1
Strategic Cross-Sectoral C4D Framework UNICEF Eritrea Country Programme
2015-2016
GOVERNMENT OF THE STATE OF ERITREA
MINISTRY OF INFORMATION
UNITED NATIONS CHILDREN’S FUND ERITREA
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Acknowledgements
Asia-Pacific Development & Communication Centre (ADCC) would like to put on record our
appreciation and thanks to UNICEF Eritrea Country Office in entrusting to us the important task of
drafting this Strategic Cross-Sectoral Communication for Development (C4D) Framework for the
remaining two years (2015 – 2016) of the Country Programme. The ADCC Team especially thanks Ms.
Awet Araya, C4D Officer for her technical leadership and placing her trust with ADCC.
ADCC would also like to acknowledge and thank those government line ministries and department
officials who contributed their inputs during and following the C4D Training Workshop held in Asmara
from 15 – 19 December 2014. This Strategic Cross-Sectoral C4D Framework builds on the various C4D
sectoral strategies already developed or being revised. This Framework is not a C4D strategy by itself
but can be used to develop a full-fledged Cross-Sectoral C4D strategy for the remaining years of the
country programme and in preparation for the next Country Programme of Cooperation.
ADCC would like to recognize the support given by its dedicated Team including Ms. Emily Samuel,
C4D Specialist and Mr. Javed Ahmad, Senior C4D Consultant who facilitated the C4D Training
Workshop in Asmara. Mr. Kritsada Udomsukh, Programme/Finance Assistant and Mr. Phanuwat
Hanyuth Administrative Associate for providing logistics support. As Team Leader for the Consultancy,
Dr. Peter F. Chen, Executive Director, had been involved throughout from the very beginning including
outlining the C4D Framework structure, reviewing the numerous drafts and its finalization.
Peter F. Chen, Ph.D., MPH, MA
Executive Director
ADCC
February 2015
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Contents Acknowledgements ................................................................................................................................. 2
Acronyms ................................................................................................................................................ 4
Executive summary ................................................................................................................................. 5
Background and Rationale ...................................................................................................................... 5
Purpose of the Framework .................................................................................................................. 5
The situation in Eritrea ............................................................................................................................ 6
Situation of Children and Women ...................................................................................................... 6
UNICEF Programme Structure ............................................................................................................... 7
Focus Areas and Issues ........................................................................................................................... 8
Focus 1: Health and Nutrition ............................................................................................................. 8
Focus 2: Basic Education .................................................................................................................... 8
Focus 3: Child Protection .................................................................................................................... 9
Focus 4: Water, Sanitation and Hygiene ............................................................................................. 9
Current UNICEF Major Partnership, Convergence &Communication for Development (C4D) ........... 9
Bottlenecks, Challenges and Risks faced by C4D ............................................................................ 10
Model for the Cross-Sectoral Strategic C4D Framework ..................................................................... 13
Strategic C4D Approaches .................................................................................................................... 14
Planning and Coordination ............................................................................................................... 14
Advocacy and Partnership ................................................................................................................ 15
Capacity Strengthening ..................................................................................................................... 15
Media Engagement ........................................................................................................................... 15
Community Mobilization .................................................................................................................. 15
Social Mobilization ........................................................................................................................... 16
Recommended Steps for C4D Cross-Sectoral Partnership Formation.................................................. 16
Phased Approach for Rolling out the Cross-Sectoral C4D Framework (2015-2016) ....................... 17
Suggested Monitoring Tools ................................................................................................................. 18
Behaviour Monitoring Checklist ....................................................................................................... 18
Annex-1: Summary of Programme Units Analysis .............................................................................. 21
Annex-2: Proposed Communication Objectives and Communication Indicators for the Programme
Sectors ................................................................................................................................................... 27
ANNEX 3: Analysis of existing KABP, Perceived Barriers and Desired Changes for Programme
sectors ................................................................................................................................................... 29
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Acronyms
ADCC Asia-Pacific Development & Communication Centre
BCC Behaviour change Communication
BE Basic Education
C4D Communication for Development
CBO Community Based Organizations
CLTS Community Led Total Sanitation
CP Country Programme
ECD Early Childhood Development
EPHS Eritrea Population & Health Survey
EPI Expanded Programme of Immunization
FGM Female Genital Cutting
IMAM Integrated management of Acute Malnutrition
IMCI Integrated Management of Childhood Illness
IYCF Infant and Young Child Feeding
MDG Millennium Development Goals
MOE Ministry of Education
MoH Ministry of Health
MOI Ministry of Information
MoLWE Ministry of Land and Water Environment
MoND Ministry of National Development
NUEW National Union of Eritrean Women
NUEYS National Union of Youth and Students
ODP Open Defecation Practice
SPCF Strategic Partnership Cooperation Framework
UXO Unexploded Ordinance
WASH Water, Sanitation and Hygiene
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Executive summary This document is an overall Cross-Sectoral Strategic Communication for Development (C4D)
Framework and not a full-fledged C4D Communication Strategy. It draws on a number of
communication strategies for the different sectors which are already in place to make it multi-sectoral
and cross-cutting. The framework seeks to create synergies and harmonize current efforts by different
programme sectors and stakeholders to work towards a common goal -- to inspire and empower children
and adolescents, women, communities and institutions to become role models and leaders for positive
social change. The C4D Framework also seeks to identify problems, design solutions and involve
decision-makers at all levels. It integrates behaviour and social change approaches in the health,
nutrition, water, sanitation and hygiene, protection and education sectors. Concurrently, it also
addresses discriminatory practices and harmful social norms across issues.
The C4D Framework has identified some key behavioural results, barriers and desired changes and
strategic approaches that, taken together, can contribute to a broad social and behaviour change. The
framework finally integrates the different strategic approaches that link different programmes and
partners to ultimately work towards a common goal that will benefit the household, community and the
villages.
As a cross-cutting discipline, all programme sectors should utilize C4D to provide technical support
and capacity building focusing on a limited number of high impact programme areas (flagships), and
geographic locations based on country priorities and resource availability. In addition, Government
ministries and other national stakeholders can be equipped with knowledge and skills to be able to take
responsibility for their own C4D initiatives through institutionalized C4D in national policies and
processes.
Background and Rationale
Communication for Development (C4D) is articulated as one of the cross-cutting Country Programme
(CP) strategies in the UNICEF Eritrea Programme of Cooperation with Government of the State of
Eritrea (2013-16). Majority of the CP outcomes are dependent on behaviour and social change to
improve key family practices for child survival, growth and development, hygiene, sanitation,
HIV/AIDS, education, harmful traditional norms and nutrition education. Some Programme specific
communication strategies have been developed to articulate communication inputs, objectives and
approaches in line with the CP for 2013-2016. However, cross-sectoral linkages have not been made.
Hence, there is a need to draft a Cross-Sectoral Strategic C4D Framework based on the country office
programme.
UNICEF Eritrea Country Office sought technical assistance from Asia-Pacific Development and
Communication Centre (ADCC), a unit of Dhurakij Pundit University in Bangkok, Thailand to conduct
the first national C4D training workshop in Eritrea and to develop the Cross-Sectoral Strategic C4D
Framework for the remaining two years (2015 and 2016) of the Country Programmes with emphasis
on social/behaviour change, monitoring and evaluation, applying Results-Based Management and other
C4D principles.
Purpose of the Framework
The purpose for developing the Cross-Sectoral Strategic C4D Framework is;
To identify synergistic entry points to maximize C4D impact in programmes e.g. prevention of
stunting, child survival and development (hygiene and sanitation promotion, breastfeeding,
immunization, IYCF etc.)
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To identify areas for evidence generation, bottleneck analysis of social norms, KAPB surveys
and evaluation of existing C4D strategies and;
Suggest mechanisms to strengthen the coordination/management structures for C4D at Ministry
level.
The situation in Eritrea
Eritrea has an estimated population of 4 million (MoH 2014) of which nearly half are under 15 years of
age (EPHS 2010)1. An estimated 15 per cent of the population is aged under five years of age. Large
variations in population estimates carry long-term consequences for essential public services such as in
education, health, water, housing and transport.
