RMNCAYH-N & SGBV Health Response in War

Affected Areas of Amhara Region,2023

January 15, 2023
Gondar
 Presentation Outline
• Background
• Introduction
• Organizational/document development
• RMNCAYH-N Response
• Capacity building and advocacy
• GBV health emergency response
• Challenges
• Way Forwards
BACKGROUND
Amhara Region;
13 Zone
08 Town Administration
238 Woreda (74town)
4060 Keble's (548 Town)
Population of 2014 EFY
 23,741,883(Gr=1.1)
Health Institutes 4742 (Gov’t)
100 Hospital
917 HC
3725 HP
1,917 Private
10 BB
5 HSC
1 APHI 3
 Introduction
Due to the war individuals and community have been exposed for humanitarian crisis:
Directly (sexual violence, injury, massacre of civilians, displacement) and

Indirectly (changes in living conditions, lack of legal protection or decreased access to

health care, mental and psychological problem)

 Women and children were victimized for Sexual and Gender based violence which include:

• physical, sexual and/or emotional/psychological problems

Normal and traditional community structures break down that exacerbate social and

psychological problems
 Affected areas/HFs and population
Public and private facilities have been extensively damaged and looted as a result of
the war in the region:
• Thirteen of twenty one zones (13/21)
• 71 of 238 Woredas were affected
• 40 hospitals, 453 health centers, and 1,850 HPs were damaged and/or looted
• More than 15,000 healthcare workers were ever displaced from their workplaces
• Ever total Internal Displaced persons in the region - 2,741,182
- Returned to their home - 2,022,839
• Currently More than 720,224 internally displaced persons (IDPs) are living
in the Amhara region (Host Communities and collective IDP sites)
• Of this, 67,002 (9.30 %) are living in 43 collective sites.
 Affected areas/HFs and population …

• In war affected zones where more than 10.6 million people were live
 Totally/partially destroyed:
Personal homes,
Public and private health facilities (HFs= 2,343)
Government administrative and social service facilities,
Enterprises and commercial centers.
• Therefore, access to essential health services remains severely impacted in war-affected
areas of the region
 Summary of Current IDPs by Zone as of Jan.2023
Zones Total IDPs & collective sites Total IDPs in Total IDPs currently Proportion
the Host (Collective +Host ) (%)
# of collective # of IDPs Community
sites

West Gojjam 0 0 240,133 240,133 33.3

Waghimra 3 12,936 60,155 73,091 10.2
Awi 0 0 70,842 70,842 9.8
Wolkayt-Tegedie- 0 0 65,540 65,540 9.1
SH
Debre Berhan city 6 26,361 19,000 45,361 6.3
South Wollo 15 15,494 28,155 43,521 6.0
South Gondar 1 431 42,347 42,778 5.9
East Gojjam 0 0 35,571 35,57 4.9
North Shewa 5 2,920 28,536 31,456 4.4
 Summary…
Zones Total IDPs &collective sites Total IDPs in the Total IDPs currently Proportion
Host Community (Collective +Host ) (%)
# of # of IDPs
collective
sites
North Wollo 7 2,787 23,205 25,992 3.6
Bahir Dar city 0 0 18,500 18,500 2.6

