Rwanda

Rwanda: UNICEF humanitarian appeal for children and women Jan - Dec 2002

Format
Appeal
Source
Posted
Originally published

Attachments


UNICEF Rwanda Financial Summary
US$
Health - vaccination campaigns
1,755,000
Health - integrated approach to child survival in unstable areas
735,000
Nutrition
495,000
Water and sanitation
710,000
Education - non formal education
235,000
Education - opportunities for vulnerable children
265,000
Child protection - orphans and vulnerable children
880,000
Child protection - children affected by armed conflict
1,120,000
HIV/AIDS prevention
450,000
Emergency preparedness
350,000
TOTAL
6,995,000

Country background - situation of children and women

Situated in the conflict endemic and poverty-stricken Great Lakes Region of Central Africa, Rwanda is a nation struggling to recover from the devastating effects of the 1994 genocide while also addressing its very real demographic, developmental and human resource constraints. With an estimated population of 8,342,000, Rwanda is one of Africa’s most densely populated countries; nearly 300 people inhabit each square kilometer; approximately 95% of the population are subsistence farmers living in rural areas; and, more than 70% of the population live under the poverty line. Revenues of poor households come mainly from agricultural production, while industrialization and urbanization are low.

Since the catastrophic genocide of 1994, which had a devastating impact on economic and social indicators, the Government of Rwanda has attempted to stabilize the economy and put in place a programme to move the country from conflict and emergency to peace and stability. Although considerable progress has been made, it was clear from the recent social sector expenditure review that the Government could not cover the entire costs of the necessary social services improvements.

No official IDP or refugee figures have been published for the last few years; however, frequent population movements often occur along the boundaries with DRC, Burundi, Uganda and Tanzania. This situation, which is linked to the political development of the neighbouring countries, often has humanitarian implications for Rwanda.

The problems faced by Rwanda are not entirely due to the events of 1994 alone. Like most sub-Saharan countries, Rwanda is faced with the growing impact of HIV/AIDS, which has the potential to significantly worsen the already difficult situation.

The floods of September and October 2001 demonstrate the vulnerabilities in high altitude regions. In addition, the lack of protective measures to control soil erosion increases the risk of natural disasters in these regions. Similar disasters are likely to occur again in high altitude regions during future rainy seasons.

Malnutrition remains problematic as 43% of children are suffering from chronic malnutrition. In addition, minimal knowledge exists vis-à-vis home management of child illnesses and feeding practices (39% of children are not breastfed exclusively for the first four months of life); maternal care is inadequate (31% of births are attended by skilled personnel) and there is a high prevalence of associated diseases (malaria, diarrheoa, ARI).

Therefore, due to the continued civil unrest in the Great Lakes, the natural disasters within Rwanda, the rise of HIV-AIDS and the existing demographic and developmental constraints, the situation of vulnerable groups in Rwanda is in fact worsening. Rwanda’s high numbers of female-headed and child-headed households, orphans (27% of all children), street children, and child soldiers is of grave concern. In addition, in a country where birth registration is essential for receipt of assistance and guarantees from the State, it is greatly worrying that one out of every three Rwandan children is not registered at birth.

UNICEF country focus

From 1998-2000 UNICEF supported a programme aimed at bridging emergency and development activities. Based on the outcomes of that programme, and UNICEF’s corporate goals as outlined in the Medium Term Strategic Plan (MTSP), a new six year Country Programme (CP) of cooperation was agreed with the Government of Rwanda, to cover the years 2001-2006. The CP aims at ensuring that child rights are realized in Rwanda. To this end, a decision was made to focus UNICEF’s programming activities on the decentralized level in the most poverty-stricken and conflict endemic portions of the country: namely in the insecure northwestern provinces of Gisenyi and Ruhengeri and, as indicated in the map above, along the Rwandan borders with DRC and Burundi. Taking into account the situation briefly described above, the programme focuses on the following areas:

  • Child survival, growth and development.
  • Education, development and protection.
  • HIV/AIDS prevention and child participation.
  • Social planning and rights advocacy.

