ? Oui

Niveau d’intervention : Niveau administratif infranational 1 Niveau administratif infranational 2 Niveau administratif infranational 3

Partenaires locaux ou parte-naires de programme

Partenaire 1 CRB Bujumbura (Siège Principal) et l’ensemble du pays

Population cible : Population de 2.900 unités collinaires et les entreprises, institutions et organisations actives au Burundi.

Nombre de bénéficiaires: Total : 77.992 Directs : 11.787 Indirects : 66.135

Secteur principal : 12220 soins de santé de base

Autres organisations impliquées : N/A

Frais opérationnels totaux pour cet Outcome (EUR) : 531.059

Indicateur stratégique


Environnement 1 Genre 1 Désertification (Marqueur de Rio) 0

Biodiversité (Marqueur de Rio) 0 Changement Climatique – Adaptation (Marqueur de Rio) 2 Changement Climatique – Mitigation/Prévention (Marqueur de Rio) 1

Développement du commerce 1 Bonne Gouvernance 0 Santé Génésique maternelle néonatale et infantile (SGMNI) 1

VIH/SIDA 1 Droits des enfants 1 Total 9

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Cadre Logique


Référence/base

2017 2018 2019 2020 2021 Moyens de vérification


Indicateur 1 : Nombre de bénéficiaires directs atteints.

Total: 0 Femmes: 0 Hommes: 0

Total: +700 Femmes: +356 Hommes: +343

Total: +3.930 Femmes: +2.000 Hommes: +1.929




CRN database ( juin 2017)+ monthly reports via KoBocollect

Indicateur 2 : Nombre de bénéficiaires indirects atteints.




Total: +33.070 Femmes: +16865 Hommes: +16204



CRN database ( juin 2017)+ monthly reports via KoBocollect

Impact: CSC 4 Assurer/Améliorer la qualité, la disponibilité et l’accessibilité aux soins de santé pour tous (Préventifs, Curatifs, Ré adaptatifs et de promotion de la santé);

Hypothèses : - cfr. TdC

Outcome 2:

Les profanes, le personnel et les volontaires Croix-Rouge possèdent les attitudes, capacités et connaissances adéquates, à-jour et evidence-based pour donner les premiers secours à

ceux qui en ont besoin, et ce, d’ici 2021. De telle façon, ils augmentent le niveau de résilience de la communauté et la capacité de soins d’urgences


Indicateur 2.1 : Nombre de personnes du grand public128 avec certificat PS valide.


Total: +200 Femmes:+ 102 Hommes: +98





HNS FA training database, HNS train-ing records

Output 2.1:

Une éducation aux PS de grande qualité pour différents groupes cibles est disponible d’ici 2021.

Hypothèses :

128 Par personnes du grand public on entend toutes les personnes formées aux PS, y compris celles formées dans le cadre de PS commerciaux. Toutefois, le CRB ne dispose pas encore d’un système de certification pour toutes ses formations. L’élaboration d’un outil de certification sera systématisé et monitoré àpd de 2017.

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- cfr. TdC

Indicateur 2.1.1 : Présence de matéraiux didactiques de formation PS de base finalisés, basés sur AFAM 129 et sexospécifique130

Non Oui Oui (Guide AFAM) Oui (Guide AFAM+ guide jeunes)

Oui (Guide AFAM+ guide jeunes et routes)

Oui (Guide AFAM+ guide jeunes et routes + simula-tion)

Matériaux didactiques et manuel de formation PS

Indicateur 2.1.2: Nombre de personnes du grand public formées aux PS. (uniquement Cofa)

Total: 0 Femmes: Hommes

Total: +200 Femmes:+ 102 Hommes: +98





rapports de formations PS com + photos

Indicateur 2.1.3 : Nombre de volontaires et membres de personnel Croix-Rouge formés aux PS.

Total: 0 Femmes: 0 Hommes: 0 Volontaires : 0, membres de personnel: 0) Total basé AFAM: 0



Total: +6774 Femmes: +3.447 Hommes: +3326 (+6734volontaires : +, membres de personne: +40) Total basé AFAM: +6774


Total: +11.787 Femmes: +5999 Hommes: +5.788 (volontaires : +11.696, membres de personnel: +91) Total basé AFAM: +11.787


Output 2.2: La SNH a un service PS fonctionnant bien et intégré dans l’organisation d’ici 2021.


Indicateur 2.2.1 : Nombre de volontaires formés aux PS enregistrés dans la base de données des volontaires de la CRB.131

Total: 0 Femmes: 0 Hommes: 0 Volontaires : 0, membres de personnel: 0) Total basé AFAM: 0



Total: +6774 Femmes: +3.447 Hommes: +3326 (+6734volontaires : +, membres de personne: +40) Total basé AFAM: +6774


Total: +11.787 Femmes: +5999 Hommes: +5.788 (volontaires : +11.696, membres de personnel: +91) Total basé AFAM: +11.787


129 Le matériel didactique comprend le matériel de formation qui peut être basé XFAM (ceci ne comprend pas les mannequins, bandages, etc.) tel que le manuel PS, le manuel de formation PS, dépliants, présentations, posters, etc. 130Par ‘sexe’ on entend les rôles et responsabilités socialement définis qui sont attribués aux hommes, femmes, garçons et filles, dans une culture, un endroit, une société et un temps donnés. A son tour, le concept sexospécificité signifie être conscient de la nécessité de comprendre les relations sociales entre hommes et femmes et d’en tenir compte avant d’engager des interventions. 131 La base de donnée est complétée au niveaux siège, branche ; les communes et unités collinaires fournissent les données de façon analogue

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Indicateur 2.2.2 : Nombre de formateurs PS actifs

Total : 85 Femmes : 15 Hommes : 70 (commercial : 1, non-commercial : 84)

Total : +0 Femmes : +0 Hommes : +0

Total : +6 Femmes : +4 Hommes : +2 (commercial : +1, non-commercial : +5)



Total : +6 Femmes : +4 Hommes : 2 (commercial : +1, non-commercial : +5)

Base de données des formateurs, Dossier de formation

Output 2.3 :

La SNH delivers des PS commerciaux de grande qualité d’ici 2021.


Indicateur 2.3.1 : Nombre de nouveaux132 clients formés aux PSCo.

0 +300 +200 +2.50 +250 +250 Base de données formation PS ou base de données clients ; Dossier de formation

Indicateur 2.3.2 : Nombre de produits PS co133 vendus

0 +700 +1.000 +2.500 +4.000 +5.000 Dossier CRB

Typologie d’activité Voir activités TdC.

132 Nouveaux clients = clients auxquels un service ou produit n’a pas été fourni dans les années précédentes. 133 vente de kits PS, livres PS, service préventif public payant

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Budget opérationnel

Partenaires

Collaboration CRB 56.164 104.219 66.895 51.441 28.118 306.837

Total Partenaires CRB : 56.164 104.219 66.895 51.441 28.118 306.837

Collaboration

Collaboration X 0 0 0 0 0 0


2017 2018 2019 2020 2021 Grand total


1. Partenaire 56.164 104.219 66.895 51.441 28.118 306.837



Frais de personnel 17.156 18.571 20.099 10.049 0 65.874









4. SP 28.018 51.663 51.663 51.663 41.215 224.222



Frais de personnel HQ 3.333 3.333 3.333 3.333 3.333 16.667

Frais de personnel terrain 13.447 26.894 26.894 26.894 26.894 121.021

Total 84.182 155.882 118.558 103.104 69.333 531.059




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Pertinence

Outcome 1 WASH

Analyse du contexte Par cette intervention, CRB-FL vise à améliorer l’accès de tous à l’eau et à l’assainissement et assurer une gestion participative durable des ressources en eau par une société civile forte (cibles stratégiques communes 1 et 6 du CSC). De cette façon, notre intervention contribue également aux objectifs de développement durable (ODD’s) 3,5,6 et 13. La pertinence d’une intervention WASH est décrite en p12 du CSC.

Le secteur AEPHA (Accès à l’Eau Potable, Hygiène et Assainissement) du Burundi est analysé dans le point 3.9 du ACC Burundi134. Il est en forte corrélation avec le secteur de santé analyse en point 3.7 du même ACC135. Le taux de couverture en eau potable demeure très bas : l’accessibilité de l’eau potable dans notre province d’intervention de Ngozi est 51% (chiffres actualisés par un spot check en août 2016), encore plus bas que la moyenne nationale de 60%.

Le taux d’assainissement de base en milieu rural est encore plus faible avec une moyenne nationale de 16% et un chiffre de 14% à Ngozi. En plus, dans les écoles, ce taux est encore moins élevé avec une moyenne nationale de 4%.

Bénéficiaires directs Nous définissons les bénéficiaires directs comme les personnes bénéficiaires d’infrastructures nouvellement construites et des sessions de sensibilisation. Un total de 32.344 bénéficiaires directs sera atteint dans les trois communes Nyamurenza, Busiga et Mwumba. CRB réalisera le programme complet à Nyamurenza et effectuera des activités du type ‘soft’ en synergie avec Protos à Busiga et Mwumba. Le dossier présentera des moyennes pour les trois communes en ce qui concerne le ‘soft’. Mais dans le courant de l’exécution du programme un suivi et monitoring sera réalisé sur chaque commune distincte.

Parmi les bénéficiaires directs (non exhaustif) :

• les familles qui seront desservies par une Ecosan individuelle : 200 • les autres familles d’une communauté ou une école, privées d’installations sanitaires adéquates (Ecosan ou autre) : 2000

x 5 • des enseignants et élèves d’une école qui manque une installation de récupération d’eau de pluie ou toilette Ecosan :

2000 • des familles dans les unités collinaires et plus spécifiquement les plus vulnérables en manque d’installations sanitaires

et/ou bénéficiaires d’un sanplat : 1000 • les familles bénéficiaires des sources aménagées : 3000 • les personnes bénéficiaires des sessions PHAST et CHAST : 5400 • les membres des comités de points d’eau : 100 x5=500 • les membres des comités des Régies Communales de l’Eau : 3x5 personnes =15 • les familles formées en utilisation et Ecosan : 200 • les familles bénéficiaires des formations en utilisation de l’eau à domicile : 2000 • les bénéficiaires des formations pour les activités génératrices de revenus : 1000

Il est important de noter que la CRB-FL a choisi de compter les bénéficiaires individuels seulement une fois, même s’ils peuvent être atteints plusieurs fois avec des différentes activités (p.ex. par différentes technique de changement de comportement, formations et formations de recyclage. Cependant, ces activités de programme ont chacune leur coût individuel, ce qui signifie que le coût par bénéficiaire ne peut pas se faire par une simple division du coût total du programme par le nombre mentionné ici.

Bénéficiaires indirects Il est prévu qu’une retombée des réalisations de ce projet affecte d’autres habitants des UC des trois communes d’intervention, y compris des deux communes pour lesquelles il y a une synergie avec Protos. Une famille au Burundi se compose de 5 membres minimum. Nous avons considéré un facteur x5 pour le calcul des bénéficiaires indirects. Cette façon de calculer est plus précise qu’un calcul basé sur la différence de la population totale moins les bénéficiaires directs. Le chiffre de la population étant trop imprécis et estimé. Ceci porte le nombre de bénéficiaires indirects à 161.720.

134 Analyse de Contexte Conjointe Burundi (2015), page 33 135 Analyse de Contexte Conjointe Burundi (2015), page 29

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Localisation L’intervention WASH OD se concentrera dans la commune de Nyamurenza. La synergie avec Protos concernera les communes de Busiga et Mwumba.

La commune de Nyamurenza même, limitrophe aux deux communes de la synergie, sera uniquement couverte par la CRB.

Cette province a subi des épisodes de malaria épidémique de 2000 à 2010 et de diarrhée épidémique périodique. La région de Ngozi a également un problème spécifique de malnutrition chronique qui est en rapport avec le grand nombre de personnes par famille. La densité de la population à Ngozi est de 475 habitants/km² par rapport à la densité nationale de 300 habitants/km. Selon le directeur Santé et Soins de la CRB, la plupart des problèmes de santé sont liés au taux de naissances et au manque d’accès à de l’eau potable, qui cause beaucoup de maladies infantiles.

Genre Conformément au 5ièmeODDetà l’article de stratégie sur le Genre du DGD’, la CRB-FL travaille au travers de cette intervention à la promotion de l’égalité des genres et l’autonomisation des femmes en améliorant l’accès à la santé pour les femmes.

La pertinence du genre dans un programme WASH est d’une importance particulière : en Afrique seulement, les personnes passent 40 billion d’heures chaque année juste en marchant pour collecter de l’eau. Ce sont généralement les femmes et les enfants qui portent cette charge.

Investir dans une disponibilité accrue d’infrastructure WASH sûre et durable, a pour cette raison un effet significatif sur le temps gagné par les femmes/filles pour des activités WASH. Ce temps gagné peut être passé à d’autres activités qui améliorent la génération de revenus ou le développement personnel. Une étude de quatre pays de la Banque Mondiale a démontré que la fréquentation scolaire des filles augmente de façon significative pour chaque heure en moins consacrée à la collecte d’eau136.

Par la remise en usage et l’extension des systèmes d’eau existants, cette intervention vise à diminuer le temps consacré à des activités WASH. Ceci est également mesuré par l’indicateur 1.4 dans le Cadre Logique. De plus, par la construction et remise en service de latrines séparées par genre dans les écoles qui répondent aux besoins en hygiène et sécurité des femmes et des filles, cette intervention contribue à un environnement scolaire favorable aux femmes qui améliore la fréquentation scolaire des filles et des femmes.

La CRB entame aussi une approche qui tient compte de la violence sexospécifique. Ceci implique une campagne de sensibili-sation auprès des unités collinaires à la problématique ; l’orientation des victimes vers de structures de santé et une orientation vers des structures d’accueil pour un prise en charge juridique.

Ces approches genre se conjuguent donc avec les activités spécifiques reprises dans le programme : - Installation de toilettes séparées - Kit hygiéniques pour les filles à l’école - Formation et sensibilisation du personnel des écoles à l’approche genre - Attention particulière à la présence des femmes dans les nouveaux comités de points d’eau (adductions et sources

aménagées)

- Discrimination positive à compétence égales dans les structures déconcentrées de la CRB

Environnement La CRB-FLest consciente des nombreux liens entre notre intervention WASH et la préservation et la protection de l’environne-ment :

• Les sources d’eau seront protégées et les latrines seront situées en aval des puits, au moins à 30m de sources d’eaux souterraines et au moins à 1,5m au-dessus de la nappe phréatique.

• La prise de conscience quant à l’importance de la conservation d’eau augmentera. Pour la construction de systèmes d’eau, il est tenu compte de l’environnement en protégeant les ressources naturelles, p.ex. la plantation d’arbres ou l’encouragement à la reforestation. Ces activités sont en majeure partie autofinan-cée par des activités génératrices de revenus au niveau collinaire.

• Par ailleurs, cette intervention WASH est implémentée avec la méthode PHAST, développée par l’OMS. Ce guide offre une méthodologie pour un changement comportemental de la communauté sur l’hygiène et pour une amélioration d’installations d’eau et d’assainissement. Dans cette approche, une meilleure santé est liée à un meilleur environnement. Pour cette raison, PHAST a une composante environnement ale so-lide137.

De plus, la CRB-FLest consciente que des interventions WASH sont liées à l’adaptation au changement climatique et à l’aug-mentation de la résilience des communautés. Le cinquième rapport de synthèse du Groupe d’experts intergouvernemental sur

136 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/193656/WASH-evidence-paper-april2013.pdf 137 http://www.who.int/water_sanitation_health/hygiene/envsan/phastep/en/

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l’évolution du climat (GIEC) indique que la tension aggravée sur les ressources en eaux faisant face à une pression significative de surexploitation et dégradation, forme des risques clés pour le continent africain138. Notre intervention vise à obtenir une disponibilité accrue d’une infrastructure WASH durable pour les communautés les plus vulnérables et à améliorer les mesures d’économies d’eau et le comportement.

Plus spécifiquement, le programme prévoit dans l’installation des toilettes ‘Ecosan’ collectives et individuelles, Ce type de toi-lettes crée de fumier humain disponible localement en compostant de la matière fécale et de l’urine, ce qui améliore l’adjonction de matériaux organiques sur le sol où il est appliqué. Des études ont prouvé que l’Ecosan améliore le taux de phosphore et nitrogène des sols, ce qui réduit la nécessité d’appliquer des fertilisants chimiques139. Ceci oriente l’agriculture vers la culture biologique et protège les sources d’eau contre la pollution par une installation dangereuse d’évacuation de déchets humains.

Outcome 2 Premiers Secours

Analyse du contexte Par notre intervention de PS, le programme veut contribuer aux cibles stratégiques 1 et 4 du CSC et aux OSD 1, 3, 5 et 8. La pertinence d’une intervention de PS est analysée en page 11 du CSC, et fait référence à l’analyse du secteur de la santé pu-blic dans l’ACC140. Citons surtout dans un contexte de premiers secours la phrase « le système de santé est peu en mesure de réagir aux situations d’urgence, aux accidents, catastrophes et violences physiques ». L’analyse SWOT dans l’ACC141et l’analyse SWOT sectorielle142 reprend les risques les plus évidents et explique surtout le contexte de crise qui met une hypothèque sur la prise en charge des patients et le danger d’écroulement du système de santé. Ce risque est particulièrement aggravé dans les structures périphériques. Combiné avec la nécessité de soins préventifs et d’urgence, cette crise exige une réponse adéquate. La CRB avec ses volontaires regroupés en unités collinaires peuvent déjà en termes de premiers secours, et donc avant la prise en charge, atténuer le risque de diminution de qualité et quantité en soins de santé primaires. De facto la relation entre les Centres de santé et les unités collinaires est déjà étroite dans ce sens que souvent les infirmiers des centres de santés sont membres des UC. Ils renforcent l’orientation des patients membres de la communauté vers les centres de santé.

D’autre part, le programme répond au Cible Stratégique 1qui prône un renforcement des organisations de la société civile Burundaise. La CRB est sans doute une des organisations le mieux structurées, déjà reconnue comme auxiliaire au pouvoir public en ce qui concerne les actions humanitaires. Son renforcement afin de se consolider et développer en profondeur comme acteur essentiel en termes de premier secours constitue un atout dans le développement du pays.

Bénéficiaires directs L’intervention atteindra 11.787 bénéficiaires directs. Ils peuvent être séparés de la manière suivante :

• Les formateurs : 91 formateurs seront encadrés durant cette période • Les volontaires dans les unités collinaires, les équipes secouristes routières et secouristes dans les unités gestion de

catastrophes : 11.696

Bénéficiaires indirects Il est très difficile de quantifier et de contrôler le nombre de bénéficiaires indirects vu le vaste porté des applications de premiers

secours (allant du nettoyage d’une petite blessure à l’arrêt d’une hémorragie grave). Sur base de l’hypothèse qu’en moyenne

une personne formée assistera 5 personnes avec des premiers secours de qualité evidence-based, le nombre de bénéficiaires

est 66.135. Ce chiffre tient compte du nombre total de personnes formées au PS par la CRB, même si ces formations ne sont

pas un output direct du programme. Ceci est le cas des 1.250 personnes qui seront formées aux Premiers Secours Commerciaux

et 1.800 brigadistes des postes de Sécurité Routière.

Localisation L’intervention Premiers Secours Communautaire se déroule sur le plan national et dans toutes les provinces. Les formateurs

encadrés seront également présents au niveau de chaque province, ce qui permettra indirectement de renforcer la qualité des

services fournis au niveau des postes de secours.

La majorité des activités de PSCo concerne la capitale vu la concentration économique et politique autour de Bujumbura.

138 http://ipcc-wg2.gov/AR5/images/uploads/WG2AR5_SPM_FINAL.pdf 139 Khatri N., Sustainability and Chimate Change aspects of Ecosan Toilet: http://www.huussi.net/wp-content/up-loads/2013/07/Nam_Raj_Khatri.pdf 140 Analyse de Contexte Conjointe Burundi, pages 29 à 31 141 Point 5.4 pages 49-50 142 Pages 81-82

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Toutefois, la CRB envisage une décentralisation ce qui aura comme conséquence pour les PSCo une meilleure couverture des

entreprises et organisations

Les grandes entreprises seront également vraisemblablement touchées par ces améliorations, et ce, quel que soit leur localisa-

tion dans le pays ou les chantiers sur lesquels elles interviennent.

Genre Le matériel de formation sera développé selon les lignes directrices AFAM et sont sensibles aux besoins spécifiques des femmes et des filles comme récepteurs et donneurs de premiers secours : l’attention est attirée sur des situations spécifiques rencon-trées par les femmes, telles que l'accouchement sans assistance médicale. Les mannequins utilisés seront développés pour répondre aux convenances des femmes et des filles. De plus, pour plusieurs indicateurs, le nombre de base est développé par des données ventilées par sexe afin de comprendre l’impact de l’intervention sur les femmes.

Environnement Nos interventions visent à soutenir la CRB à donner des formations de PS de haute qualité aux volontaires, jeune écoliers, propre personnel afin d’accroître les capacités de réponse aux urgences soudaines, et d’augmenter ainsi leur résilience. Ceci sera d’une importance particulière pour faire face aux conséquences du changement climatique, qui changera fortement la volatilité des extrêmes météorologiques.

Au niveau à petite échelle du projet, des mesures seront prise pour limiter l’impact de notre intervention sur l’environnement, tel que rendre standard l’impression double des publications et outils de formation.

Pertinence selon d'autres thèmes prioritaires de DGD

Digital 4 Development Dans le domaine de PS, la CRB-Fl soutiendra la CRB dans l'élaboration et la maintenance de bases de données au niveau du siège principal. Ces bases de données servent comme système d'enregistrement des formations de PS. Ces données aident la CRM à traiter et gérer efficacement leur service de PS.

Dans le domaine WASH également, la CRB-Fl soutient l’utilisation d’outils mobiles de collecte de données, ce qui résulte en un monitoring et évaluation précis, ponctuel et rentable. Les données d’enquêtes peuvent être traitées plus rapidement et effica-cement et le risque d’erreurs est réduit. De plus, la collecte mobile de données permet à la CRB d’assigner des coordonnées GPS à des sources d’eau et des infrastructures WASH et permet à la CRB-FL d’avoir un aperçu en temps réel de la cartographie et du travail réalisé sur le terrain, vu que les données obtenues seront téléchargées sur base régulière. Il sera ainsi possible de réajuster rapidement en cas de problèmes. En plus, la CRB-Fl envisagera avec la CRB l’utilisation d’images satellite comme partie de sa stratégie d’évaluation de son inter-vention WASH, y compris pour l’exercice de collecte des valeurs de base pour ces domaines cibles pour lesquels des peu de données sont disponibles. Une formation de base GIS pourrait être donnée au Représentant de pays CRB-Fl au Burundi afin d’être capable de réaliser les analyses de base des géo données, ainsi qu’au personnel et volontaires de la CRB impliqué dans la collecte de données primaires.

Travail décent Comme décrit dans l’annexe 3, en augmentant la qualité et la quantité des formations de PS et des services de PS Commerciaux adaptés aux professions dangereuses, la CRB-Fl et la CRB contribuent à améliorer la Santé et Sécurité au Travail (SST). La SST forme un résultat clé du programme pays pour le travail décent 2012-2015, la stratégie convenue par le gouvernement de Burundi pour mettre en œuvre leur Agenda du Travail Décent de l’Organisation internationale du Travail (OiT).

Droits de l’homme Comme décrit dans l'annexe 4, les droits de l’homme ont toujours été présents dans le travail du Mouvement de la Croix-Rouge. Nos interventions de WASH et de PS à Burundi tirent l’attention sur le droit fondamental de vivre en bonne santé. La première approche pour opérationnaliser le travail sur les droits de l’homme, est notre diplomatie humanitaire. Grace au rôle d'auxiliaire de la CRB, leur accès privilégié et la relation avec le gouvernement et les décideurs politiques est un levier pour résoudre les problèmes spécifiques liés à notre domaine d'intervention et contribue à la capacité des «détenteurs d'obligations» pour répondre à leurs engagements, telles que intégrer les PS dans les activités extrascolaires des écoles primaires.

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Efficacité

Cette intervention fait référence aux approches 1A à 1J sous CSC 1 et aux approches 6A à 6J sous CSC 6 du CSC Burundi pour l’intervention WASH et aux approches 4A, 4B, 4C, 4D, 4G et 4H pour l’intervention PS.

Tout d’abord, deux choses rendent cette intervention «CRB-Fl spécifique»:

1. Le travail avec les volontaires En tant qu'organisation Croix-Rouge, les volontaires forment l'épine dorsale de la CRB-Fl et CRB. Investir dans les compétences des volontaires assure une mise en œuvre qualitative de l'objectif principale de la CRB: aider les plus vulnérables à Burundi. Le grand atout des volontaires, est leur enchâssement dans les communautés locales, même les plus éloignés, ce qui permet la CRB d'être un premier intervenant en cas de maladie, blessure ou menace. A Burundi, où l'accès aux soins médicaux est limité, la présence de volontaires de la Croix-Rouge avec la connaissance des techniques correctes de PS, est donc un facteur clé pour réduire la mortalité et la morbidité due à une maladie ou blessure soudaine au sein de leurs propres communautés.

2. Notre « Evidence-based Practice » S’assurer que toutes les activités soient basées sur des données scientifiques probantes, est un principe de base au sein de la CRB-Fl. Pour soutenir cette initiative, la CRB-Fl a créé le Centre for Evidence-Based Practice (CEBaP) il y a 10 ans. Ce centre de recherche utilise une méthodologie reconnue internationalement pour collecter, systématiser et évaluer des données scienti-fiques pertinentes pour étayer nos activités. Lorsqu’il n’y a pas de suffisamment de données probantes, une recherche primaire est menée pour soutenir nos activités de base – par exemple, la recherche concernant la rétention de connaissances et de capacités PS au Népal ou concernant des facteurs de changement de comportement pour les interventions WASH au Malawi.

CEBaP a développé des recommandations et matériaux PS evidence-based pour le continent africain, l’Inde et le Népal qui seront utilisés dans tous nos programmes PS. (AFAM pour le Burundi). Sur base de sommaires de données probantes dévelop-pés par CEBaP, un panel d’experts régionaux/locaux a rédigé des recommandations de premiers secours, en tenant compte des préférences du (des) groupe(s) cible(s). Ces recommandations furent alors utilisées pour développer du matériel didactique éducatif pour premiers secours, tel un manuel, des posters, des cahiers d’exercices etc.

Dans le domaine WASH, la façon de travailler evidence-based est implémentée depuis 2015 à travers le partenariat entre la CRB-Fl et Professeur H.J. Mosler de la EAWAG University à Zurich. A travers cette coopération, la CRB-Fl a introduit l’approche RANAS du changement comportemental dans ses programmes WASH (voir ci-dessous).

CEBaP est reconnu en tant Centre de Référence FIRC et vise à se développer plus amplement dans le « RC³ » (Red Cross Red Crescent Research Centre), fournissant ses services au sein de mouvement CR. Ces services sont également fournis à des par-tenaires non CR (CEBaP a par exemple effectué une recherche de données probantes concernant la contamination d’eau potable par du fluorure au Sénégal, pour la Belgian Technical Cooperation). Toutes les recherches primaires et secondaires menées par CEBaP sont publiées dans des revues révisées par des pairs. En plus, par son lien avec CEBAM, le Centre Belge pour Médecine Evidence-Based et le Centre Cochrane Belge, CEBaP est sur le point d’être accrédité pour le développement de recommandations evidence- based suivant la méthodologie Cochrane143.

Outcome 1 WASH

Stratégie d’Intervention En faisant référence au TdC, qui forme l’aperçu schématique de la stratégie d’intervention, le renforcement des capacités et des activités génératrices de revenus, surtout au niveau des unités collinaires, assureront la consolidation de l’organisation de la CRB dans tous ses échelons. Ceci amènera la CRB à se constituer comme partenaire reconnue, par des activités de diplomatie humanitaire, par le gouvernement et comme organisation capable et expérimentée de fournir des activités WASH effectives.

Des activités du type ‘hard’, la construction ou réhabilitation de 100 points d’eau et la formation des CPE’s, assureront que la population cible bénéficie d'une amélioration de l'accès à l’eau potable, tandis que la construction de 1.000 latrines et 4 blocs sanitaires dans des écoles, combiné avec les formations pour utiliser ces infrastructures d’une manière adéquate, assureront un meilleur assainissement.

Les deux axes, combiné avec les formations en changement de comportement hygiénique et la stratégie de Ménages Modèles où la femme joue un rôle essentiel, amèneront le groupe cible à une meilleure capacité de gérer l’eau potable de façon res-ponsable et durable et d’utiliser durablement l’infrastructure sanitaire, ceci combiné avec des aptitudes comportementales sanitaires hygiéniques.

143 http://www.cochrane.org/

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L’amélioration de l’hygiène par le groupe cible assurera une diminution de l’incidence des maladies hydriques auprès de la population ciblée ce qui sera le canevas pour l’obtention des CSC’s 1 et 6.

L’élément-clé dans l’intervention WASH est l’amélioration des techniques de promotion d’hygiène. Pour cela, la CRB, la CRB-Fl et EAWAG ont commencé en 2016 déjà d’implémenter l’approche RANAS (Risks, Attitudes, Norms, Abilities, and Self-regulation) au Malawi, où une recherche evidence-based assiste le programme en apprenants quels éléments définissent un certain com-portement, et par conséquent identifie des interventions spécifiques qui cibles les comportements qui ont besoin de changer. Ces expériences seront partagées avec CRB et des activités d’intervention spécialisées seront fournies et enseignées à des volontaires qui vont ensuite les implémenter et atteindre les ménages cibles. L’impact de ces techniques sera mesuré durant 2019 une première fois et à nouveau à la fin en en 2021. La première mesure ne donnera pas uniquement l’opportunité d’ajuster l’intervention mais permettra aussi la CRB, armée avec cette première expérience analytique et leçons apprises, de reproduire le processus RANAS.

Outcome 2 PS

Stratégie d’intervention La CRB tiendra à la fin de son programme DGD 2014-2017 un atelier d’orientation préparatif pour élaborer la stratégie de PSCo et Premiers Secours Communautaires début 2017. Ce workshop conclura l’intervention PS des années précédentes et formera un moment fructueux pour définir plus en profondeur les choix stratégiques de l’intervention en Premiers secours profession-nels et communautaires pendant la durée du programme 17-21.

Toutefois, les leçons apprises actuelles donnent déjà une idée claire du déploiement de notre intervention PS dans les années à venir : un ensemble de formations sera organisé pour les volontaires, les formateurs et éducateurs et la standardisation des formations et du matériel de formations en assurera le caractère evidence-based au niveau des normes fixées par la CR. En plus, un système de surveillance assurera la qualité de renforcement de capacités.

Deuxièmement, un appui au développement organisationnel de la CRB sera réalisé. Un atelier d’orientation et de stratégie fixera les axes principaux d’appui managérial. Il se concentrera essentiellement dans la gestion de données, l’appui en gestion administrative et financier.

Le développement du service PSCo est un autre réalisation à court terme qui devra assurer la durabilité à long terme notamment le fait que la CRB est une organisation reconnue dans le champs du PS et d’autre part que la CRB est consolidé dans sa capacité de réaliser du PS de qualité.

Cette stratégie vise à permettre au grand public d’avoir le savoir-faire, les attitudes et les bonnes pratiques en ce qui concerne les premiers secours. D’autre part les volontaires CRB auront ainsi aussi la connaissance, l’es attitudes et la bonne pratique, mais aussi le matériel et l’ appui organisationnel afin de pratiquer du PS de qualité.

Durabilité

Outcome 1 WASH

Durabilité technique : • Les éléments et matériaux utilisés pour les infrastructures WASH sont faciles à utiliser et ont une longue durée de vie. • L’intervention tient compte des risques potentiels, c’est-à-dire que des dangers naturels et technologiques, sont pris en

considération dans l’élaboration et l’implémentation du programme. • Des infrastructures Ecosan combinent un assainissement efficace avec l’utilisation des excréta pour la production d'en-

grais.

Durabilité sociale : • L’intervention de la CRB-Fl vise à améliorer un changement comportemental durable. La CRB travaille avec des volon-

taires qui sont intégrés dans les zones d'intervention sélectionnées et qui ont une grande capacité d’améliorer l’appropriation locale de l'intervention. Ces volontaires ne dépendent pas du financement de CRB-Fl. Le renforcement de capacités réalisé pour ce groupe de volontaires par l'intervention, restera en place après que le financement sera retiré.

• La stratégie de Ménages Modèles contribue à un développement durable dans ce sens que des familles modèles qui mettent en pratique 10 critères concernant notamment l'hygiène, le comportement et l’aménagement de leurs espaces, appuient sur base de volontariat les familles les plus pauvres sur leurs collines.

• L’infrastructure installée répond aux exigences de la législation locale et est pour cette raison appliquée par les autorités locales. La CRB soutiendra aussi les unités collinaires pour les activités génératrices de revenus ce qui assurera la péren-nisation des ouvrages.

Stratégie d’exit :

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• En soi, les investissements dans des infrastructures combiné avec les techniques de promotion de l’hygiène (formations PHAST, CHAST etc.) visent une amélioration pérenne dans la disponibilité de l’eau potable, sa qualité et le comporte-ment des habitants d’une colline. La stratégie d’exit ici consiste à créer des comités d’eau qui, dès la finition des ouvrages, intègrent les RCE (Régie Communaux de l’eau) et assurent l’entretien et le recouvrement des frais de gestion auprès des clients. Ceci fait évoluer la situation de l’approvisionnement en eau d’un assistanat vers une gestion durable et autonome. L’introduction et vulgarisation de l’Ecosan constitue aussi un pas vers une prise en charge autonome (par les familles mêmes) de l’assainissement. Finalement la CRB, par le renforcement des capacités et la capitalisation des expériences via les synergies, évoluera de plus en plus vers une structure autonome en termes de WASH.

Outcome 2 PS

Durabilité technique : • L’intervention de la CRB-Fl vise à renforcer la capacité institutionnelle en PS de la CRB en intégrant un service de PS au

sein de l’organisation, qui peut ancrer les prestations en PS d’une manière durable. Ceci se fait en soutenant la gestion du service de Premiers Secours, la gestion de volontaires et le développement organisationnel.

• Cette intervention tient compte de risques, c’est-à-dire que des risques potentiels tels des dangers naturels et technolo-giques, sont pris en compte dans l’élaboration et l’implémentation du programme.

• La CRB mettra en pratique les techniques de Premiers Secours dont l’efficacité est scientifiquement prouvée et proposé par la CRB-Fl. Par exemple l’utilisation de miel en cas de brulures. Ceci limite la nécessité de « hi-tec » importé et la va-lorisation du savoir-faire ou matériel local.

Durabilité financière : • Le soutien de CRB-Fl vise à soutenir la CRB dans ses prestations services de PSCo, tout en travaillant sur les étapes im-

portantes déjà entreprises. Ainsi l'autonomie financière est renforcée et la dépendance de donateurs extérieurs est réduite.

• Condition, mais supposition justifiée (sur base des plus-values créées les années précédentes), préalablement à l’obten-tion des résultats escomptés est que la CRB réalisera un minimum de plus-value sur base de ses activités PSCo. Ces moyens financiers appuieront la structuration du service de PS et ses actions.

Durabilité sociale : • La CRB travaille avec des volontaires qui sont intégrés dans les zones d'intervention sélectionnées et qui ont une grande

capacité d’améliorer l’appropriation locale de l'intervention. Ces volontaires ne dépendent pas du financement de CRB-Fl. Le renforcement de capacités réalisé pour ce groupe de volontaires par l'intervention de la CRB-Fl, restera en place après que le financement sera retiré vu que ces volontaires ne sont pas payés et ne dépendent dès lors pas de financement de la CRB-Fl.

Stratégie d’exit : • Tout renforcement de capacités organisationnel, institutionnel et en techniques spécifiques de premiers secours contri-

buent à l’autonomisation de la CRB. L’amplification de activités de premiers secours en milieu Professional assurera des entrées financières qui non seulement prévoient dans la pérennisation du service premiers secours mais créera un canevas pour le fonctionnement de toute la CRB.

• Les activités de diplomatie humanitaires assureront la place unique que la CRB détienne déjà partiellement au niveau des formations en premiers secours dans les institutions étatiques, d’enseignement, secteurs de sécurité routière et de santé en général.

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Efficience

Délégation

Un délégué de CRB-Fl sera basé à Bujumbura, afin d’assister la CRB avec l’implémentation ponctuelle et de qualité de ce pro-gramme. Les tâches principales de ce délégué sont la coopération étroite sur base quotidienne avec CRB, tant au niveau central que dans l’aire du projet. Le délégué assiste la CRB au niveau de la gestion et au niveau technique, afin d’assurer une implé-mentation ponctuelle, effective et efficace, et sur le plan technique afin d’assurer l’impact et la durabilité. La proximité du partenaire d’implémentation permet un input directe pour réaliser les Outcomes et Outputs du projet, tout en renforçant les capacités du partenaire d’implémentation, tant au niveau du personnel qu’au niveau institutionnel. Le délégué est soutenu dans sa tâche par des experts de la CRB-Fl du siège principal qui fournit l’avis d’experts concernant les aspects de gestion (PMER, Finance, Project management) et technique (Premiers Secours et WASH). Grâce à sa proximité géographique avec les autres délégations de la CRB-Fl au Rwanda et en Tanzanie et grâce aux caractéristiques similaires entre les pays de la Région des Grands Lacs, la Croix-Rouge du Burundi bénéficiera également de l’apprentissage entre pairs et de soutien technique direct fourni par la délégation CRB-Fl au Rwanda (délégué avec un profil DP/DRR) et en Tanzanie (délégué avec profil PS).

Outcome 1 WASH

Des effets rentables des investissement dans WASH sont reconnues partout au monde : • L’OMS estime que pour chaque US$1 investi en eau et assainissement, il y a un retour économique d’US $4 en gardant

les personnes saines et productives144. • La Banque Mondiale a déclaré que la promotion d’hygiène est une des interventions santé les plus rentables145. Il y a également de forts arguments économiques pour investir dans WASH. Selon le Human development report de l’ONU, le manque d’eau salubre, d’assainissement et d’hygiène cause dans les pays Subsahariens des pertes annuelles équivalentes à 5% du Produit intérieur brut, plus que ce que le continent entier reçoit en aide au développement.146

Description des ressources

1. Frais d’investissement

Conformément aux principes comptables de la CRB, tous les frais pour l’infrastructure d’eau et d’assainissement sont inclus dans les frais de fonctionnement. La plus grande partie du budget d’investissement limité (68%, 15.959 EUR) est pour cela alloué à la réhabilitation et au matériel de bureaux. Le budget restant (7.568 EUR, 32%) est alloué à des moyens de transport, nécessaires pour voyager vers les villages éloignés.

2. Frais de fonctionnement

Les frais de fonctionnement généraux consistent principalement en 26.108 EUR pour l’entretien des véhicules de projet, 24.778 EUR pour le carburant et 17.513 EUR pour la communication et les services. Comme la construction de points d’eau est d’une importance majeure pour atteindre l’Outcome, ce poste constitue la plus grande parties du budget des frais de fonctionnement (244.227 EUR, 37%). Le renforcement de capacités en comportement hygiénique, y inclus la construction des latrines Ecosan, en est un autre poste important (179.160 EUR, 27%). L’implémentation des activités suivant le modèle RANAS est une des stratégies clés pour atteindre le changement comportemental et constitue dès lors une autre partie considérable du budget (50.000 EUR, 8%). Il est important noter que les frais d’expertise et de facilitation concernant la recherche-coopération avec EAWAG sont couverts par la BRC-Fl.

3. Frais de personnel

Personnel local CRB

L’équipe de personnel local de la CRB consiste en 4 membres (1 coordinateur, 2 responsables (« hard » et « soft ») et un comptable) + 7 membres provinciaux (3 point focaux, 1 secrétaire provincial et 3 secrétaires communales). Les coûts sala-riaux inclus dans le programme sont dégressives.

Personnel expat BRC-Fl

Les Outcomes 1 et 2 sont soutenus par un délégué temps-plein de la BRC-Fl basé à Bujumbura. Le budget salarial consiste en des frais de salaire pour la durée du programme et est partagé sur les deux Outcomes. D’autres frais, comme les frais d’accommodation, de transport et autres frais opérationnels sont compris dans les frais généraux de fonctionnement.

Personnel Siège Princi-pal BRC-Fl

L’intervention est soutenue par un expert technique WASH de la CRB-Fl , basé à Malines (Belgique). Le budget se compose du salaire et des frais de transport (0,08 Equivalent temps plein (ETP) pour Burundi). Ce point focal WASH du SP surveille la qualité en offrant l’expertise technique directement ou par le service national de Premiers Secours de la CRB-Fl et de CE-BaP à la CRB. Des exemples sont des missions techniques spécifiques de courte durée sur les techniques de changement comportemental.

144 Hutton G (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal cover-

age, p4. WHO, Geneva, Switzerland. 145 Jamison et al. (eds) (2006). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank. 146 Based on percentage estimate from UN Development Programme (2006) Human development report. Available at: www.hdr.undp.org/en/media/HDR06-complete.pdf

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Outcome 2 PS

Selon une étude de la Banque mondiale147, la formation de premiers intervenants aux premiers secours est une intervention particulièrement rentable; c’est une des opportunités rentables les plus négligés dans le pays à revenu bas et moyen. L’éduca-tion aux premiers secours coûte 8US$ par ‘Disability-adjusted life year’averted. Ceci rend cette intervention un des moyens les moins chers pour augmenter la santé publique dans les pays en cours de développement.

Description des ressources

1. Frais d’investissement

Conformément aux activités pour l’Outcome, 27.845 EUR ou 88% du budget d’investissement est alloué pour du matériel de formations de PS

2. Frais de fonctionnement

Les frais de fonctionnement généraux se constituent principalement de 17.784 EUR (6,5%) pour communication et facilités et 11.784 EUR (4%) pour frais de transport. La Formation (de recyclage) de Formateurs et des Formateurs Master sont des activités clés. Le budget pour l’amélioration de la qualité et de la durabi-lité du Service Premiers Secours de la CRB, s’élève à 51.876 EUR (19%). Le coaching, monitoring et la supervision continue des formateurs et des formations durant la période d’implémentation sont budgétés à 58.170 EUR (21%). Le développement et la production et l’entretien de matériaux de formation et PS coûte 37.189 EUR (14%) et la formation des volontaires, du personnel et de la jeunesse sont un autre poste de frais important, pour un total de 42.559 EUR (16%)

3. Frais de personnel

Personnel local CRB L’équipe de personnel local de la CRB consiste en 1 coordinateur de projet (1 ETP – 5 ans), 1 Formateur Master (1 ETP – 5 ans) et un membre de personnel de soutien (1 ETP – 5 ans). Les coûts salariaux inclus dans le programme sont dégressives.

Personnel expat BRC-Fl Les Outcomes 1 et 2 sont soutenus par un délégué temps-plein de la BRC-Fl basé à Bujumbura. Le budget salarial consiste en des frais de salaire pour la durée du programme et est partagé sur les deux Outcomes. D’autres frais, comme les frais d’accommodation, de transport et autres frais opérationnels sont compris dans les frais généraux de fonctionnement.

Personnel SP BRC-Fl L’intervention est soutenue par un expert technique de PS de la CRB-Fl, basé à Malines (Belgique). Le budget se compose du salaire et des frais de transport (0,06 ETP pour le Burundi).C’est le point focal central du Siège Principal qui surveille la qualité du programme PS en fournissant l’expertise technique du service national de Premiers Secours de la CRB-Fl et de CEBaP à la CRB. Cela se fait par exemple en exécutant ou facilitant des missions techniques spécifiques de courte durée concernant l’expertise didactique PS, expertise en exercices de simulation, analyse de rentabilité des PSCo de la CRB, …

147 In Jamison et al. (eds) (2006). ibid

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Partenariat

La CRB-Fl fonctionne toujours dans le cadre de partenariats du Mouvement International de la Croix-Rouge et du Croissant-Rouge et la Société Nationale fonctionne toujours comme seul partenaire privilégié. Les principes de la coopération et le ren-forcement des capacités sont formalisés dans la ‘Development Cooperation Policy (2007)’, the ‘National Society Development

Framework (2013)’& the ‘Code of Good Partnership’ de la Fédération Internationale des sociétés de la Croix-Rouge et du Crois-sant-Rouge (FICR).

Tous les partenaires de la Croix-Rouge dans ce programme sont des partenaires stratégiques, ce qui signifie l'engagement de coopération dans lesquels des objectifs communs sont définis et l'accent est mis sur le renforcement des capacités et le transfert de l'expertise technique. Tout ça pour que le partenaire soit en mesure de mettre en œuvre des services de PS de qualité aux personnes les plus vulnérables dans les priorités thématiques de la CRB-Fl .

CRB

La Croix-Rouge de Burundi, par son réseau décentralisé de volontaires au niveau des communautés (colline) est la plus grande organisation humanitaire au Burundi. Elle fut reconnue officiellement par le Décret Ministériel No. 100/184 le 5 avril 1963 (plus tard amandée par le Décret Présidentiel No.2111 / le 18 novembre 1968) en tant qu’organisation volontaire d’aide, autonome et auxiliaire des autorités publiques. La période de sa restructuration entamée en 2004 pour s’achever en 2007, a contribué à renforcer les capacités et les compétences de la Société Nationale dans ses interventions en faveur des vulnérables. La CRB couvre le territoire national entier : plus de 98% de collines disposent de volontaires. Sa structure est fortement décen-tralisée : le siège principal est situé à Bujumbura et soutient 17 secrétariats provinciaux, 129 comités municipaux, 2.914 unités collinaires et un réseau de plus de 600.000 volontaires répartis dans tout le pays. Au niveau des premiers secours, mis à part quelques hôpitaux qui disposent d’ambulances, les premiers secours sont un ter-rain que pratiquement seule la Croix Rouge Burundaise occupe. Elle dispose de 85 formateurs formés en PS de base qui ont formé à leur tour 1.900 volontaires en PS. En premier secours d’urgence, 24 volontaires ont été formés. La CRB est aussi la seule structure capable d’organiser des cours de PS dans un milieu professionnel. Cette activité est bien sur fortement hypo-théquée par le contexte d’insécurité depuis 2014.

Au niveau du WASH, la CRB dispose de 6 ingénieurs ainsi que d'experts en promotion d’hygiène et un staff de 20 points focaux affectés dans les provinces. Elle dispose d’équipes formées de brigadiers en eau et assainissement en urgence (100 agents formés en région). La CRB peut capitaliser sur une expérience de terrain depuis 2010 avec des multiples réalisations.

Renforcement de capacités

Au début de 2017, une étude d’évaluation sera faite avec la CRB pour déterminer les besoins en renforcement de capacités dans le domaine de Monitoring & Evaluation spécifiquement relié à cette intervention. La nature d’un soutien plus avancé sera déterminée sur base du résultat de cette évaluation des besoins.

Outcome 1 WASH La CRB assure essentiellement le renforcement de capacités à tous les niveaux de son organisation (personnel national dépar-tement WASH, points focaux provinciaux, formateurs techniciens et les maçons/fontainiers volontaires) par des formations et recyclages reprises dans les actions. Un renforcement spécifique sera réalisé à travers la construction des toilettes Ecosan, technique par excellence adaptée au contexte Burundais. Ce renforcement de capacités sera essentiellement réalisé par la synergie avec Protos et assurera la réalisabilité.

Outcome 2 PS En ce qui concerne le PS, l’intervention vise en premiers années à renforcer les capacités du service de PS de la CRB, sur la base de critères et d’une méthodologie standard déjà appliqués dans d’autres pays partenaires de la CRB-Fl. Il s’agit en premier lieu de s’assurer que les PS sont solidement intégrés au sein de la CRB à travers le développement d’une stratégie et d’un plan d’action PS, la création d’une commission consultative pour les PS, l’application uniforme des formations PS dans les différents départements de la CRB, etc. En second lieu il s’agit d’améliorer la qualité des formations par l’élaboration de manuels stan-dardisés et adaptés au contexte et groupe cibles et par un soutien au niveau pédagogique.

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Synergies & complémentarités

Au cours de la durée de vie du programme, des synergies informationnelles avec d’autres ACNG belges et la Coopération bilatérale belge au développement seront maintenues aux cours de tours de consultation périodiques qui serviront de plate-forme d’échange de connaissance et d’expérience sur des thèmes, risques ou problèmes communs. La CRB-Fl participera activement à ces moments d’échange, qui seront une base fructueuse pour la formulation et l’opérationnalisation de nouvelles synergies et complémentarités. Les organisations suivantes participeront également à cette synergie informationnelle : WSM, BIS/MSI, ANMC, Sol Soc& UNMS, en tant qu’organisations du CSC Travail Décent.

En outre, l’aperçu ci-dessous montre les synergies opérationnelles et complémentarités qui sont déjà concrétisés:

WASH : Synergie avec Protos Objectif commun recherché : Dans le cadre de CSC 6, Protos se présente comme un partenaire expérimenté, efficace et reconnu. Il est donc évident que la CRB-Fl via la CRB et Protos combinent leur potentiel afin d’assurer un plus grand impact en termes de changement pour la population ciblée. Deux communes de Ngozi (Busiga et Mwumba) seront visées par cette synergie opérationnelle et deux objectifs sont recherchés : la sensibilisation et formation communautaire en matière de WASH d’une part, et d’autre part le renforcement des capacités des structures de gestion d’infrastructures et des CPE’s.

Rôles et devoirs : Protos et CRB-Fl réaliseront ensemble 1 kit PHAST actualisé au contexte du Burundi et organiseront con-jointement une première séance de formation. CRB-Fl se chargera ensuite de la poursuite des animations PHAST et la mobilisation des ménages via les UC et la stratégie Ménages Modèles. CRB-Fl va se charger du volet sensibilisation des com-munautés alors que Protos réalisera les travaux sur les adductions d’eau et se chargera de la sensibilisation dans les écoles. Aussi, Protos encadrera les RCE et installera des Ecoson familiales et institutionnelles. CRB-FL s’inspire de cette expertise pour l’installation et le suivi utilisation/entretien des Ecosan à Nyamurenza (son autre commune d’intervention). En ce qui concerne le deuxième objectif, CRB-Fl se chargera du renforcement des capacités des structures de gestion des infrastructures et CPE en matière d’hygiène et d’assainissement. Protos se chargera du renforcement des capacités des CPE sur les aspects techniques, organisationnels (gestion kiosques, paiement coût-eau, ... ) et renforcera les capacités des organes de gestion des infrastructures (gestion, planification, organisation, équipements, etc.). Protos et CRB-Fl s’efforceront à coordonner leurs missions de monitoring et d’évaluations et leurs meetings avec les parties prenantes.

Contributions financières : Environ 1.000 EUR pour le développement du kit PHAST. Environ 21.000 EUR pour les forma-tion des educateurs en PHAST et environ 4.500 EUR pour des sessions de formation de comités des sources.

Premiers Secours : Synergie avec Croix-Rouge de Belgique – Communauté francophone (CRB-Cf) Objectif commun recherché : Considérant qu’ils travaillent avec le même partenaire local, la CRB-Cf et la CRB-Fl mettront en place des synergies et complémentarités à un niveau opérationnel et informatif. Rôles et devoirs : La CRB-Fl appuiera le programme de la CRB-Cf pour ce qui est des formations des volontaires en Premiers Secours à Bururi, Gitega et Kirundo. La CRB-Fl appuiera le recyclage des connaissances technique des maçons fontainiers Croix-Rouge, en charge de la construction des sources. La CRB-Cf appuiera la CRB-Fl dans son développement d’AGR pour les structures décentralisées de la CRB à Ngozi. Les deux organisations travailleront ensemble avec la Croix-Rouge du Burundi pour partager l’information, harmoniser les approches, et développer des synergies logistiques. La CRB-Cc et la CRB-Fl assureront une représentation commune auprès du RESO (réseau des ONG). Contributions financières : Les coûts des formations de PS à Bururi, Gitega et Kirundo et les coûts de la formation en tech-niques hydrauliques, environ 20.000 EUR ensemble.

Premier Secours : Synergie envisagé avec Handicap International (HI) Entre HI et la CRB-Fl, une initiative pilote de formation au Premier Secours inclusif est envisagée. La mise en œuvre pourrait être testée dans des communes identifiées au préalable où interviendra HI, en collaboration avec les volontaires de la Croix Rouge. Cette démarche contribuera à l’atteinte du R4 OS2 (pour HI), pour une pleine participation et implication sociale des personnes handicapées, et Outcome 2 du CRB-Fl.

Complémentarités : Il y a un haut degré de complémentarité entre l’intervention de la CRB-F et le travail d’autres Sociétés Nationales Partenaires de la CRB (La Croix-Rouge des Pays-Bas, de l’Espagne, de la Norvège, de la Finlande et du Luxembourg). Les capacités aug-mentées de la CRB dans le domaine de la formation aux PS, infrastructure WASH (En particulier les toilettes Ecosan) et la promotion d’hygiène, peuvent être déployées dans les programmes de ces dernières. Aujourd’hui déjà, il y a des meetings mensuels entre toutes les Sociétés Nationales partenaires de la CRB qui assurent qu’il n’y a pas de chevauchement entre les différents partenaires.

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Madagascar Les profanes, le personnel et les volontaires Croix-Rouge possèdent les attitudes, capaci-tés et connaissances adéquates, à-jour et evidence-based pour donner les premiers secours à ceux qui en ont besoin, et ce, d’ici 2021. De telle façon, ils augmentent le niveau de résilience de la communauté et la capacité de soins d’urgences.

2017-2021

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Samenvatting

‘Rode Kruis-Vlaanderen (RKV) helpt helpen’ is de slogan die het 17-21 programma in Madagaskar samenvat. Enerzijds verwijst dit naar de focus op zelfredzaamheid, anderzijds naar de focus op impact. Mensen zelfredzaam maken is de manier bij uitstek om een duurzame impact te hebben. Zowel RKV’s interventiestrategie als de keuze van activiteiten in Madagaskar zijn gebaseerd op het idee van zelfredzaamheid. RKV’s interventiestrategie heeft als kernprincipe dat de implementatie van het programma geleid en gedragen wordt door de lokale Rode Kruis vereniging en haar vrijwilligers. RKV neemt een ondersteunende rol op zich maar zal zelf geen directe imple-mentatie doen. Het 17-21 programma, met een totaalbudget van 737.471 EUR, wordt dan ook getrokken door het Croix-Rouge Malagasy (CRM). Het programma is op vraag van en in nauwe samenwerking met CRM opgesteld. CRM is ook de grootste nationale humanitaire organisatie van Madagaskar en is actief in het volledige land. In onze activiteiten, kiezen we voor eerstehulponderricht. Door CRM personeelsleden, CRM vrijwilligers en leken op te leiden in eerste hulp wordt de bevolking van Madagaskar zelfredzaam gemaakt. Bovendien is er een duurzaam multiplicator effect door het opleiden van de ‘master trainers148’ (1.529 directe begunstigden en 60.976 indirecte begunstigden). De aanwezigheid van lokale ‘First Responders’ is van groot belang in een land dat kampt met een systemisch gebrek aan nodige gezondheidsin-frastructuur, zeker in tijden waarbij de kans op politiek geweld een reële dreiging is. De slechte staat van de wegen en het gebrek aan tijdige hulp na een ongeval, verhogen daarnaast de menselijke tol van verkeersongevallen. Het programma richt zich in de eerste plaats op de CRM hoofdzetel in Antananarivo, die in staat zal worden gesteld om een kwalitatieve ondersteuning te bieden aan de eerstehulpopleidingen verspreid over het volledige land. Daarnaast worden 5 regio’s in het bijzonder ondersteund, gezien hun strategische locatie vlakbij de grote invalswegen en belangrijke steden die kwetsbaar zijn voor politieke onrusten. De trainingscapaciteit van CRM zal worden versterkt met 45 eerstehulptrainers en 5 master trainers. Naast het opleiden in eerste hulp, wil RKV de zelfredzaamheid van CRM versterken door hen in staat te stellen financieel autonoom te investeren in eerstehulpactiviteiten. Door CRM meer zelfredzaam te maken, garanderen we een grotere duur-zaamheid van eerstehulpactiviteiten. RKV wil dit doen door CRM te ondersteunen in het uitbouwen van bedrijfseerstehulp. Dit doen we zowel via kennisoverdracht (workshops rond marketing en het opzetten van een kostenmodel) als via een ondersteu-ning van hun humanitaire diplomatie die bijvoorbeeld eerstehulplessen of hulpposten verplicht moet maken. De uitbouw van bedrijfseerstehulp ligt in lijn met de ‘Waardig Werk’ agenda van Madagaskar rond veiligheid en preventie op de werkvloer. Naast zelfredzaamheid is impact een belangrijke focus van het RKV programma in Madagaskar. Een studie van de Wereldbank toont aan dat het investeren in de opleiding van eerstehulpvrijwilligers één van de meest kosteneffectieve interventies is met een kost van slechts 8 US$ per Disability Adjusted Life Year Averted (DALY)149. Bovendien investeert RKV via haar ‘Center for Evidence-Based Practice’ continu in onderzoek naar interventiestrategieën met de meeste impact. Zo onderzoeken we het effect van simulaties in eerstehulpopleidingen of welke eerstehulpkennis op welke leeftijd kan onthouden worden. De resulta-ten van deze onderzoeken zijn geïntegreerd in RKV’s eerstehulpondersteuning aan CRM. Daarnaast heeft het ‘Center for Evidence-Based Practice’ evidence-based eerstehulprichtlijnen uitgewerkt die volledig aangepast zijn aan de Afrikaanse context (‘AFAM’, African First Aid Materials’). Het eerstehulpopleidingsmateriaal van CRM zal op basis hiervan herzien worden zodat steeds de meest doelgerichte eerstehulppraktijken worden aangeleerd. RKV wil de impact van het programma in Madagaskar ook vergroten door gebruik te maken van haar jarenlange operationele expertise rond eerstehulpopleidingen en werken met jeugd. Binnen RKV bestaat de dienst ‘Eerste Hulp’ die 500 trainers in dienst heeft om nationaal eerstehulpopleidingen te geven. Deze trainers worden voor specifieke expertisegebieden ingezet in ons programma. Daarnaast bestaat binnen RKV de dienst ‘Jeugd Rode Kruis’ die jarenlange ervaring heeft in het aanleren van eerste hulp aan jeugd. Gezien de jonge bevolking van Madagaskar, zal specifieke aandacht worden gegeven aan het ontwik-kelen van aangepast eerstehulpmateriaal voor de jeugd en zullen 200 leerlingen een eerstehulpopleiding krijgen. De synergie met Via Don Bosco, die beschikken over een netwerk van 7 Centres de Formation Professionelle verspreid over Madagaskar, zal de impact van ons programma nog versterken. Dit programma houdt rekening met de prioriteiten van de Belgische ontwikkelingssamenwerking rond digitale innovatie, men-senrechten en waardig werk. Gedurende alle fases van het programma, wordt een gender-sensitieve benadering gehanteerd: binnen CRM zal worden gestreefd naar een gelijkmatige verdeling van vrouwen en mannen binnen de eerstehulplessen én de

148 Trainers die andere trainers kunnen opleiden. 149 DALY is een maatstaf die werd ontwikkeld door de Wereldgezondheidsorganisatie. De DALY meet niet alleen het aantal mensen dat vroegtijdig sterft door ziekte, maar meet ook het aantal jaren dat mensen leven met beperkingen door ziekte. In maatschappelijke kosten-batenanalyses worden DALY's ook toegepast om de kosteneffectiviteit van gezondheidsinterventies te bepalen. Laxminarayan et al. (2006). Intervention Cost-

Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2

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beheers- en bestuursorganen van de organisatie. Aan de hand van gender-gedesaggregeerde indicatoren zullen verwezenlij-kingen in kaart worden gebracht. Daarnaast zullen inspanningen worden gedaan om de impact van onze interventie op het milieu te beperken, door onder andere de aankoop van lokale materialen en een correcte afvalverwerking. RKV gelooft ten stelligste dat het 17-21 programma in Madagaskar rond eerstehulponderricht door zijn focus op zelfredzaam-heid en duurzame impact sterk bijdraagt tot een verhoogde toegang tot eerstelijns gezondheidszorg. Op die manier komt het programma tegemoet aan de Gemeenschappelijke Strategische Doelstellingen 3150 en 4151 van het Gemeenschappelijk Strate-gisch Kader Madagaskar en aan de Sustainable Development Goals 1, 3, 5 & 8.

150 De gezondheidssector versterken en de toegang tot gezondheidszorg vergroten. 151 Versterken van het beheer van rampenrisico’s.

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Fiche Pays

Frais opérationnels totaux pour le pays (EUR) 633.876

Personne de contact en Belgique :

Nom : Tiene Lie-vens

Organisation : Croix-Rouge de Belgique – Flandres (CRB-Fl)

Tél. : +32

15 44 33 57

E-mail :

[email protected]

Résumé Synthétique

En 2017, CRB-Fl lancera son partenariat avec la Croix-Rouge Malagasy (CRM) dans le domaine des Premiers Secours (PS). Ce domaine d’intervention offre une valeur ajoutée réelle au partenariat, vu que la CRB-Fl a une vaste expertise en la matière et vu les étapes importantes déjà prises par la CRM en ce domaine.

Les PS sont une activité prioritaire pour les Sociétés Nationales de la Croix-Rouge dans le monde entier. En plus, la formation aux PS forme une intervention très efficace, avec un coût de 8 $ par ‘DALY’ évité (disability-adjusted life year, c’est-à-dire : AVCI, nombre d’années de vie corrigé du facteur d’incapacité). Ceci rend la formation aux PS un des moyens les moins chers pour améliorer la santé publique dans les pays en cours de développement. Cela reste particulièrement pertinent à Madagascar où 60% de la population n’a pas accès aux soins de santé primaires vu le manque d’infrastructures adéquates, surtout dans les zones rurales, et la non-accessibilité pour la population appauvrie aux services existants. De plus, les catastrophes naturelles et les accidents de la route causent chaque année de nombreuses victimes. Les risques de violence pendant des manifestations politiques augmentent également (dues aux prochaines élections en 2018), surtout dans les grandes villes.

Ce programme assurera que la CRM puisse offrir une formation en secourisme de bonne qualité, tout en institutionnalisant au sein de la CRM un service de Premiers Secours compétent et autonome. 1.529 personnes, parmi eux 1.200 volontaires et 200 élèves des écoles secondaires, bénéficieront directement de ce programme. L’effet de cascade est grand : le programme compte 60.976 bénéficiaires indirects.

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Localisation de l’intervention

Liste des partenaires

Partenaire local

Nom complet et abréviation Croix-Rouge Malagasy (CRM)

Coordonnées :

Adresse : Téléphone : E-mail :

1, rue Patrice Lumumba

Tsaralalàna – Antananarivo 101

Site web : http ://www.croixrouge-Malgache.org/ +261 320 322 348 [email protected]

Personne de contact : Mme. Responsable de la commercialisation des produits et services en premiers secours, Nambinina RADOLOMALALA

Outcome :

O1 : Les profanes, le personnel et les volontaires Croix-Rouge possèdent les attitudes, capa-cités et connaissances adéquates, à-jour et evidence-based pour donner les premiers secours à ceux qui en ont besoin, et ce, d’ici 2021. De telle façon, ils augmentent le niveau de résilience de la communauté et la capacité de soins d’urgences.

Budget : (EUR) Budget O1 : 608.876

Description synthétique du rôle du partenaire :

La CRM, à travers son réseau national des sections locales et volontaires, est le partenaire d’exécution principal pour l’outcome. Avec le soutien de la CRB-Fl, à la fois du siège princi-pal et de la délégation régionale, la CRM est responsable pour la planification, la mise en œuvre, le suivi et le rapportage de ce programme.

Date de début de la relation partenariale avec la CRM :

01/01/2017

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Théorie du Changement

La Théorie de Changement (TdC) serve comme base de réflexion pour le Cade Logique (voir par exemple hypothèses et activi-

tés). Dans toutes les phases de mise en œuvre du programme, la CRB-Fl utilisera le Cadre Logique comme base pour

l’implémentation et le suivi-évaluation. Une description narrative de la stratégie d’intervention peut être trouvée sous la section

« Description de l’Efficacité » ci-dessous. En outre, une explication générale sur la façon dont la CRB-Fl a structuré et défini le

modèle de la TdC, se trouve à l’Annexe 1.

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1. Hypothèses

Hypothèse Lien avec

cadre

logique

Cela tient-il ?

(Oui/non) Argumentation/preuve

A • Les personnes deviennent plus rési-lientes quand elles sont capables d’appliquer des techniques de PS.

• L’impact négatif sur la santé en cas de blessure/maladie est plus petit lorsque les personnes sont aidées par des tech-niques PS evidenc-based.

• La formation aux PS est une interven-tion de développement très rentable pour améliorer la santé publique.

Impact • Oui • Oui

• Oui

• Une étude de la Croix-Rouge Britannique démontre un lien entre des éléments de résilience de communautés et la formation aux premiers secours.152

• Il est démontré que les techniques PS evidence-based sont plus efficaces sur le plan du rétablissement après des blessures/maladies. Le Centre for Evidence-Based Practice (CEBaP) de la CRB-Fl est spécialisé dans la méthodologie evidence-based pour le développement de recommandations en matière de premiers secours: le centre utilise les données probantes disponibles dans la littérature scientifique, qui sont ensuite complétées par le savoir-faire d’ex-perts et d’informations acquises lors de l’expérience pratique.

• La formation aux PS a un coût de 8US$ par année de vie corrigé du facteur d’incapacité (DALY), ce qui rend cette approche un des moyens les moins chers d’améliorer la santé publique dans les pays en voie de développement.153

B • L’impact négatif sur la santé en cas de blessures/maladies diminué parce que des personnes sont aidées avec des premiers secours.

Impact • Oui, mais plus de recherche est en cours

• Une revue systématique est en cours concernant les effets sur la santé de former des profanes pour prodiguer les soins d’urgence dans des populations mal servies.154 Les résultats seront disponibles en 2017. Une étude de cas en Iraq démontre qu’une réduction de la mortalité était causée par des profanes formés en tant que premiers intervenants dans un environnement où les délais d’évacuation pré-hospitaliers sont longs.155

152 British Red Cross. Assessing the links between first aid training and community resilience. 2011 http ://www.redcross.org.uk/~/media/BritishRedCross/Documents/What%20we%20do/First%20aid/As-sessing%20the%20links%20between%20first%20aid%20training%20and%20community%20resilience.pdf 153 Laxminarayan et al. (2006). Intervention Cost-Effectiveness : Overview of Main Messages. Dans Jamison et al. (eds). Disease Control Priorities in Developing Countries (2ième Edition). Washington D.C. World Bank, chapitre 2. http ://www.ncbi.nlm.nih.gov/pubmed/21250358 154 Orkin AM, Curran JD, Fortune MK, et al. Health effects of training laypeople to deliver emergency care in underserviced populations : a systematic review protocol. 2017 http ://bmjopen.bmj.com/content/6/5/e010609.full 155 Murad MK, Husum h. Trained lay first-helpers reduce trauma mortality : a controlled study of rural trauma in Iraq. 2010 http ://munin.uit.no/bitstream/handle/10037/5440/paper_2.pdf;jses-sionid=A29D143AA28B30DA5510C8DBDAB6C704?sequence=4

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C • Des profanes156, des membres de per-sonnel et des volontaires Croix-Rouge interviennent pour donner des pre-miers secours, s’ils disposent des connaissances, capacités et attitudes re-quises.

• Des profanes ont accès à du matériel de PS de base pour exécuter des tech-niques de premiers secours.

• Des profanes premiers intervenants en premiers secours aussi bien que des membres de personnel et volontaires Croix-Rouge, peuvent intervenir et pro-diguer des premiers secours dans un cadre légal sécurisé (responsabilité lé-gale).

Outcome 1 • Oui, mais plus de recherche est né-cessaire. • Oui

• Non

• Une revue systématique rapporte une augmentation significative en connaissance et capacités de premiers secours et une amélioration du comportement d’aide suite à la formation aux premiers secours d’enfants et de profanes.157 Une étude de cas en Uganda démontre que les groupes de personnes qui doivent régulièrement appliquer des PS ont une plus grande rétention en connaissances PS. Une structure Croix-Rouge pourrait être considérée comme une situation similaire.158

• La sensibilisation sur l’importance d’avoir du matériel de PS adapté et l’utilisation de matériel local, fera partie de l’intervention. Les formations PS sont également adaptées au matériel disponible localement. En plus, trousses avec du matériel de PS sont incluses dans les formations de PS pour les profanes.

• Dans aucun des pays d’intervention, la loi ne prévoit une protection pour des passants qui prodiguent des pre-miers secours. La 32ième Conférence des Sociétés Croix-Rouge et Croissant-Rouge a cependant adopté une résolution concernant le renforcement du cadre légal de réponse aux catastrophes, réduction de risques et premiers secours.159

D Des volontaires CR formés et équipés res-tent volontaires.

Outcome 1 Output 1.1 Output 1.2 Output 1.3

Oui La CRM a une grande capacité de recrutement de volontaires, certainement parmi la population jeune. Dans ce pro-gramme, les 200 jeunes formés aux PS dans des lycées, deviendront immédiatement des volontaires de la CRM.

E La Croix-Rouge est capable de recruter les volontaires et membres de personnel né-cessaires pour donner des PS.


Oui La CRM compte plus de 9.000 volontaires actifs, dont beaucoup sont désireux d’être déployés dans le domaine de PS (1.214 volontaires aptes à porter des secours en cas d’urgence en 2012).

F Il y a un suivi et un coaching adéquats des volontaires et membres de personnel CR.


Oui mais un risque dans certains pays

Notre intervention mènera au renforcement des structures nationales de PS, qui accordent un grand soin à la consul-tation interdépartementale.

156 Par ‘profanes’ on entend le grand public, c’est-à-dire des personnes qui n’ont pas de connaissances préalables. 157 He Z, Wynn P, Kendrick D. Non-resuscitative first-aid training for children and laypeople : a systematic review. 2013 http ://www.ncbi.nlm.nih.gov/pubmed/24351520 158 Jayaraman S, Mabweijano R, Lipnick MS, Caldwell N, Miyamoto J, et al. First Things First : Effectiveness and Scalability of a basic prehospital trauma care program for lay first-responders in Kampala, Uganda. 2009 http ://www.ncbi.nlm.nih.gov/pubmed/19759831 159 IFRC. Law and First Aid. Promoting and protecting life-saving action. 2016 http ://www.ifrc.org/Global/Photos/Secretariat/201506/First%20Aid%20Law%20Advocacy%20Report%20(final).pdf

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G • Les PS commerciaux génèrent des reve-nus.

• La Société Croix-Rouge est désireuse d’investir les revenus générés par les PS commerciaux au moins partiellement dans le service PS.


• Oui mais une ana-lyse plus profonde est nécessaire

• Oui mais un suivi est nécessaire

• En 2016, la CRB-Fl a entrepris en coopération avec Vlerick Business School une étude qui analyse le coût de forma-tions PS au Népal en utilisant un modèle de coût basé sur la durée d’une activité. Vu qu’il s’agit d’une étude pilote, la CRB-Fl vise à utiliser ce modèle pour améliorer les activités de PS commerciaux dans d’autres pays.160

• Déjà en 2016, la CRM organise des formations de PS pour des volontaires avec les revenus de leur PS commerciaux. Néanmoins, reste à surveiller si la volonté restera présente dans le futur.

H Les personnes qui décident de devenir volontaire ou membre de personnel Croix-Rouge, reconnaissent et apprécient l’importance des premiers secours.

Output 1.2 Oui Au sein des organisations CR, les PS sont considérés comme une activité de base et chaque volontaire nouvellement recruté fait connaissance avec la vision, la mission et la politique de l’organisation. Depuis une vingtaine d’années, la CRM mène des activités de PS. Vu la situation précoce des services de santé à Ma-dagascar, l’importance est largement reconnue.

I Les méthodes didactiques utilisées sont efficaces.

Output 1.1 Recherche planifiée par la CRB-Fl

L’utilisation de la simulation en tant qu’outil didactique sera étudiée durant la période d’implémentation.

J Les différents départements internes de la CRM parviennent à une vision partagée sous quel département le service de PS doit être inséré.

Output 1.1 Output 1.2 Output 1.3

Oui Notre intervention mènera au renforcement des structures nationales de PS, qui accordent un grand soin à la consul-tation interdépartementale.

K La CRM dispose de suffisamment de for-mateurs et de matériaux de bonne qualité pour répondre aux demandes de PS com-merciaux.

Output 1.3 Oui Au niveau du siège principal, la CRM dispose d’un service de PS Commerciaux performant, avec plusieurs formateurs disponibles. Dans les sections locales où un problème de ressources humaines ou de logistique peut se produire, une mise à disposition de personnel ou de matériel est possible.

L Les profanes (y compris les membres de personnel en volontaires Croix-Rouge) re-tiennent suffisamment les connaissances et capacités acquises durant une forma-tion (de recyclage) de premiers secours.


Recherche en cours par la CRB-Fl

La CRB-Fl conduit une étude pour évaluer le degré de rétention de connaissances et de capacités au cours d’un lapse de temps et pour déterminer l’impact de cours de recyclage et de pratique de premiers secours sur le niveau de réten-tion. Ces informations seront utilisées pour déterminer la fréquence optimale de cours de recyclage et pour évaluer la nécessité de réviser la validité de brevets de premiers secours. Une étude de cas a démontré que les connaissances en premiers secours acquises durant les formations de premiers secours commerciaux, ne diminue pas significativement avec le temps. Par contre, les capacités liées à la RCP (réanimation cardio-pulmonaire) se détériorent rapidement au cours des premiers 90 jour, ce qui suggère qu’un recyclage fréquent des capacités est nécessaire.161

160 Schumacher S, Bleys M, Pattyn S. Time-driven activity based costing of first aid trainings in Nepal. Vlerick Business School. 2016 161 Anderson et al. First aid skill retention of first responders within the workplace. 2011 https ://sjtrem.biomedcentral.com/articles/10.1186/1757-7241-19-11

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2. Analyse des parties prenantes

N° Partie prenante Rôle (quoi, quand, comment, où) Intérêt/Puissance Opportunités/menaces

1 Sapeurs-Pompiers Concurrents en PS commerciaux: don-nent des cours de sécurité incendie payantes.

Un concurrent respecté, mais leur expertise reste limitée au domaine de sécurité incendie.

Coopération avec la CRM est possible (déjà eu lieu 2 fois). Le risque de menace est moyen tant qu’ils ne fournissent pas des cours généralistes de secourisme.

2 Mutuelles de Santé Concurrents en PS commerciaux: don-nent des cours de PS gratuits aux entreprises qui sont syndiquées.

La qualité de leurs formations n’est pas élevée, néanmoins, la gratuité peut influencer les en-treprises/organisations.

Les mutuelles diminuent le prix que la CRM peut deman-der pour ses formations. Cependant, elles soulignent l’importance de la Santé et Sécurité au Travail (SST), une problématique à laquelle la CRM peut répondre.

3 Ministère de la Santé Le ministère duquel la CRM est un auxi-liaire.

Invite la CRM pour le déploiement de ses poli-tiques (par exemple: le partenariat autour des clubs de jeunes secouristes). Les ressources avec lesquelles la Ministère peut soutenir la CRM restent néanmoins limitées.

Peut faciliter le rôle de leader que la CRM joue dans les activités liées aux PS, comme les postes de secours. Pen-dant notre intervention, la CRM fera de la diplomatie humanitaire au sein de ce Ministère pour obtenir une ac-créditation officielle en PS.

4 Bureau National de Gestion des Risques de Catastrophes (BNGRC)

Gestion, coordination et suivi-évaluation des interventions de Gestion de Risques de Catastrophes (GRC) .

Après une catastrophe, le BNGRC décide où et quand la CRM peut intervenir. Le bureau a in-térêt à collaborer étroitement avec la CRM, en raison du vaste réseau de volontaires dans les communautés.

Le BNGRC fait un exercice de coordination vaste, ce qui peut ralentir la prise de décision.

5 Agences de l’ONU (en particulier UNICEF, mais aussi la Banque Mondiale, l’OMS (Organisation Mondiale de la Santé), PAM (Pro-gramme Alimentaire Mondial))

Interviennent avec un large spectre de projets humanitaires dans tout Mada-gascar.

Leurs objectifs dans les domaines de santé et de GRC sont souvent partagés avec la CRM.

La prolifération des acteurs peut diminuer l'efficacité et l'efficience. La coopération est néanmoins possible et a déjà eu lieu avec l'UNICEF sur l'hygiène menstruelle et le soutien psychosocial dans les situations d'urgence.

6 Comité International de la Croix-Rouge (CICR)

Les activités principales de la délégation régionale du CICR à Antananarivo sont les visites aux personnes privées de li-berté, la coopération avec les Sociétés nationales de la Croix-Rouge et du Croissant-Rouge et la promotion du droit international humanitaire.

Finance toutes les activités sur PPVH (Promo-tion des Principes et Valeurs Humanitaires) et une partie des activités de communication (par exemple Journée Mondiale de Premiers Se-cours).

Elargit le spectre des activités que la CRM peut entre-prendre, augmente les ressources financières et les capacités humaines.

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162 Plate-forme d’intervention régionale de l’Océan Indien

7 Autres Sociétés Nationales Parte-naires (SNP)

CR Norvégienne: programme de déve-loppement institutionnel, avec un accent sur Santé, programme de RRC. CR Danoise: programme de premiers se-cours psychologiques, programme de RRC. CR Allemande: programme de RRC, pro-gramme de sécurité alimentaire.

Partagent l'intérêt pour travailler ensemble avec une CRM solide et fiable. Différentes interventions peuvent se renforcer mutuellement.

Leur présence élargit le spectre des activités que la CRM peut entreprendre: plus de subventions et d’expertise dis-ponibles. Pour notre programme de PS: liens avec les programmes de RRC – la possibilité que d’autres SNP’s fi-nancent des formations de PS, ce qui augmente les chances de succès pour la durabilité de notre interven-tion.

8 Croix-Rouge Française (CRF) Présente dans le pays par leur réseau ‘PI-ROI162’: 2 entrepôts de stockage de matériel humanitaire. En plus, la CRF a soutenu la CRM avec un programme de PS entre 2010-2011 dont les leçons ap-prises sont prises en compte dans notre future intervention.

La plate-forme PIROI profitera d’une augmen-tation de qualité des formations de PS dans leurs propres interventions, dans lesquelles les volontaires de PS sont souvent déployés.

Notre intervention prend en compte les leçons apprises du programme de PS de la CRF entre 2010-2011, et s’aligne aux structures nationales de PS déjà développées par la CRF.

9 Gendarmerie Nationale Responsable pour l’application effective de la réglementation de la sécurité rou-tière. Opère principalement dans les provinces; dans les grandes villes, leur travail est effectué par la Police Natio-nale.

Ils ont le pouvoir de punir les délinquants rou-tiers et de maintenir la sécurité dans des situations précaires. Néanmoins, ils ont peu de ressources humaines/financières pour effec-tuer leur tâche d’une manière suffisante.

La corruption est une menace majeure: avec de l’argent, les délinquants peuvent racheter leur transgression.

10 L’agence de Transport Terrestre

Service du Ministère de Transport : donne l’autorisation pour de nouvelles voitures, pour des entreprises de trans-ports en commun, …

La responsabilité de l’agence est d’autoriser les véhicules et compagnies de transport. Cela leur donne un grand pouvoir pour faire res-pecter la législation routière.

Comme avec la gendarmerie locale, la corruption est ré-pandue. Néanmoins, cette agence constitue une partie prenante importance pour la diplomatie humanitaire de la CRM autour de la sécurité routière.

11 Comité Interministériel chargé de la Sécurité Routière (CISR)

Plate-forme de coordination pour toutes les parties prenantes concernant la sécu-rité routière.