About 80 per cent of the population lives in rural areas. Geographically, Eritrea can be roughly divided
into three geographical zones, comprising the central highlands, the western lowlands, and the eastern
coastal plain. The highland provinces of Debub and Maekel are the most populated. The lowland areas
are usually sparsely populated with most communities living far and wide apart, as evidenced by parts
of Anseba, Gash Barka, Northern Red Sea (NRS) and the Southern Red Sea (SRS). These are areas
inhabited by the nomadic populations that are estimated at about 15–30 per cent of the population (Carr-
Hill, 2005).
Eritrea has nine ethnic groups: the Afar, Bilen, Hedareb, Kunama, Nara, Rashaida, Saho, Tigre and
Tigrinya. Tigrinya and Tigre make up the largest two groups. Each group has its own language and
every child receives basic education with mother tongue as the medium of instruction at primary
education level ( Grades 1-5). Tigrinya, Tigre and Arabic are widely spoken andEnglish, Tigrinya and
Arabic are the working languages. Some of the policies and strategies developed or reviewed in the last
five years are:
• Road Map for Maternal and Newborn Health, 2012-2016 (MoH);
• National Maternal Health Policy Strategic Plan 2012-2016 (MoH);
• Health Sector Strategic Development Plan (HSSDP) 2010-2014 (March 2010) (MoH);
• National Water Strategy 2013-2017 (Ministry of Land, Water and Environment (MoLWE));
• National Health Policy 2010 (MoH)
• National Education Policy, 2011 (MoE);
• Strategic Plan on Injury Prevention2 2013 (MoH)
• Girls education Communication Strategy 2010 (MoE)
• Female Genital Mutilation Strategic communication framework 2012 (MoH)
• Hygiene and Sanitation Communication Strategy 2013 (MoH)
• School Health Policy (draft) 2014 (MoE and MoH)
•
•
Situation of Children and Women
There is little current data on the situation of women and their Children in Eritrea. The most current
demographic and health data are from 2010 (data collection) which were published in 2013 as the Eritrea
Population and Health Survey (EPHS). It can be compared to previous DHS rounds in 2002 and 1995.
Judging from these data, the country has made progress in key indicators. Maternal mortality has
steadily gone down. In 2010 it was at 486 out of 100,000 live births, a reduction by half compared to
1995. The infant mortality rate has also been reduced from 72 to 42 and the under-5 mortality rate from
1 Country Programme Action Plan 2013-2016 between The Government of the State of Eritrea(GOSE) and UNICEF 2 Situation Analysis of Children in Eritrea: 2012 (Final Draft: 12 July 2012)
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136 to 63 (1995 to 2010, deaths per 1,000 live births). Eritrea has effectively reached the goals for MDG
4 and 5. HIV prevalence is comparatively low, at 0.93 per cent in 2010 among the general population
compared to 2.4 per cent in 2002.
Despite these successes in improving key indicators, indicators for child development are less
encouraging. Elementary school enrolment rate is still low at 81.1 per cent in 2012/13. Middle school
enrolment declined from 38.3 per cent in 2011/12 to 29.3 per cent in 2012/13, providing little incentive
for elementary school completion. Generally, more boys than girls are enrolled in elementary and other
levels. The quality of education is still weak, with large fluctuation in teachers and consequently high
levels of untrained or under-trained teachers in schools. Girls marry early in Eritrea, with 20 per cent of
women aged 15-49 married by the age of 15 and 49 per cent by the age of 18 years. Early marriage is
also a key factor in dropping out of school. FGM remains prevalent at 83 per cent nationally, but with
clear reductions in some regions of Eritrea. With landmines and unexploded ordinance (UXO) a
continuing problem for some areas, injuries and death from these are significant threats to children's
wellbeing. Eritrea has a significant proportion of orphaned children. In 2010, seven per cent of under
15 year olds grew up as orphans. About 39 per cent of the population still relies on unimproved sources
of water. Open defecation is a strongly ingrained practice along with 86 per cent (2008) of the
population not having access to improved sanitation facilities. A food-scarce country with below
average daily consumption of water, Eritrea has high rates of stunting affecting 50 per cent of children
(2010) while 15 per cent of children are malnourished (wasted). Open defecation, limited understanding
of nutrition issues and limited service-seeking behaviour demarcate bottlenecks on the demand-side of
basic services3.
UNICEF Programme Structure
The UNICEF Country Programme works within the Strategic Partnership Cooperation Framework
(SPCF) between the UN and the Government of the State of Eritrea (GOSE). The SPCF in its five
strategic areas follows the government's priorities, and translates them into eight Outcomes at the
agency level. UNICEF contributes to seven out of these eight outcomes, with a strong focus on the
social services and environmental sustainability outcomes (1, 2, 3, and 7). Table 1 summarizes this
relationship.
Table 1 – UNICEF Programme Structure and relationship to the SPCF
S
PC
F
1. Basic Social Services 2. National Capacity
Development
3. Food
Security and
sustainable
livelihoods
4. Environmental
sustainability
5. Gender Equity
and Advance-
ment of Women
Outcome
1:
Health and
Nutrition
Outcome
2:
Education
Outcome
3:
Protection
Outcome 4:
Capacity
building
Outcome 5:
Stronger
DRR
Outcome 6:
Food and
livelihood
opportunities
Outcome 7:
Access to water,
renewable
energy,
conservation,
environmental
management,
sanitation
Outcome 8:
Gender
responsive
planning and
empowerment of
women
UNICEF Programme Components
U
NIC
EF
Advocacy and Partnerships
Health and
Nutrition
Basic
Education
Child
Protection
Advocacy
and
Partnerships
Child
Protection
WASH Child Protection
WASH WASH PME Basic Education
M&E, Communication for Development C4D
3 ibid
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Focus Areas and Issues
There are five Country Programme components 1) Health and Nutrition, 2) Basic Education, 3) Child
Protection, 4) Water, Sanitation and Hygiene, and 5) Advocacy and Partnership for Children. This
framework recognises the need to focus on fewer and higher impact issues that can add value to the
efforts in strenthening the different sector’s performance. Key issues to be addressed under each focus
area are presented below.
Focus 1: Health and Nutrition
C4D communication objectives for this area are:
To increase knowledge of women of reproductive age about access and utilization of the improved
basic child health interventions (IMCI, EPI) with priority accorded to hard to reach and remote
areas by 2016;
To increase the number of women and primary care giver’s knowledge, attitude and behavior about
the benefits of delivery at health facilities, with priority to hard to reach and remote areas;
To increase the knowledge of mother’s about the IMAM services;
To use multi-media to promote positive social norms around childbirth and child care through the
use of entertainment-education sessions about health through the lifecycle for adolescents;
To improve health service providers’ skills on interpersonal communication, behaviour change
counselling and community mobilization. In the process shifting gender norms and increasing
demand for required services and policies.
Existing cross-sector cooperation are a basis for more coherent programming (e.g. the joint work on
hygiene in schools and health facilities, and the joint work on mine reduction)4 There are more entry
points for strong cross-sector linkages around stunting involving Community Led Total Sanitation
(CLTS), Infant and Young Child Feeding (IYCF), and Early Childhood Development (ECD), to obtain
the desired outcomes. The involvement of Ministry of Health (MOH), Ministry of Education (MOE),
Ministry of Land, Water and Environment (MLWE) and National Union of Eritrean Women (NUEW)
would also be important player in the cross-sectrol partnership along with UN agencies. Health and
Nutrition and Child Protection programmes can combine to use Advocacy and Social Mobilization
initiatives to reduce incidence of FGM/C
Focus 2: Basic Education
C4D communication objectives for this area are:
To create awareness among parents and communities to change attitudes and take specific action to
send children (girls and ODG) to school to complete their basic education through Nation-Wide
Movement by 2016.
To create a paradigm shift in the way girls are viewed and treated by promoting an environment
where girls, ODG and all children completing their education becomes the norm, and are valued.
