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Submitted November 4, 2013 AID-FFP-A-12-00006

Annual Results Report

Mercy Corps / Uganda

Fiscal Year 2013

Northern Karamoja Growth, Health &

Governance (GHG) Program

Funded by USAID (United States Agency for International Development)

Bureau of Democracy, Conflict and Humanitarian Assistance Office of Food

for Peace

COUNTRY CONTACT Mercy Corps HQ Contact PROJECT SUMMARY

Sean Granville-Ross Country Director Plot 1102, Nsambya Road P. O. Box 32021, Clock Tower Kampala, Uganda +256 778 216 150 Fax: +256 414 501 011 Email: [email protected]

Nathan Oetting Sr. Program Officer 45 SW Ankeny St Portland, OR 9720 Phone: +1(503) 896-5043 Fax: +1 (503) 896-5011 [email protected]

Award No Start Date End Date Report Date

FFP-A-00-08-00075-00 July 19, 2012 July 18, 2018 November 4, 2013

mailto:[email protected]

mailto:[email protected]


Acronyms

ARR Annual Results Report

CAHW Community Animal Health Worker

CLTS Community Led Total Sanitation

CD Commercial destocking

CMM Conflict Mitigation and Management

CU2 Children under two years of age

CU5 Children under five years of age

DHT District Health Team

EWB Engineers Without Borders

FIC Feinstein International Center

FY Fiscal Year

GHG Northern Karamoja Growth, Health and Governance Program

HFST Health Facility Support Team

HMIS Health Management Information System

HUMC Health Unit Management Committee

IPTT Indicator Performance Tracking Table

KAPDA Kaabong Peace and Development Agency

KIF Karamoja Innovation Fund

MCG Mother Care Group

PIA Participatory Impact Assessment

PLW Pregnant and Lactating Women

PPF Pastoralism and Poverty Frontiers

RAIN Revitalizing Agriculture Incomes and New Markets

SDA Safari Day Allowance

SO Strategic Objective

TOPS Technical and Operational Performance Support Project

VHT Village health teams

WASH Water Sanitation and Hygiene

WFP World Food Programme

WV World Vision


Introduction: Annual Food Assistance Program Results

The 1.2 million inhabitants of the Karamoja sub-region of northeastern Uganda face a slow crisis

produced by the breakdown of their traditional agro-pastoralist livelihood strategy, repeated

climactic shocks and ongoing insecurity from cattle raiding. The decay of social norms and

institutions, such as elder authority and the meaningful, active role of young men and women in

tribal culture, inevitably accompany the crisis, as does malnutrition for children, high rates of

sexual violence and alcohol abuse, and gender inequality. It is difficult to overstate the

challenges facing the Karamojong.

Those challenges are, however, matched by opportunities for long-term development with the

potential for significant impact on the food insecure. As of the end of Fiscal Year 2013, four

seasons of relatively good rains have filled many village granaries, and the security situation is

improving thanks to successful military disarmament and non-governmental peacebuilding

efforts. Though pockets of high food insecurity persist, particularly in Kaabong district, in

recognition of the sub-region’s development emergency humanitarian efforts are scaling down,

leaving a gap for more development-focused interventions to fill. There is a peace dividend

waiting to be realized in Karamoja.

The Northern Karamoja Growth, Health and Governance (GHG) program was designed to

capitalize on this pivotal moment through a range of integrated economic, health, and

governance initiatives that will cement the gains from increased security and build a foundation

for broader self-sufficiency and improved health, while well targeted food aid for pregnant and

lactating women and children under the age of two hastens the process of transition from decades

of food aid by filling nutrition deficits in highly food insecure households. GHG’s geographical

focus includes the northernmost three Karamojong districts of Kaabong, Kotido and Abim, home

to approximately 540,000 individuals. It has three integrated strategic objectives (SOs):

SO1: Livelihoods Strengthened – focused on pro-poor market development to build

local capacity to provide vital products and services on a commercially sustainable basis;

SO2: Nutritional Status among Children under Five (CU5) Improved – focused on

improving local public and private healthcare, promoting improved household food

consumption, and improving water infrastructure and sanitation and hygiene behaviors;

SO3: Reduced Incidences of Conflict – focused on helping local conflict mitigation

structures adapt to the current conflict dynamic, while supporting traditional authority

structures and male and female youth to play more constructive roles in improving

security.

The GHG consortium pulls several complementary capacities into one coherent, unified

approach, embodied in the facilitative strategy that pushes local actors out front to sustainably

provide the products (e.g. seeds and energy) and services (e.g. land opening, animal husbandry,

transport, security, finance and healthcare) that make life productive, healthy and meaningful in

the 21st century. As the consortium lead, Mercy Corps takes overall responsibility for the

development of GHG’s facilitative strategy as well as the quality of all programming

implemented by the project. It also implements all economic programming and employs a

fulltime Gender Advisor to ensure that an understanding of Karamoja’s complicated gender

dynamics are incorporated into all activities. World Vision Inc. (WV), with its robust commodity

management and public health qualifications, is leading supplementary feeding activities,

community-level public health initiatives, and water, sanitation and hygiene programming. An

extraordinarily knowledgeable local partner, Kaabong Peace and Development Agency


(KAPDA), constitutes the spear-tip for GHG’s conflict management and governance activities,

working primarily through local formal and informal authority structures to bolster local systems

for conflict reduction and government service improvement. Lastly, Tufts University’s Feinstein

International Center (FIC) is charged with performing annual impact evaluations using its

community-focused Participatory Impact Assessment (PIA) methodology that will help the rest

of the consortium partners understand the impact (or lack thereof) of their work.