Reste un comité consultatif qui dépend large-ment de la volonté politique.

La CRM n’est pas encore un membre permanent, larges possibilités d’être plus impliquée.

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3. Activités

1 La diplomatie humanitaire, plus particulièrement sur l'accréditation formelle de PS commerciaux, sur la vente de trousses PS dans les pharmacies et sur l'application des lois de SST

2 Standardisation des curriculums, des profils de compétence et des stratégies d’inventorisation et évaluation des (partici-pants des) formations

3 Révision des manuels PS en fonction des recommandations AFAM – pour adultes et pour jeunes

4 Acquisition de matériel de Premiers Secours

5 Activités promotionnelles pour souligner l’importance des PS aux profanes (renforcement du service PS Commerciaux, PSCo)

6 Formation des formateurs Master

7 Formation et formation de recyclage des formateurs PS

8 Formation et formation de recyclage des volontaires de la CRM – y compris des élèves au sein des établissements sco-laires

9 Développement d’un plan de formation aux PS des membres de personnel et des volontaires de la CRM (y compris formateurs PS)

10 Trajectoire pour adapter les formations/matériel de PS à un public jeune

11 Acquisition de différents matériaux de formation PS (attèles, bandages, mannequins de réanimation, flip charts, laptop, vidéoprojecteur, petit matériel de bureaux etc.)

12 Mise-à-jour d’une base de données PS et enregistrement des formations

13 Formations PSCo pour des clients

14 Recrutement des ressources humaines : responsable de qualité et PS commerciaux, coordinateur technique de PS, comptable

15 Développement d’une stratégie/politique de PS

16 Formation du personnel

4. Facteurs contextuels

Analyse des Risques

CRB-Fl utilise un système de gestion des risques étendu et dispose d'outils pour l'évaluation, la réponse et le suivi adéquats des risques. L’évaluation des risques effectuée à ce stade de programme, est trop vaste pour entrer dans les propositions de programme selon le modèle de DGD. Nous référons à l’Annexe 2 pour un exemple d’une matrice de risque comme celle faite également pour Madagascar.

Facteurs contextuels Influence sur TdC

Législation et contexte insti-tutionnel

La CRM est reconnue par un décret comme partenaire auxiliaire du Ministère de Santé. Mal-gré la bonne relation, le soutien que le Ministère peut accorder aux activités au sein du secteur de santé, reste minimal. En plus, la législation qui donnerait la CRM l’accréditation officielle n’est pas encore promulguée et les lois sur la sécurité routière et la SST ne sont pas appliquées.

La défaillance générale des services de santé: manque d’infrastructure et non-ac-cessibilité pour la population appauvrie

Les Premiers Secours sont une étape essentielle dans la chaîne de soins. A Madagascar, l’ac-cès aux services médicaux secondaires ou tertiaires est souvent impossible pour une grande partie de la population pauvre, surtout dans les zones rurales. Cela augmente encore la né-cessité des soins primaires, mais réduit également l’impact potentiel de notre intervention.

Une population jeune Madagascar connaît une population très jeune (l’âge médian de la population était en 2013 18,4 ans), ce qui se reflète également dans le fonctionnement de la CRM qui connaît plus de 1.930 jeunes volontaires. Cela souligne à nouveau la nécessité de développer du matériel de PS qui répond aux besoins des jeunes.

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Réfé-

rence

TdC Source et impact du risque

Sévé-

rité

(1-6)

Proba-

bilité

(1-6)

Gestion du risque

Responsable

pour monito-

ring

Risques au niveau du pays et du partenaire

Facteur contex-tuel

L’instabilité politique qui frappe Madagascar et la crise socio-économique y résultant, peut s’aggraver durant les élections de 2018. Dans le cas de violence par les manifestants ou les forces de sécurité, le personnel et les volontaires de la CRM seront oc-cupés avec la gestion des postes de secours, ce qui peut mener à des retards importants dans l’exécution du programme.

(cf. Analyse de Contexte Commun (ACC) p. 64)

3 4 La CRM et le CICR mènent une diplomatie humanitaire proactive pour empêcher le déclenche-ment de la violence contre les civils. En cas de crise de violence néanmoins, la CRM a beaucoup appris de son intervention lors des crises de 2002 et 2009, lorsqu’elle a mobilisé plus de 500 volontaires dans toute l’île et a pris soin des centaines de blessés. En 2010, un plan d’urgence a été formulé qui aidera la CRM à répondre aux manifestations d’une manière efficace et effi-ciente. En plus, le soutien de la CRB-Fl au service de PS prouve son utilité lors de tels événements. Pour être bien préparés, nous avons comme but de remettre sur les rails la struc-ture nationale de PS avant 2018. La perspective de confrontations violentes dans un avenir proche, peut même accélérer le déploiement des activités.

Responsable national de se-courisme

Durant les années à venir, Madagascar doit tenir compte des ef-fets du changement climatique, qui augmenteront encore la probabilité de catastrophes naturelles, principalement des cy-clones et la sécheresse. Le plus grand risque est la perte des personnes clés et par conséquent un retard ou des interruptions dans la mise en œuvre du programme. (cf. ACC p. 65)

3 4 Comme pour le risque de violence politique ci-dessus, être préparé aux catastrophes clima-tiques est une raison pour accélérer plutôt que de ralentir les activités de PS. En plus, la présence du PIROI permet un soutien important en matériel humanitaire, ce qui est haute-ment complémentaire avec le soutien en PS de la CRB-Fl. Ces soutiens, combinés au développement des plans d’urgence et une surveillance permanente des plates-formes de prévisions météorologiques, devrait permettre à la CRM de répondre adéquatement et rapi-dement aux catastrophes naturelles.

Responsable national de se-courisme, Responsable département RCC

Risques au niveau du projet

Hypo-thèse G

Manque d'intérêt pour réinvestir les ressources des PS commer-ciaux dans le service de PS, ce qui aura un impact négatif sur la durabilité à longue terme de l’intervention.

5 3 Le professionnalisme du service de PS commerciaux est un grand atout pour toute la CRM. En outre, déjà aujourd’hui, la CRM réinvestit une partie des revenus des PS commerciaux dans les formations PS pour volontaires. Notre intervention continuera sur le même voie en renforçant les organismes interdépartementaux comme le comité de pilotage, où les PS sont représentés dans les différents départements de l’organisation.

Responsable national du se-courisme, comité de pi-lotage de PS

Facteur contex-tuel

La législation existante qui rend les cours et matériaux de PS obligatoires dans certains cas (comme par exemple dans des en-treprises de plus de 50 personnes) n’est pas réellement mise en œuvre ou contrôlée. Cela réduit les efforts du service des PS commerciaux et diminue la volonté du grand public à apprendre et appliquer les techniques de PS.

3 4 Jusqu’aujourd’hui, la CRM fonctionne dans une situation où la législation existante autour des PS n’est pas mise en œuvre correctement. Néanmoins, l’intérêt de la population pour les formations reste grande, ce qui signale la nécessité impérieuse dans un pays où les services de soin sont inadéquats. Notre intervention donnera à la CRM la chance d’accroître sa diplo-matie humanitaire au sein des différentes parties prenantes (voir ci-dessus) tout en leur permettant de promouvoir davantage l’application des lois autour des PS.

Responsable de PS com-merciaux, SG de la CRM

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Recommandations et leçons apprises

Recommandations du Dialogue Stratégique

Le Dialogue Stratégique du CSC Madagascar entre la DGD et les participants du CSC avait lieu le 14/06/2016 au sein du SPF affaires étrangères à Bruxelles.

Dans l’Avis Définitif que nous avons reçu le 29 Juillet 2016, ces deux points d’attention suivants pour les programmes 17-21 ont été formulés :

1. Prise en compte de la thématique égalité des genres de manière intégrée au niveau de tous les secteurs 2. Concrétisation des synergies et/ou de complémentarités

Pour la prise en compte du premier point, nous référons à la section «Pertinence par rapport aux thèmes prioritaires de la DGD ».

Pour la prise en compte du deuxième point, nous référons à la section « Description des Synergies et Complémentarités ».

Leçons apprises

Le partenariat avec la CRM est un nouveau partenariat pour CRB-Fl qui forme une étape logique due à certaines raisons: au cours des dernières années, la CRM a exprimé plusieurs fois sa volonté de coopérer avec la CRB-Fl en termes d’éducation aux PS, après avoir reçu la licence AFAM en 2012. En outre, cette intervention cadre dans une approche régionale pour laquelle des interventions PS dans d’autres pays sud-africains seront mises en place. La possibilité des apprentissages régionaux est grande et sera utilisée dans cette intervention sous la forme d’une formation régionale des Master formateurs en 2017 et 2018.

En plus, la CRB-Fl peut compter sur 15 ans d’expérience en implémentation de programmes de Premiers Secours dans les pays en voie de développement. Bien que nous ayons appris au cours des années que chaque pays nécessite une approche sur mesure, nous avons pu distiller certaines leçons apprises qui forment nos points d’attention clés dans la conception de nou-veaux programmes, y compris :

1. Leçon apprise: améliorer l’éducation de PS nécessite un parcours à long terme, comprenant l’amélioration des compé-tences médicales et didactiques et un système de contrôle de qualité. Action: notre intervention commencera en 2017 par la formation de 5 Master formateurs qui seront formés sur le plan didactique et médical selon les lignes directrices de PS de 2016. En même temps, un atelier pour mettre à jour la stratégie d’évaluation et de surveillance de qualité aura lieu et le budget prévoit des réunions annuelles avec tous les encadreurs de PS afin d’assurer leur encadrement.

2. Leçon apprise: améliorer l’enseignement de PS contribue à des interventions de PS de grande qualité et adéquates au sein des groupes cibles spécifiques. Les volontaires actifs ont besoin d’équipement et d’un système de suivi-évaluation approprié. Action: notre intervention déploie ses activités et ses ressources par rapport aux besoins du pays et du plan stratégique de la CRM, ce qui résulte en un focus particulier sur la jeunesse et la sécurité routière, deux sujets brûlants à Madagascar. Les jeunes seront ciblés avec des matériaux et didactiques de PS adaptés, et des formations de PS auront lieu dans des établissements scolaires et des centres de formations professionnelles (ensemble avec l’ONG Belge VIA Don Bosco). Con-cernant la sécurité routière, 1.200 volontaires qui vivent près des Routes Nationales principales seront formés aux PS et un budget est prévu pour l’organisation et l’équipement des équipes d’intervention routières.

En dehors de nos propres leçons apprises, notre intervention est une continuation des différents programmes PS que la CRM a établis depuis 15 ans. Le développement de notre stratégie d’intervention et la planification des activités a particulièrement pris en compte l’évaluation que la CRF a faite en mai 2016 de sa propre intervention en matière de PS entre 2010-2011.

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Outcome 1 First Aid

Fiche outcome

Outcome: Les profanes, le personnel et les volontaires Croix-Rouge possèdent les attitudes, capacités et connaissances adéquates, à-jour et evidence-based pour donner les premiers secours à ceux qui en ont besoin, et ce, d’ici 2021. De telle façon, ils augmentent le niveau de résilience de la communauté et la capacité de soins d’urgences.

Identificateur d’activité IIAT: BE-BCE_KBO-0461634084-2017_05_MG_DGD

Pays: Madagascar Cet outcome est-il couvert par un CSC ? Oui

Province(s) / Etat(s) ciblé(s) Régions Niveau administratif infranational 2 Niveau administratif infranational 3

Partenaires locaux ou parties prenantes

Croix-Rouge Malagasy

Vakaninkaratra, Betsiboka Boeny, Aloatra-Mangoro Antsinanana

PDA (Pas d’application) PDA

Outre localisation de l’intervention:

L’appui institutionnel sera principalement axé sur le siège à Antananarivo, et se fera sentir dans les 1.045 sections communales dans tout le pays

PDA PDA

Groupe cibl : Les volontaires de la CRM et les écoliers des 5 lycées dans les 5 régions de l’intervention, ensemble avec le personnel de la CRM.

Bénéficiaires: Total : 62.505 Bénéficiaires directs: 1.529 Bénéficiaires indirects: 60.976

Secteur principal: 12220 Soins de santé de base

Frais opérationnels du résultat (total) : 633.876

Policy Marker


Environnement 1 Genre 1 Désertification (Rio-Marker) 0

Biodiversité (Rio-Marker) 0 Changement Climatique – Adaption (Rio-Marker) 2 Changement Climatique – Mitigation/Prévention (Rio-Marker) 1

Trade Development 1 Bonne Gouvernance 0 Santé Génésique maternelle néonatale et infantile (SGMNI) 1

HIV/AIDS 1 Droits des enfants 1 Total 9

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Cadre Logique


Référence/

base

2017 2018 2019 2020 2021 Moyens de vérification


Indicateur 1 : Nombre de bénéfi-ciaires directs atteints.

PdA Total: +5 Femmes: +3 Hommes: +2





Fiches de suivi, base de don-nées

Indicateur 2 : Nombre de bénéfi-ciaires indirects atteints.

PdA

Total: +5330

Total: +15.039

Total: +27.446

Total: +42.907

Total: +60.976


Impact :

Cible 3 : Renforcer les systèmes de santé et l’accès aux soins de santé.

Cible 4 : Renforcer la gestion des risques liés aux catastrophes.

Hypothèses : voir TdC

Outcome 2 :

Les profanes, le personnel et les volontaires Croix-Rouge possèdent les attitudes, capacités et connaissances adéquates, à-jour et evidence-based pour donner les premiers secours à ceux qui en ont besoin, et ce, d’ici 2021. De telle façon, ils augmentent le niveau de résilience de la communauté et la capacité de soins d’urgences.


Indicateur 2.1: Nombre de per-sonnes du grand public avec certificat PS valide.

Total: 613 Femmes: Hommes:




Indicateur 2.2: Nombre de béné-voles et membres de personnel Croix-Rouge avec certificat PS valide.



Total: +1.663 Femmes: +1.019 Hommes: +644


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Output 2.1 :

Une éducation aux PS de grande qualité pour différents groupes cibles est disponible d’ici 2021.


Indicateur 2.1.1: Présence de maté-riaux didactiques de formation PS de base finalisés, basés sur AFAM et sexospécifique.

Non Non Oui (Manuels de PS de base)

Oui (Manuels de PS de base + matérieux de PS de base adap-tés aux jeunes)

Oui (Manuels de PS de base + ma-térieux de PS de base adaptés aux jeunes)

Oui (Manuels de PS de base + ma-térieux de PS de base adaptés aux jeunes)

Matériaux didactiques et manuels de formation de PS de base

Indicateur 2.1.2: Nombre de béné-voles et membres de personnel Croix-Rouge formés aux PS.




Total: +760 (+380 A3) Femmes: +426 Hommes: +334

Total: +1.165 (+405 A4) Femmes: +652 Hommes: +513


Base de données, fiche de suivi

Output 2.2 : La SNH a un service PS fonctionnant bien et intégré dans l’organisation d’ici 2021.


Indicateur 2.2.1: Nombre de béné-voles formés aux PS enregistrés dans la base de données des bénévoles de la CRM.




Total: +760 (+380 A3) Femmes: +426 Hommes: +334



Base de données des volon-taires et base de données des formations

Indicateur 2.2.2: Nombre de forma-teurs PS actifs, formés selon les dernières lignes directrices didac-tiques et médicales.







Base de données

Output 2.3 :

La SNH délivre des PS commerciaux de grande qualité d’ici 2021.


Indicateur 2.3.1: Nombre de nou-veaux clients formés aux PSCo.

Total: 40 Entreprises: 14 Particuliers: 26

Total: +0 Entreprises: +0 Particuliers: +0

Total: +23 Entreprises: +9 Particuliers: +14

Total: +53 (+30 A3) Entreprises: +21 Particuliers: +32



Suivi des ventes

Indicateur 2.3.2: Nombre de pro-duits PSco vendus.

Trousses: 101 Postes de se-cours payants: 21

Trousses: +0 Postes de se-cours payants: +0

Trousses: 251 (+150 A2) Postes de secours payants: 36 (+15 A2)



Trousses: 1.101 (+350 A5) Postes de secours payants: 141 (+45 A5)

Suivi des ventes

Typologie d’activité Voir activités TdC.

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Outcome 1: FA 2017 2018 2019 2020 2021 Grand total

Frais Opérationnels

1. Partenaires 73.344 180.876 162.568 118.860 73.228 608.876

Investissement 24.186 35.027 29.803 1.146 1.146 91.308

Fonctionnement 33.489 111.764 98.680 87.778 60.561 392.270

Personnel 15.669 34.085 34.085 29.937 11.521 125.297

2. Collaborations 0 0 0 0 0 0

Investissement 0 0 0 0 0 0

Fonctionnement 0 0 0 0 0 0

Personnel 0 0 0 0 0 0



Fonctionnement 0 0 0 0 0 0

Personnel 0 0 0 0 0 0

4. Siège 5.000 5.000 5.000 5.000 5.000 25.000


Fonctionnement (délégué) 0 0 0 0 0 0

Personnel (délégué) 0 0 0 0 0 0

Personnel (Siège) 5.000 5.000 5.000 5.000 5.000 25.000

Total 78.344 185.876 167.568 123.860 78.228 633.876

Investissement 24.186 35.027 29.803 1.146 1.146 91.308

Fonctionnement 33.489 111.764 98.680 87.778 60.561 392.270

Personnel 20.669 39.085 39.085 34.937 16.521 150.297

Partenaires

Total CRM 73.344 180.876 162.568 118.860 73.228 608.876

Total Partenaires: 73.344 180.876 162.568 118.860 73.228 608.876

Collaborations

Collaboration 1 0 0 0 0 0 0


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Description de la Pertinence

Analyse du contexte L’ACC (p.26-27) et le CSC (p.9) de Madagascar ont décrit la défaillance des services et systèmes de santé au sein du pays. La manque d’infrastructures adéquates, surtout dans les zones rurales, et la non-accessibilité pour la population appauvrie aux services existants, font que 60% de la population n’a pas accès aux soins de santé primaires. La situation est aggravée par la crise socio-économique et politique qui sévit à Madagascar depuis 2009 et les fortes coupes dans le budget des services sociaux: le réseau des Centres de Santé de Bases (CSB) et le taux de professionnels médicaux qualifiés a fortement diminué. Par conséquent, les principales causes de décès prématurés sont des maladies évitables et curables comme la diarrhée (7,92% de tous les décès), les complications néonatales (7,50% de tous les décès) et le paludisme (3,07% de tous les décès). 163

Le manque de services d’urgence aggrave le taux de mortalité des blessés des accidents. Cela est clairement observé pour les accidents de la route qui causent 4,26%164 des morts parmi la population entre 15 et 49 ans, un chiffre fortement aggravé par le taux de mortalité des tels accidents qui monte à 33,7%. (Par comparaison, le taux de mortalité en Belgique est 10,2%).165 En plus, INFORM166 indique que l’accès limité aux soins de base est un des facteurs principaux pour la grande vulnérabilité de la population malgache par rapport aux catastrophes qui sont décrites à l’ACC p. 24.

Par cette intervention, CRB-Fl vise à renforcer les systèmes de santé et l’accès aux soins de santé (objectif stratégique commun 3) et à renforcer la gestion des risques liés aux catastrophes (objectif stratégique commun 4) en soutenant la Croix-Rouge Malagasy à former leurs volontaires et le grand public aux premiers secours, pour qu’ils puissent donner les premiers soins à ceux qui en ont besoin au sein de leurs communautés, familles, entreprises et écoles. Ainsi, cette intervention contribue aux objectifs de développement durable (ODD’s) 1,3,5 et 8.

La pertinence des connaissances et capacités des premiers secours en Afrique sub-saharienne est aussi reconnue par la Banque mondiale, qui affirme que la formation du grand public (= des profanes) pour répondre aux urgences médicales est une inter-vention avec un excellent rapport coût-efficacité pour réduire l’impact négatif des maladies et accidents167.

Critères de sélection des bénéficiaires Les bénéficiaires directs comprennent 5 instructeurs nationaux qui seront formés comme Master formateur et 45 encadreurs de PS qui suivront une Formation de Formateurs conduite par les propres Master formateurs de la CRM. Dès que leurs compé-tences pédagogiques et techniques de PS sont à-jour, ces encadreurs formeront avec l’appui de CRB-Fl 1.200 volontaires de la CRM actifs dans 5 régions qui sont localisées le long des autoroutes principales du pays (Routes Nationales 7, 4 et 2). En plus, 200 élèves au sein des clubs de Croix-Rouge recevront une formation de PS adaptée à leur âge dans 5 établissements scolaires. Dans le cadre de la synergie avec VIA Don Bosco, 14 enseignants au sein des CFP’s (Centres de Formations Professionnelles) seront formés comme formateur de PS. Pour que les connaissances et capacités en PS soient institutionnalisées, l’ensemble du personnel (65 personnes) recevront une formation de recyclage. En total, ce programme atteint 1.529 bénéficiaires directs. Il est important de noter que la CRB-Fl a choisi de compter les bénéficiaires individuels seulement une fois, même s’ils sont atteints plusieurs fois avec des différentes activités: les 45 encadreurs de la CRM et les 14 enseignants des CFP’s recevront par exemple tous une formation de recyclage qui augmente le coût individuel. Par conséquence, calculer le cout par bénéficiaire ne peut pas se faire par une simple division du cout total du programme par le nombre mentionné ici.

Bénéficiaires indirects Il est très difficile de quantifier et suivre les bénéficiaires indirects étant donné le large éventail d’applications de PS (de net-toyage de petites blessures aux interventions qui sauvent les vies comme l’arrêt d’hémorragies graves). Sur la base d'une l'hypothèse selon laquelle, en moyenne, chaque personne formée aidera 5 personnes en appliquant des premiers soins de qualité et fondée sur des données probantes, le nombre de bénéficiaires indirects est 60.976. Ce nombre prend en compte le nombre total de personnes formées aux PS par la CRM, même si ces formations ne sont pas des sorties directes du programme.

Location La Croix-Rouge Malagasy compte 1.045 sections communales sur les 1.300 communes malgaches existantes. L’augmentation de la qualité des formations de PS par un soutien institutionnel au siège de la CRM, aura un effet de retombée dans tout le pays. Cinq régions de pilotage en particulier recevront un soutien spécifique dans la formation des volontaires en PS. Ces sections sont choisies en fonction de leur risque de vulnérabilité, particulièrement par leur localisation tout au long des Routes Nationales (RN) où des accidents routiers graves sont fréquents: la région de Vakinankaratra au long de la RN 7, les régions de Bestsiboka & Boeny au long de la RN 4 et régions Aloatra-Mangora et Antsinanana le long de la RN 2. En plus, les grandes

163 Institute for Health Metrics and Evaluation, (2014). Country profile : Madagascar. Recherché le 24/07/2015 à http ://www.healthdata.org/madagascar. 164 Global Burden of disease visualizations, recherché le 24/07/2016 à http ://vizhub.healthdata.org/gbd-compare/ 165 WHO (2013). Rapport de situation sur la sécurité routière dans le monde. p. 246. 166 INFORM Country risk profile, http ://www.inform-index.org/Portals/0/Inform/2016/country_profiles/MDG.pdf 167 World Bank (2006) Disease control priorities in developing countries, second edition.

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villes au sein de ces régions (Toamasina, Antsirabe et Mahajanga) sont particulièrement vulnérables pour les manifestations politiques qui peuvent s’aggraver en vue des élections de 2018.

Pertinence par rapport aux thèmes prioritaires de la DGD

Genre L'égalité des sexes et l'autonomisation des femmes sont essentielles pour la santé des nations, ainsi que pour le développement social et économique. Cela est souligné par le cinquième objectif de développement durable (ODD) et est également l'une des 4 priorités de DGD exprimées dans sa note stratégique sur le genre: «En ce qui concerne plus spécifiquement l’empowerment

des femmes, on notera que l’accès à la santé et aux droits sexuels et reproductifs constitue un axe fondamental de l’autonomie des femmes et de leur bien-être. Les incidences positives que cet accès procure à la communauté tout entière, ne sont plus à démontrer. » 168

Les résultats recherchés de cette intervention, la livraison des premiers soins de qualité à ceux qui en a besoin, a donc intrinsè-quement une dimension de genre: tandis que l'accès aux soins de santé de base reste un défi pour tous les habitants de Madagascar en particulier les pauvres dans les régions rurales, les femmes ont tendance à avoir encore plus de difficultés pour obtenir les soins nécessaires. En outre, des mesures spécifiques sont prises pour assurer la participation des femmes et des filles dans ce programme. Le matériel de formation sera développé selon les lignes directrices AFAM qui sont sensibles aux besoins spécifiques des femmes et des filles comme récepteurs et donneurs de premiers secours: l’attention est attirée sur des situations spécifiques rencontrées par les femmes, telles que l'accouchement sans assistance médicale. Les mannequins utilisés seront développés pour répondre aux convenances des femmes et des filles. Ces mesures sont nécessaires car la CRM reconnaît que jusqu'à présent, la participation des filles et des femmes dans les activités de PS est faible, même si en général la CRM compte plus de volontaires de sexe féminin que masculin. Il semble que la nature spécifique des activités de PS, par exemple participer à une équipe de secours au cours d'une manifestation politique, n’est pas attrayant pour un public féminin. Au cours de ce programme, la CRM adoptera des mesures spécifiques pour lutter contre ce déséquilibre: dans sa communication, principalement à travers les médias sociaux, les femmes et les filles sont parti-culièrement encouragées à participer à des activités PS. La CRM reconnaît aussi la nécessité de modèles de rôle féminins dans toutes les activités de PS. Pour vérifier l'impact de l'intervention par rapport au genre, la ligne de base et les indicateurs seront mesurés à l'aide de données ventilées par sexe.

Environnement Notre intervention vise à soutenir la CRM à donner des formations de PS de haute qualité aux volontaires, jeune écoliers, propre personnel. Par un effet de cascade, des membres de communautés aussi seront atteints par d’autres programmes (de Santé, de RRC) dans lesquels la CRM donne des formations de PS dans des communautés à haute risque. Les connaissances des techniques de PS ont comme but d’accroître les capacités de répondre aux urgences soudaines, et ainsi d’augmenter la rési-lience. Ceci sera d’une importance particulière pour faire face aux conséquences du changement climatique, qui changera fortement la volatilité des extrêmes météorologiques (voir ‘risques’).

Au niveau du programme, des mesures petites mais significatives sont prises pour réduire l’impact sur l’environnement de cette intervention: les matériaux sont achetés et même produits localement (par exemple les impressions des manuels, qui sont imprimés avec un tirage strict pour ne pas avoir de surplus) et le déchet de papier est réduit à son minimum en utilisant des outils numériques comme PowerPoint.

Digital 4 Development La CRB-Fl utilise des technologies numériques comme outils habilitants pour agrandir l'impact de ses interventions. Une gamme d'outils numériques est déployée à travers nos différentes pays et secteurs d’intervention. Dans le domaine de PS plus particu-lièrement, la CRB-Fl soutient la CRM dans l'élaboration et la maintenance de bases de données au niveau du siège principal. Ces bases de données servent comme système d'enregistrement des formations de PS. Ces données aident la CRM à traiter et gérer efficacement leur service de PS.

En outre, pour les services nationaux de PS menés à Belgique, la CRB-Fl est actuellement impliquée dans un processus d'inté-gration de « e-learning » dans nos formations de PS pour accroître leur efficacité et leur accessibilité. L'expérience et la connaissance du CRB-Fl sur cette matière, peut se refléter au cours des années dans notre soutien au service de PS de la CRM. En tout cas, déjà maintenant, la CRM favorise des médias sociaux pour diffuser des messages aux volontaires et au grand public. Leur page sur Facebook169 atteint près de 7.000 personnes.

168 Strategienota DGD “Gender in de Belgische ontwikkelingssamenwerking”, p. 10 169 https ://www.facebook.com/Croix-Rouge-Malagasy-MADAGASCAR-260002384073275/?fref=ts

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Droits de l’homme Comme décrit dans l'annexe 4, les droits de l’homme ont toujours été présents dans le travail du Mouvement de la Croix-Rouge. Notre intervention de PS à Madagascar tire l’attention sur le droit fondamental de vivre en bonne santé. La première approche pour opérationnaliser le travail sur les droits de l’homme, est notre diplomatie humanitaire. Son rôle d'auxiliaire, son accès privilégié et la relation avec le gouvernement et les décideurs politiques est pour la CRM un levier pour résoudre les problèmes spécifiques liés à notre domaine d'intervention et contribuer à la capacité des «détenteurs d'obligations» pour répondre à leurs engagements, telles que l'application correcte de la loi Malgache existante sur la sécurité routière et la SST. Les sessions de diplomatie humanitaire sont également prévues dans le budget.

Travail Décent Comme décrit dans l’Annexe 3, en augmentant la qualité et la qualité des formations de PS et des services de PS commer-ciaux adaptés aux professions dangereuses, la CRB-Fl et la CRM contribuent à améliorer la Santé et Sécurité au Travail (SST). La SST forme un résultat clé du programme pays pour le travail décent 2015-2019170, la stratégie convenue par le gouverne-ment de Madagascar pour mettre en œuvre leur Agenda du Travail Décent de l’Organisation internationale du Travail (OiT).

Description de l’Efficacité

Cette intervention fait référence aux approches 3E et 3H sous Objectif Stratégique Commun 3 et aux approches 4A et 4E sous Objectif Stratégique Commun 4 du CSC Madagascar. Tout d’abord, deux choses rendent cette intervention « CRB-Fl spéci-fique » :

1. Le travail avec les volontaires

En tant qu'organisation Croix-Rouge, les volontaires forment l'épine dorsale de la CRB-Fl et de la CRM. Investir dans les com-pétences des volontaires assure une mise en œuvre de qualité de l'objectif principal de la CRM : aider les plus vulnérables à Madagascar. Le grand atout des volontaires, est leur enchâssement dans les communautés locales, même les plus éloignées, ce qui permet la CRM d'être un premier intervenant en cas de maladie, blessure ou menace. A Madagascar, où l'accès aux soins médicaux est limité, la présence de volontaires de la Croix-Rouge avec la connaissance correcte des techniques de PS, est donc un facteur clé pour réduire la mortalité et la morbidité due à une maladie ou blessure soudaine au sein de leurs propres communautés.

2. Notre « Evidence-Based Practice »

S’assurer que toutes les activités soient basées sur des données scientifiques probantes, est un principe de base au sein de la CRB-Fl. Pour soutenir cette initiative, la CRB-Fl a créé le Centre for Evidence-Based Practice (CEBaP) il y a 10 ans. Ce centre de recherche utilise une méthodologie reconnue internationalement pour collecter, systématiser et évaluer des données scienti-fiques pertinentes pour étayer nos activités171. Lorsqu’il n’y a pas suffisamment de données probantes, une recherche primaire est menée pour soutenir nos activités de base – par exemple, la recherche concernant la rétention de connaissances et de capacités PS au Népal ou concernant des facteurs de changement de comportement pour les interventions WASH au Malawi.

CEBaP a développé des recommandations et matériaux PS evidence-based pour le continent africain, l’Inde et le Népal qui seront utilisés dans tous nos programmes PS (AFAM pour Madagascar). Sur base de sommaires de données probantes déve-loppés par CEBaP, un panel d’experts régionaux/locaux a rédigé des recommandations de premiers secours, en tenant compte des préférences du (des) groupe(s) cible(s). Ces recommandations furent alors utilisées pour développer du matériel didactique éducatif pour premiers secours, tel qu’un manuel, des posters, des cahiers d’exercices etc.

CEBaP est reconnu en tant Centre de Référence FIRC et vise à se développer plus amplement dans le RC³ (RCRC Research Centre), fournissant ses services au sein de mouvement CR. Ces services sont également fournis à des partenaires non CR (CEBaP a par exemple effectué une recherche de données probantes concernant la contamination d’eau potable par du fluorure au Sénégal, pour la Coopération Technique Belge). Toutes les recherches primaires et secondaires menées par CEBaP sont publiées dans des revues révisées par des pairs. En plus, par son lien avec CEBAM, le Centre Belge pour Evidence-Based Médi-cine et le Centre Cochrane Belge, CEBaP est sur le point d’être accrédité pour le développement de recommandations evidence-

based suivant la méthodologie Cochrane (http ://www.cochrane.org/).

Stratégie d’Intervention En faisant référence au TdC, qui forme l’aperçu schématique de la stratégie d’intervention, notre intervention se base sur trois piliers qui forment la base fondamentale des résultats recherchés à Madagascar à court et à long terme. Premièrement, notre intervention cherche à appuyer la CRM dans le développement ultérieur de ses formations de PS, pour qu’elle puisse être en mesure d’enseigner aux différents groupes cibles (volontaires Croix-Rouge, jeunes au sein des établissements scolaires, em-ployés des entreprises en organisations nationales et internationales) les techniques de PS qui sont basées sur des preuves scientifiques. Notre intervention se fonde sur les réalisations déjà atteintes en PS par la CRM mais cherche à augmenter la

170 Source : http ://www.ilo.org/public/english/bureau/program/dwcp/download/madagascar2015-19.pdf 171 www.rodekruis.be\cebap

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qualité et la quantité des formations. La qualité est poursuivie par introduire un processus de standardisation des profils de compétence, des outils d’évaluation et des stratégies d’inventaire et réapprovisionnement qui doit renforcer la homogénéité entre les formations au niveau national et les formations données au sein des régions. En plus, des matériaux didactiques de PS basés sur les preuves scientifiques les plus récentes, seront développés et distribués, comme des manuels AFAM (voir ci-dessous) adaptés au contexte malgache. Un effort spécial est fait pour développer des matériaux de PS adaptés aux jeunes.

Lorsque les matériaux et les procédures sont mises à jour en 2017, l’augmentation de la quantité des formations sera appuyée par la formation de 5 Master formateurs (« instructeurs ») en 2017-2018 qui formeront à leur tour 45 encadreurs de PS durant les années 2018-2019. Afin de garantir la qualité des formations, ils seront encadrés par des ateliers annuels de suivi-évaluation et ils recevront une formation de recyclage en 2020-2021.

A partir de 2018, la CRM commencera à atteindre des bénéficiaires directs dans les 5 régions de pilotage: au cours des quatre années 1.200 volontaires et 200 élèves au sein des clubs Croix-Rouge seront formés aux PS par des encadreurs PS: ceci est également nécessaire pour donner aux encadreurs l’expérience essentielle. En plus, des moyens financiers sont prévus pour permettre la CRM d’établir et d’équiper des équipes d’intervention au long des routes nationales, qui peuvent intervenir en cas d’accidents graves.

Deuxièmement, cette intervention donnera un appui institutionnel au siège principal de la CRM qui a comme but d’intégrer de manière durable un service de Premiers Secours au sein de l’organisation. Maintenant, les services de Premiers Secours sont coordonnés par une seule responsable qui a la responsabilité sur les formations commerciales et les formations internes des volontaires et bénéficiaires des programmes de RRC et Santé Communautaire. Renforcer les ressources humaines par le recru-tement d’un Responsable National du Secourisme (RNS) et par le renforcement des anciennes structures comme l’Equipe Pédagogique Nationale (EPN) et le Structure de Pilotage de l’activité secourisme, qui doit connecter les différents départements de la CRM concernant la question de PS font aussi parti de ce programme.

Finalement, en s’appuyant sur les réalisations des deux premiers piliers, le programme soutiendra les services de PS commer-ciaux. Déjà maintenant, les services de PS commerciaux sont profitables pour la CRM: en 2015, un revenu net d’environ 100.000.000 Ariary, soit 31.250 EURO, était gagné. Néanmoins, ces ressources ne suffisent pas encore à maintenir les activités des PS internes. L’appui de CRB-Fl se fera sous la forme d’un soutien des activités promotionnelles, la formation en matières de marketing et modèles de coûts et un soutien important pour la diplomatie humanitaire qui donnera des moyens à la CRM pour plaidoyer sur l’application correcte des lois relatives à la Santé et Sécurité au Travail. Tous les efforts ont comme but de positionner la CRM encore plus profondément dans le marché comme acteur de référence concernant les formations de PS, et de garantir aux entreprises et organisations malgaches une formation de haute qualité qui sera en faveur de la sécurité au travail.

La CRB-Fl est convaincue qu’un appui sur ces trois piliers clés, permettra à la CRM de se fonder sur un service de PS qui est bien organisé et durable, et qui est en mesure de livrer des formations de PS de qualité. En conséquence, à travers le réseau national des volontaires et le travail fait au sein des écoles et des entreprises et organisations, la diffusion des techniques de PS atténuera les besoins élevés dans le secteur de santé à Madagascar.

Description de la Durabilité

Durabilité technique: • Cette intervention vise à renforcer la capacité institutionnelle en PS de la CRM en intégrant un service de PS au sein de

l’organisation, qui peut ancrer les prestations en PS d’une manière durable. En plus, les capacités du personnel seront renforcées par des formations nécessaires comme en compétences de marketing. Aussi au niveau des volontaires, cette intervention vise à former 5 ‘formateurs Master’ qui seront en mesure de former des autres formateurs en PS en dehors de l’intervalle de ce programme.

• Cette intervention tient compte de risques, c’est-à-dire que des risques potentiels tels que des dangers naturels et tech-nologiques, sont pris en compte dans l’élaboration et l’implémentation du programme.

Durabilité financière: • Le soutien de la CRB-Fl vise à soutenir la CRM dans ses prestations et la promotion des services de PS commerciaux, tout

en travaillant sur les étapes importantes déjà entreprises. L’objectif est d’accroître le revenu net actuel et de soutenir davantage les réinvestissements dans le propre service de PS, afin de renforcer l'autonomie financière et de réduire la dépendance de donateurs extérieurs.

Durabilité sociale: • La CRM travaille avec des volontaires qui sont intégrés dans les zones d'intervention sélectionnées et qui ont une grande

capacité d’améliorer l’appropriation locale de l'intervention. Ces volontaires ne dépendent pas du financement de la CRB-Fl. Le renforcement des capacités réalisé pour ce groupe de volontaires par l'intervention, restera en place après que le financement sera retiré.

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Stratégie d’exit: • Les éléments mentionnés ci-dessus sur la viabilité technique, sociale et financière contribuent tous à des résultats durables

pour le programme. • En général, la méthodologie d'intervention est conçue pour renforcer les capacités au sein de la CRM, pour qu'elle soit en

mesure de soutenir ses propres activités de PS avec un haut niveau de qualité. Dans la dernière année du programme, le soutien financier est progressivement retiré (par exemple dans les salaires pour le personnel local), et le focus est décalé vers la mise en œuvre autonome des activités.

Description de l’Efficience

Un budget axé sur les résultats Suite à son ‘Results-Based Management Framework’, la CRB-Fl fonctionne comme suit pour la budgétisation du programme :

• La formulation du budget concerne l’ensemble des Outputs prédéfinis et des Outcomes attendus. • Les Outcomes justifient les ressources qui sont dérivées de et liées au Outputs requis pour atteindre ces Outcomes. • La performance réelle dans l’atteinte des Outcomes est mesurée par des indicateurs de performance objectifs.

Délégation Deux délégués de la CRB-Fl seront basés en Afrique du Sud afin d'aider la Croix-Rouge de Madagascar, Zimbabwe et de la République d'Afrique du Sud avec la mise en œuvre de qualité de l’intervention dans leur pays respectif. Un expert technique de PS et un spécialiste Project Cycle Management (PCM) fourniront un soutien commun, chacun dans leur domaine thématique. La tâche principale du délégué de PCM est de coopérer étroitement et sur base quotidienne avec les 3 Sociétés Nationales, tant au niveau central que dans la zone d’intervention au cours de visites sur le terrain. Le délégué aide la Croix-Rouge locale en gestion de projet, pour parvenir à une mise en œuvre rapide, efficace et efficiente. L'expert technique fournira le contenu spécialisé nécessaire et le soutien à la mise en œuvre des activités PS de manière qualitative. Cet expert profitera de l’expérience acquise à la CRB-Fl en matière de soutien de Sociétés Nationales pour professionnaliser leur formations et les services de PS. Ceci assura un impact maximum et la durabilité du processus de changement.

La proximité de ces deux experts avec la CRM permet l'entrée directe pour atteindre les résultats du programme, tout en renforçant les capacités du partenaire d'exécution, afin d'accroître les connaissances et les compétences, tant au niveau du personnel (perfectionnement du personnel) et au niveau institutionnel (systèmes, structures). Les délégués sont en outre sou-tenus dans leur rôle par les experts de la CRB-Fl au siège principal, qui fournissent l’expertise en matière de gestion (PMER, Finance, gestion du programme) et d’aspects techniques.

Finalement, par sa proximité géographique avec d’autres délégations de la CRB-Fl au Mozambique et au Malawi, et par les similarités avec les programmes de Premiers Secours, la Croix-Rouge de Malawi et du Mozambique bénéficieront également de l’apprentissage entre pairs et du support technique direct fourni par la délégation de la CRB-Fl dans la région de l’Afrique du Sud pour les Premiers Secours et le PCM.

Premiers Secours Selon une étude de la Banque mondiale, la formation de secouristes en premiers secours est une intervention extrêmement rentable; avec « un coût de 8 $ par DALY évité »,172 ce qui la rend un des moyens les moins chers pour augmenter la santé publique dans les pays en cours de développement.

Description des Ressources

1. Investissements

La majorité des coûts d’investissements est allouée à l’achat des matériaux de PS utilisés pour les formations et services de premiers se-cours (91.308 EUR) comme des manuels de PS basés sur AFAM et les matériaux pour les équipes d’intervention au sein des 5 régions cibles.

2. Fonctionnement

Les coûts de fonctionnement généraux comprennent les consommables pour les formations de PS (9.134 EUR). Etant donné que le but principal de notre intervention est d’améliorer la qualité et la quantité des formations de PS, la plus grande partie du budget est dédiée à la formation régionale des Master Formateurs (28.719 EUR) et au déploiement des formations dans la communauté des volontaires, y compris des étudiants et des enseignants des CPF’s de VIA Don Bosco (155.185 EUR). Les frais pour le renforcement du service de PS et l’appui additionnel du service de PS commerciaux avec un soutien promotionnel (23.294 EUR) et l’élaboration d’une stratégie Marketing par entre autre un atelier avec expertise externe (8.955 EUR), sont les outres postes de dépenses principaux.

172 Laxminarayan et al. (2006). Intervention Cost-Effectiveness : Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2

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3. Personnel

Personnel local CRM

L’équipe de personnel de la CRM se compose de 2 ETP (Le Responsable National du Secourisme qui est à recruter, et le Responsable qualité et PS commerciaux dont le salaire n’est supporté que pour 3 ans. En plus, le programme est soutenu par un comptable et un assistant M&E (2 fois 0,5 ETP) et 1 commercial professionnel qui travaillera dans un système de bonification par rapport aux chiffres d’affaires.

Personnel expat CRB-Fl

Les 3 programmes de PS mis en œuvres à Madagascar, Zimbabwe et Afrique du Sud, sont pris en charge par un total de 2 délégués de la CRB-Fl, basés en Afrique du Sud: 1 expert technique en PS et un expert de PCM. Les deux experts soutiendront conjointement les 3 partenaires locaux. Le budget est composé du salaire, logement, frais de transport et autres coûts opérationnels pour la durée du programme. Tous ces coûts sont budgétisés pleinement dans le programme d’Afrique du Sud, car la délégation sera basée là-bas (ce choix suit une logique logistique: les coûts sont budgétés là où ils sont faits).

Personnel HQ CRB-Fl

L’intervention est soutenue par un expert technique en PS de la CRB-Fl, basé à Malines (Belgique). Le budget se compose du salaire et des frais de transport (0,06 ETP pour Madagascar). C’est le point focal central du siège principal qui surveille la qualité du programme PS multi-pays entier en fournissant l’expertise technique du service national de Premiers Secours de la CRB-Fl et de CEBaP à la CRM. Cela se fait directement soit indirectement par le la délégation régionale de la CRB-Fl, par exemple en exécutant ou facilitant des missions techniques spécifiques de courte durée concernant l’expertise didactique PS, expertise en exercices de simulation, analyse de rentabilité des Premiers Secours Commerciaux CRM, ...

Description de la stratégie de Partenariat

Politique La CRB-Fl fonctionne toujours dans le cadre de partenariats du Mouvement International de la Croix-Rouge et du Croissant-Rouge et la Société Nationale fonctionne toujours comme seul partenaire privilégié. Les principes de la coopération et le ren-forcement des capacités sont formalisés dans la ‘Development Cooperation Policy (2007)’ 173, the ‘National Society Development

Framework (2013)174’ & the ‘Code of Good Partnership’175 de la Fédération Internationale des sociétés de la Croix-Rouge et du Croissant-Rouge (FICR).

Tous les partenaires de la Croix-Rouge dans ce programme sont des partenaires stratégiques, ce qui signifie l'engagement de coopération dans lesquels des objectifs communs sont définis et l'accent est mis sur le renforcement des capacités et le transfert de l'expertise technique. Tout ça pour que le partenaire soit en mesure de mettre en œuvre des services de PS de qualité aux personnes les plus vulnérables, conforme les priorités thématiques de la CRB-Fl.

Croix-Rouge Malagasy Comme décrit dans le CSC Madagascar (p.9), la Croix-Rouge Malagasy est un des plus importants partenaires locaux impliqués dans la gestion de risques. La CRM est une association de secours volontaire, reconnue d’utilité publique d’après le décret 63-489 du 7 août 1963 suite à la signature du Gouvernement Malgache des Conventions de Genève. A ce titre, elle est auxiliaire des pouvoirs publics dans le domaine humanitaire et travaille par conséquent en étroite collaboration avec les pouvoirs publics afin de répondre aux besoins des plus vulnérables tout en respectant les principes fondamentaux du Mouvement International de la Croix Rouge et du Croissant-Rouge.

Conformément à la stratégie 2020 de la Fédération Internationale des Sociétés de la Croix-Rouge et du Croissant-Rouge, les actions de la CRM sont guidées par son Plan Stratégique de 2011-2015 qui comprend 3 axes principaux: i. sauver des vies, promouvoir des modèles de vie sains et sûrs. ii. Promouvoir l’intégration sociale et une culture de paix et de non-violence et iii. Mobiliser des ressources pour des actions humanitaires pérennes.

En ce moment, la CRM est en train d’élaborer le Plan Stratégique pour 2017-2020.

Aujourd’hui, la CRM compte environ 14.300 volontaires sur l’ensemble du territoire dont 9.300 actifs selon le recensement du dernier rapport annuel 2015, dont 31 volontaires membres de l’Equipe Nationale de Réponse d’Urgence, 120 volontaires spé-cialisés en Eau, Hygiène et Assainissement, plus de 1.930 jeunes volontaires et 19 pairs éducateurs dans le cadre du programme « Jeunes comme Agents du Changement de Comportement ».

La CRM compte aussi 130 salariés répartis dans le pays dont 22 coordinateurs régionaux. La CRM est présente dans tout Ma-dagascar, elle est la seule organisation humanitaire présente dans toute l’île. Elle compte 1.045 sections communales sur les 1.300 communes existantes, 120 bureaux de coordination au niveau de 120 districts et 22 bureaux régionaux sur les 22 régions.

173 http ://www.ifrc.org/Global/Governance/Policies/developmentcoop-policy-en.pdf 174 http ://www.ifrc.org/Global/Documents/Secretariat/201505/1269801-NSD%20framework%202013-EN-LR.pdf 175 http ://www.ifrc.org/PageFiles/79467/CoD09_14_code%20good%20partnership_EN.pdf

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PS Conscient du rôle que les Sociétés Nationales doivent avoir en matière de secourisme et vu le grand manque qui existe à Madagascar, la CRM a entamé des actions pour répondre aux besoins de la population en toute circonstance et en tout lieu. La stratégie de la CRM en matière de PS, qui a été mise en place suite à l’évaluation effectuée par la Croix-Rouge Française (CRF) en 2007, s’est basée sur la formation des volontaires et la mise en œuvre du programme Premiers Secours à Base Com-munautaire.

Avec cet appui de la CRF, et ensuite de la Croix-Rouge Espagnole et du CICR entre 2007 et 2012, les curriculums de formation ont été reformulés, des formations d’instructeurs nationaux et des formateurs ont été effectuées et les équipements de PS ont été établis. Comme résultat, la CRM compte jusqu’à présent un millier de volontaires de PS, une dizaine d’instructeurs nationaux et une vingtaine d’encadreurs en premiers secours. Néanmoins, la taille de l’équipe de secourisme est disproportionnée par rapport à la demande et aux besoins ressentis et la maintien de la capacité est un défi. En ce qui concerne Premiers Secours commerciaux, la Croix-Rouge Canadienne a soutenu la CRM en 2014 pour développer le service de ventes des produits de premiers secours avec succès: en 2015, le revenu net était 31.250 EUR.

Vu que les éléments constitutifs sont là, l’intervention de la CRB-Fl cherche à recharger et consolider les capacités de la CRM en matière de secourisme en rendant les formations adaptées aux dernières lignes directrices et evidence-based et par le trans-fert de notre expertise dans plusieurs domaines, entre autre la modélisation des coûts pour la commercialisation de PS.

Stratégie de renforcement des capacités CRB-Fl reconnaît que le renforcement des capacités est un processus continu et long, auquel toutes les parties prenantes participent. Le renforcement des capacités englobe tout d'abord le processus de renforcement des individus avec les connais-sances et des compétences qui leur permettront d’agir efficacement. Deuxièmement, ce processus comprend le développement organisationnel, y compris l’établissement de processus et des procédures au sein de l'organisation. Troisièmement, il faut un cadre institutionnel et juridique de développement, afin d'apporter des modifications juridiques et réglementaires pour per-mettre à l'organisation d'améliorer ses capacités.

Ces trois éléments sont abordés vu que le programme PS mettra en place une structure de formation dans le pays, y compris des ‘Master’ formateurs qui peuvent former de nouveaux formateurs, même après la fin de l'intervention. En renforçant le volet de PS commerciaux, le département PS devrait être en mesure d'augmenter son chiffre d'affaires net et ainsi couvrir les frais du service à la fin de 2021. Enfin, les formations (régionales) mettent l'accent sur l'institutionnalisation qui conduira à une politique, stratégie et des procédures de PS. Le processus d'institutionnalisation des PS dans la CRM garantit non seulement l'incorporation des PS dans les structures organisationnelles, cela créera également l’appropriation de l’éducation aux PS comme tâche principale d’une Société Croix-Rouge.

De plus, une évaluation sera effectuée en 2017 pour identifier les besoins en Monitoring & Evaluation, plus spécifiquement sur le plan de gestion axée sur les résultats de l’intervention. Sur base du résultat de cette évaluation, les priorités et activités de la CRB-Fl envers la CRM en matière de soutien M&E seront déterminés.

Délégation La délégation régionale aidera la CRM non seulement sur le plan de la gestion du programme, mais aussi sur le plan technique pour assurer l’impact et la durabilité de l’intervention. Sa proximité avec le partenaire d'exécution (présence régionale et des visites régulières) permet l'entrée directe pour atteindre les résultats du programme, tout en renforçant les capacités du parte-naire d’exécution en augmentant ses connaissances et compétences nécessaires, tant au niveau du personnel (perfectionnement du personnel) et de l’institution (systèmes, structures). L'apprentissage entre pairs sera stimulée: les expé-riences, meilleures pratiques et leçons apprises en matière de PS dans les autres Sociétés Nationales seront compilées et partagées par la délégation régionale, et l’échange et l’apprentissage régional seront facilités.

Synergies & Complémentarités

Pendant la durée du programme, des synergies informationnelles avec les autres ACNG’s seront développées pendant les cycles de consultation récurrents qui serviront comme plate-forme d’échange d’idées, d’expériences, de risques et de problèmes. La CRB-Fl participera activement à ces moments d’échange, qui seront une base fructueuse pour la formulation et l’opérationna-lisation de nouvelles synergies et complémentarités.

Afin de développer ces synergies et complémentarités entre les ACNG belges intervenant à Madagascar, un comité de pilotage sera mis sur pied. Cette nouvelle structure sera chargée de l’identification, de la coordination, du suivi et de l’évaluation des activités de complémentarité et de synergie entre acteurs de la coopération non gouvernementale belge à Madagascar. Y seront invités les ACNG Nord qui ont participé à la rédaction du CSC, leurs partenaires malgaches, un membre de la DGD et un membre du poste diplomatique belge. Sa mise en place est prévue dans le courant de l’année 2017. Les modalités de son fonctionnement seront discutées à cette occasion et affinées tout au long du programme quinquennal. En outre, le tableau ci-dessous montre les synergies et complémentarités qui sont déjà concrétisés:

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Organiza-tion

Objectif commun recherché Rôles et devoirs Contributions financières

Outcome 1: FA

VIA Don Bosco

Dans le programme 17-21, CRB-Fl appuiera son parte-naire local, la CRM, à diffuser des connaissances et techniques de PS de sorte qu’ils soient appliqués au sein des communautés malgaches. Vu la population jeune du pays, un des groupes cibles de la CRM sont les jeunes au sein des établissements de formation. VIA Don Bosco de son côté, soutient les Centres de Formations Profes-sionnelles (CFP) du réseau Don Bosco. Une des activités de leur programme quinquennal est le développement et l’implantation des cours sur le développement du-rable et la citoyenneté. Etre capable d’appliquer les techniques de PS à ceux qui en ont besoin, non seule-ment augmente la sécurité au sein des Centres de Formations Professionnelles, en plus cela contribue ac-tivement à un climat de citoyenneté dans lequel on prend soin les uns des autres.

Vu l’objectif commun de nos organisa-tions, une synergie opérationnelle est mise en place dans laquelle 2 ensei-gnants/assistantes sociales de chaque Centre de Formations Professionnelle sui-vront une ‘Formation de Formateurs’ en PS donnée par la CRM. Comme résultat de cette formation, qui sera donné en 2018 avec une formation de recyclage en 2020, les enseignants/assistants seront capables d’appliquer les premiers soins au sein de leurs CFP’s et de transférer les connaissances et pratiques de PS aux élèves et par un effet de cascade aussi dans les communautés environnantes.

Les coûts de cette forma-tion seront partagés entre les deux organisa-tions. Le partenaire local de VIA Don Bosco pren-dra soin de l’hébergement pendant la durée de la formation, le partenaire local de CRB-Fl fournira des for-mateus qualifiés et des matériaux de PS. Pour la CRB-Fl, les coûts pour les deux formations de 7 jours mon-teront à envi-ron 1.500 EUR.

Complémentarités

Outre des synergies avec les partenaires du CSC, la CRB-Fl veut aussi attirer l'attention sur le niveau élevé de complémentarité entre ses interventions et les programmes d'autres Sociétés Nationales qui sont présentes à Madagascar: la Croix-Rouge Allemande, Norvégienne et Danoise, la Comité International de la Croix-Rouge (CICR) et la Croix-Rouge Française, par leur Plateforme d’Intervention Régionale de l’Océan Indien (PIROI) qui mène un programme de Réduction des Risques de Catastrophe, dans lequel deux entrepôts de stockage de matériel huma-nitaire ont été construits à Antananarivo et à Toamasina, dans la région d’Atsinanana en 2013.

Bien que les programmes de ces partenaires aient leurs propres accents, notre intervention est construite sur le développement organisationnel qu'ils ont apporté à la CRM, tandis que leurs interventions bénéficieront de la qualité renforcée des service de PS. Pour donner un exemple concret : la Croix-Rouge Danoise, Allemande et Norvégienne sont actuellement en train de dérouler un projet de RRC financé par le service de la Commission Européenne à l’aide Humanitaire et à la Protection Civile (ECHO). Un des point focaux de ce projet est la RRC au sein des écoles et une des activités sera des formations de PS aux élèves. Sans doute, pendant notre intervention future, nous nous baserons sur les réalisations acquises dans le cadre de ce projet et nous les développerons davantage.

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Mozambique Sustained use of sufficient safe water & sanitation facilities, as well as sustained safe hygiene attitudes & practices by the target population by 2021.

Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, enhancing community level resilience and emergency care capacity.

2017-2021

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Samenvatting

‘Rode Kruis-Vlaanderen (RKV) helpt helpen’ is de slogan die het 17-21 programma in Mozambique samenvat. Enerzijds verwijst dit naar de focus op zelfredzaamheid, anderzijds naar de focus op impact. Mensen zelfredzaam maken is de manier bij uitstek om een duurzame impact te hebben. Zowel RKV’s interventiestrategie als de keuze van activiteiten in Mozambique zijn gebaseerd op het idee van zelfredzaamheid. RKV’s interventiestrategie heeft als kernprincipe dat de implementatie van het programma geleid en gedragen wordt door de lokale Rode Kruis vereniging en haar vrijwilligers. RKV neemt een ondersteunende rol op zich maar zal zelf geen directe imple-mentatie doen. Het 17-21 programma, met een totaalbudget van 1.460.889 EUR wordt dan ook getrokken door het Cruz Vermelha de Moçambique (CVMO). Het programma is op vraag van en in nauwe samenwerking met CVMO opgesteld. CVMO is ook de grootste nationale humanitaire organisatie van Mozambique en is actief in het hele land. Het programma in Mozam-bique is opgebouwd uit de twee thematische specialisaties van RKV: water, sanitatie & hygiëne (WASH) en eerstehulponderricht. Beide interventies houden rekening met de prioriteiten van de Belgische ontwikkelingssamenwerking rond gender, milieu en klimaat, mensenrechten, digitale innovatie en waardig werk.

WASH Het gebrek aan water- en sanitatie infrastructuur in Mozambique kost tot 4 miljard Metical per jaar, voornamelijk door voortij-dige sterfte, medische kosten en het verlies aan productiviteit. Vrouwen, die taken rond water in het huishouden opnemen, worden bijzonder hard getroffen. Het programma van RKV beoogt daarom om 4.000 gezinnen in de districten Inhassoro en Vilancos, binnen de Inhambane provincie, te voorzien van voldoende en veilige water- en sanitatievoorzieningen. Dit doen we door het bouwen/rehabiliteren van 14 waterpunten binnen de interventiezone, waarmee 7.000 directe begunstigden worden bereikt. Voor dezelfde doelgroep wordt ook andere WASH infrastructuur (zoals toiletten) voorzien, maar begunstigden worden niet dubbel geteld. Deze infrastructuur beantwoordt aan de nationale normen en wordt op duurzame manier geïnstalleerd, waarbij er met lokale materialen wordt gewerkt en lokale Water User Committees instaan voor een correct gebruik en onderhoud. Hoewel adequate en toegankelijke infrastructuur essentieel is, is de impact beperkt wanneer toegang niet gekoppeld wordt aan gedragsverandering rond een correcte hygiëne. Naast het oprichten van Water User Committees, zullen elementen uit Community-Led Total Sanitation worden aangewend om het bewustzijn van de lokale bevolking rond toiletgebruik te verhogen. 1.000 van de meest kwetsbare gezinnen zullen via subsidies worden aangezet om een eenvoudige latrine te bouwen, waarna ze op hun beurt zelf 1.000 andere gezinnen ervan overtuigen hetzelfde te doen. Rode Kruis-Vlaanderen heeft via haar “Center for Evidence-Based Practice” (CEBaP) de nodige expertise in huis rond methodes die leiden tot effectieve gedragsverandering. 150 CVMO-vrijwilligers zullen dan ook worden opgeleid in deze sensibilisatieme-thodes alvorens te worden ingezet in de betrokken districten. Dit programma voorziet ook in de duurzame capaciteitsopbouw van CVMO’s capaciteit in WASH. Het economisch rendement van een WASH-interventie is groot: de Wereldgezondheidsorganisatie berekende dat er voor elke US $ geïnvesteerd in WASH, een economisch rendement van 4 US $ wordt gegenereerd176. Daarnaast verklaarde ook de We-reldbank dat hygiënepromotie een van de meest kosteneffectieve gezondheids-interventies is in ontwikkelingslanden, en zelfs leidt tot een negatieve kost per DALY177: de kosten voor het bevorderen van hygiëne liggen lager dan de kosten voor de behandeling van water-gerelateerde ziektes zoals diarree.

Eerste hulp Door CVMO personeelsleden, CVMO vrijwilligers en leken op te leiden in eerste hulp wordt de bevolking van Mozambique zelfredzaam gemaakt. Bovendien is er een duurzaam multiplicator effect door het opleiden van de ‘master trainers178’ (2.155 directe begunstigden en 32.480 indirecte begunstigden). De aanwezigheid van lokale ‘First Responders’ is van groot belang in een land dat kampt met een systemisch gebrek aan basisgezondheidsinfrastructuur, zeker in tijden waarin de kans op politiek geweld een reële dreiging is. Deze interventie richt zich in de eerste plaats op de CVMO hoofdzetel in Maputo, die in staat zal worden gesteld om een kwalitatieve ondersteuning te bieden aan de eerstehulpopleidingen verspreid over het volledige land, wat mogelijk wordt ge-maakt door CVMO’s 101 sub-branches die op districtsniveau actief zijn. De trainingscapaciteit van CVMO zal worden versterkt

176 Hutton G (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal cov-erage, p4. WHO, Geneva, Switzerland. 177 DALY is een maatstaf die werd ontwikkeld door de Wereldgezondheidsorganisatie. De DALY meet niet alleen het aantal mensen dat vroegtij-dig sterft door ziekte, maar meet ook het aantal jaren dat mensen leven met beperkingen door ziekte. In maatschappelijke kosten-batenanalyses worden DALY's ook toegepast om de kosteneffectiviteit van gezondheidsinterventies te bepalen. Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edi-tion). Washington D.C. World Bank, chapter 2. 178 Trainers die andere trainers kunnen opleiden.

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met 26 eerstehulptrainers en 3 master trainers. Dankzij de synergie met Apopo en Artsen Zonder Grenzen zullen we ook hun doelgroepen kunnen bereiken met een eerstehulpopleiding. Naast het opleiden in eerste hulp, wil RKV de zelfredzaamheid van CVMO versterken door hen in staat te stellen financieel autonoom te investeren in eerstehulpactiviteiten. Door CVMO meer zelfredzaam te maken, garanderen we een grotere duur-zaamheid van eerstehulpactiviteiten. RKV wil dit doen door CVMO te ondersteunen in het uitbouwen van bedrijfseerstehulp. Dit doen we zowel via kennisoverdracht (workshops rond marketing en het opzetten van een kostenmodel) als via een onder-steuning van hun humanitaire diplomatie die bijvoorbeeld eerstehulplessen of hulpposten verplicht moet maken. De uitbouw van bedrijfseerstehulp ligt in lijn met de ‘Waardig Werk’ prioriteiten van Mozambique rond veiligheid en preventie op de werk-vloer. Naast zelfredzaamheid is impact een belangrijke focus van het RKV programma in Mozambique. Een studie van de Wereldbank toont aan dat het investeren in de opleiding van eerstehulpvrijwilligers één van de meest kosteneffectieve interventies is met een kost van slechts 8 US$ per DALY179. Bovendien investeert RKV via haar CEBaP continu in onderzoek naar interventiestrate-gieën met de meeste impact. Zo onderzoeken we het effect van simulaties in eerstehulpopleidingen of welke eerstehulpkennis op welke leeftijd kan onthouden worden. De resultaten van deze onderzoeken zijn geïntegreerd in RKV’s eerstehulpondersteu-ning aan CVMO. Daarnaast heeft het CEBaP evidence-based eerstehulprichtlijnen uitgewerkt die volledig aangepast zijn aan de Afrikaanse context (‘AFAM’, African First Aid Materials’). Het eerstehulpopleidingsmateriaal van CVMO zal op basis hiervan herzien worden zodat steeds de meest doeltreffende eerstehulppraktijken worden aangeleerd. RKV wil de impact van het programma in Mozambique ook vergroten door gebruik te maken van haar jarenlange operationele expertise rond eerstehulpopleidingen. Binnen RKV bestaat de dienst ‘Eerste Hulp’ die 500 trainers in dienst heeft om nationaal eerstehulpopleidingen te geven. Deze trainers worden voor specifieke expertisegebieden ingezet in ons programma. Gedurende alle fases van de interventie, wordt een gender-sensitieve benadering gehanteerd: binnen CVMO wordt gestreefd naar een gelijkmatige verdeling van vrouwen en mannen binnen de eerstehulplessen én de beheers- en bestuursorganen van de organisatie. Aan de hand van gender-gedisaggregeerde indicatoren zullen verwezenlijkingen in kaart worden gebracht. Daarnaast zullen inspanningen worden gedaan om de impact van onze interventie op het milieu te beperken, door onder andere de aankoop van lokale materialen en een correcte afvalverwerking. RKV gelooft ten stelligste dat het 17-21 programma in Mozambique rond WASH enerzijds en eerstehulponderricht anderzijds door zijn focus op zelfredzaamheid en duurzame impact sterk bijdraagt tot een verhoogde toegang tot eerstelijns gezond-heidszorg en WASH voorzieningen. Op die manier komt het programma tegemoet aan de Gemeenschappelijke Strategische Doelstelling 3180 van het Gemeenschappelijk Strategisch Kader Mozambique en aan de Sustainable Development Goals 1, 3, 5, 6, 8 & 13.

179 Laxminarayan et al. (2006). Ibid. 180 Bijdragen aan een verbeterde toegang tot gezondheidszorg en WASH infrastructuur.

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Country Fiche

181 Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2. 182 Ibid.

Total Operational Costs (EUR) 1.460.889

Contact person in Belgium Name: Tiene Lievens Organization: Belgian Red Cross-Flanders (BRC-Fl)

Phone No: +32 15 44 33 57


Narrative summary of the country program

BRC-Fl worked in Mozambique between 2001 and 2014, mostly in the field of health and disaster response, and always with its preferential partner, the National Society, CVMO (Cruz Vermelha de Moçambique). Between 2017 and 2021, the renewed cooperation will focus on First Aid training and service delivery and water and sanitation. BRC-Fl focuses on these 2 areas of intervention in order to be able to deliver a tangible added value to the partnership, seen our extensive and evidence-based experience in those two areas of intervention.

First Aid is a priority activity for all Red Cross Societies worldwide, and especially relevant in Mozambique, given the volatile political and socio-economic situation, the disasters that frequently hit the country and the limited access to basic healthcare especially for the rural population.

Moreover, First Aid Education is a very cost-effective development intervention, having a cost of 8 US$ per disability-adjusted life year averted (DALY)181, making it one of cheapest ways to increase public health in developing countries. BRC-Fl has extensive expertise in FA education, assuring that what is thought, is conform the latest scientific evidence. This highly in-creases the efficiency of our intervention, resulting in a total of 2.155 direct beneficiaries with a large spill-over effect to 32.480 indirect beneficiaries, making a total of 34.635 beneficiaries.

Secondly, access to sufficient and safe water and sanitation is an important contributor to overall health and poverty reduc-tion. With this program, 7.000 persons in 2 districts in Inhambane province will benefit from access to safe drinking water (new and rehabilitated water points) and 5.000 persons from access to improved sanitation. Apart from access, behavior is key to good health outcomes and hygiene promotion is according to the World Bank182 one of the most cost-effective health interventions. Therefore, the program also focusses on hygiene behavior change. This is accomplished using scientific ap-proaches to behavioral change which are positively influencing our impact: 150 volunteers of CVMO will play an important role in both transmitting the right messages, and assisting the beneficiaries to change their behavior for the better. In total, the program assists 7.000 direct beneficiaries and 14.000 indirect, making a total of 20.000 beneficiaries.

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Area of intervention

List of partners

Local Partner

Full Name & abbreviation: Cruz Vermelha de Moçambique (CVMO)

Contact Details Address: Phone No: E-mail:

Avenida Agostinho Neto, 284 Maputo (258) 82 3012251 [email protected]

Contact person Marla Dava, Head of Programs. [email protected]

Outcome(s)

O1: Sustained use of sufficient safe water and sanitation facilities, as well as sustained safe hygiene attitudes and practices by the target population by 2021.

O2: Lay people, Red Cross staff and volun-teers have adequate, up-to-date and evidence based knowledge, skills and atti-tudes to provide first aid to those in need by 2021, enhancing community level resili-ence and emergency care capacity.

Budget by Outcome (EUR) Budget O1: 595.451 Budget O2: 333.136

Summary of partner role for each Outcome:

CVMO, through its nationwide network of branches and volunteers, is the main imple-menting partner for these outcomes. With support from BRC-Fl headquarters and delegation, the CVMO is responsible for the planning, implementation, monitoring and re-porting of this program.

Start date of partnership relation: 2001 (operational partnership on hold between 2014 and 2016)

Theory of Change

This Theory of Change (ToC) serves as the basis for the logical framework (see further). Throughout all phases of implementation BRC-Fl uses the logical framework as the basis for implementation & monitoring. In addition, a general explanation on how BRC-Fl has structured the ToC model can be found in Annex 1 of the program.

Outcome 1 WASH

Please find the schematic representation of the ToC of WASH on the next page.

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1. Assumptions please note that due to page limitations we excluded academic references, they are available on request

183 For an important number of assumptions we refer to the 'Water, Sanitation and Hygiene evidence paper' from DFID (May 2013). This paper synthesizes all available evidence for many of the assumptions formulated in our ToC.

Assumption Link to

logframe

Does it hold?

(yes/no) Argumentation/evidence183

A • WASH interventions have a positive effect on health outcomes.

• Less waterborne pathogens lead to better health.

Outcome 1 • Yes • Yes

• The positive effect of WASH interventions on health outcomes has been shown in many studies and systematic reviews. Moreover, DFID’s evaluation data reports wider impacts of WASH programs in the form of reduction of the burden of disease and increased school attendance. Good evidence was can be found proving that health impacts in-clude many other important diseases beyond diarrhea.

• As water related diseases such as diarrhea are caused by infections by water borne pathogens, it is evident that a reduction in infections will lead to less water related diseases and better health.

B Better hygiene leads to reduced infections by water-related pathogens.

Outcome 1 Yes

Sanitation and hygiene are critical to health, survival, and development. Providing access to safe water and sanitation facilities, and promoting proper hygiene behavior are important in reducing the burden of disease from sanitation and hygiene-related diseases.

C Access to sufficient and safe/potable water leads to better hygiene.

Outcome 1 Yes An assessment of the evidence underlying the impact of the four main WASH interventions (water quality, water availa-bility, excreta disposal, hygiene promotion) on diarrhea shows that the availability of water is the most favorable intervention based on a specific set of appraisal factors.

D • Access to sufficient and improved sanitation facili-ties leads to better hygiene and reduction of water related diseases.

• Sanitation facilities are used in a hygienic manner.

Outcome 1 • Yes, but more research is needed

• Yes

• An impact evaluation in Bangladesh showed that improvement in sanitation facilities had led to a reduction in water-borne diseases. However, only a few systematic reviews have looked at the effect of sanitation facilities on the health status or the reduction of diseases. Further research in this area is needed.

• Hand washing after toilet use will be heavily promoted during the project.

E • People practice better hygiene if they have the knowledge, skills, and attitudes. Hygiene promo-tion leads to sustainable hygiene behavior change.

• Target population has the means to apply safe hy-giene practices and appropriate use of water and sanitation hardware.


• BRC-Fl research ongoing

• Yes

• BRC-Fl is conducting a systematic review to determine which promotional approaches are effective to change hand washing and sanitation behavior. This project is a collaboration of the BRC-Fl Centre for Evidence-Based Practice and the Centre for Evidence-Based Health Care of Stellenbosch University South Africa. Oversight and guidance is provided by 3ie (International Initiative for Impact Evaluation).

• Financial means are low in the project area but people have been known to be resourceful (e.g. using ashes to wash hands).

F • CVMO is a relevant actor in the WASH sector. • Partners support CVMO’s WASH related efforts

with the provision of financial and human re-sources and expertise.

Outputs 1.1-1.4

• Yes • Yes

• Evidence suggests that the most influential factors associated with sustained adoption include frequent contact with a health promotor over a period of time. Personal follow-up may further contribute to sustained adoption. The large net-work of RC volunteers can play exactly the role of health promotor as they are part of the target communities, and are present beyond the duration of the intervention. In addition, the GoM has worked together with CVMO in previous WASH interventions and contracts its borehole drilling entity for its own projects.

• This program intends to support CVMO with financial and human resources and expertise, thus contributing directly to an increased capacity within CVMO.

G Water sources are available in the target area. Output 1.1/1.3

Yes Sea-level project area with sufficient levels of sweet water at shallow depth.

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2. Stakeholder analysis please note that due to page limitations we excluded the detailed description of stakeholders, this is available on request

1. Serviços Distritais de Planeamento e Infra-estruturas (SDPI)

2. District Administrator 3. Serviços Distritais de Saúde, Mulher e Acção Social

(SDSMAS)

4. Ministry of Public Works

5. Water User Committees (WUC) 6. Community members 7. CVMO Volunteers

8. Women and girls

9. Local traditional leaders

10. Existing community associations 11. Companies and local craftsmen

12. Research institutes (e.g. Instituto de Investigação em Aguas, IIA)

H Time saved by women for water collection leads to more possibilities for women empowerment as well as less risk of violence and injury.


Yes Studies have shown that WASH interventions significantly reduce the time that women need to spend on fetching water and taking care of sick children. In addition, a smaller time and energy burden associated with fetching water may de-crease the risk of violence and injury for women.

I • Adequate sanitation facilities reduce the exposure of women to the risk of violence and saves them time.

• Sex-aggregated and girl-friendly toilets lead to in-creased school attendance by girls.

Impact Outcome 1 Outputs 1.2-1.3

•Yes •More research needed

• DFID’s WASH evidence paper states that the impact of inadequate water and sanitation are particularly pronounced for women and girls. Inadequate sanitation facilities may expose women to the risk of violence, and finding adequate loca-tions for open defecation can require significant time.

• Qualitative research indicates that some girls may be discouraged from attending school without adequate toilet facili-ties. However, no evidence is available on the direct link between sex-aggregated toilets and increased school attendance by girls.

J • The chosen approaches/methodologies to promote WASH behavior change are effective.

• CVMO volunteers are effective agents of sustained

WASH behavior.

Outcome 1 Outputs 1.3-1.4


• Yes

• Cfr. Assumption E and ongoing systematic review by BRC-Fl in cooperation with 3ie. In addition, BRC-Fl is currently conducting research on which behavior change techniques are most and effective, spe-cifically for the intervention area in Malawi in cooperation with professor Hans-Joachim Mosler of EAWAG university in Zurich .

• Cfr. Assumption F.

K WASH interventions contribute to climate change adaptation and resilience.

Impact Yes Promotion of WASH technology and behaviors is a critical component of climate change adaptation and promoting hu-man rights. The Red Cross/Red Crescent Climate Centre underlines the link between the availability of water and sanitation infrastructure on the one hand and increasing hygiene awareness, and communities’ vulnerability to extreme weather events on the other hand. In addition, as the project area in Mozambique is flood-prone, special attention will be given to the protection of the sources during flooding in order to assure continued access to safe water during shal-low floods. This will increase the population’s resilience during floods.

L WASH interventions have a positive impact on poverty reduction.

Impact Yes DFID’s evidence paper on WASH states that improving water, sanitation and hygiene also alleviates poverty.

M By reducing distance to safe water, water will also be used for hygienic purposes, not just for drinking and cooking.

Outputs 1.2-1.3

Yes The interventions will work on this. There is suggestive evidence that health outcomes improve when the water source is closer to the household with the implication that water supply strategies should take account of distance to source and plan and invest accordingly.

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3. Context analysis please note that due to page limitations we excluded the detailed description of contextual factors, this is available on request

• Cultural factors (e.g. Open defecation is a very normal practice in the rural communities in Inhambane province. Priority should be given to the denser populated areas). • Gender issues (e.g. While collecting water is the task of women and children, managing the water at household level is often the prerogative of men. Both genders will need to be actively involved in all aspects of

the program in order to reach the desired outcomes.) • Environmental and climate issues (e.g. Desertification and reduction of livelihood options (less fish in the sea) are a direct consequence of climate change, and affect people’s capacity to invest, while increasing their

vulnerability to shocks; information on mitigation measures should accompany the awareness raising on hygiene practices.) • Legislation (e.g. CVMO always aligns its interventions with the GoM policies, and complements these with RCRC-movement’s tools and policies, in order to increase the effectiveness.) • Political and socio-economic situation (e.g. Tensions are rising in Mozambique between the main political fractions. This might require changes to the program activities and planning.)

4. Activities

1 Capacity building related to WASH

• Providing expertise related to WASH activities (EBP, technical expertise, training and learning opportunities)

• Providing resources to CVMO for activity implementation (HR, financial)

• Capacitating volunteers by providing training, tools, incentives, visibility materials and means of transport • Facilitating monitoring and evaluation of the program, including baseline, midterm- and end evaluation and

the use of digital technologies for data collection • Supporting innovation and evidence-based practice, deliver expertise

2 Provide access to safe water infrastructure

• Feasibility study for risk-informed and gender-friendly water infrastructure • Rehabilitation of existing and construction of new water points • Water quality testing

• Setting up, equipping and training Water User Committees (WUC) • Providing chlorine solution (Certeza) to vulnerable households in line with GoM policy • Mapping of water infrastructure and water-needs

3 Provide access to sanitation infrastructure

• Promoting of investment in latrines by less vulnerable households (triggering) • Provision of means/materials to selected households for latrine construction

• Training local craftsmen for the construction of latrines • Constructing of other sanitation infrastructure (washing platforms, tippy tap, drainage systems) • Researching and implementing innovative latrine construction (design and materials)

4 Increase awareness, knowledge and skills on safe hygiene practices

• Conducting awareness-raising activities, including door-to-door visits, PHAST sessions and mass-communication

• Mobilizing volunteers to influence the behavior of the members of 25 surrounding households • Training and equipping volunteers and community members for WASH related sensitization (PHAST-CLTS

fusion)

Outcome 2 FA

Please find the schematic representation of the ToC for First Aid on the next page.

143

1. Assumptions please note that due to page limitations we excluded academic references, they are available on request

Assumption Link to

logframe

Does it

hold?

(yes/no)

Argumentation/evidence

A • People get more resilient by being able to apply FA techniques.

• Smaller negative impact on health in case of injury/illness because people are assisted with evidence based first aid.

• FA education is a very cost-effective in-tervention to increase public health.

Impact • Yes • Yes

• Yes

• A British Red Cross study shows linkages between features of community resilience and first aid training. • Evidence based FA techniques are proven to be more effective towards injury treatment/illness recovery. The BRC-Fl Centre for

Evidence-Based Practice (CEBaP) specializes in the evidence based methodology for first aid guideline development, using the best available evidence from scientific literature, supplemented with know-how from experts and information gleaned through practical experience.

• FA education has a cost of 8US$ per disability-adjusted life year averted (DALY), making it one of the cheapest ways to increase public health in developing countries.

B • Smaller negative impact on health in case of injury/illness because people are assisted with first aid.

Impact • Yes • A systematic review is ongoing on the health effects of training lay people to deliver emergency care in underserviced popula-tions. Results will be available in 2017. One case study in Iraq showed that a reduction in mortality was caused by trained lay first responders in a setting where pre-hospital evacuation times are long.

C • Lay people and CVMO staff & volun-teers intervene if they have the required knowledge, attitudes and practices.

• Lay people have access to basic FA local materials for applying FA techniques.

• First aid lay responders as well as FA trained CVMO staff & volunteers can in-tervene and provide first aid in a safe legal environment (legal liability).

Outcome 2

• Yes • Yes

• No

• A systematic review reports significant increases in first aid knowledge, skills and improvement in helping behavior due to first aid training for children and lay people. A case study in Uganda shows that groups of people who regularly have to apply FA have a higher retention of FA knowledge. A RC structure could be considered similar.

• Sensitization on the importance of having adequate FA materials and on the use of local materials will be part of the interven-tion. FA trainings are also adapted to locally available materials.