The C4D strategic approach in this area will include mobilization of the communities in raising
awareness on the value of education especially girl’s education. Also multi-media campaigns to
promote Girls and ODG children education campaigns to send children to school, to enhance the quality
of education advocacy for enabling policy environment and supporting the development or review of
relevant education sector policies and strategies. Child protection and Education Programmes can work
together to use advocacy, social mobilization and SBCC to delay marriage of girls.
4 GOSE-UNICEF Country Programme 2013-2016, Mid Term Analysis, 29 November 2014, pg 14
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The above results can be achieved in partnership with the MOE’s Department of General Education,
Department of Adult and Media Education, Department of Research and Human Resource
Development and its regional and local administrations. Besides, other entry points for strong synergy
can be established with (CLTS, IYCF, ECD), hygiene education, (Basic education and CLTS), and
school enrolment hygiene education and UN agencies.
Focus 3: Child Protection
C4D communication objectives in this area include change in attitudes and behaviours about FGM/C
and ending early marriage among communities that have taken it for granted as a traditional practice.
Strategic approaches in this area will include use of multi-channel and multi-media social and behaviour
change communication with equal emphasis on the use of mass media, local media (including traditional
and modern communication aids) and interpersonal communication by peer educators.
Advocacy for child rights, legal provision and implementing the law; Social mobilization initiatives,
including use of peer education, involvement of Child Marriage Eradication Committees, child clubs
and developing leadership among young girls.
The main implementing partners will be MOE, MOH and MLHW. UNICEF can support MOH on the
boarder integration of prevention of FGM/C and early marriage into the reproductive health
programmes. Through the health promotion and public health debates public awareness and community
social dialogue can be promoted. Involving Ministry of Information (MOI) and civil society partnership
with NUEW and NUEYS can create strong cross sectrol foundation.
Focus 4: Water, Sanitation and Hygiene
C4D communication objectives for this area is to increase the levels of knowledge, attitudes and
behavioural practices related to sanitation and hygiene especially water handling, latrine use, hand
washing and personal hygiene by 2016.
The strategic C4D approaches in this area will include scaling up of the CLTS programme through use
of multi-channel communication. CLTS can be packaged and promoted as the key sanitation and
hygiene concepts and used as tools for advocacy, programme visibility, community mobilization and
programme acceleration. Specific attention will be given to sustainability of ODF. Interventions will
need to address sanitation from the perspective of social norms so that open defection becomes an
unacceptable social behaviour. WASH in schools can develop and disseminate IEC materials to
promote proper WASH practices.
The main implementing partners are zoba infrastructure departments, targeted communities, MOLWE,
MOE and Ministry of Environmental health (MOH), (UNICEF, WHO, UNDP).
Current UNICEF Major Partnership, Convergence &Communication for Development (C4D)
There are opportunities for joint programming under this framework. Harnessing of partnerships for
improved sustainability of behaviour change cut across many areas emphasizing on participation of
families, children and key local personnel, e.g. teachers and health workers to build sustainability
toward improved self-reliance5. UNICEF has major partnership with individual Ministries on specific
activities within each programme component. Other key partners include the National Union of Eritrean
Youth and Students (NUEYS) and the National Union of Eritrean Women (NUEW) especially in areas
of implementation, advocacy and capacity strengthening. This occur with overall coordination via the
Ministry of National Development (MoND).
5 UNICEF Draft country Programme document, E/ICEF/2012
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UNICEF also collaborates with other UN agencies and other international and national partners in
Eritrea. Key international partners include GAVI, Global Fund and Global Partnership for Education.
UNICEF facilitates the engagement of the Government with the latter. This includes UNICEF’s
leveraging of associated resources from international development cooperation partners.
Programme convergence, where multi-sector problems are tackled through cooperation across
programme components is not easy to accomplish in a country with strict separation between sector
ministries. However, there are some promising examples of convergence around issues that are a good
basis for capitalizing on opportunities in this regard. There is cooperation between the WASH, Health
and Nutrition, and, Education Programmes through the Education Working Group where officials from
the Ministry of Health and the Ministry of Education worked together on improving hygiene through
and in schools. The ministries of Water Resources, Health, and Education also jointly participated in
the 2014 Programme Review and Planning for WASH. Building on this will strengthen the effectiveness
of the programme. The Child Protection (CP) Programme works closely with the Basic Education (BE)
Programme on mine risk education. The Ministry of Health, with joint support from the UNICEF
WASH and the Health Section combines hygiene and basic health services at health facility level.
As an enabler of behaviour and social change elements, the UNICEF C4D Specialist provides technical
support to all Sections. Behaviour and social change communication is also a main focus of sector
convergence in the programme. In advocating for children's participation, the Country Programme
works closely with the National Union of Eritrean Youth and Students (NUEYS), a relationship that
had to overcome substantial hurdles in the first two years of the Country Programme which has only
just taken off at the time of the review6. UNICEF C4D provides technical support to the following
ministries and NGOs:
- MOH: on BCC, community based health promotion, construction of community based water
projects and water management;
- MOI: Child-to-child media programmes, multi-media message dissemination;
- MOE: Creating demand for education, especially girls’ education, and addressing social norms
around early marriage;
- MLHW: Child participation; and
- MLWE: Community participation and water management
- NUEW/NUEYS: Gender/Youth Empowerment and Participation in partnership with (Joint
Programme with UNFPA, UNAIDS,UNDP,UNHCR)
Bottlenecks, Challenges and Risks faced by C4D
While the stated outcome for the Advocacy and Partnerships for Children and the
Communication for Development components were approved by GoSE in the 2013-2016
CPAP, GoSE did not grant approval for the Ministry of Information (MoI) and NUEYS as
implementing partners with UNICEF. After sustained negotiation between UNICEF and GoSE,
the Government approved partnership through the Ministry of Labour and Human Welfare
(MLHW). This complicated working modality has significantly affected implementation of the
workplan.
Eritrea does not have a national communication policy which makes media engagement
difficult and sensitive. Deeply rooted social norms and cultural practices related to child
marriage, girls’ education, female genital mutilation (FGM) remains a challenge to sustain
positive behaviour and social change in the hard to reach communities. The need for
empowering rights holders, increasing demand for improved social services, encouraging
6 GOSE-UNICEF Country Programme 2013-2016, Mid Term Analysis, 29 November 2014
11
utilization of existing services is paramount in pushing the C4D agenda in Eritrea. Facilitating
individual behavioural, social and norms changes, promoting engagement and participation of
children, families and communities, and strengthening capacities of national and sub-national
counterparts for long-term and sustained social change will be articulated in the 2015-16 joint
work plan.
Limited knowledge about C4D among partners has also contributed to delays in rendering
support from government Ministries. This requires UNICEF’s commitment, leadership and
investment for optimal integration of C4D into government systems and programmes, enhanced
capacity of government staff on C4D, increased allocation of resources for C4D, and greater
involvement of civil society partners and other stakeholders in social and behaviour change
initiatives.
Lack of sufficient human resources also affected MoI’s capacity in programme management
and delivery of quality results. It’s also noted that the Minister of Information position has not
been re-instated since July 2013.
A planned nationwide media survey could not be completed as a result of inadequate funding
which affects major parts of the sector. This survey would provide information on audiences
and measure impact of media programmes that would guide future programming. The lack of
local research institutions also hampered the implementation of the audience research planned
this year.