North Gondar 1 2,022 5,923 7,945 1.1

Central Gondar 2 603 6,245 6,848 1.0

Gondar city 1 2,711 2,756 5,467 0.8

Oromo Zone 0 0 4,623 4,623 0.6

West Gondar 1 118 1,570 1,688 0.2

Dessie city 1 619 121 740 0.1

Regional 43 67,002 653,222 720,224 100

 Organizational structure and document development

RMNCAYH-N, MHPSS and SGBV


 Team was established under functional IMS
Response tor prepared
Response operation plan developed
Reporting template ,assessment and screening tools prepared
Response and early recovery plan prepared
Weekly TWG meeting is conducted regularly.
Different health emergency response proposal and advocacy shared for
partners
During weekly SRH,MHPSS-SGBV twg meeting @aphi-eoc
RMNCAYH-N & SGBV Health Emergency
Responses
 Major Activities
• Conducting Regional & Woreda Consultative workshop on Restoration of SRH
Services;
• Response plan advocacy workshop conducted for stakeholders
• Sensitization workshop conducted to strengthen multi sectorial zonal &
Regional level coordination
• Mobilize Mobile health Team to support SRH services and GBV screening and
management
• Strengthening referral linkage for SRH & GBV services
• Budget allocated for war affected zones for SRH response
• Conducted response review meeting at zonal level
• Community awareness creation on SRH & GBV for war affected Woredas
• Sportive supervision conducted on EHS & GBV
 Capacity building and advocacy
Activities # of trained Hws Remark
and others
HBB/HMS training provided for MWs 127
IMNCI training provided for HWs 199
CMR and 1st line support 254
Refresher training on integrated CAC/CC 218
Program coordinator/RH Officers on SRH programs support 64
Basic CAC service training 28
Abortion Self care (MA based) training for 15 private HFs 31
Pharmacists
GBV response orientation and Workshop 700
Community based GBV response 417
One stop center/GBV clinic status in war affected areas, Amhara
region,2023
 One stop center/GBV clinic status in war affected areas, Amhara
One stop center status in warregion,2023…
affected areas, Amhara region,2022
Name of OSC # of separated # of trained Remark
rooms HR
Debre sina hospital 1 3
Nifas mewucha hospital 1 5
Debark hospital 0 5
Kemisie hospital 1 4
Bati hospital 1 1
Amdework hospital 0 6
Dessie specialized hospital Fully functional Fully functional Fully functional

Debre Birhan 5 23 All multidisciplinary team

fulfilled
Gondar University Hos. - - service is not started yet
Readiness Assessment For The Selected Five Hospitals To Start OSC
During MHPSS-SGBV Sportive supervision conducted at IDP site
Regional Level multi-sectoral GBV response workshop conducted,
Multi-sectoral GBV response workshop conducted,
Sensitization workshop at Oromo special zone
SGBV response review meeting at zonal level
Community awareness Creation at Waghimira zone
GBV RESPONSE TRAINING WAS GIVEN TO HWs
GBV RESPONSE TRAINING WAS GIVEN TO HWs…
GBV response training was given to HWs and stakeholders
GBV prevention and Response Training was conducted from
Different IDP sites volunteers
 Summary of Health Services to Date, Amhara region,Dec.2023
MHNT Deployment BY Different
• 342,418 (93,546 under five) IDPs have 28 Partners:
received free health services
23
• 96 MHNT Deployed at IDP collective
sites to provide essential health
Services
12 11
8 8
5
1
Maternal & Child services provision for IDPs at Collective site as of
January, 2023
Major Indicators Services provided( cumulative to date)
ANC-1 7,317
ANC -4 3,219
SBA 3,045
PNC 2,254
Family Planning 22,187
Pentavalent 1 3,034
Pentavalent 3 1,510
MCV 1 dose 2,233
MCV 2 dose 2,992
Vitamin A 8,271
Dewormed 5,205
 Under five children treatment for IDPs at Collective site as of
January, 2023
Major Indicators Services provided ( cumulative to date)

Acute Respiratory Illness (ARI) 31,404

Pneumonia 16,207

Diarrhea (non bloody) 23,406

Dysentery (Bloody diarrhea) 16,622

Acute Mal nutrition(SAM+MAM) 29,661

 Summary of MHPSS to date in war affected areas, Amhara
region,2023
Services provided ( cumulative Remark
Major Indicators
to date)
Psycho Education 107,553
Ever Screened to date- 82,906
Counseling (individual, group 23,196
family