• In none of the intervention countries the law provides protection for bystanders providing FA. However, the 32nd International Conference of Red Cross and Red Crescent Societies adopted a resolution on strengthening legal frameworks for disaster re-sponse, risk reduction and first aid. In addition, CVMO is widely recognized as a neutral organization, and as such its operational space is rarely limited by political issues. Volunteers have operated in unsecure environments before during political unrest, and express a willingness to do so. However, there is no specific law protecting volunteers during interventions.

D Trained and equipped CVMO volunteers are retained and materials are replen-ished.


Yes The FA policy will advise on refresher training and material replenishment. However, actual delivery will depend on resources.

E CVMO is able to recruit the required vol-unteers and staff to provide FA.


Yes Cfr. D on recruitment & volunteer policies. Given the high unemployment rates and CVMO’s good reputation regarding service delivery, people see volunteering as a way to increase their skills and capacity and often apply spontaneously.

F There is adequate follow-up and coaching of CVMO volunteers and staff.


Partially CVMO’s structures are weak in many provinces because of insufficient resources to implement activities and pro-vide coaching and follow-up. The branch board members should take up this role when external funding is not available.

G • CoFA generates income.

Outputs 2.2-2.3

• Yes

• In 2016, BRC-Fl undertook a study in cooperation with Vlerick Business School analyzing the cost of FA trainings in Nepal using a time-driven activity based costing model. Being a pilot study, BRC-Fl aims to use this model to improve commercial FA activities (CoFA) in other partner countries.

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• CVMO is willing to invest the income generated from CoFA partly back into the FA service.

• Yes • FA education and service provision is a key priority within CVMO’s strategic plan, and CoFA is widely viewed as a means to partly finance this. CVMO commits itself to co-fund the FA activities for 25.000 euros during 2017-2021.

H People who decide to become a CVMO volunteer or staff recognize and value the importance of FA.

Output 2.2 Yes Within RC organizations first aid is recognized as a core activity, and each newly recruited volunteer is introduced in the vision, mis-sion and policies of the organization. In addition, experience in Mozambique shows that volunteers actively request to be trained in FA. However, resources to provide training are limited, so managing demand might be a bigger issue than the lack of it. Training for staff will be added to the FA policy, and is foreseen within the program activities.

I The used didactical methods are effective. Output 2.1 BRC-Fl research planned

The use of simulation as a didactical tool will be studied during the course of the implementation period.

J The cost for CoFA/training of lay people is (partly) financed by a 3rd party. Moreover, FA trainings are recognized as relevant throughout all CVMO (funded) programs. Alternatively, FA trainings should be pro-vided at a very low cost.

Output 2.1-2.3

Yes Most CoFA clients do not pay for the training themselves (their employer pays). CVMO will also seek to set up MoUs with relevant actors like the Ministry of Education and the National Transport Authority. CVMO will also adapt its training delivery methods to reduce the cost (e.g. decentralize trainings).

K Lay people (incl. CVMO staff and volun-teers) sufficiently retain the knowledge and skills obtained during a FA (refresher) training.


BRC-Fl research ongoing

BRC-Fl is conducting a study to assess the degree of knowledge and skill retention over a period of time and to determine the im-pact of refresher courses and first aid practice on the retention level. This information will be used to determine the optimal frequency of refresher courses and to assess the need to revise the validity of first aid certificates. One case study has shown that first aid knowledge gained during commercial first aid training does not significantly decline over time. However, skills related to CPR rapidly deteriorate over the course of the first 90 days suggesting that refreshing skills frequently is required.

2. Stakeholder analysis please note that due to page limitations we excluded the detailed description of stakeholders, this is available on request 1. Ministry of health 2. Ministry of Labour, Transport and Communications, Education

3. National Road Administration

4. Companies, tourism, private persons

5. CVMO branches 6. Other Partner National Societies/partners of CVMO

7. Schools, teachers and students

3. Context analysis please note that due to page limitations we excluded the detailed description of contextual factors, this is available on request

• Political and socio-economic situation (e.g. When civil unrest increases, so does the demand for FA. CVMO is perceived as a neutral actor and rarely hindered in its operations.) • CVMO and FA (e.g. As a result of the institutional crisis CVMO went through in the last years, the FA services have been affected as well. Trainings for volunteers continued on an ad-hoc basis, especially when disasters

occurred and FA-training was integrated in other training programs. However, there was no coordination between the different departments, and a total lack of quality control. At the same time, the CVMO Centre for FA continued its operations, and kept providing FA training and services to external clients. This program aims to bring both aspects of FA, the CoFA and volunteer-oriented FA, under one institutional umbrella.)

• CoFA (e.g. While the reputation of CVMO was badly hurt by the corruption scandal involving its former Secretary-General, the CFA (Center for FA) was able to maintain a more or less stable number of clients throughout the crisis. At this moment though, CVMO is facing more and more competition and will need to work on both the quality of its FA trainings itself, as on its reputation and positioning as an important and trustworthy actor, in general, in order to maintain and increase its client-base.)

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• Gender (e.g. In rural areas, participation by women is often hampered by the fact that they have many other tasks, including the care for children, which makes it difficult for them to leave the house for multiple days. Whenever possible, trainings are therefore decentralized, or other measures are taken to reduce the obstacles to female participation.)

• Legislation (e.g. While legislation regarding mandatory FA training or materials exists, it is rarely implemented.)

4. Activities

1 FA education standardization:

• Production and development of evidence-based didactical materials with a modular approach for different target groups based on standardized curricula

• Development and implementation of standardized training M&E tools • Provision of operational resources

2 FA education quality control

• Developing and implementation of a training quality monitoring system • Skill development of FA trainers

3 FA Training and Trainers

• Improving and standardizing the management of trainings via the CFA • Supporting (refresher) ToT and Master-level ToT (Training of Trainers)

• Scaling up FA training delivery in 3 regions for volunteers, staff and lay-people including students

• Promoting of FA training and service delivery, including

4 Management of FA Service and volunteers

• Supporting basic requirements for the CFA (human/financial/material) and capacity building of staff • Supporting interdepartmental cooperation incl. reporting/registration procedures via the FA data-

base

• Supporting cost-analysis and cost-optimization process for FA training and service delivery • Procedure development to implement FA at all levels of CVMO via the CFA

5 Organizational Development via the Centre for FA

• Developing of mission, vision, policy and strategy of FA and annual operational plans • Humanitarian Diplomacy and Advocacy, specifically regarding RS, youth (in schools) and oc-

cupational health and safety

6 Support to CoFA training and services

• Reviewing the CoFA policy, strategy and internal procedures • Supporting marketing and promotion of CoFA training and services • Humanitarian Diplomacy and Advocacy

Risk analysis

On the next page is a selection of relevant risks for Mozambique in general, and for the project outcomes in specific. A thorough and detailed risk analysis was conducted for each country, and an example is added in Annex 2. Specifically for Mozambique, the political and socio-economic situation is evolving (deteriorating) rapidly and poses potential grave risks to the implementation of the program. Together with CVMO, BRC-Fl will closely monitor the situation. Being an important local developmental and humanitarian actor, auxiliary to the authorities, CVMO is well-informed and well-reputed throughout the country, and it is expected it will be able to continue operating even in very difficult circumstances. Should it be required, strategies and activities will be adapted according to the needs and constraints.

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TOC reference Description of risk and impact Impact

(1-6)

Proba-

bility

(1-6) Mitigation

Responsable for monito-

ring

Country and Partner Level Risks

Context 01 & 2 Political unrest and deterioration of socio-eco-nomic situation 4 4

CVMO’s good reputation as a relevant and neutral actor increases its operational space. If needed, planning will be revised and FA service delivery increased.

CVMO senior manage-ment

Context 01 & 2 Central / local authorities do not enhance or facilitate the program 3 2

CVMO local branches have already established good working relations with relevant stake-holders and kept them involved throughout the formulation of this program.

CVMO Project staff

Context 01 & 2 Restrictions on work permits and residence cards for foreigners 5 4

CVMO senior management commits to oversee the request. If needed, 3-month visa rota-tions can be applied while the process is ongoing.

CVMO + BRC-Fl senior management

Context 01 & 2 Institutional stability and PCM capacity of CVMO remains weak

4 3 Constant support from BRC-Fl delegate and experts are foreseen. MoU will allow for increased direct involvement in PCM by BRC-Fl.

CVMO management + delegate

Context 01 & 2

High vulnerability to effects of climate change and natural disasters, mostly droughts, floods and tropical cyclones. (See Klimos Tool VUB).

4 4

By the decision on location and construction of WASH infrastructures, BRC-Fl makes sure they remain flood-proof. Sustainable access to water and sanitation and knowledge of appropriate FA techniques, increases community resilience hit by effects of climate change.

BRC-Fl WASH Expert, CVMO Project staff

Project Level Risks

O1: Use of safe water

Water points are badly maintained, resulting in break-down of supply 5 5

Lessons learned from previous projects will be applied. 3 years of coaching is foreseen and CVMO will be able to take over the lead of the WUC if it is not functioning

CVMO project staff

O1: Safe hygiene Behavior changes are not accomplished or du-rable.

4 3 Scientific methodologies are applied with long-term involvement from trained volunteers. Constant monitoring allows for changes to methodologies used.

CVMO project staff + delegate

O1: Access to sanitation

Research does not lead to innovative design / toilets remain expensive. 3 2

Some research has already been done, applicability needs to be tested. BRC-Fl’s own research centre (CEBaP) can assist.

CVMO project staff + delegate

O2: Accessibility The cost of FA training remains too high for lay people to attend.

2 2 BRC-Fl will apply its professional cost-analysis methodology to identify cost-reducing opportunities for both community (volunteers) and CoFA trainings.

CVMO management and CFA staff

O2: Lay-people attendance

Increased competition leads to less than re-quired revenue from CoFA

4 4 By focusing on quality first, and by increasing marketing efforts once the quality is guaran-teed, market share can be recovered steadily.

CVMO management and CFA staff

O2: Equipment and system

Insufficient follow-up and coaching of FA vol-unteers 2 2

By centralizing all FA activities, coaching can more easily be provided. Policy- and guide-lines review will further facilitate this. Other departments will be assisted to coach FA volunteers within other projects through the CFA.

CVMO project staff + board members

O2: qualitative FA service

Non-qualitative FA practices cause injuries for assisted victims. (see Joint Context Analysis

(JCA) Mozambique, p 46) 4 1

The FA practices disseminated through this program to staff, volunteers and lay-people are based on the latest evidence-based guidelines, which take the no further inflicting of inju-ries as an extremely important criterion.

CVMO project staff + BRC-Fl FA expert

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Recommendations & lessons learned

JSF Strategic Dialogue Recommendations

The Strategic Dialogue took place in the offices of Caritas in Maputo on the 9th of June 2016. Within the “Avis Définitif”, which we received on the 29th of July, following recommendations were made:

DGD Recommendation following JSF Strategic Dialogue184 Description on how these recommendations are taken into account

Further exploration of the possibilities for synergy and complementarity, including during the design phase of the programs

See the section “synergy and complementarity”

Continuous risk-analysis and –management given the rapidly changing context See the section “risk analysis”

Further elaboration of crosscutting themes and policy priorities See the section “relevance”

Lessons learned from previous programs

The decade-long experience of BRC-Fl in working with CVMO, a short suspension of activities between 2014-2016 excluded, combined with the many points of attention acquired by WASH and FA programs in other countries of intervention, result in the following lessons learned which form the building blocks of our future intervention in Mozambique.

Outcome 1 WASH • Behavior change in the community requires support of both traditional and governmental leaders in the community. For this reason, there is a lot of attention to communication, meetings and

planning with these stakeholders in the project. • In the area of WASH, Mozambique has strongly outlined national strategies and objectives. Government leadership provides a necessary sustainable framework by local authorities. The project

is as much as possible aligned to government standards and approaches. • Women are identified as key actors with high influence on water, sanitation and hygiene activities and outcomes. Despite this, involvement of women has often been neglected in planning and

execution of WASH projects. The project will monitor and encourage participation of women and girls.

Outcome 2 FA • Standardisation is the key entry point to build up quality first aid education. • Improving FA education needs a long term trajectory including improvement of medical and didactical skills, development of a quality monitoring system. • Improving FA education contributes to adequate qualitative FA interventions within different country specific target groups. Active volunteers need appropriate equipment and follow-up. • A national society needs to invest in a well-reasoned volunteer management system to ensure sustainability in delivering qualitative FA education and FA. • A well-functioning FA unit is embedded in the structure of the national society and able to advocate and promote FA to the different stakeholders and the government.

Specifically for Outcome 2, this program is complementary to BRC-Fl’s Regional First Aid Initiative for Southern Africa, an expertise-based regional program financed both by BRC-Fl and the Flemish Government. The program is being implemented with 6 National Societies in the Southern African Region, and aims at a quality improvement of their FA training and service delivery. Because of the similarities in needs and approach, CVMO will benefit both from our experience in the region (regional delegation in South-Africa, specialized in FA-support), and from the experience of other NS (peer-to-peer support and South-South cooperation). Furthermore, economies of scale are possible, for instance for the training of master trainers, which can be done on a regional level.

184 160727_Avis Définitif apres DS - Mozambique

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Outcome 1 WASH

Outcome Fiche

Outcome Sustained use of sufficient safe water and sanitation facilities, as well as sustained safe hygiene attitudes and practices by the target population by 2021.

Outcome (Nederlands): De doelgroep maakt tegen 2021 gebruik van duurzame water- en sanitaire voorzieningen die toereikend en veilig zijn, en houdt er veilige attitudes en praktijken op na omtrent hygiëne.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_08_MZ_DGD

Country: Mozambique Is this Outcome covered by a JSF Yes

Provinces / Districts targeted: Inhambane Province Inhassoro and Vilanculos District Communities to be selected

Local partners or program part-ners

CVMO Cruz Vermelha de Moçambique (Headquarters and Provincial Branch)

CVMO District Branch office of Inhassoro and Vilanculos

Target population: Approximately 4.000 households (20.000 persons) in selected communities in Inhassoro and Vilanculos district, Inhambane province

Number of beneficiaries:

Total: 20.000 people (all 4.000 HH within Inhassoro and Vilanculos) Direct: 7.000 people reached with water infrastructure and also benefit from other WASH infrastructure (eg toilets) and hygiene promotion activities and training Indirect: 14.000 family members of direct beneficiaries reached through hygiene promotion

Main sector: 14030 Basic drinking water supply and sanitation

Other organisations involved: N/A

Total operational costs for this Outcome (EUR): 955.229

Policy Marker

Subject Score Subject Score Subject Score

Environment 1 Gender 2 Desertification (Rio-Marker) 1

Biodiversity (Rio-Marker) 0 Climate Change – Adaptation (Rio-Marker) 2 Climate Change - Mitigation (Rio-Marker) 1

Trade Development 1 Good Governance 1 Reproductive, maternal, newborn and child health (RMNCH) 1

HIV/AIDS 0 Children’s Rights 1 Total 11

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Logical Framework

For some indicators, baseline data are currently not available. A full baseline exercise will be conducted after program approval to rigorously determine and update baseline and target values for each indicator. Annual numeric targets are presented as a cumulative total vis-à-vis the baseline value. Definitions are available on request.

Baseline 2017 2018 2019 2020 2021 Means of verification

Process indicators

Indicator 1: Number of direct beneficiaries reached.

0 +3.000 Female: 54% Male: 46%

+7.000 Female: 54% Male: 46%

+7.000 Female: 54% Male: 46%

+7.000 Female: 54% Male: 46%

+7.000 Female: 54% Male: 46%

CVMO monitoring & reporting forms, HH database, volunteer activity reports.

Indicator 2: Number of indirect beneficiaries reached.

0 0 Female: 54% Male: 46%

14.000 Female: 54% Male: 46%

14.000 Female: 54% Male: 46%

14.000 Female: 54% Male: 46%

14.000 Female: 54% Male: 46%

CVMO monitoring & reporting forms, HH database, volunteer activity reports.

JSF – Mozambique - Impact:

JSG 3: Contribute to the improvement of access to health care and WASH infrastructures. (approaches 3C and 3E)

JSG 2: Promote the provision of quality education, improve the quality of research and stimulate innovation by focusing on local needs and demands, in order to contribute to a sustainable develop-

ment. (approach 2D)

Assumptions: Please refer to assumptions listed under the section ‘Theory of Change’

Outcome 1: Sustained use of sufficient safe water and sanitation facilities, as well as sustained safe hygiene attitudes and practices by the target population by 2021.


Indicator 1.1: % of households in the tar-get area using sufficient safe water from an improved water point for drinking.

Inhassoro: 49% Vilanculos: 61%185

N/A N/A +35% (1.400/4.000 HH)

N/A +35% HH survey/spot checks/observation, vol-unteer monitoring reports, construction reports

Indicator 1.2: % of households in target area that use an improved latrine.

National average in rural areas: 15%186

N/A N/A +12,5% (500/4.000 HH)

N/A +25% (1.000/4.000 HH)

Construction reports, HH survey/spot checks/observation, vol-unteer monitoring reports

Indicator 1.3: % of households in target area whose members wash their hands with water & soap at critical times.

x% N/A N/A Estimated +10% N/A Estimated +15% HH survey/spot checks/observation, vol-unteer monitoring reports

Indicator 1.4: Average time required per round trip for water collection by water collector in the target area.

Total: 33 minutes per round trip187

N/A N/A Total: -y

N/A Total: -z

HH survey, volunteer monitoring reports

Output 1.1: Increased availability of safe and sustainable water supply for target population by 2021.

185 Baseline Study for Water Supply and Sanitation National Program for Rural Water and Sanitation (PRONASAR). These are averages for the totality of both districts. 186 The Five-Year Plan of the Government of Mozambique (2015 - 2019), data 2014 187 World’s Women 2015 Trends and Stakeholders, p. 167, average time required in sub-Sahara Africa for 1 round trip. Baseline to establish details, including on number of trips required per day

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Indicator 1.1.1: Number of water points constructed/rehabilitated according to national technical stand-ards.

0 constructed 0 rehabilitated

+0 constructed +6 rehabilitated





Hydrological survey reports, completion report with GPS data, hand-over report to WUC and SDPI

Indicator 1.1.2: Number of water points with an established water management committee.

0 +0 +14 +14 +14 +14 WUC and SDPI records, volunteer moni-toring reports

Output 1.2: Increased availability of safe and sustainable sanitation facilities for target population by 2021.


Indicator 1.2.1: Number of improved la-trines built by CVMO/simple pit latrines built by the target population

IL: x SL: x

IL: +0 SL: +0

IL: +500 SL: +500

IL: +1.000 SL: +1.000

IL: +1.000 SL: +1.000

IL: +1.000 SL: +1.000

Volunteer monitoring reports, HH survey

Output 1.3: Target population has improved knowledge and skills on safe hygiene practices by 2021.


Indicator 1.3.1: Number of people trained in hygiene behavior methodology (PHAST/ CLTS fusion).

Total: 0 Women: 60% Men: 40%

Total: 0 Women: 60% Men: 40%

Total: +150 Women: 60% Men: 40%




Training reports, volunteer monitoring tools

Indicator 1.3.2: Number of hygiene be-havior change techniques implemented.

0 +0 +3 +4 +4 +4 CVMO volunteer reports and monitoring tools, activity reports

Output 1.4: CVMO has an increased capacity to implement WASH related interventions by 2021.


Indicator 1.4.1: Number of activities re-lated to evidence based practice (EBP) the CVMO engages in.

0 +1 +2 +3 +4 +5 Research and distribution reports

Typology of activities Cfr. ToC activities under the section ‘Theory of Change’.

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Operational Budget

Outcome 1: WASH 2017 2018 2019 2020 2021 Grand total

Operational Costs

1. Partner 98.235 233.425 118.537 100.312 44.943 595.451

Investment costs 29.135 126.473 19.960 5.635 1.260 182.463

Working costs 49.612 73.637 65.262 68.795 24.195 281.501

Personnel costs 19.488 33.315 33.315 25.882 19.488 131.488


Investment costs 0 0 0 0 0 0

Working costs 0 0 0 0 0 0

Personnel costs 0 0 0 0 0 0

3. Local Office 0 0 0 0 0 0




4. HQ 56.591 75.705 75.705 75.705 76.072 359.778


Delegate working costs 21.018 30.608 30.608 30.608 30.975 143.815

HQ personnel costs 7.000 7.000 7.000 7.000 7.000 35.000

Delegate personnel costs 28.573 38.097 38.097 38.097 38.097 180.963

Total 154.826 309.130 194.242 176.017 121.015 955.229


Working costs 70.630 104.245 95.870 99.403 55.170 425.316

Personnel costs 55.061 78.412 78.412 70.979 64.585 347.450

Partners

Total CVMO 98.235 233.425 118.537 100.312 44.943 595.451

Total Partners: 98.235 233.425 118.537 100.312 44.943 595.451

Collaboration



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Outcome 2 FA

Outcome Fiche

Outcome (English or French) : Lay people, Red Cross staff and volunteers have adequate, up-to-date and evidence based knowledge, skills and attitudes to provide first aid to those in need by 2021, enhancing community level resilience and emergency care capacity.

Outcome (Nederlands): Leken, Rode Kruispersoneel en -vrijwilligers beschikken tegen 2021 over doeltreffende, meest recente en evidence based kennis, vaardigheden en attitudes om eerste hulp te verlenen aan zij die het nodig hebben en verhogen op die manier de zelfredzaamheid van gemeenschappen.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_09_MZ_DGD

Country: Mozambique Is this Outcome covered by a JSF Yes

Intervention area: Subnational admin level 1 Subnational admin level 2 Subnational admin level 3

Local partners or program partners

CVMO Cruz Vermelha de Moçambique HQ Ma-puto

CVMO Regional Branches (North, Central, South) CVMO Provincial Branches (11)

Target population: Lay people, Red Cross volunteers and staff who are trained in First Aid & people who need and receive First Aid services

Number of beneficiaries: Total: 34.635 Direct: 2.155 lay-people, volunteers and staff of CVMO Indirect: 32.480

Main sector: 12220 Basic health care



Policy Marker






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Logical Framework

For some indicators, baseline data are currently not available. A full baseline exercise will be conducted after program approval to rigorously determine and update baseline and target values for each indicator. Annual numeric targets are presented as a cumulative total vis-à-vis the baseline value. Definitions are available on request.


Process indicators

Indicator 1: Number of direct beneficiar-ies reached.

0 Total: +103 Female188: 34% Male: 66%

Total: +587 Female: 40% Male: 60%

Total: +1.120 Female: 42% Male: 58%



CFA database


0 Total: +2.400 Female: 48% Male: 52%




Total:+32.480 Female: 52% Male: 48%

CVMO Monitoring

JSF – Mozambique - Impact:

JSG 3: Contribute to the improvement of access to health care and WASH infrastructures. (approach 3B)

JSG 2: Promote the provision of quality education, improve the quality of research and stimulate innovation by focusing on local needs and demands, in order to contribute to a sus-

tainable development. (approach 2D)


Outcome 2: Lay people, CVMO staff and volunteers have adequate, up-to-date and evidence based knowledge, skills and attitudes to provide first aid to those in need by 2021, enhanc-



Indicator 2.1: Number of people with a registered FA certificate189.

Total: 1.329 Women: 34% Men: 66%

N/A N/A Total: +2.055 Women: 42% Men: 58%

N/A Total: +4.630 Women: 45% Men: 55%

CFA database

Indicator 2.2: Number of CVMO volunteers and staff with a FA certificate.

No data avail-able

N/A N/A Total: +875 Women: 45% Men: 55%

N/A Total: +1.600 Women: 50% Men: 50%

CFA database

188 Average for last 3 years, lay people, is 34% female, 66% male – but efforts will be made to balance that ratio 189 This includes only the persons trained by the CFA (Centre for FA), as that is the only database available.

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Output 2.1: High quality FA education for different target groups is available by 2021.

Assumptions: Please refer to assumptions listed under the section ‘Theory of Change’.

Indicator 2.1.1: Presence of finalized gender sensitive AFAM based basic FA didactical training materials190.

No No Yes

Yes

Yes

Yes

CVMO FA training manual/ didactical materials

Indicator 2.1.2: Number of CVMO volunteers and staff trained in BFA.

Total: 0






CFA database, CVMO training rec-ords

Output 2.2: CVMO has a well-functioning FA service embedded in the organization by 2021.


Indicator 2.2.1: Percentage of FA trained volunteers registered in the CFA data-base.

2%191 Minimal 10% Minimal 50% Minimal 75% 100% 100% CFA database

Indicator 2.2.2: Number of active FA Trainers (minimal 1 training per year)

Total: 0

Total: +3 Women: 1 Men: 2





CFA database, CVMO training rec-ords

Output 2.3: The HNS delivers high quality commercial FA services by 2021.


Indicator 2.3.1: Number of new clients trained in CoFA.

0 +2 +6 +10 +16 +26 CFA database, reports from mar-keting officer

Indicator 2.3.2: Number of FA kits sold. 223 +150 +350 +550 +750 +950 CFA database

Typology of activities Cfr. ToC activities under the section ‘Theory of Change’.

190 Trainer and participants Manual, presentation, posters, memory aid) 191 Estimation – only volunteers directly by CFA are registered

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Operational Budget

Outcome 2: First Aid 2017 2018 2019 2020 2021 Grand total

Operational Costs

1. Partner 57.772 109.897 67.373 74.997 23.097 333.136

Investment costs 19.150 10.000 0 0 0 29.150

Working costs 26.440 82.963 52.815 62.815 10.915 235.950

Personnel costs 12.182 16.934 14.558 12.182 12.182 68.036









4. HQ 27.920 36.112 36.112 36.112 36.269 172.524





Total 85.693 146.009 103.485 111.109 59.366 505.660


Working costs 35.448 96.081 65.933 75.933 24.190 297.585

Personnel costs 31.095 39.928 37.552 35.176 35.176 178.924

Partners

Total CVMO 57.772 109.897 67.373 74.997 23.097 333.136

Total Partners: 57.772 109.897 67.373 74.997 23.097 333.136

Collaboration



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Relevance

The need for and relevance of health interventions, and more specifically WASH and FA interventions in Mozambique has been described in chapter 3, 4 and 5 of the JCA for Mozambique, and led to the formulation of Joint Strategic Goal (JSG) number 3 in the Joint Strategic Framework (JSF) for Mozambique: to contribute to an increased access to healthcare and to water- and sanitation infrastructure. Both Outcomes of the BRC-Fl program respond to this call. Moreover, our interventions are built on RKV’s scientific research in the fields of FA guidelines and hygiene promotion. The results and methodology of this evidence-based way of working, will be shared with CVMO and other Belgian and international ANGC’s present in the field. As such, this intervention also contributes to JSG number 2 of the JSF Mozambique: to promote quality education provision, improve the quality of research and stimulate innovation by focusing on local needs and demands, contributing to sustainable development.

Outcome 1 WASH

This Outcome contributes to SDG 3 (healthy lives), SDG 5 (gender equality), SDG 13 (combat climate change) and most im-portantly, SDG 6: to ensure availability and sustainable management of water and sanitation.

Context analysis As described in the JCA (p17), water and sanitation coverage remains low in Mozambique, with great differences between urban and rural areas. More recent and other sources confirm this reality. Though the exact numbers differ, mainly due to a lack of sufficient quantitative data, it is safe to assume that on average, about half the population does not have access to safe water, and this percentage increases up to two thirds in rural areas. An estimated number of only 12% of the rural population has access to improved sanitation192. Despite the existence of an elaborate institutional (under the lead of the National Directorate for Water, DNA) and policy framework (including the 2007 Water Policy, the National Program for Water Supply and Sanitation, PRONASAR and a Code of Conduct for the Water Sector) and operational plans (for example the Strategic Rural Water Supply and Sanitation Plans, PESA-ASR), the MDG targets of 70% coverage for rural water supply and 50% for rural sanitation coverage by 2015, have not been met. The main constraint to the acceleration of WASH coverage is the limited resources available, both at household and state level, despite an allocation of some 1,4% of the national budget in 2014. This comes at great cost, both economical and in terms of human suffering. The problematic WASH situation in Mozambique has been estimated to cost 4 billion metical per year, due to premature deaths, medical costs and the loss in productivity193. A major share of this burden is carried by women, who are the primary caretakers and whose economic opportunities are reduced by their tasks to fetch water and care for the sick. Moreover, the poorest households are usually harder hit: their coverage for WASH infrastructure is lower, resulting in poorer hygiene practices, and they have less resources to cope with resulting diseases. In the current 5-year plan (Plano Quinquenal do Governo de Moçambique (2015 – 2019), the targets for the rural population are set as follows: 1) increase the percentage with access to safe water source from 52% to 75% in 2019 and 2) increase the percentage with access to adequate sanitation from 15% to 50% in 2019. This program directly contributes to the achievement of these targets, and in doing so, to a reduction in economic losses, a reduction in poverty and an increased gender equality.

Direct beneficiaries The final direct beneficiaries for this outcome will be selected after a thorough and detailed baseline, upon which it will be decided in which communities to work. At least 1 person of all households within a selected community will be a direct bene-ficiary of the program, and the number of communities selected will have a total of approximately 4.000 households. 7.000 people will have been directly reached with water infrastructure and will also benefit from other WASH infrastructure (eg toilets) and hygiene promotion activities or training. It is important to note that for the beneficiary calculations BRC-Fl chose to count unique beneficiaries only once although they may be reached multiple times with different program activities (e.g. water and sanitation instrastructure different behavior change techniques, etc.). However, these program activities each do have their individual costs, which means these beneficiary numbers cannot be used to calculate costs per beneficiary.

Indirect beneficiaries The average household in Mozambique consists of 5 members. Therefore, the total beneficiaries adds up to 20.000 people, as at least 1 member of each household will be reached with hygiene promotion activities. Subtracting the direct beneficiaries, this makes for 14.000 indirect beneficiaries. Furthermore, a spill over of some of the achievements of this project is expected in communities neighbouring the intervention zone.

Location The intervention is implemented in (to be selected) communities in 2 districts in Inhambane province: Inhassoro and Vilanculos. These districts have been selected based on the needs related to WASH on the one hand, and existing capacities within CVMO on the other hand. When CVMO implemented a Disaster Risk Reduction (DRR) program in these districts in 2014-2016, it was observed and expressed by both the local population authorities, that increased access to water- and sanitation infrastructure and improved hygiene were the top priorities for future interventions. An initial assessment and study of secondary data has

192 Demographic and health survey, 2011 193 http://www.unicef.org.mz/nosso-trabalho/o-trabalho-do-unicef/water-sanitation-hygiene/

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confirmed this, as demonstrated above. Because of the previous DRR project, CVMO has a good relation with the local author-ities and communities in both districts, and an existing volunteer network, which the BRC-Fl program will build upon.

Outcome 2 FA

This outcome contributes to SDG 1 (reduce poverty), SDG 3 (healthy lives), SDG 5 (gender equality) and SDG 8 (economic growth) and increases the resilience and intra-reliance of the target population, thus contributing to SDG 13, to combat climate change and its impacts.

Context analysis Mozambique is a disaster-prone country, vulnerable mostly to floods, droughts and cyclones, with very limited (basic) health-care infrastructures (JCA, p29) and difficult access because of the vastness of the country and remoteness of many communities. When calamities and accidents happen, within the community or on the roads, it often takes a long time for help to arrive, if it is available at all. Saving lives is often left in the hands of lay people who are the first to respond, not professionals. This is recognized by both the National Institute for Disaster Management (INGC) and the Ministry of Health (MISAU), whom both formally count on CVMO to provide surge capacity for disaster response and public health emergencies. The socio-economic situation in Mozambique is currently deteriorating as a consequence of poor economic and political policy, and incidents of violence between the ruling forces and the opposition (RENAMO) are increasing. This remains limited to the central part of the country for now (September 2016), but there is a credible fear for a serious increase in violence, should the government change the current subsidy policies for essential goods, or should the political stability be further lost. Together with an increase in violence and political unrest, the demand for interventions by trained volunteers from a political neutral and independent organisation like CVMO increases. All of the above highlights the importance and relevance of investing in both the quality and the quantity of first aid training and service provision in Mozambique.

Direct beneficiaries The direct beneficiaries of the FA intervention are the Red Cross staff and volunteers whom will receive FA training, and lay-people (including students) who will benefit from subsidized FA training courses. The training capacity of CVMO will be rein-forced with the training of 26 FA trainers and 3 FA Master trainers. Besides, 700 CVMO volunteers and staff members and 100 school children will receive a FA training. Also a number of open courses for the interested public will be provided for which 300 participants are estimated, and CoFA trainings will be organised. A total of 2.155 beneficiaries will be reached with this intervention. It is important to note that for the beneficiary calculations BRC-Fl has chosen to count unique beneficiaries only once although they may be reached multiple times with different program activities (e.g. trainings and refresher trainings). However, these program activities each do have their individual costs, which means these beneficiary numbers should not be used to calculate costs per beneficiary.

Indirect beneficiaries It is very hard to quantify and monitor indirect beneficiaries given the broad range of first aid applications (from cleaning small wounds to live-saving Cardiopulmonary Resuscitation (CPR). Based on the assumption that on average, every trained person will assist 5 persons by applying evidence-based, qualitative first aid, the number of indirect beneficiaries is estimated at 32.480. This number takes into account the total number of people trained in FA by CVMO, even though these trainings are not direct outputs of the program. We can assume this multiplier might be even higher for trained RC volunteers and staff given their role as first responders to natural and conflict-caused calamities.

Location The program is managed from the central CVMO level, its headquarters in Maputo where CFA is hosted. The intervention entails the entire country, delivering its outputs via 3 regions (North, Central, South), covering all 11 provinces of Mozambique.

Relevance according to other DGD priorities

Gender Mozambique is a frontrunner in Africa when it comes to gender, and has made remarkable progress over the last years, not in the least because of the actions coordinated by the Ministry of Women and Social Action (MMAS). It is party to some of the most important gender-related treaties (CEDAW, SADC Gender Protocol) and has a strong domestic legal framework enabling gender equality action194. Although many challenges remain, some key achievements have been made, including a greater access to education for girls, an increased presence of women in power and decision making bodies and an increase in women’s uptake of healthcare. The creation of institutional mechanisms and institutes that promote the advancement of women were

194 In accordance with the Constitution, under article 36, on the principle of gender equality, in Mozambique, men and women are equal before the law in all areas of political, economic, social and cultural life. Article 122 states that the State will promote, support and improve women’s development and encourage their increasing role in society.

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instrumental in this. A major challenge stays the participation of women in economic activity, which especially for rural areas, can be linked directly to WASH.

Gender & WASH

In Africa, on average, people spend 40 billion hours every year just walking for water. Women and children usually bear this burden. According to the Africa Human Development Report 2016195, the task of collecting drinking water has been carried by women in 71% of the cases. Investing in increased availability of safe and sustainable WASH infrastructure has therefore a significant effect on time saved by women/girls on WASH related activities. This free time can be spent on other activities that enhance their income generation or personal development. A four-country study by the World Bank showed that girl’s school attendance has increased significantly for every hour reduction in water collection196. The program will build and improve 16 water points, serving an estimated 8.000 persons (80% are women and children, given the typical composition of a household in Mozambique), and will also stimulate and oversee the appointment of women in decision-making positions within the WUCs.

Gender & FA

The gender of participants has been recorded, and data show that more men than women take FA classes – mainly due to the fact that commercial FA implies formal employment in relevant sectors (transport, industry), that are still male-dominated in Mozambique. CVMO volunteers on the other hand, are mainly female (60%). The program will strive for a 50/50 % participation for women and men in FA trainings, and especially for the subsidized trainings, female participation will be encouraged. Barriers to participation will be reduced actively to achieve this, for instance by organizing decentralized trainings where participants are close to home, and can return daily, rather than being out for days. Moreover, the AFAM-based didactical training materials developed by this intervention are sensitive for the specific needs of women and girls as receivers and givers of FA. Attention is drawn upon specific situations encountered by women such as giving birth without medical assistance. Full body mannequins are used to fit the conveniences of women and girls. Another example is the clothing advise that CVMO provides to participants prior to trainings, to ensure women wear trousers rather than skirts, for their comfort during practical exercises.

Environment Environment & WASH

BRC-Fl is aware of many existing linkages between WASH interventions and the preservation and protection of the environment and natural resources, marked as one of the 5 priority goals of the Strategic Plan for Agricultural Development (PEDSA):

• Water sources will be protected and latrines will be located downstream of wells, at least 30m from groundwater sources and at least 1,5m above the water table.

• Pit latrines will be fitted with concrete slabs to eliminate the need for secondary wooden slabs or supporting beams. The concrete slabs will also facilitate easy cleaning. The bricks for the pit lining are made locally.

• Awareness will be raised on the importance of water conservation. In the construction of water systems, the environment is taken into account by protecting the natural resources, e.g. through tree planting, encouraging reforestation.

• Moreover, most projects in the domain of WASH are implemented with the PHAST method, developed by the WHO. This guide gives a methodology for community hygiene behavior change and improvement of water and sanitation. In this approach, better health is linked to better environment. Thus, PHAST has a strong environmental component197.

• The volunteers will receive bicycles to facilitate their transport related to their activities (visiting households for sensiti-zation activities, meetings, organizing events, monitoring construction and use of WASH hardware, …).

Furthermore, BRC-Fl is aware that WASH interventions are linked with the adaptation to climate change and the enhancing of community resilience. The fifth assessment report of the Intergovernmental Panel on Climate Change (IPCC) states that com-pounded stress on water resources facing significant strain from overexploitation and degradation form one of the key risks to the African continent198. Our intervention aims at attaining an increased availability of sustainable WASH infrastructure to the most vulnerable communities in Inhassoro and Vilanculos districts and enhancing water-saving measures and behavior. As the program area is prone to flooding and drought, water points will be protected from water infiltration and elevated where needed, and boreholes will be drilled to sufficient depth in order to assure sufficient water provision, in times of reduced groundwater levels. When possible, ecosan toilets will be used as a more suitable alternative to pit latrines, in flood prone areas.

Environment & FA

Our interventions aim to support CVMO in giving high-quality FA training to staff, volunteers and community-members in order to increase their self-reliance and as such have increased abilities to ‘bounce back’ when hit by sudden emergency.

195 http://www.undp.org/content/undp/en/home/librarypage/hdr/2016-africa-human-development-report.html 196 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/193656/WASH-evidence-paper-april2013.pdf 197 http://www.who.int/water_sanitation_health/hygiene/envsan/phastep/en/ 198 http://ipcc-wg2.gov/AR5/images/uploads/WG2AR5_SPM_FINAL.pdf

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Community resilience will be of particular importance to deal with the increased volatility of the occurrence of extreme clima-tological events and natural disasters brought on by climate change. On programmatic level, efforts to minimize the ecological footprint will be made. In terms of office management, double printing for reporting and didactical materials will be mandatory. In terms of procurement, local products are at all times recommended, and the guidelines/policy on asset maintenance will include attention for environmental waste disposal. Additionally, an important reason to establish a regional monitoring struc-ture, grouping the 11 provinces of Mozambique in a North, Central and South region, is to limit both the cost and the ecological footprint of movements. Volunteers and community members attending CVMO organized trainings will rely on public or com-mon transport whenever possible.

Human Rights As described in Annex 4, a rights based mindset has always been present in the work of the Red Cross Movement. Our FA & WASH intervention in Mozambique is responding to the needs of the most vulnerable, and is as such aiming for rights-holders to claim their rights under Article 25 of the Universal Declaration of Human Rights: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, […].” Another approach operationalize this mindset, is our Humanitarian Diplomacy. By the auxiliary role CVMO has to the public authorities of Mozambique, their privileged access and relationship to the government and policy makers is a leverage for addressing specific issues related to increase and uphold legislation to make workplaces, roads and schools safer places and thus contributing to an adequate standard of living.

Digitalization BRC-Fl uses digital technologies as enabling tools to enlarge the impact of our interventions. A range of digital tools is deployed across countries and sectors. In the field of FA specifically, BRC-Fl supports CVMO in the maintenance of a database at headquarter level. This database serves as a registration system for data on FA trainings, which helps CVMO to efficiently process and manage their FA services. Also, for its national FA services in Belgium, BRC-Fl is currently involved in a process of integrating e-learning into our FA trainings in order to increase their effectiveness and accessibility. Gained experience and knowledge of BRC-Fl on e-learning techniques, will be reflected in our support to CVMO's FA service. BRC-Fl also stimulates CVMO existing tools to enhance its processes. For example, upon a simple suggestion while preparing for this program, CVMO has already set up a WhatsApp group to facilitate communication with its existing FA trainers, sharing theoretical information on FA, facilitating peer-to-peer Q&A and gathering information on the availability of trainers. In the field of WASH, BRC-Fl will look into supporting CVMO with the use of mobile data collection tools. As a result, survey data could be processed more quickly and efficiently and the risk for errors would be reduced. Also, mobile data collection would allow CVMO to assign GPS-locations to water sources and WASH infrastructure and would permit BRC-Fl to have a real-time overview and geographical mapping on the work done on the field, as obtained data are uploaded on a regular basis. In addition, BRC-Fl will look into supporting CVMO using of satellite images as part of its planning and evaluation strategy of its WASH intervention, including for the initial baseline exercise for those target areas where limited data is available. Satellite images could be used as primary data to identify the exact location of the households in the intervention area. These analyses would be done using the freeware Quantum GIS (QGIS). The BRC-Fl Country Representative in Mozambique will receive a basic GIS training in order to be able to perform the basic analysis of the geodata, as well as build capacity of CVMO staff and volunteers involved in primary data collection.

Decent Work Through increasing the quality and quantity of FA trainings and commercial FA services, tailored to hazardous occupations, BRC-Fl and CVMO contribute to improve Occupational, Health & Safety (OSH), a core element of Decent Work and the ILO Decent Work Agenda. Annex 3 elaborates on the links between First Aid and OSH. OSH is also a key result in the Decent Work Country Program, the country strategy agreed upon by the GoM to implement the ILO Decent Work Agenda.

Effectiveness

First of all, two aspects make the intervention in Mozambique specific for BRC-Fl:

1. Our “Evidence Based Practice”

To ensure that all activities are based on scientific evidence, is a core principle within BRC-Fl. To assist in this endeavor, BRC-Fl created the Centre for Evidence-Based Practice (CEBaP) 10 years ago. This research centre uses an internationally recognized methodology to collect, systematize and evaluate relevant scientific evidence to underpin our activities199. When insufficient evidence is available, primary research to support our core activities is conducted – for instance, research on FA knowledge and skills retention in Nepal or on behavior change factors for WASH interventions in Malawi.

CEBaP developed evidence-based FA guidelines and materials for the African continent (African First Aid Materials-AFAM), India and Nepal, which will be used in all our FA programs, including Mozambique. Based on evidence summaries developed by

199 www.rodekruis.be\cebap

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CEBaP, a panel of regional/local experts have developed first aid guidelines, taking the preferences of the target group(s) into consideration. These guidelines were then used to develop educational first aid materials, e.g., posters, exercise books etc.

For WASH, the evidence-based way of working has been implemented since 2015 through the partnership between BRC-Fl and Professor H.J. Mosler of the EAWAG University in Zurich. Through this cooperation, BRC-Fl has introduced the RANAS (Risks, Attitudes, Norms, Abilities & Self-Regulation) approach where evidence-based research assist the program in learning which elements define certain behaviors, and subsequently identify interventions targeting these behaviors which need to change. It is the objective of BRC-Fl to assimilate this technique and to systematically use it in all its WASH programs, including in Mozam-bique. In order to position itself, CEBaP is performing systematic reviews in the field of behavior change and WASH.

CEBaP is recognized as an IFRC Reference Centre and aims to further develop into the RC³ (RCRC Research Centre), providing its services within the RC movement. These services are also provided to non-RC partners (for example, CEBaP has performed an evidence search on the contamination of drinking water by fluoride in Senegal, for the Belgian Technical Cooperation). All primary and secondary research by CEBaP is being published in peer reviewed journals. Furthermore, through its link with CEBAM, the Belgian Centre of Evidence-Based Medicine and the Belgian Cochrane Centre, CEBaP is in the process of being accredited in evidence-based guideline development according to the Cochrane methodology200.

2. Working with volunteers

Volunteers form the backbone of all National Societies, including CVMO. Investing in volunteers through skill and knowledge development ensures a qualitative implementation of CVMO’s goal to assist the most vulnerable within Mozambique. A major strength of Red Cross volunteers is they are embedded within local communities, even the most distant ones. The volunteers enable CVMO to be a first responder in case of sickness, injury or threat. In rural Mozambique, where access to medical care is limited and the provision of basic healthcare is insufficient, the presence of RC volunteers with knowledge of the correct first aid techniques, is therefore a key mitigating factor to reduce mortality and morbidity due to sudden illness or injury within their own communities. The volunteers also enable CVMO to achieve a correct use and maintenance of water and sanitation infra-structure, as the volunteers continue to oversee or participate in the Water User Committee’s operation and maintenance activities. Moreover, a long-lasting behavioural change is more likely to be achieved as the message is brought and enforced by local and trusted community members.

Outcome 1 WASH

JSF Contribution This outcome directly contributes to the JSG number 3 of the JSF Mozambique, by the approaches 3C201 and 3E202. A contribu-tion to JSG 2 is done by the approach 2D203.

Intervention strategy As visually expressed in the ToC, 4 complementary strategies contribute to the effectiveness of this program: the increased access to safe water, the increased access to sanitation facilities, the increased knowledge and skills related to hygienic practices, and the enabling strategy of increased capacity within CVMO to implement WASH programs.

Unprotected existing water sources in the intervention area (shallow wells, surface water) will be rehabilitated and new water points will be added, directly providing access to safe water for the surrounding population204. These water points will be handed over to newly established WUCs, that will be trained, equipped and monitored by CVMO staff and volunteers, to assure smooth operation and maintenance. The water quality will be tested upon handover of the infrastructure, and periodically afterwards.

Elements of the Community-Led Total Sanitation (CLTS) approach will be used to trigger the awareness on the importance of adequate sanitation facilities, thus stimulating the population to invest in low-cost toilets. While the lifespan of simple latrines is shorter, the use of cheap locally available materials should allow the local population to easily renew these when needed. In selected communities with a denser population, the program will provide subsidies or material to facilitate the construction of improved pit latrines, especially for the most vulnerable households. The program will also research innovative materials and design, together with existing specialized institutes, in order to reduce the costs or find alternatives to the expensive brick lining of the pits in sandy soils. Examples to be looked into are ecosan toilets and lining with vegetal materials. The combination of both the CLTS and subsidized (and cost-reduced) approach will lead to a tangible increase in latrine coverage.

200 http://www.cochrane.org/ 201 To develop information and sensibilization campains contributing to access to health care for all and access to water for all. 202 Increase water supply and sanitary structures. 203 Promote scientific research within projects as well as its extension and valuation. 204 According to Mozambique national standards, one waterpoint can serve up to 500 persons, in order to assure sufficient provision of water per household.

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Moreover, and evidence-based scientific methodology will be used to design the right approach to achieve maximum behavioral change, related to hygiene practices (see above, ‘our evidence-based practice’). A group of well trained and equipped volunteers, 150 in total, will cover each of the 4.000 targeted households with diverse sensitization activities, based on the PHAST methodology. Each volunteer will act as a leader-by-example, and will directly monitor and support 25 assigned households in his direct vicinity (see also above, ‘working with volunteers’). In turn, these volunteers will be coached and monitored by 20 lead-volunteers and the CVMO project staff, in order to assure the quality and consistency of their efforts.

Finally, this program will also invest directly in the capacity of CVMO to deliver WASH programs, as an enabling action to obtain the desired project outputs, including its potential role as a spare part supplier and technical agent for operation and mainte-nance of water systems.

Outcome 2 FA

JSF Contribution This outcome directly contributes to the JSG number 3 of the JSF Mozambique, by the approach 3B205. A contribution to JSG 2 is done by the approach 2D206.

Intervention strategy As expressed in the ToC, three intertwined pillars contribute to the effectiveness of this program: the delivery of high-quality FA education to internal and external clients, the strengthening of CVMO’s institutional capacity via the CFA, and the increase in quality and quantity of commercial FA training and service delivery.

Existing didactical FA materials (manuals, curricula) will be revised and updated to assure the latest scientific evidence is taken into account, when describing FA guidelines. This will be done based on the AFAM materials (see above, ‘our evidence-based practice’) and in a modular approach to allow for easy tailoring of the training content to the needs of specific groups. The organization and management of trainings will be standardized, and a quality control system will be put in place, including continued coaching and monitoring of trainers and training sessions. Trainers will be retrained, focusing on both technical FA knowledge and didactics, in order to assure maximum learning effects.

On an organizational level, existing but outdated policies and guidelines will be reviewed based on a new organization-wide strategy for FA, positioning the existing Centre for FA as the sole and overall responsible entity for all forms of FA training and for commercial FA service delivery (preventive interventions) within CVMO. Protocols for cooperation with other relevant de-partments will be developed and formalized, so that at all times, the quality of FA training is ensured through the involvement of this specialized unit. Logistical and managerial capacities of the CFA will be enhanced to facilitate this.

Besides that, improving the training quality and strengthening the Centre for FA will contribute to an increase in CoFA activity. Assured of the quality of the product, marketing efforts will be increased towards existing and new clients, and humanitarian diplomacy will be used to advocate for more legislation, stimulating mandatory FA training or services, for instance for major sport events. Through its CoFA activities, CVMO will increase its revenue, thus reducing its financial dependency for external funding, while also contributing to the JSF approach to extend FA training to the general population.

Sustainability

Outcome 1 WASH

Technical and financial sustainability: • The water hardware will be build according to national technical standards, with features and materials that are easy-to-

use (operation) and long-lasting (maintenance). For the hand pumps, replacement materials are locally available, and the feasibility of creating an income generating activity around this (for CVMO or community members) will be studied and promoted, including via the training of local technicians.

• An operational structure (Water Users Committee, WUC) that has the necessary skills and knowledge to deal with foreseen and unforeseen technical issues, will be established, trained and equipped for each of the newly constructed and rehabilitated water points. The WUC is also responsible for the collection of users’ contributions, in order to increase the sustainability of the infrastructure with the availability of funds, for maintenance and repair.

• The subsidized toilets will have lined pits, necessary to increase their lifespan in the project area (sandy soils). These pits need very little maintenance, although they have to be emptied from time to time. Alternative use (composting and or fertilizers) will be promoted.

205 To extent FA training to community workers and the general population. 206 Promote scientific research within projects as well as its extension and valuation.

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• The intervention is risk-informed, i.e. that potential risks, such as natural hazards, are being taken into account in the design and implementation of the program. (e.g. elevated water points or ecosan toilets to avoid flood-contamination).

Social sustainability: • The intervention of BRC-Fl aims at enhancing sustainable behavioral change. CVMO works with volunteers that are em-

bedded in the selected intervention zones and have a large capacity to enhance the local ownership of the intervention. The presence and commitment of these volunteers do not depend on funding from BRC-Fl. The capacity building achieved in those volunteers by the BRC-Fl intervention, will remain in place after funding is withdrawn.

• The infrastructure installed answers to the requirements of local legislation and is therefore enforced by local authorities.

Exit Strategy: • Above mentioned elements on technical, social and financial sustainability all contribute towards durable results in the

community. Achievement of sustainability measures will smoothen the exit of the program. • Continued presence of the subchapter and the chapter, having been involved in all project activities, will guarantee follow

up of results through local authorities and by using the own volunteer network. • In the last year of the program, the level of direct support and coaching of the volunteers by the staff will gradually be

diminished, while the responsibility to monitor the activities and volunteers and WUCs will be handed over to the branch board and local authorities.

Outcome 2 FA

Technical sustainability: • The intervention of BRC-Fl aims at reinforcing the institutional capacity of CVMO by embedding a well-functioning

FA service into the organization. This is done by supporting the management of the FA service, the volunteer management and the organizational development (institutional setup) through the Centre for FA.

• The intervention is risk-informed, i.e. that potential risks, such as natural and technological hazards, are being taken into account in the design and implementation of the program. Building self-reliance through providing high quality FA training to staff, volunteers and community-members increases the response capacity of first responders to calamities, especially given the fact the CVMO is the largest national humanitarian organization in Mozambique.

Financial sustainability: • BRC-Fl supports CVMO in delivering high quality CoFA services. This will help CVMO in increasing their market share and

revenue, which will be partly reinvested in the FA training and service delivery through the Centre for FA. As such, financial autonomy is enhanced and dependence on external donors decreased, while fulfilling a core mandate of CVMO, to reduce vulnerability by increasing resilience of the Mozambique population.

Social Sustainability: • CVMO works with volunteers that are embedded in the selected intervention zones and have a direct link with CVMO’s

central or decentralized structures. Volunteers (and staff members) who are trained to be FA trainers, are carefully selected in order to assure their lasting commitment to the National Society. Both trainers and volunteers are often self-motivated to enhance their skills, and derive a certain standing in their community from the application of those skills, for the com-munities’ welfare.

Exit Strategy: • The above elements on technical/social/financial sustainability all contribute towards durable results for the program. • In general, the entire intervention methodology is designed to build sufficient capacity within CVMO, for it to be able to

sustain its own FA activities with a high level of quality. In the last year of the program, financial support is gradually withdrawn (e.g. no trainings are financed), and the focus is shifted towards expertise-delivery and the autonomous imple-mentation of the activities.

Efficiency

Delegation A BRC-Fl delegate will be based in Maputo, in order to assist CVMO with the timely and qualitative implementation of this program. The main tasks of this delegate are to cooperate closely with CVMO, both at central level and in Inhambane province. The delegate assists CVMO on a managerial and on a technical level – managerial in order to achieve a timely, effective and efficient implementation, and on a technical level, to ensure impact and sustainability. Its close proximity to the implementing partner allows for direct input to achieve the Outcomes and outputs, whilst building the capacities of the implementing partner, both at a personnel (staff development) and institutional level (systems, structures). Given the specific situation of CVMO, a delegate with a WASH background will be deployed. The delegate will further be supported in its role by the BRC-Fl experts at headquarters and regional level, whom provide expert-input regarding managerial (M&E, Finance, Project management) and technical (First Aid and WASH) aspects.

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Outcome 1 WASH

The cost-efficiency case for WASH is widely recognized. The World Health Organization (WHO) estimates that for every US$1 invested in water and sanitation, there is an economic return of US$4 by keeping people healthy and productive207. The World Bank has stated that hygiene promotion is one of the most cost-effective health interventions208. In fact, hygiene promotion leads to a negative cost per DALY averted, implying that the cost for hygiene promotion is lower than the cost for the treatment of water-related diseases. There are also strong economic arguments for investing in WASH. According to the UN’s Human Development Report, lack of safe water, sanitation and hygiene causes Sub- Saharan African countries annual losses equivalent to 5% of GDP, more than the entire continent receives in development aid.209

Description of resources

1. Investment costs

In line with the hardware activities for the Outcome, 146.200 EUR, 80% of the investment budget is allocated for the construction of water points

and sanitation facilities. Other major investments are training materials for the PHAST approach, bicycles for the volunteers and motorcycles for

the staff, and IT materials for the project management and for data collection. The required office infrastructure and transport is already in place

in the districts.

2. Working costs

General working costs are mainly 33.075 EUR for utilities, communication and stationery; and 19.400 EUR for a contribution to CVMO’s overall

organizational setup (at an average contribution of 4.850 EUR per year). Activity costs are mainly comprised of training costs (31%, 68.250 EUR,

to organize training for about 620 persons and refresher trainings for about 380) and costs related to coaching, monitoring and supporting the

activities of those volunteers and community members, including their equipment, visibility materials and incentives210 (56%, 122.448 EUR).

3. Personnel costs

Local personnel

CVMO

The local personnel team of CVMO consists of 4 direct project staff and a contribution to the salary for supporting staff

(program administration & accountancy, PMER, guards etc..

Expat personnel

BRC-Fl

Outcome 1 and 2 are supported by one full-time BRC-Fl delegate based in Maputo. The salary budget consists out of

salary costs for the duration of the program and is shared amongst both outcomes. Other costs like accommodation,

transport costs and other operational cost are taken within the general working costs.

HQ personnel

BRC-Fl

The Outcome is supported by a technical WASH expert based in Mechelen (Belgium). The budget comprises of personnel &

travel costs (0,08 FTE for Mozambique). This HQ WASH focal point safeguards the quality by providing technical expertise

directly or by linking BRC-Fl CEBaP to CVMO. Examples are carrying out or facilitating specific short-term technical missions

on behavioral change techniques within hygiene promotion.

207 Hutton G (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal cov-erage, p4. WHO, Geneva, Switzerland. 208 Jamison et al. (eds) (2006). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank 209 Based on percentage estimate from UN Development Programme (2006) Human development report. 210 In line with GoM and CVMO policy, a volunteer who dedicates 4 hours a week to volunteer activities is entitled to a monetary incentive. For CVMO volunteers, this is 35 EUR per year (3000 metical).

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Outcome 2 FA

According to a World Bank study211, training first-responders in first aid is an extremely cost-effective intervention: First aid education costs 8US$ per disability adjusted life year averted (DALY)212. This makes First Aid Education one of the most cost-efficient ways to improve public health in developing countries.


1. Investment costs

In line with the activities for the outcome, 100% of the investment budget (29..150 EUR) is allocated to purchasing materials used for FA training

and service delivery, including a small city-type vehicle to facilitate transport of trainers and volunteers.

2. Working costs

General working costs are mainly 22.987 EUR for vehicle operating costs, utilities, stationery and communication; and 43.750 EUR for the moni-

toring, supervision and coaching of trainers and volunteers during FA training and service delivery. Since the quality and quantity of FA education

is the key to achieving the program Outcome, the largest part of the activity budget is comprised of training for lay people, RC volunteers and

staff, including students (115.772 EUR, 69%). Other costs include the procurement and maintenance of FA training and promotional materials,

and activities specifically aimed at building the capacity of CVMO (staff and institute) regarding FA and commercial FA.

3. Personnel costs

Local personnel

CVMO

The local personnel team of CVMO consists out of 3 direct project staff (totaling 1 FTE for 4,5 years) and support staff (driver,

guards) (totaling 0,75 FTE for 4,5 years).

Expat personnel

BRC-Fl

Outcome 1 and 2 are supported by one full-time BRC-Fl delegate based in Maputo. The salary budget consists out of salary

costs for the duration of the program and is shared amongst both outcomes. Other costs like accommodation, transport

costs and other operational cost are taken within the general working costs.

HQ personnel

BRC-Fl

The Outcome is supported by a technical First Aid expert based in Mechelen (Belgium). The budget comprises of personnel

& travel costs (0,06 FTE for Mozambique). This HQ FA focal point safeguards the quality by providing technical expertise

directly or by linking the BRC-Fl national First Aid unit and CEBaP to CVMO. Examples are carrying out or facilitating specific

short-term technical missions on didactical expertise FA, simulation exercise, assist in profitability analysis CoFa CVMO,...

Partnership

Policy

BRC-Fl always operates within the partnership framework of the International Red Cross & Red Crescent Movement and works with the National Red Cross or Red Crescent Society as sole preferential partner. Principles of cooperation and capacity building are movement-wide formalized in the IFRC ‘Development Cooperation Policy (2007)’ 213, the ‘National Society Development

Framework (2013)214’ and the ‘Code of Good Partnership’215.

All RC partners in this program are strategic partners, meaning the commitment for cooperation spans for at least 5 years whereby common objectives are defined and where the focus lies on capacity building of and transferring technical expertise to the partner to implement quality services to the most vulnerable within the thematic priorities of BRC-Fl and CVMO. Capacity building is transversal across the interventions in FA and WASH.

Cruz Vermelha de Moçambique (CVMO)

The Mozambique Red Cross Society was founded in 1981, and is present in the entire country, with 11 provincial branches and 101 sub branches (district offices), comprising more than 6.400 volunteers. As an auxiliary to the local authorities, its main intervention areas are disaster Response and DRR, Health (including WASH and FA) and livelihoods. Its main partners are the Spanish and German Red Cross, and UN and government agencies.

BRC-Fl has been an important partner of CVMO from 2001 onwards, and supported both developmental and humanitarian activities throughout the years, including health projects with a WASH component and FA projects. At the end of 2013, the

211 Laxminarayan et al. (2006). Ibid. 212 DALY is a generic measure of disease burden, including both the quality and the quantity of life lived. It is used in economic evaluation to assess the value for money of medical interventions. 213 http://www.ifrc.org/Global/Governance/Policies/developmentcoop-policy-en.pdf 214 http://www.ifrc.org/Global/Documents/Secretariat/201505/1269801-NSD%20framework%202013-EN-LR.pdf 215 http://www.ifrc.org/PageFiles/79467/CoD09_14_code%20good%20partnership_EN.pdf

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partnership was put on hold and project-funding suspended, because of corruption cases at the highest level of the organiza-tion and the resulting institutional crisis. BRC-Fl remained in contact and continued to provide advice, while CVMO kept BRC-Fl informed on the progress made. By mid-2016, after an evaluation mission in which CVMO demonstrated a credible progress in dealing with the crisis, it was decided that BRC-Fl would resume its active partnership and project support. At the moment of writing this proposal, CVMO has cleared most of its debts (in part with GoM support) and reached agreements with its remaining debtors, fired all persons implicated in the corruption case (and brought them to court), appointed a new Secretary-General, changed its Statutes with the help of IFRC and ICRC and is preparing for a new Board Election before the end of 2016. Before the start of the new program, a specific MoU will be drafted between BRC-Fl and CVMO, outlining the modalities for the cooperation. Given the fragile state of the NS and its limited capacity and (human) resources, this agreement will include measures to assure compliance with donor regulations, modalities of increased oversight by the BRC-Fl delegate and head-quarters, and activities to build the capacity of CVMO both on a managerial and technical level, whilst implementing the program.

WASH CVMO has implemented WASH programs for almost 2 decades and even has its own borehole drilling company, which is till date contracted frequently by the GoM and other actors, but its current capacity has been reduced as a consequence of the institutional crisis, which has resulted in qualified staff to leave the organization as the project resources had been reduced. Fortunate for CVMO, some experienced WASH officers have been relocated from headquarters to provincial branches, including a software specialist (PHAST) and a technical expert, who assisted in the design of this program. Currently, WASH interventions are integrated in the German (DRR) and Spanish (Livelihood) RC projects.

FA First Aid is identified as a priority area within the CVMO strategy 2017-2021, currently under development. The NS has a decade-long experience in providing FA training and services, and continued to do so during the institutional crisis, mostly as an integrated part of other trainings in the area of health or DRR. However, the assessments done by BRC-Fl in preparation of this program show that the quality of CVMO’s FA training has been heavily reduced, partly because of the departure of key staff. The Centre for FA, established many years ago as the center-of-excellence regarding FA for the entire NS is still operational, but focusses mainly on CoFA activities, and lacks resources, managerial capacity and technical know-how.

Capacity building

Outcome 1 WASH CVMO has expressed its will and need to become again an important actor in the area of WASH, with the desire to expand both the scope and the geographical coverage of its WASH interventions. This program will directly contribute to that aim, whilst at the same time rebuilding and reinforcing the institutional capacity for qualitative WASH activity implementation. A national WASH officer will be recruited to manage and oversee the technical officers in the field, both for the software and hardware related activities. Training and coaching of the involved staff members is foreseen, and BRC-Fl will also bring its own expertise to the table, especially with regards to behavior change, where the evidence-based RANAS methodology will be introduced to CVMO, in order to enhance the effectiveness of the intervention. Specifically for WASH hardware, cooperation will be sought with relevant actors within Mozambique, like the SDPI, in order to provide additional technical expertise to CVMO. The feasibility of involving CVMO branches in WASH hardware construction and maintenance as an income generating activity will be studied, and a pilot will be supported if the study shows good opportunities in the intervention area. In the project districts, volunteers will be trained and equipped with tools and materials to complete their tasks, and they will be monitored and coached by (more experienced) lead-volunteers, district branch board members and the project staff.

Outcome 2 FA The bulk of the FA program designed for CVMO has been oriented towards the rebuilding of its capacity to deliver quality FA training and services. BRC-Fl will provide technical support to enhance the quality of CVMO’s training services via a multi-year coaching strategy, equipping CVMO with appropriate didactic materials and skills to deliver those trainings. When needed, BRC-Fl or external experts on FA education will provide the input required to establish the desired levels of quality – an example being the facilitation of Training of Trainers by BRC-Fl expert-volunteers. BRC-Fl’s expertise on the institutional and managerial aspects of FA training and service will be instrumental to guide CVMO through a series of reforms, allowing it to position the CFA at the center of all FA-related activities within the organization, equipped with the right tools and resources, material and human, to insure and oversee the quality of FA training and service delivery.

Delegation Capacity building is integrated within the WASH and FA interventions. An assessment will be conducted in 2017 together with CVMO to determine specific overall needs for capacity building within CVMO, including a special focus on specific needs related to monitoring & evaluation. Further support to CVMO will be determined based on the outcomes of this needs assessment. The BRC-Fl delegate to be recruited for Mozambique will assist CVMO not only on a managerial, but also on a technical level to ensure impact and sustainability. Its close proximity to the implementing partner allows for direct input to achieve the project outcomes and outputs, whilst building the capacities of the implementing partner, both at a personnel (staff development) and institutional level (systems, structures). Because of the specific situation CVMO finds itself in, BRC-Fl will opt for a delegate with a WASH background, in order to boost the capacity especially with regarding to Outcome 1. Outcome 2, FA, will be supported

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from within the regional BRC-Fl delegation in South-Africa, where a FA expert will be readily available to provide additional support, either directly to CVMO, or via the delegate.

Synergy & complementarity

During the lifespan of the program, informational synergies with other Belgian ANGC’s and with the Belgian bilateral develop-ment cooperation will be upheld during recurrent consultation rounds which will serve as an exchange-platform for knowledge and experience on common themes, topics, risks or problems encountered. BRC-Fl will proactively participate in these exchange moments, which will serve as a fruitful basis for further synergies and complementarities. Also FOS, as an organization of the JSF Decent Work, will join in this informational synergy. A first step will be to share our country program with the Belgian ANGCs and to provide regular updates on the evolution of our interventions. Furthermore, in line with approach 2D of the JSF, BRC-Fl will share and discuss the relevant findings of its research, conducted in Mozambique, with interested others. While elaborating this program, BRC-Fl contacted all Belgian actors who were involved in the JCA and JSF approach for Mozam-bique, 7 organizations in total, to actively pursue options for synergy and complementarity. It is to be noted however, that only 3 other Belgian ANGC’s expressed their intention to submit a program proposal to DGD (Oxfam, Handicap International and VLIR-UOS), and none of these work in the same geographical or thematic area of intervention like BRC-Fl (Inhambane Province, WASH and FA). However, especially for FA, BRC-Fl pointed out the effectiveness and utility of having staff or beneficiaries trained, especially in the volatile socio-economic climate of the moment, and throughout the program, BRC-Fl will facilitate any such request from those organizations or their partner organizations.

What concerns operational synergies and complementarities, we refer to the list on the next page:

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Outcome 1 WASH

Synergies

N/A as no other Belgian actor is present in the BRC-Fl project area.

Complementarities

The Spanish Red Cross supports CVMO with a program aimed at increasing hygienic behavior and waste-management in market places in urban areas. Behavioral change is an important component, and the Spanish Red Cross has expressed an interest in the BRC-Fl supported evidence-based approach, the RANAS-model. The capacity-building of CVMO on this approach will therefore also benefit their program. One of the main areas of intervention for the Belgian Bilateral Cooperation (ISP Mozambique 2013-2017) is livestock raising. While not directly linked, there is a complementarity with the BRC-Fl WASH intervention, as this intervention increases the availability of water, which can also be used for cattle, and includes sensitization on the subject of animal sanitation. Furthermore, the BRC-Fl WASH program is contributing directly to the sustainable use and management of the natural resource, water. Should the opportunity exist, BRC-Fl will also gladly participate in the preparations for the new ISP, as mentioned in the JSF (synergy and complementarity, point 7).

Outcome 2 FA

Synergies

Organization Objective of Synergy Roles and Tasks Budget Reference to JSF

Viva Africa, MSF,

Apopo (bilateral

actors as Embassy,

BTC and DiV will

be contacted upon

start of the pro-

gram)

To offer a limited number of

subsidized basic FA training

places to other Belgian actors,

thereby identifying potential

new clients for CoFA training/

services and increasing safety

at work within their organiza-

tions.

BRC-Fl: to inform the partner of

training dates and places available,

to offer a limited number of subsi-

dized places and to oversee the

quality of the training.

Partners: to facilitate participation

of staff/ collaborators in the FA

training, to increase adherence to

safety-at-work regulations and

guidelines.

Approximately

45 euro per client,

900 euro for

1 training with

20 participants. This

amount is included

in the BRC-Fl opera-

tional budget for

outcome 2.

Page 9 point 8

Viva Africa To draw upon each other’s

expertise to revise the FA train-

ing curricula from an HIV-

inclusive perspective (both re-

garding safety of the service

provider and appropriateness

and completeness of the tech-

niques thought).

BRC-Fl: to organize a series of in-

formation sharing sessions between

the local partners of both actors and

to assure new topics are evidence-

based (via review by the BRC-Fl cen-

ter for evidence based practice)

Viva Africa: to advise on HIV-

related topics and techniques for

integration in the FA modular train-

ing material.

Estimated at

500 euros for 2 one-

day workshops (in-

cluding hall rent and

lunch). This amount

is included in the

BRC-Fl operational

budget for

Outcome 2.

Page 9 point 8

Complementarities

Both the Spanish and German Red Cross, important partners of CVMO, have expressed the need for support to CVMO’s Centre for FA, and FA training and service delivery in general. Both partners finance programs where FA is an important component (Spanish: resilience programs with a focus on livelihood and DRR ; German: DRR) to achieve their target of more resilient communities, and both have ex-pressed their intend to support the institutionalization of FA via the CFA, implying that for their programs, they will insist on managerial and quality support from this Centre, thus supporting this program’s aim to position the CFA as the sole entity for FA within CVMO.

168

Nepal Outcome 1: Sustained use of sufficient safe water & sanitation facilities, as well as sustained safe hygiene attitudes & practices by the target population by 2018. Outcome 2: Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence-based knowledge, skills & attitudes to provide first aid to those in need by 2018, as such enhancing community level resilience and emergency care capacity.

2017-2018

169

Samenvatting

Rode Kruis-Vlaanderen (RKV) helpt helpen’ is de slogan die het 2017-18 programma in Nepal samenvat. Enerzijds verwijst dit naar de focus op zelfredzaamheid, anderzijds naar de focus op impact. Mensen zelfredzaam maken is de manier bij uitstek om een duurzame impact te hebben. Zowel RKV’s interventiestrategie als de keuze van activiteiten in Nepal zijn gebaseerd op het idee van zelfredzaamheid. RKV’s interventiestrategie heeft als kernprincipe dat de implementatie van het programma geleid en gedragen wordt door de lokale Rode Kruis vereniging en haar vrijwilligers. RKV neemt een ondersteunende rol op zich, maar zal zelf geen directe im-plementatie doen. Het 2017-18 programma, met een totaalbudget van 991.492 EUR, wordt dan ook getrokken door Nepal Red Cross Society (NRCS), een partner met wie RKV al meer dan 30 jaar samenwerkt. NRCS is de grootste nationale humanitaire organisatie van Nepal en is actief in het volledige land met meer dan 90.000 actieve vrijwilligers, 75 district chapters en 1.000 sub chapters. In onze activiteiten kiezen we voor eerste hulp & verkeersveiligheid en water, sanitatie & hygiëne (WASH). Beide interventies dragen verder ook bij tot de prioriteiten van de Belgische ontwikkelingssamenwerking rond gender, milieu en klimaat, men-senrechten, digitale innovatie en waardig werk. In eerste hulp hebben RKV en NRCS reeds 20 jaar geïnvesteerd in de opbouw van kwaliteitsvolle en duurzame eerstehulpdien-sten, met als resultaat dat NRCS dé leidende organisatie is in Nepal rond eerste hulp. Hierdoor wordt de bevolking van Nepal zelfredzaam gemaakt. De aanwezigheid van deze lokale ‘First Responders’ is van groot belang in een land dat kampt met een hoge frequentie aan natuurrampen en een systemisch gebrek aan nodige gezondheidsinfrastructuur, zeker in afgelegen en bergachtige gebieden. Na de aardbeving in 2015 waren het bijvoorbeeld 8.000 lokale Rode Kruis vrijwilligers, die onmiddellijk na de aardbeving en lang voor buitenlandse teams aankwamen, slachtoffers uit het puin haalden en eerste hulp toedienden. Het eerste hulp/verkeersveiligheidsluik 2017-18 is gefocust op een duurzame finale verankering bij NRCS en richt zich op 4 pijlers:

1. 576 leken opleiden in eerste hulp en verkeersveiligheid binnen ‘highway communities’. Dit in de districten Saptarien Mo-rang langs de Mohendra snelweg. Dit is één van de drukste verkeersaders in Nepal. Dit versterkt aanzienlijk de zelfredzaamheid van gemeenschappen die getroffen worden door een hoog aantal verkeersongevallen (150 verkeersdo-den jaarlijks in deze 2 districten216).

2. Bevestigen van NRCS als leidende organisatie in Nepal rond verkeersveiligheid. Via het nationaal verkeersveiligheid awa-reness netwerk, in samenwerking met de Nepalese Politie, worden 146.000 mensen bereikt.

3. Uitrollen van de recent ontwikkelde gender-sensitieve en evidence-based Nepal First Aid Materials (NeFAM). 4. Bestendigen van eerste hulp binnen NRCS via het opleiden en opfrissen van eerste hulp bij 720 Rode Kruisvrijwilligers/per-

soneelsleden én het verankeren van bedrijfseerstehulp als financieel duurzame manier voor NRCS om eigen middelen te investeren in haar eerstehulpdiensten.

In totaal worden 146.000 begunstigden bereikt rond eerste hulp/verkeersveiligheid. Rond WASH werken we in Bara en Gorkha district. In Gorkha, het epicentrum van de aardbeving, is veel water- en sanitatie-infrastructuur vernietigd of beschadigd. Slechts 65% van de bevolking heeft toegang tot voldoende water. Dit gemiddelde verbergt ook ongelijkheden in toegang tot water omdat vele waterpunten opgedroogd zijn door verschoven grondlagen. Hier-door doen kwetsbare gemeenschappen er veel langer over om water te halen. Via herstelde en nieuwe waterpunten richt dit programma zich er op om verbeterde toegang tot veilig water voor 9.417 mensen in Gorkha. Bara district, het tweede inter-ventiegebied, scoort het slechtste in heel Nepal qua sanitatie. Slechts 32% van de bevolking heeft toegang tot verbeterde sanitatie. Dit programma richt zich op een geïntegreerde aanpak van water- en sanitatie-infrastructuur én gedragsverandering in hygiënepraktijken (bv. handen wassen). Deze innovatieve aanpak is in lijn met de shift naar ‘totale’ sanitatie binnen de Ne-palese ‘Total Sanitation Guidelines’ (2015). Dit nationaal ontwikkelingskader koppelt expliciet gedragsveranderingstechnieken aan water- en sanitatie infrastructuur. Deze poot van de interventie bereikt 20.748 personen in Bara district. Naast deze directe begunstigden beoogt het programma ook indirecte begunstigden door de spillover-effecten van deze innovatie aanpak in gans Bara district, geleerde lessen zullen bijvoorbeeld gedeeld worden met de bevoegde instanties. In totaal worden 54.114 begunstigden bereikt rond water, sanitatie & hygiëne. Naast zelfredzaamheid is impact een belangrijke focus van het RKV programma in Nepal. Een studie van de Wereldbank toont aan dat het investeren in de opleiding van eerstehulpvrijwilligers een van de meest kosteneffectieve interventies in ontwikke-lingslanden is met een kost van slechts 8 US$ per vermeden DALY217. Daarnaast leidt hygiënepromotie zelfs tot een negatieve kost per DALY218 : de kosten voor het bevorderen van hygiëne liggen lager dan de kosten voor de behandeling van water-

216 Bron: Nepal Traffic Police Saptari en Morang . 217 DALY is een maatstaf die werd ontwikkeld door de Wereldgezondheidsorganisatie. De DALY meet niet alleen het aantal mensen dat vroegtijdig sterft door ziekte, maar meet ook het aantal jaren dat mensen leven met beperkingen door ziekte. In maatschappelijke kosten-batenanalyses worden DALY's ook toegepast om de kosteneffectiviteit van gezondheidsinterventies te bepalen. Laxminarayan et al. (2006). Intervention Cost-

Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2 218 Jamison et al. (eds) (2006). Ibid.

170

gerelateerde ziektes zoals diarree. Ten slotte is ook het economisch rendement van een WASH-interventie erg groot: de We-reldgezondheidsorganisatie berekende dat er voor elke US$ geïnvesteerd in WASH, een economisch rendement van 4 US$ wordt gegenereerd219. Bovendien investeert RKV via haar Centre for Evidence-Based Practice (CEBaP) continu in onderzoek naar interventiestrategieën met de meeste impact. Zo onderzoeken we onder andere het effect van simulaties in eerstehulpopleidingen. De resultaten van deze onderzoeken zijn geïntegreerd in RKV’s eerstehulpondersteuning aan NRCS. Daarnaast heeft het CEBaP evidence-based eerstehulprichtlijnen uitgewerkt die volledig aangepast zijn aan de Nepalese context (NeFAM). Het eerstehulpopleidingsmate-riaal van NRCS zal op basis hiervan herzien worden zodat steeds de meest doeltreffende eerstehulppraktijken worden aangeleerd. Dit programma hecht eveneens ontzettend veel belang aan het bereiken van een duurzame gedragsverandering bij de doel-groep. Zonder het aanhouden van een correcte hygiëne, is de impact van toegankelijke infrastructuur immers beperkt. Hiervoor wordt het wetenschappelijk onderbouwde RANAS220-model tot gedragsverandering toegepast binnen de verschillende tech-nieken tot hygiëne promotie in Bara district. Daartoe ging RKV via CEBaP reeds in 2015 een samenwerking aan met het Zwitserse onderzoeksinstituut EAWAG221 die dit model heeft ontwikkeld, zodat wij als organisatie dit optimaal kunnen opnemen in onze eigen werking en de expertise doorgeven aan onze partnerorganisaties zoals NRCS. Rode Kruis heeft via haar lokale vrijwilligers, die voor én na het programma deel uitmaken van de lokale gemeenschap, een enorme toegevoegde waarde om gedragsverandering duurzaam te bewerkstelligen. Gedurende alle fases van de interventie, hebben we ook aandacht voor gender: in samenwerking met het NRCS gender depar-tement wordt gestreefd naar een gelijkmatige verdeling van vrouwen en mannen binnen de eerstehulplessen en de beheers- en bestuursorganen van de organisatie. Aan de hand van gender-gedisaggregeerde indicatoren zullen verwezenlijkingen in kaart worden gebracht. De didactische materialen van NeFAM richten zich specifiek ook op vrouwen als gevers en ontvangers van eerste hulp (bv. natale zorg). Daarnaast zullen inspanningen worden gedaan om de impact van onze interventie op het milieu te beperken, door onder andere het principe van ‘local finance first’, en dus worden lokale materialen gebruikt voor water- en sanitatie-infrastructuur. RKV gelooft ten stelligste dat het 2017-2018 programma in Nepal rond WASH enerzijds en eerste hulp/verkeersveiligheid anderzijds door zijn focus op zelfredzaamheid en duurzame impact sterk bijdraagt tot een verhoogde toegang tot eerstelijns gezondheidszorg en WASH voorzieningen. Op die manier komt het programma tegemoet aan de Sustainable Development Goals 1, 3, 5, 6, 8 & 13 en het nationaal ontwikkelingskader: namelijk het WASH National Sector Development Plan (2015), de Total Sanitation Guidelines (2015) en het National Road Safety Action Plan 2013-2020.