Table 2 – Key Bottlenecks
Determinant Identified Bottlenecks
Enabling
Environment
• Government is conservative about receiving funds and extending beyond its
self-funded capacity
• Poor data availability and low complexity of data
• Government has been reluctant to agree to surveys and evaluations
• Horizontal communication between sector ministries is very low, while some
Programme Sections (e.g. Child Protection) work with several ministries –
additional obstacle
• There is no international NGOs in the country
• Exposing ministry staff to learning from other countries through travel is often
not possible due to a number of difficulties within ministries
Supply • Qualified staff regularly leave government services at all levels for better
opportunities, and new staff have to be trained constantly to even maintain a
status quo in services
• Facilities are often in poor condition
• Telecommunications and electricity are inadequate
• Basic construction materials are imported through government agency,
sourcing therefore takes a long time and is expensive
Demand • Social norms and traditional behaviours hinder progress in a number of areas
such as:
Nutrition – resulting in poor childcare and feeding practices attributable
to social norms, existing low levels of awareness of proper practices
Early marriage
FGM/C
Girls’ education
Open defecation
Use of traditional healers
Quality • Field Monitoring is difficult and very restricted
• Available data are not sufficiently disaggregated and mostly facility-centred
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CURRENT UNICEF POGRAMMES & CROSS SECTORAL COLLABORATION – AT A GLANCE
Health &Nutrition
Section
MOH:
EPI,
Child health,
C/IMCI,
PMTCT,
Maternal and
Neonatal health,
IMAM,
Micronutrient,
IYCF and blanket
feeding
MOE
Hygiene in school
Child Protection
Section
MOH:
FGM/C and
prevention, adolescent
development of child
injury
MOE:
Mine Risk education
MLHW:
N/OVC, Community
based rehabilitation
(MRE and disability),
‘donkey for schools’,
Street children,
Child justice
Basic Education
Section
MOE: Quality
education, Policy
Nomadic and
girls education
Out-of-school children
MOH:
Hygiene in school
WASH Section
MOH: Sanitation(CLTS),
Hygiene and Menstrual
hygiene management
MLWE: Construction
of community based
water projects and
water management
MLG: Coordination of water
and sanitation projects
NUEW: WASH and
C4D
Menstrual hygiene
management
Advocacy & Partnership
Section/C4D
MOH:
BCC/community based
health promotion/
Emergency,
Construction of community
based water projects and
water management
MOI: Child-to-child media
programmes,
Multi-media message
dissemination
MOE: Creating demand for
GE/ social norms around
early marriage
MLHW: Child
participation
MLWE: Community
participation and water
management
NUEY/NUEW:
Gender/Youth
Empowerment participation
13
Model for the Cross-Sectoral Strategic C4D Framework
The overall Cross-Sectoral Strategic C4D Framework is multi-sectoral and cross-cutting. The
framework seeks to create synergies and harmonize current efforts by different stakeholders to work
towards a common goal -- to inspire and empower children and adolescents, women, communities and
institutions to become role models and leaders for positive social change; to identify problems, design
solutions and involve decision-makers at all levels. It integrates behaviour and social change approaches
in health, nutrition, water, sanitation and hygiene, protection and education. Concurrently, it addresses
discriminatory practices and harmful social norms across issues. The framework lays out key
behavioural results, barriers and desired changes and strategic approaches that, taken together, can
contribute to broad social and behaviour change. The framework finally integrates the C4D strategic
approach that links different programmes and partners to ultimately work towards common goal that
will benefit the household, community and the villages.
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Strategic C4D Approaches
The approaches for C4D are linked to the communication objectives. They are also aligned with existing
successful communication initiatives of the GoSE, UNICEF and other development partners for Health
& Nutrition, Hygiene and Sanitation, Basic Education and Child Protection. Figure below illustrates the
communication approaches that can be used across the various levels.
These modalities build on the Socio Ecological Model (SEM) model. The following section explains
how each of the modalities have been defined and provides a brief overview of activities that fall under
each category
Planning and Coordination
Planning and Coordination of Cross-Sectoral C4D interventions should be vested in the Ministry of
National Development along with a smaller Task Force to manage day-to-day operations. The C4D
Framework has been designed keeping in mind diverse partners and stakeholders who will contribute
towards achieving the communication objectives and lead certain components or take on initiatives in
specific Zobas. The Coordination Committee and Task force will provide oversight and leadership,
conduct quarterly meetings and manage the transition from Phases-1 to Phase-2. A Creative
Communication Task Force can be established to plan and produce creative materials and media
campaigns. A Monitoring and Evaluation Task Force should be established to roll out the
behavioural monitoring plan and to oversee the mid-term and end-term reviews.
•Form inter-agency and partners coordination mechanism
•Launch the strategic C4D Framework at national and zoba level
•Management and oversight by C4D cross sectoral coordination group
•Establish Creative Communication and M&E Task forces
Planning and Coordination
•Generate high level national political commitment
•Generate multi-sectoral partnerships
•Generate commitment at Zoba levels
Advocacy and Partnership
•Train health workers and WASH promoters (ToT)
•Train community groups on Child Protection (ToT)
•Train teachers on issues related to ODG, FGM/C,WASH in schools
•Train media on child friendly and gender sensitive reporting
Capacity Strengthening
•Carry out media blitz through MOI
•Sustain media coverage on C4D Cross sectoral collaboration
•Develop trans-media Entertainment Education programme
•Utilize IPC, traditional folk media
Media Engagement
•Train and organize children and adolescents
•Engage men and boys
•Mobilize community and religious leaders
Community Mobilization
•Mobilize govt, educational institutions, civil society & UN agencies
•Mobilize law enforcement and protection bodies
•Engage girls and boys for C4D interventions
Social Mobilization
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Advocacy and Partnership
In order to achieve high level commitment and ownership, the cross-sectoral C4D interventions require
concerted advocacy and partnership building. This will entail bringing together relevant ministries and
national bodies such as MoH, MOE, MLHW, MLG, NUEW and NUEY among others. Advocacy will
also need to include Zobas and systems and structures. Partnerships need to be strengthened between
the UN and bilateral agencies working in the country. These high-level partnerships and initiatives will
provide support and financing for what is essentially a decentralized, bottom-up and community-led
initiative.
Capacity Strengthening
Capacity strengthening of stakeholders across all components of the Country Programme is required to
implement the cross-sectoral C4D interventions to achieve the desired behaviour and social changes.
This modality focuses on strengthening capacities of key implementers such as health workers, teachers
and existing community groups (e.g., Children’s and Youth Clubs, Women’s groups, etc.). These actors
will need to be oriented and trained in the focus areas as well as the cross-cutting issues. For instance,
teachers will need to be trained on positive discipline techniques, HWs on inclusive interpersonal
counselling and engaging men and boys. The media will also need to be trained to enhance their skills
in child friendly, gender sensitive and inclusive reporting. This will be a prerequisite for the media
engagement and community mobilization to take place. Once these groups are trained and their
capacities are strengthened, they can in turn train others and the knowledge and skills will reinforce
positive behaviours at the family and individual levels.
Media Engagement
Participatory communication and media engagement are core elements of C4D interventions. They
include mass media, local and digital/social media channels and interpersonal communication (IPC).
They can be used across the SEM levels, contributing to national level advocacy, visibility as well as
changing individual level knowledge, attitudes and behaviours. The media will inform, influence and
will also serve as a feedback mechanism to elicit stories and inputs from children and their families.
C4D recognizes that the boundary between various media platforms is increasingly blurring and aims
to link different media platforms with common messages, themes and story lines. Recognizing that
motivating people to change behaviours and social practices is also dependent on interpersonal
communication, the mass media, social media and IPC components are designed to be mutually
reinforcing and a two-way process. Mass mediated messages will spur dialogue and action and local
level dialogue, voices, and experiences will feed into mediated messages.
Community Mobilization
Mobilizing communities will entail engaging children and adolescents, women, men and community
leaders to promote the key behaviours. Orientation and training on the focus areas as well as select
communication/media skills and Behaviour Monitoring tools will be essential. It is envisioned that these
community members will serve as “triggers” for social change and will promote as well as role model
positive practices. They will also undertake community level behavioural monitoring. Community
mobilization builds on participatory communication models whereby awareness spurs community
dialogue and ultimately leads to community level actions to denounce harmful practices and enforce
new norms. Such an approach is considered empowering as individuals and communities gain both self
and collective efficacy to take positive actions.