Program Startup

The GHG consortium began the fiscal year with a focus on building staffing capacity for all three

SOs, establishing expanded office and team housing facilities, and putting in place the

infrastructure required to store and distribute supplementary feeding commodities. Hiring began

immediately prior to the start of FY13 and continued into the year’s third quarter. As they came

onboard, staff across SOs set to work analyzing their geographic and technical areas of focus

prior to activity design. All four in-country partners expanded or relocated office facilities in

Abim, Kotido and Kaabong to accommodate the increased staffing levels required by the project.

Lastly, WV established intermediary warehousing facilities in Lira to receive commodities

shipped from Dar es Salaam, with two forward rubhalls (one each in Kaabong and Kotido).

Research partner FIC completed a thorough Gender Assessment in the first quarter, meticulously

detailing the region’s complex gender dynamics as they relate to access and utilization of the

products and services (across all SOs) the program

intends to impact. FIC in the second quarter conducted a

PIA on Livelihood Dynamics in Northern Karamoja,

detailing community perceptions of wealth, poverty and

inequality within the three-district program area;

characteristics of production and constraints to household

access to productivity-promoting services and products;

market access; and non-traditional economic

opportunities (basically everything excluding crop and

livestock production). These two excellent reports have

been foundational to program design, and are included in

the supplementary materials attached to this ARR. Other

assessments are detailed in the sections below, and listed

in the box to the right.

Setbacks During FY13

Before diving into a discussion of FY13 annual results, it

is worth noting two significant setbacks to

implementation that occurred during FY13 (details on

each of these issues will be provided in the appropriate

sections below). First, in the course of registering

beneficiaries in the portion of the program area

delineated for the supplementary feeding program (SFP),

the GHG consortium encountered significant difficulty

finding the number of pregnant and lactating women

(PLW) and children under two years of age (CU2)

estimated in the GHG proposal. In addition to contributing to a massive shortfall in performance

GHG Studies Completed in FY13:

1. Gender Assessment (FIC)

2. Livelihood Dynamics in

Northern Karamoja (FIC)

3. The Conflict Management

System in Karamoja (MC,

KAPDA, PPF)

4. Economic Sector Assessments:

Karamoja Cattle Market, Animal

Health, Agricultural Inputs,

Financial Services, Commodity

Trade, Private Healthcare (MC)

5. Public Health Facility

Functionality Assessment (MC)

6. VHT Functionality Assessment

(WV)

7. Supplementary Feeding

Beneficiary Registration (WV)

8. Barrier Analysis of Eight Health-

Related Behaviors (WV)

9. Sub-County Formal and Informal

Security Capacity Assessments

(MC, KAPDA, PPF)

10. Assessment of the Efficacy and

Challenges of Bolus Implantation

in Cattle in Karamoja (MC)


against targets (meeting 51 percent of the target, in aggregate – see Table 1, below), this situation

has caused a significant commodity overhang and led to a reduced call forward for FY14.

Second, SO3 partner PPF in September was terminated from the consortium for extreme

underperformance. As of the time of writing the ARR, a thorough internal audit has yet to reveal

outright fraud, but the PPF Program Manager’s dishonesty, poor quality work and

unresponsiveness to demands for correction left GHG’s senior management with no alternative

but to cut that organization from the program. PPF was responsible for implementing SO3

activities in Kotido and Abim districts, so its underperformance meant that SO3 programming

foundered in those two districts during the latter half of FY13 while high-performing KAPDA, in

Kaabong, sped forward. As such, performance data for Abim and Kotido under SO3 was

excluded from calculations in the IPTT.

Table 1: Cross cutting Indicator Results for FY13 (see IPTT for full GHG list) Target Actual % of

target

63. Number of people benefitting from USG-supported social assistance

programming

105,468 54,020 51%

64. Number of food security private enterprises (for profit), producer

organizations, water users associations, women’s groups, trade and business

associations, and community-based organizations (CBOs) receiving USG

assistance

85 92 109%

65. Number of rural households benefitting from USG assistance 14,178 8,572 60%

66. Number of vulnerable households benefitting from USG assistance 14,178 8,572 60%

SO1: Pro-Poor Market Development

Under SO1, as staff came on board they dove into district economic profiles, leading to sector-

focused assessments relevant to their teams (agricultural inputs, financial access, animal health

and marketing, and food commodity trade). As SO1 teams neared the completion of sector

assessments GHG organized a Making Markets Work for the Poor (M4P) training, held in

Kotido the week of March 18. The four-day M4P training was developed by Mercy Corps with

the support of the UK-based Springfield Centre, and delivered by the GHG Chief of Party and

Mercy Corps’ Economic and Market Development Program Manager. Staff from Engineers

Without Borders (EWB), GHG’s coaching partner, delivered a training on Day Three on the

topic of facilitation. The M4P training also included SO3 partners PPF and KAPDA, the Health

Facility Support Team (HFST), and senior GHG management from WV. The M4P training led

into results chain and activity design for each team.