219 Hutton G (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal cover-

age, p4. WHO, Geneva, Switzerland. 220 Dit acroniem staat voor Risks, Attitudes, Norms, Abilities en Self-Regulation, de 5 factoren die een grote invloed spelen op gedragsverande-ring. 221 Swiss Federal Institute of Aquatic Science and Technology

171

Country Fiche

Total Operational

Costs (EUR) 991.492

In-country contact

person

Name:

Els Gorsia-

Schapendonk

Organization: Belgian Red

Cross-Flanders (BRC-Fl) Phone No: +977 9841534828

E-mail:

els.schapendonk

@rodekruis.be

Narrative summary of the country program BRC-Fl has worked in Nepal for almost 30 years and always with its preferential partner, the Nepal Red Cross Society (NRCS). In 2017 and 2018, the cooperation will continue to focus on First Aid (FA) and Water, Sanitation and Hygiene promotion (WASH). BRC-Fl focuses on these 2 given they are, according to the World Bank222, two of the cheapest ways to increase public health in developing countries.

FA is also a priority activity for all Red Cross Societies worldwide, and especially relevant in Nepal, because of the lack of a strong health infrastructure, especially to remote, inaccessible parts of the country. Building self-reliance through providing high quality First Aid increases the response capacity of crucial local first responders given NRCS is the largest national humanitarian organization in Nepal, reaching all districts through 75 district chapters and over 1.000 sub chapters. The UN and international NGO’s in Nepal use this organizational structure of NRCS to mobilize volunteers at grass roots level in response to (looming) disaster. BRC-Fl brings extensive expertise in FA education, assuring that what is taught, is conform the latest scientific evidence. This increases the effectiveness of FA and explains the large spill-over effect to 147.296 benefi-ciaries, amongst whom 1.296 are directly reached.

The second priority of the program, i.e. access to sufficient and safe water and sanitation, is an important contributor to overall health and poverty reduction. The program also focusses on hygiene promotion through behavior change since it is a key condition for good health. This is accomplished using scientific approaches to behavioral change coupled with the extensive volunteers base of NRCS, which plays an important role in both transmitting the right messages and assisting communities to change their behavior for the better. A total of 54.114 beneficiaries is reached, amongst whom 30.165 are directly reached.


222 Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2.

172

List of partners

Local Partner

Full Name & abbreviation: Nepal Red Cross Society (NRCS)

Contact Details:

Address: Phone No: E-mail:

Red Cross Marg, Kalimati,

Kathmandu, Nepal +977 1 4272761 [email protected]

Website : www.nrcs.org

Contact person Mr. Dev Ratna Dhakhwa, Secretary-General

Outcome(s)

O1: Sustained use of sufficient safe water &

sanitation facilities, as well as sustained safe

hygiene attitudes & practices by the target

population by 2018.

O2: Lay people, Red Cross staff & volunteers

have adequate, up-to-date and evidence-

based knowledge, skills & attitudes to

provide first aid to those in need by 2018, as

such enhancing community level resilience

and emergency care capacity.


Summary of partner role for each

Outcome:

NRCS, through its nationwide network of branches and volunteers, is the main implementing

partners for these outcomes. With support from BRC-Fl headquarters and delegation, the NRCS

is responsible for the planning, implementation, monitoring and reporting of this program.

Start date of partnership relation: 1988

Coherence with BRC-Fl Strategy

Vision

The vision of BRC-Fl is the universal vision of the International Red Cross & Red Crescent Movement:

“To inspire, encourage, facilitate and promote at all times all forms of humanitarian activities by National Societies, with a view to preventing and alleviating human suffering, and thereby contributing to the maintenance and promotion of human dignity and peace in the world.”

Mission

As part of the International Red Cross & Red Crescent Movement, BRC-Fl is bound by 7 fundamental principles which are the basis of all Red Cross & Red Crescent actions globally: humanity, impartiality, independence, voluntary service, unity, universality & neu-trality. For development activities, BRC-Fl subscribes to a shared Red Cross/Red Crescent strategic aim for enabling healthy

and safe living. This is a part of Strategy 2020, formulated in consultation with its 189 member National Societies, by the International Federation of Red Cross and Red Crescent Societies (IFRC)223.

Medium & long-term objectives in Nepal

The partnership between NRCS and BRC-Fl started in 1988. Together with BRC-Fl, NRCS has grown from a young National Society to a well-established and well recognized humanitarian organization in Nepal, most relevant in a disaster prone country. In this period, support from BRC-Fl has evolved from basic institutional capacity building towards more specialized and more innovating support, in these areas WASH and First Aid. BRC-Fl’s support for Nepal is coherent with its own expertise and its interventions in other program countries. Specifically, all BRC-Fl development programs contribute to healthy and safe living in the medium-term by supporting the National Red Cross or Red Crescent Society in First Aid (FA) Education, Water, Sanitation & Hygiene (WASH) and Blood. In the long-term, BRC-Fl aims for National Societies and communities to be self-reliant so that they provide or sustain these health services autonomously and in a sustainable manner.

223 Strategy 2020 guides the actions of the IFRC. It defines three strategic aims and three enabling actions. http://www.ifrc.org/Global/Publica-tions/general/strategy-2020.pdf

173

In order to achieve this in Nepal, BRC-Fl has invested in high quality FA education for different target groups through stand-ardization, quality control & improvement as well as support to trainers/trainings. BRC-Fl also provided institutional support and supported development of high quality commercial FA services. In 2017 it remains key for NRCS to roll out the new content of the new evidence-based FA manual among Red Cross staff, volunteers, lay people and FA trainers in particular. NRCS also needs to further strengthen its income generation by Commercial First Aid (CoFA). In the field of Road Safety (RS), in which NRCS is stepping up as a driver for change since 2014, NRCS needs to continue to profile itself. BRC-Fl finds it important to continue its support to the FA-division of NRCS within First Aid & Road Safety for the coming two years as an exit strategy for BRC-Fl. After having provided years of capacity building and tailored expertise to the FA-division of NRCS, BRC-Fl is confident the FA-division of NRCS will be able to provide sustainable high quality FA-services without the support of BRC-Fl after 2018. Till then, BRC-FL still intends to strengthen the current portfolio, developed with the support of BRC-Fl over the past decade, of the FA-division. NRCS should be able to guarantee funding through income generating activities (CoFA) as well as through other donors.

In the WASH sector, Nepal has made remarkable progress in the area of sanitation over the last years. Millions of toilets have been built, bringing up the sanitation coverage from 43% in 2010 to an estimated 90% in 2016. NRCS has been recognized, also through BRC-Fl supported programs, as a strong implementation partner to achieve this result, even more specific in remote communities covering a range of challenging socio-economic and cultural backgrounds.

In the next years, Nepal Government will shift its focus from basic sanitation to total sanitation, from building toilets to using them along with improved hygienic environments and appropriate hygiene behavior. With the new program, BRC-Fl will sup-port NRCS to grow experience and develop expertise for total sanitation. The Nepalese challenges and current ambitions for behavior change are fully in line with BRC-Fl’s core strategy in WASH: hygiene promotion through evidence based behavior change at community level. One of the objectives of the next intervention is to develop a cost-efficient model to reach total sanitation, maximizing inputs from volunteers and stakeholders present in the community. NRCS could partner with local gov-ernments and other actors to replicate this intervention in other districts.

Strategy

In a cross-cutting manner, it’s also important to stress that all aid activities of BRC-Fl, domestically and internationally, should be ‘Evidence Based’, or founded in the most recently available scientific evidence. We use scientific evidence to test our para-medical, humanitarian and development activities, and to tackle many aspects of our internal guidelines systematically. Moreover, applying concepts from health economics to consider the cost-effectiveness of interventions has helped BRC-Fl to focus on interventions that deliver maximum impact with the resources at our disposal224.

In 2016, BRC-FL and NRCS have worked hard to update the existing first aid manual, upgrading it to an evidence based first aid manual for Nepal. Medical professionals studied the burden of disease in Nepal and integrated implications of medical scientific research on these diseases for the First Aid Manual in Nepal. This will result in publication of NeFAM by the end of 2016 that will be rolled out over Nepal in 2017.

BRC-Fl collaborates since 2 years with Prof. Dr. Mosler from the University of Zurich to integrate evidence based behavior change in current hygiene promotion approaches. During the baseline study, main obstacles and barriers for behavior change are analyzed. Knowledge of these specific behavioral factors makes it possible to identify specific behavior change techniques to enhance behavior change. NRCS already hosted a workshop with Dr. Mosler, the next program will be a first experience implementing evidence based behavior change.

Theory of Change

This Theory of Change (ToC) serves as the basis for the logical framework (see further). Throughout all phases of implementation BRC-Fl uses the logical framework as the basis for implementation & monitoring. In addition, a general explanation on how BRC-Fl has structured the ToC model can be found in Annex 1 of the program.

Outcome 1 WASH

Please find the schematic representation of the Toc for WASH on the next page.

224 For example training first-responders in first aid and hygiene promotion as a diarrhea preventive intervention are extremely cost-effective interventions; they are among the most neglected low-cost opportunities in middle- and low-income countries. Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edi-tion). Washington D.C. World Bank, chapter 2.

175

1. Assumptions (please note that due to page limitations we excluded academic references; these are available on request)

225 For an important number of assumptions we refer to the 'Water, Sanitation and Hygiene evidence paper' from DFID (May 2013). This paper synthesizes all available evidence for many of the assumptions formulated in our ToC.

Assumption Link with

logframe

Does it hold?

(yes/no) Argumentation/evidence225




• The positive effect of WASH interventions on health outcomes has been shown in many studies and systematic reviews. Moreover, DFID’s evaluation data reports wider impacts of WASH programs in the form of reduction of the burden of disease and increased school attendance. It found that there is good evidence that the health im-pacts include many other important diseases beyond diarrhea.

• As water related diseases such as diarrhea are caused by infections by water borne pathogens, it is evident that a reduction in these infections will lead to less water related diseases and a better health overall.

B Better hygiene leads to reduced infections by water-related pathogens.

Outcome 1 Yes

Sanitation and hygiene are critical to health, survival, and development. Providing access to safe water and sanita-tion facilities, and promoting proper hygiene behavior are important in reducing the burden of disease from sanitation and hygiene-related diseases.

C Access to sufficient & safe/potable water leads to better hygiene.

Outcome 1 Yes An assessment of the evidence underlying the impact of the four main WASH interventions (water quality, water availability, excreta disposal, hygiene promotion) on diarrhea shows that the availability of water is the most favourable intervention based on a specific set of appraisal factors.

D Access to sufficient & improved sanitation facilities leads to better hygiene and reduction of water re-lated diseases.

Outcome 1 Yes, but more research is needed

An impact evaluation in Bangladesh showed that improvement in sanitation facilities had led to a reduction in water-borne diseases. Only a few systematic reviews have looked at the effect of sanitation facilities on the health status or the reduction of diseases. Further research in this area is needed.

E • People practice better hygiene if they have the knowledge, skills, and attitudes. Hygiene promo-tion via different methodologies leads to sustainable hygiene behavior change.


BRC-Fl research on-going

BRC-Fl is conducting a systematic review to determine which promotional approaches are effective to change handwashing and sanitation behavior in low- and middle-income countries. This program is a collaboration of the BRC-Fl Centre for Evidence-Based Practice and the Centre for Evidence-Based Health Care of Stellenbosch Univer-sity South Africa. Oversight and guidance is provided by 3ie (International Initiative for Impact Evaluation).

F NRCS is a relevant actor in the WASH sector. Outputs 1.1-1.3

Yes Evidence suggests that the most influential factors associated with sustained adoption include frequent contact with a health promotor over a period of time. Personal follow-up may further contribute to sustained adoption. The large network of Red Cross volunteers can play exactly the role of health promotor as they are part of the tar-get communities, and are present beyond the duration of the intervention. In addition, NRCS is mentioned specifically as stakeholder in the Nepal Sanitation & Hygiene Master Plan 2011, and is a member of central and decentralized WASH Coordination Committees.

G Time saved by women for water collection leads to more possibilities for women empowerment less risk of violence and injury.

Impact Outcome 1

Yes Studies have shown that WASH interventions significantly reduce the time that women need to spend on fetching water and taking care of sick children. In addition, a smaller time and energy burden associated with fetching wa-ter may decrease the risk of violence and injury for women.

176

2. Stakeholder analysis (please note that due to page limitations we excluded the detailed description of stakeholders, this is available on request)

1. D-WASH-CC: District Water, Sanitation and Hygiene Coordination Committee 2. V-WASH-CC: VDC (Village Development Committee) Water, Sanitation and Hy-

giene Coordination Committee 3. W-WASH-CC: Ward Water and Sanitation Coordination Committee 4. Community leaders: Mukhiye 5. Community 6. Women/girls

7. Schools 8. Media 9. DPHO (Department of Health District Public Health Office)/Health Posts/ FCHV (Fe-

male community health volunteers) 10. Private companies 11. Water user committees 12. IFRC, other Partner National Societies (PNS)

3. Context analysis (please note that due to page limitations we excluded the detailed description of contextual factors, this is available on request)

• Nepal is a relatively strong male dominated society. • Young Nepalese people search for employment abroad due to the lack of opportuni-

ties in Nepal. • Widespread poverty in Bara District. • High population density in Bara District. • Transborder migration with neighboring India. • Bara district is not ODF. • Some areas in Bara are prone to flooding.

• Uncertain political context. • High turnover of government staff. • Other main actors in WASH have made a similar need based analysis and are focusing

their sanitation activities to Bara and 7 other districts in Central and Eastern Terai Re-gion.

• NRCS is a recognized partner for WASH interventions at community level. • The NSHMP (´11) will be further deepened based on the 2015 Total Sanitation Guide-

lines, reflecting a shift from basic to total sanitation

H • Adequate sanitation facilities reduce the exposure of women to the risk of violence and saves them time.



•Yes •More research needed

• DFID’s WASH evidence paper states that the impact of inadequate water and sanitation are particularly pro-nounced for women and girls. Inadequate sanitation facilities may expose women to the risk of violence, and finding adequate locations for open defecation can require significant time.

• Qualitative research indicates that some girls may be discouraged from attending a school without adequate toi-let facilities. However, no evidence is available on the direct link between sex-aggregated toilets en increased school attendance by girls.

I • The chosen approaches to promote WASH behav-ior change are effective.

• NRCS volunteers are effective agents of sustained WASH behavior.


• BRC-Fl research on-going

• Yes

• Cfr. Assumption E and ongoing systematic review by BRC-Fl in cooperation with 3ie. • Cfr. Assumption F

J WASH interventions contribute to climate change adaptation and resilience.

Impact Yes Promotion of WASH technology and behaviors is a critical component of climate change adaptation and promot-ing human rights. The Red Cross/Red Crescent Climate Centre underlines the link between the availability of water and sanitation infrastructure and increasing hygiene awareness, and communities’ vulnerability to extreme weather events

K WASH interventions have a positive impact on poverty reduction.


L By reducing distance to safe water, water will also be used for hygienic purposes, not just drinking and cooking.

Outputs 1.2-1.3


177

4. Activities

1 Support to reach total sanitation 5 + 1 indicators: Awarding of ‘total sanitized’ households; (collection/preparation of photos, video clips, success stories, best practice, media messages, data).

2 Provide population with safe water supply infrastructure: Drinking water needs assessment and site selection; Water quality testing of identified tubewells; Procurement of tubewell materials; Tender for labour contract of tubewell construction; Pre-construction orientation; Platform construction and repair of existing tubewells.

3 Raise awareness, knowledge and motivation for WASH behavior change: Child clubs formation in schools, orientation and mobilisation of child club members; Sensitization activities (“triggering”) to schools and health institutions; Hand washing demonstrations and practice sessions for communities and schools; Organization of street drama shows; Household visits by motivators to sensitize about hand washing at critical times; School level WASH competitions; WASH Promotion; Radio/FM-WASH message airing; National Sanitation Week activities at district and VDC levels; Global Hand Washing Day activities at district and VDC levels; Conduction of specific hygiene behavior change techniques (to be defined after RANAS baseline analysis).

4 Provide population with sanitation facilities: Upgrade of household toilets; Monitoring of ‘total sanitation’ status by volunteers; Construction of washing platforms; Construction of improved cooking stoves; Awarding ‘total sanitized’ households; Construction of household and street water drainage systems; Construction of school toilets; Construction of improved domestic animal sheds; Setup of community waste management system.

5 Provide expertise and resources to conduct WASH activities: Quarterly meetings with D- and V-WASH-CC; V-WASH-CC orientation; Establishment of VDC matching fund; Orientation to health facility staff, FCHVs and civil society representatives; Orientation to W-WASH-CCs and schools; Social mobilization and communication training for motivators and supervisors; Update on intervention strategy (choose behavior change techniques) after baseline; Household survey on ‘total sanitation’ status; Monitoring on ‘total sanitation’ status; Procurement and distribution of visibility materials: T-shirts, stickers, caps.

6

Support to NRCS implementation of WASH program: Establishment of program steering committee at district level; Stakeholders and coordination meeting at district level; Program orientation workshop (1 day); Program planning workshop (2 days); Annual review and planning workshop (including beneficiaries); District chapter review and planning meetings (quarterly); ODID training for district chapter and sub-chapters; IG-support to district chapter and sub-chapters; Support to district sanitation conference; Baseline (evidence-based); Development of ‘total sanitation’ criteria and indicators; Program final evaluation.

Outcome 2 FA

Please find the schematic representation of the ToC for FA on the next page.

179

1. Assumptions (please note that due to page limitations we excluded academic references, they are available on request)

Assumption Link to

log-

frame

Does it

hold?

(yes/no)



• Smaller negative impact on health in case of injury because people are as-sisted with evidence-based first aid.

• FA education is a very cost-effective development intervention.

Impact • Yes • Yes • Yes

• A British Red Cross study shows linkages between features of community resilience and first aid training. • Evidence-based FA techniques are proven to be more effective towards injury treatment/illness recovery. The BRC-Fl Centre for

Evidence-Based Practice (CEBaP) specializes in the evidence-based methodology for first aid guideline development, using the best available evidence from scientific literature, supplemented with know-how from experts and information gleaned through practical experience.


B • Smaller negative impact on health be-cause people are assisted with first aid and road safety in case of illness/in-jury/accident.

Impact Yes, more research is ongoing

A systematic review is ongoing on the health effects of training lay people to deliver emergency care in underserviced populations. Results will be available in 2017. Another case study in Iraq showed that a reduction in mortality was caused by trained layperson first responders in a setting where pre-hospital evacuation times are long. In addition, post-earthquake Nepal 2015 it was evident that FA trained NRCS people in affected districts had a noticeable impact on the overall health outcome.

C • Lay people and NRCS staff & volunteers intervene if they have the required knowledge, attitudes and practices.

• Lay people have access to basic FA local materials for applying first aid tech-niques.

• First aid lay responders as well as NRCS staff & volunteers can intervene and provide first aid in a safe legal environ-ment.

Out-come 2

• Yes

• Yes

• No

• A systematic review reports significant increases in first aid knowledge, skills and improvement in helping behavior due to first aid training for children and lay people. A case study in Uganda shows that groups of people who regularly have to apply FA have a higher retention of FA knowledge. A Red Cross structure could be considered similar.

• Sensitization on the importance of having adequate FA materials and on the use of local materials will be part of the interven-tion. FA trainings are also adapted to locally available materials; first aiders are trained to use local materials. Moreover, the FA intervention as such is localized and adapted to the locally available materials.

• In none of the intervention countries the law provides protection for bystanders providing first aid. Also in Nepal this may cause a risk for FA provision in particular situations due to individual insecurities (cfr. risk matrix). However, the 32nd Interna-tional Conference of Red Cross and Red Crescent Societies adopted a resolution on strengthening legal frameworks for disaster response, risk reduction and first aid.

D Trained and equipped NRCS volunteers are retained.

Out-come 2 Outputs 2.1-2.3

Partially There is a relatively high flux among volunteers due to social and economic factors (cfr. risk matrix).

E NRCS is able to recruit the required volunteers and staff to provide FA and RS awareness.


Yes Cfr. D on recruitment & volunteer policies.

F There is adequate follow-up and coaching of NRCS volunteers and staff.


Yes A specific department for FA exists within NRCS, however remoteness of some areas may prove to be a barrier.

G • Commercial FA generates income.

Output 2.2

• Yes

• In 2016, BRC-Fl undertook a study analyzing the cost of FA trainings. BRC-Fl aims to use this model to improve commercial first aid activities in other partner countries.

180

• NRCS is willing to invest the income generated from CoFA trainings at least partially back into the FA service.

• Yes • NRCS is committed to reinvest the generated income for replenishment of FA materials when no other funding is available for this.

H People who decide to become a NRCS volunteer or staff recognize and value the importance of first aid and road safety.

Outputs 2.2-2.3

Yes Within RC organizations first aid is recognized as a core activity, and each newly recruited volunteer is introduced in the vision, mis-sion and policies of the organization. In addition, NRCS volunteers are recognized by their local community for providing first aid.

I The used didactical methods are effective. Output 2.1

BRC-Fl research planned

The use of simulation as a didactical tool will be studied during the course of the implementation period. In addition, didactical methods are specifically taught during a Training of Trainers.

J Stakeholders of Road Safety have the ca-pacity, resources and interest to participate in the RS Network Nepal.

Output 2.3

Partially Most stakeholders will have the interest and the capacity or resources to participate but few stakeholders may have all three.

K Lay people (incl. NRCS staff and volun-teers) sufficiently retain the knowledge and skills obtained during a first aid (re-fresher) training.

Out-come 2 Output 2.1

BRC-Fl research ongoing

BRC-Fl is conducting a study to assess the degree of knowledge and skill retention over a period of time and to determine the im-pact of refresher courses and first aid practice on the retention level. This information will be used to determine the optimal frequency of refresher courses and to assess the need to revise the validity of first aid certificates. One case study has shown that first aid knowledge gained during commercial first aid training does not significantly decline over time. However, skills related to CPR rapidly deteriorate over the course of the first 90 days suggesting that refreshing skills frequently is required.

2. Stakeholder analysis (please note that due to page limitations we excluded the detailed description of stakeholders, this is available on request)

1. FA volunteers 2. Lay people 3. People in need of FA/ traffic victims

4. GoN, health and road safety related departments 5. Ambulance services 6. GoN, Traffic Police

7. Schools: Students/ Teachers 8. GoN, Health Workers 9. Bus Drivers

3. Context analysis (please note that due to page limitations we excluded the detailed description of contextual factors, this is available on request)

• In line with global initiatives and ever growing traffic accidents, injuries and fatalities in Nepal, GoN has developed a Road Safety Action Plan 2013 – 2020 addressing the need for road safety

initiatives through 5 pillars of Road Safety (RS).

• There are no laws enforcing a FA-curriculum. No organisations or people are obligated by law to follow FA-training.

• The unique position of NRCS as only FA-provider has not been legalised. Though NRCS is unofficially acknowledged by GoN as the only FA-trainer in Nepal.

• A lack of funds is often faced among road safety stakeholders who may not have appropriate FA-materials or be able to pay for refresher training

• NRCS is the largest humanitarian organisation in Nepal with a high nr. of volunteers in all districts of the country.

• Due to difficult to access regions of Nepal it is difficult to sufficiently monitor FA training and activities over the country and/or to involve FA-trainers / volunteers sufficiently.

181

4. Activities

1 First Aid and Road Safety diplomacy: Diplomacy by NRCS for Road Safety initiatives within GoN, traffic police in particular, and other non-governmental stakeholders.

2 FA quality / standardization: NeFAM development and implementation; NeFAM introduction training to FA trainers; NeFAM training PPT-presentation.

3 FA quality / control and improvement: Baseline studies and evaluation; review meetings; staff (planning) meetings / workshops.

4 FA & RS trainings: Trainings of Trainers (ToT) FA NRCS and Traffic Police; FA refresher training; FA advanced training; FA trainings for school children; FARS training to teachers, bus drivers, ambulance

personnel, health workers; Training Psycho Social Support (PSS), Simulation training.

5 Institutional management FA service: Support to NRCS to maintain FA department at HQ level; Provide further FA training to NRCS HQ FA program staff.

6 Institutional volunteer management: Human Resource support to First Aid department; Provision of incentives such as food and transport to volunteers and payment of insurance of FARS team

members. Purchase training materials and manuals, FA kits and equipment and visibility items to support trainings and FA activities. Support to national FA volunteer D-base maintenance.

7 Institutional and organisational development: Diplomacy by NRCS for approval of NeFAM by GoN as standard curriculum for all FA trainings.

8 Road Safety Awareness: Road Safety education classes, radio messages and promotional materials; Media Coverage; Traffic Week; World FA day; World RC day, NRCS day.

182

Lessons learned

The decade-long experience of RKV in working with NRCS, combined with experience of WASH and FA programs in other countries, results in a wide range of lessons learned.

Outcome 1 WASH The lessons below are incorporated in the different activities of the program

• Behavior change in the community requires support of both traditional and governmental leaders in the community. For this reason, there is a lot of attention to communication, meetings and planning with these stakeholders in the program;

• In the area of WASH, Nepal has strong outlined national strategies and objectives. Government leadership provides a necessary sustainable framework by local authorities. The program is as much as possible aligned to government standards and approaches;

• Women are identified as key actors with high influence on water, sanitation and hygiene activities and outcomes. Despite this, involvement of women has often been neglected in planning and execution of WASH programs. The program will monitor and encourage the participation of women and girls;

• Communities adhere stronger to hardware (infrastructure) components then software (sensitization) components of WASH programs. However, it is evident that hardware without adapted behav-ior is less effective and less sustainable. For this reason, the program strategically emphasizes during the first years on software, where some achievements are conditional thresholds to start hardware activities.

Outcome 2 FA The lessons below are incorporated in the different activities of the program

• Standardization is the key entry point to build quality first aid education; • Improving first aid education needs a long term trajectory including improvement of medical and didactical skills and development of a quality monitoring system; • Improving first aid education contributes to adequate qualitative first aid interventions within different country specific target groups. Active volunteers need appropriate equipment and

follow up; • NRCS needs to continue investing in a well-reasoned volunteer management system to ensure sustainability in delivering qualitative first aid education and first aid services; • A well-functioning first aid unit is embedded in the structure of the National Society and able to advocate and promote First Aid to the different stakeholders.

The lessons align well with the required FA program activities. In Nepal, these activities have extensively been implemented over the past two decades. This has led to the conclusion that NRCS should by now have received a sufficiently broad range of expertise from BRC-Fl enabling standardized, high quality, evidence-based and income generating FA services. Therefore, the intervention strategy of this program focuses on the ´final´ strengthening of the current FA portfolio of NRCS as an exit strategy from FA in Nepal for BRC-Fl.

183

Risk analysis

Below is a selection of relevant risks for Nepal. Given space limitations, this is simplified version. A detailed risk analysis was

conducted for each country, an example is added in Annex 2.

ToC reference Description of risk and impact Im-

pact

(1-6)

Proba-

bility

(1-6) Mitigation

Responsable for

monitoring


O1 C / D / G O2: A / B

Natural disasters, e.g. flooding (cfr. JCA p.47); delays in implementation and population displacement.

2 4

Ongoing (seasonal) monitoring of disas-ters and epidemics. Replan, reformulate, relocate activities timely if and where necessary.

NRCS Manager, Coordi-nator, Field Officer, BRC-Fl Delegate

O1: B / C / D / F O2: B

Socio-economic and/or political situ-ation (cfr. JCA p.47); delays in implementation.

3 4

Ongoing monitoring of the political and economic situation, combined with con-tinuous assessment of safety/security.

NRCS Manager, Coordi-nator, Field Officer, BRC-Fl Delegate

O1: C - F O2: E / F / H / K

Capacity for project management and/or implementation; activities less cost-effective.

2 2

Constant monitoring of progress of im-plementation and spending rate. Reallocate funding if necessary.

NRCS Manager, Finance Officer, BRC-Fl Delegate

O1: C - F O2: G

Capacity for procurement manage-ment; delay in implementation and/or less cost effective. 3 3

Advocacy and/or NRCS management for providing transparency of the process; speeding up progress and providing technical support where necessary or take over the procurement from NRCS.

NRCS Manager, Finance Officer, BRC-Fl Delegate

Program Level Risks

O1: A - D O2: K

Local/central authorities do not en-hance or facilitate the program; activities cannot be implemented or may not be sustainable after the program.

2 5

Work in line with government policies and in cooperation with GoN-bodies where possible. Involve GoN from the beginning and enhance local ownership among beneficiaries.

NRCS Manager, Coordinator, Field Officer

O1: C - F O2: C

Public (general or target) not con-vinced of added value of intervention; no or dubious imple-mentation, lack of continuity or diminished impact.

3 4

Use of appropriate didactic methodolo-gies, practical suggestions, and counter superstitious beliefs through continuous social mobilization at grass root level.

NRCS Coordinator, Field Officer, BRC-Fl Delegate

O1: B / C / G O2: G

Price fluctuations due to exchange rate or inflation (cfr JCA p. 47); insuf-ficient budget for all or specific activities.

3 2

Monitoring of economic and monetary situation. Update the budget and activi-ties according to the new situation.

NRCS Coordinator, Fi-nance Officer, BRC-Fl delegate

O1: B / C

Landowners hinder development of infrastructures on their land; activity stop and/or destruction of infra-structures.

3 4

Approach local leaders as important change agent. Integrate them and key landowners in planning and implementa-tion of activities.

NRCS Coordinator, Field Officer, BRC-Fl delegate

O1: B / C

Water Committees do not properly function; lack of maintenance of wa-ter infrastructure.

3 3

Provide training & tools for mainte-nance. Register WUCs at DDC.

NRCS Coordinator, Field Officer

O2: G / K

No new stakeholders are willing to take the lead; Road Safety network and/or FA-activities may not be sus-tainable.

3 5

Involve some serious stakeholders in the RS network through a MoU. Convince donors to fund certain activities from 2018 onwards as part of the exit strat-egy.

NRCS Manager, Coordi-nator, BRC-Fl Delegate

184

Outcome 1 WASH

Outcome Fiche

Outcome (English) : Sustained use of sufficient safe water & sanitation facilities, as well as sustained safe hygiene attitudes & practices by the population of 4 Village Development Committees (VDCs) in Bara District and 9 VDCs of Gorkha District by 2018.

Outcome (Nederlands): De doelgroep, 4 VDC’s in Bara District en 9 VDC’s in Gorkha District, maakt tegen 2018 gebruik van duurzame water- en sanitaire voorzieningen die toereikend en veilig zijn, en houdt er veilige attitudes en praktijken op na omtrent hygiëne.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_10_NP_DGD

Country: Nepal Is this Outcome covered by a JSF No

Province(s)/state(s) targeted: Subnational admin level 1 Subnational admin level 2 Subnational admin level 3

Local partner NRCS NRCS HQ NRCS Bara District Chapter NRCS Gorkha District Chapter

NRCS Sub Chapters in Tetariya, Madhrijabdi, Inarwamal, Tedhakatti VDC NRCS Sub Chapters in Harmi, Thalajung, Bakrang, Barpak, Shreenatkot, Gankhu, Jaubari, Manakamana, Mirkot VDC

Other localisation of the intervention: Kathmandu

GPS Coordinates: Longitude Bara: 85.0129 Longitude Gorkha: 84.5956

Latitude: 27.0266 Latitude Gorkha: 27.9713

Target population: Total population of 4 Bara VDCs: Tetariya, Madhrijabdi, Inarwamal, Tedhakatti VDCs Partial population of 9 Gorkha VDCs: Harmi, Thalajung, Bakrang, Barpak, Shreenatkot, Gankhu, Jaubari, Manakamana, Mirkot VDCs

Number of beneficiaries: Total: 54.114 Direct: 30.165 Indirect: 23.949




Policy Marker






185

Logical Framework

A full baseline exercise will be conducted after program approval to rigorously determine and update baseline and target values for each indicator. Annual numeric targets are presented as a cumula-tive total with regard to the baseline value. Definitions are available on request.


Process indicators


0 Total: +29.919 Female: +14.691 Male: +15.229

Total: +30.165 Female: +14.811 Male: +15.355

N/A N/A N/A NRCS monitoring & reporting forms

Indicator 2: Number of indirect benefi-ciaries reached.

0 Total: +126 Female: +104 Male: +22


N/A N/A N/A NRCS monitoring & reporting forms

Impact: To contribute to the health, well-being and resilience of Bara and Gorkha district by 2018.

Assumptions: Cfr. assumptions listed under section ‘Theory of Change’.

Outcome 1: Sustained use of sufficient safe water & sanitation facilities, as well as sustained safe hygiene attitudes & practices by 4 VDCs of Bara district (B) and 9 VDCs of Gorkha district (G) by 2018.


Indicator 1.1: % of households in the target area using sufficient safe water from an improved water point for drinking.

B: 19% (569HH/2.947HH) G: 65% (5.279HH/ 8.122HH)

N/A N/A B: +80% (3.028HH/ 3.054HH) G: +12% (6.557HH/ 8.418HH)

N/A N/A Household survey/spot checks/observation, volunteer monitoring reports

Indicator 1.2: % wards of target area communities declared ODF according to national standards.

50 % (18/36 wards)

N/A N/A +50% (36/36 wards)

N/A N/A Secondary data: ODF certificates (D-WASH-CC)

Indicator 1.3: % of households in tar-get area whose members wash their hands with water & soap at critical times.

36% (1.061HH/2.947HH)

N/A N/A +20% (1.710HH/3.054HH)

N/A N/A Household survey/spot checks/observation, volunteer monitoring reports

Output 1.1: Increased availability of safe and sustainable water supply for 4 VDCs of Bara district (B) and 9 VDCs of Gorkha district (G) by 2018.


Indicator 1.1.1: Number water points constructed/rehabilitated according to national standards.

0 constructed 0 rehabilitated

B: +36 constructed B: +200 rehabilitated G: +571 constructed G: +1.714 rehabili-tated

B: +135 constructed B: +600 rehabilitated

N/A N/A N/A Hydrological survey reports, de-sign documents (drawings and bills of quantity), drilling log, test pumping log, completion report with GPS data, hand-over re-port/donation certificate

Indicator 1.1.2: Number of con-structed/rehabilitated with an established water user committee.

0 B: +36 G: +40

B: +135 N/A N/A N/A NRCS monitoring tools, mem-bership records, WUC meeting records, records of funds col-lected

186

Output 1.2: Increased availability of safe and sustainable sanitation facilities for 4 VDCs in Bara district by 2018.


Indicator 1.2.1: Number of improved toilets built

0

+ 1.100 toilets

+ 1.309 toilets N/A N/A N/A NRCS volunteer monitoring re-ports

Indicator 1.2.2: Number of Child, Gen-der and Differently-abled friendly

toilets built in schools in the target area.

0 + 3 toilets + 10 toilets N/A N/A N/A NRCS volunteer monitoring re-ports

Output 1.3: 4 VDCs in Bara district have improved knowledge & skills on safe hygiene practices by 2018.


Indicator 1.3.1: Number of people trained in hygiene behavior methodology

Total: 0 Total Women: 0 Total Men: 0

Total: +60 Total Women: +38 Total Men: +22

N/A

N/A

N/A

N/A NRCS volunteer monitoring tools

Indicator 1.3.2: Number of hygiene be-havior change techniques

implemented.

0 +1 +5 N/A N/A N/A NRCS volunteer monitoring tools

Output 1.4: NRCS WASH Division and Bara district chapter/subchapters have increased capacity to implement WASH related interventions by 2018.


Indicator 1.4.1: Number of activities re-lated to evidence-based practice (EBP) NRCS engages in.

0 +1 +3 NRCS monitoring tools

Typology of activities Cfr. activities listed under section ‘Theory of Change’.

187

Operational Budget

Partners

Total NRCS 140.212 359.743 0 0 0 499.955

Total Partners: 140.212 359.743 0 0 0 499.955

Collaboration


Collaboration X 0 0 0 0 0 0



Operational Costs

1. Partner 140.212 359.743 0 0 0 499.955


Working costs 65.251 265.415 0 0 0 330.666

Personnel costs 25.582 37.000 0 0 0 62.582









4. HQ 54.349 53.961 16.115 0 0 124.425


Delegate working costs 15.013 14.625 3.947 0 0 33.585

HQ personnel costs 15.000 15.000 0 0 0 30.000

Delegate personnel costs 24.336 24.336 12.168 0 0 60.840

Total 194.561 413.704 16.115 0 0 624.380


Working costs 80.263 280.040 3.947 0 0 364.251

Personnel costs 64.918 76.336 12.168 0 0 153.422

188

Outcome 2 FA

Outcome Fiche

Outcome (English or French) : Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence-based knowledge, skills & attitudes to provide first aid to those in need by 2018, as such enhancing community level resilience and emergency care capacity.

Outcome (Nederlands): Leken, Rode Kruispersoneel- en vrijwilligers beschikken tegen 2018 over doeltreffende, meest recente en evidence-based kennis, vaardigheden en attitudes om eerste hulp te verlenen aan zij die het nodig hebben en verhogen op die manier de zelfredzaamheid van gemeenschappen.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_11_NP_DGD

Country: Nepal Is this Outcome covered by a JSF No


Local partner Nepal Red Cross Society NRCS HQ NRCS DC Saptari, Morang, N/A

Other localisation of the intervention : Kathmandu Along dangerous roads and the Mahindra highway in particular.

GPS Coordinates: Longitude: 26.66667 Latitude : 87.28333

Target population: Local communities living besides dangerous roads (the Mahindra highway in particular) in Saptari, and Morang districts of Nepal.

Number of beneficiaries: Total: 147.296 Direct: 1.296 people trained in FA. Indirect: 146.000 people reached by FARS awareness activities




Policy Marker






189

Logical Framework

A baseline exercise will be conducted after program approval to rigorously determine and update baseline and target values for each indicator. Annual numeric targets are presented as a cumulative total vis-à-vis the baseline value. Definitions are available on request.


Process indicators

Indicator 1: Number of direct beneficiaries reached through FA training.


Total: +1.296 Female: +428 Male: +868

NRCS monitoring & reporting forms

Indicator 2: Number of indirect beneficiaries reached through FA-training and RS awareness activities.

0 +73.000 +146.000 NRCS monitoring & reporting forms

Nepal Impact: Improved health, wellbeing and resilience of the target population through improved road user behavior and post-crash response by 2020.

Outcome 2: Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence-based knowledge, skills & attitudes to provide first aid to those in need and/or apply road

safety measures by 2020, as such enhancing community level resilience and emergency care capacity.

Indicator 2.1: Number of lay people with a FA certificate, registered in the NRCS FA database.

Total: 1.793 Female: 717 Male: 1.076

N/A N/A Total: +576 Female: +190 Male: +386

NRCS FA training d-base, NRCS training records

Indicator 2.2: Number of Red Cross volunteers and staff with a FA certificate, registered in the NRCS FA database.

Total: 1.994 Female: 758 Male: 1.236


NRCS FA training d-base, volunteers database, NRCS training records

Output 2.1: High quality FA & RS awareness education for different target groups is developed by 2017 and maintained.

Indicator 2.1.1: Implementation of finalized gen-der sensitive NeFAM based basic FA didactical training materials.

No

Yes

Yes NRCS FA training manual / didactical materials

Indicator 2.1.2: Number of lay people trained in FARS.



NRCS FA training database, NRCS training records

Output 2.2: NRCS has a well-functioning FA service embedded in the organization by 2020.

Indicator 2.2.1: Number of Red Cross volunteers trained and/or refreshed in FA.

0

Total:+288 Female: +96 Male: +192

Total:+672 Female: +222 Male: +386

NRCS FA training D-base, NRCS training records

Indicator 2.2.2: Number of active FA Trainers.

Total: 895 Female: 358 Male: 537



NRCS trainer database, NRCS training records

190

Output 2.3: NRCS has established a national sustainable road safety awareness network and activities in Nepal.

Indicator 2.3.1: Nr. of organizations contrib-uting resources to the road safety awareness network and/or activities in Nepal.

2, NRCS, Traffic Police

+21 Dept. of Transportation Private compa-nies/ NGOs

+33 WHO, Dept. of Roads Private compa-nies/NGOs

IEC-materials, MoUs, additional RS activities, meeting minutes, activity reports.

Indicator 2.3.2: Nr. of beneficiaries reached through FA and RS awareness activities.

0 +73.000

+146.000

Meeting/activity reports.

191

Operational Budget


Operational Costs

1. Partner 142.121 105.557 0 0 0 247.688

Investment costs 2.586 0 0 0 0 2.586

Working costs 122.530 82.894 0 0 0 205.425

Personnel costs 17.004 22.672 0 0 0 39.676









4. HQ 51.849 51.461 16.115 0 0 119.425


Delegate working costs 15.013 14.625 3.947 0 0 33.585

HQ personnel costs 12.500 12.500 0 0 0 25.000

Delegate personnel costs 24.336 24.336 12.168 0 0 60.840

Total 193.970 157.028 16.115 0 0 367.113


Working costs 137.543 97.520 3.947 0 0 239.010

Personnel costs 53.840 59.508 12.168 0 0 125.516

Partners

Total NRCS 142.121 105.557 0 0 0 247.688

Total Partners: 142.121 105.557 0 0 0 247.688

Collaboration



192

Relevance

Outcome 1 WASH

Context analysis The Government of Nepal has set a target to achieve universal coverage (100%) of water supply and sanitation by 2017. Mid 2014, water supply coverage of Nepal was 83.6% while that of sanitation reached 70.3%. 41.1% of Village Development Com-mittees (VDCs) had been declared free of open defecation (ODF).226

Water Coverage Sanitation Coverage ODF Status

2010 2014 2010 2014 2014

% % % % %

Ecological

Mountain 77.6 80.2 33.6 74.5 42.7

Hill 79.9 84.9 52.9 87.1 57.6

Terai 81.2 84.8 35.6 56.9 17.8

Nepal 80.4 83.6 43.3 70.3 41.1

Water coverage figures shield large differences in actual functionality of water infrastructure and sustainable management of water services. Effective access to water is only 40%, considering the functionality of water supply, without even accounting for water quality.227 After the 2015 earthquakes, the coverage is even lower due to damage in WASH infrastructures in 14 most affected districts. Beginning of 2016, NRCS measured 65% of households had adequate access to potable water in Gorkha district. Through the table above, it is evident the sanitation progress has been impressive, compared with that of water supply over the same period of time. The steep increase in sanitation coverage of 27% can be linked to the implementation of a National Hygiene and Sanitation Master Plan from 2011 with massive expansion of ODF campaign in the form of a social movement. The sanitation situation of the country is unevenly distributed across the development and ecological regions as well as rural and urban areas. Sanitation coverage is remarkably lower in Terai, and most problematic in 8 districts of Eastern and Central Terai. (Parsa, Bara, Rautahat, Sarlahi, Mahotari, Dhanusa, Siraha, Saptari) June 2016 figures from the Global Sanitation Fund on these districts, show low coverage in between 32% and 52%, despite special efforts being made by local authorities and its partners. Among most frequent cited reasons are strong cultural habits, political instability in 2015, poverty, high population density and the bordering location to India. Specific attention is being attributed to these 8 districts, following a Terai Conference on Sanitation held early 2014. The 2011 National Hygiene and Sanitation Master Plan will be further deepened based on the 2015 Total Sanitation Guidelines. This reflects a focus shift from basic sanitation (ODF) towards total sanitation, from sanitation infrastructure towards changing human behavior. The document outlines key hygiene and sanitation behaviors on 5 + 1 indicators.228 The 2015 WASH National Sector Development Plan clearly mentions the need for specific research on factors that hold back the prioritization of sanitation/hygiene and adapting good hygiene practices.

226 Nationwide Coverage and Functionality of WASH in Nepal, National Management Information Project, 2014 227 Nationwide Coverage and Functionality of WASH in Nepal, National Management Information Project, 2012 228 1. Use of toilets, 2. Personal Sanitation & Hygiene, 3. Access to safe water, 4. Safe use of food, 5. Clean house and environment / +1. Urban environmental sanitation

193

Beneficiaries The target group of the program is the total population living in the 4 selected VDCs of Bara district and population benefitting from rehabilitation and construction of water supply schemes in 9 VDCs of Gorkha district. VDCs have been selected by con-sidering several criteria: presence of NRCS subchapter, ODF status, coverage by other WASH actors and geographical concentration.

VDC’s Bara District 2016 Population Households

Tetariya 3.612 565

Madhurijabdi 3.458 507

Inarwamal 8.139 1.136

Tedhakatti 5.049 739

Total: 20.259 2.947

A special focus will be put on women as main responsible for the health of the family. Through improving their status, a positive leverage effect on the health of the whole family will set in. This will be achieved through the recruitment of female program staff and volunteers and women’s quota in all village level program committees.

The second group of direct beneficiaries are the NRCS volunteers. The program activities will - in large parts and with support by qualified professional staff - be implemented by Red Cross volunteers. These volunteers are recruited directly from the targeted intervention area. Acceptance by the beneficiaries is high and direct access to the target group guaranteed. The mem-bers of the district chapter committee and concerned sub-chapter committees are direct beneficiaries since the proposed program will further increase the capacity of the existing NRCS structures in order to guarantee sustainability of the program outputs, through trainings and support to income generating activities.

This brings the total number of direct beneficiaries by 2018 (1.2% annual population growth) to 20.748 persons for Bara district and 9.417 beneficiaries of rehabilitated/new water supply infrastructure in Gorkha district brings the overall total to 30.165 beneficiaries. It is important to note that for the beneficiary calculations BRC-Fl chose to count unique beneficiaries only once. However, various program activities targeted at a unique beneficiary each do have their individual cost, which means these beneficiary numbers should not be used to calculate cost per beneficiary.

Indirect beneficiaries The D-WASH-CC (25 members) especially will be in a position to divert more financial means to other VDC’s, as will the VDC’s of the program intervention area be able to divert financial means from WASH-activities to other development activities within the VDC. Without the direct intervention of the program, the geographical expansion will be promoted through sharing of tools, knowledge and success stories at district level. Local stakeholders from ‘total sanitized’ wards or VDCs can enhance dynamics in neighboring wards or VDC’s. In the long term, all VDCs of Bara District should indirectly be influenced. The volun-teers of Bara district chapter (101) can also be regarded upon as indirect beneficiaries: the achievements of the program will motivate them to carry out and participate in different Red Cross activities.

Location Following criteria have been taken in account to select the intervention district: accessibility, access to drinking water, access to sanitation, ODF-status, organizational capacity and presence of other NRCS projects/other actors. 4 districts have been pre-selected (Bara, Rautahat, Khotang, Udaypur), out of which Bara has been chosen.

Sanitation coverage in Bara is low at only 32% in June 2016. This makes Bara the lowest performing district from Nepal. Access to drinking water is 82.5%. However this figure doesn’t take into account the specific problem of the quality of the water. In the lower Terai plains, with households using water from shallow wells, there is a high rate of bacteriological contamination as well as natural presence of metals. 14% of samples taken in a study dating from 2002 showed arsenic levels higher then WHO guideline. In a second phase, 4 VDCs of Bara have been selected. These VDCs are geographically concentrated and not covered by other actors for WASH. 2 VDCs (Tetariya and Madhurijabdi) were declared ODF in May/June 2016. In these VDCs the program can start implementing post ODF activities. 2 other VDCs (Inarwamal and Tedhakatti) still have a very low sanitation coverage of 13% and 20%. (June 2016). They will have to go through the ODF process in the first intervention year. The post ODF inter-vention of other 2 VDCs will serve later as a pilot for these 2 VDCs. Moreover, because as the result of the 2015 earthquake which epicenter lay immediately east of Gorkha District many WASH facilities became inoperable and recovery is still far from being completed, the rehabilitation and construction of water supply schemes in 9 VDCs of Gorkha district will be supported.

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Local civil society, decentralized authorities, public institutions On district level, the program will be implemented under the oversight of public authorities such as the District Development

Committee (DDC), the Water supply and sanitation (sub-) division Offices (WSSD/SDO) and the D-WASH-CC. To formalize the

cooperation and coordination mechanisms, a MoU between the District Development Committee and NRCS will be signed. The

program, will involve a lot of stakeholders from:

- Civil society: water user committees, forest user groups, women groups, mother groups, cooperatives, transport asso-

ciations, waste collector groups, media, private companies and other (I)NGO’s.

- Local authorities: Local Development Officer, Water Supply and Sanitation District Office, District WASH Coordination

Committee, the Women & Children Development Office, the District Public Health Office, District Agriculture Office,

District Education Office, District Forest Office, District Disaster Management Committee, VDC Secretary and the VDC

WASH Coordination Committee

- Public institutions: police, health posts, schools, markets.

Gender The program will improve the status of women in the targeted communities. Specific attention will be awarded to inclusion of women in program trainings, workshops and in local decision making bodies. (W-WASH-CC, WUCs) Women are key in house-hold decision-making regarding all health related matters. An improvement of their status will therefore contribute significantly to an improved health status of the whole community. By the construction and rehabilitation of gender-sensitive latrines in schools that meet the hygienic and safety needs of women and girls, this intervention contributes to a female-friendly school environment that enhances attendance of girls and females. In the Terai plains, still some socio-cultural practices related to menstruation adversely affect the health and well-being of girls and women. The program will attribute specific attention to menstrual hygiene management at different levels (safe disposal in toilets, awareness against taboos and stigmas).

As described in the JCA229, the lack of toilets forces women and girls to urinate and defecate outside, mostly in darkness. This puts them at risk of physical assaults and attacks from animals. Availability and use of toilets at household level will con-tribute to the safety of women and girls.

NRCS has a gender department and a policy on gender and social inclusion. The WASH division is experienced and has main-streamed gender in its interventions. Strategies aimed at increasing gender awareness and empowerment of women will include: formalized consultations with women as part of program planning, targeting of women in health awareness and technical trainings, attention to sex-disaggregated data for baseline and reporting, gender balanced staffing, lobbying for women’s participation in local NRCS structures, construction of washing platforms and utensil dryers easing the burden of household chores, setting quotas and skills training to encourage women’s participation in WASH committees and water user groups, and ensuring recognition of women’s WASH related work.

Environment BRC-Fl is aware of the existing links between our WASH interventions and the preservation and protection of the environment:

• Water sources will be protected and latrines will be located downstream of wells, at least 30m from groundwater sources and at least 1,5m above the water table.

• Pit latrines will be fitted with concrete slabs to eliminate the need for secondary wooden slabs or supporting beams. The concrete slabs will also facilitate easy cleaning.

• Up- and down-stream impact of water use and sanitation will be considered, also its cumulative impact on a watershed. • The Nepal government developed in 2013 the Environment Friendly Local Governance Framework to encourage and

support environmental protection through local bodies. Several of the Frameworks indicators will be integrated when establishing the list of criteria for a total sanitized household, ward of VDC.

Furthermore, BRC-Fl is aware that WASH interventions are linked with the adaptation to climate change and the enhancing of community resilience. One of the key risks for Bara district is increasing severity of floods related to increasing variability of monsoon intensity (and population density). Management of water resources is listed as one of the key adaptation needs in the Government of Nepal National Adaptation Program of Action to Climate Change.

229 JCA Nepal page 25

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Outcome 2 FA

Context analysis As described in the JCA230, Nepal is facing a triple burden of diseases: communicable diseases, emerging diseases and esca-lating rise of non-communicable diseases (NCDs). In Nepal 42% of deaths are caused by NCDs. A cross-sectional study carried out in 2012-2013 found high prevalence of major risk factors (including behavioral). Only recently, attention has been given to NCDs as a public health concern among policy makers.

In 2011, a UN Economic and Social Commission for Asia and the Pacific (UNESCAP) report estimated that road traffic accidents in Nepal had increased fourfold in the last decade. According to the WHO estimates, the nr. of traffic fatalities sums up to 4.787 per year (JCA p. 25)231. Since 2002, this number has been continuously on the rise. One of the main reasons for these high fatality rates is the increased motorization of the country. In Nepal, the numbers of casualties even exceed the trend of increasing motorization. The Asian Development Bank warns: “in developing countries casualty reduction is unlikely to occur during periods of rapid motorization”.232

Almost half of the people who die in road accidents are pedestrians, cyclists, or people on scooters and motorbikes. For Nepal, very few recent data are available but serious bus accidents are often reported in the press. Males constitute the majority of casualties (83%). The accident rate seems particularly high among teenagers.233 Aside from the huge loss of lives, there is also an economic loss: the cost to countries, many of which already struggle with economic development, may be as much as 1-2% of their gross national product.234

Globally, 162 countries have a lead agency for road safety and many of them have national strategies on road safety. Nepal has neither a lead agency, nor a national road safety strategy. In line with the UN Global Action Plan 2011-2020, the Government of Nepal did, however, develop a National Road Safety Action Plan 2013-2020. This action plan, among others, puts emphasis upon collaborative inputs from all stakeholders. Several public offices are responsible for different aspects of road safety: Department of Roads (DptR), the Department of Transportation (DoT) and the Nepal (Traffic) Police. In addition, WHO is an advocate of road safety in Nepal. NRCS has started a pilot program on First Aid and Road Safety (2014-2016).

NRCS focuses on two pillars of road safety: “enhancing the behaviour of road users” and “post-crash care”, in which by 2016 it has taken the (informal) lead in Nepal in close cooperation with the Traffic Police. By doing so, NRCS contributes to several SDGs235, and SDG 3 ´Ensure healthy lives and promote well-being for target population at all ages´ in particular. Not only does the program contribute to the reduction of the number of global deaths and injuries from road traffic accidents (3.6), also First Aid contributes to adequately respond to other accidents or non-communicable diseases as well as (symptoms of) communi-cable diseases, such as dehydration, hypothermia or fever.

Beneficiaries Within the program, the first aid activities target Red Cross volunteers from local communities and specific groups of road users (lay people) such as school children, teachers, traffic police and female community health workers. These stakeholders benefit directly from diverse FA-trainings and/or FA-equipment. In order to roll out the finalized gender sensitive NeFAM (Nepal First Aid Materials) based basic FA didactical training materials in Nepal, NRCS staff and volunteers will also benefit from regional

workshops and FA Training of Trainers (ToT). The total number of direct beneficiaries of this program is 1.296.

Indirect beneficiaries Within this program, the road safety awareness activities will reach the larger general public in Nepal. Populations vulnerable to road accidents will be targeted in their communities, at district level as well as at national level through TV and radio spots, RS folders, hoarding boards and banners, reflecting RS stickers, rallies, celebration of WFA, RC and NRCS day, FA-simulations, RS education classes for school children and RS awareness sessions for communities. Road safety awareness activities will be implemented at national level through radio and TV and by organizing national stakeholder meetings. Other RS-activities will be held in the intervention districts. Road traffic week will be held in six districts where people are vulnerable to road accidents. These districts will be selected from the 14 districts involved in road safety in the pilot program (2014-2016) and will (partially) differ from year to year. Also, the number of persons that received basic FA after having been injured in a road accident in the program area is counted as indirect beneficiaries. The number of indirect beneficiaries of this program is 146.000.A-activities will be implemented in the districts Saptari and Morang in the South-Eastern lowland of Nepal. The selected program interven-tion area, along the Mahendra Highway (also called the East-West Highway), is densely populated. Biratnagar, in Morang district, is also the second largest city in Nepal after Kathmandu. Local communities reside directly by a highway and other busy

230 JCA Nepal, page 21 231 Last WHO-report: 4.713 estimated deaths of which 1.744 reported. http://www.who.int/violence_injury_prevention/road_safety_sta-tus/2015/Country_profiles_combined_GSRRS2015_2.pdf?ua=1 (p188). 232 Asian Development Bank, Road Safety Action Plans and Programs 233 http://www.irinnews.org/report/95960/NEPAL-Road-traffic-accidents-on-the-rise 234 WHO, Data systems, a road safety manual for decision makers and practitioners, 2010, V. 235 Amongst whom as well SDG 1, 5 and 8

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roads used, leading to a high number of traffic accidents, injuries and deaths in these districts (150 deaths in these 4 districts combined in 2015 according to the Nepal Police).

Local civil society, decentralized authorities, public institutions The Nepal Red Cross Society is auxiliary to the Government of Nepal. As such, in the pilot First Aid/Road Safety (FARS)-program 2014-2016, NRCS has signed a MoU with the Nepal Police, in which it is agreed to jointly work on road safety in Nepal. Within the proposed intervention, NRCS will work within the existing MoU. The MoU enhances the coordination between the two organizations at national as well as district level. Also, training in First Aid will be provided to different government staff, such as female community health volunteers as well as traffic police, armed police and possibly a few army personnel as well as other key stakeholders in road safety, such as teachers, bus drivers and ambulance drivers. Both, GoN as well as NRCS will learn and benefit from each other´s expertise and resources as well as work together to institutionalize successful ways of working to-gether. As described in the Joint Context Analysis (JCA)236, as the various aspects of road safety are dispersed among different ministries and departments, it unavoidably involves inter-sectorial coordination of road safety stakeholders within and outside the Government of Nepal. By training numerous stakeholders of road safety in first aid, the Nepalese population will have better access to health providers in post-crash situations. Civil society participation in health care delivery in Nepal has been identified as the least costly but most effective means for improving population health. NRCS not only mobilizes human resources to provide first aid, but also ensures community participation through many different social awareness campaigns on first aid and road safety. Local businesses will be actively approached to support these campaigns (e.g. by funding the printing of RS-folders developed in 2016).

Gender The NeFAM-based didactical training materials rolled out by this intervention are sensitive for the specific needs of women and girls as receivers and givers of First Aid. Attention is drawn upon specific situations encountered by women such as giving birth without medical assistance. Full body mannequins are used to fit the conveniences of women and girls who might feel awkward having to practice FA on actual human (male) bodies. The First Aid Policy and the FA-Division of NRCS strive for gender equity in its trainings. The selection of female participation in trainings is prioritized237: at least 1 out of 3 participants should be female. In 2012 on average 40% of the participants of trainings in the First Aid Response in Emergencies (FARE)-program were women. Participation of women in the FARS-curriculum was also relatively high. Training of trainers or advanced FA trainings typically have less female participants, since the selection of participants is a process mostly organized at district level. To remedy this problem, the FA-division has organized two Trainings of Trainers exclusively for female participants in the past. With regard to training of participants of external organisations like the Nepal Police, a minimum required participation of women will be set and trainings of community health volunteers will all be female.

Environment Our intervention aims to support NRCS in giving high-quality FA training sessions to staff, volunteers and community-members in order to increase their self-reliance and as such have increased abilities to ‘bounce back’ when hit by sudden emergency. Though this intervention targets road safety, community resilience through FA will also be of particular importance to deal with the increased volatility of the occurrence of extreme climatological events and natural disasters brought by climate change. Though road safety addresses climate change, it does so particularly through pillar 3 ´Safer vehicles´ (new or better maintained, hence cleaner vehicles), which is not part of this program. This matter can be addressed under ´complementarity´ by the De-partment of Transport and private companies. Within this intervention we will advocate for this. Furthermore, we will apply following measures to lower the impact of our proposed FARS-program on the environment: • FA manuals are sustainable manuals that suffice during and after a FA-training. All are printed double sided. • Presentations during a training are projected on the wall and not printed on paper. • FA-materials used in a training are mostly reusable in next trainings. • Trainings will be provided locally as much as possible to reduce travelling. • Intervention areas (districts) are selected nearby each other to reduce traveling and related pollution.

Relevance according other DGD priorities

Human Rights As described in Annex 4, a rights based mindset has always been present in the work of the Red Cross Movement. Our WASH and FA interventions are responding to the needs of the most vulnerable, and is as such aiming for rights-holders to claim their rights under Article 25 of the Universal Declaration of Human Rights : “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, […].” Another approach to operationalize this mindset, is our Human-itarian Diplomacy. By the auxiliary role NRCS has to the public authorities of Nepal, their privileged access and relationship to the government and policy makers is a leverage for addressing specific issues related to our domain of intervention and con-tributes to the capacities of ‘duty bearers’ to meet their obligations. In Nepal, traditionally vulnerable for discriminating against women, girls and lower caste population, humanitarian diplomacy at intervention level will focus on guaranteeing results ‘for all’. In the FA intervention, NRCS will work in close coordination with the Nepal Traffic Police, strengthening the advocacy for

236 JCA Nepal, page 31 237 NRCS First Aid Policy, amended in 2008, Annex 5 “FA trainer selection system”, p. 39.

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road safety initiatives among governmental and non-governmental stakeholders. In addition, NRCS will continue to assure that NRCS´s FA-curriculum is acknowledged by GoN and it should be included in the regular school curricula in Nepal with NRCS able to provide the FA ToTs to school teachers.

Digitalization BRC-Fl uses digital technologies as enabling tools to enlarge the impact of our interventions. In the field of FA specifically, BRC-Fl has supported NRCS in the set-up and maintenance of a FA database at HQ level. This helps NRCS to efficiently process and manage their FA-services and volunteers. In addition, BRC-Fl will look into supporting NRCS with setting up mobile data collection for a baseline and evaluation of the FA-program.

Also in the field of WASH, BRC-Fl supports the use of mobile data collection tools for timely, accurate and cost-efficient moni-toring. Survey data can be processed more quickly and efficiently and the risk for errors is reduced. Mobile data collection allows NRCS to assign GPS-locations to water sources and WASH infrastructures and permits BRC-Fl to have a real-time over-view and geographical mapping on the field work, as obtained data are uploaded on a regular basis. As such, quickly readjusting in case of problems, is possible. In Nepal, Open Data Kit (ODK) will be used in order to conduct household surveys to set up a baseline and to measure Outcomes.

In addition, BRC-Fl will look into supporting NRCS with the use of satellite images as part of its evaluation strategy of its WASH intervention. These analyses would be done using the freeware Quantum GIS (QGIS). A basic GIS training will be given to the BRC-Fl Country Representative in order to be able to perform the basic analysis of the geodata, as well as to NRCS staff and volunteers involved with primary data collection. On social media, it is the ambition of the WASH program and the Bara district chapter to use social media to share its interven-tions and to raise awareness. Depending on the behavior barriers, identified through the RANAS (Risk, Attitudes, Norms, Abilities and Self-regulation) baseline, social media can be identified as an appropriate channel to target layers of the popula-tion. Equally, RS-awareness materials are being disseminated through Youtube and Facebook in order to reach broader

audiences.

Decent Work Through increasing the quality and quantity of first aid trainings and commercial first aid services tailored to hazardous occu-pations, BRC-Fl and NRCS contribute to improve Occupational, Health & Safety (OSH), a core element of Decent Work and the ILO Decent Work Agenda. For details on the link between FA and Decent Work, we refer to Annex 3 of the program.

Effectiveness

First of all, two aspects make the intervention in Nepal BRC-Fl-specific:

1. Working with volunteers Volunteers form the backbone of NRCS. Investing in volunteers through skill and knowledge development ensures effective implementation of NRCS’s goal to assist the most vulnerable within Nepal. A major strength of Red Cross volunteers is their embedding within local communities, which enables NRCS to be a first responder in case of sickness, injury or threat. In Nepal, where access to medical care is limited, the presence of Red Cross volunteers with knowledge of the correct first aid techniques, is therefore a key mitigating factor to reduce mortality and morbidity due to sudden illness or injury. Moreover, community-based volunteers aid NRCS to achieve a correct use and maintenance of water and sanitation infrastructures. The close con-nection between the NRCS volunteers and the community, to which the volunteers belong themselves, is a key element for behavioral changes to be accepted in the very traditional societies and groups from the Terai plains.

2. Our “Evidence-based Practice” To ensure that all activities are based on scientific evidence, is a core principle within BRC-Fl. To assist in this endeavor, BRC-Fl created the Centre for Evidence-Based Practice (CEBaP) 10 years ago. This research centre uses an internationally recognized methodology to collect, systematize and evaluate relevant scientific evidence to underpin our activities. When insufficient evi-dence is available, primary research to support our core activities is conducted – for instance, research on FA knowledge and skills retention in Nepal or on behavior change factors for WASH interventions in Malawi.

CEBaP developed evidence-based FA guidelines and materials for the African continent, India and Nepal (NeFAM), which will be used in all our FA programs, including the one in Nepal (NeFAM). Based on evidence summaries developed by CEBaP, a panel of regional/local experts developed first aid guidelines, taking the preferences of the target group(s) into consideration. These guidelines were then used to develop educational first aid materials such as handbooks, posters, exercise books etc.

In the field of WASH, the evidence-based way of working is implemented since 2015 through the partnership between BRC-Fl and Professor H.J. Mosler of the EAWAG University in Zurich. Through this cooperation, BRC-Fl has introduced the RANAS (Risks, Attitudes, Norms, Abilities & Self-Regulation) approach where evidence-based research assists the program in learning which elements define certain behaviors, and subsequently identify specific interventions targeting these behaviors which are needed to change. It is the objective of BRC-Fl to assimilate this technique and to systematically use it in all its WASH programs,

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including in Nepal. In order to position itself in this sector, CEBaP is also performing systematic reviews in the field of behavior change and WASH.

CEBaP is recognized as an IFRC Reference Centre and aims to further develop into the Red Cross Research Centre, providing its services within the RC movement. These services are also provided to non-RC partners (for example, CEBaP has performed an evidence search on the contamination of drinking water by fluoride in Senegal, for the Belgian Technical Cooperation). All primary and secondary research by CEBaP is being published in peer reviewed journals. Furthermore, through its link with CEBAM, the Belgian Centre of Evidence-Based Medicine and the Belgian Cochrane Centre, CEBaP is in the process of being accredited in evidence-based guideline development according to the Cochrane methodology 238.

Outcome 1 WASH

Intervention strategy The program aims at improving health status of the po of Bara district by improving total sanitation status of 4 VDC’s and by enhancing a further scale up of the ‘sanitation momentum’ in the district. As such, this program contributes to the SDGs 3, 5, 6 and 13.

Total sanitation status is awarded based on a government promulgated 5 + 1 indicators. The program supports reaching this status by its 3 main results: improved access (quantity & quality) to safe sanitation, improved access (quantity & quality) to safe water and acquired & sustained behavior change for safe hygiene. In order to reach large scale effects, expandable to other VDC’s in the district, the program will aim to achieve its targets with minimum investments maximizing local financing, local solutions and local motivation/dynamics towards behavior change. Strategies have been developed to tackle two main barriers towards total sanitation observed: lack of infrastructure and inappropriate behavior:

The main financial principle of the program is “local finance first”. The program will work towards models in which investment costs are covered as much as possible through local funding sources, using local solutions. Operation and maintenance costs are always paid through local financing instruments. Household level type WASH-investments, such as household latrines, water filters, soak away pits etc, are promoted through a ‘social marketing’ approach. This approach uses household visits and campaigning methods by the Red Cross volunteers to enhance demand. Only those households who lack the financial capacity to procure the necessary materials are supported through low cost investments.

Evidence-based behavior change using the RANAS approach. During the baseline study, main obstacles and barriers for behavior change will be studied. Analysis of these behavioral factors will make it possible to identify specific behavior change techniques to enhance behavior change.

Principle of ‘awarding’: Handing out prizes and awards is a traditional practice in the Nepalese society and is also used by NRCS in its programs. Initially awards will be attributed to so-called sanitation champions, these are persons complying stand-ard indicators with capacities to inspire and motivate fellow community members to improve sanitation status.

Outcome 2 FA

Intervention strategy This First Aid and Road Safety program will contribute to a better health status (SDG 3) in the targeted areas through various approaches. NRCS will build up its own and its volunteers´ capacity as well as the capacity of local communities to effectively respond to road accidents through enhanced local post-crash coordination and First Aid services. Additionally, NRCS will posi-tion itself to raise awareness among policy makers, road safety stakeholders and the general public and develop road safety awareness in the local ‘highway-communities’ and schools in the intervention area. Lay people from the communities will be trained in FA and properly registered in the FA d-base of NRCS.

Therefore, high quality FA education for different target groups will be further developed and rolled out by 2017. In order to do so, implementation of finalized gender sensitive NeFAM based basic FA didactical training materials should be rolled out over Nepal in 2017. In order to do this, NRCS will keep investing in a well-functioning FA service embedded in the organization. Thus, NRCS needs to have sufficient qualified FA-trainers as well as volunteers trained, refreshed in FA, which can be mobilized well equipped. Also, NRCS will continue its diplomacy activities to strengthen its position and the role of FA in Nepal.

In addition to typical FA-activities, the FA-division of NRCS works on establishing a national sustainable road safety awareness network and activities in Nepal that are both effective and sustainable. Therefore, it is important that a number of organizations contribute resources to the road safety awareness network and/or activities in Nepal and activities reach a high number of indirect beneficiaries through high quality FA and RS awareness materials.


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Sustainability

Outcome 1 WASH

Technical sustainability: • The materials and suppliers used for deepwells, bio sand filters are locally available and are long-lasting. • The intervention is risk-informed, i.e. that potential risks, such as natural and technological hazards, are being taken

into account in the design and implementation of the program. E.g. The program will motivate the community to raise the plinth level of their toilet to keep them safe from flood water, and so that floods cannot contaminate the ground water. These measures protect the water resources in the target areas.

• An operational structure (e.g. water user committees, school toilet management committees) that has the necessary skills and knowledge to deal with foreseen and unforeseen technical knowledge, will be installed.

Social sustainability: • The intervention of BRC-Fl aims at enhancing sustainable behavioral change. NRCS works with volunteers that are

embedded in the selected intervention zones and have a large capacity to enhance the local ownership of the inter-vention. These volunteers will remain in the communities after the intervention and will have been strengthened technically and socially in their capacity as local leaders.

• The infrastructure installed answers to the requirements and demands of local legislation and is therefore enforced by local authorities. A monitoring mechanism will be set in place to monitor sanitation status of awarded wards and VDCs and to sanction possible decline in sanitation.

• It is evident that impact of a total sanitized will impact positively to all, which will be a sustainable driver to maintain the status of the community. The 5th element of the RANAS model (Self Regulation) pays explicit attention to planning and self-monitoring strategies preventing relapse of behavior elements.

Financial sustainability: • The principle of ‘local finance first’ and the choice for local solutions should enhance financial sustainability. • In the development of the district and VDC Post ODF plans, NRCS will plead for specific allocations to be granted for

total sanitation (more specific than the general WASH allocation) in the district and VDC annual budgets

• District chapter and subchapters will be supported to start income generating activities. These will provide with an income to run activities after the program intervention period.

Exit Strategy: Above mentioned elements on technical, social and financial sustainability all contribute towards durable results in the com-munity. Achievement of these will smoothen the exit of the program. Continued presence of the subchapter and the chapter, having been involved in all program activities, will guarantee a continued follow up of results through local authorities and by using the own volunteer network.

Outcome 2 FA

Technical sustainability: • The intervention of BRC-Fl aims at enforcing the institutional capacity of NRCS by embedding a well-functioning FA

service into the organization that can anchor the delivery and training of FA. This is done by supporting the manage-ment of the first aid service, the volunteer management and organizational development.

• BRC-Fl has supported NRCS in the development of technical capacities for nearly two decades and all above men-tioned components have been covered. What remains essential is the roll out of the gender-sensitive NeFAM training materials in 2017.

Financial sustainability: • BRC-Fl has supported NRCS over the years in delivering high quality commercial First Aid services. This helps NRCS

in increasing their market share and revenue, which will be reinvested in the FA service. As such, financial autonomy is enhanced and dependence on external donors decreased.

• Saptari and Morang district were already intervention zones of the FARS program since mid 2015. Activities will con-tinue here though program staff will shift to the adjoining Sunsari and Jhapa districts in 2017. In this manner the previous program activities in Saptari and Morang can continue in a cost efficient manner.

• In addition, BRC-Fl has supported NRCS in the development of road safety awareness materials and road safety education classes together with the Traffic Police. Both offer income generating opportunities. Also, NRCS profiling itself within the road safety sector as such offers access to new donors.

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Social Sustainability: • NRCS works with volunteers that are embedded in the selected intervention zones and have a large capacity to

enhance the local ownership of the intervention. These volunteers do not depend on funding from BRC-Fl. The capacity building achieved in those volunteers by the BRC-Fl intervention, will remain after funding is withdrawn.

Exit Strategy: The intervention strategy of this program itself aims to support NRCS in strengthening the existing portfolio of the FA-division while preparing for the exit of BRC-Fl from program support to FA in Nepal. While previous programs focused on developing new FA-components, such as policies and strategies; CoFa; didactics; standardized curricula, this program focuses on the strengthening of these components that have been designed over the past two decades. Hence, the focus does not lie on bringing new technical expertise, but rolling out NeFAM nationally; training and refreshing volunteers and staff beyond merely the intervention districts and supporting NRCS in the retention of its existing volunteer base. Hence, the intervention/exit strat-egy focuses on strengthening the FA-division to assure a strong core portfolio when BRC-Fl exits. In addition, the FA-division of NRCS will further profile itself as the informal lead in Road Safety in Nepal, which offers new income generating activities and possible donors to work with.

Efficiency

Delegation

A BRC-Fl Delegate will be based in Kathmandu in order to assist NRCS with implementation of this program. The main tasks of this delegate are to cooperate closely with NRCS, both at central level and in the program area. The delegate assists NRCS on a managerial and on a technical level – managerial in order to achieve a timely, effective and efficient implementation, and on a technical level, to ensure impact and sustainability. Its close proximity to the implementing partner allows for direct input to achieve the Outcomes and outputs, whilst building the capacities of the implementing partner, both at a personnel and insti-tutional level. The delegate is further supported in its role by the BRC-Fl experts at headquarters, whom provide expert-input regarding managerial (Monitoring & Evaluation, Finance, Project management) and technical (First Aid and WASH) aspects.

Outcome 1 WASH

The cost-efficiency case for water, sanitation and hygiene (WASH) is widely recognized. The World Health Organization (WHO) estimates that for every US$1 invested in water and sanitation, there is an economic return of US$4 by keeping people healthy and productive239. The World Bank equally stated that hygiene promotion is one of the most cost-effective health interven-tions240.

1. Investment costs

In line with the activities for the Outcome, 38.987 EUR, 36% of the investment budget is allocated to purchasing immovable construction materials for water points. 38.793 EUR, 36% of the investment budget is used for construction of school toilets. Other major investments are IT-materials and 2 motorbikes.

2. Working costs

General working costs are mainly 5.378 EUR (4% of the workings costs budget) for utilities, transportation, communication and stationery and 6.654 EUR (5%) for institutional support within the program. Increased availability of safe and sustainable water supply and sanitation facilities (materials and labor) are key activities to facilitate achieve the Outcome, totaling 50.069 EUR, 38% of the working costs. Since change of behavior is also a key objective for achieving the Outcome, costs for general awareness raising and conduction of specific behavior change techniques also represent a significant part of the working costs budget (43.218 EUR, 33%).

3. Personnel costs

Local personnel NRCS

The local personnel team of NRCS consists during 2 years out of 1 program officer (1 FTE) and support staff (account officer (0,5 FTE), 3 district staff (2,5 FTE), junior engineer (1FTE for 2 years) and 4 VDC staff (4FTE)).

Expat personnel BRC-Fl

Outcome 1 and 2 are supported by one full-time BRC-Fl delegate based in Kathmandu. The salary budget consists out of salary costs for the duration of the program and is shared amongst both Outcomes. Other costs like accommodation, transport costs and other operational costs are taken within the general working costs.

HQ personnel BRC-Fl

The intervention is supported by a technical WASH expert based in Mechelen (Belgium). The budget comprises of personnel & travel costs (0,08 FTE for Nepal). This HQ WASH focal point safeguards the quality by providing technical expertise directly or by linking BRC-Fl CEBaP to NRCS. Examples are carrying out or facilitating specific short-term technical missions on behavioral change techniques within hygiene promotion.

239 Hutton G (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage, p4. WHO, Geneva, Switzerland. 240 Jamison et al. (eds) (2006). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank

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Outcome 2 FA

According to a World Bank study241, training first-responders in first aid is an extremely cost-effective intervention; it’s among the most neglected low-cost opportunities in middle- and low-income countries. First aid educations costs 8US$ per disability-adjusted life year averted (DALY)242. This makes First Aid Education one of the most cost-efficient ways to improve public health in developing countries. Civil society participation in health care delivery in Nepal was also proposed as the least costly but most effective means for improving population health243.

1. Investment costs

In line with the activities for the Outcome, 2.069 EUR, 80% of the investment budget is allocated to purchasing IT-materials for NRCS to be able to implement the activities.

2. Working costs

General working costs are mainly 4.919 EUR allocated for the district chapters running costs and transport in the districts, and 17.683 EUR for the NRCS HQ for transport, monitoring and indirect costs in particular, totaling to 11% of the total working costs. Since FA-training is a key activity for achieving the Outcome, training is the most significant part of the working costs budget (96.293 EUR, 47%). Also, FA kits and materials and FA train-ing materials and equipment are purchased. Another 26.052 EUR (13%) is allocated for road safety related and coordination activities.

3. Personnel costs

Local personnel NRCS

The local personnel team of NRCS consists out of 1 program manager (0,25 FTE – 21 months), 1 program coordinator (1 FTE – 21 months) 1 account officer (0,5 FTE – 21 months) and 2 field officers (2 FTE – 21 months)

Expat personnel BRC-Fl

Outcome 1 and 2 are supported by one full-time BRC-Fl delegate based in Kathmandu. The salary budget consists out of salary costs for the duration of the program and is shared amongst both Outcomes. Other costs like accommodation, transport costs and other operational costs are taken within the general working costs.

HQ personnel BRC-Fl

The intervention is supported by a technical First Aid expert based in Mechelen (Belgium). The budget comprises of personnel & travel costs (0,06 FTE for Nepal). This HQ FA focal point safeguards the quality by providing technical expertise directly or by linking the BRC-Fl national First Aid unit and CEBaP to NRCS. Examples are carrying out or facilitating specific short-term technical missions on didactical expertise FA, simulation exercise, assist in profitability analysis CoFa NRCS.

Partnership

Policy

BRC-Fl always operates within the partnership framework of the International Red Cross & Red Crescent Movement and works with the National Red Cross or Red Crescent Society as sole preferential partner. Principles of cooperation and capacity building are Movement-wide formalized in the IFRC ‘Development Cooperation Policy (2007)’ , the ‘National Society Development Frame-

work (2013)’ & the ‘Code of Good Partnership’. All Red Cross partners in this program are strategic partners, meaning common objectives are defined and where the focus lies on capacity building and transferring technical expertise to the partner to implement quality services to the most vulnerable within the thematic priorities of BRC-Fl (WASH and FA).

NRCS

Established on September 4th, 1963, with the objective of reducing human suffering without discrimination on any ground, NRCS was recognized by the International Committee of the Red Cross (ICRC) on October 1, 1964. Over the years, NRCS has grown to be the largest humanitarian organization in Nepal with a nationwide network, run by more than 90.000 active volun-teers. NRCS is an independent, volunteer based and non-profit humanitarian organization that delivers humanitarian services and support to the most vulnerable in Nepal in an impartial and neutral manner. It carries out its services through the district chapters and sub-chapters in all 75 districts of the country. The scope ranges from WASH, health, HIV/Aids, First Aid to disaster preparedness and promotion of humanitarian values. Currently, the seventh NRCS Development Plan 2016-2020 is in force. It states health service as one of its focal areas.

Outcome 1 WASH NRCS has more than 30 years of experience in improving the health of the most vulnerable through water and sanitation interventions. Nepal Red Cross is recognised as a major implementer of WASH-programs in vulnerable and remote communi-ties across Nepal by the public authorities as well as other development actors. The organisation is a member of the National

241 Ibid. 242 DALY is a generic measure of disease burden, including both the quality and the quantity of life lived. It is used in eco-nomic evaluation to assess the value for money of medical interventions. 243 Joint Context Analysis Nepal, paragraph 4.1.1, page 28.