Community mobilization should build on the vast existing communication networks in collaboration
with the two government owned CBO’s (NUEY & NUEW) and the presence of a sizeable number of
diverse community groups. There are health volunteers, community-based schools, health facilities,
Water Supply Management Committees as well as social mobilizers. These community groups will be
encouraged to join the C4D cross-sectoral initiatives and serve as important channels to promote social
16
change. Community mobilization has been operationalized as community driven participation and
engagement of community level groups and actors and is differentiated from social mobilization
described below.
Social Mobilization
Social mobilization is the process of bringing together diverse and inter-sectoral partners and allies, to
raise awareness, demand and promote the desired change. This includes eliciting participation of formal
institutions and structures to promote the key behaviours. In addition to local governance structures,
educational institutions (e.g., Teachers Association, Universities), law enforcement and protection
bodies (Army, Police,) should be engaged to promote the key behaviours.
Recommended Steps for C4D Cross-Sectoral Partnership Formation
Working in partnerships, collaborations and coalitions can be challenging. However, it is a powerful
tool for mobilizing stakeholders to action, bringing community issues to prominence and developing
policies. These associations are also effective means of integrating health services with other social
issues so that resources are not wasted and efforts are not needlessly duplicated. Cross sectoral
collaborations are often best equipped to utilize the resources and findings of participants and apply
them more effectively than any single group or organization.
This C4D Framework recommends a step by step approach for making collaboration work efficiently
by building effective partnerships. Rather than creating new projects or programmes, C4D cross sectoral
alliances can harness existing resources to develop a unique community approach and achieve results
beyond the scope of one single institution or organization.
Discuss and analyze the group’s objectives and determine the partnership need(s): A multi-
sectoral approach is a prevention tool, so groups must be specific about what needs to be
accomplished. After the needs have been determined, the group must consider if this approach is
the best approach to meet the identified needs. Groups must ask the following questions:
- What are we trying to accomplish?
- What are our common objectives, expected results and outputs and types of activities
that can be synergized?
- What are community’s strengths and needs that can be jointly addressed?
- What are the pros and cons associated with the proposed collaboration?
Adopt more detailed activities and objectives suiting the needs, interests, strengths, and
diversity of the membership: A key to successful cross-sectoral collaboration is the early
identification of common goals and benefits of working together. The partnership must avoid
competing with its members for funding. An important consideration for adopting specific
collaborative activities is to identify some short-term outcomes. For example, if a joint objective
is boarder integration of prevention of FGM/C and early marriage, the main implementing
partners that can work together will be MOE, MOH and MLHW. UNICEF can support MOH on
integrating this issue into the health programmes. Through the health promotion and public health
debates public awareness and community social dialogue can be promoted. Involving Ministry
of Information (MOI) and partnership with NUEW and NUEYS can create strong cross-sectoral
foundation.
Convene C4D cross-sectoral members: A meeting, workshop or a conference can be
convened. The lead agency such as Ministry of National Development (MND) can plan the first
meeting using a time-specific prepared agenda, a comfortable and well-located meeting area,
and adequate refreshments. It is appropriate to prepare a draft mission statement and proposal
along with structure and membership.
17
Develop budgets and map agencies resources and needs: Lead agencies usually provide staff
time to keep the partnership up and running and to handle detailed work. Though these kinds
of partnerships can usually run on a minimal budget, each member’s time is a valuable
contribution.
Design the C4D cross-sectoral structure: Structural issues of the include:
- Drafting of a ToR
- how long the cross-sectoral partnership will exist,
- meeting locations,
- meeting frequency and length,
- decision making processes,
- meeting agendas,
- membership rules and participation between meetings by subcommittees or planning
groups. (i.e. Task Force on M&E, behavioural research)
- Templates of different structures should be collected prior to the meeting and presented
for discussion to reduce the time needed to make management decisions.
Plan for ensuring the C4D cross-sectoral partnerships vitality: Methods for noting and
addressing problems, sharing leadership, recruiting new members, providing training on
identified needs, and celebrating success can help ensure viability and success. It is very
important to recognize both the individual and organizational contributions each step of the
way.
Evaluate programmes and improve as necessary: Each joint activity and event should
include evaluations. This can be as simple as a satisfaction survey or it could be the more formal
use of pre- and post-tests of specific focus areas or issues.
Phased Approach for Rolling out the Cross-Sectoral C4D Framework (2015-2016)
The strategic C4D Framework is programmed in two phases toward achieving the intended behaviour
and social change results for 2015-2016. This section provides an outline for Phase-1 and broad
directions for Phase-2. Close monitoring and evaluation between the phases will enable programme
managers to review results and accordingly develop the subsequent phase. Detailed implementation and
behavioural monitoring plans will have to be developed prior to each phase.
Phase-1 (2015) Phase-2 (2016)
Sustain and scale up cross-sectoral C4D
approaches
Implement local solutions
Include additional behaviours
Shift from child survival to protection,
development & participation
Intensify local initiatives and actions
Engage children and community in decision-
making
Intensify community & media engagement
Conduct end term review
Formation of C4D cross-sectoral partnership
Set up coordination mechanisms
Conduct Formative Research
Address few joint cross-sectoral issues for
intervention in one selected zoba and
implement local solutions
Pre-test/Pilot concept
Build capacities
Develop and pretest creative, cross-sectoral
C4D media campaigns
Engage communities and promote role models
Pilot tools for behaviour monitoring
Conduct mid-term review
18
Phase-1: – Mid 2015 – This phase is devoted to formation of the C4D cross-sectoral
partnership core group and establishing coordination mechanisms, building capacities to
address essential family behaviours and social practices selected as priorities across the focus
areas in selected pilot Zobas which will be determined.7 In collaboration and consensus with
cross-sectoral partners a high level multi-media campaign should be launched and be
accompanied by advocacy campaigning across diverse media to create a “buzz” at the national
level. Community engagement should also include celebrity role models and generating locally
contextualized solutions during Phase-1. Behavioural monitoring will need to engage multiple
community groups and institutional members and ensure regular feedback mechanisms to
further improve and adapt the interventions. In addition, a mid-term review should be conducted
by UNICEF and partners towards the end of Phase-1 to determine the specific modalities for
Phase-2. A more detailed implementation plan, revised strategic approach, creative materials
and a behavioural monitoring plan would need to be developed for Phase-2.
Phase-2: – 2016 onwards – This phase will include long-term vision beyond the current
country programme cycle and post-2015 MDGs. Phase-2 will entail scaling up and sustaining
the strategic C4D interventions that have effectively gained momentum and traction. It will
also pave the way for piloting additional local initiatives that would evolve from Phases-1.
Community engagement will need to be further enhanced with the community generating and
owning many of the social change initiatives and processes. Overall, it is envisioned that there
will be a shift from the child survival focus to address more issues related to child development,
protection and participation. The strategic approaches for Phase-2 will be identified with
participating cross-sectoral groups and decided upon during the GoSE-UNICEF end of present
Country Programme of Cooperation evaluation/review.
Suggested Monitoring Tools
Record keeping and reporting of C4D activities plays an important role in getting “evidence-base” for
the success of C4D interventions. Daily activities can be recorded in a diary. The reporting forms will
determine what should be recorded in the diary. Below are some suggested areas to monitor.
Behaviour Monitoring Checklist
During monitoring visits to project sites, it is useful to take along a monitoring checklist. Example of
some points to be considered in a behaviour monitoring checklist is given below.
Checklist 1: Audience segmentation.
The primary audience for the activities (it can be an advocacy, social mobilization or SBCC activity) in
this place is: (tick one or more)
□ In-school adolescents □ Out-of-school adolescents
□ Healthcare Workers (doctor, nurse, ANM) □ Community Workers
□ Educators / Teachers □ Parents
Checklist 2: Participation.
The activities (it can be an advocacy, social mobilization or SBCC activity) in this place encourages
participation: (tick one or more)
□ There is evidence of discussion among community members
7 UNICEF and counterparts will define pilot/priority zobas for local implementation and scope of national campaign.
19
□ The intended primary audiences take active part in suggesting activities that they like
□ Audiences are free to speak up
Checklist 3: Behaviour monitoring indicators.
