UNITED METHODIST CHURCH AND

METHODIST CHURCH SIERRA LEONE

0.1 PROJECT TITLE: Community Based Primary Health Care      programmes.

0.2 PROJECT AGENCY:  The United Methodist Church (UMC) and

   The Methodist Church Sierra Leone (MCSL)

  The President of Conference, MCSL

0.4 APPLICANTS ADDRESS: UMC-SL – UMC House

  Lightfoot Boston Street

  Freetown

  MCSL -  Wesley House

  4 George Street

  P.O. Box 64

  Freetown

  Sierra Leone

0.5 PROJECT EXECUTION

AND SUPERVISION The Development Secretaries UMC and MCSL

0.6 PROJECT TYPE: Development: Health and Environmental Sanitation

  0.7 TYPE OF BENEFICIARIES: Rural and Urban population resettling after the war.  These particularly include women and children, the aged and the handicapped.

0.8 DURATION OF PROJECT: 3 Years (Three)

0.9 PROJECT BUDGET: Total Project Cost:  $390,000

  Request from Donors: $350,000

1.0 INTRODUCTION AND PROBLEM STATEMENT

1.1. SOCIAL, POLITICAL AND ECONOMIC CONDITIONS IN SIERRA LEONE

1.1.1 Vital Statistics In the Country

 The following vital statistics can portray a clear picture of the Economic and Socio-political status of Sierra Leone.

 The country has a land Area of 71,470 km^{2 (28,000 Square miles); a population (1994 Estimate) of 4.2 Million out of which 2,226 Million (53%) are females and 1,974 Million (47%) are males.  The population Density (1994 Estimate) is 58.77 per Sq. Km; population growth-rate (1986 - 91) is 2.3% and population distribution (1993) is as follows: Urban 42% and Rural 58%.}

 Land use statistics show that 8.0% is cultivated; 0.01% is used for grazing; there is 0.01% of Forest woodland and 91.9% account for other land.  Temperature Range is 18oC-35oC.

1.1.2 Economic Indicators and Prospects

The country has a GDP per Capita (1993/94) of 195 U.S Dollars; an Income per Capital (1992) of 170 US Dollars; a total External Debts (1992) of USD 965.6 Million, of which long and medium term (1994) is USD 658.72 Million and Debts Service ratio (1994) was 22.9% of exports.  There has been only negligible export since the course of the war (1991-1999).

 GDP% share of productive sectors (1992/93) are as follows: Agriculture 37.5%; Mining 10.0% manufacturing 4.7% Electricity and water 0.2%; construction 2.5%; Transport and Communication 10.0% and other non-governmental services 13.8%.

 Because the rebel war  rendered most parts of the country inaccessible, certain development indicators can only be inferred.  The indicators stated above and the following analysis have relied strongly on the UNDP most recent development co-operation Report (1994) pages 6-10.

 Since 1991, economic policy in Sierra Leone has been governed by Structural Adjustment Support Programme (SASP) as outlined in policy framework papers (PFPs) developed by government, in consultation with the International Monetary Fund (IMF) and the World Bank.  The basic elements of the SASP are improved fiscal management to enhance the efficiency and effectiveness of revenue administration and public expenditures; public sector management reforms, including civil service and public enterprises reforms; sectoral reforms; and trade liberalisation.  These measures - with the objectives of creating macro-economic stability, particularly the lowering of inflation to facilitate sustainable growth; restoring governments capacity to provide basic services; and creating a conducive economic, institutional and regulatory environment for private sector development - were complemented by socially oriented measures to reduce poverty and especially the adverse impact of the SASP on vulnerable social groups.

 The just ended rebel war slowed the pace of reforms in 1994, having especially adverse effect on production, employment, and expenditures on the social sectors.  Nevertheless, the SASP remained on course with the key indicators moving in the right direction.

