13 05 09 BSF-IAe COMPLOT

BSF-IAe (1 January - 31st March 2013)

Government of South Sudan

Fund Management of the Basic Services Fund – Interim Arrangement extension (BSF-IAe)

Department for International Development (DFID)

BMB Mott MacDonald

8 May 2013

Mott MacDonald, Amsterdamseweg 15, 6814 CM Arnhem, PO Box 441, 6800 AK, Arnhem, Netherlands T +31 (0)26 3577 111 F +31 (0)26 3577 577 W www.mottmac.com

BSF-IAe Completion Report (May 2013)

ContentChapter Title PageList of Abbreviations 1

Introduction and Background 3

1. Review of Progress and Performance 7

1.1 Impact: Improved health and education particularly in communities hosting large numbers of returnees________________________________________________________7

OUTCOME __________________________________________________________________________101.2. Outcome: Improved access to effective primary health services and primary education,

particularly for vulnerable groups and in priority host communities for returnees_____10OUTPUTS __________________________________________________________________________11Output 1. Strengthen primary health services, particularly for vulnerable groups and in priority host

communities for returnees___________________________________________________11Output 2. Strengthened Primary Education Services particularly for vulnerable groups and in

priority host communities for returnees________________________________________12Output Indicators 2.2 Teachers Trained (PSTT) & Output Indicator 2.3 Teachers Trained (ISTT)________12WASH __________________________________________________________________________12

2. Fund Management 14

3. Assumptions and Risks 15

3.1 Austerity budget_____________________________________________________________15

4. Unit Costs 16

Annex 1a. Logical Framework 17

Annex 1b. Source table for Logframe 21

Annex 2. Grantee Overview 24

Annex 3. Grantee Disbursement 25

Annex 4a. Primary Health Targets and Achievements in all 4 phases 26

Annex 4b. Primary Education Targets and Achievements in 4 Phases 27

Annex 4c. WATSAN Targets and Achievements in 4 Phases 28

Annex 5a. Steering Committee Meeting Record 29

Annex 5b. Key Dates 30

Annex 6a. Summary Table – Primary Health Services 33

Annex 6b. Summary Table – all PH targets versus achievements 34

Annex 7. Summary Table – Primary Health facilities Staffing (1) 35

Annex 8. Summary Table – Primary Health Staffing and payroll (2) 36

Annex 9a. Summary Table – Primary Health Training (Long Term) 37

Annex 9b. Summary Table – Primary Health Training (Short Term)_______________________________37

Annex 9c. Summary Table – Primary Health Training (Categories of trainees) 38

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Annex 9d. DHIS training 2012 39

Annex 10. Summary Table – Primary Education 40

Annex 11. Summary Table – Primary Education Long term Training 41

Annex 12. Summary Table – Primary Education Short term Training 42

Annex 13. Summary Table WATSAN – Waterpoints 43

Annex 14. Summary table – WATSAN Institutional Latrines 44

Annex 15. Summary Table – WATSAN Training 2012 45

Annex 16. Field Visits Record 46

Annex 17 Technical Assistance (TA) Days Allocated 48

Annex 18a. Primary Health Unit Costs 49

Annex 18b. Primary Education Unit Costs 52

Schools Construction___________________________________________________________________52Teacher Training______________________________________________________________________54

Annex 18c. WATSAN Borehole Unit Costs 57

Construction of Boreholes_______________________________________________________________57Rehabilitation of Boreholes______________________________________________________________59Minor and Major Repairs of Boreholes_____________________________________________________59

Annex18d. WATSAN Latrine Unit Costs 61

Institutional Latrines____________________________________________________________________61Household Latrines____________________________________________________________________64

Annex 19. Grantee Project Summary 66

TablesTable 1: BSF-IAe Basic Project Data.............................................................................................................3Table 2: BSF Phases, finance and dates.......................................................................................................3Table 3: BSF’s donors with their contributions in GBP per phase.................................................................4Table 4: BSF financial allocation per sector (in GBP)....................................................................................4Table 5: BSF-Phase, financial envelope in GBP and dates...........................................................................4Table 6: BSF Beneficiaries per sector and per phase...................................................................................5Table 7: BSF number of grant contracts, INGO, NNGO (round & call for proposals)....................................5Table 8: Maternal Mortality ratio; baselines and targets per source..............................................................7Table 9: Proportion of birth attended by skilled health staff; baselines and targets per source.....................8Table 10: Birth attended by skilled health staff..............................................................................................8Table 11: Under five mortality baselines and targets per source...................................................................8Table 12: DPT3 coverage (Diphtheria, Pertussis,Tetanus)............................................................................9Table 13: Curative outpatients consultations (all ages) in all BSF phases...................................................10