The below are some Process Indicators that can be used as proxies for monitoring behaviour change
Related to Advocacy, Planning and Supervision
No. of C4D planning, supervision and coordination meetings conducted
No. of C4D partners per state/district
No of health workers, teachers, etc. trained on IPC
No of social mobilization activities conducted at state/regional/district levels
No of advocacy activities conducted at state/regional/district levels
Related to cross-sectoral implementation:
No. of health workers, teachers and volunteers with improved IPC skills and knowledge of ANC,
breastfeeding, nutrition, sanitation and hygiene
No. of health education talks conducted at the health centres
No. of health workers with user friendly materials for health education talks
No. of health workers trained on Interpersonal Communication skills
No. of teenage marriage in the state/region/district over 12 months compared to the previous
12 months
No. of health facility deliveries by skilled birth attendants
Reports from health centres on the number of pregnant women’s knowledgeable about high
risk signs and when to seek care
Related to Nutrition:
Reports from health centres on the increased practice of exclusive breastfeeding for at least six
months after delivery
Reports from health centres on trend in consumption of IFA and deworming tablets through
monitoring of stocks (rapid decrease or unchanged distribution on a monthly basis).
Related to Community level:
No. of community mobilisers trained on IPC, community dialogues, data collection, etc.
No. of community activities implemented (Meetings, dialogues, dramas) etc.
No. of households reached per month
Related to WASH:
Reported No. of improved drinking water sources
Reported No. of villages becoming defection free
Reported No. of gender sensitive WASH facilities installed and utilized within 30 selected
elementary schools in rural areas.
20
CROSS-SECTORAL STRATEGIC CONVERGENCE for C4D
Health & Nutrition
Results/outcomes that can be achieved together
• increased proportion of people who are willing
to use latrines and knowledge of sanitation and
hygiene
• reduction in incidents of FGM/C
reduction in incidence of early marriage of girls
Strategic approaches that can work together
• WASH, H/N and Education programmes can
combine through SBCC to increase the
proportion of people who are willing to use
latrines and knowledge of sanitation and
hygiene
• H/N and Child Protection (CP) programmes
can combine to use advocacy, social
mobilization and SBCC to reduce incidents of
FGM/C
• CP and Education programmes can work
together to use advocacy, social mobilization
and SBCC to delay marriage of girls
Partners who can be brought together to
achieve this goal
MOH, MLHW, MLG, MOE, MOI, NUEY,
NUEW, Adult Education Classes, Radio Bana, all
mass media channels, MOC, PTA, NUEYS,
NUEW, Eritrean Union of Workers, Creative
group such as; Association of Eritrean artists,
Music, Theatre and Traditional media practitioners
and UN agencies
Entry points for strong cross-sector linkages
around stunting (CLTS, IYCF, and ECD), hygiene
education (Basic Education and CLTS), and
school enrolment (Community social assistance
and Basic Education)
Sanitation & Hygiene
Communication Objective:
To increase knowledge of women of reproductive age about access
and utilization of the improved basic child health interventions
(IMNCI, EPI) with priority to hard to reach and remote areas by
2016.
To increase the number of women and primary care giver’s
knowledge, attitude and behaviour about the benefits of delivery at
health facilities, with priority to hard to reach and remote areas.
To increase the knowledge of mother’s about the IMAM services
Desired Outcome:
Increased knowledge and practice of EB
Increased knowledge and attitudes for institutional birth deliveries
Increased knowledgeable about a high risk signs and when to seek
care
Key Strategies
multi-media campaigns to promote positive social norms around
childbirth and childcare
entertainment-education sessions about health through the lifecycle
for adolescents
Communication Objective
increase knowledge about sanitation and hygiene especially water
handling, latrine use, hand washing and personal hygiene by
2016.
Desired outcomes
80 selected communities have knowledge of handling water
supply
Increase the proportion of people who are willing to use latrines
in 300 villages
Key Strategies
scale up CLTS programme through multi-channel communication
Package and promote the key sanitation and hygiene concepts and
use them as tools for programme visibility, community
mobilization and programme acceleration
Basic Education Child Protection
Communication Objectives
To create awareness among parents and communities to change
attitude and take specific action to send children (girls and ODG)
to school to complete their basic education through Nation-Wide
Movement by 2016.
To create a paradigm shift in the way girls are viewed and treated
by promoting an environment where girls, ODG and all children
completing their education becomes the norm, and are valued.
Desired outcome
Change of attitudes to accept and increase Girls and Other
Disadvantaged Groups children going to school
Key Strategies
multi-media campaigns to promote Girls and ODG children education
Communication Objective
to change attitudes and behaviours about FGM/C and early
marriage among communities that have taken it for granted as a
traditional practice.
Desired Outcome
Increased knowledge and change of attitudes towards effects of
FGM/C and early marriage
Key Strategies
Advocate child rights, legal provision and implementing the law
and act.
Social mobilization initiatives, including: peer education; Child
Marriage Eradication Committees; child clubs and developing
leadership among young girls
Behaviour change communication multi-channel
communication approach with equal emphasis on mass media,
local or other types of media (including traditional and modern
communication aids) and interpersonal communication by peer
educators
21
Annex-1: Summary of Programme Units Analysis Summary of Programme Units Analysis
Programme
Unit
Importance of
this area
Goals
2013-2016
Hard to reach
and remote areas
Expertise
brought to
collaborative
Assets &
Strengths
Current key
strategies
Desired
outcomes
Data Partner-
ships
Benefits of
participating in
this
collaboration
Health &
Nutrition
- Neonatal
deaths
- Low level of
skilled
assisted
delivery
- breastfeeding
- Iodine
deficiency
disorder
- stunting
- poor quality
of basic
services
- limited
access to
health
facility
- insufficient
referral
capacity.
1. access and
utilization of
basic package of
child health
services and
interventions
(IMNCI and EPI
services)
improved
2. access and
utilization of
basic package of
maternal health
services &
interventions
improved
3. underweight
prevalence
among under-
five children
reduced
EPI, Child
health,
C/IMNCI,
PMTCT,
Maternal &
Neonatal
health,
IMAM,
Micronutrient,
IYCF and
blanket feeding
Training,
Funding,
Technical
support in Health
& Nutrition
inter-sectoral
approach to
health;
involving
community
participation;
ownership of
policies
partnerships
with donors.
(ODI, 2011, p
27)
Increased
practice of
exclusive
breastfeeding for
at least six
months after
delivery
More health
facility deliveries
by skilled birth
attendants
Mother are
knowledgeable
about high risk
signs and when
to seek care
EPHS
2010,
NSSS
2010,
HMIS
2010
KAP
Child &
Nutrition
2010
MOH,
MLHW,
MLG,
MOE,
MOI,
NUEY,
NUEW,
Support all
important child
health issues
policy.
FGM/C and
prevention,
adolescent
development of
child injury,
Sanitation
(CLTS), Hygiene
and Menstrual
hygiene
management,
BCC/community
based health
promotion/
Emergency,
Construction of
community
based water
projects and
water
management
22
Programme
Unit
Importance of
this area
Goals
2013-2016
Hard to reach
and remote areas
Expertise
brought to
collaborative
Assets &
Strengths
Current key
strategies
Desired outcomes Data Partner-
ships
Benefits of
participating in
this
collaboration
Basic
Education
54% of OOSC
are females,
Nomadic
education
Equity of access to basic education
for about 100,000
children (emphasis
on girls) in
Anseba, Gash
Barka, Southern
Red Sea, Northern
Red Sea and
Debub through
formal and NFE.
Quality:, learning
outcomes
improved for all
children
successfully
advocated for
nomadic
education ,
mainstreamed
Nomadic
Education into
the Education
Management
Information
System (EMIS)
of MOE
Funded the
capacity
building
workshops for
national and
Zoba level
education
officials
Supporting the
MOE to
conduct the
Out of School
Children
initiative in
collaboration
with UNESCO
Institute of
Statistics and
UNICEF
ESARO.
