In 2013, UNICEF and partners plan for:
children to benefit from free and adequate care to manage malaria, ARIs and diarrhoea
caregivers to adopt improved infant and young child feeding practices
persons in districts at high risk of cholera outbreaks to benefit from hygiene and sanitation promotion messages
2013 requirements (US$)
Update of humanitarian situation
Following a decade of socio-political turmoil, which ended with widespread armed violence in April 2011, the return of peace has not yet yielded viable solutions to millions of children who remain affected by a silent emergency in Côte d’Ivoire. The humanitarian needs of the population remain a concern to the Government but often go unaddressed in light of multiple priorities in this fragile post-conflict context. The first half of 2013 was characterized by the return home of around 36,500 internally displaced people who fled their homes in 2011. Yet 45,000 people remain displaced from their homes with continued humanitarians needs for them and host communities in the west. Despite continued efforts, risks of violence and abuse against children and women remain high, worsened by the lack of access to justice for victims, and impunity.1 More than 4,200 preschool-aged and 7,500 school-aged displaced children2 do not have access to quality education, mostly because of the lack of classrooms and teachers. As a result of inappropriate feeding practices, poor hygiene and limited access to potable water and health services,3 Côte d’Ivoire has one of the highest neonatal mortality rates in Africa with 41 deaths for every 1,000 live births, maternal mortality at 614 for 100,000 live births,4 and just 36 per cent5 of HIV-positive pregnant women receiving antiretroviral (ARV) prophylactic treatment in 2011. The Demographic and Health Survey (DHS) 2012 shows that among children under 5, only 17 per cent of those suffering from diarrhoea received adequate treatment (oral rehydration) and 17 per cent of malaria cases were managed with the recommended artemisinin-based combination therapies (ACT). The health system regularly experiences essential drug stock-outs in health structures at all levels.
Adjusted planned results for 2013
2013 adjusted programme targets
- 12,000 children suffering from severe acute malnutrition treated at 25 in-patient and 200 out-patient centres
- 200,000 caregivers adopt improved infant and young child feeding practices
- 325,000 children under 5 benefit from free and adequate care to manage malaria, ARIs and diarrhoea
- 75,000 deliveries managed by skilled attendants and at least 20,000 complications receive adequate care, and 75,000 pregnant women are provided antenatal care
- 50,000 IDPs and host community members most affected by the crisis provided with safe water
- 100,000 persons in districts at high risk of cholera outbreaks benefit from hygiene and sanitation promotion messages
- 100% of all identified child victims of violence and abuse have access to appropriate care and services
- Children in contact with the judiciary system benefit from improved treatment
- 11,750 displaced boys and girls aged 3–12 have access to community early child development centres; formal education and community-based non-formal education programme
HIV and AIDS
- 150,000 pregnant women benefit from PMTCT care; 6,000 children from HIV-positive women are prevented against the mother-to-child transmission of HIV
- 17,600 young people tested for HIV and 1,000 (6%) HIV+ received care and treatment
UNICEF and partners will focus the coming months on supporting the Government response to the continued needs of more than 8 million children. In particular, this will include continuation of vaccination campaigns to reach all under-5 children nationwide. Nutrition programmes will focus on treating 12,000 children suffering from severe acute malnutrition (SAM), and to promoting life-saving infant and young child feeding practices to 200,000 caregivers, including in early childhood development centres. With strengthened partnerships, community interventions will be scaled up. HIV interventions in the eight most vulnerable regions of the west, southwest and the northeast will continue to provide prevention of mother-to-child transmission (PMTCT) services to 150,000 pregnant women and 6,000 children. In addition, 17,600 young people will be tested and 1,000 HIV+ people will receive treatment and care. Health interventions carried out in the most vulnerable regions will support 150,000 pregnant women, providing antenatal care to 75,000 women and supporting deliveries managed by skilled attendants to 75,000 women. Additionally, UNICEF will support case management of malaria, diarrhoea and acute respiratory infections (ARIs) to reach 50 per cent of all children under 5 (750,000). UNICEF will also continue to support the Government in providing free health services to under-5 children and pregnant women nationwide, and reinforce the national immunization coverage through expanded outreach activities and the restoration of the cold chain. WASH interventions will mitigate cholera outbreaks through prevention activities among 100,000 persons in high-risk districts, and provide safe water for 50,000 persons still affected by the post-electoral crisis. The cholera target has been reduced due to less number of cases observed this year. UNICEF will pursue efforts for enhanced protection systems to prevent exploitation, abuse and neglect for the most vulnerable children, and provide alternative care services for children in need of special protection. Psychosocial support and access to quality justice for identified child victims of violence will be strengthened and children in contact with the judiciary system will be treated appropriately. With a view to improving judiciary assistance for children, capacity of the police services will be strengthened. In addition to its leadership role in education, UNICEF will also expand community-based, non-formal education and supplementary formal education services such as accelerating learning programmes to 11,750 displaced boys and girls aged 3–12, and will train 482 teachers to offer children who dropped out of school an opportunity to attend catch-up classes. Furthermore, the deteriorating security situation in Mali has resulted in thousands of Malians fleeing to neighbouring countries, including around 4,000 into Côte d’Ivoire as of June.6 In preparation, UNICEF has procured and prepositioned non-food items and WASH materials.