 On cash basis, the fiscal deficit was 6.7% of GDP, higher than the 5.5% targeted, but reduced from 12% in 1989/90.  Inflation which was over 100% at the beginning of the adjustment period stood at just under 17% at the end of 1994.  This, together with reduced need for Central Bank accommodation to finance the fiscal deficit, induced a marked fall in the growth of money supply and helped to keep the exchange rate fairly stable simultaneously, the process of structural reforms continued with prices essentially market determined, the Civil Service further rationalised, and public enterprises operating more efficiently, thus enabling an increased number to contribute to the budget instead of being recipient subsidies.

 Despite substantial increases in expenditure on the war (31.3% over the original budget) sizable public investments were made in economic and social infrastructure, particularly the transport and communication sector.  Rehabilitation work was also done on the power plant to ensure constant flow of electricity supply.

 During the past four years (1995/96 - 1998/99) much of the economic gains made as a result of various fiscal policy interventions were disrupted as a result of the intensification of armed conflict in the country.  Escallation in this conflict since January 6, 1999 rendered the capacity of individual and coporate productive bodies to be drastically reduced.  This has reversed the positive economic trends as outlined in the above paragraphs.  Rate of inflation has doubled, unemployment level increased and basic prices of essential commodities sky rocketed.

 The entire economy plunged into disarray affecting the vulnerable members of society who now form the majority.

1.1.3 Social Indicators and Social Sector Development Issues

 With regard to health, the country has a Crude Birth Rate (1992) of 48 per 1,000 population; Crude Death Rate (1992) of 23 per 1,000 population; an Infant Mortality Rate (1992) of 150 per 1,000 Live Births; Maternal Mortality Rate (1992) of 700 per 100,000 Live Births; Life Expectancy at Birth (1992) of 47 years (which now stand at 37) and Total Fertility Rate (1992) of 6.5 births per woman.

 Access to safe water 1988 - 1990) was 43% of population 83% Urban and 22% Rural; access to sanitation (1988 - 1991) was 43% of population, Urban 59%, Rural 35%; population per Doctor (1994) was 10,641 and population per hospital bed (1994) was 1,068.

 Inspite of the gloomy economic trends heightened by nearly nine years of civil war, several improvement initiatives have been embarked upon in the social sector, particularly in Health and Education.  New National Policies and Action Plans were developed for Health and Education.  Government pursued also, the efforts to increase budgetary allocations to the social sectors.  The introduction of the Structural Adjustment Support Programme (SASP) created reasonable strains on the social sector.  In response government established a programme for Social Action and Poverty Alleviation (SAPA).  The SAPA Programme is designed to address, in the short-run, the social cost of adjustment and to bring the issue of poverty to the fore front of national development policies and decision-making.  Despite these efforts, the present status of the social indicators remains below desirable levels.

1.1.4 Political Conditions

 Sierra Leone has four administrative regions; the Western Area, the Southern Region, the Eastern Region and the Northern Region.  The MCSL and UMC-SL Development Programmes operate in all of these regions. The country has thirteen districts and one hundred and forty-nine Chiefdoms.  From April 1992 up to 1996 the country was ruled by a Military regime.  A democratically elected government led by the President Dr Ahmad Tejan Kabba took over the reigns of power in March 1996.  A Military Junta the AFRC/RUF violently seized power in May 1997 but was removed from power after nine months by the West African Regional Peace Keeping Force, ECOMOG through a Military intervention.  The restored democracy suffered an invasion on the capital city of Freetown, the seat of government on January 6, 1999 by combined AFRC/RUF forces but was again repelled after causing heavy loss of thousands of lives and destruction of property.  Of very significant note, the Revolutionary United Front (RUF) and AFRC protagonists accepted the government's offer for peaceful resolution of the nine year-old rebel war.  The outcome of the on-going consultations held in Togo will be vital to political stability in the country.

 A ceasefire and finally a Peace Agreements were signed by both parties mediated the entire international community under the Chairmanship of the Economic Community of West African States (ECOWAS), a regional political organization.  The result of the cited Peace Agreement was the formation of a "Government of Inclusion" in which all the warring factions are taking part.