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List of Abbreviations

AES Alternative Education SystemANC Ante-Natal CareALP Accelerated Learning ProgrammeBMB MM BMB Mott MacDonaldBSF Basic Services FundBSF IA Basic Services Fund Interim Arrangement (to bridge the period to a sector support programme)BSF IAe Basic Services Fund Interim Arrangement extension (12 month extension of the bridging period)BPHS Basic Package of Health ServicesCBR Crude Birth RateCED County Education DepartmentCHW Community Health WorkerCHD County Health DepartmentCMO County Medical OfficerCPA Comprehensive Peace Agreement (date….)CSO Civil Society OrganisationCWD County Water DepartmentDFID Department for International Development, UK GovernmentDHIS District Health Information SystemDPT3 Diphtheria, Pertussis, Tetanus 3ELT English Teacher TrainingEMIS Education Management Information System EPI Extended Programme ImmunisationFBO Faith Based OrganisationGoSS Government of South SudanHMIS Health Management Information SystemHPF MoH Health Pooled Fund with DFID as lead donorIDP Internally Displaced PersonISTT In-Service Teacher TrainingLQAS Lot Quality Assurance Sampling (survey method)MDG UN’s Millennium Development GoalsMMR Maternal Mortality RateMoEST Ministry of Education, Science and TechnologyMoGEI Ministry of General Education and InstructionMoFEP Ministry of Finance and Economic PlanningMoH Ministry of HealthMNRH Maternal Neonatal & Reproductive HealthMWRI Ministry of Water Resources and IrrigationMDTF Multi Donor Trust FundNGO Non Governmental OrganisationINGO International Non Governmental OrganisationNNGO National Non Governmental OrganisationOPD Outpatient DepartmentPHCC Primary Health Care CentrePHCU Primary Health Care UnitPTA Parent Teacher AssociationPSTT Pre-Service Teacher TrainingSHTP-2 Sudan Health Transformation Project phase-2SIDA Swedish International Development AgencySPLM Sudan People Liberation MovementSSDP South Sudan Development PlanSSHP South Sudan Health Program

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SHTP MoH SouthSudan’s HealthTransformation Project financed by USAID ( 2007/12)SRF Sudan Recovery FundTA Technical Assistance (BMB MM consultants )TBA Traditional Birth AttendantUN United NationsWATSAN Water & SanitationWHO World Health OrganisationWUC Water User CommitteeVHC Village Health Committee

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Introduction and Background

Table 1: BSF-IAe Basic Project DataProject Name Extension Basic Services Fund - Interim Arrangement

(BSF-IAe)Duration 15 months from 1 January 2012-31 March 2013Grants 12 months from 1 January-31 December 2012Project Authority of the Government of the Republic of South Sudan (GoSS)

GoSS Steering Committee chaired by Ministry of Finance

DFID (lead donor)16,312,200 £16.3 mSIDA (Sweden) 3,687,800 £3.7 m (equivalent of Swedish Kroner 40m)TOTAL donors contribution £20,000,000Grant component £18,347,290Location South SudanManagement Consultant; BMB Mott MacDonald (BMB MM) 1 January 2012-28 February 2013

The process leading to the establishment of the BSF started with workshops held in 2004 (the year before the CPA was signed in 2005) bringing Sudan Peoples Liberation Movement (SPLM), Non Governmental Organisations (NGOs), Civil Society Organisations (CSOs) , the UN, donors together to coordinate and plan support basic services provision in South Sudan. Key issues in these discussions included: developing the capacity of GoSS ministries to plan and manage basic services within the proposed local government framework; alignment of non-state actor activities in basic service provision with (SPLM) /GoSS policy; development of common standards for sector-based services; and improved harmonisation, co-ordination transparency and accountability between GoSS, the international community and implementing partners supporting basic services.

Table 2: BSF Phases, finance and datesTotal Contract Managed Funds NGO grants Grant Dates BMB contract

Phase £ £ # From to from to

1 18,925,902 17,186,077 14 1-04-2006 31-12-2008 19-08-2006 31-12-2008

2 23,121,450 21,554,792 25 1-01-2009 31-06-2010 01-01-2009 31-08-2010

IA 43,013,082 39,970,000 38 1-07-2010 31-12-2011 01-03-2010 29-02-2012

IA extension 20,000,000 18,347,290 27 1-01-2012 31-12-2012 01-01-2012 31-03-2013

Total 105,060,434 97,058,159 103

With SPLM and GoSS, DFID initiated BSF as a bridge to assist basic services by non-state service providers, while GoSS’ capacity to manage, finance and deliver social services was being built up with the Multi Donor Trust Fund (MDTF).BSF’s status changed mainly because of delays in MDTF’s delivery in investments in Basic Services and plans.