Results from 20137
UNICEF and its partners are focusing their joint response on supporting the most vulnerable populations. Results through June have included the provision of essential drugs following the Government’s decision to offer free health services; the improvement of access to health care for pregnant women and under 5 children in 17 districts in the west and the southwest; the reinforcement of the national immunization coverage through expanded outreach activities and the restoration of the cold chain; and the provision of safe water to 14,000 vulnerable persons at high risk of cholera.8 UNICEF is leading the nutrition cluster while also supporting the development and implementation of a nationwide nutrition surveillance system and providing direct support to local NGOs, which significantly increased the national capacity to identify and manage SAM. To date, this has resulted in the treatment of 5,000 children under 5 with SAM, with a cure rate of 87 per cent. UNICEF also supported the provision of Vitamin A to 6.9 million children aged 6–59 months and the administration of deworming treatment to over 6 million children aged 1–5 years during the first campaign in 2013. For the prevention, care and treatment of people living with HIV, over 108,000 adolescents and women received information on the disease, and 46,980 pregnant women and adolescents received care and treatment between December 2012 and June 2013, including continuing care for those previously under treatment. Additionally, UNICEF reached 16,239 young people through community Voluntary Confidential Counselling and Testing (VCCT) service, including 1,000 (6 per cent) young people found to be HIV positive and referred to health services for care and treatment. In education, 10 integrated early childhood centres were created for 1,092 children with the support of NGO partners. UNICEF provided school supplies and equipment to 2,400 children in eight primary schools rehabilitated in 2012.
UNICEF funding requirements for 2013
In line with the country’s 2013 Inter-Agency Humanitarian Strategy in Phase of Transition, which has been developed in lieu of the Consolidated Appeals Process, and following a mid-year review, UNICEF has revised its funding requirements to US$12,763,000 to meet the humanitarian needs of children in Côte d’Ivoire in 2013, and to respond to the influx of Malian refugees into Côte d’Ivoire. Funding shortfalls have been significant in all sectors, but particularly, WASH and Child Protection, and failure to mobilize additional funding will prevent UNICEF from supporting on-going efforts by the Government to address unmet post-crisis needs. Particular support is needed for IDPs in the west; upholding children’s rights to education and protection in the delicate transition phase; responding to alarming malnutrition trends in the north; providing basic health care; and ensuring critical coordination responsibility for WASH, nutrition, education and protection activities while the country navigates the delicate path from relief to development. As of 30 June, UNICEF Côte d’Ivoire has received US$5 million, or 39 per cent of the required US$12,763,000 required for 2013.
2 Estimation based on the 2012 CAP Review (9 per cent of displaced children aged 3–5, and 16 per cent of displaced children aged 6–12).
3 Ministry of Health, National SMART survey 2012.
4 Demographic and Health Survey (DHS), 2012.This DHS 2012 result was reported to UNICEF Country Report on Indicators for the Goals (CRING 2013) system.
5 World Health Organisation (WHO), Universal Access Report, WHO Geneva, 2010.
6 International Organization for Migration (IOM), Mali Crisis: A Migration Perspective, June 2013.
7 Results between January-June 2013.
8 There have not been any cholera cases observed to date in 2013 and the target number of beneficiaries has hence been reduced. Cholera prevention activities are planned in the most cholera prone districts of Adiaké, Aboisso and Tiassalé for around 18,800 persons.
9 UNICEF is the Nutrition cluster lead and is the only organization that supports the provision of therapeutic foods and other severe acute malnutrition related supplies, hence the same targets for the Cluster and UNICEF. UNICEF Côte d’Ivoire centralizes all data related to the treatment of severe acute malnourished children.
10 Cluster targets and results are not available for Child Protection since the Cluster has been deactivated and data is no longer being collected at the cluster level.