 Since July, 1999 all including the people of Sierra Leone continue to be actively involved in consolidating the hard earned peace.  A UN peacekeeping force continues to be deployed in all areas of the country.  The crucial aspect of the peace agreement, the Disarmament, Demobilisation and Reintegration (DDR) continues to be implemented although at a much slower pace than wished by the civil society.

2.0 PROBLEM STATEMENT

The target communities comprise of traumatise and severely war affected population with very limited access to adequate health facilities.  Since the beginning of the civil and military conflicts in Sierra Leone these affected normally population continued to be subjected to much suffering resulting into illnesses and deaths from diseases which are preventable or otherwise can be treated.

The level of destruction of health delivery facilities in both MCSL and UMC project areas have been high as a result of the war.  Over the past years, there has been mass movement of people from their original habitants to Internally Displaced Camps or Refugee Camps in neighbouring countries.  Conditions at these camps have been far from good compared to their homes.  Various forms of diseases have become much more prevailent in project communities.  Preventable disease such as Tuberculosis, Cholera/Diarrhoea, meningitis etc. continue to be causes of death of many.

The cost of treatment of these disease and many more are high which makes access by the vast majority of the population to satisfactory health facilities very difficult in some cases impossible.

The level of awareness (among the target population) regarding primary health care practices continues to be low.  As a result of high level of poverty prevailent within war torn Sierra Leone, access to basic health promoting facilities by majority of the population continues to be very poor.

Poor nutritional status, especially among children and women, lack of access to clean and safe source of water; poor environment sanitation (indiscriminate sewage disposal, lack of convenient toilet facility etc.); poor maternal and child health unco-ordinated health education and community sensitisation; and lack of epidemic mitigation and preparedness are health problems this proposed project is expected to address.

3.0 TARGET GROUP ANALYSIS

 The proposed project is expected to benefit target communities in selected locations within which the two churches carry out their development and rehabilitation work.  Specifically, women, children and the aged including the handicapped who are vulnerable members of these communities are to be the primary beneficiaries.

 Survey conducted by Ministry of Agriculture, Forestry and the Environment (MAFE) in collaboration with FAO in 1999 revealed that Sierra Leone's food production has drastically declined from 40% to 15%.  About 85% of communities assessed and serviced by both MCSL & UMC development Agency indicated severe food insufficiency as a result of years of civil conflict.  This has culminated into malnutrition cases as often reported by our primary health care staff.

 Violent crimes particularly sexual abuse against the female population during armed conflict have also been committed.  Victims of such circumstances have been diagnosed to have contracted veneral diseases such as Syphilis, Gonorrhoe, HIV etc.

  Due to the promiscuous sexual behaviour prevailent among ex-combatant, sexually transmittable diseases are often reported by medical staff.

 Criteria for selection of target beneficiaries

 To ensure a satisfactory implementation of this proposed project, target beneficiaries will be selected in consultation with opinion leaders in target communities.  This criteria will include, persons resident in selected communities within the following categories:-

i. Lactating mothers

ii. Under 5 years

iii. Pregnant women

iv. Aged

v. Children below 18 years

vi. Sexually abused females in war affected areas.

vii. Ex-combatant

 ^{PROFILE OF PROJECT LOCATION AND ESTIMATED # OF BENEFICIARIES}

The following table highlights indications of areas of programme implementation as well as number of beneficiaries per location.