Tillage – In May local businessman Denis Otim received a $26,723 lease from DFCU Bank Ltd.

for a new 85-horsepower Massey Ferguson tractor he would use to provide mechanized tillage

services to farmers in Kotido, Abim and Kaabong. Mr. Otim was one of four area applicants

supported by GHG with cost sharing through GHG’s Karamoja Innovation Fund (KIF) for the

upfront cash payment (50 percent of the value of the asset) required under DFCU’s lease terms

(two of the applicants were dismissed, while the fourth decided to wait until the following

agricultural season). Though the process took much longer than expected and the machine

arrived late in the agricultural season, Mr. Otim used the tractor to open up 209 acres of land for

110 local farmers, many of which were poor women and youths working in groups supported by

NGOs. These achievements are reflected in Table 2, below (see Indicators 9, 10, 11, 12 and

14).


Agricultural Inputs – The agricultural input strategy is designed to address a gap in farmer

access to quality inputs for crop production. At the time of GHG’s launch there was not a single

consistent retailer of high quality agricultural inputs in the entire program area. After developing

a results chain that details a path toward the development of a sustainable agro-inputs industry in

northern Karamoja, the inputs team profiled 74 existing retailers in Abim, Kotido and Kaabong

to identify those who could carry long-term commercial relationships with national sellers of

high quality seeds, eventually selecting 27 (22 male and 5 female-owned – see Table 2,

Indicator 15, below) retailers for business support and linkages with national seed sellers. Ten

of these retailers are in Kotido, ten are in Abim, and seven are in Kaabong. As the fiscal year

ended the inputs team was engaging Kampala-based seed sellers, including NASECO, Pearl

Seeds, and FICA Seeds, to gauge their interest in experimenting with the Karamojong market. A

September collaboration meeting with the USAID/Uganda Feed the Future Agricultural Inputs

Activity helped inform the choice and modality of cooperation with national seed sellers. Lastly,

In August, the inputs team took five traders from Kaabong to Kitgum and Lamwo districts for an

exposure tour, fostering linkages with agro stockists from Kitgum and learning about the input

agent strategy’s success under Mercy Corps’ USDA-funded Revitalizing Agricultural Incomes

and New Markets (RAIN) program.

Financial Access – The financial Access Team profiled 17 savings and credit cooperatives

(SACCOs) in the program area, eight in Kaabong, five in Kotido and four in Abim. The team

selected seven SACCOs as preliminary partners (three in Kaabong, two in Kotido and two in

Abim). SACCO partners were selected according to a variety of criteria, including the need to

partner with middle-tier financial services that supported a broad range of economic activities (and

Table 2: SO1 Indicator Results for FY13 (see IPTT for full GHG list) Target Actual % of

Target

9. Number of farmers and others who have applied new technologies or

management practices as a result of USG assistance

75 110 147%

10. Number of private enterprises (for profit), producer organizations, water

users associations, women’s groups, trade and business associations, and

community-based organizations (CBOs) that applied new technologies or

management practices as a result of USG assistance

1 1 100%

11. Number of hectares under improved technologies or management

practices as a result of USG assistance

209 209 100%

12. Value of agricultural and rural loans $25,000 $26,723 107%

13. Number of individuals who have received USG-supported short-term

agricultural sector productivity or food security training

0 0 N/A

14. Number of MSMEs receiving USG assistance to access bank loans

(including farmers), disaggregated by sex of owner

1 1 100%

15. Number of female-owned businesses included in

stockist/agent/distribution networks supported by the program

0 9 N/A

16. Number of MSMEs, including farmers, receiving business development

services from USG assisted sources, disaggregated by sex of owner

0 0 N/A

17. Business Confidence Index (see Supplementary Materials) None 60.35 N/A

18. Percent of Chamber of Commerce chapter members who are female 0 25% 0%

19. Number of Karamjong-language weekly business shows produced on a

cost recovery basis as a result of USG assistance

0 0 N/A

20. Number of communities with early warning and response (EWR)

systems working effectively

0 0 N/A

21. Number of hazard risk reduction plans, policies, strategies, systems, or

curricula developed

3 1 33%


were thus regionally disparate from one another) and populations. For example, Kamukoi, Thurr

and Lotuke SACCOs are all located in the western green belt, presenting an opportunity for

agricultural financing. Nakapelimoru SACCO, on the other hand, is located in the most populated

area of Kotido district (outside of Kotido Town Council), bordering Kenya and therefore

presenting an opportunity for a variety of trade-related economic opportunities. Meanwhile, two

women-led SACCOs (Pioneer Model and Kitogogong) were founded and are led by

businesswomen dedicated to expanding and enabling financial inclusion within their communities.

After selection, the team began working with SACCO partners on a range of internal governance

issues, including board re-election and internal record keeping, but those efforts were only just

starting to yield fruit as of the end of FY13 so the results were not included in Indicator 10 of the

IPTT.