The first meeting of the Steering Committee (Rumbek, 28 October 2005) launched the BSF. In 2005 DFID engaged the NGO “Skills for Southern Sudan”, assisted by the IDL group (UK), to organize the procurement of six grantees (Table 7). On 19 August 2006, after an international tender, DFID appointed BMB MM as BSF’s management consultant. BMB MM set up a BSF secretariat in Juba, staffed with TA, in Juba (Annex 17). The management model was decentralized at the BSF secretariat that used 85% of the TA workdays. From the first round of NGO projects, BMB MM took over all the contracts from DFID. Plans to roll BSF into South

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Sudan’s recovery Fund were abandoned as SRF concentrated on governance and security. As a result BSF’s Steering Committee decided to extend the fund from its original closing date of 30 June 2008 to 31 December 2008.

BSF was further extended into BSF-2, which ended June 2010. For BSF-IA DFID again launched an international tender for the management of the fund and on 30 March 2010 the contract was awarded again to BMB MM for an inception phase that coincided with the final months of phase 2 and implementation until December 2011. On 16th January 2012 DFID signed a contract amendment with BMB MM for the BSF-IA extension (BSF-IAe). This contract included a budget with 2651 TA workdays for a 12 month period compared with 3368 TA days for the 18 months of BSF-IA. All these extensions cover the 4.5 year period from 30 June 2008 (original end date of BSF-1) till the end date of BSF-IAe on 31 March 2013.

BSF’s main expected results were the establishment of operational primary schools, primary health clinics, drinking water points and latrines. This was done in parallel with capacity building, including training of teachers and health professionals and management training of local beneficiary groups, county authorities and the Steering Committee, to ensure that the access gained would be maintained at minimum levels for the medium term (Annex 1).

Table 3: BSF’s donors with their contributions in GBP per phasePhase Total (GBP)

DonorDFID MINBUZA NORAD CIDA SIDA EU

BSF 1 18,925,902 18,925,902

BSF 2 23,121,450 9,001,450 6,500,000 3,720,000 3,900,000

BSF-IA 43,013,082 12,470,000 10,000,000 6,682,170 6,410,000 7,450,912

BSF-IAe 20,000,000 16,312,200 3,687,800

Total 105,060,434 56,709,552 16,500,000 10,402,170 3,900,000 10,097,800 7,450,912

Subsequently other donors decided to contribute to the fund and therefore a second phase started on 1 January 2009 (Table 2 and 3).

Table 4: BSF financial allocation per sector (in GBP)Phase Total Health Education WATSAN Capacity Building Unallocated

BSF 1 17,186,077 6,657,431 3,213,692 5,217,645 2,097,309

BSF 2 21,554,792 8,560,689 5,057,208 4,448,266 3,082,475 406,154

BSF-IA 39,970,000 18,938,767 9,504,000 8,688,401 2,715,630 123,201

BSF-IAe 18,347,290 13,002,072 3,441,009 942,049 855,148 107,012

Total 97,058,159 47,158,960 21,215,909 19,296,362 8,750,562 636,367

BSF was implemented through grants to non-state actors who could apply for grants in calls for proposals, of which the fund issued 4. The first call was in 2005, the second in 2006, the third in 2008 and the fourth in 2010. The rationale behind this implementation model is the specialisation of these non-state actors in Basic Service delivery, which was created already during the civil war (Operation Lifeline Sudan). Over 80% of health services in South Sudan’s rural areas are still supported by NGO/Faith Based Organisations.

Table 5: BSF-Phase, financial envelope in GBP and datesTotal Contract Grants NGO

grantsGrant Dates BMB contract

1 18,925,902 17,186,077 14 1-04-2006 31-12-2008 19-08-2006 31-12-2008

2 23,121,450 21,554,792 25 1-01-2009 31-06-2010 01-01-2009 31-08-2010

IA 43,013,082 39,970,000 38 1-07-2010 31-12-2011 01-03-2010 29-02-2012

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IAe 20,000,000 18,347,290 27 1-01-2012 31-12-2012 01-01-2012 31-03-2013

Total 105,060,434 97,058,159 103

Main stakeholders were: the beneficiaries, members of the rural communities, with particular inclusion of vulnerable groups: women and children, IDPs and returnees. Stakeholders were also County, State and GoSS authorities of the Ministry of Health (MoH), the Ministry of General Education and Instruction (MoGEI) and the Ministry of Water Resources and Irrigation (MWRI) /Ministry of Physical Infrastructure), local government, BSF’s international donors, INGOs (International NGO) and NNGOs (National NGO).