Within specific sectors, this focus is reflected on a number of key priorities.

Health and nutrition

  • Reduce mother-to-child transmission of HIV/AIDS.
  • Eliminate neonatal tetanus.
  • Eradicate poliomyelitis.
  • Reduce infant and child deaths related to malaria, acute respiratory infections and diarrhoea.
  • Reduce numbers of measles cases.
  • Reduce maternal deaths related to eclampsia, post-partum hemorrhage and severe anaemia.
  • Reduce the malnutrition rate amongst under-five children.
  • Ensure sound feeding practices of infants from HIV positive mothers.
  • Eliminate vitamin A deficiency.
  • Reduce the prevalence of anaemia amongst under-five children.

Water and environmental sanitation
  • Increase access to safe water in rural areas.
  • Improve sanitation conditions and hygiene practices in programme areas.
  • Advocate for water and sanitation systems to be managed by community associations.
  • Support water and sanitation facilities and promotion of good hygiene practices in primary schools.

Education and child protection

The overall objective of this section is to ensure the realization of children’s right to a quality education while recognizing the role of education as the main preventive strategy against vulnerability, abuse and exploitation.

Non-formal education

  • Complementary education opportunities (CEO), non-formal education (NFE) and catch-up education.
  • Develop a NFE curriculum and policy with the Ministry of Education.
  • Build capacity through the training of teachers.
  • Open pilot centres.
  • Reintegrate children into the formal education system.

Education opportunities for vulnerable children
  • Reinforce NGO partners to respond to the education needs of vulnerable children.
  • Ensure access to education for vulnerable children.
  • Secure behavioural change vis-a-vis HIV transmission amongst vulnerable children.
  • Reduce hazardous and exploitative forms of child exploitation .

Child protection

In the area of orphans and vulnerable children, the objective is to reinforce the social service delivery system and capacity of stakeholders to care for and protect orphans and vulnerable children, in particular those affected by HIV/AIDS, thereby reducing their vulnerability.

  • Reinforce the legislative and policy framework for the protection of orphans and vulnerable children.
  • Strengthen capacities of central and local authorities in planning and developing mechanisms to protect orphans and vulnerable children, provide access to social services and monitor their situation.
  • Develop community based mechanisms to provide care and protection for the most vulnerable children, in particular those affected by HIV/AIDS.
  • Facilitate access to social services for orphans and vulnerable children.

In the area of children affected by armed conflict (CAAC) and former child-combatants, the objective is to ensure the protection of former child combatants, assist with their reintegration into society, and to provide assistance to other CAAC.
  • Provide care and protection for former child-combatants.
  • Trace their families and prepare the children and families for reunification.
  • Support reintegration through community based interventions and the establishment of appropriate protection mechanisms.
  • Train civilian and military authorities on child rights and protection.
  • Develop mechanisms for cross-border collaboration regarding unaccompanied minors and child combatants.

HIV/AIDS prevention

The overall objective of this section is to reduce the transmission and prevalence of HIV/AIDS/STI among young people and develop their capacity to identify, claim and realize their rights to participation in decision-making for positive behaviour change, and to mitigate the socio-economic impact of the HIV/AIDS pandemic.

  • Increase HIV/AIDS awareness among the youth in those areas of the country that experience endemic instability.
  • Support community-based interventions to promote HIV/AIDS prevention amongst both in-school and out-of-school adolescents, and develop psychosocial life skills among this group.
  • Support HIV/AIDS education and prevention programmes that target new groups of people (especially women and youth) who are coming into the country as a result of instability in the Great Lakes region (refugees, returnees and ex-combatants).

Emergency response and preparedness
  • Support social information systems in central and decentralized government, thereby updating the situation analysis of children and women in Rwanda.
  • Provide support in introducing the Government’s monitoring systems.
  • Establish community-based monitoring and evaluation systems for sectoral programmes to prepare baseline data for the 2001-2006 programme of cooperation.
  • Strengthen the planning, early warning and impact-evaluation mechanisms within UNICEF’s country programme in Rwanda.
  • Enhance the readiness of UNICEF’s Rwanda country office to response to calamity.