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WASH Coordination Committee, and has strong and long-term partnerships with national level WASH stakeholders such as the responsible Ministries as well as UN agencies and international NGOs. NRCS is member of the National Sanitation and Hygiene Steering Committee (NSHSC), as well as from decentralized WASH-bodies, such as the District and VDC WASH Coordination Committees. NRCS has its own Drinking Water and Sanitation Policy that dates from 2003 and was revised in 2009. This policy ensures consistency in all activities related to WASH carried out by NRCS. It also mandates to cover related areas as environment protection, food hygiene and WASH in emergencies. Currently, NRCS is guided by its 7th Development Plan 2016-2020. Specific for WASH, the scope has been broadened by including WASH Disaster Risk Reduction, innovative urban sanitation technologies and emergency WASH as to be covered.

Outcome 2 FA First Aid has been an integral activity of NRCS since its inception in 1963. Given the difficult topography, limited transport facilities and inadequate health infrastructure, First Aid services are often needed and practiced by urban and rural populations alike. The ongoing political unrest in Nepal has also demanded a prompt response, which in turn contributed to build the image and credibility of NRCS. In order to increase the access of first aid activities throughout the country and to different target groups, NRCS has been implementing different first aid activities: • Community Based Health and First Aid (CBHFA) assisting targeted communities to improve their health status and build

their capacities to manage basic health problems; • Emergency First Aid program (EFA), specifically designed to assist the victims of the ten year long armed conflict; • In 2010, NRCS started offering First Aid trainings to external organizations through its Commercial First Aid program (CoFA).

Already in 2012 a total of 45 trainings were organized to UN-agencies, bilateral development agencies, companies and (I)NGO’s;

Capacity building

Outcome 1 WASH The BRC-Fl delegation in Nepal monitors the programs and gives quality feed-back and technical back-up to the NRCS WASH-team. Over the past programs, NRCS has developed enhanced capacities to run interventions successfully, mainly community-based WASH (such as CLTS, Community Led Total Sanitation), school sanitation and emergency WASH.

In this program, BRC-Fl will specifically support to introduce and strengthen capacities for evidence-based behavior change communication. Identifying key behavior factors using the RANAS approach (see also ‘intervention strategy’) will enable NRCS to update and fine-tune its existing approaches for total sanitation. NRCS will be able to better adapt its intervention to local context and challenges. Fully in line with national WASH priorities, NRCS can become one of the lead agencies to implement post ODF total sanitation interventions. This equals a shift from a conventional awareness raising approach to a behavior change approach.

At district, VDC and community level, volunteers and staff will be trained and equipped to run activities at community level and to monitor program activities. The district chapter and subchapter will be supported through a specific organizational devel-opment training and through startup of income generating activities.

Outcome 2 FA BRC-Fl has built the capacity of the FA-division NRCS for more than a decade, FA-curricula have been standardized all over the country which has led to government approval. Also, different standardized curricula have been developed, e.g. school FA and FARS. M&E tools of FA-trainings have been standardized; a didactics manual for the FA ToT has been developed; the FA-database has been developed and maintained, input has been provided to FA/policies and strategies; resource support to the FA-division as well as district chapters and volunteers; development of regional coordination mechanisms of FA activities; development of staff capacities. Currently the FA-manual is being developed into evidence-based. In the new proposed FA-program capacity building mostly involves the national roll out of NeFAM training materials, training of the NRCS volunteer base and resource support to volunteers and the FA-division.

Delegation The delegate assists NRCS not only on a managerial but also on a technical level to ensure impact and sustainability. Its close proximity to the implementing partner allows for direct input to achieve the program Outcomes and outputs, whilst building the capacities of the implementing partner, to increase the knowledge and skills required to do so, both at a personnel (staff development) and institutional level (systems, structures).

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BRC-Fl actively explored on possibilities for formal synergies with Handicap International (WASH accessibility, targeting of vul-nerable groups, first aid, trauma protocols) and Wereldsolidariteit NGO (occupational First Aid). However, as mentioned in the JCA on page 51, NRCS is currently not allowed to partner with NGO’s functioning under the Social Welfare Council umbrella, due to an ongoing administrative issue. Informal contacts have been established.

Outcome 1 WASH

Synergy At district level, a synergy between the district authorities and the program will be formalized through a Memorandum of Understanding between NRCS district chapter and the District Development Committee. (DDC) This MoU will include the mechanisms of the allocation of financial support, the geographic program areas and responsibilities of each party. This ensures bringing together capacities to mobilize, influence the community, cost-sharing arrangements and avoiding duplication.

Complementarities Other Partner National Societies (Australian RC, British RC, Danish RC, Finnish RC) from the International Red Cross and Red Crescent Movement are supporting NRCS. Coordination and communication is assured through bi-monthly PNS meetings. All PNS are complementary in their mission to strengthen the National Red Cross Society of Nepal. On the level of the WASH Division, the intervention will be complementary to an intervention from the Community Resilience Division (both under Community Development Department). There will be exchange and mutual learning opportunities with this intervention, sup-ported by Finnish Red Cross in the neighboring Rautahat district.

The intervention will be complementary to many actors at district level in Bara. All of them are brought together in the D-WASH-CC and V-WASH-CC. Agreements on common approaches, exchange of information and coordination of intervention areas will ensure complementarity of different actors. Currently, BRC-Fl has established relation with 2 other main actors at district level: UN-Habitat (Global Sanitation Fund) and SNV. At VDC level, the program will work in cooperation with all the V-WASH-CC members and other major stakeholders such as schools, mother groups and forest user groups.

Outcome 2 FA

Synergy Since this proposed FA-program is an exit strategy for BRC-Fl with regard to FA and road safety in particular, the objective is to find another organization to support NRCS in taking the informal lead in road safety. The World Health Organisation is the most likely to offer support in the future. As such, including WHO in the road safety network of Nepal through financial support of road safety activities is an objective of the exit strategy in this proposed program.

WHO will be approached to provide funding for road safety awareness activities at national and district level in order to keep road safety on the agenda of GoN and to intensify coordination between stakeholders. In order to do so, a minimum budget of ± 20.000 euro per year would be needed sustain national coordination, a yearly Traffic Week in a considerable number of districts and provide adequate materials as well as national broadcasting of road safety TV and radio clips. Moreover, NRCS has signed a MoU with the Nepal Police, in which it is agreed to jointly work on road safety in Nepal.

Complementarities In the newly proposed program we intend to include the Department of Roads and the Department of Transportation as well as private companies in the Road Safety Network Nepal. NRCS will also advocate with the department of transportation and private companies for pillar 3 ´Safer vehicles´ of Road Safety, to contribute to a better environment.

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Rwanda Improved community resilience in Karongi and Rutsiro district and enhanced organiza-tional first aid capacity

2017-2021

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Samenvatting

‘Rode Kruis-Vlaanderen (RKV) helpt helpen’ is de slogan die het 17-21 programma in Rwanda samenvat. Enerzijds verwijst dit naar de focus op zelfredzaamheid, anderzijds naar de focus op impact. Mensen zelfredzaam maken is de manier bij uitstek om een duurzame impact te hebben. Zowel RKV’s interventiestrategie als de keuze van activiteiten in Rwanda zijn gebaseerd op het idee van zelfredzaamheid.

RKV’s interventiestrategie heeft als kernprincipe dat de implementatie van het programma geleid en gedragen, wordt door de lokale Rode Kruis vereniging en haar vrijwilligers. RKV neemt een ondersteunende rol op zich maar zal zelf geen directe imple-mentatie doen. Het 17-21 programma, met een totaalbudget van 1.166,990EUR wordt dan ook getrokken door Rwanda Red Cross Society (RRCS). Het programma is op vraag van en in nauwe samenwerking met RRCS opgesteld. RRCS is ook de grootste nationale humanitaire organisatie van Rwanda en is actief in het hele land. Het programma in Rwanda is opgebouwd uit de twee thematische specialisaties van RKV: water, sanitatie & hygiëne (WASH) en eerstehulponderricht. Beide interventies houden rekening met de prioriteiten van de Belgische ontwikkelingssamenwerking rond gender, milieu en klimaat, mensenrechten, digitale innovatie en waardig werk.

WASH Ondanks grote stappen voorwaarts, blijft de het WASH aanbod in Rwanda momenteel ontoereikend om de noden van de meest kwetsbaren te beantwoorden, vooral in afgelegen gebieden. De duurzaamheid van de beschikbare infrastructuren is vaak ook te laag, mede door een gebrek in human resources op het gebied van planning, management en onderhoud. Vrou-wen, die vaak verantwoordelijk zijn voor taken rond water in het huishouden, worden bijzonder hard getroffen. Het programma van RKV beoogt daarom om 3.320 begunstigden binnen de districten Karongi en Rutsiro te voorzien van voldoende en veilige water- en sanitatievoorzieningen. Dit doen we door het rehabiliteren van bestaande gravity-flow schema’s waarop 10 water-punten worden geïnstalleerd. Daarnaast worden 4 scholen uitgerust met gender-sensitieve ecosan-toiletten die tegemoet komen aan de noden van meisjes rond privacy en hygiëne, vooral tijdens hun maandelijkse menstruatieperiode.

Hoewel adequate en toegankelijke infrastructuur essentieel is, is de impact beperkt wanneer toegang niet gekoppeld is aan gedragsverandering. Naast het oprichten van 10 Water Point Management Committees die instaan voor een correct gebruik en onderhoud van het waterpunt, zullen elementen uit de Participatory Hygiene and Sanitation Transformation (PHAST) aanpak

worden aangewend om het bewustzijn van de lokale bevolking rond toiletgebruik te verhogen. 300 van de meest kwetsbare gezinnen zullen via de distributie van sanplats worden aangezet om een eenvoudige latrine te bouwen, waarna ze op hun beurt andere gezinnen ervan overtuigen hetzelfde te doen. Rode Kruis-Vlaanderen heeft via haar “Center for Evidence-Based Practice” (CEBaP) de nodige expertise in huis rond methodes die leiden tot effectieve gedragsverandering. RRCS-vrijwilligers zullen dan ook worden opgeleid in deze sensibilisatiemethodes alvorens te worden ingezet in de betrokken districten om via een cascade-effect een totaal van 5.838 begunstigden te bereiken.

Binnen de scholen zal gewerkt worden met Children’s Hygiene and Sanitation Training (CHAST). RRCS kan rekenen op een jarenlange ervaring in het werken met deze methodologie. De expertise die hierrond werd opgebouwd zal gedeeld worden met VVOB, die binnen hun interventiedomein de participatie van meisjes in de laatste jaren van het lager onderwijs wil verho-gen.

Het economisch rendement van een WASH-interventie is groot: de Wereldgezondheidsorganisatie berekende dat er voor elke US$ geïnvesteerd in WASH, een economisch rendement van 4 US$ wordt gegenereerd244. Daarnaast verklaart ook de Wereld-bank dat hygiënepromotie een van de meest kosteneffectieve ontwikkelingsinterventies is, en zelfs leidt tot een negatieve kost per DALY averted245: de kosten voor het bevorderen van hygiëne liggen lager dan de kosten voor de behandeling van water-gerelateerde ziektes zoals diarree.

Deze interventie gebeurt in sterke coördinatie met het Croix-Rouge de Belgique – Communauté Francophone (CRB-CF) die werkzaam is in hetzelfde interventiegebied. De verwezenlijkingen die door onze WASH-interventie worden bereikt, vormen een integraal onderdeel van hun community resilience benadering. Coördinatievergaderingen tussen BRC-FL, CRB-CF en RRCS zul-len regelmatig plaatsvinden.

244 Hutton G (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal cov-erage, p4. WHO, Geneva, Switzerland. 245 DALY is een maatstaf die werd ontwikkeld door de Wereldgezondheidsorganisatie. De DALY meet niet alleen het aantal mensen dat vroegtij-dig sterft door ziekte, maar meet ook het aantal jaren dat mensen leven met beperkingen door ziekte. In maatschappelijke kosten-batenanalyses worden DALY's ook toegepast om de kosteneffectiviteit van gezondheidsinterventies te bepalen. Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edi-tion). Washington D.C. World Bank, chapter 2.

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Eerste hulp Door RRCS personeelsleden, RRCS vrijwilligers en leken op te leiden in eerste hulp wordt de bevolking van Rwanda zelfredzaam gemaakt. Bovendien is er een duurzaam multiplicator effect door het opleiden van de ‘master trainers246’ (461 directe begun-stigden en 10.405 indirecte begunstigden). De aanwezigheid van dergelijke ‘First Responders’ is van groot belang in een land dat kampt met een ongelijke toegang tot basisgezondheidsinfrastructuur.

Deze interventie richt zich in de eerste plaats op de RRCS hoofdzetel in Kigali, die in staat zal worden gesteld om een kwalita-tieve ondersteuning te bieden aan de eerstehulpopleidingen die plaats vinden verspreid over het hele land. De trainingscapaciteit van RRCS zal worden versterkt met 10 nieuwe en 60 bijgeschoolde eerstehulptrainers en 11 master trainers. Ook zullen er 24 trainers een opleiding krijgen in EH-simulatie, zodat de deelnemers tijdens de trainingen letsels en ziektes waarheidsgetrouw leren behandelen.

Naast het opleiden in eerste hulp, wil RKV de zelfredzaamheid van RRCS versterken door hen in staat te stellen financieel autonoom te investeren in eerstehulpactiviteiten. Hierdoor garanderen we een grotere duurzaamheid van de activiteiten. RKV wil dit doen door RRCS te ondersteunen in het uitbouwen van bedrijfseerstehulp. Dit doen we in de eerste plaats via kennis-overdracht (workshops rond marketing en het opzetten van een kostenmodel). De uitbouw van bedrijfseerstehulp ligt in lijn met de ‘Waardig Werk’ prioriteiten van Rwanda rond veiligheid en preventie op de werkvloer.

Naast zelfredzaamheid is impact een belangrijke focus van het RKV programma in Rwanda. Een studie van de Wereldbank toont aan dat het investeren in de opleiding van eerstehulpvrijwilligers één van de meest kosteneffectieve interventies is met een kost van slechts 8 US$ per DALY averted247. Bovendien investeert RKV via het CEBaP continu in onderzoek naar interven-tiestrategieën met de meeste impact. Zo onderzoeken we onder andere het effect van simulaties in eerstehulpopleidingen. De resultaten van deze onderzoeken zijn geïntegreerd in RKV’s eerstehulpondersteuning aan RRCS. Daarnaast heeft het CEBaP evidence-based eerstehulprichtlijnen uitgewerkt die volledig aangepast zijn aan de Afrikaanse context (“AFAM-African First Aid Materials”). Het eerstehulpopleidingsmateriaal van RRCS zal op basis hiervan herzien worden zodat steeds de meest doeltref-fende eerstehulppraktijken worden aangeleerd.

Gedurende alle fases van de interventie, wordt een gender-sensitieve benadering gehanteerd: binnen RRCS wordt gestreefd naar een gelijkmatige verdeling van vrouwen en mannen binnen de eerstehulplessen én de beheers- en bestuursorganen van de organisatie. Aan de hand van gender-gedisaggregeerde indicatoren zullen verwezenlijkingen in kaart worden gebracht. Daarnaast zullen inspanningen worden gedaan om de impact van onze interventie op het milieu te beperken, door onder andere de aankoop van lokale materialen en een correcte afvalverwerking.

RKV gelooft ten stelligste dat het 17-21 programma in Rwanda rond WASH enerzijds en eerstehulponderricht anderzijds door zijn focus op zelfredzaamheid en duurzame impact sterk bijdraagt tot een verhoogde toegang tot eerstelijns gezondheidszorg en WASH voorzieningen. Op die manier komt het programma tegemoet aan de Gemeenschappelijke Strategische Doelstelling 4248 van het Gemeenschappelijk Strategisch Kader Rwanda en aan de Sustainable Development Goals 1, 3, 5, 6, 8 & 13.

246 Trainers die andere trainers kunnen opleiden. 247 Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2. 248 Aan allen de kans geven in goede gezondheid te leven en het recht op gezondheid en op kwaliteitsvolle gezondheidszorg bevorderen voor allen op elke leeftijd.

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Country Fiche

Total Operational Costs (EUR) 1.166,990

Contact person in Belgium Name: Tiene Lievens

Organization: Belgian Red Cross-Flanders (BRC-Fl)

Phone No: +32 15 44 33 57


Narrative summary of the country program BRC-Fl has collaborated with Rwanda Red Cross Society (RRCS) between 2003 and 2010. Until today, the results of this collaboration can be seen in the First Aid (FA) service of RRCS.

Between 2017 and 2021, the cooperation will focus on first aid training and water, sanitation & hygiene (WASH) as those are, according to the World Bank249, two of the cheapest ways to increase public health in developing countries. Moreover, the program directly contributes to the Joint Strategic Goal (JSG) 4 and indirectly to JSG’s 1 and 7 of the Rwandan Joint Strategic Framework (JSF).

FA is a priority activity for all Red Cross Societies worldwide, and especially relevant in Rwanda, because of frequent disasters and lack of health infrastructure and services. BRC-Fl has extensive expertise in FA education, assuring that what is thought, is conform to the latest scientific evidence. This significantly increases the effectiveness of the intervention and allows RRCS to reach at least 10.405 beneficiaries with FA assistance in times of need.

Secondly, access to sufficient and safe water and sanitation is an important contributor to overall health and poverty reduction. With this program, 3.320 persons in Murunda and Bwishyura Sectors will benefit from improved water and sanitation infrastructure. Apart from access, the program also focuses on hygiene behavioral change. This is accomplished using scientific approaches to behavioral change, whereby the many volunteers of RRCS play an important role in both transmitting the right messages through different methods, and assisting the 11.676 beneficiaries to change their behavior for the better.


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List of partners

Local Partner

Full Name & abbreviation: Rwanda Red Cross Society (RRCS)

Contact details

Address: B.P. 425 Kacyiru - Kigali

Phone No: + 250 78 850 24 65

E-mail: emmanuel. [email protected]

Website : http://www.rwandared-cross.org/

Contact person Emmanuel Ntakirutimana (PMER Coordinator)

Outcome(s)

O1: Sustained use of sufficient safe wa-ter & sanitation facilities, as well as sustained safe hygiene attitudes & practices by the target population by 2021.

O2: Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhanc-ing community level resilience and emergency care capacity.



RRCS, through its nationwide network of branches and volunteers, is the main implementing partner for these outcomes. With support from BRC-Fl headquarters and delegation, RRCS is responsible for the planning, implementation, monitoring and reporting of this program.

Start date of partnership relation:

2003

Theory of Change

This Theory of Change (ToC) serves as the basis for reflection on our intervention strategy and lays the basis for the logical framework. Throughout all phases of program implementation, BRC-Fl will use the logical framework for tracking & monitoring of the intervention outputs and Outcomes. A narrative description of the intervention strategy, as visualized in the ToC’s, is found in the section ‘Effectiveness’. In addition, a general explanation on how BRC-Fl has structured and defined the ToC model can be found in Annex 1

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For assumptions, scientific references are available but not listed in the document – these can be obtained upon request.

Stakeholders and contextual factors are listed here. An elaborate description of their role or influence on the ToC is available on request.

Outcome 1 WASH

Please find the schematic representation on the next page.

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1. Stakeholder Analysis 2. Contextual factors 3. Activities

1/2/3: Relevant governmental bodies such as the Ministry of Infrastruc-ture, the Ministry of Health, the Sector Wide Approach (SWAp) Secretariat, the decentralized offices of partner ministries in Karongi and Rutsiro dis-trict (LGA’s) including the Water Department and the Rwanda Revenue Authority. 4: Users (individuals, households, organizations and companies) 5: Unicef 6: WASAC Ltd 7: School management, Parents Teachers’ Association (PTA), pupils 8: Suppliers related to sanitation and/or water (spare part) system 9: Coforwa 10: CRB-Cf

8. Legislation in place for the water and sanitation sector: National Policy and

Strategy for Water Supply and Sanitation

Services (2010). 9. Size of the country: focus on Karongi

and Rutsiro district. 10. Rwanda is a society with a relatively

strong male dominance. 11. Widespread poverty in Karongi and

Rutsiro districts. 12. RRCS is a well-known recognized part-

ner for WASH interventions at community level.

7. Water supply: water infrastructure: extension of existing systems in Karongi district (Bwishyura) and Rutsiro district (Murunda Sector) depending on the feasibility stud-ies

8. Water supply: sensitization and education. In 16 villages: operation and maintenance of existing water systems in Karongi and Rutsiro district (watershed protecttion).

9. Sanitation infrastructure (sanitation marketing) at household level and in schools.

10. Sanitation sensitization and education (environmental sanitation) at household level and in schools

11. Hygiene promotion at household and community level and in schools using PHAST (Partic-ipatory Hygiene and Sanitation Transformation) and CHAST (Children’s Hygiene and Sanitation Training) methodology.

12. Capacity strengthening activities of RRCS

4. Assumptions

Assumption Link to log-

frame

Does it

hold?

(yes/no)




Outcome 1 • Yes

• Yes

• The positive effect of WASH interventions on health outcomes has been shown in many studies and systematic reviews Moreover, DFID’s evaluation data reports wider impacts of WASH programs in the form of reduction of the burden of disease and increased school attendance. It is found that there is good evidence that the health impacts include many other important diseases beyond diarrhea.

• As water related diseases such as diarrhea are caused by infections as a result of water borne pathogens, it is evident that a reduction in these infections will lead to less water related diseases and a better health overall.

B Better hygiene leads to reduced infections by water-re-lated pathogens.

Outcome 1 Yes

Sanitation and hygiene are critical to health, survival, and development. Providing access to safe water and sanitation facil-ities, and promoting proper hygiene behavior are important in reducing the burden of disease from sanitation and hygiene-related diseases.


Outcome 1 Yes An assessment of the evidence underlying the impact of the four main WASH interventions (water quality, water availability, excreta disposal, hygiene promotion) on diarrhea shows that the availability of water is the most favourable intervention based on a specific set of appraisal factors.

D Access to sufficient & improved sanitation facilities leads to better hygiene and reduction of water related diseases.

Outcome 1 Yes, but more re-search is needed

An impact evaluation in Bangladesh showed that improvement in sanitation facilities had led to a reduction in water-borne diseases. Only a few systematic reviews have looked at the effect of sanitation facilities on the health status or the reduction of diseases. Further research in this area is needed.

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E People practice better hygiene if they have the knowledge, skills, and attitudes. Hygiene promotion via different methodologies leads to sustainable hygiene behavior change.


BRC-Fl re-search ongoing

BRC-Fl is conducting a systematic review to determine which promotional approaches are effective to change hand washing and sanitation behavior in low- and middle-income countries. This project is a collaboration of the BRC-Fl Centre for Evi-dence-Based Practice and the Centre for Evidence-Based Health Care of Stellenbosch University South Africa. Oversight and guidance is provided by 3ie (International Initiative for Impact Evaluation).

F RRCS is a relevant actor in the WASH sector. Outputs 1.1-1.3

Yes Evidence suggests that the most influential factors associated with sustained adoption include frequent contact with a health promotor over a period of time. Personal follow-up may further contribute to sustained adoption. The large network of Red Cross volunteers can play exactly the role of health promotor as they are part of the target communities, and are present beyond the duration of the intervention.

G Time saved by women for water collection leads to more possibilities for women empowerment as well as less risk of violence and injury.


Yes Studies have shown that WASH interventions significantly reduce the time that women need to spend on fetching water and taking care of sick children. In addition, a smaller time and energy burden associated with fetching water may decrease the risk of violence and injury for women.




•Yes

•More research needed

• DFID’s WASH evidence paper states that the impact of inadequate water and sanitation are particularly pronounced for women and girls. Inadequate sanitation facilities may expose women to the risk of violence, and finding adequate loca-tions for open defecation can require significant time.

• Qualitative research indicates that some girls may be discouraged from attending a school without adequate toilet facil-ities. However, no evidence is available on the direct link between sex-aggregated toilets en increased school attendance by girls.

I • The chosen approaches/methodologies to promote WASH behavior change are effective.

• RRCS volunteers are effective agents of sustained WASH behaviour.


• BRC-Fl re-search ongoing

• Yes

• Cfr. Assumption E and ongoing systematic review by BRC-Fl in cooperation with 3ie. In addition, BRC-Fl currently is conducting research on which behavior change techniques are most and effective specifically for the intervention area in Malawi in cooperation with professor Hans-Joachim Mosler of EAWAG university in Zurich. • Cfr. Assumption F

J WASH interventions contribute to climate change ad-aptation and resilience.

Impact Yes Promotion of WASH technology and behaviours is a critical component of climate change adaptation and promoting hu-man rights. The Red Cross/Red Crescent Climate Centre underlines the link between the availability of water and sanitation infrastructure and increasing hygiene awareness, and communities’ vulnerability to extreme weather events.

K WASH interventions have a positive impact on poverty reduction.


L By reducing distance to safe water, water will also be used for hygienic purposes, not just drinking and cook-ing.

Outputs 1.2-1.3


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Outcome 2 FA


1. Stakeholder Analysis 2. Contextual factors 3. Activities

1. Other FA training providers such as Elec-tronic 2020

2. Rwanda National Ambulance Services 3. Rwanda National Police (including Depart-

ment Traffic Policy and Road Safety) 4. Rwanda Revenue Authority 5. Private and Public Health Service Providers 6. FA equipment suppliers 7. Companies 8. Relevant governmental bodies such as

Ministry of Health, Ministry of Public Ser-vice and Labor and decentra-lized offices of partner ministries.

9. ICRC and other partner national societies (PNS) active in Rwanda

10. ICRC and other partner national societies (PNS) active in Rwanda

1. Legal context on first aid and legislation in place on CoFA (Commercial FA). No legal framework on accreditation of FA training providers.

2. Increased injuries at working places. 3. Rwanda is a society with a relatively strong

male dominance. Women are still largely ex-pected to prioritize family life over professional opportunities.

4. The unique position of RRCS as only FA-pro-vider has not been legalized though RRCS is unofficially acknowledged by the govern-ment as the only FA-trainer.

5. RRCS is the largest humanitarian orga-nisa-tion in Rwanda with a high nr. of volunteers in all districts of the country.

1. Regional trainings on institutionalization: focusing on standardization of FA training curricula, development, trans-lation and dissemination of FA policy, standardization, translation and dissemination of FA procedures, development of a FA training plan, set-up of FA training database and registration of trainings.

2. Development of quality evidence based FA materials: revision of basic and advanced FA manual for trainers and trainees based on AFAM/evidence based guidelines, revision of commercial FA manual for trainers and trainees based on AFAM/evidence based guidelines, Development of simulation manual for trainers and trainees.

3. Training RRCS volunteers and staff in FA: i.e. Refreshment training of 11 Master Trainers, 1 Training of Trainer (TOT) to train 10 FA trainers, Refresher training of 60 FA trainers, Training of 300 TRCS volunteers in basic FA, Training of 24 volunteers in basic simulation, Training of 12 volunteers in advanced simulation, Training of 10 volunteers as simulation trainers, Training of 11 FA trainers as AED trainers, Training of 20 staff in basic FA.

4. Procurement of various FA training materials (splints, bandages, resuscitation mannequins, …). 5. Promotional activities during World First Aid day. 6. Monitoring activities, including baseline, midterm and end-evaluation. 7. Recruitment of 1 FA coordinator (100%) and 1 assistant person (100%). 8. Regional trainings on marketing CoFA: training 5 people: focusing on development of CoFA policy, strategy, and

internal procedures, training support to HR qualified in commercial activities, management and organisation of CoFA trainings, registration & database, marketing and marketing plan , financial management, business plan, CoFA operational plan.

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4. Assumptions


frame

Does it

hold?

(yes/no)



• Smaller negative impact on health in case of injury/illness because peo-ple are assisted with evidence based first aid.

• FA education is a very cost-effective development interven-tion to in-crease public health.


• Yes

• A British Red Cross study shows linkages between features of community resilience and first aid training.

• Evidence based FA techniques are proven to be more effective towards injury treatment/illness recovery. The BRC-Fl Centre for Evidence-Based Practice (CEBaP) specializes in the evidence based methodology for first aid guideline development, using the best available evidence from scientific literature, supplemented with know-how from experts and information gleaned through practical experience.


B Smaller negative impact on health in case of injury/illness because people are assisted with first aid.


• A systematic review is ongoing on the health effects of training lay people to deliver emergency care in underserviced popula-tions. Results will be available in 2017. One case study in Iraq showed that a reduction in mortality was caused by trained layperson first responders in a setting where pre-hospital evacuation times are long.

C • Lay people and RRCS staff & volun-teers intervene to apply FA if they have the required know-ledge, atti-tudes and practices.

• Lay people have access to basic FA local materials for applying first aid techniques.

• First aid lay responders as well as FA trained RRCS staff & volunteers can intervene and provide first aid in a safe legal environment (legal liabil-ity).

Outcome 2 • Yes, but more re-search is needed. • Yes

• No

• A systematic review reports significant increases in first aid knowledge, skills and improvement in helping behavior due to first aid training for children and lay people. A case study in Uganda shows that groups of people who regularly have to apply FA have a higher retention of FA knowledge. A Red Cross structure could be considered in a similar way. In addition, evidence that volunteers give proper first aid is observed during monitoring sessions and regular data collection.

• Sensitization on the importance of having adequate FA materials and on the use of local materials will be part of the intervention. FA trainings are also adapted to locally available materials.

• In none of the intervention countries the law provides protection for bystanders providing first aid. However, the 32nd Interna-tional Conference of Red Cross and Red Crescent Societies adopted a resolution on strengthening legal frameworks for disaster response, risk reduction and first aid.

D Trained and equipped RRCS volunteers are retained.

Outcome 2, Outputs 2.1-2.3

Yes RRCS has a volunteer policy in place to recruit, motivate and retain volunteers.

E RRCS is able to recruit the required vol-unteers and staff to provide FA.

Outcome 2, Outputs 2.1-2.3

Yes Cfr. D on recruitment & volunteer policies. In addition, RRCS has already a volunteer base of 15.000 volunteers.

F There is adequate follow-up and coaching of RRCS volunteers and staff.

Outcome 2, Output 2.1-2.3

Yes, but a risk in some countries

The workshops on institutionalisation will define the current quality control mechanisms and identify the gaps. Refresher trainings will upgrade skills and knowledge of staff and volunteers. Supervision of trainings will show the dedication and competences of the RRCS instructors.

216


• RRCS is willing to invest the income generated from commer-cial first aid trainings at least partly back into the FA service.

Outputs 2.2-2.3

• Yes, but more analysis is needed

• Yes

• In 2016, BRC-Fl undertook a study in cooperation with Vlerick Business School analyzing the cost of FA trainings in Nepal using a time-driven activity based costing model. Being a pilot study, BRC-Fl aims to use this model to improve commercial first aid activities in other partner countries.

• As part of an exit strategy, a scheme will be set up (cfr. section ‘Relevance’). RRCS commits itself to reach financial sustainability by the end of the project for HR for the FA dept. and FA materials.

H People who decide to become a RRCS volunteer or staff recognize and value the importance of first aid.

Output 2.2 Yes Within RC organizations first aid is recognized as a core activity, and each newly recruited volunteer is introduced in the vision, mission and policies of the organization. Recognition of this importance will show through their participation in FA training and their compliance to the Red Cross Code of Conduct.

I The used didactical methods are effec-tive.

Output 2.1 BRC-Fl research planned


J Lay people (incl. RRCS staff and volun-teers) sufficiently retain the knowledge and skills obtained during a FA (re-fresher) training.



BRC-Fl is conducting a study to assess the degree of knowledge and skill retention over a period of time and to determine the impact of refresher courses and FA practice on the retention level. This information will be used to determine the optimal frequency of refresher courses and to assess the need to revise the validity of FA certificates. One case study has shown that FA knowledge gained during commercial FA training does not significantly decline over time. However, skills related to CPR rapidly deteriorate over the course of the first 90 days suggesting that refreshing skills frequently is required.

217

Risk analysis

The risk analysis as shown here below is the result of a joint reflection of BRC-Fl with CRB-Cf and RRCS. We refer to Annex 2 to give an example of the more extensive risk analysis developed for each of our programs including Rwanda. This matrix was too large to be included in the DGD proposal.

TOC

refer-

ence Description of risk and impact

Impact

(1-6)

Probabi-

lity

(1-6) Mitigation

Responsable for

monitoring


Context

Analysis

Lack of interest of local authorities 3 1 Provide support for coordination meetings of development actors at district level (District Joint Action De-velopment Forum), participation in open door activities which are conducted annually by the districts and include this process in the RRCS policy. Ensure optimal visibility of the actions of the Red Cross through greater involvement of the authorities in steering meetings held at district and sector level.

Secretary General of RRC, person in charge of local com-mittees

Context

Analysis

Major catastrophe in the intervention zone (floods, droughts and landslides, to name the most important ones) (cfr ACC Rwanda, 9.2, p. 60)

4 2 The RRCS possesses disaster response teams (at district and sector level) which will be trained and equipped with emergency stocks (available in each district) that will be used to restore the life of the population back to normal conditions following a crisis. The action itself also aims to strengthen the capacity of the commu-nities (individuals, households, community) to return rapidly and sustainably to a normal life following disasters. Moreover, WASH infrastructure built by this pro-gram is developed to overcome effects related to extreme weather as a result of climate change: built in flood-proof areas, use of local and easy replaceable materials, etc.

Head of Disaster Management, District Coordinator

Program level risks

Ass. E

O2

Inactivity and desertion of FA volunteers as a result of a lack of moti-vation.

3 3 The RRCS has renewed the decentralized structures in the districts and sectors, which guarantee the proper management of Red Cross activities and volunteers. The volunteer management policy is also being revised to allow for effective management of voluntary actions and their active involvement, including in particular the system of evaluation, motivation and gratification. This will help attract and maintain dynamic volunteers but also replace those who have left or are failing.

Department Head Organizational De-velopment, Program coordinator

Stke-

holders

O1

Risk that the protected water points are poorly managed and will not be re-paired in case of damage due to poorly organized or inactive water manage-ment committees.

3 2 The management committees will be supported by local authorities and RRCS volunteers in case of technical difficulties (catchment, pipes or valves damaged etc.). If needed, the hydraulic engineer of the district will be called upon. As access to clean water is an important goal in the performance contracts of the authorities, they are interested in well-functioning management systems and effective maintenance of water points. In case of malfunction of a committee, volunteers from the RRC will appeal to local authorities to intervene and come up with solutions.

Watsan expert of RRC and voluteers trained in PHAST at sector level

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Recommendations and Lessons Learned

JSF Strategic Dialogue Recommendations

The Strategic Dialogue between the actors of the JSF Rwanda and DGD took place on the 9th of June in Kigali. Within the “Avis Définitif”, the recommendation was made to materialize the suggestions for synergy and complementarity or to identify further opportunities. For this, we refer to the section “Synergies and Complementarities”.

Lessons learned from previous programs The long experience of BRC-Fl in working with RRCS, a suspension of activities between 2010-2016 excluded, combined with the many points of attention acquired by WASH and FA programs in other countries of intervention, result in a wide range of lessons learned which form the building blocks of our future intervention in Rwanda.

WASH Next to lessons learned of BRC-Fl in WASH programs, CRB-Cf implemented a program on “model villages” in the same region during the period 2014-2016. One of the components was WASH support. The midterm review formulated 17 recommenda-tions. 2 of those are of particular importance for this program:

• Concerns were raised on the quality of the water after protection of the water source. This will be taken into consideration from the design and feasibility study. Local expertise within Rwanda Red Cross will be supported by external expertise.

• A simple design of latrines (without sanplats) was chosen, which turned out to be poor quality of sanitation. This will be tackled by providing 300 improved latrines and 64 ecosans.

FA The last 15 years, BRC Fl implemented First Aid Programs in many African countries resulting in an increased capacity of national societies delivering qualitative first aid education and first aid services to the population.

First aid is a central health activity for many of our National Societies which implies the possibility to use a general approach in building first aid capacity. Although the program in Rwanda is a start-up program with regard to FA, we could distill out of the lessons learned from other countries, the following key points of attention:

Lessons Learned Action

Standardisation is the key entry point to build up quality first aid education.

This programs focuses on quality and standardisation in the first place (more than on train-ing big amounts of beneficiaries). Standardised curricula and development of standardised, evidence based first aid materials will be included and updated in the pro-gram.

Improving First aid education needs a long term trajectory including improvement of medical and didactical skills, development of a quality monitoring sys-tem and timely activating trained volunteers.

The program includes different steps to establish a quality monitoring system, adequate coaching and appropriate calculation of deployable trainers and volunteers in first aid and commercial first aid.

A well-functioning first aid unit is embedded in the structure of the national society and is able to advocate for and pro-mote First Aid to the different stakeholders and the government.

Institutional development is included in all the first aid program, elaborating a clear strat-egy and policy on first aid, development of guidelines and procedures, defining clear positioning into the national society contributing to lay a solid foundation of a first aid service.

Installation of well-managed, profitable commercial first aid service is complex and needs a commercial enterprise ap-proach.

RRCS needs clear guidance, basic knowledge and skills on commercial approaches. Intro-duction, support and step by step guidance to obtain a marketing plan, business plan, adequate data- and financial management is included in CoFA programs.

In the regional First aid program in southern Africa (FAI 2015-2018) , national societies benefit from the peer to peer exchange with colleagues from other national societies.

A regional approach is included to provide possible exchange between national societies encountering similar challenges in building up a first aid capacity in their countries. Some trainings and workshops will be organised regionally.

219

Outcome 1 WASH

Outcome Fiche

Outcome (English or French) : Sustained use of sufficient safe water & sanitation facilities, as well as sustained safe hygiene attitudes & practices by the target population by 2021.

Outcome (Nederlands): De doelgroep maakt tegen 2021 gebruik van duurzame water -en sanitaire voorzieningen die toereikend en veilig zijn, en houdt er veilige attitudes en praktijken op na omtrent hygiëne.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_12_RW_DGD

Country: Rwanda Is this Outcome covered by a JSF Yes



RRCS Kigali (RRCS HQ) and Western Province

Karongi and Rutsiro district

Bwishyura & Mubuga Sectors (Karongi District) Mubuga Sector (Rutsiro District)

Target population: Rural population of Karongi and Rutsiro district, in 16 villages (Karongi: Kivomo, , Gakomeye, Bwishyura, , Gitega, Bupfune, , Bizu, Gitarama, , Kabuga. Rutsiro district: Nyarucundura, Kamuramira, , Gatare, Ruhimbi, , Bulimba, Gasasa, , Kariba, Mubirizi,).




Policy Marker






220

Logical Framework

For some indicators, baseline data are currently not available. A full baseline exercise will be conducted after program approval to rigorously determine and update baseline and target values for each indicator. Numeric targets are presented as a cumulative total vis-à-vis the baseline value. References and definitions are available on request.


Process indicators

Indicator 1: Number of direct beneficiar-ies reached.

0 Total: 68 Female (F): 34 Male (M): 34

Total: +3.320 F: +1.660 M: +1.660

Total: +3.320 F: +1.660 M: +1.660

Total: +3.320 F: +1.660 M: +1.660

Total: +3.320 F: +1.660 M: +1.660

RRCS monitoring & reporting forms

Indicator 2: Number of indirect be-nefi-ciaries reached.

0 Total: +0 Female (F): 0 Male (M): 0

Total: +8.256 F: +4.128 M: +4.128

Total: +8.256 F: +4.128 M: +4.128

Total: +8.256 F: +4.128 M: +4.128

Total: +8.256 F: +4.128 M: +4.128

RRCS monitoring & reporting forms

Impact:

Joint Strategic Goal 4 – JSF Rwanda: Allow all to live in good health and promote the right to health and qualitative health care for all at all ages.


Outcome 1:

Sustained use of sufficient safe water & sanitation facilities, as well as sustained safe hygiene attitudes & practices by the target population by 2021.


Indicator 1.1: % of households in the tar-get are using sufficient safe water from an improved water point for drinking.

Karongi: 20% Rutsiro: 14%

N/A N/A K:+ 20% R:+36%

N/A K:+ 20% R:+36%

Household survey/spot checks/ob-servation, volunteer monitoring reports

Indicator 1.2: % of households in target area that uses an improved latrine.

Karongi: 13% Rutsiro: 22%

N/A N/A + 20% N/A + 40% Secondary data: Household sur-vey/ spot checks/observation, volunteer monitoring reports

Indicator 1.3: % of households in target area whose members wash their hands with water & soap (or local acceptable alternative) at critical times.

% TBD N/A N/A + 9% N/A + 15% Household survey/spot checks/ob-servation, volunteer monitoring reports

Indicator 1.4: Time required per round trip for water collection by water collec-tor (incl. queuing time).

33 min

N/A N/A -5 min

N/A -13 min

Household survey, volunteer moni-toring reports

Output 1.1:

Increased availability of safe and sustainable water supply for target population by 2021.


Indicator 1.1.1: Number water points con-structed/rehabilitated according to national standards.

0 +0 constructed + 0 rehabilitated

+10 constructed +10 constructed +10 constructed +10 constructed Hydrological survey reports, design documents (drawings and bills of quantity), drilling log, test pumping log, completion report with GPS

221

data, hand-over report/donation certificate

Indicator 1.1.2: Number of con-structed/rehabilitated with an esta-blished water management committee (COWSO) or assigned service provider.

0 +0 +10 +10 +10 +10 RRCS monitoring tools, contract with service provider, membership records, contract between commit-tee and spare part supplier, records of funds collected



Indicator 1.2.1: Number of improved la-trines built (ecosan by the target population/by RRCS).

0 By RRCS: 0 By community:

+0 By RRCS: +0 By community: + 0

+528 By RRCS: +64 ecosan, +300 improved By community: +164

+692 By RRCS: +364 By community: +328



RRCS volunteer monitoring reports

Output 1.3:

Target population has improved knowledge & skills on safe hygiene practices by 2021.


Indicator 1.3.1: Number of people trained in hygiene behavior methodology

0 Total: +68 F: +34 M: +34 (branch 68, re-gion/district 0, etc.)

Total: +1.138 F: +569 M: +569 (branch 68, com-munity: 920, schools: 150)

Total: +1.928 F: +964 M: +964 (branch 68, com-munity: 1.560, schools: 300)

Total: +1.928 F: +964 M: +964 (branch 68, community: 1.560, schools: 300)

Total: +1.928 F: +964 M: +964 (branch 68,com-munity: 1.560, schools: 300)

RRCS volunteer monitoring tools

Indicator 1.3.2: Number of hygiene be-havior change techniques implemented.

TBD +0 +1 (HH visits)

+6 (soap business, competitions, drama, …)

+6 +6 RRCS volunteer monitoring tools Training reports

Output 1.4:

RRCS has an increased capacity to implement WASH related interventions by 2021.


Indicator 1.4.1: Number of activities re-lated to evidence based practice (EBP) the RRCS engages in.

0 +1 +2 +3 +4 +5 RRCS monitoring tools

Indicator 1.4.2: Number of WASH tool adopted and used by RRCS.

TBD +1 (monitoring tool PHAST)

+3 (monitoring tool WUC, moni-toring tool

+6 (soap busi-ness procedure, procedure WASH exchange

+6 +6 RRCS monitoring tools

222

CHAST, HH visit tool)

visits, procedure WASH competi-tion)


Operational Budget

Outcome 1 WASH 2017 2018 2019 2020 2021 Grand total

Operational Costs

1. Partner 59.242 217.767 60.622 41.911 23.601 403.143

Investment costs 23.631 151.357 11.429 0 0 186.417

Working costs 25.512 46.211 28.995 21.713 13.502 135.933

Personnel costs 10.099 20.198 20.198 20.198 10.099 80.793









4. HQ 16.725 47.114 47.114 47.114 47.114 205.183





Total 75.967 264.881 107.736 89.026 70.716 608.326


Working costs 30.926 66.085 48.868 41.587 33.376 220.841

Personnel costs 21.409 47.439 47.439 47.439 37.340 201.068

223

Outcome 2 FA

Outcome Fiche

Partners

Total Partner RRCS 59.242 217.767 60.622 41.911 23.601 403.143

Total Partners: 59.242 217.767 60.622 41.911 23.601 403.143

Collaboration



Outcome (English or French) : Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, thus enhancing community level resilience and emergency care capacity.

Outcome (Nederlands): Leken, Rode Kruispersoneel- en vrijwilligers beschikken tegen 2021 over doeltreffende, meest recente en evidence-based kennis, vaardigheden en attitudes om eerste hulp te verlenen aan zij die het nodig hebben en verhogen op die manier de zelfredzaamheid van gemeenschappen en hun capaciteit om zorg te verlenen in noodsituaties.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_13_RW_DGD

Country: Rwanda Is this Outcome covered by a JSF Yes



RRCS Ville de Kigali : RCCS Headquarters

Target population: FA volunteers, FA staff members, RRCS staff members, community volunteers and company workers in different parts of Rwanda

Number of direct beneficiaries: Total: 10.866 Direct: 461 Indirect: 10.405



224

Logical Framework

For some indicators, baseline data are currently not available. A full baseline exercise will be conducted after program approval to rigorously determine and update baseline and target values for each indicator. Annual numeric targets are presented as a cumulative total vis-à-vis the baseline value.

Output 2.1:

High quality FA education for different target groups is available by 2021.


Indicator 2.1.1: Presence of a fi-nalized gender sensitive AFAM based basic FA didactical train-ing materials.

No Yes (Basic FA manual for trainers/trainees,

Yes

Yes

Yes

Yes

RRCS FA training manual/didactical materi-als

Policy Marker

Subject Score Sujet Score Sujet Score






Process indicators







RRCS monitoring & report-ing forms


0 Total: +1.680 Female: +840 Male: +840





RRCS monitoring & report-ing forms

Impact

Joint Strategic Goal 4 – JSF Rwanda: Allow all to live in good health and promote the right to health and qualitative health care for all at all ages.


Outcome 2:

Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhancing

community level resilience and emergency care capacity.


Indicator 2.1: Number of lay people with a valid FA certifi-cate.

Total: 180 F: 97 M: 83

N/A N/A Total: +540 F: +292 M: +248

N/A Total: +900 F: +486 M: +414

RRCS FA training database, RRCS training records

Indicator 2.2: Number of Red Cross volunteers and staff with a valid FA certificate.

Total: 2.377 F: TBD M: TBD

N/A N/A Total: +742 F: +371 M: +371

N/A Total: +942 F: +471 M: +471

RRCS FA training database, volunteers database, RRCS training records

225

AFAM based didac-tical materials)

Indicator 2.1.2: Number of Red Cross volunteers and staff trained in FA.

0 Total: +24 F: +12 M: +12

Total: +207 F: +103 M: +104

Total: +442 F: +221 M: +221

Total: +442 F: +221 M: +221

Total: +442 F: +221 M: +221

RRCS FA training database, RRCS training records

Output 2.2: The RRCS has a well-functioning FA service embedded in the organization by 2021.


Indicator 2.2.1: Number of FA trained volunteers registered in RRCS volunteer database.

0 +124 +407 +742 +842 +942 RRCS volunteer da-tabase, FA training database

Indicator 2.2.2: Number of ac-tive FA Trainers.

Total: 0 F: TBD M: TBD

Total: +16 F: TBD M: TBD



Total: +26 F: TBD M : TBD

Total: +26 F: TBD Men: TBD

RRCS trainer database, RRCS training records

Output 2.3:

The RRCS delivers high quality commercial FA services by 2021.


Indicator 2.3.1: Number of new

clients trained in CoFA.

0 +5 +10 +15 +20 +25 RRCS FA training or client database, RRCS training records

Typology of activities

Cfr. activities listed under section ‘Theory of Change’.

226

Operational Budget

Outcome 2 FA 2017 2018 2019 2020 2021 Grand total

Operational Costs

1. Partner 54.241 136.579 98.994 41.416 27.252 358.481


Working costs 38.302 72.734 75.863 23.416 18.252 228.566

Personnel costs 9.000 19.083 19.083 18.000 9.000 74.167









4. HQ 15.725 46.114 46.114 46.114 46.114 200.183





Total 69.966 182.694 145.109 87.530 73.366 558.664


Working costs 43.716 92.607 95.737 43.289 38.125 313.474

Personnel costs 19.310 45.324 45.324 44.241 35.241 189.441

Partners

Total RRCS 54.241 136.579 98.994 41.416 27.252 358.481

Total Partners: 54.241 136.579 98.994 41.416 27.252 358.481

Collaboration



227

Relevance

Outcome 1 WASH

Context analysis The need for health support interventions in Rwanda is described in the JSF Rwanda (paragraph 2.2, p. 11) and the JCA Rwanda (chapter 3-4-5) and formed the base for the formulation of JSG 4 on health to which this program contributes, namely to « Allow all to live in good health and promote the right to health and qualitative health care for all at all ages”.

Additional sources point out that despite certain progress in clean water accessibility and sanitation coverage, the sector is facing a number of challenges, including funding gaps for increasing access, particularly in unplanned and scattered settlements in difficult hilly terrain and depleting water resources resulting in high costs for service provision. Also gaps in human resource capacity in the areas of planning, management and maintenance and a low level of sustainability of WASH services in rural areas, form major problems. In their second Economic Development and Poverty Reduction Strategy (EDPRS), the government of Rwanda has set the target to ensure country-wide access to water and sanitation by 2020. Our program contributes to this national policy, as well as to the Sustainable Development Goals (SDG’s) 3 (healthy lives), 5 (gender equality), 13 (combat climate change) and most importantly SDG 6: ensure availability and sustainable management of water and sanitation.

Direct beneficiaries In the 16 selected villages (see here below), 32 community groups of 30-50 community members will be formed who will carry out community sensitizations and household visits, which will reach directly reach 50% of the 2.522 HH or 5.838 people. Lastly, 3240 people will benefit from the renovation of gravity flow schemes, which foresees 10 tap stands to be built. In total, 6.032 direct beneficiaries will be reached.

It is important to note that for the beneficiary calculations BRC-Fl chose to count unique beneficiaries only once although they may be reached multiple times with different program activities (e.g. by different behaviour change techniques, trainings and refresher trainings). However, these program activities each do have their individual cost, which means these beneficiary num-bers could not be used to calculate cost per beneficiary.

Indirect beneficiaries The total population of the area of intervention – 11.676 people – can be classified as beneficiaries, as less use will be made of other available WASH facilities and more opportunities exist to invest in the construction, rehabilitation and O&M of these other points. When we subtract the direct beneficiaries (3320), 8.436 indirect beneficiaries remain. The visitors, travelers and refugees who find a temporary home in the Sectors of intervention, are not being included in these calculations.

Location The program will focus on a limited number of sites composed out of rural multi-villages schemes and serving large popula-tions. The intervention is targeting an extension of existing systems rather than developing new infrastructure. A first selection of districts has been conducted during the formulation mission in July 2016. Based on data from poverty levels, field visits and exchanges at District and regional level, the districts of Karongi and Rutsiro have been chosen. Those districts are among the 10 poorest districts of Rwanda (out of 30), and score far below the national WASH averages with only 16,8% of the population having access to clean water and only 17,1% having access to an improved latrine. Within these districts, the sectors of Murunda (Rutsiro) and Bwishyura (Karongi) are chosen. Together with CRB-Cf, 16 villages were selected where community groups will be formed who’ll carry out community sensiti-zation on hygiene promotion. In Karongi District, following communities will be targeted: Gakomeye, Bwishyura, , Gitega, Bupfune, , Bizu, Gitarama, , Kabuga. Kivomo In Rutsiro district, the intervention will focus on following communities: Nyarucundura, Kamuramira, , Gatare, Ruhimbi, , Bu-limba, Gasasa, , Kariba, Mubirizi. Precaution was made to avoid overlap with interventions of the Districts or other development partners such as WASAC Ltd, who is also implementing WASH hardware intervention in Musasa Sector of Rutsiro District. For the rehabilitation and construction of WASH hardware facilities, gravity-flow schemes will be used due to the hilly geogra-phy of the region. The exact location will be determined during a profound feasibility study in 2017, but a first assessment done in July 2016 led to the following preliminary conclusions: 1) 16 km gravity flow scheme serving Musongati, Bambiro, Ruhanda, Gataba, Gasutamo villages. 2) extension of existing scheme with 6 tap stands serving Kamubuye Village, Rugeyo cell. 3) 12 km gravity flow scheme serving Kivomo, Gitarama, Bwishyura, Bupfune villages

Gender In our intervention area, 22,4% of the households are run by women. These households are on average poorer and more vulnerable due to their (traumatized) past, low social status and the burden of a single parenthood. The construction and rehabilitation of WASH infrastructures will in particular have an impact on those women living in the sectors of intervention. In Africa alone, people spend 40 billion hours every year just walking for water. Women and children

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usually bear this burden. According to the Africa Human Development Report 2016, the task of drinking-water collection is in 71% of the cases carried by women. Investing in increased availability of safe and sustainable WASH infrastructure, has therefore a significant effect on time saved by women/girls on WASH related activities. This free time can be spent on other activities that enhance their income generation or personal development. A four-country study by the World Bank showed that girl’s school attendance increased significantly for every hour reduction in water collection. Moreover, national policies on Water and Sanitation and Gender will be followed, including participation of women in the management of the water point.

Environment In line with IFRC, in all its actions and interventions, BRC-Fl is aware of the many existing linkages between our WASH inter-ventions and the preservation and protection of the environment: • Water sources will be protected and latrines will be located downstream of wells, at least 30m from groundwater sources

and at least 1.5m above the water table. • Pit latrines will be fitted with concrete slabs to eliminate the need for secondary wooden slabs or supporting beams. The

concrete slabs will also facilitate easy cleaning. • The up- and down-stream impacts of water use and sanitation will be considered, as well as its cumulative impact on a

watershed. • Groundwater extraction will be monitored to ensure that the natural recharge rate is not exceeded. • Awareness will be raised of the importance of water conservation. In the construction of water systems, the environment

is also taken into account by protecting the natural resources, e.g. through the planting of trees, encouraging reforestation.

Furthermore, BRC-Fl is aware that WASH interventions are linked with the adaptation to climate change and the enhancing of community resilience. The Fifth Assessment report of the Intergovernmental Panel on Climate Change (IPCC) states that com-pounded stress on water resources facing significant strain from overexploitation and degradation form one of the key risks to the African continent. Our intervention aims at attaining an increased availability of sustainable WASH infrastructure to the most vulnerable communities and enhancing water-saving measures and behavior.

Outcome 2 FA

Context analysis Similar to WASH, the First Aid – intervention is in line with JSG 4 of the JSF Rwanda, for which the relevance has already been demonstrated in chapters 3-4-5 of the JCA Rwanda. Moreover, the intervention is in line with the Third Health Sector Strategic Plan (HSSP III) of the Government of Rwanda, especially the priority on health promotion and environmental health and with SDG’s 1 (reduce poverty), 3 (healthy lives), 5 (gender equality), 8 (economic growth). In line with the BRC-Fl internal strategy 2020, this intervention also increase the resilience and self-reliance of the target population, thus contributing to SDG 13, to combat climate change and its impacts.

The recent Rwanda’s Factsheets of Health Statistics 2016, confirm the conclusions formulated in the JSF and the JCA: despite realizing big gains in the health sector, the population still faces a high burden of disease. When calamities and accidents happen, within the community or on the roads, it often takes a long time for help to arrive, if at all available. Saving lives is often left in the hands of lay people who are the first to respond, not professionals.

Direct beneficiaries The direct beneficiaries of the program will be the different categories of skilled volunteers of RRCS who will be (re)trained as FA trainers/master trainers/simulators, which totals 122 people. Once they have up-to-date FA teaching skills, they will train 300 volunteers in their respective regions. These 300 volunteers will be deployed during events and emergencies, but also apply FA techniques on a daily basis within their households and communities. Additionally RRCS will be assisted in institution-alizing FA training and services into the organization. The current Master Trainers will be retrained and a 4 year process to introduce and train Simulation Master Trainers will be followed, this will allow RRCS to train more FA trainers and simulators with in-country expertise. A same trajectory will be followed for automatic external defibrillator (AED) trainers. Currently, RRCS depends on the Ministry of Health trainers to be able to provide this course. An additional group of direct beneficiaries are the 2 staff members employed by the program, the 20 staff trained n FA and the 9 people trained in commercial FA marketing and institutionalization. A total of 461 direct beneficiaries are reached.

It is important to note that for the beneficiary calculations BRC-Fl chose to count unique beneficiaries only once although they may be reached multiple times through different program activities (e.g. trainings and refresher trainings). However, these program activities each do have their individual cost, which means these beneficiary numbers should not be used to calculate cost per beneficiary.

Indirect beneficiaries It is very hard to quantify and monitor indirect beneficiaries given the broad range of first aid applications (from cleaning small wounds to life-saving Cardiopulmonary Resuscitation (CPR)). Based on the assumption that on average, every trained person will assist 5 persons by applying evidence-based, qualitative first aid, the number of indirect beneficiaries is estimated at 10.405. This number takes into account the total number of people trained in FA by RRCS, even though these trainings are not direct

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outputs of the program. For Rwanda, this includes as estimated 900 clients of Commercial First Aid that will be trained from 2019 onwards, and 100 FA-volunteers per year trained by RRCS but funded by other organizations such as CRB-Cf or ICRC. We can assume this multiplier might be even higher for trained RC volunteers and staff given their role as first responders to natural and conflict-caused calamities.

Location The program is managed from the central level of RRCS, its headquarters in Kigali, but covers the entire country.

Gender This program will strive for a 50/50 % participation for women and men in FA trainings, and especially for the subsidized trainings, female participation will be encouraged. Barriers to participation will be reduced actively to achieve this, for instance by organizing decentralized trainings where participants are close to home, and can return daily, rather than being out for days. Moreover, the AFAM-based didactical training materials developed by this intervention are sensitive for the specific needs of women and girls as receivers and givers of First Aid. Attention is drawn upon specific situations encountered by women such as giving birth without medical assistance.

Environment Our interventions aim to support RRCS in giving high-quality FA training sessions to staff, volunteers and community-members in order to increase their self-reliance and as such have increased abilities to ‘bounce back’ when hit by sudden emergency. Community resilience will be of particular importance to deal with the increased volatility of the occurrence of extreme clima-tological events and natural disasters brought by climate change.

On programmatic level, efforts to minimize the ecological footprint will be made. In terms of office management, double print-ing for reporting and didactical materials will be mandatory. In terms of procurement, local products are at all times recommended, and the guidelines/policy on asset maintenance will include attention for environmental waste disposal.

Relevance according to other DGD priority themes

Human rights As described in annex 4, a rights based mindset has always been present in the work of the Red Cross Movement. Our FA & WASH intervention in Rwanda is responding to the needs of the most vulnerable, and is as such aiming for rights-holders to claim their rights under Article 25 of the Universal Declaration of Human Rights : “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, […].” Another approach to operationalize this mindset, is our Humanitarian Diplomacy. The auxiliary role RRCS has vis-a-vis the public authorities of Rwanda and their privileged access and relationship to the government and policy makers provides leverage for addressing specific issues related to increasing and upholding legislation to make communities and schools safer and healthier places and thus contributing to an adequate standard of living.

Digitalization BRC-Fl uses digital technologies as enabling tools to enhance the impact of our interventions. In the field of FA, BRC-Fl supports RRCS in the set-up and/or maintenance of a database at headquarter level. This database serves as a registration system for data on First Aid trainings, which will help RRCS to efficiently process and manage their First Aid service. In the field of WASH, BRC-Fl will look into supporting RRCS with the use of (mobile) data collection tools. This would allow survey data to be processed more quickly and efficiently and the risk for errors to be reduced. Mobile data collection will also allow RRCS to assign GPS-locations to water sources and WASH infrastructures and permits BRC-Fl to have an overview and geographical mapping on the work done on the field. As such, quickly readjusting the intervention in case of problems, is possible.

In addition, BRC-Fl will together with RRCS look into the possibility of the use of satellite images as part of its evaluation strategy of its WASH intervention and, if feasible, a basic GIS training will be given to the BRC-Fl Country Representative in Rwanda in order to be able to perform the basic analysis of the geo-data, as well as to RRCS staff and volunteers involved with primary data collection.

Decent Work Through increasing the quality and quantity of first aid trainings and commercial first aid services tailored to hazardous occu-pations, BRC-Fl and RRCS contribute to improve Occupational, Health & Safety (OSH), a core element of Decent Work and the ILO Decent Work Agenda. For further elaboration on the subject, we refer to annex 3.

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Effectiveness

First of all, two aspects make the intervention in Rwanda BRC-Fl-specific:


To ensure that all activities are based on scientific evidence, is a core principle within BRC-Fl. To assist in this endeavor, BRC-Fl created the Centre for Evidence-Based Practice (CEBaP) 10 years ago. This research centre uses an internationally recognized methodology to collect, systematize and evaluate relevant scientific evidence to underpin our activities. When insufficient evi-dence is available, primary research to support our core activities is conducted – for instance, research on FA knowledge and skills retention in Nepal or on behavior change factors for WASH interventions in Malawi.

CEBaP developed evidence-based FA guidelines and materials for the African continent, India and Nepal, which will be used in all our FA programs, including Rwanda. Based on evidence summaries developed by CEBaP, a panel of regional/local experts developed first aid guidelines, taking the preferences of the target group(s) into consideration. These guidelines were then used to develop educational first aid materials such as handbooks, posters, exercise books etc.

In the field of WASH, the evidence based way of working is implemented since 2015 through the partnership between BRC-Fl and Professor H.J. Mosler of the EAWAG University in Zurich. Through this cooperation, BRC-Fl has introduced the RANAS (Risks, Attitudes, Norms, Abilities & Self-Regulation) approach where evidence-based research assist the program in learning which elements define certain behaviors, and subsequently identify specific interventions targeting these behaviors which are needed to change. It is the objective of BRC-Fl to assimilate this technique and to systematically use it in all its WASH programs, including in Rwanda. In order to position itself in this sector, CEBaP is also performing systematic reviews in the field of behavior change and WASH.

CEBaP is recognized as an IFRC Reference Centre and aims to further develop into the RC³ (RCRC Research Centre), providing its services within the RC movement. These services are also provided to non-RC partners (for example, CEBaP has performed an evidence search on the contamination of drinking water by fluoride in Senegal, for the Belgian Technical Cooperation). All primary and secondary research by CEBaP is being published in peer reviewed journals.


Volunteers form the backbone of all National Societies, including RRCS. Investing in volunteers through skill and knowledge development ensures a qualitative implementation of RRCS’s goal to assist the most vulnerable within Rwanda. A major strength of Red Cross volunteers is their embeddedness into the local communities, even the most distant ones. The volunteers enable RRCS to be a first responder in case of sickness, injury or threat. In rural Rwanda, where access to medical care is limited, the presence of Red Cross volunteers with knowledge of the correct first aid techniques, is therefore a key mitigating factor to reduce mortality and morbidity due to sudden illness or injury within their own communities. The volunteers also enable RRCS to achieve a correct use and maintenance of water and sanitation infrastructure, as they continue to oversee or participate in the Water User Committee’s operation and maintenance activities. Moreover, a long-lasting behavioural change is more likely to be achieved as the message is brought and enforced by local and trusted community members.

Outcome 1 WASH

This outcome directly contributes to the JSG number 4 of the JSF Rwanda, by the approaches 4A, 4B, 4E, 4F and 4G. Indirectly,

a contribution is made to JSG 1 by approaches 1A, 1C, 1F and 1G and to JSG 7 by approach 7E.

Intervention strategy The program is aligned with the Ministry of Infrastructure National Policy and Strategy for Water Supply and Sanitation Services and will provide specific support to RRCS and will work with the main bodies involved in sustaining rural water supply services.

Four complementary strategies contribute to the effectiveness of this program: the increased access to safe water, the increased access to sanitation facilities, the increased knowledge and skills related to hygienic practices, and the enabling strategy of increased capacity within RRCS to implement WASH programs.

Non-functioning existing water systems in the project area will be rehabilitated and new water points will be added, thus directly providing access to safe water for the surrounding population. These water points will be handed over to newly established Water Point Management Committees, who’ll be trained, equipped and monitored by RRCS staff and volunteers, to assure smooth operation and maintenance. The quality of the water will be tested upon handover of the infrastructure, and periodically afterwards.

Elements of the PHAST and CHAST approach will be used to trigger the awareness on the importance of adequate sanitation facilities, thus stimulating the population to invest in low-cost toilets. While the lifespan of simple latrines is shorter, the use of

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cheap locally available materials should allow the local population to easily renew these when needed. In selected communities with a denser population, the program will provide subsidies or material to facilitate the construction of improved pit latrines, especially for the most vulnerable households. The combination of both PHAST and subsidized (and cost-reduced) approach will lead to a tangible increase in latrine coverage.

Thirdly, an evidence-based scientific methodology will be used to design the right approach to achieve maximum behavioral change, related to hygiene practices. A group of well trained and equipped volunteers will reach 3535 beneficiaries with diverse sensitization activities, based on the PHAST methodology. Each volunteer will act as a leader-by-example, and will directly monitor and support the assigned households in his/her direct vicinity. In turn, these volunteers will be coached and monitored by the RRCS project staff, in order to assure the quality and consistency of their efforts.

Finally, this program will also invest directly in the capacity of RRCS to deliver WASH programs, as an enabling action to obtain the desired project outputs, including its potential role as the technical agent for Operation and Maintenance of the water systems.

Outcome 2 FA

This outcome directly contributes to the JSG number 4 of the JSF Rwanda, by the approaches 4H. Indirectly, a contribution is made to JSG 1 by approaches 1A, 1C, 1F and 1G and to JSG 7 by approach 7E.

Intervention strategy Three key strategies contribute to the effectiveness of this program. Firstly, establishing high quality FA education, with the main focus on basic first aid course for the own volunteers. Secondly, strengthening the institutional capacity of the RRCS by embedding a well-functioning FA service into the organization. And finally, assisting RRCS to deliver high quality commercial FA services.

Once a FA unit is established and scientifically proven qualitative training materials are developed, a training structure is put in place or updated. Basic equipment will be provided to community volunteers and procedures related to emergency response and reporting are established. A lot is invested in organizational development: several regional meetings aim at strengthening skills in policy and procedure development, reporting skills, training and teaching competences and knowledge on (CoFA) marketing. RRCS will use the same (volunteer) training structure and resources to approach companies and provide commercial first aid (CoFA).

Sustainability

Outcome 1 WASH

Technical sustainability: The installed infrastructure answers to the requirements and demands of national legislation and is therefore enforced by local

authorities. Additionally, water user committees will be installed and trained to take up their role. (Local and regional) suppliers

will be trained and a spare part chain will be set up. Also, the intervention is risk-informed, i.e. that potential risks, such as

natural and technological hazards, are being taken into account in the design and implementation of the program (such as

constructing elevated toilets in areas with regular flooding).

Social sustainability: The intervention of BRC-Fl aims at enhancing sustainable behavioral change. RRCS works with volunteers that are embedded in the selected intervention zones and have a large capacity to enhance the local ownership of the intervention. These volun-teers do not depend on funding from BRC-Fl. The capacity building achieved for those volunteers by the BRC-Fl intervention, will remain in place after funding is withdrawn.

Financial sustainability: The Water User committees have the front line responsibility for sustaining rural water supply services on behalf of their mem-

bers. Their roles are tariff setting, revenue collection,… They are supported by the local authorities, however, as they do not

always have the resources to carry out their duties.

Exit strategy: Commitment by local stakeholders to establish multi villages water user committees according to the national policy is a pre-

condition before investing in water infrastructure works. In Rwanda, a public-private partnership is compulsory and the

management committee is part of the private partner engagement. The RRCS could take up that role. This paradigm shift

towards sustainable management (introduction of tariffs, permanent staffing, water source protection, O&M procedures etc…)

will be introduced and mandatory, to enable sustainability.

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Outcome 2 FA

Technical sustainability: The intervention of BRC-Fl aims at enforcing the institutional capacity of the RRCS by embedding a well-functioning FA service into the organization that can anchor the delivery and training of FA. This is done by supporting the management of the first aid service, the volunteer management and the organizational development. The program invests heavily in a strong training structure of RRCS, this guarantees a strong multiplier effect of quality trainings in the future among Red Cross volunteers.

Financial sustainability: BRC-Fl supports RRCS in delivering high quality commercial First Aid services. This helps RRCS in increasing their market share and revenue, which will be reinvested in the FA service. As such, financial autonomy is enhanced and dependence on external donors decreased.

Social Sustainability: RRCS works with volunteers that are embedded in the selected intervention zones and have a large capacity to enhance the local ownership of the intervention. These volunteers do not depend on funding from BRC-Fl . The capacity building achieved for those volunteers by the BRC-Fl intervention, will remain in place after funding has come to an end, as those volunteers are unpaid and as such by no means dependent on BRC-Fl funding.

Exit strategy: The exit strategy is closely linked to the chosen strategy to guarantee financial sustainability. By investing in a strong training structure and by giving additional skills in marketing, the Commercial First Aid department strengthens its market share and revenue for RRCS.

Efficiency

Delegation A BRC-Fl Delegate will be based in Kigali, in order to assist RRCS with the timely and qualitative implementation of this program. The main tasks of this delegate are to cooperate closely and on a day-to-day basis with the partner National Society, both at central level and in the project area. The delegate assists RRCS on a managerial and on a technical level – managerial in order to achieve a timely, effective and efficient implementation, and on a technical level, to ensure impact and sustainability. His/her close proximity to the implementing partner allows for direct input to achieve the project Outcomes and outputs, whilst building the capacities of the implementing partner, to increase the knowledge and skills required to do so, both at a personnel (staff development) and institutional level (systems, structures). The delegate is further supported in its role by the BRC-Fl experts at headquarters, whom provide expert-input regarding managerial (PMER, Finance, Project management) and technical (First Aid and WASH) aspects. Because of its geographical closeness to the other BRC-Fl delegations in Burundi and Tanzania and because of the similarities in characteristics between countries in the Great Lakes Region, Rwanda Red Cross will also benefit from peer-to-peer learning and from direct technical support provided by the BRC-Fl delegation in Burundi (delegate with a WASH profile) and in Tanzania (delegate with a FA profile).

Outcome 1 WASH The cost-efficiency case for water, sanitation and hygiene (WASH) is widely recognized. The World Health Organization (WHO) estimates that for every US$1 invested in water and sanitation, there is an economic return of US$4 by keeping people healthy and productive. The World Bank has stated that hygiene promotion is one of the most cost-effective health interventions. There are also strong economic arguments for investing in WASH. According to the UN’s Human Development Report, lack of safe water, sanitation and hygiene causes Sub-Saharan African countries to suffer annual losses equivalent to 5% of GDP, more than the entire continent receives in development aid. The same reasoning is followed by the Rwandan Government. The EDPRS II has an overall goal of “accelerating progress to middle income status and better quality of life for all Rwandans through sustained

economic growth of 11.5% and accelerated reduction of poverty to less than 30% of the population”. EDPRS II has set a target of ensuring universal access to water and sanitation by 2020.

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1. Investment costs

In line with the activities for the Outcome, 132.976 EUR (33%) of the investment budget is allocated to purchasing construction materials for water points. Other major investments are procurement of improved sanitation (36.952 EUR, 9%), HH water treatment kits and office mate-rial including IT (16.488 EUR, 4%).

2. Working costs

Working costs comprise of 2 main blocks: - 90.552 EUR (22%) for volunteer management within the program, including all the WASH sensitization activities. This comprises

of training of volunteers, teachers and women groups (in soap making). Training and facilitation of volunteers form the heart of the intervention to change the behavior of people on the ground.

- General working costs (45.380 EUR, 11%) for communication, transportation, promotion, stationary, media and bank costs

3. Personnel costs (80.793 EUR, 20%)

Local personnel RRCS The local personnel team of RRCS consists of 1 field WASH coordinator (1 FTE – 4 years), 35% FTE contribution to WASH coordinator at HQ and 50% FTE contribution to an accountant – 4 years.

Expat personnel BRC-

Fl

Outcome 1 and 2 are supported by one full-time BRC-Fl delegate based in Kigali. The salary budget consists out of salary costs

for the duration of the program and is shared amongst both Outcomes. Other costs like accommodation, transport costs and

other operational costs are taken within the general working costs.

HQ personnel BRC-Fl The intervention is supported by a technical WASH expert based in Mechelen (Belgium). The budget comprises of personnel & travel costs (0,08 FTE for Rwanda). This HQ WASH focal point safeguards the quality by providing tech-nical expertise directly or by linking BRC-Fl CEBaP to RRCS. Examples are carrying out or facilitating specific short-term technical missions on behavioral change techniques within hygiene promotion.

Outcome 2 FA

According to a World Bank study250, training first-responders in first aid is an extremely cost-effective intervention; it’s among the most neglected low-cost opportunities in middle- and low-income countries. First aid educations costs 8US$ per disability-adjusted life year (DALY). This makes First Aid Education one of the most cost-efficient ways to improve public health in devel-oping countries.


1. Investment costs (55.748 EUR, 15%)

In line with the activities for the Outcome, 37.891 EUR, 68% of the investment budget is allocated to training materials. 17.857 EUR (32%) is used to renovate and equip a FA training room.

2. Working costs (228.566 EUR, 65%)

Working costs comprise of 3 main blocks: - 105.517 EUR (46 % of the total working costs budget) for training volunteers, community members and staff and 19.047 EUR (8%)

is for FA manuals. The whole simulation ToT process is a key activity, improving quality and sustainability of RRCS First Aid train-ing. This includes 4 trainings given by international experts. The total cost of this process comes to 24.239 EUR (10% of the training cost). Training 450 community members requires 36.785 EUR (15%) of the training budget.

- 37.477 EUR (16%) is for general working costs like communication, transportation, media, stationary and contribution towards meetings and utilities.

- 42.284 EUR (18,5%) goes towards monitoring and evaluation

3. Personnel costs (74.166 EUR, 21%)

Local personnel RRCS:

100.504 EUR (22%)

The local personnel team of RRCS consists of 1 project coordinator (1 FTE – 4 years) and 1 assistant staff (1 FTE – 4 years).

Expat personnel BRC-Fl Outcome 1 and 2 are supported by one full-time BRC-Fl delegate based in Kigali. The salary budget consists out of salary costs for the duration of the program and is shared amongst both Outcomes. Other costs like accommodation, transport costs and other operational cost are taken within the general working costs.

HQ personnel BRC-Fl The Outcome is supported by a technical First Aid expert based in Mechelen (Belgium). The budget comprises of personnel & travel costs (0,06 FTE for Rwanda). This HQ FA focal point safeguards the quality by providing technical expertise directly or by linking the BRC-Fl national First Aid unit and CEBaP to RRCS. Examples are carrying out or facilitating specific short-term technical missions on didactical expertise FA, simulation exercise, assist in profitability analysis CoFa RRCS,...


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Partnership

BRC-Fl always operates within the partnership framework of the International Red Cross & Red Crescent Movement and works with the National Red Cross or Red Crescent Society as sole preferential partner. Principles of cooperation and capacity building are Movement-wide formalized in the IFRC ‘Development Cooperation Policy (2007)’, the ‘National Society Develop-

ment Framework (2013)’ & the ‘Code of Good Partnership’.

All Red Cross partners in this program are strategic partners, meaning the commitment for cooperation spans for at least 3 years whereby common objectives are defined and where the focus lies on capacity building of & transferring technical ex-pertise to the partner to implement quality services to the most vulnerable within the thematic priorities of BRC-Fl. Capacity building is transversal across the interventions in First Aid & WASH.

RRCS

In Rwanda, RRCS is recognized by the Government of Rwanda as auxiliary to the government in the delivery of services in the field of FA, disaster response, health and social projects. At decentralized levels, RRCS is operational in all provinces and districts. It has committees in the districts, sectors and cells. It has over 52.000 members and 15.000 volunteers working in communities with vulnerable people. RRCS is an 'emerging' National Society that has a vision and a clear strategic plan and a strong identity guided by humanitar-ian principles and values shared within its decentralized basis (districts, sectors and cells administrative) and its network of volunteers. At the same time, a number of challenges that have been jointly identified persist and will receive a particular fo-cus in the program.

WASH RRCS has an established WASH department with 1 WASH engineer position (currently vacant since August 2016) and a specialist in hygiene education. Hardware interventions are executed by subcontractors whereby the supervision is done by RRCS. The organization has a strong volunteer network which it uses to facilitate behavior change in the communities. These volunteers, who are rooted in the targeted communities, remain in their communities beyond the program lifespan. Compared to other stakeholders in the WASH sector, the Red Cross pays special attention to the most vulnerable in the community and makes sure that their hygiene needs are also looked at.

FA RRCS has an established FA department with 2 people under community FA and 3 staff under commercial FA. The organiza-tion has basic procedures in place. In the recent past they have received support from ICRC. Weaknesses of the department are: outdated content of manuals, no use of simulation to improve the quality of the trainings, weak data management sys-tems and need to strengthen Commercial First Aid.

Capacity building

BRC-Fl recognizes that capacity building is a long-term, continuing process, in which all stakeholders participate. Capacity building encompasses firstly the process of equipping individuals with the understanding and skills that enables them to per-form effectively. Secondly it includes organizational development, and establishing processes and procedures within the organization. And thirdly, it requires institutional and legal framework development, making legal and regulatory changes to enable the organization to enhance their capacities. In our intervention strategy and description of sustainability was described how long term capacity building is aimed at within our WASH and FA interventions.

Moreover, also the delegation plays an important role in reinforcing capacities of RRCS: the delegate assists RRCS not only on a managerial but also on a technical level to ensure impact and sustainability. Its close proximity allows for direct input to achieve the project outcomes and outputs, whilst building the capacities of the implementing partner both at a personnel (staff development) and institutional level (systems, structures).

In early 2017, the delegate will also facilitate an assessment together with RRCS to determine the needs for capacity building on M&E specifically related to the intervention. Further support will be determined based on the outcome of this needs assess-ment. Peer-to-peer learning and technical support from the other BRC-Fl delegations in Great Lakes Region will further add to the capacity building of RRCS.

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During the lifespan of the program, informational synergies with other Belgian ANGC’s and with the Belgian bilateral develop-ment cooperation will be upheld during recurrent consultation rounds which will serve as an exchange-platform for knowledge and experience on common themes, topics, risks or problems encountered. Also WSM & IFSI/IVSI, as organizations of the JSF Decent Work, will join in this information exchange. Moreover, together with CRB-Cf, BRC-Fl will continue to participate in Health Sector coordination meetings held by the Belgian Embassy in Rwanda. What concerns logistical synergies, RRCS has a training center and a guesthouse including individual rooms and dormitories (whose rehabilitation was funded by DGD in 2016). These infrastructures can be rented by other Belgian ANGC’s and their local partners for a price below the market price in Kigali. Besides, 2 operational synergies form an integral part of this program:

1. Synergy with CRB-Cf Objective: BRC-Fl and CRB-Cf work with the same implementing partner: RRCS. The fields of specialization of BRC-Fl, FA and WASH, have many links with CRB-Cf’s approach of community resilience. Therefore, together with RRCS the decision was made to work conjointly in the same intervention area. The objective of both the programs, to enhance the health in the 16 villages of the Murunda and Bwishyura sectors, is a shared one. Roles and Tasks: BRC-Fl will be in charge of the rehabilitation of water points and the promotion of improved latrines, including community sensitization and hygiene promotion using the PHAST-methodology. CRB-Cf will be in charge of community sen-sitization in the field of DRR, with special focus on sanitary risks, and will ensure the individual follow-up of the households involved, the establishment of ‘clubs d’hygiène’ and the general training of RRCS volunteers in the 54 villages where CRB-FL was already previously present. Also, they’ll be in charge of the general program coordination in the intervention zones. Shared coordination meeting between CRB-Cf, BRC-Fl and RRCS will take place.

Material contributions: BRC-Fl will be in charge of hiring a WASH coordinator, and the purchase of construction and sensiti-zation material. CRB-Cf will be in charge of hiring 3 program and volunteer coordinators, the sensitization material on DRR and ‘clubs d’hygiène’.

Financial contributions: Financial contributions are provided separately in the programs of BRC-Fl and CRB-Cf. For BRC-Fl, the total budget allocated to WASH (403.143 EUR) is allocated to this synergy.