PROVINCE	DISTRICT	C/DOM/WARD COMMUNITY	PROPOSED # OF BENIFICIARIES	PREVIOUS IMPLEMENTING AGENCY	PROPOSED IMPLEMENTING PARTNERS
Eastern	Kono	Tankoro Gbense Sandor Nimikoro	13,728  16,336  14,460  21,714	UMC/MCSL     "  "  "	UMC/MCSL   "   "   "
	Kailahun	Njaluahun Peje West Peje Bongre Upper Bambara Malema Penguia Yawei Jawei Luawa Kissi Kama	66,328    11,415  4,422  5,394  4,030  4,641  4,425  4,026  6,056  22,785   3,159	MCSL  "  "  "  "  "  "  "  "  "	"   "             "   "   "             "   "   "             "   "
	Kenema	Nongowa Lower Bambara Dama Tonkia	70,353    16,500          3,927  5,214   5,157  30,798	MCSL UMC  "  "	"   "   "             "
WESTERN AREA	Urban   Urban Rural Rural	Kissy Community Pa Lokko Brookefields Goderich York	50,432  10,723  46,235  17,126   5,987  130,503	UMC    " MCSL    "    "	"   "             "   "   "
SOUTHERN	Bonthe       Bo	Urban/Island Bum Satie   Tikonko Bagbo Kakua	12,500  6,508         5,000    10,383  7,358  16,308	UMC MCSL UMC      "    "    "	"             "   "     "   "   "
	Moyamba	Kori Moyamba Town Rotifunk/Bradford	53,057    16,668  14,295   4,742  35,705	" " "	"   "   "
NORTHERN	Tonkolili	Yonibana Ribbi	6,984   4,539  11,523	UMC "	"            "

4.0 OVERALL OBJECTIVE

 The goal of this proposed programme is to help improve the public health status and ensure adequate community health care delivery system among resettling war returnees in MCSL/UMC communities in Sierra Leone within a three year period.

 

 The following table highlights indications of areas of programme implementation as well as number of beneficiaries per location.

 

4.1 Specific Objectives of proposed programme and their expected results will include as stated in following table;

 

Specific Objectives		Expected Result
1. To help improve household nutritional status from present 15% to 35% through food production, processing storage and income generating activities among target beneficial by the year 2003.		90% of target beneficiaries would have been sensitized about household food security and nutritional issues.  85% of Malnourished children, especially under-fives would have been surveillanced and monitored.  Therapeutic and supplementary feeding centres would have been set-up in highly affected areas.  80% of matters with the target groups would have been trained in preparing basic weaning foods.  33 women's group would have been organized, supported and engaged in vegetable gardening and other food production and processing and storage activities to ensure household food security and proper nutrition.  330 women's groups of 5 women each would have been empowered through micro-credit and other support schemes to generate household income.
2. To increase access from 10% to 50% of medical facilities for treatment of common ailments in severely deprived communities in targeted communities by the year 2003.		8 Mobile Clinics with basic diagnostic equipment and adequate treatment facilities to ensure treatment of common ailments in target communities.  An appropriate disease surveillance and referral cases would have been established.  33 communities with expected population of about 200,000 (50% of population) are expected to receive treatment through the mobile clinics.
Specific Objectives		Expected Result
3. To improve Maternal and Child Health care delivery facilities from 10% to 60% among 3 vulnerable categories include lactating mother pregnant women and children below 5 years in target communities by the end of the year 2003.		90 Traditional Birth Attendant would have been trained through 5 training of trainers workshop.  An average of 3 delivery facilities in 33 locations in village communities would have been set-up to serve over 250 women.  Six combined Antenatal clinics with reproductive health programme would have been rehabilitated and made functional within target areas.  90% of children under-five years old would have been immunized against child devastating diseases.
4. To deliver health education and advocacy programmes within target areas creating awareness among beneficiaries to live healthy lives.		Target groups would have been sensitized on the control and prevention of Epidemic diseases outbreak in their respective communities by the year 2003.  Six Training of Trainers Workshop/Seminar in the concept of community-based health care would have been conducted.
5. To increase access to safe drinking water and refuse/excreta disposition from 22% to 50% among 7 vulnerable categories of target Beneficiaries in target communities by the year 2003.		330 trained blue flag volunteers and ORT (Oral Rehydration Therapy) sachets, would have been available to target community for the control and prevention of epidemic disease by the year 2003.  165 toilets and 95 water wells would have been constructed and rehabilitated by the year 2003.  There would have been a significant change in the beneficiary's knowledge and behaviour in good hygiene practice.