UNICEF humanitarian action 2001

Notable achievements in 2001

Immunization

  • During 2001, support was given to NIDs and was aimed at the eradication of the wild polio virus, a significant reduction in infant mortality due to measles and a significant reduction in vitamin A deficiency.
  • An average 97% coverage rate achieved for OPV through two rounds of immunization.
  • 93% coverage rate achieved for measles vaccinations.
  • An average 89% coverage of vitamin A supplementation achieved over two rounds.

Nutrition
  • During 2001, UNICEF was active in assisting with efforts to deal with the constant high levels of malnutrition in the country.
  • The provision of supplies to health centres, including therapeutic milk (39MT of F-100 and 850kg of F-75), supplementary and therapeutic OXFAM kits, anthropometrics materials, IEC materials, etc.
  • A study on the current approach to emergency nutrition rehabilitation and the subsequent development of improved protocols.
  • The development of a Memorandum of Understanding as a basis for collaboration between UNICEF, WFP and the Ministry of Health.
  • Technical support to emergency nutrition interventions in Bugesera (a drought-prone part of Rwanda) and Mudende (in the unstable northwestern province of Gisenyi).
  • The nutrition programme also collaborated with NIDs, by supporting the distribution of vitamin A capsules.

Water and environmental sanitation

During 2001, UNICEF supported the planning and construction of community water and sanitation facilities, through the following activities:

  • Procurement of materials.
  • Financing of implementation through partner NGOs.
  • Development and printing of materials for the training of committees, technicians, hygiene promoters and school sanitation programmes.
  • Collaboration with the Ministry of Water, Energy and Natural Resources and the World Bank Water and Sanitation Programme, to develop an approach to hygiene promotion and school hygiene and sanitation programmes.

Non-formal education

During 2001, UNICEF supported the preparation of a non-formal education system by:

  • Fieldwork at grassroots levels, which included a sensitization campaign promoting "education for all" targeting girls and vulnerable children in particular.
  • The campaign highlighted the three provinces that were particularly affected by the phenomenon of "out-of-school children".
  • Assisting communities and local authorities to develop sustainable mechanisms to support the most vulnerable children during the catch-up phase.
  • Children participated in the decision-making process by deciding to have two shifts of classes each day because of their work commitments.

Orphans and vulnerable children
  • During 2001, UNICEF continued to support programmes to address the situation of orphans and vulnerable children in Rwanda, most of whom are victims of the 1994 genocide. The new emphasis during 2001 was vis-à-vis the HIV/ AIDS pandemic.
  • Support to the Ministry of Local Government and Social Affairs in proceeding with legal revisions (i.e. adoption and fostering, draft law on child protection) and policy development (i.e. draft guidelines for unaccompanied children in institutional care; inclusion of policy for orphans and vulnerable children in provincial action plans; plan of action and draft policy on street children).
  • About 12 000 orphans - including those in child-headed households and other vulnerable children - were assisted through ten local NGOs by school reintegration, income generating activities, vocational training, life skills (in particular HIV/AIDS sensitization), children’s associations and recreational/cultural clubs.
  • Training of partners, local authorities, NGOs and communities on child rights, HIV/AIDS and participatory techniques.
  • Advocacy regarding free access for children to governmental support and services.

HIV/AIDS prevention

In 2001, HIV/AIDS awareness and prevention was a UNICEF priority and in fact was integrated into all UNICEF programmes. Achievements included:

  • HIV/AIDS education, information and communication materials distributed to all former child combatants captured in the northwest during rebel insurgencies. UNICEF supported a team of facilitators from the province to animate the HIV/AIDS education sessions and to provide psychosocial support to the children.
  • Supporting Gisenyi province to implement a community-based HIV/AIDS information, education and communication programme for IDPs and refugees. In this regard, UNICEF collaborated with UNHCR and Gisenyi provincial authorities.