Table 6: BSF Beneficiaries per sector and per phase.

Phase

Primary Health Primary Education WASH - Water WASH - Sanitation Total

Target Actual % Target Actual % Target Actual % Target Actual % Target Actual %

BSF - 1 1,815,0001,910,00

0 105 28,00026,80

0 96 69,750 52,750 76 3,815 5,965 156 1,916,565 1,995,515 104

BSF - 2 2,605,0002,885,00

0 111 33,25025,60

0 77 62,000 75,750 122 20,48024,23

0 118 2,720,730 3,010,580 111

BSF - IA 1,857,7441,511,75

6 81 17,80017,70

0 99 112,000138,25

0 123 60,78055,54

5 91 2,048,324 1,723,251 84

BSF - IAe 760,000 975,880 128 2,400 1,600 67 18,750 8,250 44 4,650 1,650 35 785,800 987,380 126

BSF-IAe, like its previous phase BSF-IA, was a transitional arrangement to allow time for GoSS, in partnership with the international community, to develop sector plans for service delivery post-Independence (9 July 2011) and to allow for a seamless, uninterrupted, transition into the new interventions for support to primary health.

After the six years (2005/11) of the Interim Period of the Comprehensive Peace Agreement (CPA) that followed the signing of the CPA in 2005, GoSS started a Transition period (2011/15) that will culminate in South Sudan’s national elections planned for 2015. For this GoSS’ Transition period MoH and donors agreed to re-organise support for Primary Health geographically (Table 6) and to harmonize the support. The three main interventions are: the Integrated Service delivery project (USAID financed) in Eastern and Central Equatoria, the Rapid Results heath project (financed by World Bank) in Upper Nile and Jonglei and the Health Pooled Fund with DFID as lead donor in the remaining 6 States. Harmonisation applies to CHD capacity, payroll, and, all future grants of HPF, like SHTP will, cover at least an entire county. Health System Strengthening of County and State Ministry and support to direct service delivery through health facilities and community support will be the key priority.

This report is prepared by the Management agent, BMB Mott MacDonald, as part of the terms of reference of BSF-IAe.

Table 7: BSF number of grant contracts, INGO, NNGO (round & call for proposals)

Total contracts Lead agent INGO Lead agent NNGO

Consortium member INGO

Consortium member NNGO

BSF-1 Round 1 6 6 7

BSF-1 Round 2 8 7 1 4 6

BSF-2 Round 3a 11 9 2 8

BSF-2 Round 3b 5 4 1 1 4

Subtotal 30 26 4 5 25

BSF-IA Round 4a 32 30 2 1 23

BSF-IA Round 4b 6 6 1 4

Subtotal 38 36 2 2 27

BSF-IA extension 24 20 3 0 4

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5 month bridge contracts with IRC, JSI and SCiSS.

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Total 162 144 15 14 108

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1. Review of Progress and PerformanceThis section of the report addresses the logical framework’s impact, outcome and outputs with their indicators, milestones, targets and achievements (Annex 1 and Annex 1b).

1.1 Impact: Improved health and education particularly in communities hosting large numbers of returnees

Impact Indicator 1. Maternal Mortality Rate (MMR)

Table 8: Maternal Mortality ratio; baselines and targets per sourceMaternal mortality Baseline Milestones TargetLogframe BSF-IA 1,500 NA 1,130 (Goss target 25% reduction)Jam* (March 2005) 1,7002006 Household survey 2,0541

MNRH (draft 2009/12) 2,054 1630 (2010) 1,300 (2012); 1040 (2015)MDG 5 513 by 2015 (2054 reduced by 3 quarters)Logframe BSF-IAe 2,054 3% reduction by end of 2012: from 2054 to 1992

*Jam =UN’s Joint Assessment Mission prior to the CPA.