The financial access strategy also included preparatory work with potential partner Mango Fund,

a frontier financier that provides loans for value addition to businesses that would not normally

qualify for commercial credit. GHG’s partnership with Mango Fund was awaiting formal AID

approval as the close of FY13, but it was anticipated that the partnership with Mango Fund

would be a linchpin in the sustainable provision of credit to early stage, key partners.

Animal Health and Marketing – GHG’s animal health strategy focuses on building a

commercially viable animal health industry that serves the program area’s 10’s of thousands of

livestock owning households. Starting off, the animal health team profiled 96 community animal

health workers (CAHWs), selecting 52 (41 men and 11 women) CAHWS for partnership through

linkages to GHG-supported local veterinary medicine sellers and (inter)national drug

wholesalers. The team also identified and began working with three local drug shops, helping

two of them prepare loan applications for submission to Mango Fund. At the national level, the

team identified three promising agrovet drug wholesalers, all based in Kampala, and began

engaging them to undertake market assessments in northern Karamoja (Norbrook (U) Ltd., the

largest importer in Uganda, visited shortly after the close of the fiscal year – a short writeup was

sent to USAID describing this very successful visit).

To kick off activities to enhance livestock marketing activities in the program, Mercy Corps

hired an external consultant to conduct an exhaustive study of the Karamoja Cattle Market

(included in the Supplementary Materials section), then began convening local and regional

traders to discuss opportunities for accelerating the pace of cattle, sheep and goat trade. Two

meetings in July – one between local traders and political figures and another between local and

regional traders – resulted in an impromptu visit by regional traders to the seldom visited

Komoria market in Kaabong by four regional traders who bought a record 62 bulls, one donkey

and two sheep from local traders and owners.

Commodity Trade – The commodity trade team is focused on creating more efficient food

markets in Karamoja on the belief that the vast majority of households are net food purchasers.1

In the course of profiling internal and external food traders, grain storage facilities, and

processors, the team found enormous differences in food prices across relatively short distances.

For example, they found a 100 percent difference in the price of beans between Kacheri sub-

county in Kotido and neighboring Lobalangit in Kaabong, and a 300 percent difference in the

price of millet in a village in Panyangara and Kotido Town Council (only eight kilometers

away). To alleviate these massive inequalities in food prices (ideally smoothing prices faced by

1 The FIC PIA baseline found that approximately half of households in the program area produce only around 30 percent of their annual food requirements.


food purchasing households), the team profiled 86 internal traders and eventually selected 18 (11

men, four women – see Indicator 15, above – and three groups) for initial partnership. GHG

also profiled 42 external traders from Acholi, Lango, Mbale and further southeast, seeking

external partners interested in importing grains to Karamoja, which typically has some of the

highest food prices in the country. As of the close of FY13 the team had mapped 57 community

storage facilities and 24 (mostly nonfunctional) processors across the program area.

Chambers of Commerce – Activities in support of Karamojong chapters of the National

Chamber of Commerce and Industry began in September with meetings in Kampala between

GHG staff, an Abim-based businessman interested in leading the founding effort, and

representatives of the national chapter. Those activities were ongoing as of the close of FY13 and

no membership drives had occurred as yet, thus the program’s underperformance in supporting

the enlistment of female entrepreneurs (see Table, Indicator 18).

Risk Reduction and Early Warning and Response – GHG’s risk reduction strategies involve

commercial destocking and, in the future, more formal insurance mechanisms designed to

cushion losses faced by crop and livestock producers in the event of drought. During FY13 GHG

developed a commercial destocking program (see Table 2, Indicator 21) that would work

through local and regional traders, transporters and banks to offtake cattle, sheep and goats

before major losses occur, allowing livestock owners to convert physical stock to cash they could

use to restock following the crisis. Regarding GHG’s underperformance on the IPTT (only one

plan, against a proposed three), the program should have developed a tailored emergency plan

for each district but had not achieved that tailoring as of the close of FY13.

New Activities – An activity that was added to GHG’s SO1 during FY13 but not part of the

original plan (though transport was an explicit focal sector in the proposal) is the construction of

96 kilometers of rural roads that, when completed, will join with existing national roads to form

two rural/urban circuit routes. One of these, 38 kilometers of road connecting Kacheri sub-

county with Lobalangit sub-country, will produce a circuit that connects Kotido and Kaabong

towns to the productive western green belt in a loop that can be completed in one day. The

second stretch, 56 kilometers of road connecting Panyangara sub-county with Nyakwae sub-

county, will form a Kotido and Abim town loop. GHG plans to support local transport

companies to ply these roads, creating a thrice weekly rural transporter that will dramatically

reduce transport costs and accelerate the pace of economic growth in the program area. As of the

end of FY13, a GHG engineer had produced specifications for road construction and plans were

underway to perform an environmental impact evaluation in the first quarter of FY14.

SO2: Improved CU5 Nutrition

Under SO2, Mercy Corps (staffing the HFST) and WV (staffing the community health and

commodity teams) work under a unified (WV-led) management structure to improve public and

private healthcare, impact community health seeking behavior, promote health childcare

practices among target communities, build water infrastructure, and promote health sanitation

practices. As under SO1, staff dove into analysis of their focal areas as soon as they came on

board.