Psychosocial First Aid (PFA) 16,353

Identified mental disorders- 11,497

Pharmacotherapy 6,950
Linkage with facility 4,260
 Emergency Nutrition Response:
268,315 under-five children and 116,255 PLW were screened for malnutrition
to date/Jan.2023/
Major Indicators Services provided ( cumulative to date) Remark

U5 SAM case 8,056

U5 SAM linked to SC/OTP 6,093
U5 MAM cases 29,855

linked to TSFP- 26,452

PLW with <23 cm) 21,607

PLW linked to TSFP 11,787

 SGBV survivors reported by health facilities/OSC in December, 2022
OSC/Hospitals Total SGBV survivors Emergency PEP for STI Rx Tested HIV
<18 yrs >18 yrs Total contraceptive HIV positive
Female Female
Dessie OSC 204 862 1079 51 54 89 16
Wadla hospital 84 587 673 30 37 155 8
Debre Birhan hospital 92 125 218 14 10 43 10
Tefera haIlu hospital 40 114 155 12 24 15 7
Ataye hospital 18 135 154 9 11 35 3
Debark hospital 35 68 104 30 30 5 2
F/hiwot hospital 34 62 97 48 43 47 12
Akasta hospital 19 44 63 11 11 15 3
Lalibela hospital 4 42 46 1 1 7 1
Debre Tabor Hospital 6 39 45 6 6 20 0
Kombolcha hospital 21 16 38 9 8 8 0
Kemissie hospital 11 11 22 6 6 6 0
Woldia hospital 10 8 18 10 11 12 0
Nefasmewcha Hospital 3 14 17 4 4 0 0
Debre Sina hospital 7 9 16 2 2 16  
Kobo hospital 8 3 12 11 12 0 0
Bati hospital 3 1 4 1 3 1 0
Grand Total 615 2164 2779 255 273 474 32 62
 Kits and other supplies distributed for GBV response
Dignity kit and post rape kit distributed by UNFPA, , Ipas, WHO, ICAP engender
health and ICRC:-
Sygnomanometer- 150
Autoclave- 25
Virginal speculum (M&L)- 224
Surgical glove- 1500 Box
Exam. glove- 1900 Box
Gowon (L&M)- 500
MVA- 472 Kit
MA- 1200 doses
Dignity kit= 13,280
Post rape kit= 50
Sanitary pad= 38682
Medical equipment's and furniture's donated for war affected areas worth 7,110,520 ml ETB
 Major response gaps/ challenges
• Many HFs damaged and/or looted resulting lack of laboratory equipment's, reagents, and
essential drugs and other medical equipment's to provide MCH services in war-affected areas
of the region
• Limited health service restoration of partial or fully damaged health facilities to resume
essential health services in war affected HFs
• Lack of essential drugs, recording tools, prescriptions, referrals & stationery in the IDP
clinics
• FP Supplies interruption at IDPs
• SGBV services are limited to selective hospitals and OSC which hinders access for the
survivors
• Shortage of Ambulances (looted or damaged) for maternal health services
• Backup generator or solar light during interruption of Electric light to provide maternal
health services
 challenges…

Lack of standardized one stop centers for SGBV survivor response

Limited coordination between sectors (TWGs) for SGBV cases identification, referrals and
MHPSS
Lack of vehicles for survivor transportation
Absence of 24/7 health service for survivors at OSC
Limited safe house in war affected areas
 Way Forwards
Efforts of partners should be strengthened for humanitarian assistance:
Technical and Financial assistance is required for essential and life-saving healthcare
Continuous support/Provision of medical equipment's, supplies and materials
Need to give attention for infrastructures restoration/ damaged HF during the war
 Strengthening multi sectorial Integration and coordination to fully restore essential
health services in war affected HFs
 Advocacy, capacity building, and medical supplies are required to improve SGBV
access and service utilization
Establish additional one stop centers /OSCs/ at Hospitals to fully provide
comprehensive services for SGBV survivors
Community awareness creation on GBV prevention and response
THANK YOU!!