2. Synergy with VVOB Objective: The synergy between VVOB and BRC-Fl will lead to a sharing of expertise and information in the field of hygiene promotion in schools. RRCS, BRC-Fl’s local partner, has substantial experience in WASH education approaches for different levels in primary education. Since hygiene is a determining factor for girl’s absenteeism, especially during their monthly men-struation periods, VVOB is interested to take up the importance of sanitation and hygiene education in primary schools as well as to build administrative capacity to better sustain WASH services in schools. WASH in schools will also be one of the activities of BRC-Fls program as they will build gender-sensitive toilet blocks for 4 schools. The exchange with VVOBs network and their results of their M&E and research related to learning outcomes and gender responsiveness in primary schools, will therefore be of particular importance for further strengthening of RKVs and RRCSs capacities on WASH in schools. Roles and Tasks: Experienced volunteers/staff of RRCS will exchange information on their experience with working with WASH education approaches in primary education within VVOBs network of school leaders. VVOB will share findings on the effects of professional development of head teachers, NQT (Newly Qualified Teachers) mentor teachers and NQTs on implementation of the competence based curriculum and learning outcomes, including on gender-responsiveness, with BRC-Fl and RRCS.

Material/ Financial contributions: Both VVOB and BRC-Fl foresee time and budget in order to allow RRCS and VVOB experts and advisors to participate in these information exchange sessions and to institutionalize knowledge and experiences gained during the synergy. This costs are covered by the salary costs and transport provision.

Lastly, this program is highly complementary to the programs of other Partner National Societies such as the Danish Red Cross and ICRC who are supporting RRCS. Coordination and communication is assured through quarterly PNS meetings. The institu-tional capacity development of RRCS in the fields of WASH and FA can directly be used in the programs of other PNS.

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Tanzania Improving institutional and commu-nity capacity to meet the own health needs

2017-2021

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Samenvatting

‘Rode Kruis-Vlaanderen (RKV) helpt helpen’ is de slogan die het 17-21 programma in Tanzania samenvat. Enerzijds verwijst dit naar de focus op zelfredzaamheid, anderzijds naar de focus op impact. Mensen zelfredzaam maken is de manier bij uitstek om een duurzame impact te hebben. Zowel RKV’s interventiestrategie als de keuze van activiteiten in Tanzania zijn gebaseerd op het idee van zelfredzaamheid. RKV’s interventiestrategie heeft als kernprincipe dat de implementatie van het programma geleid en gedragen wordt door de lokale Rode Kruis vereniging en haar vrijwilligers. RKV neemt een ondersteunende rol op zich maar zal zelf geen directe imple-mentatie doen. Het 17-21 programma, met een totaalbudget van 1.495.759 EUR wordt dan ook getrokken door Tanzania Red Cross Society (TRCS). Het programma is op vraag van en in nauwe samenwerking met TRCS opgesteld. TRCS is ook de grootste nationale humanitaire organisatie van Tanzania en is actief in het hele land. Het programma in Tanzania is opgebouwd uit de twee thematische specialisaties van RKV: water, sanitatie & hygiëne (WASH) en eerstehulponderricht. Beide interventies houden rekening met de prioriteiten van de Belgische ontwikkelingssamenwerking rond gender, milieu en klimaat, mensenrechten, digitale innovatie en waardig werk.

WASH Volgens recente schattingen heeft slechts 16% van de bevolking in Tanzania toegang tot een verbeterde vorm van sanitatie en heeft 40% van de huishoudens geen toegang tot een veilige waterbron. Vrouwen, die vaak verantwoordelijk zijn voor taken rond water in het huishouden, worden bijzonder hard getroffen. Het programma van RKV beoogt daarom om 7.886 gezinnen in Buhigwe district (Kigoma regio) te voorzien van voldoende en veilige water- en sanitatievoorzieningen. Dit doen we door het bouwen/rehabiliteren van 30 waterpunten en 1.100 latrines binnen de interventiezone, waarmee 11.780 directe begunstig-den worden bereikt. Ook worden 4 toiletblokken in scholen gebouwd. Deze infrastructuur beantwoordt aan de nationale normen en wordt op duurzame manier geïnstalleerd, waarbij er met lokale materialen wordt gewerkt en lokale “Community Owned Water Supply Organizations” (COWSO’s) instaan voor een correct gebruik en onderhoud. Hoewel adequate en toegankelijke infrastructuur essentieel is, is de impact beperkt wanneer toegang niet gekoppeld wordt aan gedragsverandering rond een correcte hygiëne. Naast het oprichten van COWSO’s, zullen elementen uit Participatory Hy-

giene and Sanitation Transformation (PHAST) worden aangewend om het bewustzijn van de lokale bevolking rond toiletgebruik te verhogen. 1.100 gezinnen, inclusief de meest kwetsbare in de gemeenschap, zullen via subsidies worden aangezet om een eenvoudige latrine te bouwen, waarna ze op hun beurt zelf 1.240 andere gezinnen ervan overtuigen hetzelfde te doen. In scholen gaat speciale aandacht uit naar meisjes door onder andere een training aan te bieden in het maken van herbruikbare maandverbanden. Rode Kruis-Vlaanderen heeft via haar “Center for Evidence-Based Practice” (CEBaP) de nodige expertise in huis rond methodes die leiden tot effectieve gedragsverandering. 20 TRCS-vrijwilligers zullen dan ook worden opgeleid in deze sensibilisatieme-thodes alvorens te worden ingezet in de betrokken districten. Dit programma voorziet ook in de duurzame capaciteitsopbouw van TRCS capaciteit in WASH. Het economisch rendement van een WASH-interventie is groot: de Wereldgezondheidsorganisatie berekende dat er voor elke US $ geïnvesteerd in WASH, een economisch rendement van 4 US $ wordt gegenereerd251. Daarnaast verklaart ook de Wereld-bank dat hygiënepromotie een van de meest kosteneffectieve interventies is, en zelfs leidt tot een negatieve kost per DALY averted252: de kosten voor het bevorderen van hygiëne liggen lager dan de kosten voor de behandeling van water-gerelateerde ziektes zoals diarree.

Eerste hulp Door TRCS personeelsleden, TRCS vrijwilligers en leken op te leiden in eerste hulp wordt de bevolking van Tanzania zelfredzaam gemaakt. Bovendien is er een duurzaam multiplicator effect door het opleiden van de ‘master trainers253’ (451 directe begun-stigden en 4.850 indirecte begunstigden). De aanwezigheid van lokale‘First Responders’ is van groot belang in een land dat kampt met een systemisch gebrek aan basisgezondheidsinfrastructuur. Deze interventie richt zich in de eerste plaats op de TRCS hoofdzetel in Dar Es Salaam, die in staat zal worden gesteld om een kwalitatieve ondersteuning te bieden aan de eerstehulpopleidingen met een focus op de 4 uit 7 pilootregio’s Dodoma, Mbeya, Kilimanjaro, Arusha, Morogoro, Kagera en Dar Es Salaam. De geüpdatete baseline zal de keuze bepalen. De trainingscapaciteit

251 Hutton G (2012) Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal cov-erage, p4. WHO, Geneva, Switzerland. 252 DALY is een maatstaf die werd ontwikkeld door de Wereldgezondheidsorganisatie. De DALY meet niet alleen het aantal mensen dat vroegtij-dig sterft door ziekte, maar meet ook het aantal jaren dat mensen leven met beperkingen door ziekte. In maatschappelijke kosten-batenanalyses worden DALY's ook toegepast om de kosteneffectiviteit van gezondheidsinterventies te bepalen. Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edi-tion). Washington D.C. World Bank, chapter 2. 253 Trainers die andere trainers kunnen opleiden.

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van TRCS zal worden versterkt met 30 eerstehulptrainers en 5 master trainers. Dankzij de synergie met VIA Don Bosco plannen we ook hun doelgroepen te kunnen bereiken met een eerstehulpopleiding. Naast het opleiden in eerste hulp, wil RKV de zelfredzaamheid van TRCS versterken door hen in staat te stellen financieel autonoom te investeren in eerstehulpactiviteiten. Door TRCS meer zelfredzaam te maken, garanderen we een grotere duur-zaamheid van eerstehulpactiviteiten. RKV wil dit doen door TRCS te ondersteunen in het uitbouwen van bedrijfseerstehulp. Dit doen we in de eerste plaats via kennisoverdracht (workshops rond marketing en het opzetten van een kostenmodel). De uit-bouw van bedrijfseerstehulp ligt in lijn met de ‘Waardig Werk’ prioriteiten van Tanzania rond veiligheid en preventie op de werkvloer. Naast zelfredzaamheid is impact een belangrijke focus van het RKV programma in Tanzania. Een studie van de Wereldbank toont aan dat het investeren in de opleiding van eerstehulpvrijwilligers één van de meest kosteneffectieve interventies is met een kost van slechts 8 US$ per DALY averted254. Bovendien investeert RKV via het CEBaP continu in onderzoek naar interven-tiestrategieën met de meeste impact. Zo onderzoeken we het effect van simulaties in eerstehulpopleidingen of welke eerstehulpkennis op welke leeftijd kan onthouden worden. De resultaten van deze onderzoeken zijn geïntegreerd in RKV’s eerstehulpondersteuning aan TRCS. Daarnaast heeft het CEBaP evidence-based eerstehulprichtlijnen uitgewerkt die volledig aangepast zijn aan de Afrikaanse context (‘AFAM’, African First Aid Materials’). Het eerstehulpopleidingsmateriaal van TRCS zal op basis hiervan herzien worden zodat steeds de meest doeltreffende praktijken in eerste hulp worden aangeleerd. RKV wil de impact van het programma in Tanzania ook vergroten door gebruik te maken van haar jarenlange operationele expertise rond eerstehulpopleidingen. Binnen RKV bestaat de dienst ‘Eerste Hulp’ die 500 trainers in dienst heeft om nationaal eerstehulpopleidingen te geven. Deze trainers worden voor specifieke expertisegebieden ingezet in ons programma. Gedurende alle fases van de interventie, wordt een gender-sensitieve benadering gehanteerd: binnen TRCS wordt gestreefd naar een gelijkmatige verdeling van vrouwen en mannen binnen de eerstehulplessen én de beheers- en bestuursorganen van de organisatie. Aan de hand van gender-gedisaggregeerde indicatoren zullen verwezenlijkingen in kaart worden gebracht. Daarnaast zullen inspanningen worden gedaan om de impact van onze interventie op het milieu te beperken, door onder andere de aankoop van lokale materialen en een correcte afvalverwerking. RKV gelooft ten stelligste dat het 17-21 programma in Tanzania rond WASH enerzijds en eerstehulponderricht anderzijds door zijn focus op zelfredzaamheid en duurzame impact sterk bijdraagt tot een verhoogde toegang tot eerstelijns gezondheidszorg en WASH voorzieningen. Op die manier komt het programma tegemoet aan de Gemeenschappelijke Strategische Doelstelling 4255 van het Gemeenschappelijk Strategisch Kader Tanzania en aan de Sustainable Development Goals 1, 3, 5, 6, 8 & 13.

254 Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2. 255 Bijdragen aan een verbeterde toegang tot preventieve en curatieve gezondheidszorg en tot WASH infrastructuur voor de volledige bevol-king, met speciale aandacht voor de noden van de meest kwetsbaren.

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Country Fiche

Total Operational Costs 1.495.759

Contact person in Belgium Name: Tiene Lievens


Cross-Flanders (BRC-Fl)

Phone No: +32

15 44 33 57

E-mail: Tiene.Lie-

[email protected]

Narrative summary Between 2017 and 2021, the newly established cooperation between BRC-Fl and Tanzania Red Cross Society (TRCS) will focus on first aid (FA) training and water and sanitation (WASH). The WASH program actively contributes to the sustainable development goals (SDG) 3, SDG 5, 6 and 13. The FA intervention contributes to SDG 1, 3, 5 and 8. Additionally, the program directly contributes towards Joint Strategic Goal (JSG) 4256 on health in the Joint Strategic Framework (JSF) of Tanzania and is in line with our internal Strategy 2020257.

BRC-Fl focuses on these 2 areas of intervention in order to be able to deliver a tangible added value to the partnership.

Firstly, FA is a priority activity for all Red Cross Societies worldwide, and especially relevant in Tanzania, because of frequent disasters and lack of health infrastructure and services. Moreover, FA Education is a very cost-effective intervention. At a cost of 8US$ per disability-adjusted life year (DALY)258, FA is one of the cheapest ways to increase public health in developing countries. BRC-Fl has extensive expertise in FA education, assuring that what is thought, is conform the latest scientific evidence. Due to the large spillover effects, a total of 5.301 beneficiaries will be reached.

Secondly, access to sufficient and safe water and sanitation is an important contributor to overall health and poverty reduction. In rural Tanzania of the Kigoma region, many water supply systems are malfunctioning or out of order. Apart from access, this program will use scientific approaches to hygiene behavioral change, building on the vast network of TRCS volunteers. With this program, 49.809persons in maximum 7 villages (Buhigwe, Mulera, Kavomo, Munyegera, Songambele, Kajana, Kasumo) in Buhigwe district will benefit from the WASH intervention. The technical survey will identify the exact intervention area. This outcome is complementary to the intervention of the Belgian Development Agency (BDA) and possibilities for synergy will be explored.

256 To contribute to improving access to preventive and curative healthcare & washing infrastructure for the general population, paying particu-lar attention to the needs of vulnerable people. 257 Rode Kruis-Vlaanderen, Strategie 2020: “Increased resilience (‘zelf-redzaamheid’) and intra-reliance (‘samen redzaam’) of the target popula-tion by the end of 2021.”

258 Laxminarayanet al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2.

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List of partners

Local Partner

Full Name & abbreviation: Tanzania Red Cross Society (TRCS)

Contact details Address: MwaiKibaki Rd, Dar es Salaam, Tanzania Website: http://trcs.or.tz/

Phone No: +255 22 260 0473 E-mail: [email protected]

Contact person Kinyagu, John Thomas: [email protected]

Outcome(s)

O1: Sustained use of sufficient safe water & sanitation facilities, as well as sustained safe hygiene attitudes & practices by the target population by 2021.

O2: Lay people, Red Cross staff & volun-teers have adequate, up-to-date and evidence based knowledge, skills & atti-tudes to provide first aid to those in need by 2021, as such enhancing community level resilience and emergency care capac-ity.



TRCS, through its nationwide network of branches and volunteers, is the main implementing partner for these outcomes. With support from BRC-Fl headquarters and delegation, TRCS is responsible for the planning, implementation, monitoring and reporting of this program.


01/04/2017

Theory of Change (ToC)

The ToC’s as presented in this section, serve as the basic reflection for the Logical Framework, which will be used as a monitoring document through all phases of program implementation. A narrative description of the intervention strategy which is sche-matically presented in this ToC, can be found in the section ‘Effectiveness’. In addition, a general explanation on how BRC-Fl has structured and defined the ToC model can be found in Annex 1.

For assumptions, scientific references are available but not listed in this document due to page limitations – they are available upon request.

241

Stakeholders and contextual factors are listed here. An elaborate description of their role and influence on the ToC is available on request.

Outcome 1: WASH


243

1. Assumptions


frame

Does it

hold?



• Less waterborne pathogens lead to

better health.


• The positive effect of WASH interventions on health outcomes has been shown in many studies and systematic reviews. Moreover, DFID’s evaluation data reports wider impacts of WASH programs in the form of reduction of the burden of disease and increased school attendance. It found that there is good evidence that the health impacts include many other important diseases beyond diar-rhea.

• As water related diseases such as diarrhea are caused by infections by water borne pathogens, it is evident that a reduction in these infections will lead to less water related diseases and a better health overall.

B Better hygiene leads to reduced infec-tions by water-related pathogens.

Outcome 1 Yes Sanitation and hygiene are critical to health, survival and development. Providing access to safe water and sanitation facilities and pro-moting proper hygiene behavior are important in reducing the burden of disease from sanitation and hygiene-related diseases.


Outcome 1 Yes An assessment of the evidence underlying the impact of the four main WASH interventions (water quality, water availability, excreta disposal, hygiene promotion) on diarrhea shows that the availability of water is the most favorable intervention based on a specific set of appraisal factors.

D Access to sufficient & improved sanita-tion facilities leads to better hygiene and reduction of water related diseases.

Outcome 1 Yes, but more re-search needed

Sanitation has the second highest impact on reducing diarrhea in Tanzania, decreasing the impact by about 36%. In addition, an impact evaluation in Bangladesh showed that improvement in sanitation facilities had led to a reduction in water-borne diseases. Only a few systematic reviews have looked at the effect of sanitation facilities on the health status or the reduction of diseases. Further research in this area is needed.

E Hygiene promotion via different meth-odologies leads to sustainable hygiene behavior change.



BRC-Fl is conducting a systematic review to determine which promotional approaches are effective to change hand washing and sanita-tion behavior in low- and middle-income countries. This project is a collaboration of the BRC-Fl Centre for Evidence-Based Practice (CEBaP) and the Centre for Evidence-Based Health Care of Stellenbosch University South Africa. Oversight and guidance is provided by 3ie (International Initiative for Impact Evaluation).

F TRCS is a relevant actor in the WASH sector.

Outputs 1.1-1.3

Yes Evidence suggests that the most influential factors associated with sustained adoption include frequent contact with a health promoter over a period of time. Personal follow-up may further contribute to sustained adoption. The large network of Red Cross volunteers can play exactly the role of health promoter as they are part of the target communities, and are present beyond the duration of the inter-vention. TRCS has implemented WASH interventions before though the WASH expertise is limited (cfr. risk analysis).

G Time saved by women for water collec-tion leads to more possibilities for women empowerment as well as less risk of violence and injury.


Yes Studies have shown that WASH interventions significantly reduce the time that women need to spend on fetching water and taking care of sick children. In addition, a smaller time and energy burden associated with fetching water may decrease the risk of violence and injury for women.


• Sex-aggregated and girl-friendly toi-lets lead to increased school attendance by girls.


•Yes

•More re-search needed

• DFID’s WASH evidence paper states that the impacts of inadequate water and sanitation are particularly pronounced for women and girls. Inadequate sanitation facilities may expose women to the risk of violence, and finding adequate locations for open defecation can require significant time.

• Qualitative research indicates that some girls may be discouraged from attending school without adequate toilet facilities. However, no evidence is available on the direct link between sex-aggregated toilets and increased school attendance by girls. Specifically in the Tanzanian context, girls in particular are less likely to regularly attend school after reaching puberty if toilet and hygiene facilities are inadequate or non-existent.

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2. Stakeholder Analysis

1. Relevant governmental bodies like the Ministry of Water, Ministry of Natural Resources and Forestry, Ministry of Gender, Labour & Social Development, Ministry of Education and Vocational-Training, Ministry of Health and Social Welfare, the Prime Minister’s Office and the Energy and Water Utility Regulatory Authority

2. Decentralized offices of partner ministries in Buhigwe district (LGAs), including the Water Department, (= District Water Engineer’s office, DWE’s office), Office of Regional Administration and Local Government (PMO-RALG), Regional Water and Sanitation Team (RWST), Regional Secretariats (RS)

3. Tanzania Revenue Authority 4. Users (individuals, households, organizations and companies) like Community Owned Water Supply Organizations (COWSOs) 5. UNICEF 6. BDA (=BTC) 7. School management, Parents Teachers’ Association (PTA), pupils

8. Suppliers (related to sanitation and/or water (spare part) systems) , like Urban Water Supply and Sewerage Authorities (UWSAs)

I • The chosen approaches/methodolo-gies to promote WASH behavior change are effective.

• TRCS volunteers are effective agents of sustained WASH behavior change.



• Yes

• Cfr. Assumption E and ongoing systematic review by BRC-Fl in cooperation with 3ie. In addition, BRC-Fl currently is conducting re-search on which behavior change techniques are most effective specifically for the intervention area in Malawi in cooperation with prof. Hans-Joachim Mosler of EAWAG university in Zurich .

• Cfr. Assumption F

J WASH interventions contribute to cli-mate change adaptation and resilience.

Impact Yes Promotion of WASH infrastructure and behaviors is a critical component of climate change adaptation and promoting human rights. The Red Cross/Red Crescent Climate Centre underlines the link between the availability of water and sanitation infrastructure and in-creasing hygiene awareness, and communities’ vulnerability to extreme weather events.

K WASH interventions have a positive im-pact on poverty reduction.


L By reducing the distance to safe water, water will also be used for hygienic pur-poses, not just drinking and cooking.

Outputs 1.2-1.3


245

3. Context analysis

• Legislation in place for the water and sanitation sector: Tanzania Water & Sanitation Development Plan 2007-2020 (WSDP), Sustainability Strategy June 2015- July 2020

• Size of the country: focus on Buhigwe district (Kigoma region) • Tanzania is a society with a relatively strong male dominance.. • Widespread poverty in the remote Kigoma region. • TRCS is a well know recognized partner for (WASH) interventions at community level. • Population growth (3% per year). • In rural Tanzania and Kigoma region many water supply systems are malfunctioning or out of order due to weak management, ageing infrastructures and lack of operation and maintenance

(O&M) throughout time. • The sanitation sector is undermined by the lack of accurate data on the current state of latrine coverage. The lack of proven effective strategies to persuade and enable rural and urban house-

holds to invest in improved sanitation in the Tanzanian context is also holding back the sector.

4. Activities

1 Water supply: construction and/or rehabilitation of one existing system in Buhigwe district

2 Water supply: - operation and maintenance of existing system in Buhigwe district (watershed protection) - Establishment and training of COWSOs.

3 Sanitation construction (marketing sanitation) at household level and in schools, including the construction of handwashing facilities

4 Sanitation software (environmental sanitation) at household level and in schools

5 Hygiene promotion at household and community level: - implementing PHAST and PHASE methodology - ‘triggering’ households to promote household latrine construction. - hygiene sensitization of communities by TRCS volunteers, facilitated by the production of IEC materials

6 Capacity strengthening activities - Provision of BRC-Fl WASH expertise to TRCS - Training of TRCS WASH staff and /or volunteers. - Set-up of (mobile) data collection system and continuous monitoring of program implementation. - Baseline study, Midterm evaluation, End term evaluation - Annual financial audit

Outcome 2: FA


247

1. Assumptions


frame

Does it

hold?




• FA education is a very cost-effective develop-ment intervention to increase public health.


• Yes

• A British Red Cross study shows linkages between features of community resilience and first aid training. • Evidence based FA techniques are proven to be more effective towards injury treatment/illness recovery. The BRC-Fl Cen-

tre for Evidence-Based Practice (CEBaP) specializes in the evidence based methodology for first aid guideline development, using the best available evidence from scientific literature, supplemented with know-how from experts and information gleaned through practical experience.


B Smaller negative impact on health in case of in-jury/illness because people are assisted with first aid.


• A systematic review is ongoing on the health effects of training lay people to deliver emergency care in underserviced populations. Results will be available in 2017. One case study in Iraq showed that a reduction in mortality was caused by trained layperson first responders in a setting where pre-hospital evacuation times are long.

C • Lay people and TRCS staff & volunteers inter-vene to apply FA if they have the required knowledge, attitudes and practices.

• Lay people have access to basic FA local ma-terials for applying first aid techniques.

• First aid lay responders as well as FA trained TRCS staff & volunteers can intervene and provide first aid in a safe legal environment (legal liability).

Outcome 2 • Yes, but more re-search is needed.

• Yes

• No

• A systematic review reports significant increases in first aid knowledge, skills and improvement in helping behavior due to first aid training for children and lay people. A case study in Uganda shows that groups of people who regularly have to apply FA have a higher retention of FA knowledge. A Red Cross structure could be considered in a similar way. In addition, evidence that volunteers give proper first aid is observed during monitoring sessions and regular data collection.

• Sensitization on the importance of having adequate FA materials and on the use of local materials will be part of the inter-vention. FA trainings are also adapted to locally available materials.

• In none of the intervention countries the law provides protection for bystanders providing first aid. However, the 32nd International Conference of Red Cross and Red Crescent Societies adopted a resolution on strengthening legal frame-works for disaster response, risk reduction and first aid.

D Trained and equipped TRCS volunteers are re-tained.


Yes TRCS has a volunteer policy in place to recruit, motivate and retain volunteers.

E TRCS is able to recruit the required volunteers and staff to provide FA.

Outputs 2.1-2.3

Yes Cfr. D on recruitment & volunteer policies. In addition, TRCS has already a volunteer base of 12.000 volunteers (however, these data are not up-to-date).

F There is adequate follow-up and coaching of TRCS volunteers and staff.

Outcome 2 Output 2.1-2.3

Yes, but a risk

The workshops on institutionalization will define the current quality control mechanisms and identify the gaps. Refresher trainings will upgrade skills and knowledge of staff and volunteers. Supervision of trainings will show the dedication and competences of the TRCS instructors.

G • Commercial FA generates income. • TRCS is willing to invest the income generated

from commercial first aid trainings at least partly back into the FA service.

Outputs 2.2-2.3

• Yes

• Yes

• In 2016, BRC-Fl undertook a study in cooperation with the Vlerick Business School analyzing the cost of FA trainings in Ne-pal using a time-driven activity based costing model. Being a pilot study, BRC-Fl aims to use this model to improve commercial first aid activities in other partner countries.

• As part of an exit strategy, a scheme will be set up (cfr. section ‘Relevance’). TRCS commits itself to reach financial sustaina-bility by the end of the project for HR for the FA dept. and FA materials.

H People who decide to become a TRCS volunteer or staff recognize and value the importance of first aid.

Output 2.2 Yes Within RC organizations first aid is recognized as a core activity, and each newly recruited volunteer is introduced in the vi-sion, mission and policies of the organization. TRCS recognizes FA as their core business.

248

I The used didactical methods are effective. Output 2.1 BRC-Fl re-search planned


J Lay people (incl. TRCS staff and volunteers) suf-ficiently retain the knowledge and skills obtained during a FA (refresher) training.



BRC-Fl is conducting a study to assess the degree of knowledge and skill retention over a period of time and to determine the impact of refresher courses and FA practice on the retention level. This information will be used to determine the optimal frequency of refresher courses and to assess the need to revise the validity of FA certificates.

2. Stakeholder analysis

1. Other FA training providers like Occupational Safety and Health Authority, FA Africa,… 2. Tanzania National Ambulance Services 3. Tanzania Police Force (Traffic Police, Directorate of Fire Rescue, Marines Department) 4. Tanzania Revenue Authority 5. Private and Public Health Service Providers 6. FA equipment suppliers 7. Companies 8. Ministry of Health, Community Development, Gender, Elderly and Children, Ministry of Labor and Employment 9. Decentralized offices of partner ministries 10. Other partner national societies of TRCS 11. Civil society organisations with strengths in conducting advocacy work

3. Context Analysis

• Legal context on first aid. Legislation in place on CoFA. • External motivation for companies to comply with the Labor laws on Occupational Safety and Health in Tanzania. • Size of Tanzania and the remoteness of some areas makes it difficult to sufficiently monitor FA training and activities over the country and/or to involve FA-trainers / volunteers sufficiently. • Tanzania is a society which is relatively strongly dominated by males. Women are still largely expected to prioritize family life over professional opportunities. • TRCS is the largest humanitarian organisation in Tanzania. • Annual population growth of 3% with youths below 14 years making up 44% of the population (GCA Tanzania, p. 23) • Ministry of Health does not enhance TRCS as a FA provider. • Increased competition in commercial first aid training from national or international actors, including from the National Occupational Safety and Health Authority (who should be monitoring

the legal framework)

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4. Activities

1 Capacity strengthening of the FA department in the organization, i.e. 2 trainings on: • Standardization of FA training curricula • Development, translation and dissemination of FA policy • Standardization, translation and dissemination of FA procedures • Set-up of FA training database and registration of trainings.

2 Development of quality evidence-based FA materials: including: • Revision of basic FA manual for trainers & trainees based on AFAM/evidence based guidelines • Revision/development of FA didactical training materials based on AFAM/evidence based guidelines.

3 Training TRCS volunteers in FA: • 2 Trainer of Trainer (TOT) trainings to train 30 FA trainers and training of 5 master trainers in 1 regional training • Refresher training of 30 FA trainers • Training of 400 TRCS volunteers in basic FA

4 Procurement of various FA training materials (splints, bandages, resuscitation mannequins, flip charts, laptop, beamer, minor office equipment, etc.)

5 Promotional activities during World First Aid day.

6 Monitoring activities, including : • Monitoring of FA trainings • Baseline, Midterm evaluation, End evaluation • Annual external financial audit

7 Recruitment of 1 FA coordinator (100%) and 1 finance person (50%)

8 • Promotion of Commercial First Aid (CoFA): • 1 training on marketing CoFA, Marketing and marketing plan (marketing strategy) • Development of CoFA policy, strategy, and internal procedures • Definition of the organisational set up (integrated or autonomous set-up) • Training support to HR qualified in commercial activities (sales, administration) • Management and organisation of CoFA trainings, registration & database • Financial management (cost model), development of a business plan and CoFA operational plan

250

Risk Analysis

Below is a selection of relevant risks for Tanzania in general, and for the project outcomes in specific. A thorough and detailed risk analysis was conducted for each country, and an example is added in Annex 2.

TOC refer-

ence Description of risk

and impact

Im-

pact

(1-6)

Pro-

babi-

lity

(1-6)

Mitigation Responsable

for monito-

ring


Outcome 1,

Projections indicate that by 2025 Tanzania will experience water stress due to popula-tion growth and the resulting increase in consumption (Joint

Context Analysis (JCA)

Tanzania, p. 69)

3 1 This risk is beyond the scope of the program, how-ever, an annual population growth of 3% will be taken into account when designing the construction or re-habilitation works. Also, by the decision on location and construction of WASH infrastructures, BRC-Fl makes sure they remain flood-proof. Moreover, sus-tainable access to water & sanitation and knowledge of appropriate FA techniques, increases resilience of communities hit by effects of climate change.

MoW, regional WASH coordinator

Outcome 1

and Out-

come 2, S1

Limited capacity of TRCS

6 2 The program pays a lot of attention to capacity building of the local partner. The delegate assists in the planning, monitoring of implementation and re-porting. Use of external local and international experts will fill potential gaps in expertise.

Delegate, Sec-retary General TRCS

Project Level Risks

Outcome 2

A lot of competition in the field of Com-mercial First Aid, in the first place from the National Occupa-

tional Safety and

Health Authority (who should be monitoring the legal framework)

3 5 An analysis of the sector will indicate which (com-mercial) groups are served by whom. Once TRCS has a strong training structure in place, it can outline a focused strategy for specific (underserved) target groups.

Delegate, Sec-retary General and senior management

Outcome 1,

output 1. J.

S1

Risk that the pro-tected water points are poorly managed and not repaired in case of problems be-cause of poorly organized manage-ment committees

6 3 The formation and training of COWSO’s is im-portant. The management committee(s) will be supported by local authorities and the branch in case of technical difficulties. A Memory of Under-standing with the district should indicate clear roles and responsibilities. In case of malfunction of a committee, volunteers from the RC will appeal to lo-cal authorities to intervene and solve problems.

Field coordina-tion

251

Lessons learned and Recommendations

Strategic Dialogue Recommendations

The Strategic Dialogue (StDi) between DGD and the participants of the GSK Tanzania, took place on the 13th of June 2016 within the offices of the Embassy of Belgium in Dar Es Salaam.

In the final advice of DGD, two points of consideration for the programs 17-21 should be taken addressed:

1. Transversal themes gender & environment should be taken into account. We refer to the section “Relevance re-lated to the priorities of the Belgian Development Cooperation” for a description on how those themes find their reflection in our intervention.

2. The operationalization of commitments for synergies and complementarities. Here, we kindly refer to the section « Synergies and Complementarities » in which concretized synergies and complementarities are described.

Lessons Learned from previous in-country experiences in WASH and FA – pro-

gramming

Since more than 15 years, BRC-Fl implements WASH and First Aid Programs in different (African) countries, resulting in an increased capacity of national societies to deliver qualitative WASH and first aid services to the population. This experience results in a wide range of lessons learned which form the building blocks of our future intervention in Tanzania.

WASH

FA


Standardisation is the key entry point to build up quality

first aid education.

This clarifies why the programs focuses on quality and standardisation in the first

place (more than on training big amounts of beneficiaries). Standardised curric-

ula and development of standardised, evidence based first aid materials will be

included and updated in the program.

A well-functioning first aid unit is embedded in the struc-

ture of the national society and able to advocate and

promote First Aid to the different stakeholders and the

government.

Institutional development is included in all the first aid programs, elaborating a

clear strategy and policy on first aid, development of guidelines and procedures,

defining clear positioning into the national society contributing to a solid foun-

dation for the first aid service.

Improving FA education contributes to adequate qualita-

tive FA interventions within different country specific

target groups. Active volunteers need appropriate equip-

ment and follow up.

The program adapts the activities and resources in relation to the country needs

and specific strategic approaches described in the strategic plan of the national

society towards specific target groups. TRCS has chosen to focus on the own vol-

unteers as the priority target group.

Installation of well-managed, profitable commercial first

aid service is complex and needs a commercial enterprise

approach.

TRCS needs clear guidance, basic knowledge and skills on commercial ap-

proaches. Introduction, support and step by step guidance to obtain a marketing

plan, business plan, adequate data- and financial management is included in

CoFA programs.


A combination of several WASH interventions in the same (limited) geographical area is preferred to create impact. A combination of different approaches in water, sanitation and hygiene, both construction and educa-tional support, motivates community members to change their behavior.

The program provides resources for construction/rehabilitation of the water sys-tem and latrines at household level and in schools, all in the same area. Additionally, the intervention invests in different software approaches.

Only providing WASH facilities does not automatically lead to behavior change. A long term focus on software is needed to create long term behavior change.

Different approaches of software are executed by a network of volunteers on the ground. This is the strong added value of the Red Cross. By setting up community structures with trained, local volunteers, a strong supportive and (social) control mechanism is established, which remains even after the intervention.

252

Outcome 1 WASH

Outcome Fiche

Outcome (English or French) : Sustained use of sufficient safe water & sanitation facilities, as well as sustained safe hygiene attitudes & practices by the target population by

2021.

Outcome (Nederlands): De doelgroep maakt tegen 2021 gebruik van duurzame water- en sanitaire voorzieningen die toereikend en veilig zijn, en houdt er veilige attitudes

en praktijken op na omtrent hygiëne.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_14_TZ_DGD

Country: Tanzania Is this Outcome covered by a JSF? Yes


Local partners or program

partners TRCS

Tanzania Red Cross Society Headquarters,

Dar Es Salaam TRCS: Kigoma region TRCS: Buhigwe Branch

Target population: Households and schools in a rural setting in possible 7 villages -Buhigwe, Mulera, Kavomo, Munyegera, Songambele, Kajana, Kasumo- in Buhigwe

branch, Kigoma region. (to be determined after a detailed technical study)

Number of beneficiaries:

Total: 49.809

Direct: 11.780

Indirect: 38.029


Other organisations involved N/A


Policy Marker



Biodiversity (Rio-Mar-

ker)

1 Climate Change – Adaptation (Rio-Marker) 2 Climate Change - Mitigation (Rio-Marker) 1



253

Logical Framework

For some indicators, baseline data are currently not available. A full baseline exercise will be conducted after program approval to rigorously determine and update baseline and tar-get values for each indicator. Annual numeric targets are presented as a cumulative total vis-à-vis the baseline value. References and definitions are available on request.


Process indicators

Indicator 1: Number of direct ben-eficiaries reached.

0 Total: +20 Female: + 10 Male: +10

Total: +4.080 Female: + 2.324 Male: +1.756

Total: +10.060 Female: + 5.733 Male: +4.327

Total: +11.780 Female: + 6.713 Male: +5067

Total: +11.780 Female: + 6.713 Male: +5067

TRCS monitoring & reporting forms

Indicator 2: Number of indirect beneficiaries reached

0 Total: +0

Total: +10.000

Total: +25.000

Total: +38.029

Total: +38.029


Impact: JSG 4 – JSF Tanzania: “Contribute to improving access to preventive and curative healthcare & WASH infrastructure for the general population, paying particular attention to the needs of

vulnerable people.”


Outcome 1: Sustained use of sufficient safe water & sanitation facilities, as well as sustained safe hygiene attitudes & practices by the target population by 2021.


Indicator 1.1: % of households in the target area using sufficient safe water from an improved water point.

40%

N/A N/A +T12% N/A +12% Household survey/spot checks/obser-vation, volunteer monitoring reports

Indicator 1.2: % of households in target area that uses an improved latrine.

16% N/A N/A +17% N/A +26% Secondary data: ODF certificates (data-base), Household survey/spot checks/observation, volunteer moni-toring reports

Indicator 1.3: % of households in target area whose members wash their hands with water & soap (or local acceptable alternative) at crit-ical times.

20% N/A N/A +12% N/A +18% Household survey/spot checks/obser-vation, volunteer monitoring reports

Indicator 1.4: time required per day for water collection by water collector (incl. queuing time).

30 min

N/A N/A -13 min

N/A -13 min

Household survey, volunteer monitor-ing reports

Output 1.1: Increased availability of safe and sustainable water supply for target population by 2021.


Indicator 1.1.1: Number water points constructed / rehabilitated according to national standards.

TBD +0 +15 +30 +30 +30 Hydrological survey reports, design documents, drilling log, completion re-port with GPS data, hand-over report

254

Indicator 1.1.2: Number of water points with an established water management committee or as-signed service provider.

TBD +0 +15 +30 +30 +30 TRCS monitoring tools, contract with service provider, membership records, records of funds collected



Indicator 1.2.1: Number of im-proved latrines built.

0 +0 +1.100

+1513 +1926 +2340

TRCS volunteer monitoring reports

Indicator 1.2.2: Number of girl/women-friendly latrine blocks built in schools.

0 +0 +0 +4 +4 +4 TRCS volunteer monitoring reports

Output 1.3: Target population has improved knowledge & skills on safe hygiene practices by 2021.


Indicator 1.3.1: Number of people trained in/through PHAST

Total: 0

Total: +20 Men: +10 Women: +10

Total: 1.032 Men: +516 Women: +516

Total: +4.232 Men: +2.116Women: +2.116

Total: +6.232 Men: +3.116 Women: + 3.116

Total: +6.232 Men: +3.116 Women: + 3.116

TRCS volunteer monitoring tools

Indicator 1.3.2: Number of hygiene behavior change techniques im-plemented.

0 +0 +3 +5 +5 +5 TRCS volunteer monitoring tools

Output 1.4: TRCS has an increased capacity to implement WASH related interventions by 2021.


Indicator 1.4.1: Number of activi-ties related to evidence based practice (EBP)

0 +1 +2 +3 +4 +5 TRCS monitoring tools

Indicator 1.4.2: Number of WASH tools adopted and used by TRCS.

0 +1

+3

+4

+4 +4 TRCS monitoring tools


255

Operational Budget

Partners

Total TRCS 65.989 213.270 189.209 71.630 38.471 578.568

Total Partners: 65.989 213.270 189.209 71.630 38.471 578.568

Collaboration




Operational Costs

1. Partner 65.989 213.270 189.209 71.630 38.471 578.568

Investment costs 6.735 104.858 115.266 226.858

Working costs 44.561 79.024 44.555 42.242 23.777 234.159

Personnel costs 14.694 29.388 29.388 29.388 14.694 117.551









4. HQ 39.959 53.319 53.319 53.319 53.319 253.236





Total 105.948 266.589 242.528 124.949 91.790 831.804

Investment costs 6.735 104.858 115.266 226.858

Working costs 60.273 98.974 64.505 62.192 43.727 329.672

Personnel costs 38.940 62.757 62.757 62.757 48.063 275.274

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Outcome 2 FA

Outcome Fiche

Outcome (English or French): Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhancing community level resilience and emergency care capacity.

Outcome (Nederlands): Leken, Rode Kruispersoneel- en vrijwilligers beschikken tegen 2021 over doeltreffende, meest recente en evidence based kennis, vaardigheden en attitudes om eerste hulp te verlenen aan zij die het nodig hebben en verhogen op die manier de zelfredzaamheid van gemeenschappen

IATI activity identifier: BE-BCE_KBO-0461634084-2017_15_TZ_DGD

Country: Tanzania Is this Outcome covered by a JSF Yes



Tanzania Red Cross Society

Headquarters (based in Dar Es Salaam) 4 regions (Dar-es Salaam, Dodoma, Mbeya, Kilimanjaro, Arusha, Morogoro and Kagera)

Target population: Lay people, Red Cross staff & volunteers & people in need of FA services

Number of beneficiaries: Total: 5.301 Direct: 451 Indirect: 4.850


Other organisations involved N/A


Policy Marker






257

Logical Framework

For some indicators, baseline data are currently not available. A full baseline exercise will be conducted after program approval to rigorously determine and update baseline and tar-get values for each indicator. Annual numeric targets are presented as a cumulative total vis-à-vis the baseline value. References and definitions are available on request.


Process indicators

Indicator 1: Number of direct ben-eficiaries reached.



Total: +447 Female: +223Male: +224


Total: +451 Female: +225Male: +226



0 Total: +375

Total: +2.730

Total: +3.050

Total: +4.950

Total: +4.850

Midterm and end evaluation

IMPACT: JSF – Tanzania JSG 4 (Health): Contribute to improving access to preventive and curative healthcare & washing infrastructure for the general population, paying particular

attention to the needs of vulnerable people.

Assumptions: cfr. assumptions listed under section ‘Theory of Change’.

Outcome 2: Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such

enhancing community level resilience & emergency care capacity.


Indicator 2.1: Number of lay peo-ple with a valid FA certificate.

Total: 0 Women: 0 Men: 0

N/A N/A Total: +0 Women: +0 Men: +0

N/A Total: +200 Women: +100 Men: +100

TRCS FA training database, TRCS train-ing records


Total: 0 Women: +0 Men: +0

N/A N/A Total: +580 Women: +290 Men: + 290

N/A Total: +680 Women: +340 Men: +340

FA training/volunteer database, train-ing records

Output 2.1: High quality FA education for different target groups is available by 2021, as such enhancing community level resilience and emergency care capacity.


Indicator 2.1.1: Presence of a final-ized gender sensitive AFAM based basic FA didactical training materi-als.

No Yes

Yes

Yes Yes Yes TRCS FA training manual/didactical materials



Total: +15 Women: +8 Men: +7

Total: +430 Women: +215 Men: +215

Total: +460 Women: +230 Men: +230

Total: +460 Women: +230 Men: +230

Total: +460 Women: +230 Men: +230

TRCS FA training database, TRCS train-ing records

Output 2.2: The TRCS has a well-functioning FA service embedded in the organization by 2021.


Indicator 2.2.1: Number of FA trained volunteers & staff regis-tered in a TRCS volunteer database.

0 +15 +430 +430 +430 +430 TRCS volunteer da-tabase, FA training database

258

Indicator 2.2.2: Number of active FA Trainers.




Total: +65 Women: +32

Men: +33


Men: +33


Men: +33

TRCS trainer database, TRCS training records

Output 2.3: The TRCS delivers high quality commercial FA services by 2021.


Indicator 2.3.1: Number of new cli-ents trained in CoFA.

0 +0 +0 +0 +10 +20 TRCS FA training or client database, TRCS training records


259

Operational Budget

Total TRCS 114.867 146.075 71.784 52.243 30.750 415.719

Total Partners: 114.867 146.075 71.784 52.243 30.750 415.719

Collaboration




Operational Costs

1. Partner 114.867 146.075 71.784 52.243 30.750 415.719


Working costs 72.451 121.585 47.294 27.753 18.505 287.588

Personnel costs 12.245 24.490 24.490 24.490 12.245 97.959









4. HQ 38.959 52.319 52.319 52.319 52.319 248.236





Total 153.826 198.394 124.103 104.562 83.070 663.954


Working costs 88.163 141.535 67.244 47.703 38.455 383.101

Personnel costs 35.491 56.859 56.859 56.859 44.614 250.682

260

Relevance

Outcome 1 WASH

Context analysis The need for health support interventions in Tanzania is described in the JSF Tanzania (paragraph 2.2, p. 9) and the JCA Tanzania (chapter 3-4-5) and formed the basis for the formulation of joint strategic goal 4 on health, namely to ‘contribute to improving

access to preventive and curative health care & washing infrastructure for the general population, paying particular attention to

the needs of vulnerable people’. Moreover, this intervention contributes to SDG 3 (healthy lives), SDG 5 (gender equality), SDG 13 (combat climate change) and most importantly, SDG 6: to ensure availability and sustainable management of water and sanitation.

Estimates indicate that only 16% of the population is using an improved sanitation facility and only 47% uses water from an improved source. This context contributes to infant mortality of 37.7/1.000 live births (2012) and an under 5 mortality of 54/1000 live births. According to a recent baseline in Kigoma region, only 51% of the rural population has access to an improved water source point, whereby the biggest challenge is the poor functioning of many water supply systems. They are out of order due to poor construction, ageing infrastructure and lack of O&M throughout time.

The Sustainability Strategy, from the Ministry of Water which covers the period 2015-2020, addresses these operation and maintenance challenges of the sector in a single, overall framework supported by a series of action plans. The strategy defines how, through effective operation and maintenance, the water sector will achieve its objectives aiming at ensuring sustainable water resources and services. Also the Belgian government has decided to enhance its previous efforts towards poverty reduc-tion in Tanzania, through support to the water sector.

Direct beneficiaries Seven villages are selected in Buhigwe district, which counts a total population of 49.809 people, making up 8.884 households (HH). A total of 11.780 direct beneficiaries within some of these villages will be reached.

The feasibility study will confirm the exact villages (out of the 7 villages selected) which will benefit from the gravity flow construction renovation giving access to safe water. The ‘value for money ‘of investments (cost per capita) must be less than TZS 90,000 to fulfil WSDP requirements. This brings the estimate to 4.853-6120 beneficiaries with an investment of 178.286 euro. Secondly, what concerns improved hygiene practices: minimum 10% of the population of the chosen intervention area (800HH) will be organized in 40 groups and trained. Each group comprises of 20-25 households. These 40 groups are guided through the PHAST package by 20 trained volunteers. After applying the improved hygiene practices in their own households, each of these 888 HH become agents of behavior change and have to induce change in 4 other/neighboring HH. As a direct beneficiary, one HH member is counted.

The intervention will also work with 4 schools in the district. We use an estimate of 300 children per school.

It is important to note that for the beneficiary calculations BRC-Fl chose to count unique beneficiaries only once although they may be reached multiple times with different program activities (e.g. by different behaviour change techniques). However, these program activities each do have their individual cost, which means these beneficiary numbers should not be used to calculate cost per beneficiary.

Indirect beneficiaries The total population of seven (or less) villages of intervention can be classified as indirect beneficiaries, as less stress will be put on other available WASH facilities and more opportunities exist to invest in the construction, rehabilitation and O&M of these other points. When we subtract the direct beneficiaries, 38.029 indirect beneficiaries remain. The visitors, travelers and refugees who find a temporary home in the sectors of intervention, are not being included in these calculations.

Location The WASH intervention will take place in maximum 7 villages in Buhigwe district in Kigoma region: Buhigwe, Mulera, Kavomo, Munyegera, Songambele, Kajana, Kasumo . The region is prone to cholera and there is a regular influx of refugees from the Democratic Republic of the Congo and Burundi. This district has been selected during the program formulation mission in July 2016, based on data from the water point mapping system, field visits and exchanges at district and regional level. Special attention has been given to not select sites which are targeted for a WASH intervention by districts through WSDP2 or other development partners like BTC.

Gender In accordance with the 5th SDG and DGD’s strategy paper on Gender, BRC-Fl works through this intervention towards the promotion of gender equality and empowerment of women by enhancing female access to health.

261

The construction and rehabilitation of WASH infrastructures will in particular have an impact on those women living in the villages of intervention. In Africa alone, people spend 40 billion hours every year just walking for water. Women and children usually bear this burden. According to the Africa Human Development Report 2016, the task of drinking-water collection is in 71% of the cases carried by women. Investing in increased availability of safe and sustainable WASH infrastructure, has therefore a significant effect on time saved by women/girls on WASH related activities. This free time can be spent on other activities that enhance their income generation or personal development. A four-country study by the World Bank showed that girl’s school attendance increased significantly for every hour reduction in water collection.

That’s why, by the construction and rehabilitation of gender-sensitive latrines in schools that meet the hygienic and safety needs of women and girls, this intervention contributes to a female-friendly school environment that enhances attendance of girls. A recent report estimates that in Sub-Saharan Africa half of all girls who drop out of school say that a lack of adequate water and sanitation facilities are a contributing factor. A further 10% of school-age girls who have reached the age of puberty do not attend school during menstruation (Tearfund, 2008). The school WASH mapping in Tanzania, indicates that 52% of girls latrines do not have doors providing dignity and privacy. Special attention will be paid to menstrual hygiene management by training girls in the production of re-usable pads.

Environment In line with IFRC and DGD’s Strategy Paper on Environment, BRC-Fl is aware of the many existing linkages between our WASH interventions and the preservation and protection of the environment. Following points are essential for this intervention: • Water sources will be protected and latrines will be located downstream of wells, at least 30m from groundwater sources

and at least 1.5m above the water table. • Pit latrines will be fitted with concrete slabs to eliminate the need for secondary wooden slabs or supporting beams. The

concrete slabs will also facilitate easy cleaning. • Awareness will be raised of the importance of water conservation. In the construction of water systems, the environment

is also taken into account by protecting the natural resources, e.g. through the planting of trees, encouraging reforestation The program has budgeted 6.667 euro for watershed conservation, i.e. tree planting (training, nursery, tilling and planting).

• Moreover, most projects in the domain of WASH are implemented with the PHAST method, developed by the WHO. This guide gives a methodology for community hygiene behavior change and improvement of water and sanitation facilities. In this approach, better health is linked to a better environment. Therefore, PHAST has a strong environmental component.

• Environmental sustainability will be considered in the design of the hardware (water and sanitation). And the use of alter-native sustainable technologies (like rainwater harvesting, biomass latrines in schools or eco-san toilets) will be considered.

Furthermore, BRC-Fl is aware that WASH interventions are linked with adaptation to climate change and the enhancing of community resilience. The Fifth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC) states that com-pounded stress on water resources facing significant strain from overexploitation and degradation form one of the key risks to the African continent. Our intervention aims at attaining an increased availability of sustainable WASH infrastructure to the most vulnerable communities and enhancing water-saving measures and behavior.

Outcome 2 FA

Context analysis Similar to WASH, the First Aid – intervention is in line with JSG 4 of the JSF Tanzania, for which the relevance has already been demonstrated in chapters 3-4-5 of the JCA. Indirectly, this intervention also contributes to SDG 3.

Moreover, our intervention is built on RKV’s scientific research in the fields of FA guidelines, hygiene promotion and disaster reduction. The results and methodology of this evidence-based way of working, will be shared with TRCS and other Belgian and international ANGC’s present in the field, that’s why an indirect contribution to JSG 3 is also apparent. Furthermore, this intervention is in line with SDG’s 1 (reduce poverty), 3 (healthy lives), 5 (gender equality), 8 (economic growth)

The recent Tanzania’s Factsheets of Health Statistics 2016, the Tanzania Demographic and Health Survey and Malaria Indicator

Survey 2015-2016 - Key Indicators and Tanzania Service Provision Assessment Survey 2014-2015 (Feb 2016) confirm the conclu-sions formulated in the JSF and the JCA: despite having some gains in the health sector, the population still faces a high burden of disease (especially due to malaria, TB, and HIV/AIDS).

Without repeating the different challenges in the health sector, our intervention aims to strengthen coping mechanisms within the communities by providing timely first aid services through community-based first aiders. As such, we are bridging missing links within the Tanzanian health coverage, strengthening healthy lives and promoting well-being. The set-up of a sustainable first aid training system will assure that Tanzanians will have access to life savings skills through training. The trained volunteers will give first aid services during public events and during emergencies like road accidents. In 2015, a total of 8.337 major traffic accidents were reported nationwide, 23 accidents per day.

262

Also the World Bank acknowledges the usefulness of First Aid: the training of lay persons to respond to medical emergencies is a cost-efficient and profitable intervention to reduce the effect of illness and injuries in Sub-Sahara Africa. Therefore training first aiders is considered as an intervention that is very cost effective and addresses a high burden of diseases and injury.

Beneficiaries The direct beneficiaries of the program will be 30 skilled volunteers of TRCS (medics or teachers) from 4 regions who will be trained as FA trainers. The 5 best trainers will be trained as Master Trainers, which will allow TRCS to train more FA trainers with in-country expertise beyond the scope of our program.

Once the FA trainers have up-to-date FA teaching skills, they will train 400 (already active) volunteers in their respective regions. These 400 volunteers will be deployed during events and emergencies. Additionally TRCS will be assisted in institutionalizing FA training and services into the organization, through different technical trainings which will reach capacity building in 13 TRCS staff members. The total number of direct beneficiaries is thus 451.

It is important to note that for the beneficiary calculations BRC-Fl chose to count unique beneficiaries only once although they may be reached multiple times with different program activities (e.g. by different behaviour change techniques). However, these program activities each do have their individual cost, which means these beneficiary numbers should not be used to calculate cost per beneficiary.

Indirect beneficiaries It’s very hard to quantify and monitor indirect beneficiaries given the broad range of first aid applications (from cleaning small wounds to live-saving Cardiopulmonary Resuscitation (CPR)). Based on the assumption that on average, every trained person will assist 5 persons by applying evidence-based, qualitative first aid, the number of indirect beneficiaries is estimated at 4.850.

This number takes into account the total number of people trained in FA by TRCS, even though these trainings are not direct outputs of the program. For Tanzania, this includes an estimated 200 clients of Commercial First Aid that will be trained from 2019 onwards (and for which companies in Dar-es Salaam, Dodoma, Mbeya, Kilimanjaro, Arusha, Morogoro and Kagera will be approached), and 50 FA-volunteers per year trained by TRCS but funded by other organizations such as American or Spanish Red Cross.

Location The program has identified seven potential regions: Dar-es Salaam, Dodoma, Mbeya, Kilimanjaro, Arusha, Morogoro and Ka-gera. The regions are prone to various disasters such as floods and epidemics. Accidents in these regions make up 61% of the total of 8.337 accidents which were reported in Tanzania in 2015. Additionally, TRCS has active structures in those regions to build upon, with regional offices and staff members already in place. A selection of 4 regions will be made as pilot regions from the mainland, based on the baseline results.

Gender Gender equality and women’s empowerment are essential to the health of nations, as well as social and economic development. This is clearly expressed in DGD’s strategy paper on gender: ‘Access to health and sexual and reproductive rights is key to women's empowerment, and is a basic component of female independence and well-being. It goes without saying that such access has many positive effects on the community as a whole.’

Therefore, the program will strive for a 50/50 % participation for women and men in FA trainings, and especially for the subsi-dized trainings, female participation will be encouraged. This is especially necessary as currently, only 36% of the TRCS members are female. Barriers to participation will be reduced actively to achieve this, for instance by organizing decentralized trainings where participants are close to home, and can return daily, rather than being out for days.

Moreover, the AFAM-based didactical training materials developed by this intervention are sensitive for the specific needs of women and girls as receivers and givers of First Aid. Attention is drawn upon specific situations encountered by women such as giving birth without medical assistance.

Environment Our intervention aims to support TRCS in giving high-quality FA training sessions to staff, volunteers and community-members in order to increase their self-reliance and as such have increased abilities to ‘bounce back’ when hit by sudden emergency. Community resilience will be of particular importance to deal with the increased volatility of the occurrence of extreme clima-tological events and weather extremes brought by climate change. Tanzania scores according the INFORM model 5,3 and is categorized in the ‘very high’ risk category.

On programmatic level, efforts to minimize the ecological footprint will be made. In terms of office management, double print-ing for reporting and didactical materials will be mandatory. In terms of procurement, local products are at all times recommended, and the guidelines/policy on asset maintenance will include attention for environmental waste disposal.

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Relevance according to DGD Priority themes

Decent Work Through increasing the quality and quantity of first aid trainings and commercial first aid services tailored to hazardous occu-pations, BRC-Fl and TRCS contribute to improve Occupational, Health & Safety (OSH), a core element of Decent Work and the ILO Decent Work Agenda. OSH is also key result in the Decent Work Country Program, the country strategy agreed upon by the Government of Tanzania to implement the ILO Decent Work Agenda. Annex 3 elaborates on the links between First Aid and OSH.

Digitalization BRC-Fl uses digital technologies as enabling tools to enlarge the impact of our interventions. A range of digital tools is deployed across countries and sectors. For our intervention in Tanzania, digital technology is used for monitoring and evaluating both our FA and WASH interventions. Having solid, up-to-date and reliable project data is crucial to properly monitor and evaluate progress on key performance indicators and adjust the implementation strategy where and when needed.

In the field of FA specifically, BRC-Fl supports TRCS in the set-up and/or maintenance of a database at headquarter level. These databases serve as a registration system for data on First Aid trainings, which helps TRCS to efficiently process and manage their First Aid service. In addition, BRC-Fl will support TRCS with setting up mobile data collection of FA activities carried out by staff and volunteers in the field.

In the field of WASH, BRC-Fl will look into supporting TRCS with the use of mobile data collection tools which would result in timely, accurate and cost-efficient monitoring and evaluation. Survey data could be processed more quickly and efficiently and the risk for errors would be reduced. Also, mobile data collection would allow TRCS to assign GPS-locations to water sources and WASH infrastructures and would permit BRC-Fl to have a real-time overview and geographical mapping on the work done on the field. As such, quickly readjusting in case of problems, is possible.

Human Rights As described in annex 4, a rights based mindset has always been present in the work of the Red Cross Movement. Our FA & WASH intervention in Tanzania is responding to the needs of the most vulnerable, and is as such aiming for rights-holders to claim their rights under Article 25 of the Universal Declaration of Human Rights : “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, […].” Another approach to operationalize this mindset, is our Humanitarian Diplomacy. By the auxiliary role TRCS has to the public authorities of Tanzania, their privileged access and relationship to the government and policy makers is a leverage for addressing specific issues related to increase and uphold legislation to make communities and schools safer and healthier places and thus contributing to an adequate standard of living.

Effectiveness

Two aspects make the intervention in Tanzania BRC-Fl-specific:

1. Our “Evidence Based Practice” To ensure that all activities are based on scientific evidence, is a core principle within BRC-Fl. To assist in this endeavor, BRC-Fl created the Centre for Evidence-Based Practice (CEBaP) 10 years ago. This research centre uses an internationally recognized methodology to collect, systematize and evaluate relevant scientific evidence to underpin our activities. When insufficient evi-dence is available, primary research to support our core activities is conducted – for instance, research on FA knowledge and skills retention in Nepal or on behavior change factors for WASH interventions in Malawi.

CEBaP developed evidence-based FA guidelines and materials for the African continent, India and Nepal, which will be used in all our FA programs, including Tanzania. Based on evidence summaries developed by CEBaP, a panel of regional/local experts developed first aid guidelines, taking the preferences of the target group(s) into consideration. These guidelines were then used to develop educational first aid materials such as handbooks, posters, exercise books etc.

In the field of WASH, the evidence based way of working is implemented since 2015 through the partnership between BRC-Fl and Professor H.J. Mosler of the EAWAG University in Zurich. Through this cooperation, BRC-Fl has introduced the RANAS (Risks, Attitudes, Norms, Abilities & Self-Regulation) approach where evidence-based research assists the program in learning which elements define certain behaviors, and subsequently identifying specific interventions targeting these behaviors which are needed to change. It is the objective of BRC-Fl to assimilate this technique and to systematically use it in all its WASH programs, including in Tanzania. In order to position itself in this sector, CEBaP is performing systematic reviews in the field of behavior change and WASH.

CEBaP is recognized as an IFRC Reference Centre and aims to further develop into the RC³ (RCRC Research Centre), providing its services within the RC movement. These services are also provided to non-RC partners (for example, CEBaP has performed an evidence search on the contamination of drinking water by fluoride in Senegal, for the Belgian Technical Cooperation). All

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primary and secondary research by CEBaP is being published in peer reviewed journals. Furthermore, through its link with CEBAM, the Belgian Centre of Evidence-Based Medicine and the Belgian Cochrane Centre, CEBaP is in the process of being accredited in evidence-based guideline development according to the Cochrane methodology.

2. Working with volunteers Volunteers form the backbone of all National Societies, including TRCS. Investing in volunteers through skill and knowledge development ensures a qualitative implementation of TRCS’s goal to assist the most vulnerable within Tanzania. A major strength of Red Cross volunteers is their embeddedness into the local communities, even the most distant ones. The volunteers enable TRCS to be a first responder in case of sickness, injury or threat. In rural Tanzania, where access to medical care is limited, the presence of Red Cross volunteers with knowledge of the correct first aid techniques, is therefore a key mitigating factor to reduce mortality and morbidity due to sudden illness or injury within their own communities. The volunteers also enable TRCS to achieve a correct use and maintenance of water and sanitation infrastructure, as the volun-teers continue to oversee or participate in the Water User Committee’s operation and maintenance activities. Moreover, a long-lasting behavioural change is more likely to be achieved as the message is brought and enforced by local and trusted commu-nity members.

Outcome 1 WASH

JSF Contribution This outcome directly contributes to the JSG number 4 of the JSF Tanzania, by the approaches 4A (Improve water & sanitation

facilities (coverage, quality & use) by upgrading hardware and educating the people using the facilities) and 4B (Improve hygiene

behavior by (1) carrying out software interventions in the field of WASH i.e. raising awareness and education through community

volunteers/village health teams and community systems for referral, for hygiene promotion/health facilities; and (2) providing

equipment to community health care workers and training them in treatment adherence technologies.).

Intervention strategy As can be seen in the Theory of Change, four complementary strategies contribute to the effectiveness of this program: the increased access to safe water, the increased access to sanitation facilities, the increased knowledge and skills related to hygienic practices, and the enabling strategy of increased capacity within TRCS to implement WASH programs.

Non-functioning existing water systems in the project area will be rehabilitated and new water points will be added, thus directly providing access to safe water for the surrounding population. The infrastructure for water supply in the areas bordering the lake and bordering the Burundian border are most of the time piped networks. The source of water is often surface water. The current practice is to distribute it without any treatment. At the moment, in Buhigwe district, 17 networks supply untreated water and 3 more are being built. Given the way the intakes are designed, chlorination cannot be enough to effectively treat this surface water. Therefore another treatment step will be added. In case it is decided to work in areas where water has to be drawn from a borehole, the design shall take into account that on the lakeshore of lake Tanganyika, very high concentrations of iron and manganese are found in water, making it salty, even when still potable. This often implies that people refuse to use that water because of its salty taste or because of its color.

The WASH program will not only increase access to clean water by renovating one multi-villages gravity flow scheme, it will pay a lot of attention to the establishment of a community owned water supply organization (COWSO), managed by the Red Cross. These water points will be handed over to newly established COWSOs, who’ll be trained, equipped and monitored by TRCS staff and volunteers, to assure smooth operation and maintenance. The quality of the water will be tested upon handover of the infrastructure, and periodically afterwards.

Elements of the PHAST and PHASe approach will be used to trigger the awareness on the importance of adequate sanitation facilities, thus stimulating the population to invest in low-cost toilets. While the lifespan of simple latrines is shorter, the use of cheap locally available materials should allow the local population to easily renew these when needed. In selected communities with a denser population, the program will provide subsidies or material to facilitate the construction of improved pit latrines, especially for the most vulnerable households. The combination of both PHAST and subsidized (and cost-reduced) approach will lead to a tangible increase in latrine coverage.

Thirdly, an evidence-based scientific methodology will be used to design the right approach to achieve maximum behavioral change, related to hygiene practices. A group of well trained and equipped volunteers, 20 in the first phase and 1000 more in the second phase, will cover each of the 4.440 targeted households with diverse sensitization activities, based on the PHAST methodology. Each volunteer will act as a leader-by-example, and will directly monitor and support 4 assigned households in his/her direct vicinity. In turn, these volunteers will be coached and monitored by the 20 lead-volunteers and the TRCS project staff, in order to assure the quality and consistency of their efforts. Finally, this program will also invest directly in the capacity of TRCS to deliver WASH programs, as an enabling action to obtain the desired project outputs, including its potential role as the technical agent for Operation and Maintenance of the water systems.

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The program is aligned with the Ministry of Water (MoW) Sustainability Strategy and will provide specific support to TRCS. The program will work with the main bodies involved in sustaining rural water supply services which are COWSOs, Local government Authorities, PMO-RALG and their Regional Secretariats as well as the Ministry of Water. There will be a close coordination with the WASKiRP Project of BTC to avoid overlap and to harmonize the strategies for Buhigwe District.

Outcome 2 FA

JSF Contribution This outcome directly contributes to the JSG number 4 of the JSF Tanzania, by the approach 4C259 and 4E260.

Intervention strategy Three key strategies contribute to the effectiveness of this program. Firstly, establishing high quality FA education, with the main focus on basic first aid course for the own volunteers. Secondly, strengthening the institutional capacity of the TRCS by embedding a well-functioning FA service into the organization. And finally, assisting TRCS to deliver high quality commercial FA services.

Existing didactical FA materials (manuals, curricula) will be revised and updated to assure the latest scientific evidence is taken into account, when describing FA guidelines ; this will be done based on the AFAM materials and in a modular approach to allow for easy tailoring of the training content to the needs of specific groups. The organization and management of trainings will be standardized, and a quality control system will be put in place, including continued coaching and monitoring of trainers and training sessions. Trainers will be retrained, focusing on both technical FA knowledge and didactics, in order to assure maximum learning effects. Basic equipment will be provided to community volunteers in 4 regions and procedures related to emergency response and reporting are established.

On an organizational level, missing policies and guidelines will be introduced based on a new organization-wide strategy for FA, positioning a (new) FA unit as the sole and overall responsible entity for all forms of FA training and for commercial FA service delivery (preventive interventions). Protocols for cooperation with other relevant departments will be developed and formalized, so that at all times, the quality of FA training is ensured through the involvement of this specialized unit. Investments in organizational development include several (regional) meetings aim at strengthening skills in policy and procedure devel-opment, reporting skills, training and teaching competences and knowledge on (CoFA) marketing.

Lastly, the improvements in quality of the trainings will contribute to an increase in commercial FA activity. TRCS will use the same (volunteer) training structure and resources to approach companies and provide commercial first aid (CoFA). Assured of the quality of the product, marketing efforts will be increased towards existing and new clients, and Humanitarian Diplomacy will be used to advocate for more legislation, stimulating mandatory FA training or services, for instance for major sport events. Through its CoFA activities, TRCS will increase its revenue, thus reducing its financial dependency for external funding, while also contributing to the JSF approach to extend FA training to the general population.

Sustainability

Outcome 1 WASH

Technical sustainability: The installed and rehabilitated infrastructure answers to the requirements and demands of national legislation and is therefore enforced by local authorities. Additionally, COWSOs will be installed and trained to take up their role. The intervention is also risk-informed, i.e. that potential risks, such as natural and technological hazards, are being taken into account in the design and implementation of the program.

Social sustainability: The intervention of BRC-Fl aims at enhancing sustainable behavioral change. TRCS works with volunteers that are embedded in the selected intervention zones and have a large capacity to enhance the local ownership of the intervention. These volun-teers do not depend on funding from BRC-Fl. The capacity building achieved in those volunteers by the BRC-Fl intervention, will remain in place after funding is withdrawn. Additionally, local and regional structures are put in place and strengthened.

259 Improve first aid competencies by (1) training lay people in first aid through a decentralised training structure using evidence-based local-ised materials; (2) professionalising commercial first aid; (3) carrying out advocacy work on the importance of first aid; (4) providing equipment to the community volunteers and assisting them to handle emergencies. 260 Support organisational development & the exchange of expertise with local partners on, for example, identifying innovative responses to global & local health challenges and strengthening the competences of health care staff, including pedagogical skills, initial training and life-long learning.

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Financial sustainability: The COWSOs have the front line responsibility for sustaining rural water supply services on behalf of their members. Their roles are tariff setting, revenue collection,… The permanent Red Cross structure on the ground will ensure the follow up and guidance, even beyond the program lifespan.

Exit strategy: The exit strategy is integrated into the design. A paradigm shift towards sustainable management (introduction of tariffs, per-manent staffing, water source protection, O&M procedures etc…) will be introduced from the start as a pre-condition before investing in water infrastructure works. The commitment by local stakeholders to establish multi-villages water user committees according to the national policy and managed by TRCS, will smoothen the exit of the program.

Outcome 2 FA

Technical sustainability: The intervention of BRC-Fl aims at enforcing the institutional capacity of the TRCS by embedding a well-functioning FA service into the organization that can anchor the delivery and training of FA. This is done by supporting the management of the first aid service, the volunteer management and the organizational development. The program invests heavily in a strong training structure of TRCS, this guarantees a strong multiplication effect of quality trainings in the future among Red Cross volunteers. The same training structure is used to train CoFA. By training master trainers, TRCS is able to train others. Currently, TRCS is depending on external facilitators to train their own trainers.

The intervention is also risk-informed, i.e. that potential risks, such as natural and technological hazards, are being taken into account in the design and implementation of the program. Building self-reliance through providing high quality First Aid train-ing sessions to staff, volunteers and community-members increases the response capacity of local first responders to calamities, especially given the fact the TRCS is the largest national humanitarian organization in Tanzania.

Financial sustainability: BRC-Fl supports the TRCS in delivering high quality commercial First Aid services. This helps the TRCS in increasing their market share and revenue, which will be reinvested in the FA service. As such, financial autonomy is enhanced and dependence on external donors decreased.

Social Sustainability: TRCS works with volunteers that are embedded in the selected intervention zones and have a large capacity to enhance the local ownership of the intervention. Volunteers (and staff members) who are trained to be FA trainers, are carefully selected in order to assure their lasting commitment to the National Society. Both trainers and volunteers are often self-motivated to enhance their skills, and derive a certain standing in their community from the application of those skills, for the communities’ welfare.

Exit strategy: Above mentioned elements on technical, social and financial sustainability all contribute towards durable results for the pro-gram. In general, the entire intervention methodology is designed to build sufficient capacity within TRCS, for it to be able to sustain its own FA activities with a high level of quality. In the last year of the program, financial support is gradually withdrawn (e.g. no trainings are financed), and the focus is shifted towards expertise-delivery and the autonomous implementation of the activities.

Efficiency

Delegation

A BRC-Fl Delegate will be based in Dar Es Salaam, in order to assist TRCS with the timely and qualitative implementation of this program. The main tasks of this delegate are to cooperate closely and on a day-to-day basis with the partner National Society, both at central level and in the project area. The delegate assists TRCS on a managerial and on a technical level – managerial in order to achieve a timely, effective and efficient implementation, and on a technical level, to ensure impact and sustainability. Its close proximity to the implementing partner allows for direct input to achieve the project Outcomes and outputs, whilst building the capacities of the implementing partner, to increase the knowledge and skills required to do so, both at a personnel (staff development) and institutional level (systems, structures). The delegate is further supported in its role by the BRC-Fl experts at headquarters, whom provide expert-input regarding managerial (PMER, Finance, Project management) and technical (First Aid and WASH) aspects. Because of its geographical closeness to the other BRC-Fl delegations in Rwanda and Burundi and because of the similarities in characteristics between countries in the Great Lakes Region, Tanzania Red Cross will also benefit from peer-to-peer learning and from direct technical support provided by the BRC-Fl delegation in Rwanda (delegate with a DRR profile) and in Burundi (delegate with a WASH profile).

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Outcome 1 WASH


1. Investment costs (39,5%)

In line with the activities for the Outcome, 178.286 EUR, (31%) of the total budget is allocated to purchasing construction materials for water points and 26.122 EUR (4,5%) towards the construction of sanitation blocks in schools. Other investments (22.449 EUR, 4%) are moveable items including san-plats, hand wash facilities, IT-materials and training materials.

2. Working costs (27%)

Working costs comprise of these main blocks: - setting up and training volunteers in communities and schools (118.280 21%). This is the driving force behind behavior change on the ground. - Monitoring and evaluation (72.290 EUR, 13%)general working costs (36.245EUR, 6%) which cover communication, stationary, utilities, bank

charges among others.

3. Personnel costs

Local personnel TRCS (20%)

The local personnel team of TRCS consists out of 1 regional project coordinator (1 FTE – 4 years), 1 field coordi-nator (1 FTE – 4 years) and 2 accountants (50% FTE – 4 years).

Expat personnel BRC-Fl Outcome 1 and 2 are supported by one full-time BRC-Fl delegate based in Dar Es Salaam. The salary budget consists out of salary costs for the duration of the program and is shared amongst both Outcomes. Other costs like accommodation, transport costs and other operational cost are taken within the general working costs.

HQ personnel BRC-Fl The intervention is supported by a technical WASH expert based in Mechelen (Belgium). The budget comprises of personnel & travel costs (0,08 FTE for Tanzania). This HQ WASH focal point safeguards the quality by providing technical expertise directly or by linking BRC-Fl CEBaP TRCS. Examples are carrying out or facilitating specific short-term technical missions on behavioral change techniques within hygiene promotion.

Outcome 2 FA

According to a World Bank study, training first-responders in first aid is an extremely cost-effective intervention; it is among the most neglected low-cost opportunities in middle- and low-income countries. First aid educations cost 8US$ per disability-adjusted life year averted (DALY)261. This makes First Aid Education one of the most cost-efficient ways to improve public health in developing countries.


1. Investment costs (7%)

In line with the activities for the Outcome, 30.171 EUR (7 %) of the total budget is allocated to purchasing moveable investments, i.e.

FA equipment and office materials, including IT.

2. Working costs (70%)

Working costs are the following main blocks:

- setting up a FA training structure (70.451EUR, 17%) As main trainings: 2 Training of Trainers (ToT), both are facilitated by interna-

tional experts, 2 trainings on institutionalization, Master training, refresher training and commercial first aid training.

- training of 400 volunteers in FA (37.143EUR, 8,9%)

- training materials (23.437 EUR, 5,6%)

- visibility costs and activities (18.857 EUR, 5%)

- PMER costs (64.788 EUR, 15,4%)

- Communication activities (7.348 EUR, 1,8%)

- and general working costs (65.563 EUR, 16%) which cover stationary, utilities, bank charges and fuel for 4 regions plus HQ

3. Personnel costs

Local personnel TRCS (23%)

The local personnel team of TRCS consists out of 1 FA coordinator (1 FTE – 4 years) and 1 accountant (50% FTE – 4 years)

Expatpersonnel BRC-Fl Outcome 1 and 2 are supported by one full-time BRC-Fl delegate based in Dar Es Salaam. The salary budget consists out of salary costs for the duration of the program and is shared amongst both Outcomes. Other costs like accommodation, transport costs and other operational cost are taken within the general working costs.

HQ personnel BRC-Fl The intervention is supported by a technical First Aid expert based in Mechelen (Belgium). The budget comprises of personnel & travel costs (0,06 FTE for Tanzania). This HQ FA focal point safeguards the quality by providing technical expertise directly or by linking the BRC-Fl national First Aid unit and CEBaP to TRCS. Examples are carrying out or facilitating specific short-term technical missions on didactical expertise FA, simulation exercise, assist in profitability analysis CoFa TRCS,...

261DALY is a generic measure of disease burden, including both the quality and the quantity of life lived. It is used in economic evaluation to assess the value for money of medical interventions.

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Partnership

Policy

BRC-Fl always operates within the partnership framework of the International Red Cross & Red Crescent Movement and works with the National Red Cross or Red Crescent Society as sole preferential partner. Principles of cooperation and capacity building are Movement-wide formalized in the IFRC ‘Development Cooperation Policy (2007), the ‘National Society Development Frame-work (2013)’and the ‘Code of Good Partnership’.

All Red Cross partners in this program are strategic partners, meaning the commitment for cooperation spans for at least 3 years whereby common objectives are defined and where the focus lies on capacity building of & transferring technical exper-tise to the partner to implement quality services to the most vulnerable within the thematic priorities of BRC-Fl. Capacity building is transversal across the interventions in First Aid & WASH.

TRCS

Tanzania Red Cross Society (TRCS) is a voluntary and independent humanitarian organization established in Tanzania by Act of Parliament No. 71 of 1962 and is mandated to play specific voluntary humanitarian roles, both during disasters/emergencies and in peace time, as an auxiliary organ to the public authorities. The Society is part of the worldwide network Red Cross and Red Crescent Societies since 1963 when it fulfilled the requirements for membership to the International Federation of the Red Cross and Red Crescent Societies (IFRC). Today, TRCS has employed staff in 15 (out of the 22) regions where TRCS is operational. The Society has more than 700 branches with over 12.000 members and more than 10.000 volunteers. 36% of the members and volunteers are women.

TRCS went through organizational challenges in 2015-2016 and the new senior management team will be completed by the end of 2016. The new management members already appointed have put FA back on the table and recognizes it as a core area of the RC movement worldwide.

WASH TRCS has many years of experience in WASH interventions in the refugee camps. Their experience is mainly in sensitization and hygiene promotion mainly on basic hygiene and household water treatment. Recently, it started health interventions outside the camps, serving the host communities (with support from Spanish Red Cross). In the past, multiple WASH interventions were implemented in Zanzibar (supported by German Red Cross and ICRC).

FA After the bombing of the American Embassy in Dar Es Salaam in 2002, a FA capacity building intervention was supported by IFRC. 20 FA trainers were trained. However, little attention was paid to sustainability. The FA training activities have since 2004 been challenged due to a lack of uniformity in terms of its management system, material, equipment and staff. No one is responsible for FA at HQ level. District coordinators are supposed to organise FA activities, however, it is not specified in their job description. No data system or certification procedure is in place. FA trainings are happening, but there is no coordination or quality control mechanism in place.

Capacity building

BRC-Fl recognizes that capacity building is a long-term, continuing process, in which all stakeholders participate. Capacity building encompasses firstly the process of equipping individuals with the understanding and skills that enables them to per-form effectively. Secondly it includes organizational development, and establishing processes and procedures within the organization. And thirdly, it requires institutional and legal framework development, making legal and regulatory changes to enable the organization to enhance their capacities. In addition, an assessment will be conducted in 2017 to identify needs related to M&E specifically with the eye on results based management of the intervention. Based on the outcome of this assessment the priorities and activities for BRC-Fl M&E support to TRCS will be determined.

Outcome 1 WASH As described above, TRCS has many years of experience in WASH interventions in the refugee camps. The implicated branch receives limited support from IFRC for the camp activities. There is no WASH vision or strategy available at national level. TRCS expressed the will and need to become an important actor in the area of WASH, within the coming years, with the desire to expand both the scope and the geographical coverage of its WASH interventions. This program will directly contribute to that aim, whilst at the same time rebuilding and reinforcing the institutional capacity for qualitative WASH activity implemen-tation. A WASH officer will be recruited to manage and oversee the technical officers in the field, both for the software and hardware related activities. Training and coaching of the involved staff members is foreseen, and BRC-Fl will also bring its own expertise to the table, especially with regards to behavior change, where the evidence-based RANAS methodology will be

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introduced to TRCS, in order to enhance the effectiveness of the intervention. Specifically for WASH hardware, cooperation will be sought with relevant actors within Tanzania, in order to provide additional technical expertise to TRCS. In the project district, volunteers will be trained and equipped with tools and materials to complete their tasks (mainly related to sensitization), and they will be monitored and coached by (more experienced) lead-volunteers, district branch board members and of course the project staff.

Outcome 2 FA The bulk of the FA program designed for TRCS is in fact oriented towards the rebuilding of its capacity to deliver quality FA training and services. BRC-Fl will provide technical support to enhance the quality of TRCS’ training services via a multi-year coaching strategy, equipping TRCS with appropriate didactic materials and skills to deliver those trainings. When needed, BRC-Fl or external experts on FA education will provide the input required to establish the desired levels of quality – an example being the facilitation of Training of Trainers by BRC-Fl expert-volunteers. BRC-Fl’s expertise on the institutional and managerial aspects of FA training and service will be instrumental to guide TRCS through a series of reforms, allowing it to position the (Co)FA at the center of all FA-related activities within the organization, equipped with the right tools and resources, material and human, to insure and oversee the quality of FA training and service delivery.