Public Health Facilities – Between February and March the HFST profiled a total of 58 health

facilities (43 HC IIs and 17 HC IIIs) to determine their levels of functionality and specific gaps

in their capacities to provide critical maternal and young child health services to nearby

communities. That assessment (included in the Supplementary Materials section) informed

activity design that took place following the M4P training, resulting in a quid pro quo strategy


whereby key investments in infrastructure (such as maternity wards, placenta pits and delivery

rooms) and equipment grants related to MCHN would be made by GHG on condition that

District Health Teams (DHTs) fulfilled a series of conditions, including reforming defunct or

poorly functioning Health Unit Management Committees (HUMCs – local governance bodies

charged with supervising facilities) and adhering to national guidelines around the reporting of

clinic activities through the national Health Management Information System (HMIS). A delay

in rolling out HMIS training due to protracted negotiations with Ministry of Health (MoH)

trainers in Kampala led to GHG’s FY13 underperformance in training HCII and HCIII staff (see

Table 3, Indicator 28, below).

To develop comprehensive agreements with each district spelling out the quid pro quo strategy,

the team conducted six meetings with the district health teams (DHTs) of the three districts to

discuss the program intervention and strategy towards achieving the program which entailed

setting of performance bench marks of the health facilities. When GHG staff failed to gain

traction with district staff due to the program’s refusal to pay allowances for meeting attendance

the threat of withdrawing facility support for that district, instead directing it to the other two

districts, proved sufficient to gain the buy-in of the required staff (see Lessons Learned, below).

During these meetings the HFST and DHTs agreed critical infrastructures and equipment needs

per district (of the 159 pieces of infrastructure needed at the health facilities, DHTs prioritized 19

facilities as critical for construction in first phase of partnership, while the remaining 140 would

be considered for construction in later phases).

In June and July GHG partnered with Makerere University’s Faculty of Medicine to field 30

medical students (18 fifth year students and 12 first year students) in the two hospitals of Abim

and Kaabong and one HCIV of Kotido for period. The placement was intended to temporarily

bridge chronic staffing gaps, foster learning and transfer of knowledge between the students and

the local staff, promote better understanding of the local context and have students consider

working in Karamoja upon graduation, and also establish long term partnership between

Ugandan medical schools and the districts of North Karamoja.

Private Health Facilities – The private healthcare sector plays a significant role in healthcare

delivery in northern Karamoja, especially in terms of ambulatory care. To better understand the

private health sector, the HFST profiled 29 drug shops and 4 clinics, detailing their capacities,

viability and the potential to link them with external drug suppliers. While active support for the

private healthcare sector has yet to commence (see Table 3, Indicator 27), the HFST did work

with two of the higher performing local clinics to prepare loan applications for Mango Fund for

equipment, including an ultrasound machine.


Target

27. Number of commercial sustainable private clinics supported by USG

assistance

0 0 N/A

28. Number of government health staff trained in planning and management of

health facilities, disaggregated by sex

88 0 0%

29. Number of people trained in child health and nutrition through USG-

supported programs, disaggregated by sex

392 449 115%

30. Number of VHTs consistently attending monthly review and mentoring

meetings supported by USG, disaggregated by sex

0 0 N/A

37. Number of households adopting 3 or more improved gardening/poultry

production practices promoted by the project

254 0 0%

38. Number of mother care groups supported by USG assistance 30 40 133%


While GHG’s support to public and private healthcare facilities spans the entire program area,

our work at the community level to promote healthy behaviors, provide supplementary feeding

and improve access to water is packaged together and focused on a limited number of mostly

rural sub-counties selected to skirt the World Food Programme (WFP) distribution footprint. The

focal area includes select parishes in Alerek and Nyakwae sub-counties in Abim; Nakapelimoru

and Panyangara sub-counties in Kotido; and Kapedo, Kathile, Kawalokol, Lodiko, Lolelia,

Loyoro and Kamion sub-counties in Kaabong. Of these 11 sub-counties, Nywakwae and Kamion

were added mid-way through the year after the program encountered difficulty reaching expected

beneficiary numbers.

Village Health Teams (VHTs) – Launching our support for community-level VHTs (the first

line of healthcare in Uganda’s public health system), GHG conducted a functionality assessment

of VHTs across the initial nine sub-counties (assessing 440 VHTs in total) to understand their

education and experience levels, equipment stocks, supervision and previous trainings (see

Supplementary Materials). Of these, 265 VHTs (152 male and 113 female) were selected in

collaboration with DHTs for a five-day basic refresher training. Also based on the functionality

assessment, GHG procured 336 bicycles toward the end of FY13 for distribution to those VHTs

who lacked their own means of transportation, though bicycle distribution was delayed due to

concerns by DHTs that VHTs not within the program area would object to being excluded.

Negotiations to resolve that impasse were ongoing as of the end of the fiscal year. Lastly, GHG

support monthly mentoring and review meetings had yet to begin by the close of the fiscal year –

that activity was planned to start shortly into the following year (see Table 3, Indicator 30).