Training,
Funding,
Technical
support in Basic
Education
Production &
dissemination
of curriculum
instructional
materials
Promoting co-
curricular
activities
including
learning
competitions,
Capacity
building of
untrained
teachers
through in-
service
programmes,
Affirmative
action for
females
teachers and
students, in
partnership
with NUEYS,
NUEW.
Advocacy to
deploy
qualified
teachers to
disadvantaged
areas.
Equity of access to basic education
for about 100,000
children (emphasis
on girls) in
Anseba, Gash
Barka, Southern
Red Sea, Northern
Red Sea and
Debub through
formal and non-
formal education.
Quality: by 2016,
learning outcomes
improved for all
children
EMIS
2011
MLA
MOE,
MOH,
MOI
MLHW,
MLG,
NUEY,
MOD
Policy on
FGM/C
Prevention of
early marriage
WASH to
provide child
friendly learning
spaces by
providing timely
information on
growing up and
water and
sanitation
facilities to
schools and
learning centres.
extend coverage
of the Mine risk
education in
collaboration
with Child
protection
programme
Education
interventions to
nomadic
education
centres,
Integrate former
street children
into the formal
school system.
23
Promote flexible
learning routes
for OOSC.
Leverage
partnerships with
communities to
foster and sustain
demand for
education
24
Programme
Unit
Importance of
this area
Goals
2013-2016
Hard to reach
and remote areas
Expertise
brought to
collaborative
Assets &
Strengths
Current key
strategies
Desired
outcomes
Data Partner-
ships
Benefits of
participating in
this
collaboration
Child
Protection
FGM/C
Prevention of
adolescent &
child injury ,
Early marriage
Mine Risk
education
N/OVC,
Community
based
rehabilitation
( MRE and
disability ),
‘donkey for
schools’,
Street children,
Child justice
By 2016, Children
and adolescents at
risk are protected
from harmful
practices,
exposure to
injuries, violence
and exploitation,
FGM/C practice
reduced among
under 15 girls,
Integrated
National Social
Welfare
Assistance System
strengthened.
Joint work plan
Advocacy for
finalization of
draft policies
and strategic
plans.
increase and
strengthen the
Child Protect-
ion data
collection
method and
management
information
Review and
develop relevant
Child Protection
and/or
Communication
strategies.
Training,
Funding,
Technical
support
comprehensive
and sector-wide
community-
based
programme on
prevention and
reduction of
child injuries
32 Adolescents
and Child
Friendly
Spaces
nationwide
villages
established,
Advocacy for
FGM/C free
villages
ongoing
promulgation
that banns
FGM/C
Abandonment
and abolition of
harmful
traditional
practices of
FGM/C
Ending of early
marriage among
girls under 15
years
HMIS
2013
MoH,
MOE,
MOI,
MLHW,
NUEW,
NUEYS
the local
administrat
ions in the
6 Zobas
Basic
education
Support all
important child
health issues
policy.
FGM/C and
prevention of
early marriage,
Mine risk
Education
25
Programme
Unit
Importance
of this area
Goals
2013-2016
Hard to reach
and remote
areas
Expertise
brought to
collaborative
Assets &
Strengths
Current key
strategies
Desired
outcomes
Data Partner-
ships
Benefits of
participating in
this collaboration
WASH Water is
extremely
scarce in
Eritrea.
Poor water
and sanitation
standards
directly linked
to leading
causes of
mortality and
morbidity –
notably,
diarrhoeal
disease
Overall,
access to safe
water and
sanitation in
Eritrea is still
low
80 selected
communities have
environmentally
sustainable
improved
drinking water
sources, through
construction of
appropriate and
environmentally
sustainable water
supply systems
and capacity
development of
GoSE.
300 villages
become open
defecation free.
Gender sensitive
WASH facilities
installed and
utilized within 30
selected
elementary
schools in rural
areas
Focus on
evidence base
and data
collection
Improve cross
sectoral
linkages &
synergies.
Greater focus
on real time
monitoring
(MoRES)
framework.
Capacity building
of GoSE
partners,
Advocacy for co
funding–
leveraging
resources,
High level
advocacy
Allocation of
greater
percentages of
GoSE
budgets,
capacity
building of
GoSE partners
for planning,
implementing
and
monitoring
WASH
programmes.
Recruitment
of additional
UNICEF
capacity to
conduct field
monitoring &
assessments.
80 selected
communities
have improved
drinking water
sources,
300 villages
become defection
free,
Gender sensitive
WASH facilities
installed and
utilized within 30
selected
elementary
schools in rural
areas.
(WHO/UNIC
EF, 2010, p.
43).
MoLWE,
2012, p. 90),
MOH:
MLWE:
MLG:
NUEW
MOE
MOI
Sanitation
(CLTS), Hygiene
and Menstrual
hygiene
management
Construction of
community based
water projects and
water management
Coordination of
water and
sanitation projects
26
Programme
Unit
Importance
of this area
Goals
2013-2016
Expertise
brought to
collaborative
Assets &
Strengths
Current key
strategies
Desired
outcomes
Data Partner-
ships
Benefits of
participating in
this
collaboration
Advocacy
&
Partnership
(handling
M&E,
External
Comm.&
Donor
Relations
Data for
development)
Cross cutting
program
supports all
above
programmes
Enhanced
Capacity of the
MOI & NUEW,
NUEYS
Enhance national
media capacity to
design and
monitor children
and youth
participation in
Intersectoral C4D
strategy and
communication
policy developed
and implemented
National media
capacity to design
and monitor
children and
youth
participation
programmes
C4D, M&E,
Capacity
building
Training,
Funding,
Technical support
Strategy
developed for
Girls
education,
FGM/C, EPI,
WASH.
Initiated
several
advocacy
meetings with
the (MoI) for
the
development of
a national
communication
policy.
60 youth media
journalists were
equipped with
message
design,
packaging and
broadcasting
skills
Enhance
capacity of
media
programmers
and health
promoters in
message design
and
dissemination;
child-sensitive
photography
and C4D
Activity Report MOH:
MOI:
MOE:
MLWE:
NUEW:
UNFPA,
UNAIDS,
UNDP
and
UNHCR
NUEYS
BCC/community
based health
promotion/
Emergency
Construction of
community
based water
projects and
water
management
Child-to-child
media
programmes,
Multi-media
message
dissemination
Creating
demand for GE/
social norms
around early
marriage
Community
participation and
water
management
Youth
empowerment
and participation
Gender related
programmes
27
Annex-2: Proposed Communication Objectives and Communication Indicators for the Programme Sectors
Health & Nutrition
PCR Outcome 1:- By 2016, access and utilization of basic package of child health services and interventions (IMNCI and EPI services )improved with priority to
hard to reach and remote areas
PCR Outcome2: By 2016, access and utilization of basic package of maternal health services and interventions improved with priority to hard to reach and remote
areas (PMTCT/MH)
PCR Outcome 3:-By 2016, underweight prevalence among under-five children reduced from 38% (2010) to 23% with focus on most disadvantaged groups and in
hard to reach and remote areas
Communication Objectives:
To increase knowledge of women of reproductive age about access and
utilization of the improved basic child health interventions (IMNCI, EPI)
To increase the number of women and primary care giver’s knowledge,
attitude and behaviour about the benefits of delivery at health facilities
To increase the knowledge of mother’s about the IMAM services.
Communication Indicators:
Proportion of women of reproductive age know where to get IMNCI & EPI services
Proportion of women who know the benefits of delivery at health facilities and are
favourable to having their deliveries in health centres
Proportion of mothers who know about IMAM services
Basic Education
PCR Outcome 4: Equity of Access: 95,000 out of school children aged 6-16 enroll into basic education by 2016 (with particular emphasis on girls) in Anseba, Gash
Barka, Southern Red Sea, Northern Red Sea and Debub.
PCR Outcome 5: Improved Quality of Education: Quality of education enhanced leading to improved learning outcomes for all children by 2016 (minimum
standards applied, with guidelines developed and used)
Communication Objectives (Immediate)
To create awareness among parents and communities to change attitudes
and take specific action to send children (especially girls and ODG) to
school to complete their basic education through Nation-Wide Movement
by 2016.