5.0 IMPLEMENTATION STRATEGY

Proposed programme is phased into categories;

i. Maternal Child Health

ii. Household food Security and Nutrition.

iii. Community Health Education

iv. Water and Sanitation

v. Provision of Treatment Centres

 

The following therefore give a line-up of schedule of activities pertaining to the implementation of proposed programme;

 

1. Integrated Health Programme

Planned Activity	By Whom	When
Health Education Production of Teaching/Learning Materials   Conduct community mass sensitisation campaign. Conduct training/sensitisation workshop. Child to Child programme Radio/TV discussion School Health Education activities	Development Desks + Med. Co-ords. Programme Officer             " "           " "           " "           " "           " "	First 3 Months   Yearly      "      "      "      "      "      "
Maternal and Child Health  Developing Training Materials  Running of Antenatal clinics   Family Planning (Reproductive Health Prog.)  Training of TBAs/CSH aides  Refilling of TBA Kit   Supervision of MCH activities	Development Desk Health co-ordinator MCH Prog. Officer       "               "       "               "       "               "	First 3 Months Weekly       " Every 6 Months     "     "       " Weekly
Expanded Programme of Immunisation  Secure and distribute vaccines to mobile clinics.  Maintain cold chain  Implement immunisation activities  Monitoring of immunization activities  Supervision of immunization activities	Health Co-ordinator/ Public Health Prog Off EPI Staff    "      "    "      "    "      "	Throughout Year   " " " "
Treatment of Common Ailment   Supply of drugs/equipment    Supervision of clinic activities  Monitoring of Clinic activities   Management of cost recovery funds	Prog. Officer/MCH & Clinic     "                "     "                "     "                "	Weekly         "       "       "
Water and Sanitation  Supply of rehabilitation materials  Supply of hand pumps  Supply of chlorine  Chloronation of wells   Training of Blue flag volunteers (BFV)  Maintenance of Wells	WATSAN Officer         "            "         "            " Community Officer Health Training Team Community	Beginning of Prog         "         "    " Twice Yearly      "         " Once       " 3 Monthly

6.0 FOOD SECURITY & NUTRITION

Food security's main focus is to facilitate food production and availability of  balanced diet at household level in all target communities.  It is a common knowledge that food crops and vegetable play a key role in supply human body with proteins, minerals, vitamins and fat have proved to the maintenance of the human body.  However, in most part of Sierra Leone, Foodstuff is not accorded the importance they deserve.  This is because of the ignorance on the part of most growers with respect to nutritive value of vegetable and other food crops.  Also the high cost of production and the difficulty in storage and distribution pose problems.

 

The main activity will include provision of input for production, storage and processing food crops and vegetables.  These inputs will include; cutlasses, Hoes, shovels, wheelbarrow and cassava grating machines.

 

With the aid of the food security unit, therapeutic feeding center will be established for severally malnourished children, pregnant women, lactating mothers and the aged.  Special diet will be supplied at the center on weekly basis.

 

Furthermore, small-scale animal production will form part of this sector.  Vulnerable communities will have access to farm animals such as fowls, goat, sheep, ducks and pigs.

 

Therapeutic feeding centres will be established to take care of severely malnourished cases.  At such centres, mothers will be sensitized and where appropriately, trained to take care of nutritionally balanced foods for themselves and their children.