Delegation The delegate assists TRCS not only on a managerial but also on a technical level to ensure impact and sustainability. Its close proximity to the implementing partner allows for direct input to achieve the project outcomes and outputs, whilst building the capacities of the implementing partner, to increase the knowledge and skills required to do so, both at a personnel (staff development) and institutional level (systems, structures). Beginning of 2017, the delegate will also facilitate an assessment together with TRCS to determine the needs for capacity building on M&E specifically related to the intervention. Further support will be determined based on the outcome of this needs assessment. Peer-to-peer learning and technical support from the other BRC-Fl delegations in Great Lakes Region will further add to the capacity building of TRCS.


This chapter describes further operationalization of the synergy and complementarity (referring to the commitments between accredited organisations taken in the frame of the JSF) contributing to achieving the outcome/specific objective. Following the JSF and the DGD guidelines for this chapter, information has been collected through email exchange’s and 2 meetings resulting in the two tables below. BRC-Fl has engaged to cooperate to 7 cross-thematic/transversal synergies and complementarities and 2 synergies/complementarities related to JSG 4.

1. Cross-thematic/transversal synergies and complementarities

Strategic partner (INGO,

Belgian CSO/IA, BTC) or group

Nr/code related synergy-element (ch 3 JSF) Content of the cooperation – indicating their complementary exper-tise or any other reasons of cooperation or exchange

All

Organize a yearly meeting between Belgian CSO/IA and some key stakeholders (1) in Tanzania back-to-back with the Embassy meetings (2/year) and (2) in Brussels (1/year).

- All (+ can include actors who are not part of this JSF): meeting once a year back to back to the StDi to discuss and follow up syn-ergy and complementarity, and share intervention and risk management strategies, challenges for the partners, changes in the context - Lead: coordination and facilitation by overall lead

All + BTC/embassy

Creation of different e-mail groups with different goals & mandates to be used to: inform each other about calls, meetings, evaluation findings, policies, networks, invitations to workshops/events, digitali-sation, etc.

- Sub-lead: to be determined - Agreed time: operational in first semester of 2017, in meanwhile the already operational OneDrive will be used

All

Keep the OneDrive platform (or another web-based platform) active to store & update contact details, lists of local partners, intervention zones and exper-tise (no full documents, only overview).

- purpose: contribute to CSO/IAs Knowledge management, produce “one pagers” on relevant policy topics once or twice a year and to share them through the One Drive sharing platform. Share value chain reports, sector studies and evaluation reports. - sub-lead: to be determined - agreed time: operational in first semester of 2017, in meanwhile the already operational OneDrive will be used

All Decent work: IA/CSO from this JSF active in decent work will be linked with IA/CSO from the JSF IA/CSO.

- All: assess opportunities throughout program implementation to share and take up

All BTC/embassy +

While elaborating new programs and projects, iden-tify opportunities for common activities (e.g. on the transversal issues listed in the JCA Chapter 10).


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Trias, Fracarita Belgium, BOS+, VSF; IdP, VECO, VLIR UOS, Red Cross, LFTW, IRSNB-CEBioS, BOS+ BTC/embassy +

Identify opportunities for cooperation in/around the geographical areas where the bilateral cooperation is focused (Kigoma, Arusha) when preparing the IDCP or other CSO/IA initiatives.

- All: assess opportunities throughout program implementation and take them up: see table here below.

VLIR-UOS, APOPO, Red Cross, VECO, Trias, BOS+, LFTW, VSF, VIA Don Bosco, IDP

Join forces for joint research activities or sharing les-sons/research outputs.


2. Synergies/complementarities related the Outcomes of our intervention and JSG 4 of the JSF

Organi-zation

Objective of Synergy Roles and Tasks Material and financial con-tributions

Outcome 1: WASH

BTC The Buhigwe district in Kigoma is a shared intervention zone be-tween the WASH programs of BTC and BRC-Fl. Future infor-mation synergies will be of major importance in order to avoid overlap and to share lessons learned and best prac-tices.

The BTC WASKiRP project, starting in 2017, will provide specific support to the main bodies involved in sustaining rural water supply services which are COW-SOs, Local government Authorities, PMO-RALG and their Regional Secretariats as well as the Ministry of Water for Kigoma region. BTC will rehabilitate 26 existing water supply system as well as construct new ones in 6 districts, in-volving 26 villages (including 3 villages in Buhigwe district). The BRC-Fl intervention will strengthen the hardware component in 7 villages in Buhigwe district. Through a trained network of local volunteers behavior change in the area of water, sanitation and basic hygiene is targeted, this as-pect is not covered by the BTC-intervention and can possibly form a future possibility of cooperation.

RC-Fl foresees time and budget in order to allow WASH TRCS staff to partici-pate in information exchange sessions, if they might happen, and to insti-tutionalize knowledge and experiences gained. This costs are covered by the salary costs and transport provision.

Outcome 2: FA

VIA Don Bosco

Don Bosco and the Red Cross will explore op-tions of working together in the field of first aid ed-ucation in a school environment.

Once the Tanzanian Red Cross is fully trained, from 2019 onwards, a possible collaboration with the partners of VIA Don Bosco can be envisioned. Several options: -VIA Don Bosco VTC Trainers, Job Placement Office staff and production managers can be trained in first aid. - Also a ‘train the trainer’ project together with the VIA Don Bosco trainers, including joint certification instruments, is a possibility.

No specific budget is re-quired. The cost of the meetings will be covered in the operational costs.

Complementarities

Other Partner National Societies such as the American and Spanish Red Cross from the International Red Cross and Red Crescent Movement are supporting RRCS. Coordination and communication is assured through quarterly PNS meetings. All PNS are complementary in their mission to strengthen the National Red Cross Society of Tanzania. The institutional capacity development of TRCS in the fields of WASH and FA can directly be used in the programs of other PNS.

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Zimbabwe Lay people, Zimbabwe Red Cross staff & vol-unteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhancing community level resilience and emergency care capacity.

2017-2021

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Samenvatting

Rode Kruis-Vlaanderen (RKV) helpt helpen’ is de slogan die het 17-21 programma in Zimbabwe samenvat. Enerzijds verwijst dit naar de focus op zelfredzaamheid, anderzijds naar de focus op impact.

Mensen zelfredzaam maken is de manier bij uitstek om een duurzame impact te hebben. Zowel RKV’s interventiestrategie als de keuze van activiteiten in Zimbabwe zijn gebaseerd op het idee van zelfredzaamheid.

RKV’s interventiestrategie heeft als kernprincipe dat de implementatie van het programma geleid en gedragen wordt door de lokale Rode Kruis vereniging en haar vrijwilligers. RKV neemt een ondersteunende rol op zich maar zal zelf geen directe imple-mentatie doen. Het 17-21 programma, met een totaalbudget van 542.743 EUR, wordt dan ook getrokken door Zimbabwe Red Cross Society (ZRCS). Het programma is op vraag van en in nauwe samenwerking met ZRCS opgesteld. ZRCS is ook de grootste nationale humanitaire organisatie van Zimbabwe en is actief in het volledige land.

In onze activiteiten, kiezen we voor eerstehulponderricht. Door ZRCS personeelsleden, ZRCS vrijwilligers en leken op te leiden in eerste hulp wordt de bevolking van Zimbabwe zelfredzaam gemaakt. Bovendien is er een duurzaam multiplicator effect door het opleiden van de ‘master trainers262’ (2.310 directe begunstigden en 84.786 indirecte begunstigden). De aanwezigheid van ‘First Responders’ is van groot belang in een land dat kampt met een systemisch gebrek aan nodige gezondheidsinfrastructuur, zeker in tijden waarbij de kans op politiek geweld een reële dreiging is. Het programma richt zich in de eerste plaats op de ZRCS hoofdzetel in Harare, die in staat zal worden gesteld om een kwalitatieve ondersteuning te bieden aan de eerstehulpop-leidingen verspreid over het volledige land, via 4 nationale trainingscentra in Bulawayo, Gweru, Mutare en Harare. De trainingscapaciteit van ZRCS zal worden versterkt met 45 eerstehulptrainers. Dankzij de samenwerking met de Belgische NGO Africalia kunnen we ook hun doelgroep opleiden in eerste hulp.

Naast het opleiden in eerste hulp, wil RKV de zelfredzaamheid van ZRCS versterken door hen in staat te stellen financieel autonoom te investeren in eerstehulpactiviteiten. Door ZRCS meer zelfredzaam te maken, garanderen we een grotere duur-zaamheid van eerstehulpactiviteiten. RKV wil dit doen door ZRCS te ondersteunen in het uitbouwen van bedrijfseerstehulp. Dit doen we zowel via kennisoverdracht (workshops rond marketing en het opzetten van een kostenmodel) als via een ondersteu-ning van hun humanitaire diplomatie die bijvoorbeeld eerstehulplessen of hulpposten verplicht moet maken. De uitbouw van bedrijfseerstehulp ligt in lijn met de ‘Waardig Werk’ prioriteiten van Zimbabwe rond veiligheid en preventie op de werkvloer.

Naast zelfredzaamheid is impact een belangrijke focus van het RKV programma in Zimbabwe. Een studie van de Wereldbank toont aan dat het investeren in de opleiding van eerstehulpvrijwilligers één van de meest kosteneffectieve interventies is met een kost van slechts 8 US$ per Disability Adjusted Life Year averted (DALY)263. Bovendien investeert RKV via haar ‘Center for Evidence-Based Practice’ continu in onderzoek naar interventiestrategieën met de meeste impact. Zo onderzoeken we het effect van simulaties in eerstehulpopleidingen of welke eerstehulpkennis op welke leeftijd kan onthouden worden. De resulta-ten van deze onderzoeken zijn geïntegreerd in RKV’s eerstehulpondersteuning aan ZRCS. Daarnaast heeft het ‘Center for Evidence-Based Practice’ evidence-based eerstehulprichtlijnen uitgewerkt die volledig aangepast zijn aan de Afrikaanse context (‘AFAM’, African First Aid Materials’). Het eerstehulpopleidingsmateriaal van ZRCS zal op basis hiervan herzien worden zodat steeds de meest doelgerichte eerstehulppraktijken worden aangeleerd.

RKV wil de impact van het programma in Zimbabwe ook vergroten door gebruik te maken van haar jarenlange operationele expertise rond eerstehulpopleidingen en werken met jeugd. Binnen RKV bestaat de dienst ‘Eerste Hulp’ die 500 trainers in dienst heeft om nationaal eerstehulpopleidingen te geven. Deze trainers worden voor specifieke expertisegebieden ingezet in ons programma. Daarnaast bestaat binnen RKV de dienst ‘Jeugd Rode Kruis’ die jarenlange ervaring heeft in het aanleren van eerste hulp aan jeugd. Gezien de jonge bevolking van Zimbabwe, zal specifieke aandacht worden gegeven aan het ontwikkelen van aangepast eerstehulpmateriaal voor de jeugd en zullen 320 leerlingen een eerstehulpopleiding krijgen.

Dit programma houdt rekening met de prioriteiten van de Belgische ontwikkelingssamenwerking rond digitale innovatie, men-senrechten en waardig werk. Gedurende alle fases van het programma, wordt een gender-sensitieve benadering gehanteerd: in lijn met Zimbabwe’s National Gender Policy 2013-2017, wordt binnen ZRCS gestreefd naar een gelijkmatige verdeling van vrouwen en mannen binnen de eerstehulplessen én de beheers- en bestuursorganen van de organisatie. Aan de hand van gender-gedisaggregeerde indicatoren zullen verwezenlijkingen in kaart worden gebracht. Daarnaast zullen inspanningen wor-den gedaan om de impact van onze interventie op het milieu te beperken, door onder andere de aankoop van lokale materialen en een correcte afvalverwerking.

262 Trainers die andere trainers kunnen opleiden. 263 DALY is een maatstaf die werd ontwikkeld door de Wereldgezondheidsorganisatie. De DALY meet niet alleen het aantal mensen dat vroegtijdig sterft door ziekte, maar meet ook het aantal jaren dat mensen leven met beperkingen door ziekte. In maatschappelijke kosten-batenanalyses worden DALY's ook toegepast om de kosteneffectiviteit van gezondheidsinterventies te bepalen. Laxminarayan et al. (2006). Intervention Cost-


273

RKV gelooft ten stelligste dat het 17-21 programma in Zimbabwe rond eerstehulponderricht door zijn focus op zelfredzaamheid en duurzame impact sterk bijdraagt tot een verhoogde toegang tot eerstelijns gezondheidszorg. Op die manier komt het programma tegemoet aan de Gemeenschappelijke Strategische Doelstelling 1264 van het Gemeenschappelijk Strategisch Kader Zimbabwe en aan de Sustainable Development Goals 1, 3, 5 & 8.

264 Een bijdrage leveren aan en het promoten van een gezond leven voor allen op alle leeftijden, door een versterking van de gezondheidssec-tor en het ontwikkelen van innovatieve modellen voor gezondheidszorg.

274

Country Fiche

Total Country Budget (EUR) 542.743

Contact person in Belgium

Name:

Tiene

Lievens


Cross-Flanders (BRC-FL)

Phone No: +32

15 44 33 57

E-mail: Tiene.Lie-

[email protected]

Narrative summary of the country program

BRC-Fl has worked in Zimbabwe since 2015 with its preferential partner Zimbabwe Red Cross Society (ZRCS) on the strength-

ening of their first aid department. During the future program running from 2017-2021, we’ll continue to strengthen the

capacity of ZRCS to provide high quality FA Education. First aid is a priority activity for all Red Cross Societies worldwide, and

especially relevant in Zimbabwe, considering its stretched and subpar health infrastructure, the frequent occurrence of dis-

asters and the remoteness of certain areas.

FA Education is a proven cost-effective development intervention, with a cost of 8US$ per Disability-Adjusted Life Year

averted (DALY), making it one of the cheapest ways to increase public health in developing countries265. Moreover, our pro-

gram is underpinned by scientific research in order to increase the effectiveness and efficiency of our intervention. As a result,

84.786 beneficiaries can be reached from which 2.310 direct ones.

This program will ensure ZRCS can offer qualitative trainings by institutionalizing evidence-based didactical materials, and

developing reliable and competent structures. Moreover, it will consolidate the place of ZRCS as market leader in commercial

first aid, which highly increaces the financial sustainability of the program. Lastly, it will provide aid training to key selected

volunteers relating to road safety and potential election violence, ensuring high-quality pre-hospital care is available to those

in need.


275


List of partners

Local Partner

Full Name & abbreviation: Zimbabwe Red Cross Society (ZRCS)

Contact details:

Address: Phone No: E-mail:

10 St. Annes Road

Avondale, Harare

Website: http://www.redcrosszim.org.zw/ +2634307241 [email protected]

Contact person Mr. Maxwell Phiri, Secretary-General ZRCS

Outcome(s)

Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based

knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhanc-


Budget by Outcome (EUR) Budget O1: 542.743

Summary of partner role for

each Outcome:

ZRCS, through its nationwide network of branches and volunteers, is the main implementing

partners for this outcome. With support from BRC-Fl headquarters and regional delegation,

ZRCS is responsible for the planning, implementation, monitoring and reporting of this pro-

gram.

Start date of partnership rela-

tion: 1/01/2015

Theory of Change

The Theory of Change (ToC) serves as the basis of reflection for the logical framework, e.g. assumptions & Outcomes (see

further). Throughout all phases of program implementation BRC-Fl will use the logical framework as the basis for implementa-

tion, tracking & monitoring. A narrative description of the intervention strategy can be found in the section ‘Effectiveness’. In

addition, a general explanation on how BRC-Fl has structured and defined the ToC model can be found in Annex 1.

Outcome 1 FA


277

1. Assumptions


frame

Does it hold?

(yes/no) Argumentation/evidence

A • People get more resilient by being able to ap-ply FA techniques.

• Smaller negative impact on health in case of in-jury/illness because people are assisted with evidence based first aid.

• FA education is a very cost-effective

development intervention to increase public health.

Impact • Yes

• Yes

• Yes

• A British Red Cross study shows linkages between features of community resilience and first aid training.266

• Evidence based FA techniques are proven to be more effective towards injury treatment/illness recovery. The BRC-Fl Centre for Evidence-Based Practice (CEBaP) specializes in the evidence based method-ology for first aid guideline development, using the best available evidence from scientific literature, supplemented with know-how from experts and information gleaned through practical experi-ence.

• FA education has a cost of 8US$ per disability-adjusted life year averted (DALY), making it one of the cheap-est ways to increase public health in developing countries.267

B • Smaller negative impact on health in case of in-jury/illness because people are assisted with first aid.

Impact • Yes, more re-search is ongoing

• A systematic review is ongoing on the health effects of training lay people to deliver emergency care in un-derserviced populations.268 Results will be available in 2017. One case study in Iraq showed that a reduction in mortality was caused by trained layperson first respond-ers in a settting where pre-hospital evacuation times are long.269

C • Lay people and ZRCS staff & volunteers intervene to apply FA if they have the required knowledge, attitudes and practices.

• Lay people have access to basic FA local materi-als for applying first aid techniques.

Outcome 1 • Yes, but more re-search is needed. • Yes

• A systematic review reports significant increases in first aid knowledge, skills and improvement in helping behavior due to first aid training for children and lay people.270 A case study in Uganda shows that groups of people who regularly have to apply FA have a higher retention of FA knowledge. A Red Cross structure could be considered similar.271

• Sensitization on the importance of having adequate FA materials and on the use of local materials will be part of the intervention. FA trainings are also adapted to locally available materials. In addition, ZRCS ensures that during the trainings ample attention is given to availability and ac-cessibility of local training materials.

• In none of the intervention countries the law provides protection for bystanders providing first aid. How-ever, the 32nd International Conference of Red Cross and Red Crescent Societies adopted a resolution on strengthening legal frameworks for disaster response, risk reduction and first aid.272

266 British Red Cross. Assessing the links between first aid training and community resilience. 2011 http://www.redcross.org.uk/~/media/BritishRedCross/Documents/What%20we%20do/First%20aid/As-sessing%20the%20links%20between%20first%20aid%20training%20and%20community%20resilience.pdf 267 Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2. http://www.ncbi.nlm.nih.gov/pubmed/21250358 268 Orkin AM, Curran JD, Fortune MK, et al. Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol. 2017 http://bmjopen.bmj.com/content/6/5/e010609.full 269 Murad MK, Husum h. Trained lay first-helpers reduce trauma mortality: a controlled study of rural trauma in Iraq. 2010 http://munin.uit.no/bitstream/handle/10037/5440/paper_2.pdf;jses-sionid=A29D143AA28B30DA5510C8DBDAB6C704?sequence=4 270 He Z, Wynn P, Kendrick D. Non-resuscitative first-aid training for children and laypeople: a systematic review. 2013 http://www.ncbi.nlm.nih.gov/pubmed/24351520 271 Jayaraman S, Mabweijano R, Lipnick MS, Caldwell N, Miyamoto J, et al. First Things First: Effectiveness and Scalability of a basic prehospital trauma care program for lay first-responders in Kampala, Uganda. 2009 http://www.ncbi.nlm.nih.gov/pubmed/19759831 272 IFRC. Law and First Aid. Promoting and protecting life-saving action. 2016 http://www.ifrc.org/Global/Photos/Secretariat/201506/First%20Aid%20Law%20Advocacy%20Report%20(final).pdf

278

• First aid lay responders as well as FA trained ZRCS staff & volunteers can intervene and pro-vide first aid in a safe legal environment (legal liability).

• No

D Trained and equipped ZRCs volunteers are re-tained.


Yes The recruitment of volunteers is linked to ZRCS’ volunteer management policy, where volunteers are organized in local district-structures, ensuring continuity (cfr. risk register).

E ZRCS is able to recruit the required volunteers and staff to provide FA.


Yes Cfr. D on recruitment & volunteer policies. In addition, as largest humanitarian organization of Zimbabwe, rep-resented in all districts and as auxiliary to the government, ZRCS can rely on a large and widespread volunteer base.

F There is adequate follow-up and coaching of ZRCS volunteers and staff.


Yes Through the establishment of a national and provincial core group of master trainers, volunteers and trainers are frequently monitored and coached.

G • Commercial FA generates income. • ZRCS is willing to invest the income generated

from commercial first aid trainings at least partly back into the FA service.

Outputs 1.2-1.3


• Yes

• In 2016, BRC-Fl undertook a study in cooperation with Vlerick Business School analyzing the cost of FA train-ings in Nepal using a time-driven activity based costing model. Being a pilot study, BRC-Fl aims to use this model to improve commercial first aid activities in other partner countries.273

• Decreased funding will imply an increased contribution from ZRCS, who understands and is committed to further development of its FA service (cfr. risk register).

H People who decide to become a ZRCS volunteer or staff recognize and value the importance of first aid.

Output 1.2 Yes Within RC organizations first aid is recognized as a core activity, and each newly recruited volunteer is intro-duced in the vision, mission and policies of the organization. In addition, within the strategic plan of ZRCS (which serves as a key document for volunteer recruitment), FA knowledge is recognized as a key pillar.

I The used didactical methods are effective. Output 1.1 BRC-Fl research planned


J The cost for CoFA/training of lay people is (partly) financed by a 3rd party. Moreover, First Aid train-ings are recognized as relevant throughout all HNS (funded) programs.

Outputs 1.1-1.3

Yes Current donors to ZRCS, either in CBH&FA or DRR programs, are incorporating FA training for volunteers in their activities.

K • Lay people (incl. ZRCS staff and volunteers) suf-ficiently retain the knowledge and skills obtained during a first aid (refresher) training.

• Trainings offered by ZRCS appeal to lay people.


• BRC-Fl research on-going

• Yes

• BRC-Fl is conducting a study to assess the degree of knowledge and skill retention over a period of time and to determine the impact of refresher courses and first aid practice on the retention level. This information will be used to determine the optimal frequency of refresher courses and to assess the need to revise the validity of first aid certificates. One case study has shown that first aid knowledge gained during commercial first aid training does not significantly decline over time. However, skills related to CPR rapidly deteriorate over the course of the first 90 days suggesting that refreshing skills frequently is required.274

• Promotional activities, with special attention for gender balance, will ensure the ZRCS trainings are well mar-keted.

273 Schumacher S, Bleys M, Pattyn S. Time-driven activity based costing of first aid trainings in Nepal. Vlerick Business School. 2016 274 Anderson et al. First aid skill retention of first responders within the workplace. 2011 https://sjtrem.biomedcentral.com/articles/10.1186/1757-7241-19-11

279


Stakeholder Role (what, when, how, where) Interests/Power Opportunities/threats

1 ZRCS Master trainers - Train and coach First Aid Trainers - Conduct (CO)FA trainings in their communities. - Perform evidence based first aid in case of emer-

gencies.

- Assure reliable and correct implementation and training of evidence-based FA tech-niques.

- Support ZRCS FA training systems, making it sustainable.

Key staff, needs to be retained.

2 ZRCS Trainers - Conduct (CO)FA trainings in their communities. - Perform evidence based first aid in case of emer-

gencies.

- Assure reliable and correct implementation of FA techniques by volunteers/lay people.

Need for timely refresher training and monitoring by master trainers. Possibility to become a master trainer.

3 ZRCS volunteers - Perform evidence based first aid in case of emer-gencies.

- Be deployed as part of Action Teams (elections, large events, …).

- Improve, through the implementation of FA techniques, the health and well-being of their communities.

- Represent the Red Cross movement.

Need for timely refresher trainings.

4 Community members/lay people

Perform evidence based first aid in case of emergen-cies.

- Improve, through the implementation of FA techniques, the health and well-being of their communities.

- Spread, through examples of implementa-tion, the usefulness and importance of knowledge on FA techniques.

Rely on the availability and affordability of FA materials.

5 Companies (tourism, ministries, INGO’s, private sector, …)

Book FA trainings as provided by ZRCS. - Acquire first aid knowledge and techniques. - Provide income to ZRCS.

Competition from other FA training providers.

6 Ministry of Health Understand and support the role of ZRCS as auxiliary to government, especially on disaster management and health programming.

- Ensure accreditation of ZRCS Rely on grass-roots and widespread volunteer base of ZRCS, for instance for hy-giene messages.

Lack of financial means.

7 Other emergency actors: fire department, police, military, private and public health care service providers

Conduct joint training exercise with ZRCS (disasters, big events). Jointly response in cases of actual disasters, events.

Understand the possibilities but also the limi-tation of ZRCS as first responder. - Strengthen the disaster response mecha-

nisms in Zimbabwe by knowing all actors and the limitations.


8 Other Red Cross Partners Understand the importance of FA trainings and include them in their programs curricula.

Ensure ZRCS volunteers are all first aid-trained first responders.

Might not prioritize FA trainings.

9 Road Safety Council Monitor the traffic situation in Zimbabwe – identify hot spots and assess needs

Decrease mortality and injuries due to traffic accidents.


10 Ministry of Education Assess the relevance and importance of First Aid Edu-cation as a staple in the curriculum.

Enforce importance for first aid education in schools.

Demotivation of government staff.

280

3. Context analysis

Contextual factor Influence on ToC

ZRCS enjoys a positive perception as main humanitarian actor, both in terms of short term humani-tarian response as long term development programming.

The motivated participation of the target population is highly likely.

Occurrence of natural disasters such as floods. The up-side is that the importance of first aid knowledge is emphasized, strengthening the relevance of the program and providing an (increasing) demand in First Aid trainings. For operational mitigation in case of floods, avoiding negative impact on the programs implementation, refer to the risk analysis.

Prevalence of food insecurity. Food insecurity is expected to put pressure on lay peoples’ interest/understanding of the importance of first aid, nega-tively affecting their attitude and incentives towards FA.

Political and economic unrest. Zimbabwe is currently go-ing through a very tense build-up for the 2018 election (where it is expected President Mugabe will seek reelections), aided by widespread dis-satisfaction with the government’s economic policies and its failure to pay salaries. Reports indicate and predict in-tensified demonstrations.

Similar to the above – political and economic instability could decrease the demand for first aid trainings. Additionally, in cases of serious and widespread protests and strikes, it can hamper the possibility for ZRCS to freely implement its pro-grams (cf. risk analysis). Also similar to the above – violent protests will, on a positive note, emphasize the relevance of first aid knowledge.

Favorable Commercial First Aid Climate – high demand. In Zimbabwe, the mining industry employs a considerable amount of lay people, all who have to be trained in First Aid.

ZRCS can rely on a steady base of income thanks to this industry.

Increased competition in commercial first aid trainings from national or international actors.

Unstable market-share, making it difficult for ZRCS to correctly estimate the CoFA revenue, and plan accordingly. Lay people might still get trained (leaving the ToC intact), but there is no control on the evidence-based nature of the trainings, and the sustainability of ZRCS FA department become uncertain.

281

4. Activities

1 First Aid Education: - Basic First aid Training and refresher - Advance First aid Training - Junior First aid Training - Profiecency in First Aid - Establishment and training of action teams at 6 Road Safety Hot spots - Establishment and training of action teams in connection to 10 foreseen electoral violence hot spots - Basic Simulation for Instructors and refresher - Basic Simulation ToT

2 Institutional support: - Operational plan workshop - Recruitment of Key Organisational staff - Establishment of Regional Support and coaching Structure - Curriculum development and review - Quarterly Technical meetings - Quarterly coordination Meetings with instructors (coaching) - Bi-annual Steering Committee meetings - Develop training data base

3 Humanitarian Diplomacy: - On standardization of first aid training - Training of instructors in HD

4 COFA: - Marketing workshop - Review/draft tailor-made training packages - Promotional activities - Produce and distribute promotion materials - Conduct world first aid day - Conduct Red Cross Day

282

Risk Analysis

Below is a selection of relevant risks for Zimbabwe in general, and for the program outcome in specific. A thorough and detailed

risk analysis was conducted for each country, and an example is added in the annex 2.

TOC ref-

erence Description of risk and im-

pact

Im-

pact

(1-6)

Proba-

bility

(1-6)

Mitigation Responsable

for monito-

ring


C/D/E

Zimbabwe is going through a period of high political un-rest in the build-up towards 2018 elections, often turning to violent demonstrations, potentially hampering the feasibility of project imple-mentation. (See risk analysis

Joint Context Analysis (JCA)

p.76)

4 2

ZRCS relies on the 7 principles of the Red Cross Movement, independence and neutrality being key elements, as widely accepted throughout Zimbabwe where ZRCS enjoys a positive percep-tion as key humanitarian player.

ZRCS is and will continue to advocate with the Zimbabwean government to indenpendently fulfill its mandate to as-sist the most vulnerable.

Senior management ZRCS; BRC-Fl delegate

E/I/H

The current status of food in-security is putting a considerable pressure on a predicted 2.2 million people and is expected to worsen. Motivation and interest for First Aid could dwindle.

3 3

Non-commercial First Aid trainings for vulnerable communities (such as through CBHFA programming) provide lunch and snacks, ensuring an immedi-ate incentive to partake.

Senior Man-agement ZRCS; BRC-Fl delegate

D/F

Pressure on the capacity of ZRCS to implement its nor-mal programming, due to the above risks, potentially requirng emergency inter-ventions from ZRCS.

2 3

Regional experiences (Mozambique, Malawi, Namibia) have increased the will throughout the Red Cross Move-ment to ensure parallel operational structures re set-up and ensure conti-nuity in all projects, emergency or long-term development.

BRC-Fl delegate, Program management

Project Level Risks

Price fluctuations (caused by uncertain exchange rate; in-flation, …).

2 2

Funds for implementation will be dis-bursed to ZRCS on a quarterly basis – leaving ample time for budget reviews when needed.

Program management

E

Turnover of key staff mem-bers and/or volunteers.

2 3

Continuity is a key aspect when ZRCS volunteers are recruited. ZRCS staff qualify for personal staff development, providing motivation.

Senior Man-agement ZRCS; BRC-Fl delegate

G

Lack of incentive/agreement to reinvest COFA revenue in the First Aid Service.

2 2 Understanding of the finality of FA pro-gram support will be emphasized from inception onwards.

BRC-Fl delegate

H

Existing agreements on man-datory FA certificates (mining industry) are not respected

1 3 Humanitarian Diplomacy specifically targets to ensure other stakeholders

Program Management

283

(primarily legislative actors such as gov-ernment) are aware of the importance of FA.

J

Availability of affordable and locally available materials is uncertain and unreliable.

2 1

Instructors will only use locally available materials in their trainings, and rely on possible alterna-tive materials. The regional training centers will actively monitor the supply of materials, lobbying with the private sector for availability where necessary.

Program Management

Lessons Learned & Recommendations


The Strategic Dialogue took place in the offices of DGD in Brussels on the 9th of June 2016.

Within the “Avis Définitif”, which we received together with the letter of Minister De Croo on the 29th of July, following recom-mendations were made:

1. Attention should be given to the rights-based approach and digitalization. 2. Synergies and complementarities should be further concretized.

For the first recommendation, we refer to the section ‘Relevance’ where it’s described how the priority themes of the Belgian Development Cooperation find their reflection into our program.

For the second recommendation, we refer to the section ‘Synergies and Complementarities’ were we present the operationali-zation of intentions made during the Dialogue.

Lessons learned from previous programs

From the current first aid program that BRC-Fl has supported over the last one and a half year in six countries in Southern Africa, a number of important lessons can already be drawn. Underneath is an overview:

General

� Lesson learned: For a First Aid service, it can be a daunting task to clearly establish priorities and responsibilities, struggling to find a balance between immediate activities (FA deployments or trainings), and long-term organiza-tional development.

� Action: ZRCS will be assisted in their planning activities through the organization of an operational planning work-shop.

Training � Lesson learned: Introducing (universal) didactical principles to increase the „learning‟ is of the utmost importance.

A majority of the courses still use an „ex cathedra‟-style of teaching, with little interaction with the students. � Action: ZRCS, when developing training materials, will implement the “didactical guide” developed by the “Di-

dactic-Pedagogical cell” of BRC-Fl, which is tested in Nepal and Uganda.

Practice

� Lesson learned: after organizing a ToT, teachers must as soon as possible be teaching themselves, otherwise they quickly „loose‟ the knowledge they gained.

� Action: the quantity of trainers trained will not be the determining factor, but the guarantee that they can and will be adequately followed-up after, when implementing their trainings.

Data management

� Lesson learned: both for „general‟ FA as for CoFA it is important to keep up to date records. This is a basic require-ment to be able to plan and organize the roster for trainers, to be able to organize refresher courses, etc.

� Action: ZRCS will be supported in the development of a First Aid Database.

284

Outcome 1 FA

Outcome Fiche

Outcome (English or French) : Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhancing community level resilience and emergency care capacity.

Outcome (Nederlands): Leken, Rode Kruispersoneel- en vrijwilligers beschikken tegen 2021 over doeltreffende, meest recente en evidence-based kennis, vaardigheden en attitudes om eerste hulp te verlenen aan zij die het nodig hebben en verhogen op die manier de zelfredzaamheid van gemeenschappen.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_16_ZW_DGD

Country: Zimbabwe Is this Outcome covered by a JSF Yes



Zimbabwe Red Cross

Society Harare (HQ ZRCS)

GPS Coordinates: Longitude : Latitude :

Target population: Lay people, Red Cross staff & volunteers & people in need of first aid.




Policy Marker






285

Logical Framework

A full baseline exercise will be conducted after program approval to rigorously determine and update baseline and target values for each indicator. Numeric targets are presented in a cumulative

manner vis-à-vis the baseline value.


Process indicators





Total: +1.900 Female: +760 Male: +1.140


ZRCS training reports (standardized), attendance list, SARCS data base

Indicator 2: Number of indirect beneficiaries reached.

0 Total: +1.070

Total: +16.019 Total: +34.740 Total: +58.016 Total: +84.786 ZRCS training reports (standardized), attendance list, SARCS data base

JSF – Zimbabwe

Impact: Contribute to ensure healthy lives and promote well-being for all at all ages through the strengthening of the health system and by developing innovative models for health care

(JSG 1).275

Outcome 1:

Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhancing

community level resilience & emergency care capacity.


Indicator 1.1: Number of lay people276 with a valid FA certifi-cate.

Total: 3.400 Women: 270 Men: 330

N/A N/A Total: +4.560 Female: +1.824 Male: +2.736

N/A Total: +12.206 Female: +4.882 Male: +7.324

ZRCS CoFA client database



N/A N/A Total: +1.476 Female: +590 Male: +886

N/A Total: +2.310 Female: +924 Male: +1.386

ZRCS training reports, ZRCS volunteers database

Output 1.1:

High quality FA education for different target groups is available by 2021.


275 Additionally, contributions towards JSG0 “Contribute to achieve gender equality and empowerment of all women and girls” are also included in this proposal. 276Lay people consists of all people trained, including those people trained as part of commercial FA.

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Indicator 1.1.1: Presence of a finalized gender sensitive277 AFAM based basic FA didactical training materials278.

Yes

Yes

Yes

Yes

Yes

Yes

ZRCS FA training manual/didactical materials

Indicator 1.1.2: Number of lay people279 trained in FA.





Total: +320 Female: + 128 Male: +192


ZRCS CoFA attendance list, ZRCS CoFA data base



Total: +214 Female: +86 Male: + 128

Total: +979 Female: + 392 Male: + 587


Total: +1900 Female: + 760 Male: +1.140

Total: +2.310 Female: + 924 Male: + 1.386

ZRCS training reports (standardized), attendance list, ZRCS volunteer data base

Output 1.2: The ZRCS has a well-functioning FA service embedded in the organization by 2021.


Indicator 1.2.1: Number of FA trained volunteers registered in a ZRCS volunteer data-base.280





Total: +3.160 Female: + 1.264 Male: + 1.896

Total: +3.740 Female: + 1.496 Male: + 2.244

ZRCS volunteer database, training database

Indicator 1.2.2: Number of active FA Trainers.281



Total: +75 Female: 30 Male: +45




ZRCS data base

Output 1.3:

The ZRCS delivers high quality commercial FA services by 2021.


Indicator 1.3.1: Number of new282 clients trained in CoFA.

0 +10 +20 +30 +40 +50 ZRCS FA training or client database, ZRCS training records

Indicator 1.3.2: Number of FA commercial prod-ucts283 sold.

0 +195 +350 +575 +810 +1.060 ZRCS records to be speci-fied per country

Typology of activities

Cfr. activities listed under section ‘Theory of Change’.

277Gender is the socially defined roles and responsibilities assigned to men, women, boys and girls, in a given culture, location, society and time. In turn, gender sensitivity means being conscious of the need to understand the social relations between men and women, and to take these into account before embarking on interventions. 278 Didactical training materials includes training materials that can be AFAM based 279 Lay people is defined the same as for indicator 2.1. 280 To be selected at which level this FA training database is most relevant/realistic (HQ, target district, etc.). 281 All ZRCS trainers are allowed to implement both COFA and non-COFA trainings 282 New clients = clients who were not provided a service or product in any previous years. 283 Products include: small, medium and large FA kits, Vehicle kits, Blankets and Stretchers.

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Operational Budget

Partners

Total Partner ZRCS 110.696 153.150 107.303 103.292 68.301 542.743

Total Partners : 110.696 153.150 107.303 103.292 68.301 542.743

Collaboration




Operational Costs

1. Partner 110.696 153.150 107.303 103.292 68.290 542.743


Working costs 52.646 110.310 60.722 74.804 54.057 352.540

Personnel costs 14.244 28.488 28.488 28.488 14.244 113.953









4. HQ 0 0 0 0 0 0


Delegate working costs 0 0 0 0 0 0

Delegate personnel costs 0 0 0 0 0 0

HQ personnel costs 0 0 0 0 0 0

Total 110.696 153.150 107.303 103.292 68.301 542.743


Working costs 52.646 101.310 60.722 74.804 54.057 352.540

Personnel costs 14.244 28.488 28.488 28.488 14.244 113.953

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Relevance

Context analysis As amply summarized in the JCA, Zimbabwe’s health system is recovering from an unprecedented decline during the first decade of this millennium, where the infrastructure deteriorated, investments lacked, health workers were poorly remunerated and essential supplies and commodities were hard to come by, leading the health sector to an almost collapse in late 2008 and early 2009.284 Even now, the health infrastructure, especially in rural areas, remains in badly maintained state with water supply, electric network, radios, ceilings, doors, windows and furniture often broken without being repaired.285 In addition, there are 1,6 physicians and 7,2 nurses for every 10.000 population286, compared to the WHO recommendations of 23 doctors, nurses and midwifes per 10.000 population.287

Zimbabwe will face elections in 2018. In July 2016 and again at the end of August, protests emerged around the #thisflag movement from Pastor Evan Mawarire, who was subsequently arrested288 and upon his release called for more non-violent protests289. Additionally, the announcement of Zimbabwe’s finance minister on 9 September that up to 25.000 government jobs would be cut and annual bonuses are to be suspended because of limited public funds290, which was subsequently and soon after shot down by the own government291, is illustrative for the governments thorny financial situation, giving way to general disgruntlement of the population. The traction and support the #thisflag movement has received is a strong indication that protests will not fade away but are expected to increase in the run-up to Election Day and beyond and, as a consequence, that the possibility of injuries will arise.

Besides, the road network in Zimbabwe is in decay and while road constructions and repairs are undertaken, many roads are in bad shape, riddled with potholes. Adding the volume increase of traffic, road traffic accidents and injuries have gone up, as demonstrated in the Global Status Report on Road Safety, where it is mentioned that 28,2 people in 100.000 die in road acci-dents, as opposed to the global average of 17,4.292 The absence of post-crash care also contributes to the need for widespread and accessible (strategically places) first aid coverage.293

In light of this, our program contributes to the JSF identified strategic goal number 1: “contribute to ensure healthy lives and promote well-being for all at all age through the strengthening of the health system and by developing innovative models for health care”294, and additionally to the Sustainable Development Goals 1, 3, 5 and 8 (cf. ToC) and the transversal strategic goal number 0 on gender 295. Furthermore, the JSF quotes how the usefulness of first aid as an intervention to contribute to the reduction of mortality and morbidity due to injury or sudden illness has been demonstrated and scientifically proven in many ways. Training first responders is considered as an intervention that is very cost effective and addresses a high burden of diseases and injury.296

Beneficiary selection criteria The direct beneficiaries are the volunteers and staff members of ZRCS, coming to a total of 2.310. Amongst whom:

- 45 Trainers - 960 Basic First Aiders - 300 Advanced First Aiders - 200 Profiecency First Aiders - 320 Junior First Aiders - 30 Basic Simulators - 10 Basic Simulator Trainers - 125 Youth Trainers - 120 Road Traffic Safety Volunteers - 200 Action Reponse Volunteers

Volunteers are selected based on the 7 principles of the Red Cross movement, of which volunteerism is a key pillar.

284 JCA Zimbabwe, p. 23 285 Ibid., p. 24 286 Zimbabwe Ministry of Health and Child Welfare, Human Resources for Health information sheet, 2010 287 Achieving the health-related MDGs. It takes a workforce! (2015). Retrieved from http://www.who.int/hrh/workforce_mdgs/en/ 288 BBC News, Zimbabwe's protest pastor Evan Mawarire arrested. Retrieved from http://www.bbc.com/news/world-africa-36781448 289 Al Jazeera, Zimbabwe: Evan Mawarire calls for continued protests. Retrieved from http://www.aljazeera.com/news/2016/07/zimbabwe-evan-mawarire-calls-continued-protests-160714111622089.html 290 http://www.newzimbabwe.com/news-31124-Chinamasa+to+fire+25,000,+stop+bonuses/news.aspx 291 http://af.reuters.com/article/topNews/idAFKCN11K159 292 http://www.who.int/violence_injury_prevention/road_safety_status/2015/GSRRS2015_Summary_EN_final2.pdf?ua=1 293 http://www.who.int/violence_injury_prevention/road_safety_status/2015/country_profiles/Zimbabwe.pdf?ua=1 294 JSF Zimbabwe, p. 8. 295 “Contribute to achieve gender equality and the empowerment of all women and girls”, JSF Zimbabwe p.7 296 Ibid.

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Indirect beneficiaries The indirect beneficiaries are lay people and community members who benefit from first aid trainings (not directly funded through this program) or services, or commercial first aid clients. Special mention should be made of road users who will be able to benefit from FA-trained action teams, established at 6 identified traffic hot spots.

It’s very hard to quantify and monitor indirect beneficiaries given the broad range of first aid applications (from cleaning small wounds to live-saving CPR). Based on the assumption that on average every trained person will assist 5 persons by applying evidence-based, qualitative first aid service, the number of indirect beneficiaries is 84.786. This number takes into account the total number of people trained in FA by ZRCS, even though these trainings are not direct outputs of the program.

Location The program’s scope compasses Zimbabwe in its entirely. The strengthening of ZRCS’ structures to provide qualitative FA training and interventions includes the development of regional systems, ensuring the availability of First Aid trainings in all 8 provinces.

Together with the Zimbabwean Road Traffic safety Council, ZRCS has identified 6 traffic hot spots, statistically known for a high number of accidents and injuries. These will be located in Harare, Beatrice (the Harare – Masvingo highway), Harare to Chirundu highway (around the 303 to 313 km mark), Bulawayo (Glangani to Bhebhe stretch), Harare to Mukukumbula (around the 50 km peg), and Masvingo Beitbridge highway (at the Gundu area).

Relevance according to priorities of the Belgian Development cooperation

Gender In line with DGD’s strategy paper on Gender, BRC-Fl fully subscribes the transversal JSG based on SDG 5 to contribute to gender equality and empowerment of all women and girls, by including or improving the integration of empowerment as a guiding framework for thinking and action within the project policies and interventions.

As mentioned in the description on local partner ZRCS, gender-equality in staffing and volunteer members is an absolute starting point, in support and endorsement of the National Gender Policy (2013-2017) issued by the Ministry of Woman Affairs, Gender and Community Development. In the recruitment and selection of volunteers and/or ZRCS organized trainings, and the establishment of a steering committee at Board level, a 50-50% gender balance will at all times be strived towards. Data col-lected for monitoring and evaluation will be disaggregated, in order for BRC-Fl to track progress in this matter.

Moreover, the AFAM-based didactical training materials developed by this intervention are sensitive for the specific needs of women and girls as receivers and givers of First Aid. Attention is drawn upon specific situations encountered by women such as giving birth without medical assistance. Mannequins are used to fit the con-veniences of women and girls.

Environment Our intervention subscribes DGD’s strategy paper on Environment and specifically the linkages made between environment and healthcare. We aim to support ZRCS in giving high-quality FA training sessions to staff, volunteers and community-mem-bers in order to increase their self-reliance and as such have increased abilities to ‘bounce back’ when hit by sudden emergency. This Community resilience will be of particular importance to deal with the increased volatility of the occurrence of extreme climatological events and natural disasters brought by climate change, and the diseases that originate with it.

On programmatic level, efforts to minimize the ecological footprint will be made. In terms of office management, double print-ing for reporting and didactical materials will be mandatory. In terms of procurement, local products are at all times recommended, and the connected guidelines/policy on asset maintenance will include attention for environmental waste dis-posal.

Additionally, an important reason to establish a monitoring structure with antennas throughout the regions in Zimbabwe is to limit movements by car in order to organize and/or monitor trainings to an efficient and necessary minimum. Community members attending ZRCS organized trainings will rely on public transport.

Human Rights As described in annex 4, a rights based mindset has always been present in the work of the Red Cross Movement. Our FA intervention in Zimbabwe is responding to the needs of the most vulnerable, and is as such aiming for rights-holders to claim their rights under Article 25 of the Universal Declaration of Human Rights : “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, […].” An approach to operationalize this mindset, is our Humanitarian Diplomacy. By the auxiliary role ZRCS has to the public authorities of Zimbabwe, their privileged access and relationship to the government and policy makers is a leverage for addressing specific issues related to our domain of inter-vention, such as ensuring implementation of mandatory FA certificates in the mining industry and/or the possible inclusion of FA knowledge and skills in the educational curriculum and as such contributes to the capacities of ‘duty bearers’ to meet their obligations.

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Digitalization BRC-Fl uses digital technologies as enabling tools to enlarge the impact of our interventions. A range of digital tools is deployed across countries and sectors. In Zimbabwe, this is in line with Zimbabwe’s E-Health Strategy 2012-2017. 297

For our interventions in Zimbabwe, digital technology is used for monitoring and evaluating. Having solid, up-to-date and reliable project data is crucial to properly monitor and evaluate progress on key performance indicators and adjust the imple-mentation strategy where and when needed.

In the field of FA specifically, BRC-Fl will support ZRCS in the set-up and/or maintenance of databases at headquarter level. These databases serve as a registration system for data on First Aid trainings, which help ZRCS to efficiently process and manage their First Aid service. Also, for its national FA services in Belgium BRC-Fl is currently involved in a process of integrating e-learning into our FA trainings in order to increase their effectiveness and accessibility. Gained experience and knowledge of BRC-Fl on e-learning techniques within FA in Belgium, could be reflected in our support to ZRCS's FA service.

Lastly, ZRCS is an active player on social media, where it uses a website and facebook page to frequently reach out to its benificiaries, the people of Zimbabwe.

Decent Work Through increasing the quality and quantity of first aid trainings and commercial first aid services tailored to hazardous occu-pations, BRC-Fl and ZRCS contribute to improve Occupational, Health & Safety (OSH), a core element of Decent Work and the ILO Decent Work Agenda. Annex 3 elaborates on the links between First Aid and OSH. OSH is equally a key result in the Decent Work Country Program, the country strategy agreed upon by the Government of Zimbabwe to implement the ILO Decent Work Agenda.

Effectiveness

In order to attain JSG 1, this program will “support Zimbabwe Red Cross for the development of non-commercial and commer-cial first aid education and the organizational capacity needed to deliver high quality first aid services to the general population”298 (contribution 1A).

In order to attain JSG 0, this program will “Include or improve the integration of empowerment as a guiding framework for thinking and action within policies and interventions” 299 (contribution 0A).

First of all, two aspects make the intervention in Zimbabwe BRC-Fl-specific:

1. Working with volunteers Volunteers form the backbone of ZRCS. Investing in volunteers through skill and knowledge development ensures a qualitative implementation of ZRCS’s goal to assist the most vulnerable within Zimbabwe. A major strength of Red Cross volunteers is their embeddedness into the local communities, even the most distant, which enables ZRCS to be a first responder in case of sickness, injury or threat. In Zimbabwe, where access to medical care is often difficult, the presence of Red Cross volunteers with knowledge of the correct first aid techniques, is therefore a key mitigating factor to reduce mortality and morbidity due to sudden illness or injury within their own com-munities.

2. Our “Evidence Based Practice” To ensure that all activities are based on scientific evidence, is a core principle within BRC-Fl. To assist in this endeavor, BRC-Fl

created the Centre for Evidence-Based Practice (CEBaP) 10 years ago. This research centre uses an internationally recognized

methodology to collect, systematize and evaluate relevant scientific evidence to underpin our activities300. When insufficient

evidence is available, primary research to support our core activities is conducted – for instance, research on FA knowledge and

skills retention in Nepal or on behaviour change factors for WASH interventions in Malawi.

CEBaP developed evidence-based FA guidelines and materials for the African continent (AFAM), India (IFAM) and Nepal (NE-

FAM), which will be used in all our FA programs, including the one in Zimbabwe. Based on evidence summaries developed by

297 http://www.who.int/goe/policies/countries/zwe_ehealth.pdf 298 JSF Zimbabwe, p. 5, 299 JSF Zimbabwe, p. 4 300 www.rodekruis.be\cebap

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CEBaP, a panel of regional/local experts developed first aid guidelines, taking the preferences of the target group(s) into con-

sideration. These guidelines were then used to develop educational first aid materials such as handbooks, posters, exercise

books etc.

CEBaP is recognized as an IFRC Reference Centre and aims to further develop into the RC³ (RCRC Research Centre), providing

its services within the RC movement. These services are also provided to non-RC partners (for example, CEBaP has performed

an evidence search on the contamination of drinking water by fluoride in Senegal, for the Belgian Technical Cooperation). All

primary and secondary research by CEBaP is being published in peer reviewed journals. Furthermore, through its link with

CEBAM, the Belgian Centre of Evidence-Based Medicine and the Belgian Cochrane Centre, CEBaP is in the process of being

accredited in evidence-based guideline development according to the Cochrane methodology 301.

Intervention strategy Referring to the intervention logic as described in the Theory of Change, our intervention strategy is built around three main pillars:

Firstly, the program will support the further developments of ZRCS’ FA trainings as an evidence-based and qua-litative product, by introducing AFAM-based contextualized manuals, including simulation skills in the training for trainers, standardizing mon-itoring and evaluation tools, and the production and development of evidence based first aid didactical material for different target groups, such as mining industry, tourism etc.

In terms of quantity, this ZRCS program will train volunteers in basic first aid, advanced first aid and junior first aid, with a focus on the newly establish action teams for traffic accident hot spots, as well as the lead up to the elections in 2018.

Secondly, institutionally supporting the embodiment of First Aid in ZRCS will ensure its sustainability and further development. The logistical and HR capacities of the First Aid unit will be strengthened, by supporting them in acquiring the necessary equip-ment and infrastructure, by training and refreshing additional trainers and by setting up a monitoring and coaching structure by the master trainers (overseen by a steering committee at Board level). Inter-departmental cooperation within ZRCS will be encouraged, ensuring other ZRCS programs can rely on the FA unit to train their program volunteers and possibly community members.

Lastly, building on the activities and accomplishments in the first two pillars, the program will support ZRCS in offering com-mercial FA trainings. In addition to deciding on specialized curricula for different client target groups, promotional activities should further cement the market position of ZRCS as primary First Aid provider and educator in Zimbabwe. Through the commercial first aid, not only will ZRCS ensure income, it will also increase the first aid knowledge within Zimbabwe.

Through supporting these three intertwined pillars, ZRCS will be able to rely on a well-organized, qualitative and sustainable FA service. Volunteers and staff will rely on evidence-based knowledge and skills, relevant available equipment, a supportive organizational system to either train or provide first aid to those in need.

Sustainability

Technical sustainability: • The intervention of BRC-Fl aims at enforcing the institutional capacity of the ZRCS by embedding a well-func-

tioning FA service into the organization that can anchor the delivery and training of FA. This is done by supporting the management of the first aid service, the volunteer management and the organizational devel-opment.

• Master trainers (which you become by combining both experience and training) will continue to coach and train the existing First Aid trainers, which, at their turn, can grow to become master trainers, ensuring contin-ued qualitative coaching, even in case of staff or volunteer turnover.

• The intervention is risk-informed, i.e. that potential risks, such as natural and technological hazards, are being taken into account in the design and implementation of the program.

• The provision of locally adapted AFAM-based training materials and manuals contextualized to Zimbabwe ensure the continuity of qualitative evidence-based and socially accepted training methods.

Financial sustainability: • BRC-Fl supports the ZRCS in delivering high quality commercial First Aid services. This helps the ZRCS in in-

creasing their market share and revenue, which will be reinvested in the FA service and ZRCS. As such, financial autonomy is enhanced and dependence on external donors decreased.


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Social Sustainability: • ZRCS works with volunteers that are embedded in the selected intervention zones and have a large capacity

to enhance the local ownership of the intervention. These volunteers do not depend on funding from BRC-Fl to reach and be active in their communities. The capacity building achieved in those volunteers by the BRC-Fl intervention, will remain in place after funding is withdrawn.

Exit strategy: As the program set-up is largely aimed at strengthening the capacity of ZRCS’ first aid unit, as well as the general institutional-ization of FA within the National Society, the program will, from the programs’ inception, work on it’s phase out. Important structural improvements strengthening the sustainability are the setting up of a (regionally anchored) coaching and monitoring structure, ensuring senior instructors (and specifically master trainers) have the capacities and reflex to didactically and medi-cally control and improve all instructors.

Secondly, as described above, by strengthening the first aid unit’s commercial first aid activities, the financial capacities of ZRCS will improve, decreasing the need for external funding.

Efficiency

According to a World Bank study302, training first-responders in first aid is an extremely cost-effective intervention; it’s among the most neglected low-cost opportunities in middle- and low-income countries. First aid educations cost 8US$ per disability-adjusted life year (DALY)303. This makes First Aid Education one of the most cost-efficient ways to improve public health in developing countries.

Results-based budgeting

Following its Results-Based Management (RBM) framework, BRC-Fl works as follows for budgeting the program: • Budget formulation revolves around the set of predefined Outcomes and expected outputs; • Expected results justify the resource requirements which are derived from and linked to outputs required to

achieve such Outcomes and: • In which actual performance in achieving results is measured by objective performance indicators.

Delegation

Two BRC-Fl Delegates will be based in South Africa in order to assist Zimbabwe, South Africa and Madagascar Red Cross with the timely and qualitative implementation of this Outcome, in their respective country. A technical expert on First Aid and a Project Cycle Management (PCM)-specialist will jointly provide support, each in their thematic area. The main task of the PCM delegate is to cooperate closely and on a day-to-day basis with the 3 partner National Societies, both at central level and in the program area during field visits. The delegate assists the local Red Cross on a project-managerial level in order to achieve a timely, effective and efficient implementation. The technical expert on First Aid will provide the required specialized content and support for the implementation of the FA activities in a qualitative manner. The expert will build upon the extensive BRC-Fl experience in supporting National Societies’ endeavors to professionalize their FA training and services, assuring maximum impact and sustainability of the change processes. Their close proximity to the implementing partner allows for direct input to achieve the program Outcome and outputs, whilst building the capacities of the implementing partner, to increase the knowledge and skills required to do so, both at a personnel (staff development) and institutional level (systems, structures). The delegates are further supported in their role by the BRC-Fl experts at headquarters, whom provide expert-input regarding managerial (PMER, Finance, Program management) and technical aspects (First Aid focal point).

Finally, because of its geographical closeness to the other BRC-Fl delegations in Mozambique/Malawi and because of the similarities in respective First Aid country programs, Malawi Red Cross & Mozambique Red Cross will also benefit from peer-to-peer learning and from direct technical support provided by the BRC-Fl regional delegation in South Africa on First Aid and PCM.

302 Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2. 303 DALY is a generic measure of disease burden, including both the quality and the quantity of life lived. It is used in economic evaluation to assess the value for money of medical interventions.

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1. Investment costs In line with the activities for the Outcome, 24.222 EUR, 32% of the investment budget is allocated to ensuring the training centra and cre-ated actions teams have adequate intervention and training materials. Other major investments are office-materials and AFAM-based training manuals.

2. Working costs In order to support the execution of the program, general working costs consists mainly in transportation costs 3.774 EUR, communication costs 6.667 EUR and IT support 7.111 EUR.

Trainings form the bulk of the activity budget. Costs for a Training of Trainers (and refresher), Basic First aid, Advanced FA, Proficiency in FA, Junior FA, Basic Simulation training and Basic Simulation ToT combine for 188.310 EUR or 53% of the activity budget. Setting up the action teams relating to road safety and the 2018 election amount to 23.727 EUR.

3. Personnel costs Local personnel ZRCS The local program management team is the Head of Training (0,5 FTE), the Head of Health and Social

Services (0,15 FTE), Operations Manager (0,1 FTE). Support staff further includes a regional training officer (1 FTE), a finance assistant (0,15 FTE) and the PMER expert (0,1 FTE).

Expat personnel BRC-Fl The 3 First Aid (Outcome 1) programs implemented in Zimbabwe, South Africa and Madagascar are supported by a total of 2 BRC-Fl delegates, based in South-Africa: 1 technical expert on FA and 1 PCM-specialist –who jointly are responsible for supporting the 3 partner National Societies during this program. The budget consists out of salary, accommodation, transport costs and other operational cost for the duration of the program. All costs are budgeted fully within the South-Africa program, because of the location of the delegation (logis-tically logic choice – costs budgeted where they are made /where the delegation resides).

HQ personnel BRC-Fl The intervention is supported by a technical First Aid expert based in Mechelen (Belgium). The budget comprises of personnel & travel costs (0,06 FTE for Zimbabwe). This HQ FA focal point safeguards the quality by providing technical expertise directly or by linking the BRC-Fl national First Aid unit and CEBaP to ZRCS. Examples are carrying out or facilitating specific short-term technical missions on di-dactical expertise FA, simulation exercise, assist in profitability analysis CoFa ZRCS,...

Partnership

Policy

BRC-Fl always operates within the partnership framework of the International Red Cross & Red Crescent Movement and works with the National Red Cross or Red Crescent Society as sole preferential partner. Principles of cooperation and capacity building are Movement-wide formalized in the IFRC ‘Development Cooperation Policy (2007)’ 304, the ‘National Society Development

Framework (2013)305’ & the ‘Code of Good Partnership’306.

All Red Cross partners in this program are strategic partners, meaning the commitment for cooperation spans for at least 3 years whereby common objectives are defined and where the focus lies on capacity building of & transferring technical exper-tise to the partner to implement quality services to the most vulnerable within the thematic priorities of BRC-Fl. Capacity building is transversal across the interventions.

ZRCS

Zimbabwe Red Cross Society (ZRCS), established by an act of parliament in 1981, engages, as biggest humanitarian organization in Zimbabwe, in grass root work in the areas of water and sanitation, livelihood and food security, disaster preparedness and response, first aid and HIV/AIDS education. The ZRCS operates in all the provinces in Zimbabwe through 282 branches. As a gender sensitive organization, women constitute more than 52 per cent of the total members. At headquarters, women consti-tute 53 per cent of the senior staff members.

304 http://www.ifrc.org/Global/Governance/Policies/developmentcoop-policy-en.pdf 305 http://www.ifrc.org/Global/Documents/Secretariat/201505/1269801-NSD%20framework%202013-EN-LR.pdf 306 http://www.ifrc.org/PageFiles/79467/CoD09_14_code%20good%20partnership_EN.pdf

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Their key strategic goals are: to strengthen community, family and individual resilience; to work towards a self-sufficient society; to promote safe and healthy living in Zimbabwe and to improve food security and livelihoods promotion. Health, care and first aid training remain an integral part of any given health and safety and or disaster risk reduction program.

FA Since its creation, ZRCS has conducted First Aid trainings. At current, trainings are largely limited to the context of Community-Based Health and Care projects and the creation/training of action response teams in DRR projects. With support from BRC-Fl and the Flemish Government, ZRCS recently introduced AFAM-based materials for its FA trainings, the 46 active instructors are currently becoming conversant with these materials.

In terms of operational structure, ZRCS, until before this program, relies on one head of training, who is, in the absence of a regional support structure, responsible for all commercial first aid trainings and the 45 existing trainers. The department falls directly under the Health and Social Services Coordinator. Commercial First Aid trainings are offered on an ad hoc basis.

Capacity building

Outcome 1 FA As described in the intervention strategy, organizational and institutional development of the first aid department is a primor-dial activity in the program. The participatory program approach (where ZRCS implements the activities, technically supported by a regional delegation, see below) maximizes the opportunities of staff development. In addition, an assessment will be conducted in 2017 to identify needs related to M&E specifically with the eye on results based management of the intervention. Based on the outcome of this assessment the priorities and activities for BRC-Fl M&E support to ZRCS will be determined.

Delegation The regional delegation assists ZRCS not only on a managerial, but also on a technical level to ensure impact and sustainability. Its close proximity to the implementing partner (regional presence and regular visits) allows for direct input to achieve the program Outcome and outputs, whilst building the capacities of the implementing partner, to increase the knowledge and skills required to do so, both at a personnel (staff development) and institutional level (systems, structures). Peer-to-peer learning will be stimulated, as the experience, best practices and lessons learned from different National Societies involved in First Aid will be compiled and shared by the regional delegation, and regional exchange and learning will be facilitated.

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The process of elaborating a JCA and JSF together with other Belgian Civil Society Organisations (CSO’s) or Institutional Actors (IA’s) created an atmosphere of trust and mutual understanding between the actors present in Zimbabwe. This results in the creation of a synergie on the level of operational collaboration with Africalia.

Besides, during the lifespan of the program, informational synergies with other Belgian ANGC’s will be upheld during recurrent consultation rounds which will serve as an exchange-platform for knowledge and experience on common themes, topics, risks or problems encountered. BRC-Fl will proactively participate in these exchange moments, which will serve as a fruitful basis for the formulation and operationalization of further synergies and complementarities. Also FOS, as an organization of the JSF Decent Work, will join in this informational synergy.

What concerns operational synergies and complementarities, we refer to the list below:

Synergies

Organi-zation

Objective of Synergy Roles and Tasks Budget Reference to JSF

Africalia Through its support of evidence-based qualitative First Aid Trainings, and institutionalization and standardiza-tion of first aid within ZRCS, BRC-Fl assist ZRCS is offering qualitative commercial First Aid trainings. In ad-dition to offering ZRCS financial means to continue to build and improve its first aid system, commercial first aid is an effective and sustainable way to spread first aid knowledge and skills through Zimbabwe. Africalia, through its partnerships within the cultural sector in Zimbabwe, is well-placed to encourage these first aid trainings, providing ZRCS a valuable “win” in the Zimba-bwean cultural sector.

Seeing the mutual benefit for both Afri-calia (FA knowledge for their partners) and BRC-Fl (exposure and income for ZRCS), 20 beneficiaries a year (i.e arts students, teachers and performing artists) would be trained by ZRCS.

Cost are split by BRC-FL and Afri-calia, making a contribution from BRC-Fl of 3.500 USD and a contri-bution from Africalia of 3.500 USD.

This synergy re-fers to intention formulated in the JSF p 12: “ Pro-vide information and facilitate co-operation between local partners and other actors, re-garding First Aid training and in-terventions upon request”.

Complementarities

Apart from Belgian CSO’s/IA’s present in Zimbabwe, synergies and complementarities with other international actors are also sought. As BRC-Fl is part of the international Red Cross/Red Crescent Movement, our intervention has a strong complementarity with other sister National Societies present in Zimbabwe, which are the Finnish Red Cross, Danish Red Cross, American Red Cross and the IFRC. Both the Finnish and Danish Red Cross are currently implementing Community Based Health and Care programs in disaster prone regions. Estimates indicate that they will combine to train 400 community members per year, for five years, coming to a total of 2.000 trained lay people. The outcome and outputs of this program directly benefits the quality of these trainings.

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South Africa

Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhanc-ing community level resilience and emergency care capacity.

2017-2021

297

Samenvatting

‘Rode Kruis-Vlaanderen (RKV) helpt helpen’ is de slogan die het 17-21 programma in Zuid-Afrika samenvat. Enerzijds verwijst dit naar de focus op zelfredzaamheid, anderzijds naar de focus op impact. Mensen zelfredzaam maken is de manier bij uitstek om een duurzame impact te hebben. Zowel RKV’s interventiestrategie als de keuze van activiteiten in Zuid-Afrika zijn gebaseerd op het idee van zelfredzaamheid. RKV’s interventiestrategie heeft als kernprincipe dat de implementatie van het programma geleid en gedragen wordt door de lokale Rode Kruis vereniging en haar vrijwilligers. RKV neemt een ondersteunende rol op zich maar zal zelf geen directe imple-mentatie doen. Het 17-21 programma, met een totaalbudget van 1.122.488 EUR307 wordt dan ook getrokken door South African Red Cross Society (SARCS). Het programma is op vraag van en in nauwe samenwerking met SARCS opgesteld. In onze activiteiten, kiezen we voor eerstehulponderricht. Door SARCS personeelsleden, SARCS vrijwilligers en leken op te leiden in eerste hulp wordt de bevolking van Zuid-Afrika zelfredzaam gemaakt. Bovendien is er een duurzaam multiplicator effect door het opleiden van de ‘master trainers308’ (2.765 directe begunstigden en 72.072 indirecte begunstigden). De aanwezigheid van ‘First Responders’ is van groot belang in een uitgestrekt land dat geteisterd wordt door verschillende (overdraagbare) ziektes zoals HIV/AIDS terwijl de toegang tot gezondheidszorg voor de meest kwetsbaren geen evidentie is. Het programma richt zich in de eerste plaats op de SARCS hoofdzetel in Johannesburg, die in staat zal worden gesteld om een kwalitatieve ondersteuning te bieden aan de eerstehulpopleidingen verspreid over de 6 provincies waar SARCS actief is. Daar-naast werden 4 provincies geselecteerd (Gauteng, Kwa-Zulu Natal, Eastern Cape & Limpopo) waarin een intensief eerstehulpopleidingstraject zal worden aangegaan. De trainingscapaciteit van SARCS zal worden versterkt met 50 eerstehulp-instructeurs, 10 master trainers en 5 eerstehulpexaminators. Al deze zullen een educatief traject volgen zodat ze door de overheid geaccrediteerd zijn om eerstehulptrainingen te geven. Dankzij de synergie met VVOB kunnen we ook hun lokaal personeel opleiden in eerste hulp. Naast het opleiden in eerste hulp, wil RKV de zelfredzaamheid van SARCS versterken door hen in staat te stellen financieel te investeren in eerstehulpactiviteiten. Door SARCS meer zelfredzaam te maken, beogen we een grotere duurzaamheid van eer-stehulpactiviteiten. RKV wil dit doen door SARCS te ondersteunen in het uitbouwen van bedrijfseerstehulp. Dit doen we zowel via kennisoverdracht als via ondersteuning in het ontwikkelen van een gevarieerd eerstehulpopleidingenaanbod dat verschil-lende doelgroepen aanspreekt. De uitbouw van bedrijfseerstehulp ligt in lijn met de ‘Waardig Werk’ prioriteiten van Zuid-Afrika rond veiligheid en preventie op de werkvloer. Belangrijk om te melden is dat SARCS zich in een herstelperiode bevindt na een periode van institutionele crisis. Recent is een opnieuw een nationaal kantoor opgezet in Johannesburg. Aan het hoofd staat een nieuwe nieuwe CEO en een nieuwe raad van bestuur, opgezet volgens de Companies Act van Zuid-Afrika. Institutionele hervormingen zijn doorgevoerd zoals een centrale boekhouding en een organisatie audit. Voor RKV en andere Rode Kruis partners is het nu de opdracht om SARCS te onder-steunen in haar doelstelling om opnieuw de leidende nationale humanitaire organisatie in Zuid-Afrika te worden. RKV kan SARCS ondersteunen in dit proces door de focus op opleidingen en de nationale trainingsstructuur mee te herstellen. RKV erkent deze fragiele status van SARCS en dit programma mikt expliciet op capaciteitsopbouw naar betere dienstverlening rond eerste hulp bij de Zuid-Afrikaanse bevolking. RKV zal rigoreus de activiteiten opvolgen om de correcte en tijdige uitvoering te garanderen, en zal indien nodig gepaste maatregelen nemen om het programma tot een goed einde te brengen gegeven de beperkte beheerscapaciteit van SARCS op dit moment. Naast zelfredzaamheid is impact een belangrijke focus van het RKV programma in Zuid-Afrika. Een studie van de Wereldbank toont aan dat het investeren in de opleiding van eerstehulpvrijwilligers één van de meest kosteneffectieve interventies is met een kost van slechts 8 US$ per Disability Adjusted Life Year averted (DALY)309. Bovendien investeert RKV via haar ‘Center for Evidence-Based Practice’ continu in onderzoek naar interventiestrategieën met de meeste impact. Zo onderzoeken we het effect van simulaties in eerstehulpopleidingen of welke eerstehulpkennis op welke leeftijd kan onthouden worden. De resulta-ten van deze onderzoeken zijn geïntegreerd in RKV’s eerstehulpondersteuning aan SARCS. Daarnaast heeft het ‘Center for Evidence-Based Practice’ evidence-based eerstehulprichtlijnen uitgewerkt die volledig aangepast zijn aan de Afrikaanse context (‘AFAM’, African First Aid Materials’). Het eerstehulpopleidingsmateriaal van SARCS zal op basis hiervan gebaseerd worden zodat steeds de meest doelgerichte eerstehulppraktijken worden aangeleerd.

307 Dit budget bedraagt ook de kost voor 2 RKV-afgevaardigden die regionaal zullen worden ingezet in de 3 EH-interventies in zuidelijk Afrika (Madagaskar, Zimbabwe en Zuid-Afrika). 308 Trainers die andere trainers kunnen opleiden. 309 DALY is een maatstaf die werd ontwikkeld door de Wereldgezondheidsorganisatie. De DALY meet niet alleen het aantal mensen dat vroegtijdig sterft door ziekte, maar meet ook het aantal jaren dat mensen leven met beperkingen door ziekte. In maatschappelijke kosten-batenanalyses worden DALY's ook toegepast om de kosteneffectiviteit van gezondheidsinterventies te bepalen. Laxminarayan et al. (2006). Intervention Cost-


298

RKV wil de impact van het programma in Zuid-Afrika ook vergroten door gebruik te maken van haar jarenlange operationele expertise rond eerstehulpopleidingen. Binnen RKV bestaat de dienst ‘Eerste Hulp’ die 500 trainers in dienst heeft om nationaal eerstehulpopleidingen te geven. Deze trainers worden voor specifieke expertisegebieden ingezet in ons programma. Dit programma houdt rekening met de prioriteiten van de Belgische ontwikkelingssamenwerking rond digitale innovatie, men-senrechten en waardig werk. Gedurende alle fases van het programma, wordt een gender-sensitieve benadering gehanteerd: binnen SARCS wordt gestreefd naar een gelijkmatige verdeling van vrouwen en mannen binnen de eerstehulplessen en de beheers- en bestuursorganen van de organisatie. Aan de hand van gender-gedesaggregeerde indicatoren zullen verwezenlij-kingen in kaart worden gebracht. Daarnaast zullen inspanningen worden gedaan om de impact van onze interventie op het milieu te beperken, door onder andere de aankoop van lokale materialen en een correcte afvalverwerking. RKV gelooft ten stelligste dat het 17-21 programma in Zuid-Afrika rond eerstehulponderricht door zijn focus op zelfredzaam-heid en duurzame impact sterk bijdraagt tot een verhoogde toegang tot eerstelijns gezondheidszorg. Op die manier komt het programma tegemoet aan de Gemeenschappelijke Strategische Doelstelling 1310 van het Gemeenschappelijk Strategisch Kader Zuid-Afrika en aan de Sustainable Development Goals 1, 3, 5 & 8.

310 Een bijdrage leveren aan en het promoten van een gezond leven voor allen op alle leeftijden, door een versterking van de gezondheidssec-tor en het ontwikkelen van innovatieve modellen voor gezondheidszorg.

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Country Fiche

Total Operational Costs (EUR) 1.122.488

In-country contact person Name: Letitia Kleij

Organization: Belgian Red Cross-Flanders (BRC-Fl)

Phone No: +27 71 879377


Narrative summary of the country program In the partnership between Belgian Red Cross-Flanders (BRC-Fl) and South African Red Cross Society (SARCS), the program 2017-2021 will focus on First Aid (FA). First aid is a priority activity for all Red Cross Societies worldwide, and especially relevant in South Africa, considering its stretched, sub-par health infrastructure and the burden of various communicable and non-communicable diseases. The focus will be on strengthening SARCS as an organization, improving the first aid training quality in commercial and non-commercial first aid and embedding first aid services at community level in 5 provinces (Gaut-eng, Kwa-Zulu Natal, Western Cape, Eastern Cape, Limpopo). The goal will be to contribute to improved health and well-being of the people in the selected provinces by increasing coping mechanism of community members in emergencies and basic health situations. FA Education is a proven cost-effective development intervention, with a cost of 8US$ per disability-adjusted life year averted (DALY), making it one of the cheapest ways to increase public health in developing countries311. Moreover, our program is underpinned by scientific research in order to increase the effectiveness and efficiency of our intervention. As a result, 72.072 beneficiaries can be reached.

Aria of intervention


300

List of partners

Local partner

Full Name & abbreviation: South African Red Cross Society (SARCS)

Contact details: Address: Phone No: E-mail:

103, 11th Street, Parkmore, Jo-hannesburg, South Africa

27 (0) 12 3428612 + 27 (0) 82 571 6527 [email protected]

Contact person Derick Naidoo, Secretary-General

Outcome O1: Lay people, Red Cross & volunteers staff have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhancing community level resilience and emergency care capacity.

Budget by Outcome (EUR) Budget O1: 502.439


SARCS through its nationwide network of branches and volunteers, is the main implementing partner for these outcome. With support from BRC-Fl headquarters and the delegation, SARCS is responsible for the planning, implementation, monitoring and reporting of this program.


2011

Theory of Change

The Theory of Change (ToC) serves as the basis & reflection for the logical framework, e.g. assumptions & Outcomes (see further). Throughout all phases of program implementation BRC-Fl uses the logical framework as the basis for tracking & monitoring. A narrative description of the intervention strategy, as visualized in the ToC, is found in the section ‘Effectiveness’. In addition, a general explanation on how BRC-Fl has structured and defined the ToC model can be found in Annex 1.

Outcome First Aid


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1. Assumptions


frame

Does it hold?

(yes/no) Argumentation/evidence



• FA education is a very cost- effective development intervention to increase public health.


• Yes

• A British Red Cross study shows linkages between features of community resilience and first aid training.312

• Evidence based FA techniques are proven to be more effective towards injury treatment/illness recovery. The BRC-Fl Centre for Evidence-Based Practice (CEBaP) specializes in the evidence based methodology for first aid guideline development, us-ing the best available evidence from scientific literature, supplemented with know-how from experts and information gleaned through practical experience.

• FA education has a cost of 8US$ per disability-adjusted life year averted (DALY), making it one of the cheapest ways to in-crease public health in developing countries.313

B Smaller negative impact on health in case of injury/illness because people are assisted with first aid.

Impact Yes, more research is on-going

A systematic review is ongoing on the health effects of training lay people to deliver emergency care in underserviced popula-tions.314 Results will be available in 2017. One case study in Iraq also showed that a reduction in mortality was caused by trained layperson first responders in a setting where pre-hospital evacuation times are long.315

C • Lay people and Red Cross staff & volunteers intervene to apply FA if they have the required knowledge, attitudes and practices.

• Lay people have access to basic FA local materials for applying first aid techniques.

• First aid lay responders as well as FA trained Red Cross staff & volunteers can intervene and provide first aid in a safe legal environment (legal li-ability).

Outcome 1 • Yes, but more research is needed. • Yes • No

• A systematic review reports significant increases in first aid knowledge, skills and improvement in helping behavior due to first aid training for children and lay people.316 A case study in Uganda shows that groups of people who regularly have to apply FA have a higher retention of FA knowledge. A Red Cross structure could be considered similar.317

• Sensitization on the importance of having adequate FA materials and on the use of local materials will be part of the inter-

vention. FA trainings are also adapted to locally available materials. • In none of the intervention countries the law provides protection for bystanders providing first aid. However, the 32nd Inter-

national Conference of Red Cross and Red Crescent Societies adopted a resolution on strengthening legal frameworks for disaster response, risk reduction and first aid.318

312 British Red Cross. Assessing the links between first aid training and community resilience. 2011 http://www.redcross.org.uk/~/media/BritishRedCross/Documents/What%20we%20do/First%20aid/As-sessing%20the%20links%20between%20first%20aid%20training%20and%20community%20resilience.pdf 313 Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2. http://www.ncbi.nlm.nih.gov/pubmed/21250358 314 Orkin AM, Curran JD, Fortune MK, et al. Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol. 2017 http://bmjopen.bmj.com/content/6/5/e010609.full 315 Murad MK, Husum h. Trained lay first-helpers reduce trauma mortality: a controlled study of rural trauma in Iraq. 2010 http://munin.uit.no/bitstream/handle/10037/5440/paper_2.pdf;jses-sionid=A29D143AA28B30DA5510C8DBDAB6C704?sequence=4 316 He Z, Wynn P, Kendrick D. Non-resuscitative first-aid training for children and laypeople: a systematic review. 2013 http://www.ncbi.nlm.nih.gov/pubmed/24351520 317 Jayaraman S, Mabweijano R, Lipnick MS, Caldwell N, Miyamoto J, et al. First Things First: Effectiveness and Scalability of a basic prehospital trauma care program for lay first-responders in Kampala, Uganda. 2009 http://www.ncbi.nlm.nih.gov/pubmed/19759831 318 IFRC. Law and First Aid. Promoting and protecting life-saving action. 2016 http://www.ifrc.org/Global/Photos/Secretariat/201506/First%20Aid%20Law%20Advocacy%20Report%20(final).pdf

303

D Trained and equipped RC volunteers are retained.


Yes Turnover will be avoided by assigning 5 full time master trainers and ensuring their salary, as the previous experience shows that part time trainers resign more easily.

E Red Cross is able to recruit the re-quired volunteers and staff to provide FA.


Yes Cfr. D on recruitment & volunteer policies.

F There is adequate follow-up and coaching of RC volunteers and staff.


Yes, but a risk in some coun-tries

Through the establishment of a monitoring system by the national training manager assisted by the master trainers, RC volunteers and staff will be coached.


• Red Cross Society is willing to invest

the income generated from com-mercial first aid trainings at least partly back into the FA service.



• Yes

• In 2016, BRC-Fl undertook a study in cooperation with Vlerick Business School analyzing the cost of FA trainings in Nepal using a time-driven activity based costing model. Being a pilot study, BRC-Fl aims to use this model to improve commercial first aid activities in other partner countries.319

• SARCS expressed the willingness to revolve funds from CoFA trainings partly back into the FA service.

H People who decide to become a Red Cross volunteer or staff recognize and value the importance of first aid.

Output 1.2 Yes Within RC organizations first aid is recognized as a core activity, and each newly recruited volunteer is introduced in the vision, mission and policies of the organization. Within SARCS’ strategic plan, (which serves as a key document for volunteer recruit-ment), first aid is recognized as a key pillar.

I The used didactical methods are ef-fective.

Output 1.1 BRC-Fl research planned

The use of simulation as a didactical tool will be studied during the course of the implementation period. In addition, master trainers and instructors (assessors) will receive workshops/trainings to strengthen their teaching methods and to strengthen the use of AFAM.

J Lay people (incl. Red Cross staff and volunteers) sufficiently retain the knowledge and skills obtained during a first aid (refresher) training.



