1998 Yemen: A Formative Assessment of the Area-Based Program in Abyan and Ibb Governorates
Author: Al-Adawi, I.; El-Gousi, H.; Khalil, H.; Moustafa, M.; Center for Development Services
UNICEF's Country Program consists of five main programs: Health and Nutrition; Education; Area-specific Child Survival and Development (the Area-Based Program (ABP); Communication and Social Mobilization; and Monitoring, Planning and Advocacy for Children.
The ABP was developed in the 1994-98 Master Plan of Operations to cover four governorates as a pilot phase. It was agreed between UNICEF and the Ministry of Planning and Development to test the ABP in Abyan Governorate with possible expansion to Ibb Governorate in 1997. Currently, the ABP covers six districts in Abyan Governorate and one district in Ibb Governorate. The services rendered under the ABP benefit thirty-four village-clusters (Uzla) with an estimated population of 400,000 individuals.
Purpose / Objective
The purpose of the formative assessment was to assess the achievements of the ABP supported by UNICEF Yemen in Abyan and Ibb Governorates in order to identify the strengths and weaknesses of the program.
The methodology used to perform this assessment was to compare the effectiveness and the processes of service delivery in villages covered by the ABP in Ibb and Abyan, and other neighboring villages not covered by the program. The logic of this comparison was to assess the added value of the ABP interventions.
Key Findings and Conclusions
The ABP employed a strategy that emphasizes the integration of services and involvement of the local communities and the authorities as a means to sustain the program. From a cost-effectiveness aspect, it is clear that the areas assisted by the ABP are more effective in terms of costs than other areas where the ABP has not intervened.
In the health sector, it was found that the ABP has succeeded in strengthening the delivery of PH services through the revitalization of several health units to ensure availability of health services at village level, in addition to improving the quality of services at these health units. The revitalization process included the formulation of community committees; the provision of a twelve-month supply of essential drugs to each unit; and training of health workers, community midwives and TBAs. CHMCs were also trained on management of cost recovery systems for ED.
UNICEF is currently focusing on improving the services of the Health Centers/ Districts Hospitals as the first referral level in the HUs.
Before the implementation of the ABP, the health services provided at the village level were either non-existent or very poor. There was also a chronic shortage of trained manpower; especially TBAs and community midwives.
The cost-sharing system introduced by UNICEF is a very effective system. Given the fact that centralizing of government expenditure is becoming a norm, cost sharing seems to be the only viable option for providing HUs' services.
In the water sector, UNICEF introduced three technologies to suit communities' needs: Hand Pump Technology; Rainwater Collectors; and Mechanized Water Schemes. The ABP intervention has made a great impact on rural communities' lives through meeting one of the most urgent and essential unmet needs, which is providing clean water. It also achieved a great success in mobilizing local communities to participate in water projects.
However, there is a sanitation problem in many sites of the water projects, which certainly cause health and environmental problems. Many dirty ponds of stagnant waste water are found in the communities where the water projects exist because communities used clean water without thinking of the problem of wastewater.
In the education sector, there has been a notable improvement in the schooling environment through the construction of classrooms in catchment areas in the two governorates; provision of school furniture and educational supplies; and the training of female teachers.
It is easy to recognize at a first glance the difference between the schools supported by the ABP and others with non-ABP support, in terms of the general school conditions and quality of learning environment.
The ABP has succeeded in designing and conducting training programs aiming to improve the skills of those responsible for implementing the project at all levels.
Concerning project management, it should be acknowledged that UNICEF field staff are making a considerable effort in monitoring the different program activities. The relation between UNICEF's field offices and the districts' officials is that of integration. There is mutual understanding and positive attitude between both parties.
The assessment team is convinced that the ABP has successfully achieved its main objectives. Based on this success, the team feels comfortable to recommend expanding the ABP to new governorates/districts using the same strategy and approach.
However, a base-line survey should be conducted in the new targeted communities prior to making any program interventions. An integrated and synchronized approach should be considered having health, water and basic education as one package in any future intervention.
In the PHC sector, the ABP should introduce a nutrition program in the extension phase of the project, and emphasize more on MCH services.
Water projects should be accompanied by sanitation projects. There are simple sewage disposal programs that could be designed by specialized firms.
The water schemes can continue with the same level of efficiency upon improving the financial and managerial skills of the village committees.
In spite of the ABP interventions in the area of education, the girls' dropout rates are still high. The building of new classes, the rehabilitation efforts, and the provision of educational materials are not the only factors in girls' education. It is a national problem that needs an awareness campaign at the national and sub-national levels that goes parallel with improving the schooling environment. Using television, radio, face-to-face communication, household visits and other methods should also be considered.
With regard to program management, there is weak coordination and flow of information among the responsible central parties. Effective collaboration between all stakeholders should be improved through establishing a Central Executive Committee (CEC) responsible for following-up the program's progress and taking decisions regarding difficulties facing implementation.
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