 

The following key activities are identified

 

Planned Activity	By Whom	When
Food Production/Processing/Storage  Sensitisation meetings.  Training of community animators.   Nutritional surveillance and Growth Monitoring.	Field/Extension Worker Training Team Field Officer & Team	Periodic First 3 Months Quarterly
Organising  target beneficiaries into  groups.  Procure, allocation and distribution of farm inputs   Supervision and monitoring of  field activities  Training in post harvest losses  Construction of storage and drying floor facilities	Field Personnel Dev. Secretariat Field Officer/Dev Secs. Trainers/Dev. Secs. Field Officer	First 2 Months Before Harvest     "       "     "       "     "       "
Procurement and allocation of single processing machines i.e and cassava grating machine.  Training in quality control and standardization of farm produce.	Dev. Secretariat   Trainees/Dev Sec.	"       "       "       "
Nutrition  Establishment of  therapeutic feeding centres  Registration/verification of target beneficiaries   Provision of food commodities at various centres  Supervision and monitoring of all feeding centres	Field Officer     "         "     "         "     "         "/Med Cord.	Start of Prog.    "     "    " Daily Continous
Construction of animal housing using 60% of local materials  Procurement of animal stock   Distribution/allocation of animal stock  Supervision and monitoring	Field Officer Development Secretariat Field Officer Field Officer/Dev Sec.	Continous

7.0 INCOME GENERATING ACTIVITIES

This project will cater for micro-credit schemes to be set up in targeted communities.  This scheme will target mainly women who are engaged in petty trading vegetable production and skills development towards economic empowerment through Income Generating Activities.

 

Soft loans will be provided to target women who are engaged in palm oil selling, fish monger, garri buying and selling, soap making and gara tie and dying.

 

Basic agricultural imput for vegetable growers will be acquired and supplied to farmers on loans to be repaid after harvest.  These inputs including tools, and planting materials.  Equally necessary inputs for garri production, soap making palm oil selling and gara tie dying will be supplied to beneficiaries and be repaid after a specific period agreed upon by the beneficiary community and project management.  All conditions regarding this micro-credit schemes will be clearly spelt out in project deeds (riders).

 

IMPLEMENTATION SCHEDULE

 

Planned Activity	By Whom	When
Identification of beneficiaries  Conduct community/beneficiary sensitisation through workshops/seminars; dramatization etc. and project in a bid to ensure 95% loan recovery.	Field Officer Dev Secretariat	Start of Programme Half Yearly
Loan approved and recovery committees are set up in the beneficiary communities.  Riders/deeds are prepared together with the beneficiary communities.  Identification/Registration/Verification of beneficiaries for approval  Approval of beneficiary and signing of documents before issuance of loan  Revolving scheme set up at community level	Dev Secretariat/Med Co-ordinator Field Officer/Dev Secretariat Field Officer Dev. Secretariat/ Magt. Committee   Launching Ceremony by Dev Secretariat/ Board	1st Month   2nd Month   1st Month   3rd Month   4th Month
Monitoring of beneficiary activities  Meeting of beneficiaries to share experience and lessons learnt, at chiefdom level.  Training of beneficiaries on standardization, Bookkeeping etc.	Field Officer Field Officer & Com.   Dev. Secretariat	Continious Quarterly   Quarterly

8.0 PROGRAMME MANAGEMENT AND ADMINISTRATION

Proposed programme will be a Joint Management Team (IMT) comprising a mix of Development and Administrative personnel of both MCSL and UMC.

 

A Joint health Management Committee will be set-up whose responsibility will be the day-to-day administration of programme.

 

In each of the programme administrative zones a lead Agency will be identified whose role is to head all programme activities and personnel and ensure effective implementation of area.

 

Programmes

The following organogram outlines proposed management structure;

 

 

 

 

 

 

 

 

 

NOTE:  1. The positions of Public Health Programme Officer and the following Field Officers are applicable to both MCSL UMCSL.

2. Job Descriptions of the above positions are also enclosed.

Role's and Responsibilities

 

1. Joint Development Board

 This Board serves as the overall clearing House for all Joint development and Relief projects/programmes of MCSL and UMC-SL.  It consists of 16 Members (8 from each church) with co-chairmanship of the two Church Institutions.  The Development Secretaries of the two churches (MCSL and UMC) are Secretaries of this Board.  They can also serve as technical/professional advisers on development/emergency programming and management; and other related issues normally considered by the Board.