Depending on the source values and targets for Maternal Mortality vary (Table 8). While the JAM (2005) estimated the ( Maternal Mortality Rate (MMR) at 1700/100,000 live births, the South Sudan Household Survey (SSHS of 2006) reports a MMR of 2,054 per 100,000 live births. MoH’s 2011 Maternal Neonatal & Reproductive Health (MNRH) strategy sets the target for 2012 at 1,300/100,000 live births. Since 2006 MoH nor UN did update this estimate. Therefore there are no data to measure progress towards BSF’s logical framework’s target of a 3% reduction. The District Health Information System (DHIS) and BSF-IAe database are incomplete on maternal deaths because these records are limited to the health facilities and maternal deaths mostly outside the facilities.

In the absence of updated information on MMR “birth attendance by skilled health personnel” can be used to measure progress towards reducing maternal mortality. The proportion of births assisted in the BSF supported health facilities by a skilled health worker (according the MDG definition and MoH policy) of all expected births in 2012 was 1.5%, below BSF’s target of 5% and a fraction of the SSDP target of 30%. Most facility-based deliveries were attended by other health workers with proven delivery skills such as Community Midwives, Community Health workers, village midwives and trained Traditional Birth Attendants (TBA) . But according to the MDG Handbook these do not classify as “skilled” birth attendant. Of all pregnant women (4.2% of catchment population) in the catchment area 11% delivered in a BSF supported health facility compared with 3 % in 2011.

1 This maternal mortality ratio (MMR) is the reported estimate for Southern Sudan from the 2006 Sudan Household Health Survey (SHHS) and pertains to the years 2004-2006. This estimate should be interpreted with caution, as data collection did not follow standard procedures and thus may have statistical errors. An adjusted United Nations inter-agency MMR estimate for South Sudan has not been calculated yet. [from UNICEF Country Programme document 2012-2013]

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Table 9: Proportion of birth attended by skilled health staff; baselines and targets per sourceBaseline Targets

JAM (March 2005) 5% 90% by 2015BSF-IA Logframe 5% (2006) 7% by Dec 2011MNRH Strategy 2011-2013 14.75% (SHHS 2006) 20% by end of 2010

30% by end of 201240% by end of 2015

SSDP (2011-2013) 15% (2010) 30% by end of 201240% by end of 2013

BSF-IAe logframe 5000 (5%) by end of 2012

The baseline and target probably refer to a different definition of skilled attendant. Until 2012 community midwives were also considered skilled as reflected in the Basic Package of Health Services (BPHS). Several BSF-IAe grantees reported skilled attended births using this wider (than MDG’s) definition. BSF Secretariat corrected the figures for this Completion Report.

Table 10: Birth attended by skilled health staff

BSF phaseExpected deliveries (4%)

Deliveries in the facility

% attended by skilled in facility

% attended by ‘unskilled’

Logframetarget skilled attended birth

% attended by skilled staff of all births

BSF IA 74,311 2.9% (2832) 7% 0.78%BSF-IAe 114,046 11% (12613) 14% 86% 5% (5000) 1.5%

BSF invested in quality Ante Natal Care (ANC) and delivery services through pre- and in service training and mentoring on the job of health workers, provision of equipment and essential drugs and regular supervision, thus contributing to safer deliveries and reduction of maternal mortality.

MoH’s targets are not “costed” and therefore not budgeted. For example to increase the “births attended by skilled staff” to SSDP’s (South Sudan Development Plan 2011) target (30%) MoH needs to deploy hundreds of qualified midwives whilst there are presently only very few available. Less than 15% of BSF supported facilities have a qualified midwife. Moreover, in facilities with certificated midwives pregnant women still risk to be attended by unskilled staff as observed in several urban PHCC in Juba and Wau and in hospitals. The qualified midwives tend to become supervisors and advisers leaving the actual birth attendance to community midwives and trained TBAs. Besides it will take several years to train midwives and the training capacity in-country is low. Work permits for non-South Sudanese medical staff are increasingly difficult to obtain. MoH’s policy is to phase out and upgrade Community Midwives to qualified midwives and TBAs to Home Health Promoters.

Impact Indicator 2. Child or Under-five Mortality Rate (U5MR)

Table 11: Under five mortality baselines and targets per sourceUnder-five mortality MDG 4 Baseline TargetJAM (March 2005) 250/1000 (2001) 83/1000 (2015)2006 Household survey 134/1000 (2005/06)BSF-IA Logframe (2010/11) 250/1000 188/1000 (GoSS target 25% reduction by 2011)MNRH Strategy 2009/12 135/1000 ( 2006) 128/1000 (milestone 2011)2010 SSHHS survey 105/1000 live birthsMDG 4 Reduce by two thirds, between 1990 and 2015, the under-5 mortality rateBSF-IAe 135/1000 7% reduction by end 2012 126/1000

Similarly to the MMR, values and targets for (Under 5 years old Mortality rate (U5MR) vary. The latest figures are from the 2010 Household Survey: 105/1000 live births. DHIS only records death of under-fives in the facilities while most children die at home. DHIS data are still incomplete because MoH started the DHIS early 2011 and not all counties have adopted it yet.