BRC-Fl is conducting a study to assess the degree of knowledge and skill retention over a period of time and to determine the impact of refresher courses and first aid practice on the retention level. This information will be used to determine the optimal frequency of refresher courses and to assess the need to revise the validity of first aid certificates. One case study has shown that first aid knowledge gained during commercial first aid training does not significantly decline over time. However, skills re-lated to CPR rapidly deteriorate over the course of the first 90 days suggesting that refreshing skills frequently is required.320

319 Schumacher S, Bleys M, Pattyn S. Time-driven activity based costing of first aid trainings in Nepal. Vlerick Business School. 2016 320 Anderson et al. First aid skill retention of first responders within the workplace. 2011 https://sjtrem.biomedcentral.com/articles/10.1186/1757-7241-19-11

304


No Stakeholder Role (what, when, how, where) Interests/Power Opportunities/threats

1 Department of Health The Department of Health (DoH) has an overall responsibility for healthcare in the country, with a specific responsi-bility for public-sector healthcare.

- Statutory and regulatory organization - MOU - Any good help can improve overall health

situation for example combatting FA - South Africa

- Can create legal environment sup-porting FA activities in general and for SARCS specifically.

2 Health and Welfare Sector Ed-ucation and Training Authority (HWSETA)

Standardization Body. - Ensure accreditation of SARCS - Rely on grass-roots and widespread volunteer base of

SARCS

- Partnership between HSWETA and SARCS

3 FA material supplier Delivery of FA material like content FA kits & material for training (stationary).

- Income from selling products - Low power

- Winning a CBA

4 Other FA training providers like Wild Medix /First Aid

Training SA/ PulsePoint/

Aid&Hand

Providing and certifying FA training and other trainings related to occupa-tional safety and health.

- High interest in FA - Low power

- Competition

5 Lay people who attend CoFA Performing evidence based first aid when an emergency occurs in their re-spective communities/work environment.

− To perform adequate first aid when required. − Sense of pride to be able to perform FA when needed. − Can influence other community members.

Opportunity= Image of SARCS strengthened/own image in commu-nity enhanced. Threat = FA skills and competences not updated in time.

6 RC master trainers and FA in-structors

Training and monitoring of RC volun-teers in evidence based first aid.

− To train RC volunteers in evidence based FA skills. − Monitor RC volunteers. − Proud to be part of Red Cross.

Opportunity= SARCS strengthened in capacity Threat = turnover of RC staff

7 Red Cross staff & volunteers Performing evidence based first aid in an emergency situation in their re-spective communities.

− To perform adequate first aid when required. To have sufficient FA materials.

− Proud to be part of Red Cross. − They are the eyes and ears of the community.

Opportunity= Image of SARCS strengthened Threat = turnover of well trained staff

3. Context analysis

Contextual factor Influence on ToC

An organization within South Africa has to be accredited by Health and Welfare Sector Education and Training Authority (HWSETA) in order to give accredited (FA) trainings

Every person/RC staff is obliged to follow a course by a training institute approved by HWSETA in order to be ac-credited. After being accredited the competences can be strengthened by additional evidence based trainings.

305

Prevalence of HIV is 9,2%321 People do not want to become a RC volunteer out of fear to be infected when giving first aid and come into con-tact with blood. Therefore the information (knowledge) about preventive measures in FA by SARCS will have to intensify in order to take away possible fear that people have.

The ''Draft General Health and Safety Regulations'' where Gazette on 28 October 2005 (Government Gazette, No. 28162) states that ''an employer shall take all reasonable steps that are necessary under the circumstances, to ensure that persons at work receive prompt first aid treatment in case of injury or emergency.''

This regulation is a window of opportunity for SARCS to increase dramatically their first aid activities to the wider public.

South Africa area is 1.221.037 square km and distances are far. Human resources have to be in place and assigning 1 national training officer and 1 master trainer per province will suffice in monitoring of FA activities. With the assistance of RC instructors (assessors) the monitoring of RC volunteers will take place.

Uncertain political context due to upcoming general elections in 2018 in South Africa

Political tensions involving strikes, road blockades and violence might lead to insecurity that impacts negatively on communities’ stability. However jointly with ICRC/IFRC the RC volunteers will be mobilized and a security plan will be drafted that includes first aid services.

4. Activities

1 Holding national training on institutionalization & branch management:

a) standardization of FA training curricula b) development, translation and dissemination of FA policy c) standardization, translation and dissemination of FA procedures d) development of a FA training plan (incl. FA trainers) e) set-up of FA training database and registration of trainings.

2 Holding yearly follow-up meeting on institutionalization and branch management/M&E

3 Training of 10 master trainers (after they are trained through HWSETA and accredited)

4 Refresher training of 10 master trainers

5 Training of Trainer (TOT) of 50 RC instructors (after they are trained through HWSETA and accredited)

6 Training of 2.700 SARCS volunteers in basic FA

7 Procurement of various FA training materials (1 Family Pack, 1 Little Anne Pack, 24pc Airway per province)

8 Promotional activities during World First Aid day.

9 Recruitment of 1 national training manager (100%), 1 finance person (20%), and 5 master trainers

10 1 national training in view of marketing CoFA: development of CoFA policy/strategy, and business plan

11 Renovations & Office Furniture of 5 branches for HWSETA Accreditation

321 https://www.avert.org/professionals/hiv-around-world/sub-saharan-africa/south-africa

306

Risk analysis

Below is a selection of relevant risks for South-Africa in general, and for the program outcome in specific. A thorough and detailed risk analysis was conducted for each country, and an example is added in Annex 2.

TOC refer-

ence Description of risk and

impact Impact

(1-6)

Probabi-

lity

(1-6 Mitigation

Respon-

sable for

monito-

ring


Outcome 1

Political unrest (strikes/protests) and therefore trainings ham-pered at community level, looting of project resources and price and currency volatility.

2 3 At all times, Red Cross strives for non-violent conflict resolution by humanitarian diplomacy towards actors involved. Nevertheless, when political unrest would rise, the neutrality of SARCS forms a buffer to the looting of tangible outputs of the program. Moreover, flexibility within activity planning and budget will help the program to cope with unforeseen situations.

SG and national training manager

Outcome 1

Erratic rainfall patterns, extreme drought, … caused by climate change (cfr (JCA point 9 p 80-84).

1 2 Floods might affect travelling as bridges can collapse, however as RC volunteers are community based and most of the time already at the spot, they will be able to act. Monitoring from provincial level might be hampered and has to take up again the soonest after the situation improves.

National training manager

Outcome 1

Governmental structure changes related to elec-tions (Change of Minister), (cfr JCA point 9 p 80-84).

2 4 As Red Cross is auxiliary to the Government, change in govern-mental structures will be overcome by continuous lobbying and advocacy (humanitarian diplomacy).

Secretary General

Program Level Risks

Output 1.1

Lack of good trainers (cfr CJA point 9 p 80-84) and therefore lay people not convinced of added value of FA services of SARCS.

5 3 The investment in evidence based trainings using AFAM will result in good trainers. Furthermore, the program will focus on a marketing plan in order to better sell the CoFA product to lay people.


Output 1.3

Increased competition in commercial first aid from national actors resulting in a loss of market share for SARCS and thus fewer resources gained by Commercial FA activi-ties, impeding the financial sustainability of the program

3 3 Coping will be enhanced as the program focusses on strengthening the training competences of SARCS and their marketing activities. The fact that SARCS will use evidence based material and trainers that use AFAM, will strengthen their value on the market.


Outcome 1

Limited buy-in of higher management and staff to support the FA pro-gram and assist in reaching the outcome and outputs, plus assist in compliance to finan-cial rules and regulations.

5 2 Clear cut discussion with higher management, information about the program and sharing of requirements (donor rules and regulations), in combination with stringent oversight by the regional delegation, will ensure buy in of higher management and staff, and compliance with the rules and regulations.

Secretary General and BRC-Fl delega-tion

307

Output 1.2

Staff turnover due to changing politics (cfr JCA point 9 p 80-84) or in turnover of RC master trainers and RC instruc-tors.

4 3 In the selected provinces 1 master trainer will be assigned full-time. For the part-time master trainers and the RC instructors a proper remuneration scheme (commission fee) will be set up. Staff will be kept motivated by training, regular meetings to discuss progress of activities and a reward system.


Outcome 1

Corruption (cfr JCA point 9 p 80-84) and therefore mismanagement of funds.

4 2 SARCS will sign a project agreement including financial procedures which can be adapted according to the needs. Strict monitoring and follow up will be done by the BRC-Fl delegation in country.

Secretary General and BRC-Fl delega-tion

Lessons learned & Recommendations


The Strategic Dialogue between DGD and the participants of the GSK South Africa, took place on the 14th of June 2016 within the offices of the FPS Foreign Affairs in Brussels.

In the final advice of DGD, three points of consideration for the program 17-21 were listed: 1. Transversal themes gender & environment should be taken into account. We refer to the section

“Relevance related to the priorities of the Belgian Development Cooperation” for a description how those themes find their reflection in our intervention.

2. Attention should be given on the priority themes ‘Rights-based approach’ and Digitalization (D4D), when possible. Our vision and steps into those two subjects, can be found in the section “Relevance related to the priorities of the Belgian Development Cooperation”.

3. The operationalization of commitments for synergies and complementarities. Here, we kindly refer to the correspond-ing section on “Synergy & Complementarity”.

Lessons learned

From the current first aid program that BRC-Fl has supported over the last one and half year in six countries in Southern Africa, a number of important lessons can already be drawn.

1) General lessons learned Training

� Lesson learned: Introducing (universal) didactical principles to increase the „learning‟ is of the utmost importance. A majority of the courses still use an „ex cathedra‟-style of teaching, with little interaction with the students.

� Action: BRC-Fl will use the “didactical guide” developed by the Didactic-Pedagogical cell” and tested in Nepal and Uganda.

Practice

� Lesson learned: After organizing a ToT, teachers must as soon as possible be teaching themselves, otherwise they quickly „loose‟ the knowledge they gained.

� Action: quantity of trainers trained will not be the determining factor, but the guarantee that they can and will be „deployed‟ soon after the ToT.

Market plan

� Lesson learned: Drafting a market survey and business plan for CoFA is needed, but CoFA activities can only generate income if the right initiatives for commercialization of the product are taken and if the CoFA is managed as commer-cial enterprise.

� Action: Basic principles for the setting up and running of a CoFA service have been drafted and will be disseminated with new partners.

Data management

� Lesson learned: Both for „general‟ FA as for CoFA it is important to keep up to date records. This is a basic require-ment to be able to plan and organize the roster for trainers, to be able to organize refresher courses, etc.

� Action: SARCS will be supported in the development of a pragmatic data system.

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Position of FA within organization

� Lesson learned: A FA coordinator or focal point is essential to adequately manage and support the implementation of a FA project/program.

� Action: Clear positioning of FA (unit) and its focal point within the organizational structure.

2) Lessons learned SARCS

Human Resources

� Lesson learned: Adequate number of staff has to be in place in order to serve for the implementation of activities as planned and in view of the services that SARCS according to its strategy should deliver. In the previous program SARCS head of training could not finalize the FA handbook as she was assigned acting SG. And since the restructuring in 2012/13 national headquarters is only having 4 positions.

� Action: Assist SARCS in human resources and appoint a national training manager, finance officer, 5 full-time master trainers.

Turnover

� Lesson learned: Turnover of staff have a negative influence on implementation of activities and covering the needs that SARCS is aimed for. For example a newly assigned marketing officer left soon after the assignment, head of training changed position and job became vacant. As a result marketing activities have been long on hold

� Action: Motivate staff of which consistency in payment of salary is one factor. Business plan

� Lesson learned: Only first attempts at a marketing strategy and a business plan were developed in the previous program and marketing activities were on hold. However it is of utmost importance to revitalize the formulation of the marketing strategy as well as the business plan as it is crucial to the success of the goals set for commercial first aid.

� Action: Revitalize the formulation of the marketing strategy as well as the business (marketing) plan for commercial first aid and increase the number of clients and income successively.

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Outcome First Aid

Outcome Fiche

Outcome : Lay people, Red Cross staff & volunteers have adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhancing community level resilience and emergency care capacity.

Outcome (Nederlands): Leken, Rode Kruispersoneel en - vrijwilligers beschikken tegen 2021 over doeltreffende, meest recente en evidence based kennis, vaardigheden en attitudes om eerste hulp te verlenen aan zij die het nodig hebben en verhogen op die manier de zelfredzaamheid van gemeenschappen.

IATI activity identifier: BE-BCE_KBO-0461634084-2017_17_ZA_DGD

Country: South Africa Is this Outcome covered by a JSF Yes

Province(s)/state(s) targeted Subnational admin level 1 Subnational admin level 2 Subnational admin level 3

Local partner SARCS Province: Western-Cape, Kwazulu-Natal, Eastern-Cape, Lim-popo & Gauteng

Branch level: After the ToTs by the master trainers the trained 50 RC instructors (assessor) will be divided over the branches in the 5 provinces/average of two RC instructor per branch.

Community level: The 50 instructors (assessors) will train RC volunteers at the branches, who then will return to their respective communities. Which branches (communities) still to be de-cided.

Target population: Lay people, Red Cross staff & volunteers & people in need of First Aid

Number of beneficiaries: Lay people, Red Cross staff & volunteers & people in need of First Aid

Main sector:

Total: 74.837 Direct beneficiaries: 2.765 (SARCS staff and volunteers trained in FA, RC instructors and RC Master Trainers) Indirect beneficiaries: 72.072 (This is based on the assumption that on average every trained person will assist 5 persons by applying evidence-based, qualitative first aid service.)

Total operational costs for this Outcome (EUR):

502.439

Policy Marker






310

Logical framework

For some indicators, baseline data are currently not available. A full baseline exercise will be conducted after program approval to rigorously determine and update baseline and target values for each indicator. Numeric targets are presented in a cumulative manner vis-à-vis the baseline value.

Baseline 2017 2018 2019 2020 2021 Means of

verification

Process indicators

Indicator 1: Number of direct beneficiaries reached in the selected 5 provinces.

Total: 0 Female/Male: no data


Total: +965 Female: + 386 Male: +579

Total: +1.865 Female: +746 Male:+1.119



SARCS training reports (standardized), attend-ance list, SARCS data base

Indicator 2: Number of indirect beneficiaries reached in the selected 5 provinces.

Total: 0

Total: N/A

Total: +14.460

Total:+38.286

Total: +62.112 Total: +72.072

SARCS training reports (standardized), attend-ance list, SARCS data base

Impact:

JSF – South Africa- Joint Strategic Goal 1

Contribute to ensure healthy lives and promote well-being for all at all ages through the strengthening of the health system and by developing innovative models for health care.


Outcome 1:

Lay people, Red Cross staff & volunteers with adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid to those in need by 2021, as such enhancing

community level resilience and emergency care capacity.


Indicator 1.1: Number of SARCS volunteers with an AFAM based valid FA certificate in the selected 5 provinces.

Total: 1678 Female/Male: no data


N/A Total: +2700 Female: +1080 Male: +1620

SARCS training reports, SARCS volun-teers database

Indicator 1.2: Number of lay people322 with a valid FA certificate in the selected 5 prov-inces.

Total: No data


N/A Total: +9762 Female: +4881 Male: +4881

SARCS CoFA data base

Output 1.1:

High quality FA education for RC volunteers and lay people available by 2021.


322 Lay people consists of people trained as part of commercial FA.

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Indicator 1.1.1: Presence of a finalized gen-der sensitive323 AFAM based basic FA didactical training materials324 in the selected 5 provinces.

No No Yes Yes Yes Yes SARCS FA training manual/didactical materials

Indicator 1.1.3: Number of SARCS volunteers trained in FA in the selected 5 provinces.

Total: 1.678 Female/Male: no data

Total: +0 Female: Male:





SARCS training reports (standardized), attend-ance list, SARCS volunteer data base

Output 1.2: SARCS has a well-functioning, sustainable FA structure embedded in the organization by 2021.


Indicator 1.2.1: Number of FA trained volun-teers registered in SARCS database

Total: 1.678 Female/Male: no data

Total: +0 Female: Male:





SARCS volunteer database, training database

Indicator 1.2.2: Number of FA trainings regis-tered in a FA training database

0 +0 +45 +90 +135 +135 SARCS FA training database

Output 1.3:

SARCS delivers high quality commercial FA services by 2021.


Indicator 1.3.1: Number of new clients trained in CoFA in the selected 5 provinces.

Total: 0

+0 Total: +10

Total: +20

Total: +30

Total: +40

SARCS CoFA client database/ records

Typology of activities Please refer to the activities listed under the Section ‘Theory of change’.

323 Gender is the socially defined roles and responsibilities assigned to men, women, boys and girls, in a given culture, location, society and time. In turn, gender sensitivity means being conscious of the need to understand the social relations between men and women, and to take these into account before embarking on interventions. 324 Didactical training materials includes training materials that can be AFAM based (i.e. this does not include mannikins, bandages, etc.) such as FA manual, FA training manual, leaflets, presentations, booklets, posters, etc.

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Operational Budget

Partners

Total Partner SARCS 80.498 212.403 81.866 78.991 48.680 502.439

Total Partners : 80.498 212.403 81.866 78.991 48.860 502.439

Collaboration

Collaboration 1 - - - - - -

Total Collaborations - - - - - -

Relevance

General

This intervention aims to contribute to SDG’s 1, 3, 5, 8 and 13 and Joint Strategic Goal 1 of the JSF South-Africa. In this JSF (p.4) is described how, even though the health politics of South-Africa are aiming to strengthen the whole health sector, the access to quality health care for the most vulnerable remains a challenge. Despite the difficult conditions as described in the JCA (p.11-15), the communities within South Africa seem resilient and ever seeking to overcome their challenging context. Those coping mechanisms within the communities have to be strengthened by bridging the missing link of health coverage and timely first aid services. This can be done by creating first aiders within communities and as such strengthen healthy lives and promote well-being.

In this intervention, BRC-Fl works with our partner SARCS towards this goal by empowering community and Red Cross volun-teers with adequate, up-to-date and evidence based knowledge, skills & attitudes to provide first aid services. The usefulness of FA as an intervention to contribute to the reduction of mortality and morbidity due to injury or sudden illness has been demonstrated. As an auxiliary to their government, local Red Cross (RC) National Societies provide immediate assis-tance to victims of illness and accidents, disasters and political or social agitation. In countries where the access to medical care is limited because of geographical or social-economic reasons, or where the provision of basic healthcare is insufficient, knowledge of FA is a key mitigating factor. Also the World Bank acknowledges the usefulness of FA: the training of lay persons to respond to medical emergencies is a cost-efficient and profitable intervention to reduce the effect of illness and injuries in Sub-Sahara Africa325.


2017 2018 2019 2021 2021 Grand total

Operational Costs

1. Partner 80.498 212.403 81.866 78.991 48.680 502.439


Working costs 26.582 150.681 50.769 37.004 22.242 287.279

Personnel costs 13.986 27.972 27.972 38.862 24.876 133.668

2. Collaboration - - - - - -

Investment costs - - - - - -

Working costs - - - - - -

Personnel costs - - - - - -

3. Local Office - - - - - -

Investment costs - - - - - -

Working costs - - - - - -

Personnel costs - - - - - -

4. HQ 52.867 179.887 180.512 179.887 26.895 620.050

Investment costs 313 - - - - 313


HQ personnel costs - - - - - -

Delegate personnel costs 25.659 107.612 107.612 107.612 - 384.494

Total 133.365 392.291 262.379 258.878 75.576 1.122.488


Working costs 53.478 222.957 123.670 109.280 49.137 558.522

Personnel costs 39.645 135.584 135.584 146.474 24.876 482.162

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The key knowledge and skills learned within an FA course aim to empower participants to be able to react promptly to diseases as HIV/AIDS, malaria, diarrhoea, stroke and many others. Those diseases are all part of the top 6 of causes of death in women for low-to middle-income countries (including South-Africa). Training also includes skills for recognizing clear danger signs (e.g. during an emergency childbirth).

Moreover, First Aid services not only contributes to reducing mortality, but transforms people into active caring actors capable to respond correctly in case of serious health threat, outside of the realm of formal health facilities, by community members themselves. Training makes up the very core of the program: ensuring prime focus on skills-development rather than mere transfer of knowledge and information. That’s why skills necessary for protecting oneself for possible HIV/AIDS transmission during the FA intervention (e.g. wearing plastic bags over the hands when stopping a severe blooding) are part of the FA curriculum, as this is crucial if you want to ensure that trained people do provide FA when the situation actually happens.

UNICEF states in its 2015 report on “The State of the Wold's Children”326 that ventures that spring from the initiative of com-munity members and proceed with their participation are more likely to address their needs in ways that are acceptable and sensitive to local, social, cultural and political factors that outsiders may well miss. The fact that our intervention builds the competences of Red Cross volunteers who are deeply imbedded in their local communities to deliver FA to those around them in need, forms therefore the stronghold of our program.

Relevance for local partner

However, not only do we aim to be of relevance in the general context of the South African Health Sector, we equally have the intention to connect closely to the needs that have been formulated by our partner itself. Therefore, our intervention is based on following three questionnaires and baseline studies that indicated how SARCS wants a serious scaling up of their capacity to train more RC volunteers:

1. Questionnaire for the National Societies of the Southern African Development Community (SADC – 10 countries) (2008 and 2013)

2. External market study of National Societies of SADC-countries (2013) 3. Questionnaire (assessment) in view of FA program proposal, SARCS, was send to 5 provinces and

23 branches, June 2016.

The latter one showed that currently, clear systems and monitoring guidelines are lacking within the FA department of SARCS. Sixty percent (60%) of the respondents indicated that there is currently no FA policy/strategy present. Country wide there are 11 master trainers of which one is accredited, 20 full-time instructors of which 3 are accredited and 44 part time instructors of whom 4 are accredited. So in total only 8 people are accredited currently. This indicates the lack of accredited instructors within SARCS, which may cause SARCS to lose its accreditation as an education and training provider for several courses. A minimum of 2 to 10 FA instructors-depending on the capacity of a branch, are required (a total of roughly 225 FA instructors country wide). Moreover, the turnover of assessors (instructors) is high and the remaining ones have not been retrained since 2014, resulting in SARCS not being able to train new RC volunteers or refresh the knowledge and skills of the current ones. The RC stated that only 4 branches are indeed active in organizing commercial FA trainings in 2015, indicates that also the financial sustainability of the RC service needs readjusting. Accreditation is only received at head quarter level as facilities as the branches do not adhere to the standards of HWSETA and ‘satellite’ accreditation has to be set up by upgrading these training facilities.

Beneficiaries

The direct beneficiaries consist of: o 2.700 Red Cross volunteers o 5 full-time master trainers o 5 part-time master trainers o 5 moderators o 50 FA instructors

In total this makes 2.765 direct beneficiaries. It is important to note that for the beneficiary calculations BRC-Fl chose to count unique beneficiaries only once although they may be reached multiple times with different program activities (e.g. trainings and refresher trainings). However, these program activities each do have their individual cost, which means these beneficiary numbers cannot be used to calculate cost per beneficiary.

Moreover, it’s very hard to quantify and monitor indirect beneficiaries given the broad range of first aid applications (from cleaning small wounds to live-saving CPR). Based on the assumption that on average every trained person will assist 5 persons by applying evidence-based, qualitative first aid service, the number of indirect beneficiaries is 72.072 people. This number takes into account the total number of people trained in FA by SARCS, even though these trainings are not direct outputs of

326 The State of the World's Children 2015. Reimagine the future. UNICEF; 2015.

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the program, for example the 9.762 people trained in Commercial FA. The formula that is used is (# total FA certificates of the SARCS327 – FA certificates which are direct outputs328) + (# of total FA certificates329*5).

Location

5 out of 6 provinces that SARCS covers are selected. The strengthening of SARCS structures to provide qualitative FA training and interventions includes the development of regional systems, ensuring the availability of first aid trainings in 5 provinces. Successful activities will be replicated to cover a wider area in the same provinces as well as to extend the activities in the other provinces, for example Free State.

Province Population

Gauteng 12.272.263

Kwa-Zulu Natal 10.267.300

Western Cape 5.822.734

Eastern Cape 6.562.000

Limpopo 5.405.000

Relevance related to the priorities of the Belgian Development Cooperation

Gender Gender equality and women’s empowerment are essential to the health of nations, as well as social and economic development. The promotion of gender equality and empowerment of women is the fifth SDG and is equally expressed in DGD’s strategy paper on gender: ‘Access to health and sexual and reproductive rights is key to

women's empowerment, and is a basic component of female independence and well-being. It goes without saying that such access

has many positive effects on the community as a whole.’330

Gender-equality in staffing and volunteer members is an absolute starting point for SARCS, in support and endorsement of the SARCS gender policy. The recent newly elected board consists of 50% male and 50% female. Related to the proposed program, the AFAM-based didactical training materials developed by this intervention are sensitive for the specific needs of women and girls as receivers and givers of First Aid. Attention is drawn upon specific situations encountered by women such as giving birth without medical assistance. When a training or workshop is given, gender equity will be emphasized and stim-ulated. Practical advice on how to identify barriers to female participation and how to address those, will be given, and positive discrimination will be encouraged. During this intervention, RKV will specifically monitor the presence of finalized gender sensitive RC training materials, as expressed in indicator 1.1.1 of the Logframe. Also, in order to measure the degree to which the program has effectively mainstreamed gender, gender-disaggregated data will be collected on many other indi-cators as well.

Environment The IFRC acknowledges the importance of environmental issues. This can be found in Resolution XVII from the 22nd International Conference in Teheran in 1973, in Resolution XXI from the 23rd International Conference in Bucharest in 1977, the annex to Resolution I ‘Together for humanity’ from the 30th International Conference in Geneva in 2007 and in Strategy 2021.

As IFRC mentions “from rural villages and remote islands to sprawling metropolises, Red Cross and Red Crescent volunteers have witnessed and raised the issue of environmental degradation as a major factor in disaster risk with immediate conse-quences on the lives and livelihoods of the people they serve”. Red Cross Red Crescent network is taking serious steps to promote environmental values and practices through advocacy and social mobilization331. On programmatic level, efforts to minimize the ecological footprint will be made. The environment will be respected by for example double printing for publication, reporting etc. In addition broken dummies will be brought to assigned place for waste management.

In view of climate change, BRC-Fl interventions aim to support SARCS in giving high-quality RC training sessions to staff, vol-unteers and community-members in order to increase their self-reliance and as such have increased abilities to ‘bounce back’ when hit by sudden emergency. Community resilience will be of particular importance to deal with the increased volatility of the occurrence of extreme climatological events and natural disasters brought by climate change.

327 These are logframe outcome indicators 1.1 and 1.2 which entails all certificates issued in and outside BRC-Fl financed trainings. 328 This entails certificates issued for BRC-Fl financed FA trainings only. 329 This again refers to outcome indicators 1.1 and 1.2. 330 DGD, Strategy paper on gender Gender in Belgian Development Cooperation, 2016, p. 9. 331 http://www.ifrc.org/fr/nouvelles/nouvelles/common/highlighting-the-importance-of-promoting-environmental-values-and-practices-within-communities-66106/

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Decent Work The International Labour Organization (ILO) estimates that 317 million accidents occur on the job annually, many of these resulting in extended absences from work, causing severe human and economic costs. The human cost of this daily adversity is vast and the economic burden of poor occupational safety and health practices is estimated at 4 per cent of global Gross Domestic Product each year.

Through increasing the quality and quantity of first aid trainings and commercial first aid services tailored to hazardous occu-pations, BRC-Fl and SARCS contributes significantly in South Africa to improving Occupational, Health & Safety (OSH), a core element of Decent Work and the ILO Decent Work Agenda. Within the International Labour Standard instruments, the ILO explicitly states it is an employer responsibility to organize first aid and emergency treatment services in the Occupational Health Services Convention (C161, 1985) and in stresses the importance of first aid personnel; exclusively consisting of suitably qualified persons, the promotion of regular trainings and supervision/maintenance of RC equipment in Recommendation 112 on Occupational Health Services (1959).

The reasoning is straightforward, the effect of first aid administered to the victim of a serious accident at work is no different from that administered to the victim of a serious traffic accident332.. When a severe accident happens in the workplace, the first few minutes may be decisive for survival. For instance, where respiratory arrest follows an electric shock, there is still, after three minutes, a 75 per cent chance of complete recovery if artificial respiration is established. After four minutes, the chances are only 50 per cent, and after five minutes no more than 25 per cent333. The sooner help is available, the greater the chance of complete recovery and the prevention of possible complications. Likewise, the sooner help is provided, the shorter the treat-ment.

In South Africa, “improved Occupational Safety and Health” is a key result in the Decent Work Country Program, the country strategy agreed upon by the Government of South Africa to implement the ILO Decent Work Agenda.

Digitalization BRC-Fl uses digital technologies as enabling tools to enlarge the impact of our interventions. A range of digital tools is deployed across countries for evaluating both our FA interventions. Having solid, up-to-date and reliable project data is crucial to properly monitor and evaluate progress on key performance indicators and adjust the implementation strategy where and when needed.

In the field of FA specifically, BRC-Fl can support SARCS in the set-up and/or maintenance of databases, online survey tools at headquarter level. These databases serve as a registration system for data on First Aid trainings and number of volunteers, which would help SARCS to efficiently process and manage their First Aid service. Also, for its national FA services in Belgium BRC-Fl is currently involved in a process of integrating e-learning into our FA trainings in order to increase their effectiveness and accessibility. Gained experience and knowledge of BRC-Fl on e-learning techniques within FA in Belgium, will be reflected in our support to SARCS's FA service.

Human Rights Our First Aid program in South Africa is responding to the needs of the most vulnerable, and are as such aiming for rights-holders to claim their rights to contribute to under Article 25 of the Universal Declaration of Human Rights: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, […].”Annex 4 elaborates on how human rights are further reflected in the work of BRC-Fl.

Effectiveness

First of all, two aspects make the intervention in South-Africa BRC-Fl-specific:


To ensure that all activities are based on scientific evidence, is a core principle within BRC-Fl. To assist in this endeavor, BRC-Fl created the Centre for Evidence-Based Practice (CEBaP) 10 years ago. This research centre uses an internationally recognized methodology to collect, systematize and evaluate relevant scientific evidence to underpin our activities334. When insufficient evidence is available, primary research to support our core activities is conducted – for instance, research on FA knowledge and skills retention in Nepal or on behavior change factors for WASH interventions in Malawi.

332 International Labour Organization (1999). The Organization of First Aid in the Workplace. ILO, Geneva. 333 Gatz, K.J. (1985). Erste Hilfe im Betrieb. Zentralstelle fallverhund Arbeitsmedizin, Cologne. 334 www.rodekruis.be\cebap

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CEBaP developed evidence-based FA guidelines and materials for the African continent, India and Nepal, which will be used in all our FA programs, including South-Africa. Based on evidence summaries developed by CEBaP, a panel of regional/local experts developed first aid guidelines, taking the preferences of the target group(s) into consideration. These guidelines were then used to develop educational first aid materials such as handbooks, posters, exercise books etc.

CEBaP is recognized as an IFRC Reference Centre and aims to further develop into the RC³ (RCRC Research Centre), providing its services within the RC movement. These services are also provided to non-RC partners (for example, CEBaP has performed an evidence search on the contamination of drinking water by fluoride in Senegal, for the Belgian Technical Cooperation). All primary and secondary research by CEBaP is being published in peer reviewed journals. Furthermore, through its link with CEBAM, the Belgian Centre of Evidence-Based Medicine and the Belgian Cochrane Centre, CEBaP is in the process of being accredited in evidence-based guideline development according to the Cochrane methodology 335.


Volunteers form the backbone of all National Societies, including SARCS. Investing in volunteers through skill and knowledge development ensures a qualitative implementation of SARCS’s goal to assist the most vulnerable within South-Africa. A major strength of Red Cross volunteers is their embeddedness into the local communities, even the most distant ones. The volunteers enable SARCS to be a first responder in case of sickness, injury or threat. The presence of Red Cross volunteers with knowledge of the correct first aid techniques, is therefore a key mitigating factor to reduce mortality and morbidity due to sudden illness or injury within their own communities.

JSF Contribution

As described in the JSF (p4), BRC-Fl will effectively contribute to Joint Strategic Goal 1 by cooperating with SARCS as a local partner to improve service delivery in the field of first aid (contribution 1C).

Intervention strategy

Referring to the intervention logic as described in the Theory of Change chapter, the intervention to support the JSF strategic goal is to be achieved through supporting SARCS with activities dividable over three main pillars:

Firstly, SARCS institutional capacity will be strengthened to ensure its sustainability and further development. The logistical and HR capacities at national level and provincial level will be strengthened with a focus on accredited master trainers and accredited instructors, the necessary equipment purchased and a monitoring and coaching structure set up (by the national training manager overseen by a supporting committee at Board level). In more detail, a national training manager will be assigned, who will become the first aid expert and will manage the non-commercial and commercial first aid activities. Ten people -after been trained (3 day course) and therefore accredited by HWSETA, will be trained during ten days as master trainer and gain compe-tences in didactic skills and AFAM. Five will be assigned part-time and five will be assigned full-time. The part-time master trainers also serve as a backup in case of turnover of staff. So every province will have 2 master trainers, 1 part-time and 1 full-time. On their turn these master trainers will train a total seventy five instructors (assessors) after these people are being trained and therefore accredited by HWSETA. By upgrading their training competences and safeguarding accreditation, SARCS will deliver excellent training again. As SARCS becomes once more a training center of excellence the position as accredited training provider for first aid by HWSETA will be secured. SARCS strives to become the regional center of reference for first aid and advice and/or support neighboring national societies in Southern Africa. Inter-departmental cooperation will be encouraged, ensuring other SARCS programs can rely on the FA unit to train their program volunteers and lay people. The training rooms of the five selected provinces will be up-graded to HWSETA standards so they will receive accreditation and trainings can be given per province instead of only headquarters.

Secondly, the program will support the further developments of SARCS’ FA commercial and non-commercial trainings as an evidence-based and qualitative product, by further introducing AFAM-based contextualized manuals in the training for trainers, standardizing monitoring and evaluation tools, and the production and development of evidence based first aid didactical material for different target groups. Specialized curricula for different client target groups, promotional activities should further cement the market position of SARCS as primary first aid provider and educator in South Africa. Through the commercial first aid, not only will SARCS ensure income, it will also increase the first aid knowledge within South Africa.

Lastly the sense of ownership of lay people and volunteers at community level will be solidified, as they themselves are the ones who will give primary care in emergencies (this is also described in section about sustainability). Their coping mechanism in emergencies and basic health situations is strengthened through the training from the 75 RC accredited instructors who use AFAM based teaching materials, who on their turn are trained by the 10 accredited master trainers who use AFAM based


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didactical methods. All the trainings are evidence based and the lay people and volunteers adequately trained and able to apply correct first aid.

Sustainability

Technical sustainability: • The intervention of BRC-Fl aims at enforcing the institutional capacity of the SARCS by embedding a well-

functioning RC service into the organization that can anchor the delivery and training of RC volunteers. This is done by: 1. Supporting the management of the first aid service, the volunteer management and the organizational

development. 2. Support in human resources to organize, monitor and support all FA activities and in turn ensure the

continuity of FA activities within SARCS (1 National Training Manager, 1 Finance/Admin Officer, 5 full-time master trainers, 5 part-time master trainers and 75 RC assessors)

3. The standardization of FA policies and strategies across the region. 4. Ensuring the proper implementation of RC policies and strategies. 5. Ensuring SARCS has adequate FA training materials and establishing and implementing a maintenance

strategy for FA materials. 6. Ensuring all RC assessors (instructors) and RC volunteers have received up to date FA training and are

sufficiently qualified and accredited according to HWSETA.

• The intervention is risk-informed, i.e. that potential risks, such as natural and technological hazards, are being taken into account in the design and implementation of the program. For instance, building self-reliance through providing high quality First Aid training sessions to staff, volunteers and community-members increases the response capacity of local first responders to natural and man-made hazards, espe-cially given the mandate of SARCS as humanitarian actor in South-Africa.

Financial sustainability: • BRC-Fl aims to strengthen SARCS in delivering high quality commercial RC services. Financial sustainability will

be achieved by: 1. Increasing CoFA activities to generate revenue. 2. Reinvest income generated through CoFA in the FA service. 3. By increasing CoFA activities, SARCS will increase their market share and potentially

becoming the number one RC provider in the region. 4. By generating and reinvesting income, financial autonomy is enhanced and dependence on external

funding is decreased.

Social Sustainability: • SARCS works with volunteers that are embedded in the selected intervention zones and has a large capacity

to enhance the local ownership of the intervention. Following aspects contribute to the social sustainability: 1. These volunteers do not depend on funding from BRC-Fl. 2. The capacity building achieved in those volunteers by the BRC-Fl intervention, will remain in place after

funding is withdrawn, as those volunteers are unpaid and as such by no means dependent on BRC-Fl funding.

3. Continuous monitoring by RC volunteers within the regions will ensure that communities remain empowered through the capacity of these volunteers.

4. From the second year onwards, SARCS will contribute to the remuneration of the master trainers using revolving funds from CoFA activities.

Exit Strategy: The program set-up is largely aimed at strengthening the capacity of SARCS, as well as the general institutionalization of FA within the National Society, the program will, from inception, work on it’s phase out. Important structural improvements strengthening the sustainability are the setting up of a coaching and monitoring structure, ensuring senior instructors (and specifically master trainers) have the capacities and reflex to didactically and medically control and improve all instructors. Secondly, as described above, by strengthening the first aid unit’s commercial first aid activities, the financial capacities of SARCS will improve, decreasing the need for external funding.

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Efficiency

According to a World Bank study336, training first-responders in first aid is an extremely cost-effective intervention; it’s among the most neglected low-cost opportunities in middle- and low-income countries. First aid educations costs 8US$ per disability-adjusted life year averted (DALY)337. This makes First Aid Education one of the most cost-efficient ways to improve public health in developing countries.

Results-based budgeting

Following its Results-Based Management (RBM) framework, BRC-Fl works as follows for budgeting the program: • Budget formulation revolves around the set of predefined Outcomes and expected outputs, • Expected results justify the resource requirements which are derived from and linked to outputs required to achieve

such results and, • In which actual performance in achieving results is measured by objective performance indicators.


1. Investment costs

In line with the activities for the Outcome, the majority of the investment budget is allocated to • 27.445 EUR (34%) is allocated for FA dummies and FA material to be used during the ToTs and training of volunteers/staff). • 30.625 EUR (38%) is allocated for branch renovation for HWSETA accreditation, so trainings can be given at branch level too. • 18.547 EUR (23%) is for printing of AFAM materials as every volunteer needs a basic FA manual.

2. Working costs

General working costs include stationery costs, printing costs, communication costs (26.235 EUR, 9% of working costs). The majority of the working costs, 138.048 EUR (48%) is to be used for various trainings for example institutionalization, accreditation, mas-ter (refresher) training, instructor training. Training of volunteers will cost 53.548,76 EUR. Training is the substance of strengthening SARCS. To deliver high quality commercial FA services, 27.790,61 EUR (10%) is assigned for a workshop in which SARCS will be assisted in the design of a business plan.

3. Personnel costs

Local personnel SARCS This includes the national training manager of SARCS (1 FTE, 4 years) and a contribution to salary of 5 full-time master trainers, which will regress over the course of the program (totaling 2,5 FTE over 4 years). Finally, 1 finance and admin officer (1 FTE for 1 year) com-plete the national SARCS personnel budgeted.

Expat personnel BRC-Fl The 3 First Aid (Outcome 1) programs implemented in South Africa, Zimbabwe and Madagascar are supported by a total of 2 BRC-Fl delegates, based in South-Africa: 1 technical expert on FA and one PCM-specialist, who jointly are responsible for supporting the 3 partner National Societies during this program. The budget (see HQ) consists out of salary, accommodation, transport costs and other operational cost (included under general working costs) for the duration of the program. All costs are budgeted fully within the South Africa program, because of the location of the delegation (logistically logic choice – costs budgeted where they are made/where the delegation resides).

HQ personnel BRC-Fl The intervention is supported by a technical First Aid expert based in Mechelen (Belgium). The budget comprises of personnel & travel costs (0,06 FTE for South Africa). This HQ FA focal point safeguards the quality by providing technical expertise directly or by linking the BRC-Fl national First Aid unit and CEBaP to SARCS. Examples are carrying out or facilitating specific short-term technical missions on didactical expertise FA, simulation exercise, assist in profitability analysis CoFa SARCS,...

Delegation Two BRC-Fl Delegates will be based in South Africa in order to assist South Africa, Zimbabwe and Madagascar Red Cross with the timely and qualitative implementation of the FA program in their respective country. A technical expert on First Aid and a Project Cycle Management (PCM)-specialist will jointly provide support, each in their thematic area. The main task of the PCM delegate is to cooperate closely and on a day-to-day basis with the 3 partner National Societies, both at central level and in the program area during field visits. The delegate assists the local Red Cross on a project-managerial level in order to achieve a timely, effective and efficient implementation. The technical expert on First Aid will provide the required specialized content and support for the implementation of the FA activities in a qualitative manner. The expert will build upon the extensive BRC-Fl experience in supporting National Societies’ endeavors to professionalize their FA training and services, assuring maximum

336 Laxminarayan et al. (2006). Intervention Cost-Effectiveness: Overview of Main Messages. In Jamison et al. (eds). Disease Control Priorities in Developing Countries (2nd Edition). Washington D.C. World Bank, chapter 2. 337 The disability-adjusted life year (DALY) is a measure of overall disease burden, expressed as the number of years lost due to ill-health, disa-bility or early death It is used in economic evaluation to assess the value for money of medical interventions.

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impact and sustainability of the change processes. Their close proximity to the implementing partner allows for direct input to achieve the program Outcome and outputs, whilst building the capacities of the implementing partner, to increase the knowledge and skills required to do so, both at a personnel (staff development) and institutional level (systems, structures). The delegates are further supported in their role by the BRC-Fl experts at headquarters, whom provide expert-input regarding managerial (PMER, Finance, Program management) and technical aspects (First Aid focal point). Finally, because of its geo-graphical closeness to the other BRC-Fl delegations in Mozambique/Malawi and because of the similarities in respective First Aid country programs, Malawi Red Cross & Mozambique will also benefit from peer-to-peer learning and from direct technical support provided by the BRC-Fl regional delegation in South Africa on First Aid and PCM.

Partnership

Policy

BRC-Fl always operates within the partnership framework of the International Red Cross & Red Crescent Movement and works with the National Red Cross or Red Crescent Society as sole preferential partner. Principles of cooperation and capacity building are Movement-wide formalized in the IFRC ‘Development Cooperation Policy (2007)’ 338, the ‘National Society Development

Framework (2013)339’ & the ‘Code of Good Partnership’340.

All Red Cross partners in this program are strategic partners whereby common objectives are defined and where the focus lies on capacity building of & transferring technical expertise to the partner to implement quality services to the most vulnerable within the thematic priorities of BRC-Fl. Capacity building is transversal across the interventions.

SARCS

Humanitarian services in South Africa can be traced back to the late 1800’s. The South African Red Cross Society itself was founded in 1921 with the amalgamation of the various Red Cross entities which existed in the country. It was recognised by the International Committee of the Red Cross in 1928 and admitted into the International Federation of Red Cross and Red Crescent Societies in 1929. The South African Red Cross Society is one of the 190 members of the International Federation of Red Cross and Red Crescent Societies (IFRC) and responds to needs in each province, territory and provides relief during minor and major disasters and emergencies throughout South Africa. In August 2007 the South African Government recognized The South African Red Cross Society as an Official Auxiliary to the Government in Humanitarian Aid.

As mentioned in the JSF, SARCS has gone through a considerable reform, following an institutional crisis in 2013, and is re-establishing its operations in many parts of the country. Program funding (for example Netherlands/Norwegian) came to an end in 2012 and administrative costs could not be paid. Programs were stopped and staff dismissed and in actuality the national office was dissolved. SARCS downsized about 90%. In 2013 the power of authority was given to the provincial manager of Kwa-Zulu Natal as they were the best in managing and had funding of the British Red Cross.

Fortunately SARCS is recovering and re-establishing itself. Just recently a national office is set up again in Johannesburg headed by a new CEO who has a clear vision and mission for the national society. There is a new board according to the Companies Act of South Africa. One accounting system is set up. Last financials were consolidated from all the branches and six provinces. A clean audit was done. All statutory obligations are met and therefore it is up to us as partners to support SARCS in taking its rightful place again as leading humanitarian organization in Southern Africa. The main challenge now is the lack of resources, strategies and motivation to run programs at branch level. Branches need to get again the confidence and empowerment that they can run programs and to give an example RC instructors have to be accredited again. In terms of development BRC-Fl can support SARCS in this turnaround by focussing on training and capacitating the national training structure.

In 2009 the head of training (position vacant now) became a member of the BRC-Fl expert panel for African first aid materials (AFAM), which triggered the request from SARCS for additional partnership with BRC-Fl. A program in commercial first aid commenced January 2011 with the intention to be finalized by December 2013. However as a result of the restructuring the program the project ended mid-2013.

BRC-Fl recognises the fragile status of SARCS and this program is part of reinforcing SARCS again in aiming better service delivery on first aid to the South African population. BRC-Fl will monitor rigorously the implementation of the FA activities as part of proposed program, and take immediate actions whenever deviations and or nonconformities occur.

338 http://www.ifrc.org/Global/Governance/Policies/developmentcoop-policy-en.pdf 339 http://www.ifrc.org/Global/Documents/Secretariat/201505/1269801-NSD%20framework%202013-EN-LR.pdf 340 http://www.ifrc.org/PageFiles/79467/CoD09_14_code%20good%20partnership_EN.pdf

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First Aid

The South African Red Cross Society has conducted first aid training courses for 95 years. At current, trainings for Red Cross volunteers are basic first aid and disaster management. Community members are trained in home based care. Commercial first aid trainings given to organizations consist of level 1-3, occupational health and safety and firefighting.

The Health and Welfare Sector Education and Training Authority (HWSETA) is responsible for the education, training and skills development requirements of the health, social development and veterinary sectors, and instructors (assessors) have to be trained by HWSETA, in order to be accredited.

Currently there are about 2.195 active Red Cross volunteers who are monitored by the branch manager or branch project officer. In 2015 a hundred and eight commercial FA trainings were held country wide.

In terms of operational structure, SARCS headquarters has a human resource manager, a program manager and a finance officer, but still lacks a head of training.

Capacity building

BRC-Fl recognizes that capacity building is a long-term, continuing process, in which all stakeholders participate (Red Cross instructors/volunteers, lay people, ministry of health). Capacity building encompasses firstly the process of equipping individ-uals with the understanding and skills that enables them to perform effectively. Secondly it includes organizational development, establishing processes and procedures within the organization. And thirdly it requires institutional and legal framework development, making legal and regulatory changes to enable the organization to enhance their capacities. These three components are addressed as the program will allow the lay people and Red Cross staff/volunteers to access information, knowledge and training. Secondly management structures will be elaborated and first aid activities institutional-ized. Thirdly lobbying will take place with the respective government department in view of accreditation.

Teaching is the bulk of the program and the well trained lay persons and Red Cross volunteers will be able to contribute to healthy lives and well-being in their respective communities.

In addition, an assessment will be conducted in 2017 to identify needs related to M&E specifically with the eye on results based management of the intervention. Based on the outcome of this assessment the priorities and activities for BRC-Fl M&E support to SARCS will be determined.

Delegation

The regional delegation assists SARCS not only on a managerial, but also on a technical level to ensure impact and sustainability. Its close proximity to the implementing partner allows for direct input to achieve the Outcome and outputs, whilst building the capacities of the implementing partner, to increase the knowledge and skills required to do so, both at a personnel (staff development) and institutional level (systems, structures). Peer-to-peer learning will be stimulated, as the experience, best practices and lessons learned from different National Societies involved in First Aid will be compiled and shared by the regional delegation, and regional exchange and learning will be facilitated.

A steady expansion of capacity will be achieved by first assessing in detail the current capacity and needs of SARCS, the imple-mentation of RC policies/ strategies to strengthen the existing framework, the appointment of key management staff (National Training Manager, Finance/ Admin Officer, M&E Officer, Marketing Officer etc.), providing up to date training to existing RC instructors, training additional RC instructors, establishing and marketing of CoFA and continuous monitoring and evaluation.


As pointed out during the Strategic Dialogue and understood by DGD, the operationalization of Synergies with other Belgian development actors is challenging, due to the few actors present and their expanse across multiple domains. Nevertheless, during the lifespan of the program, informational synergies with other Belgian ANGC’s will be upheld during recurrent consul-tation rounds which will serve as an exchange-platform for knowledge and experience on common themes, topics, risks or problems encountered. BRC-Fl will proactively participate in these exchange moments, which will serve as a fruitful basis for the formulation and operationalization of further synergies and complementarities. Also BIS/MSI and FOS, as organizations of the JSF Decent Work, will join in this information synergy.

What concerns operational synergies and complementarities, we refer to the list below:

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Synergies

Organiza-tion

Objective of Synergy Roles and Tasks Budget Reference to JSF

VVOB “Improved Occupational Safety and Health” is a key result of South Afri-can’s “Decent Work Country Program”. By providing a First Aid training to its lo-cal team members, VVOB contributes to the Decent Work Agenda and ena-bles its employees to act promptly in case of emergencies or basic health situations. At the same time, this syn-ergy contributes to the goal of Belgian Red Cross–Flanders (BRC-Fl) to im-prove health and well-being and increase coping-mechanisms within our one of our provinces of interven-tion Gauteng.

The local team of VVOB, consisting out of approximately 10 people and based in Pretoria (Gauteng) and Bloemfontein (Free State), will follow a “Save A Live” Basic FA training of 6 hours, given by the South-African Red Cross (SARCS) in 2018. At this stage, the results of BRC-Fl’s country program in strengthening the first aid training capac-ity of SARCS, will positively impact the quality of the training provided to VVOB local team-members, who will be able to correctly apply first aid procedures when needed, both on the workplace, in public as at home. In order to ensure the reten-tion of the first aid techniques used, a refresher training will be given in 2021.

600 Euro in to-tal and the cost will be evenly divided between VVOB and BRC-Fl

P13

American Red Cross Society (AmRC)

The AmRC programming in Southern Africa consists out of resilience pro-grams in Zimbabwe and Zambia. In South-Africa, and collaborating with SARCS on an Organizational Develop-ment initiative related to a branding strategy. ” By providing a First Aid train-ing to its local team members, this synergy contributes to the goal of Bel-gian Red Cross– landers (BRC-Fl) to improve health and well- being and increase coping-mechanisms within our one of our provinces of inter-vention Gauteng.

Similar to the synergy with VVOB, the lo-cal team of AmRC, consisting out of 4 people and based in Sandton (Gauteng) will follow a “Save A Live” Basic First Aid training of 6 hours, given by the South-African Red Cross (SARCS) in 2018.

240 Euro in to-tal and the cost will be evenly divided be-tween AmRC and BRC-Fl

P13

Complementarities

VLIR-UOS

As described in the JSF p. 11 -13, Belgian CSO’s and IA’s will allow each other to tap into each other’s networks for complementarities in the areas of research. Within the scope of VLIR-UOS South Initiative titled “Community of Practice as a strategy to strengthen the capacities of community health workers”, the South-African Red Cross (SARCS) will be one of the organizations contacted as they are a key South-African actor in grassroots work in the area of peer-education within their activities of Community Based Health Care and Home Based Care. The intervention of Belgian Red Cross–Flanders (BRC-Fl) will strengthen first aid training capacities of SARCS which will trickle down into those Community and Home Based Care activities. Consequently, the results of the study of VLIR-UOS would form an interesting entry point for further reflection within SARCS on their role and methodologies within the peer-education they apply in the health-sector.

IFRC

The major complementarity is with the International Federation of Red Cross and Red Crescent Societies (IFRC), that was founded in 1919 and coordinates activities between the 190 National Red Cross and Red Crescent Societies within the Movement. The interven-tion of BRC-Fl within South-Africa is in line with Strategy 2021, the major strategic guiding document for Red Cross interventions worldwide. This strategy defines three strategic aims and three enabling actions. RKV’s intervention in South-Africa specially collabo-rates in achieving strategic aim 1 (“Save lives, protect livelihoods, and strengthen recovery from disasters and crises) and 2 (“Enable healthy and safe living”), this by enforcing enabling action n° 1 (‘Build strong National Red Cross and Red Crescent Societies”). At this moment, no other Partner National Society (PNS) is present in South-Africa. But as the American Red Cross has staff based in South Africa –and not in the countries they are in partnership with, SARCS will train their staff in first aid. The moment other PNS’s enter, also our coupled intervention will have a high degree of complementarity.

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Annexes 1. Explaining the Theory of Change approach 2. Example of detailed Risk Analysis (Nepal) 3. Explaining the link between Decent Work and First Aid 4. Human Rights within the work of BRC-Fl 5. Example Partnership Agreement with National Societies 6. Example Cooperation Agreement (Synergy)

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Annex 1: Explaining the Theory of Change approach

The Theory of Change scheme illustrates visually how BRC-Fl and its partners envision change to take place with the target population within the framework of a WASH/FA intervention.

The pink boxes represent changes in the short run, i.e. changes which fall within our sphere of control.

For WASH, different hygiene aspects are listed in hygiene clusters according to IFRC’s policy on WASH long-term program-ming.341 These boxes are not changes by themselves, only an explanation of what we understand under hygiene related Outcomes.

For First Aid (FA), all aspects for which BRC-Fl can offer support to the National Society to achieve the set Outcomes are listed under the 3 output boxes. For both WASH and FA schemes, those aspects listed in grey italic are not worked on within the scope of the proposed intervention, those in black are included in the intervention.

The shorter term changes result in longer term changes illustrated by green boxes, which are situated more in our sphere of influence.

At the top of the scheme the blue boxes represent very long term changes (impact), which are materialized when there is a sustained and prolonged change in behaviour.

The blue arrows represent causal relationships illustrating how one change leads to another.

The small brown letter boxes illustrate the assumptions based on which we assume that these changes take place. These as-sumptions are underpinned by the available scientific evidence. Although we aim for the highest level of scientific evidence (systematic reviews) allowing us to have 'the most reliable and comprehensive statement about what works', this level of evidence is often lacking for a number of assumptions. In these cases we have referred to (one or more) individual studies or papers, and/or complemented with relevant country specific experience and facts. With support from CEBaP, the supporting evidence for WASH and FA will periodically be updated and improved, evidence gaps and priorities will be set for the set-up of systematic reviews and research.

Although this ToC scheme illustrates how BRC-Fl sees change and effects with the target population, it needs to be noted that BRC-Fl does not aim to work on every single change reflected in the scheme. However, it is important to identify the relevant stakeholders (represented in the yellow boxes) and the role they play in the theory of change. In countries where page limita-tions have obliged us to only briefly present the ToC, stakeholders and contextual factors are very limited included in the proposal. Upon request, the full information can be provided to the DGD. At the left, country specific contextual factors are represented, which influence the ToC (e.g. government policies, legislation, cultural factors, etc.).

The red circles represent the actual BRC-Fl project activities, which will be implemented by the National Society. Logically, these red circle are situated more in the bottom half of the scheme as these all under our sphere of control.

To illustrate how the ToC is linked with the intervention logical framework, logframe impact, Outcomes and outputs are noted in red in the relevant boxes. Moreover, this illustrates the structure of the logframe and shows where we will measure project outputs and outcomes based on a set of SMART indicators. Next to the evidence based underpinning of the assumptions, we will also cooperate with CEBaP to continually improve and scientifically underpin the selection of the most relevant indicators and their data collection methods for each of the selected logframe Outcomes and outputs.

341 IFRC. Software tools for long-term water and sanitation programming (p6-7). 2007 http://www.ifrc.org/Global/Publications/Health/water-and-sanitation/WatSan-Software_Tools.pdf

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Annex 2: Example of detailed Risk Analysis (Nepal)

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Annex 3: Explaining the link between Decent Work and

First Aid.

The International Labour Organization (ILO) estimates that every day 6,300 people die globally as a result of occupational accidents or work-related diseases – more than 2.3 million deaths per year. 317 million accidents occur on the job annually, many of these resulting in extended absences from work, causing severe human and economic costs.

The thematic priority of this Belgian Red Cross-Flanders development programme is to increase the quality and quantity of first aid trainings and commercial first aid services342 within all partner countries. As such, this programme contributes significantly to improve Occupational, Health & Safety (OSH), a core element of the Decent Work Agenda.

To explain this long-standing link, we refer to the International Labour Standards instruments, where the ILO explicitly states it is an employer responsibility to organize first aid and emergency treatment services in the Occupational Health Services Con-vention (C161, 1985) and stresses on the importance of first aid personnel; exclusively consisting of suitably qualified persons, the promotion of regular trainings and supervision/maintenance of first aid equipment in Recommendation 112 on Occupa-tional Health Services (1959).

The reasoning is straightforward, the effect of first aid administered to the victim of a serious accident at work is no different from that administered to the victim of a serious traffic accident343. When a severe accident happens in the workplace, the first few minutes may be decisive for survival. For instance, where respiratory arrest follows an electric shock, there is still, after three minutes, a 75 per cent chance of complete recovery if artificial respiration is established. After four minutes, the chances are only 50 per cent, and after five minutes no more than 25 per cent344. The sooner help is available, the greater the chance of complete recovery and the prevention of possible complications. Likewise, the sooner help is provided, the shorter the treat-ment.

In terms of complementarity to national development strategies, we look to Decent Work Country Programmes as the main reference point. In these framework documents, the ILO, national governments, national employer and worker representatives agree upon national priorities adapted to the local context. Improved occupational health and safety as such, is a key result in the Decent Work Country Programme of Burundi, Malawi, Mozambique, South Africa, Tanzania and Zimbabwe345. Thus, our First Aid Outcomes in these countries subscribe significantly to national development strategies on Decent Work.

In terms of the international development framework, the entire First Aid programme contributes to Sustainable Development Goal 8 on Decent Work and economic growth.

342 Tailored to hazardous occupations and sectors (e.g. mining). 343 International Labour Organization (1999). The Organization of First Aid in the Workplace. ILO, Geneva. 344 Gatz, K.J. (1985). Erste Hilfe im Betrieb. Zentralstelle fallverhund Arbeitsmedizin, Cologne. 345 http://www.ilo.org/public/english/bureau/program/dwcp/countries/index.htm

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Annex 4: Human Rights within the work of BRC-Fl

A rights based mindset has always been present in the work of the Red Cross Movement, including Belgian Red Cross-Flanders (BRC-Fl). The unfolding of International Humanitarian Law, which regulates the conduct of war, during the Geneva and The Hague Conventions, is rooted by the same origins as the creation of Human Rights. Nowadays both instruments are used in a cumulative fashion346.

One important approach to operationalize this mindset, is our Humanitarian Diplomacy by which we aim to persuade decision makers and opinion leaders to act, at all times, in the interests of vulnerable people, and with full respect for fundamental humanitarian principles.347 This is translated in the BRC-Fl Strategy 2020 Iedereen Helpt348, in which one of our pursued objec-tives is to have a “signal function towards society within our areas of expertise”. For national policy-makers, International Humanitarian Law is named as one of those areas of expertise.

Nevertheless, these areas of expertise of BRC-Fl go further than International Humanitarian Law. Our First Aid and Water, Sanitation & Hygiene (WASH) development interventions are responding to the needs of the most vulnerable, and are as such aiming for rights-holders to claim their rights under Article 25 of the Universal Declaration of Human Rights349: “Everyone has

the right to a standard of living adequate for the health and well-being of himself and of his family, […].”

Humanitarian Diplomacy is equally used within our development programme. By the auxiliary role each Red Cross National Society has to the public authorities of their country, the privileged access and relationship to the government and policy makers is a leverage for addressing specific issues related to our domains of intervention and contributes to the capacities of ‘duty bearers’ to meet their obligations.

Importantly, in no way this Humanitarian Diplomacy would be contradictory to our Fundamental Principle of Neutrality, which should be seen as a means to achieve humanitarian outcomes and is not an end in itself. Our privileged access and credibility as organization have as a result that often, a silent and discrete form of Humanitarian Diplomacy proves to be the most effective to the humanitarian results we aim to achieve. Moreover, our added value lays in our expertise, knowledge and evidence from the terrain, which is based on our global network of local community-based Red Cross volunteers.

346 Schindler, D. (s.d.). The International Committee of the Red Cross and Human Rights. Retrieved August 3rd from https://www.icrc.org/eng/re-sources/documents/article/other/57jm9z.htm. 347 IRFC Humanitarian Diplomacy Policy. 348 Rode Kruis Vlaanderen, Strategie 2020 Iedereen Helpt. Retrieved August 3rd from http://www.rodekruis.be/storage/main/strategie-2020.pdf 349 Universal Declaration of Human Rights. Retrieved August 3rd from http://www.ohchr.org/EN/UDHR/Documents/UDHR_Translations/eng.pdf

“(Name of Programme)” Partnership Agreement between RKVI and XRC 337

Annex 5: Partnership Agreement template

PARTNERSHIP AGREEMENT

between

..X.. RED CROSS SOCIETY and

–RODE KRUIS-VLAANDEREN INTERNATIONAAL VZW (“RED-CROSS FLAN-DERS INTERNATIONAL NON-PROFIT ORGANISATION”)

for the

“(Name of Programme)” Development Programme

BETWEEN:

1. Rode Kruis-Vlaanderen Internationaal VZW, with registered office at Motstraat 40, 2800 Mechelen, Belgium; (hereinafter referred to as “RKVI”), represented by Prof. dr. Philippe Vandekerckhove, CEO and

2. the ....... Red Cross Society (hereinafter called “XRC”) [to be completed legal form, regis-tered office ], represented by .................

hereinafter jointly referred to as “Parties”.

WHEREAS:

A. RKVI and XRC will work together as partners with regard to the implementation of “the ............... Development Programme (hereafter the “Programme”);

B. RKVI and XRC have concluded a letter of intent on [..] with regard to the Programme;

C. The Parties are entering into a programme agreement (hereafter the “Partnership Agree-ment” or the “PA”) in order to set out the final terms and conditions of the implementation of the Programme.

HAS BEEN AGREEDS AS FOLLOWS:

1. Definitions

For the purposes of the Agreement, the following terms shall have the meaning set forth below:

“DGD” the Belgian Directorate General for Development Co-opera-tion, the back donor for the Programme;

“RKVI Financial Guidelines” the financial guidelines of RKVI as set forth in Annex 2 and Annex 3;


“Fixed assets register” an inventory of all infrastructure and equipment acquired throughout the Implementation Period with exception of the infrastructure and equipment intended for the final beneficiaries;

“Programme” the …. Development programme as set forth in article 2;

“Programme Accounts” the specific accounts related to the Programme on an an-nual basis;

“Partnership Agreement” or “PA” the present programme agreement relating to the imple-mentation of the Programme and its annexes, which are incorporated by reference;

“Programme Funds” the funds provided by RKVI as set forth in 7. a);

“Programme Manager” the manager of XRC assigned by the XRC to manage the im-plementation of the Programme.

In case of conflict between or inconsistency of the provisions of the actual programme agreement and the contents of the annexes, the provisions of the actual agreement shall prevail.

2. Subject

Parties will cooperate on the implementation of the Programme. The Programme can be de-scribed as follows:

[…]

The Outcome of the Programme as well as the different outpus and activities of the Programme are outlined in the logical framework and the related budget of the Programme in Annex 1.

Both parties acknowledge that the Programme is part of a development programme which was submitted by RKVI to the Belgian Directorate General for Development Co-operation (hereinafter called “DGD”), who acts as the main back donor to this Programme.

3. Duration

This PA will be valid for the implementation period of the Programme, from MONTH XXst YEAR to MONTH XXst XXXX, hereafter called the “Implementation Period”. The Implementation Period can-not be extended beyond this end date.

4. Sustainability

Specific measures to substantially enhance the sustainability of the Programme’s results and activ-ities will be included in the Programme and both Parties agree to give priority attention to these measures. These measures/mechanisms will be developed in close cooperation with the different programme stakeholders.


5. DGD

The Parties agree that DGD’s general conditions, rules and regulations, including forthcoming mod-ifications hereto, will be applicable at all times during the implementation of the Programme.

The XRC acknowledges that:

• RKVI can unilaterally change the RKVI Financial Guidelines due to any modifications to the rules, conditions or regulations of DGD;

• All financial commitments made by RKVI in the framework of this PA are subject to the final acceptance of the Programme and subsequent financial commitment by DGD;

• RKVI can unilaterally decide to change the budget, budget plans,... as set forth in Annex 1 and Annex 4 due to modifications to the rules, conditions or regulations of DGD or due to any request made by DGD;

• XRC will have to repay the expenditures refused by DGD (even if such refusal takes place after the Implementation Period);

• The Programme will be terminated with immediate effect if DGD decides to stop the fund-ing of the Programme for whatever reason.

6. Responsibilities of the XRC

a) The XRC shall be responsible for the qualitative implementation, management, monitoring and reporting of the Programme. On behalf of XRC, the Secretary General will be account-able to RKVI for the implementation of this PA. He may delegate this responsibility to the relevant Head of Department or Programme Manager, who will liaise with and work in direct cooperation with the RKVI delegate or desk in abstention of a delegate.

b) The XRC will appoint or dedicate adequate and qualified staff and volunteers for the im-plementation of the Programme, both at headquarters and in the branches. Furthermore, XRC will ensure that the organizational set-up and reporting lines are structured in the most efficient and effective way possible.

c) The XRC shall use the funds received from RKVI within the framework of this PA exclusively for the Programme as defined in Annex 1, and in the way set out in this PA.

d) The implementation of the Programme will be done following the RKVI Financial Guide-lines and XRC’s own procedures. To that end, XRC will send all financial, logistical and HR procedures and manuals to RKVI. Should inconsistencies or contradictions be identified between the RKVI Financial Guidelines the procedures and guidelines of XRC, the RKVI Financial Guidelines will pre-vail unless the procedures and guidelines of XRC are more strict in this respect.

e) XRC will fully inform RKVI of any modification or change to XRC’s procedures, manuals or policies affecting the Programme in any way prior to such change or modification. Any resulting changes to the Programme, its budget or implementation scheme as set forth in Annex 1 and Annex 4 or the RKVI Financial Guidelines can only be executed after prior explicit and written approval by RKVI.

f) XRC will coordinate effectively all interventions of its partners and provide adequate and precise information on the assistance and technical advice rendered by the various partners in order to ensure the most effective use of available funds and expertise and maximise complementarities and synergies between its partners.

g) The XRC shall open a specific bank account on headquarter level for the Programme for the Implementation Period. All Programme related funds shall be transferred to this account and this account shall be used exclusively for the Programme. All interests generated on this account shall be considered and reported on as income for the Programme.

h) XRC will keep a Fixed Assets Register for all investment goods procured under the Pro-gramme, as further specified in heading 9 of this PA.


i) The XRC will facilitate monitoring visits of representatives of RKVI and DGD. Both RKVI and DGD may send external auditors in order to gather information regarding all aspects of the management of the financial contribution by DGD to the Programme. The XRC shall give these representatives, external auditors as well as the RKVI delegates and desk officers full and unrestricted access to all relevant records, reports, accounts, t sites and premises related to the Programme and this at all times for specific missions as well as for regular monitoring.

j) The XRC shall keep all original invoices and supporting documents related to the implemen-tation of the Programme ready for inspection at its headquarters for at least 10 years after the closing of the Programme.

k) The XRC commits itself to submitting quarterly narrative and financial reports, including a duly filled in cash request, according to the formats presented in Annex 2 and 3 to the RKVI delegate for approval. After approval by the RKVI delegate the above mentioned reports will be submitted to RKVI. XRC will submit these reports and cash request to BRC-FL before the 30th of the month following the reported quarter.

l) Furthermore, the Programme Accounts of XRC will be audited annually and the audited annual financial report will be submitted before February 28th of the following year, in accordance with the relevant provisions of this PA and the rules and procedures set forth in Annex 2.

m) In the case that the XRC does not adequately comply with the RKVI Financial Guidelines, RKVI can impose stricter financial guidelines, including pre-signing rights for procurement, monthly reporting, co-signing rights for programme bank accounts, making copies all doc-umentation,...

7. Responsibilities of RKVI

a) RKVI will provide a maximum amount of …………… EUR to the XRC during the Implementation

Period in order to realise the Programme. These funds originate from: a. DGD for app. 80% b. RKVI proper funds for app. 20%

The amount can be decreased if DGD decides to decrease the funding of the Programme.

b) Within the limits of the fixed bi-weekly payment dates of RKVI, and based on the timely receipt of a duly compiled narrative and financial report and cash request as set forth in RKVI Financial Guidelines, approved by the RKVI delegate, RKVI will assure timely fund transfers in EUR to the assigned bank account referred to in 6. g) of this PA.

c) RKVI will work in close collaboration with XRC and will provide technical advice and support through its delegate and visiting representatives. In doing so, RKVI envisages assisting in maximising the quality and timely implementation of the Programme and ensuring the com-pliance with DGD’s general conditions and the provisions set out in this PA and its Annexes.

d) RKVI will coordinate its technical assistance with the assistance provided by other partners to the XRC in order to ensure synergy and complementarities and to strive for efficient standardisation and information exchange.

e) RKVI will inform XRC of all relevant conditions, rules and regulations of both RKVI and DGD, applicable to the implementation of the Programme, as well as any changes thereto.

f) RKVI will be the only responsible for communicating with and for submitting finalised fi-nancial and narrative reporting to DGD. If relevant, RKVI will facilitate meetings between XRC and DGD’s local representation.

g) If and when deemed appropriate, RKVI will send its headquarters representative(s) to dis-cuss the progress and outlook of the Programme and to visit the programme sites. The


Programme staff of the XRC may also be invited to Belgium for consultation and for Pro-gramme related sensitising activities for the Belgian public and Red Cross volunteers.

h) RKVI delegates or consultants may be given responsibilities in providing technical advice or monitoring of the quality implementation of the Programme. A generic job description is attached in annex 5.

8. Financial transfers, budget modification and annual audit a) Before the start of every year a detailed annual activity plan, annual budget and annual

forecast per quarter will be prepared by XRC and approved by RKVI. The detailed plans for 2014 are attached in annex 4. The detailed plans for 2015 and 2016 will be added once finalised and become an integral part of this PA.

b) RKVI will make financial transfers to the specific bank account opened by XRC for the Pro-gramme as defined in 6. g), following a cash request approved by RKVI added to the quarterly narrative and financial report.

c) These funds will be transferred in quarterly instalments based on a detailed forecast of expenditure and provided that the previous instalments have been duly reported on and accounted for. All submitted expenditure shall be in line with the Programme budget and in compliance with the RKVI Financial Regulations.

d) The exchange rate fluctuations will be monitored by both RKVI and XRC. In case the ex-change rate fluctuations cause a deviation of more than 10% (positive or negative) to the original local currency budget in annex 4, XRC will submit a proposal for modification of the allocation of the budget to RKVI.

e) The amounts of the 3 major budget headings (Investment Costs, Working Costs, Personnel Costs) are fixed and cannot be changed without prior written agreement of RKVI. The XRC strives to maximally respect the foreseen annual expenditure. Unspent funds can only be transferred to the next implementation year after a motivated request by XRC and prior written approval of RKVI.

f) For the amounts of the various budget sub-headings XRC can apply a maximum budget flex-ibility of 10% at its own discretion. A higher deviation can only be allowed after prior explicit and written approval by RKVI.

g) The Programme Accounts shall be included in the annual accounts of XRC and a copy of the complete general audit report will be provided by XRC to RKVI in accordance with the RKVI Financial Guidelines.

h) The Programme Accounts will also be annually audited by an internationally recognized and duly authorized external auditor, contracted by XRC. The selection of this audit firm and the drafting of the terms of reference will be done in close consultation with RKVI and following the RKVI Financial Guidelines.

i) The annual audit report of the Programme Accounts will be sent to RKVI before February

28th of the following year. The XRC will give the auditors full and unrestricted access to

all documents, records, programme sites, staff and premises relating to the implementation of this PA.

j) At the end of the year RKVI will only accept the invoice list approved by RKVI and approved and accepted by the external auditor appointed as set forth in 8.g) as the expenditure made for the Programme. The remaining balance can be transferred to the next year’s budget only after prior explicit and written approval of RKVI. Without this approval, XRC will refund the balance to RKVI as soon as the annual accounts are closed, audited and approved. All expenses and planned activities have to be finalised before December 31st 2016. Expenses made or activities carried out after this date shall not be eligible for reimbursement by BRC-FL.


9. Ownership of infrastructure and equipment All infrastructure and equipment acquired within the framework of the Programme are to be used exclusively for the planned activities and by authorized Programme personnel only, until its com-pletion. XRC shall keep and regularly update a Fixed Assets Register for the purpose of formally transferring ownership to XRC of these goods at the end of the Programme.

During the Implementation Period all infrastructure and equipment acquired within the framework of the Programme and with the funding of RKVI, will remain the property of RKVI until the transfer of ownership at the end of the Implementation Period.

This Register will be kept according to the criteria and principles of the relevant XRC procedure which has been submitted to RKVI according to 6.d) of this PA. The updated Fixed Asset Register shall be included as an annex in every annual report with regard to the Programme Accounts and

the annual accounts of XRC.

10. Transparency and economic use of funds

a) XRC declares to do everything in its power to implement the Programme according to the highest possible managerial standards in order to ensure a transparent and professional use of the Programme funds. Procurement will be done in full respect of the letter and spirit of the procurement and authorization procedures of XRC and the RKVI Financial Guidelines. XRC Programme staff will strive to economise on Programme Funds in order to reach the highest possible quality results for the Programme with a minimal necessary investment of Programme Funds.

b) In case inappropriate use of Programme Funds, assets or resources or fraudulent practices should be identified by XRC staff, RKVI representatives or third parties, XRC commits itself to immediately inform RKVI and investigate with all means at its disposal, share the full results of this investigation with RKVI as soon as possible. After consultation of RKVI and

approval by RKVI of the proposed measures, XRC will undertake effective action (as agreed

with RKVI) in order to remedy the damage done and take the measures agreed upon in order to prevent further misuse of Programme Funds, assets or resources.

c) RKVI shall have the right to refuse specific expenditure on the invoice list in case that these costs were made based on inappropriate use of Programme Funds, non-respect for applica-ble procedures or fraudulent practices. To that end, RKVI will have the right to send representatives (own staff or external auditors) to investigate alleged misuse or fraud. XRC will cooperate with these representatives and give timely and unrestricted access to all relevant records, persons, sites, premises and documents.

11. Modifications, Cancellation, termination

a) The provisions of this PA can only be modified or amended by means of mutual, written agreement.

b) In case difficulties occur in the implementation of the provisions of this PA, both parties agree to consult each other immediately in order to find amicable solutions.

c) The Parties have the right to terminate this PA in the event of ‘Force Majeure’ and such Force Majeure event continues beyond a period of thirty (30) days.

d) RKVI has the right to terminate the PA with immediate effect if the XRC materially breaches any of its obligations under this contract and notwithstanding a written request from RKVI to rectify the situation within a period of thirty (30) calendar days, fails to comply with such request, in which case termination of the PA shall become effective thirty (30) days following the XRC’s receipt of the request of RKVI.

e) Should this PA be terminated for any reason, payments shall only be due for supplies pro-cured by means of a purchase order before the notice date or services rendered up to the notice date and which are eligible under the Programme budget and planning as approved


by RKVI. All expenditure between notice date and effective termination date will be ex-plicitly requested by XRC and approved in writing by RKVI. The balance of unutilised working advances will be duly returned by the XRC to RKVI without delay.

f) In case of termination of this PA, XRC will submit a narrative and financial report up to the effective termination date, following the model and templates as attached in Annex 2 and 3.

g) The Parties strive to settle any dispute, including but not limited to termination of this PA and related claims, amicably and through direct negotiations. Should Parties not be able to find an amicable solution, the dispute will be referred to the International Federation of Red Cross and Red Crescent Societies for arbitration. This arbitration will be held in Geneva in the English language.

This PA has been issued and signed by the Parties in two original copies.

Signed for Rode Kruis-Vlaanderen Internationaal VZW Signed for …….. (.....RC):

-------------------------------------------- ------------------------------------------

Name: Prof. Dr. Philippe Vandekerckhove Name: Mr(s). ............... Title: CEO Title: ............... Place: Mechelen, Belgium Place: ............... Date: ............... Date: ...............

Annexes:

Annex 1: Logical framework and overall budget for the duration of the Programme (XXXX-XXXX) Annex 2: Guidelines for Financial Reporting Annex 3: Guidelines for Narrative Reporting Annex 4: Detailed budget and annual work plan for XXXX (and XXXX and XXXX once finalised) Annex 5: Generic job description delegate Annex 6: Back donor’s list of ineligible expenditure

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Annex 6: Cooperation agreement (synergies) template

LETTER OF INTENT

ON SYNERGY IN COUNTRY

BETWEEN:

1. Rode Kruis-Vlaanderen Internationaal VZW, with registered office at Motstraat 40, 2800 Mechelen, Belgium, duly represented by Prof. Philippe Vandekerckhove, MD, PhD., CEO (here-inafter referred to as “RKVI”);

AND 2. NGO, with its registered office at __________ [address], duly represented by

____________________________ (hereinafter referred to as “NGO ABBREVIATION”).

RKVI and NGO ABBREVIATION are also individually referred to as a “Party” and collectively as the “Parties”. WHEREAS:

+ The Parties intend to work together as partners with regard to the implementation of their country Programmes 2017-2021 in COUNTRY.

+ The Parties acknowledge that these Programmes are the respective development pro-grammes 2017-2021 for COUNTRY (hereafter the “Programmes”), which will be submitted by RKVI and NGO ABBREVIATION separately to the Belgian Directorate General for Development Co-operation (hereinafter called “DGD”), who acts as the main back donor to these Pro-grammes.

+ The Parties are entering into this letter of intent (the Letter of Intent) in order to set out the major terms and conditions for the future cooperation within the framework of the Pro-grammes.

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THEREFORE, THE PARTIES HAVE AGREED AS FOLLOWS: Article 1 – Cooperation objective & roles

The Parties intend to cooperate on the realization of their respective Programmes and agree that the objective of their cooperation is XX (describe objective of operational synergy) in COUNTRY.

The Parties acknowledge this cooperation is a necessary condition for successfully implementing the respective Programmes of the Parties.

In order to achieve this cooperation objective, the Parties intend to realize and carry out their re-spective Programmes in the following manner: RKVI will contribute through describe what and where (geographical location) we are going to carry out activities in this cooperation. NGO ABBREVIATION will contribute through describe what and where (geographical location) we are going to carry out activities in this cooperation.

Article 2 – Conditions

The cooperation between Parties on the realization of their Programmes is subject to:

+ The final confirmation by Ministerial Decree in Belgium of allocation of the funds as communicated by e-mail by the Belgian government to the Parties.

+ The undersigning of a Cooperation Agreement between Parties in which the specific terms and conditions of the cooperation on the realization of the Programmes are determined. The provisions of this Cooperation Agreement shall comply with all requirements and conditions imposed by DGD in order to receive the funds.

Article 3 – Timing

Parties agree that the Cooperation Agreement will be undersigned before XX, XX. If no such agree-ment is undersigned by this date, present letter of intent will become null and void.

Article 4 – Governing Law

This Letter of Intent will be governed by and will be construed in accordance with Belgian law. The Parties strive to settle any dispute, amicably and through direct negotiations. Executed in __________ [place], on __________ [date], in two original copies, each party acknowledging receipt of one original copy.

FOR AND ON BEHALF OF THE NGO ABBR FOR AND ON BEHALF RKVI ______________________________ [name] Prof. Philippe Vandekerckhove, MD, PhD ______________________________ [title] CEO ______________________________ [date] ______________________________ [date] [signature] [signature]