 

 The Board will meet once every quarter to deliberate on all aspects of the development and emergency responses of their two development Secretariats.

 

 The Development Board shall from time to time establish sub-committees management.

 

 Committees for the purpose of direct supervision of specific programme/project work.

 

2. Development Secretariats

 

i. Functions as the Administrative Clearing House (ACH) of all Programmes/Projects.

ii. Co-ordinates sectoral planning and formulation/preparation of all projects/programmes.

iii. Establise and supervise the Management Information System (MIS) of the Public Health Programme.

iv. Responsible for Reporting to both Joint Development Board and Development Board and Donors.

v. Has overall responsibility for the Monitoring and Evaluation of programmes/projects.

3. Public Health Management Committee

This committee shall comprise of 10 members from each Institution).  It supervises the direct management of the proposed public health programme.  It shall be responsible directly to the Joint Development Board.

 

This Committee will be co-chaired by the Secretary of Conference (MCSL) and Secretary/Council Director (UMC).

 

The Health Management Committee shall vet all health proposals; deliberate on field and monitoring reports; recruitment and placement of suitably qualified personnel and guide implementing staff in overall programme management.

 

4. Medical Co-ordinator/Superintendent

 

i. Co-ordinates overall health management activities of the Joint Programmes.

ii. In collaboration with the Development Desks and the Accounts Officials of the two Institutions, he/she will prepare annual work plan and including budget for approval of the Development Board through the Health Management Committee.

iii. Prepare monthly progress reports in concert with Programme Officer for the consideration of the Health Management Committee.

iv. Presides over monthly programme co-ordinating and review meetings.

v. Help develop and puts in place appropriate public health management information system.

vi. Undertakes internal monitoring of programme activities.

vii. Liaise with the two Development Desk Secretariat in all matters relating to programme planning implementation and monitoring.

viii. Work in close collaboration with Public Health Programme, Field Officers and other Medical personnel of the two institutions to effect a successful implementation of programmes.

ix. Perform any other duties that can be assigned by the Development Board.

x. Responsible to the Development Board through the Public Health Management Committee.

5. Public Health Programme Officer

 

i. Have direct responsibility in implementing the Joint Community Based Health Programme in both MCSL and UMC operational areas.  Supervises all field operations.

ii. Supervises technical and field staff in the public health sector.

iii. Prepares monthly operational and other health monitoring reports and presents such to Medical Co-ordinator/Superintendent.

iv. Hold periodic planning and management meetings with field and other staff.

v. Supervises field assessment exercised to determine type and extent of community coverage.

vi. In liaison with the Medical Co-ordinator/Superintendent, provides technical and professional guidance to direct field implementation team(s).

vii. Properly accounts for all programme resources to the Medical Co-ordinator/Superintendent, which are verified and forwarded for internal auditing by the Development Secretaries.

viii. Shall request for resources through the Medical Co-ordinator/Superintendents who shall vet/verifies the appropriateness (programmatic and budgetary) of such request and forward these to the Development Secretariat.

ix. The Public Health Programme Officer is not permitted to raise resources without clearance from the Development Secretariat and Medical Co-ordinators/superintendents.

x. He/She can represent joint programme in technical/professional fora at regional level.

xi. He/She is directly responsible to the Medical Co-ordinators/Superintendents.

6. Field Officer:   Income Generating and Women's Empowerment

 

i. Conducts community sensitisation workshops.

ii. Organisation informal skills/vocational training programme for target women/girls in MCSL/UMC areas of operation.

iii. Plan and implement proper management system of micro-credit and other income generating strategies.

iv. Organise small-scale enterprise management courses.

v. Work with communities to mobilize local resources for sustainable programme implementation.

vi. Ensure proper management of all programme resources.

vii. Directly responsible to the Public Health Programme Officer.