Mother Care Groups (MCGs) – MCGs are community-based groups of 10 to 15 Lead Mothers

who act as informal health educators, each responsible for regularly visiting 10 to 15 of her

neighbors. They are GHGs focal point for promoting healthy childcare and hygiene practices in

target communities. To inform behavior change messages GHG would advocate through MCGs,

the program first conducted a Barrier Analysis examining community incentives and

disincentives to engaging in eight behaviors (latrine use, hand washing, facility-based delivery,

exclusive breastfeeding, extra meals for PLWs, extra meals for children 6-12 months in addition

to breastfeeding, at least four antenatal visits, and use of contraception – see Supplementary

Materials). Following the barrier analysis, GHG trained 449 VHTs (226 male and 223 female) on

the Care Group model so that they could act as supervisors of the Lead Mothers in their

respective villages. As the Care Group activity focuses exclusively on child health and nutrition,

this training was recorded as contributing to GHG’s achievement of Indicator 29 for FY13.

Following that training, GHG staff worked with VHTs in nine sub-counties to form 40 MCGs

(nine in Abim, 19 in Kotido and 12 in Kaabong – see Indicator 38), against an FY13 target of

39. Number of children 6-23 months receiving PM2A rations, disaggregated by

sex

16,018 7,733 48%

40. Number of PLW receiving rations 18,562 3,979 21%

41. Number of individuals receiving a protection ration, disaggregated by sex 70,888 42,308 60%

42. Number of children under five reached by USG-supported nutrition

programs

23,443 16,057 68%

48. Number of boreholes constructed or rehabilitated meting water quality

standards

5 5 100%

49. Number of gender-balanced water committees established and trained at

each water point

5 5 100%

50. Percent of households which use and maintain a hygienic household latrine 0 0 N/A

51. Number of latrines built by community members as a result of CLTS 0 0 N/A


30. The reason for exceeding the target was community enthusiasm for the model – it was picked

up more quickly than expected. Lastly, though pushing permaculture gardening and poultry

training through MCGs had been planned for FY13, delays in staff hiring and the general

demands of startup led the program to delay this activity until January 2014, when an expert

from the USAID/FFP-funded Technical and Operational Performance Support (TOPS) program

will train GHG staff on bio-intensive permaculture that is appropriate to Karamoja’s semi-arid

context, who will in turn train VHTs and MCGs to promote household cultivation of nutrient-

rich vegetables near the village.

Supplementary Feeding – SFP began in April, after putting the commodity storage

infrastructure in place. Six

months later, at the close of

FY13, GHG had completed six

rounds of distributions in

Kotido, four rounds of

distributions in Kaabong, and

four rounds of distributions in

Abim, reaching a total of 54,020

people with 625 metric tons of food. The sex breakdown of SFP beneficiaries by category is

detailed in Table 4. Achievements against targets are also shown in the table’s far right column,

quantifying the setback mentioned at this report’s introduction – GHG has managed to find a

much lower number of CU2 and PLW than originally committed to in the proposal (resulting in a

48 percent achievement for CU 2 – Indicator 39 – and a 21percent achievement for PLW –

Indicator 40). Our population figures were drawn from 2002 census projections used by a range

of actors, including the WFP and local authorities. While we are uncertain as to the cause of this

massive inaccuracy, several options present themselves as likely: 1) The projection calculations

themselves are likely erroneous, and it is possible that the original census included inaccurate

data; 2) Security deterioration immediately following the 2002 census likely incentivized

movement from rural to urban areas, resulting in reduced population growth in extremely rural

areas targeted for SFP; 3) Recent security improvements have brought increased economic

activity in urban areas, likely creating an incentive for rural/urban migration both within and

beyond Karamoja (we are currently witnessing increased urbanization across the program area

and will examine this more fully with the FY14 FIC analysis, as it has obvious implications for

the long-term resilience of both rural and urban poor).

As of the close of FY13 SFP beneficiary numbers were continuing to increase, but it is likely that

GHG will be unable to identify an SFP population mass in the originally intended focal area that

will justify the volume of commodity distribution indicated in the proposal. This will require a

collective rethink in terms of resources and/or focal geography – a conversation the program

looks forward to having with USAID.

Lastly, as community-level health activities picked up across the program, SFP was the only

activity in place by the close of FY13 that had a verifiable connect to CU5, reaching 16,057

children with supplementary feeding (either protective or PM2A – see Indicator 42).

Water, Sanitation and Hygiene (WASH) – To improve focal community access to clean water

GHG committed to drilling or repairing 59 boreholes of the life of the award. It achieved its

target of five new boreholes drilled (see Table 3, Indicator 48) and five gender-balanced water

management committees formed (see Indicator 49) in FY13. However, in the course of siting

boreholes program staff encountered difficulty finding appropriate locations that were not

Table 4: FY13 SFP Beneficiaries by Category

Ind. Category Male Female Total Target % of

Target

39. CU2 3,659 4,074 7,733 16,018 48%

40. PLW 0 3,979 3,979 18,562 21%

41. Prot. Rat. 22,587 19,721 42,308 70,888 60%

Total 26,246 27,774 54,020 105,468 51%


already served by an existing (functioning or nonfunctioning) borehole. Reviewing our analysis

from before the proposal against a new analysis conducted toward the end of the fiscal year, we

found that the number of boreholes in the program area had increased dramatically in the nearly

two years that had elapsed, while the functionality of boreholes had plummeted – across the focal

area, only approximately 60 percent of existing boreholes were operational. Clearly, a strategy

revision for FY14 was required, a process which was underway as of the close of the fiscal year.