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In the absence of updated data on child mortality, Extended program Immunization (EPI) coverage can be used to measure progress towards reducing U5MR v(Table 12). SHHS (2010) recorded a DPT3 (Diphtheria, Pertussis, Tetanus) coverage rate of 15% (against a DPT3 coverage of 20% in the 2006 survey). SSDP sets the target for DPT 3 coverage for 2012 at 60%. BSF-IAe reached a DPT 3 coverage of 46% of all under-ones in the catchment population of BSF supported facilities. This is only an estimate but indicates a sizeable contribution.

Increased utilization of curative health services and access to treatment of malaria, pneumonia and diarrhoeal diseases also shows a trend towards reducing child mortality (Table 13). Utilization of curative (Out Patient department ) OPD services by under-fives is measured by the number of recorded OPD consultations over the total under-five population (20% of catchment population). BSF-IAe supported facilities reported an OPD consultation rate of 1.00 visits per under-five capita per year. There are no comprehensive figures on the utilization of preventive services (immunization, growth monitoring, therapeutic feeding support etc.)

Table 12: DPT3 coverage (Diphtheria, Pertussis,Tetanus)

BSF phase Target group of under one year

Target in logframe

DPT3 completed DPT3 coverage SSDP target

BSF IA (2011) 74,311 n.a. 29,709 40% 50%BSF-IAe (2012) 114,046 35% (33,000) 52,176 46% 60%

Impact Indicator 3. Primary School drop-out rate

Trends show high levels of dropout especially girls in P-4 onward. Reasons for dropout include, poverty (lack of cash for uniforms, fees etc), late enrolment, traditional gender role, low quality of teachers, language barriers and lack of infrastructure. In every round of BSF, through the in-service, pre-service and English language and PTA trainings, BSF grant recipients attempt to address the cultural paradigms that students, especially girls face.

Since 2008 EMIS monitors and records the drop out in all 7000 primary education schools that are included in EMIS database. MoGEI published its first EMIS in 2009 (EMIS is supported by USAID). EMIS drop-out rate is between 25 and 30% in P1-2 which reduces to 15-20% in P2-3 (Fig 1). For girls this rate peaks again at P4-5 when girls reach puberty.

BSF-IAe’s logframe’s baseline (Jan 2012) is 27% (girls 28%). BSF-IAe logframe target is 23%, which is 3% below EMIS’s 2011 average of 26%. For P2-3 and P4-5 the national record is lower than BSF-IAe’s target of a drop out of 23%. That means that this BSF-IAe baseline and target are not in line with EMIS. But the EMIS data should be interpreted with caution since data collection and data quality still need improvement and pupil’s ages vary more than usual, as is typical for a post-conflict situation. The last quarter of 2012 showed a drop-out rate of 16% in schools supported by the organisation HARD and 5% in schools supported by Food for the Hungry (FFH) due to teacher’ salaries not being paid. Lack of payment of teacher salaries, caused teachers to not go to work toward the end of quarter 4, causing higher student attrition rates at the end of 2012 (Annex 10).

Due to influx of returnees to Makal County the enrolment in FFH assisted schools there was high with a pupil to classroom ratio of 176 -MoGEI recommends pupil to classroom ratio is maximum 50.

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P1-P2 P2-P3 P3-P4 P4-P5 P5-P6 P6-P7 P7-P80

5

10

15

20

25

30

35

40

45 2010 F2010 To-tal

Figure 1 South Sudan primary drop-out rate (%) 2010-2012 (EMIS)

OUTCOME

1.2. Outcome: Improved access to effective primary health services and primary education, particularly for vulnerable groups and in priority host communities for returnees

Outcome Indicator 1. Outpatient consultations (curative care)

Table 13: Curative outpatients consultations (all ages) in all BSF phasesduration grant(months)

Number supported facilities

Total catchment population

catchment pop according to

Target OPD consults

Achieved OPD consults

AverageOPD cons per HF

OPD attendance rate

BSF-1 33 69 1,815,000 50,000 per PHCC

15,000 per PHCU

none 74,2914 3,915 0.15BSF-2 18 120 2,605,000 none 75,5146 4,195 0.19BSF-IA 18 195 1,857,774 payam population none 1,511,756 5,168 0.54BSF-IAe 12 272 2,851,149 payam population 760,000 1,367,084 5,637 0.53

BSF-1, BSF-2 and BSF-IA had no targets for Out patients consultations. OPD target for BSF-IAe was based on expected attendance rates converted to absolute figures but these were based on underestimated population figures (Table 13 and Annex 1b).