Emergency preparedness
  • In 2001, this activity focused primarily on the development of monitoring, evaluation and planning tools.
  • Training and orientation sessions were conducted for both UNICEF professionals and their counterparts for data collection and management, study designs and assessments, and monitoring plans and mechanisms.
  • In addition, technicians from the Department of Statistics were trained in statistical software packages with a view to strengthening their capacities in data processing and analysis, in particular for rapid assessments.
  • Networked with UNICEF offices in Burundi, Tanzania, and DRC; including, a meeting held with the Burundi and Tanzania offices and UNICEF’s Regional Office regarding child protection and emergency preparedness.
  • Played an active role in the preparation of a UN contingency plan.
  • A sub-office was established in Gisenyi to support vulnerable groups and strengthening emergency preparedness in the insecure north-west.

Constraints and lessons learned in 2001

Two key constraints had a marked impact on UNICEF activities in 2001; under-funding in most sectors and limited capacity within state structures. These issues are gradually being addressed; however, funding is still required to address them fully. In the education sector, as non-formal education and life skills are innovative approaches in the Rwandan education system, the development of the curriculum was delayed numerous times. The lack of life skills education expertise within the Ministry of Education also contributed to the overall delay of the programme. The weak integration of protection activities for orphans and vulnerable children within the overall programme areas also limited the scope of projects in the child protection sector. In HIV/AIDS related work, the gains made in 2001 have supported UNICEF’s primary goal of raising awareness and increasing knowledge of HIV/AIDS to ultimately lead to the adoption of behaviour that will prevent the spread of HIV/AIDS. This has been particularly important in the unstable parts of the country. However, more work certainly needs to be done to ensure that all young people adopt behaviour to reduce the risk of HIV infection in future years.

UNICEF planned humanitarian action 2002

Health - vaccination campaigns for measles and poliomyelitis

The measles campaign is to be countrywide and targets all children from nine months to 15 years of age. Measles is a major cause of childhood illness and death in Rwanda, particularly in the unstable areas where routine immunization is more difficult to achieve. It is felt that a one-off campaign of this kind will make a major impact in reducing the measles prevalence.

The polio campaign will target specific areas of the country where previous coverage has been low and/or are vulnerable due to location near to the border with the DRC. The coverage of polio immunization in the DRC is relatively low and the country is still a reservoir for the wild virus. This makes Rwanda vulnerable, due to the movement of people between the two countries, and it is felt that a sub-national campaign, aimed at these vulnerable areas, is necessary.

The requirements for the campaigns are:

  • 5,255,553 doses of measles vaccine.
  • 2,356,275 doses of OPV.
  • 4,340,000 auto-destruct syringes.
  • 564,000 reconstitution syringes.
  • 49,000 safety boxes.
  • Materials for campaign sensitization, publicity etc.
  • Transport and logistical support.

Partnership is with the Ministry of Health, WHO and GAVI. Procurement of vaccines is through the UNICEF Supply Division, Copenhagen.

Vaccination campaigns for measles and poliomyelitis budget summary

Activity
US$
Supply of measles vaccine
935,000
Supply of OPV
240,000
Supply of syringes, safety boxes
470,000
Materials for campaign sensitization
35,000
Transport and logistical support
25,000
Technical support and project management
50,000
TOTAL
1,755,000

Health - integrated approach to child survival in unstable areas

The intention is to support areas of the country, which are affected by the regional instability, to move towards a more developmental approach to child survival. The focus will be on the prevention of transmission of HIV from mothers to children (PMTCT) and caring practices to reduce the impact of other key illnesses, particularly on children and mothers - both HIV negative and HIV positive. Partnership is with the Ministry of Health, Ministry of Local Government and Social Affairs, WHO and UNAIDS.

Key activities

  • Support community-based decision making processes and capacity-building in relation to PMTCT and child survival issues.
  • Support capacity-building in local government structures to improve linkages and support to communities.
  • Support MTCT centres to provide a full range of services (voluntary HIV/AIDS counselling and testing, anti-retroviral, infant feeding etc.).
  • Improve ante-natal care and obstetric services.
  • Promotion of treated bednets for malaria prevention.
  • Improved provision of primary health services.
  • Improved nutrition services (see below).
  • Improved water and sanitation facilities and hygiene practices (see below).

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