To address community-level sanitation behaviors, particularly widely practiced open defecation,

GHG began triggering communities in keeping with the Community-Led Total Sanitation

(CLTS) methodology. GHG trained 16 district local government staff and 18 staff the CLTS

approach and orientated sub-county and parish leaders, then triggered 19 communities by the

close of FY13. Most of the triggered communities have swung into action; communities have

resorted to covering feaces after defecation (called “cat sanitation”) as they planned for latrine

construction after the September/October harvest season. GHG will advocate toilet construction

using locally available materials in all triggered communities, but as of the close of FY13 none

had been built yet (see Table 3, Indicator 51).

SO3: Reducing Conflict and Improving Governance

GHG’s conflict and governance programming in FY13 began in earnest with a November to

December assessment examining The Conflict Management System in Karamoja (see

Supplementary Materials), supported by two conflict and governance experts from Mercy Corps’

headquarters and carried out via local partners PPF and KAPDA. That study gave an overview of

the functionality of conflict management structures within the program area and laid out the

broad strokes of relevant programming. In essence, the study showed that, while the conflict

dynamic in the program area had evolved considerably over the last several years – moving away

from large-scale livestock-focused raiding and toward a simmering rural insecurity (this was also

supported by findings in the Gender Assessment) – the conflict management system, involving

sub-county level bodies, traditional authorities, and district security committees, had remained

focused on large-scale raiding. In other words, the conflict had evolved but local capacity to

manage it had not. This central insight provided the starting point for program design.

Several months of in-depth sub-county level analysis followed, along with intensive program

design (which was also informed by the facilitative strategy laid out in the March M4P training),

resulting in a strategy that was heavily tailored to allow PPF and KAPDA to address the unique

disfunction in communication and conflict management in each of the program’s 25 sub-

counties.

KAPDA, working in Kaabong, raced ahead with intensive support to sub-county peace

committees and traditional authority structures, while also providing support to district authority

efforts to stem cross-border raids from South Sudan and Kenya that were driving Kaabong

farmers out of their fields. Almost all of the information reported in Table 5 (below) is a result of

their activities working with local peace committees (see Indicators 52, 54, 55, 58, 59, and 62)


Target

52. Number of reported incidents of armed conflict in the past three months –

KAABONG ONLY

none 23 N/A

54. Percent of supported community structures that have successfully mitigated

or resolved at least two community conflicts – KAABONG ONLY

60% 56% 93%

55. Number of groups trained in conflict mitigation/resolution skills or

consensus-building techniques with USG assistance – KAABONG ONLY

20 10 50%


Abim- and Kotido-focused PPF, however, showed extremely slow progress and produced subpar

analyses and workplans. Repeated efforts to prod that agency into improvement and

responsiveness, including a temporary suspension of its subgrant in the third quarter of FY13 due

to significant financial reporting inadequacies, proved insufficient to improve its performance.

PPF’s Program Manager also repeatedly made dishonest statements about his own whereabouts,

his staff’s activities, and the utilization of program-procured assets (particularly motorcycles,

which he took to Soroti without informing GHG management). In sum, PPF’s ineptness,

dishonesty and inability to improve its performance led GHG management in September to

terminate its subgrant. This was a huge setback for SO3, but it did allow for a program rethink

that will produce a more tailored and decentralized approach to conflict mitigation and

governance improvement in Kotido and Abim. As of the close of the fiscal year a revised

strategy was being developed.

Lastly, SO3 benefitted from the participation of a USAID/CMM-funded research program into

the link between peacebuilding and community resilience, which used GHG as a vehicle for its

research. That two-year study has provided data that is currently being used in the post-PPF

redesign, as well as informing baselines for Indicator 57 and Indicator 60, though follow-up

data will not be available until the second round of research in FY14. A contracted study into the

Ugandan government’s failed bolus tagging initiative was also conducted in FY13 (see Table 5,

Indicator 56) which will be disseminated in FY14 in an effort to reinvigorate the electronic

tagging program.

Youth-focused programming outside of peace committee support had yet to commence as of the

close of FY13 (see Indicator 61), partly as a result of the effort to fix PPF’s issues. These

activities would commence early in FY14.