The figures above are a bit misleading due to the different approach in catchment population estimation. The controversial BPHS standard of a population of 15.000 per PHCU and 50.000 per PHCC used in BSF 1 and 2 resulted in overestimates. After correction (based on average population per facility in BSF-IA and BSF-IAe) the estimated OPD attendance rates for BSF-1 is 0.3 and for BSF-2 it is 0.4. After an initial increase between 2006 and 2010 the OPD attendance rate for curative services stabilizes at 0.5 and exceeds the SSDP targets for 2011-2013.

OPD attendance refers to curative services and excludes preventive services consultations like ANC attendance, immunization, nutrition status screening, HIV/AIDS related services etc. Facilities are in reality busier than the OPD figures suggest.

According to BSF secretariat the returnee population is not included in the population figures of the National Statistical Yearbooks. This affects coverage figures: an estimated minimum of 500,000 returnees

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live in host communities served by BSF supported facilities, based on UN’s Office for Migration. Taking this population increase into account reduces OPD attendance rates as well as coverage figures for ANC, attended delivery and DPT3 immunization.

Outcome Indicator 2. Primary pupil enrolment for classrooms constructed through BSF-2012.

Initially BSF-IAe planned £12m for Primary Health and £6m for Primary Education. In the course of BSF-IAe’s budget grant consultations it became clear that PH needed £14.8m to meet extra demand for payroll allocations (more and higher stipends), for extra drug supplies and for overall price increases. As a result the Steering Committee approved a reduced allocation for Primary Education of £3.55 m and targets for school construction and teacher training lowered from 133 to 48 classrooms and an overall reduction from 1,033 trained teachers (900 ISTT and 133 PSTT) to 214 ISTT and 158 PSTT).

This report compares progress with these reduced targets but the logical framework still has the original targets. Thus the capacity-enrolment for the 48 classrooms constructed reached only 2400 (max. 50 pupils per classroom) compared with the original logical framework target of 8,000 (based on 133 classrooms) and compared with an actual attendance of 4,000 (Annex 10).

OUTPUTS

Output 1. Strengthen primary health services, particularly for vulnerable groups and in priority host communities for returnees

Output Indicator 1.1. Women attending ANC service for 1st timeBSF phase Pregnant women

(4.2%)Target in logframe ANC 1st visit ANC -1 coverage SSDP target

BSF IA (2011) 78,027 n.a. n.a. n.a. n.a.BSF-IAe (2012) 119,748 30% 64,067 54% n.a.

At 54% ANC-1coverage is higher than the logical framework’s target of 30%. But 46% of all pregnant women do not attend ANC services. This percentage is probably even higher when the returnees’ population is taken into account. BSF-IA set no targets for ANC-1 and ANC 4 and recorded only ANC 2+.

Output Indicator 1.2. Women attending 4 or more ANC services

BSF phase Pregnant women (4.2%)

Target in logframe

ANC 4+ visit ANC 4+ coverage

ANC care rate SSDP target

BSF IA (2011) 78,027 n.a. n.a. n.a. n.a. 15%BSF-IAe (2012) 119,748 15% 31,417 26% 49% 30%

Around one quarter of all pregnant women attended ANC services at least 4 times and probably completed the essential TT immunization. Of the 64,067 pregnant women who attended once (see table on indicator 1.1) 31,417 attended at least 4 times. This means that the ANC care rate is 0.49.

Output Indicator 1.3. Births attended by skilled health worker

Births in the facility % of all expected birth attended by skilled staff(MDG)

BSF phase

Expected deliveries (4%)

Logframetarget skilled attended birth

Total % attended by skilled in facility

% attended by ‘unskilled’ in facility

SSDP target*

BSF IA 74,311 7% 2.9% (2832) 0.78% 30%BSF-IAe 114,046 5% (5000) 11% (12613) 14% 86% 1.5% 40%

* SSDP includes community midwives the category “skilled”.