7. Field Officer:   MCH and Mobile Clinics

 

i. He/She is to facilitate the identification and establishment of community MCH and mobile clinics in MCSL/UMC operational areas.

ii. Supervises Nurses and other Staff/Workers in providing basic clinical services in target communities.

iii. Gather information on mother and child health status; as well as other health threatening conditions within target communities.

iv. Set-up and maintain a health information base for management and other unit personnel/collaborating health related NGOs.

i. Responsible for direct implementation of water and sanitation aspects of the overall public health programme.

ii. Prepares appropriate and relevant technical drawings/project descriptions for water wells, water treatment and VIP toilets facilities to be provided in the target communities.

iii. Conducts workshops and seminars on household and community water resource management.

iv. Conduct periodic assessment of water and sanitation facilities and needs within communities.

v. Liaise with other NGOs and share information on WATSAN conditions and services within target communities.

vi. Compile and submit weekly reports to Programme Officers.

vii. Properly manage scarce resources of the Unit for optimal benefit to target beneficiaries.

  viii. Directly responsible to the Public Health Programme Officer.

Community participation in the administration of proposed project will be encouraged.

Village/Community Health Committees (CHC) will be set-up whose role is to represent their kinsmen/women in various meetings, bringing the concerns/ideas from community to planning implementations, monitoring and evaluating sessions/activities.

9.0 GENDER CONSIDERATIONS

MCSL/UMC are constantly involved in gender Specific analysis particularly with women.  Therefore, proposed project was conceptualized with much emphasis on the improvement of the living standards of women.  As women and children form most of vulnerable groups in society today, (estimated 75%) this programme will specifically target these groups.  These include war widows, women married to extremely under previledged men, school dropouts, unaccompanied children (UCA).  MCSL/UMC is fully determined to improve the lot of these specially vulnerable groups providing effective medical services at a very minimal affordable cost.

10.0 CO-ORDINATION WITH OTHER AGENCIES

Proposed project will be implemented by the Development Department of MCSL/UMC in collaboration with other agencies and The Ministry of Health.  The programme management will liaise with the Ministry of Health and Sanitation for technical support and in some cases for material support.

Proposed project will also be implemented in collaboration with UNICEF and other NGOs (National and International).  MCSL/UMC shall be represented in the Regional Technical Committee on the sectoral components of proposed project.  This will facilitate effective information sharing between MCSL/UMC and other aid agencies thereby improving co-ordination.

11.0 MONITORING AND EVALUATION

Proposed project will be jointly monitored and supervised by the Development Departments of MCSL and UMC.  MCSL/UMC (Head Office Freetown) will send monitoring officers to monitor project activities in the provinces once in every month to see whether intended objectives of the project are being achieved.

The project performance monitoring report will be prepared by the Project Officers (MCSL and UMC) and submitted to the Development Secretaries (MCSL and UMC) every month to identify constraints so that adjustments in implementation can be made as and when necessary.  Moreover, quarterly and yearly review meetings will be organised to bring the project officials of MCSL and UMC together.

The services of an external evaluator will be enlisted to carry out a summative evaluation of project outcomes and achievements at the end of every year over the 3 year period of implementation.  A terminal evaluation will be conducted at the end of 3 year period.

BUDGET

	2000 US #	2001 US #	2002 US #
OBJECTIVE   I To help improve household nutritional status from present 15% to 35% through food production, processing, storage and income generating activities among target beneficial by the year 2003.
ACTIVITIES 1. 90% of target beneficiaries would have been sensitized about household food security and nutritional issues.  (workshops) 2. 85% of Malnourished children, especially under-fives would have been surveillanced and monitored 3. Therapeutic and supplementary feeding centres would have been set-up in highly affected areas by establishing feeding centres. 4. 80% of Mothers with the target groups would have been trained in preparing basic weaning foods (Workshops). 5. 33 women's groups would have been organised supported and engaged in vegetable gardening and other food production and processing storage activities to ensure household food security and proper nutrition by establishing community animators garden project. 6. 330 women's groups of 5 women each would have been empowered through micro-credit and other support schemes to generate household income by establishing revolving loan scheme.