Gender Integration

The focus of our gender work in this quarter was on ensuring that women (both individuals and

groups) were profiled for partnership by our SO1 sector teams. A minimum target of 30 percent

was set for female-owned businesses, but, because women tend to be less market ready than their

male peers, the partnership requirements for this group were lowered. For the most part, teams

met this target and the gendered breakdown for private sector partners is as follows: 69 percent

male retailers to 31 percent female under Ag-Inputs; 67 percent individual male business owners

to 33 percent female under Commodity Trade; and 79 percent male CAHWs to 21 percent

56. Number of USG-funded events, trainings, or activities designed to build

support for the bolus tagging initiative

1 1 100%

57. Proportion of sub-county leaders (disaggregated by traditional and

government) involved in conflict management who report effective

collaboration (working relationships) with each other, disaggregated by sex –

CMM RESEARCH, GATHERED YR 2

N/A N/A N/A

58. Number of consensus building forums (multi-party, civil/security sector,

and/or civil/political) held with USG assistance – KAABONG ONLY

6 14 233%

59. Number of local women participating in a substantive role or position in a

peacebuilding process supported with USG assistance – KAABONG ONLY

80 110 138%

60. Percent decrease in youth with propensity (at risk) to engage in violence –

CMM RESEARCH, GATHERED IN YR 2

N/A N/A N/A

61. Number of joint initiatives between youth organizations and strategic

governance agencies

3 0 0%

62. Number of young people trained in conflict mitigation/resolution skills with

USG assistance, disaggregated by sex – KAABONG ONLY

90 102 113%


female under Animal Health. GHG’s teams are committed to taking on more female partners, as

our understanding of their needs, preferences and constraints grows.

Because women entrepreneurs and producer groups were more difficult to identify and access

than their male counterparts, the GHG gender officers conducted a mapping exercise of 74

women's groups. The purpose of the exercise was to determine if any of these groups might be of

interest to our livelihoods team. Kapilanbar and Rikitae women’s groups were chosen as partners

by GHG’s food trade team. Kapilanbar managed UGX 2.3 million in maize and sorghum during

the lean season and Rikitae handles considerable volumes of bean, maize and sorghum and is

transitioning from NGO-oriented supply to commercially-focused trade.

The financial access team conducted a gender audit of mixed male and female SACCOs in July

2013. The audit revealed that men dominate the institutions. The breakdown of active members

was 59 percent male to 33 percent female and 9 percent groups and, while managers claimed that

women received approximately 23 percent of loans in the current fiscal year, our research

suggested otherwise. In the next quarter, the findings will be shared with SACCO management,

who will be encouraged to engender their business practices and to develop tailored products and

services for this client group.

The team also continued its work with women-led SACCOs, Pioneer Model and Kitogogong. It

facilitated several in-person meetings between the SACCOs and UCSCU’s representative in

Karamoja, which led to the development of capacity building plans. The team also assisted

Kitogogong with recruitment drives to increase its membership and linked it with the GHG ag-

input team and MTN mobile in Kampala.

As part of its Do No Harm activities, the gender team organized a capacity building session on

the prevention of sexual exploitation and abuse (PSEA) with World Vision's food distribution

staff in the Mercy Corps Kotido office on July 31, 2013. The session reviewed the humanitarian

code of conduct and staff's obligation to provide free assistance. PSEA messages have been

included in pre-distribution addresses, as have messages about reproductive health and the link

between poverty and family size.

To support the health team in its work of reconstituting the HUMCs, and to ensure that the new

bodies are gender-balanced and representative of the constituents that they purport to serve, a

gender audit was conducted in August 2013. The audit revealed that women’s presence on the

interviewed HUMCs, both as members and leaders, is lower than men’s. Women currently make

up 31 percent of members but hold 6 percent of the positions on the executive. Kaabong trails

behind the other districts in both categories, with a 25 percent female membership rate and no

women leaders. A series of recommendations for increasing women’s participation on the

HUMCs was generated with the audit findings and shared with district officials responsible for

appointing HUMC members. The national Ministry of Health (MoH) has expressed interest in

the report findings and in the possibility of making adjustments to the new draft guidelines to

ensure that they are gender-responsive and adjusted to the local context. A meeting is planned

with the MoH in the first week of November to discuss this last point.

Lessons Learned

Refusing to pay allowances for meeting attendance caused significant conflict at the outset of

programming. This approach, though necessary from a sustainability and governance

perspective, is made all the more difficult by the practices of other organizations and multilateral

agencies which regularly pay local government staff for meeting attendance. GHG has taken a

hard line on this issue from the outset, refusing especially to pay the nearly ubiquitous ‘safari day


allowance’ (SDA). Some pressure to pay SDA has alleviated over time, and we feel that over the

life of the project the sustainability of initiatives will be significantly boosted by the fact that we

will have declined to provide extraordinary payments for local government participation in

initiatives that simply help them perform their jobs better.

Related to the issue of allowances, threatening to withhold support when encountering

recalcitrant public officials is an effective means of achieving productive local government

involvement – this was done in Abim under SO2 and it has so far worked very well.

Though communities are responding positively towards CLTS approach, there is a tendency to

relapse back into open defecation habits where follow up is not regularly done. There is a need

to establish strong follow up structures at the community level (perhaps through MCGs).

Another problem is the dependency mindset where community members frequently ask for

subsidies such as free latrine construction tools and materials, which is an unsustainable

approach.

Consolidating implementation risk across two thirds of the program area under one untested

partner (PPF, in this case) led to a broad performance shortfall for the program when that partner

failed to engage. It could be better, both from a risk perspective and from a programmatic

perspective, to work through many smaller agencies.

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