Communication Objectives (Long Term)
To create a paradigm shift in the way girls are viewed and treated by
promoting an environment where girls, ODG and all children completing
their education becomes the norm, and are valued.
Communication Indicators
% Change in knowledge and attitudes of target audience to send children(girls &Other
Disadvantaged Groups(ODG)-Over aged out-of-school children (10-14yrs), children of
nomadic communities, children with disability to schools to complete basic education
% Expressed intentions of the target audience to send children (girls and ODG) to
school and complete their basic education
% Changes in behavior of the target audience in promoting an environment where
girls, ODG and all children completing their education becomes the norm, and are
valued
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WASH
PCR Outcome 6: Rural Water Supply: 80 selected communities have environmentally sustainable improved drinking water sources. The emphasis is on service
provision, through construction of appropriate and environmentally sustainable water supply systems and capacity development of GoSE and communities improved
coordination, planning, operation and maintenance and sustainability of systems.
PCR Outcome 7: Sanitation & Hygiene: 300 villages become open defecation free.
PCR 8: WASH in Schools: Gender sensitive WASH facilities installed and utilized within 30 selected elementary schools in rural areas
Communication Objectives
• To increase the knowledge people have about
sanitation and hygiene, by developing positive
attitudes and motivate them to practice water
handling and latrine use, hand washing and
personal hygiene by 2016.
Communication Indicators8
• % Decrease in the proportion of people who believe that it is fine to defecate in the open
• %Increase the proportion of people who wash hands with water and soap after defecating, before
handling or preparing food and before eating
• %Increase the proportion of households that keep their food clean
• %Increase the proportion of schools with clean compounds and surroundings
Child Protection
PCR Outcome 9:. Children and adolescents at risk protected from harmful practices, exposures to injuries, violence and exploitation. Female Genital
Mutilation/Cutting (FGM/C) and (Early Marriage)
PCR Outcome 10: Integrated National social welfare system strengthened
Communication Objectives (FGM/C)
• The communication for development objective is to attain a permanent
change of attitudes and behaviours about FGM/C among individuals
and communities that have taken it for granted as a traditional practice
Communication Objectives (Early Marriage)
The communication for development objective is to reduce and
change of attitudes and behaviours about early marriage of
girls/boys before 18 years among parents and communities that
have taken it for granted as a traditional practice
Communication Indicators(FGM/C)
% of Individuals that have changed their attitudes towards FGM/C for their
daughters under 15 years
% of Communities that have attained changes in their behaviour and do not take
FGM/C of girls under 15 years as granted traditional practice
Communication Indicators (Early Marriage)
% of parents that have changed their attitudes towards early marriage and get
their daughters/sons married only after 18years
% of Communities that have attained changes in their behaviour and do not marry
their girls/boys before they become 18 years
8 Communication Strategy for Sanitation and Hygiene in Eritrea 2013-2016, Ministry of Health Eritrea, Asmara- January 2013
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ANNEX 3: Analysis of existing KABP, Perceived Barriers and Desired Changes for Programme sectors
Programme Unit Existing KABP Perceived Barriers Desired Change Key Messages
Health& Nutrition 4 ANC visits by for mothers with no
formal education
Overall knowledge in breastfeeding was
high but did not translate into practice at
the household level
Low % of mothers had initiated
breastfeeding 24 hours after birth
Complementary feeding initiated earlier
around 4mths.
Majority of caregivers had knowledge that
a sick child should be given more food and
liquids, but the practice was to give less
thinking it would increase the diarrhea in
the children
Knowledge about Child complete
vaccination at 9 months is lower among
illiterate mothers
Gender Norms wherein women
tend to eat last and the least
Lack of awareness and knowledge
by families, communities and
women of the high risk signs and
when to seek care
Cultural practices surrounding the
feeding of pre-lacteal and those
negative health seeking practices
for a child who has diarrhoea
Increased knowledge and practice
of IMCI/EPI
Increased knowledge and attitudes
for institutional birth deliveries
Increased knowledgeable about a
high risk signs and when to seek
care
Increased knowledge about
immunization
Seek antenatal care
Breastfeed your baby
exclusively for six months
Get child immunized
Basic Education Lack of awareness and undervaluing the
benefits of formal education especially to
for girls,
Early marriage,
Son preference
Negative cultural practices like stigma
against children with disabilities,
Belief that formal education corrupts the
morals of children
Other hidden societal norms and values
that determine individuals’ and
communities’ mind sets and behaviour
regarding girls education and their status in
society
Girls do not have equal status in
society,
Girls are burdened with house hold
duties than boys
Temporary habitats of semi-
nomadic tribes,
Not enough facilities for disabled
children,
Lack of value for educating
girls/ODG,
Girls are vulnerable to sexual,
exploitation,
Lack of inspiring role models and
icons
Lack of community based early
learning opportunities
Every child in school learning and
attaining her/his full potential.
To increase Girls and Other
Disadvantaged Groups access to
education
“Our daughters are Pride for us
and the Nation”
“We take a vow that our
daughter will marry only after
she has completed her
education”
“Our daughter used to do lot of
household work, but now we
realize that is more important
for her to go to school”
“We want our children to go to
school, as they deserve better
life than we had”
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Programme Unit Existing KABP Perceived Barriers Desired Change Key Messages
WASH Water Supply
People washing hands with water and soap
are only 50%, before handling food 40.9%,
before eating 46.6%
People draw water from unprotected water
source
Some water sources are not separated
from laundry and for animals to drink
People do not wash hands before drawing
water
Many people are not aware that it is
important to protect water sources
Sanitation & Hygiene
47.3% without access to latrines.
94.7% of the population desires to own
their own latrines, indicating a large unmet
demand.
61% of children living in the rural and
semi-rural areas defecate in the open
Urban areas have greater access to sanitary
fecal disposal facilities (92%) than semi-
rural areas (55.4%) and rural areas 24.9%.
30% believe that it is fine to defecate in the
open so long as you are hidden
The practice of open defecation is still in
place and many people defecate in the open
Some people say that defecating in the
open is good because it does not confine
you in a small space and allows people to
engage in conversation as they defecate
Lack of knowledge that water can
get contaminated and cause
diseases and should be treated
Some believe that bathing with
cold water makes children and old
people sick with colds and chest
pain
Lack of knowledge that not
washing hands can contaminate
water
Lack appropriate water storage
containers and drawing cups
People complain that they walk
long distances to get water so they
use water for more essential
purposes only
Sanitation & Hygiene
Lack of knowledge that OD can
lead to contamination of water
sources and diseases.
Boil or chlorinate drinking water
People washing hands with water
and soap before handling food
before eating
Increased awareness about latrine
use
Wash your hands with water
and soap:
After cleaning a baby who has
defecated,
Before handling or preparing
food
Before eating
Before breastfeeding or
feeding the baby
Construct and use a latrine for
faecal disposal, keep your
latrine clean
Train small child to defecate in
a potty, collect the faeces of
your child and throw in a
latrine
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Programme Unit Existing KABP Perceived Barriers Desired Change Key Messages
Child Protection FGM/C
Traditional religious and cultural practice
12.9% FGM/C prevalence for under five
vis-à-vis 83 % for older women, with huge
regional disparities;
By doing FGM/C women will be more
faithful to their husbands
Early Marriage
Currently no direct intervention related to
child marriage
According to EPHS 2010, among women
aged 25-49, 20 % were married by age 15
and 49 % were married by age 18.
EPHS 2010 revealed that the main reason
for dropping out of school for 69 % of
women and 39% of men was early
marriage
Social Norms
Traditional religious and cultural
practice
Abandonment and abolition of
harmful traditional practices of
FGM/C among girls under 15 years
Abolition of Early Marriages
“FGM/C is harmful and
violates the rights of girls and
women”.
“Our daughters are Pride for us
and the Nation”
“ I will only marry when I have
finished my education”
“My vision for new Eritrea is
where everyone is educated”
32