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While a growing number of pregnant women delivers in a health facility (11% in 2012 versus 2.9% in 2011), few pregnant women (1.5%) were actually attended to by a skilled birth attendant during birth giving because qualified midwives are hardly available in South Sudan, particularly in peripheral health facilities. In 3 supported urban PHCC in Juba there are several qualified midwives but in reality only 10% of the deliveries are attended by them. The majority of deliveries is assisted by trained TBAs and community midwives. To what extent the qualified midwives or clinical officers supervise is not recorded or reported. Data on the outcome of the deliveries are incomplete; still births are clearly underreported.

Output Indicator 1.4. Children under 1 year completing DPT3

BSF phase Target group of under one year (4%)

Target in logframe

DPT3 completed

DPT3 coverage SSDP target

BSF IA (2011) 74,311 n.a. 29,709 40% 50%BSF-IAe (2012) 114,046 35% (33,000) 52,176 46% 60%

DPT3 coverage increased over time, exceeds the target in the logical framework but still lags behind the SSDP target. A coverage below 50% indicates that communities remain at risk of epidemics.

Output 2. Strengthened Primary Education Services particularly for vulnerable groups and in priority host communities for returnees

Output Indicator 2.1. Number of classrooms constructed with 2 latrines per classroom, adequate offices, teacher quarters and water points on school site

BSF-IAe ’s enrolment target for the 48 classrooms constructed is 2,400 as based on MoGEI recommend maximum capacity of 50 students per classroom (Annex 10). Actual enrolment reached 4,485. Attendance fell again to 4,000 which is still well above the recommended capacity.

Output Indicators 2.2 Teachers Trained (PSTT) & Output Indicator 2.3 Teachers Trained (ISTT)In BSF-IAe had only six grantees in Primary education, compared with twelve in the previous phase. A total of 214 teachers were trained through ISTT (92% of target) and 158 through PSTT (97% of target). WR's ISTT trainees increased test scores with seven per cent. ACROSS' YTTC PSTT trainees increased theirs with 1%. WTI had a total of 425 teachers complete the ELT and 389 passed. 86% of targeted teachers passed the training (Annex 11).

EMIS 2011 shows that there are approximately 26,549 teachers in South Sudan currently in the school system. Of those teachers, only 3,389 (13%) have received pre-service training. Since 2006 BSF grant recipients have trained 2,198 teachers through in-service and 296 through pre-service training. This is 35% of the national total of teachers trained through in-service and 8% of the national total of teachers trained through pre-service training.

WASHIn GoSS’s post-CPA Transition period DFID dropped the WASH sector from its investment priorities in basic services in South Sudan. As a result £46,915 or 5% of the budget was dedicated for water and sanitation and these investments were strictly limited to wash for primary schools and health facilities. Overall the grantees met their targets (Annex 13).

There always has been, and still is, widespread concern about the sustainability of newly drilled boreholes. According to the MRWI’s 2007 Water Policy document 30-50% of the boreholes in South Sudan are non-functional. There are a number of reasons: poverty, sub-standard drilling, inefficient contracts, spare parts logistics and availability. To improve Value for Money BSF started financing the repair and rehabilitation of broken down boreholes: compare a unit cost of £8,000 for a newly drilled borehole with this cost for repair/rehabilitation of £1,400-3,700 (Annex 18). And the passed cost for drilled borehole are sunk cost and as such are not included in the economic cost benefit analysis making repair and rehabilitation more cost-

12


effective compared with newly drilled boreholes. To maximize VfM further BSF requested grantees to make contracts based on Bill of Quantities or an itemized and costed list of all inputs (rather than lump sums) and imposed the geological survey prior to drilIing.

In 2012 BSF’s secretariat conducted an assessment of all boreholes drilled with BSF financial support. The responses included 69% of the newly drilled boreholes. The 31% of the boreholes on which no information was received are mostly the inaccessible boreholes. The functionality rate was 96.5%. The main reasons for reduced functionality were difficulties with pumping and an objectionable taste or colour. The assessment showed once again that Water User Committees have a positive impact on borehole functionality. Therefore, it is important to continue training of WUC, with a special focus on early warning signs and preventive maintenance.

13


2. Fund ManagementAt the end of BSF-IAe the grant disbursement reached 99% (Annex 3).The combined external grant audits recorded 0.08 % ineligible expenses. Both these percentages indicate high levels of performance in particular taking into account the short 12 months grant period and the short closing down period of 2 months ( DFID extended this to 3 months).

Main factors that contributed to this record are:1 Selection of grantees included financial criteria; submission of at least 3 annual audits and the annual

turnover should be at least twice the requested grant;2 Standard grant budgets linked to targets;3 Monthly invoicing in arrears with monthly inspection of these invoices;4 Two step audits with a first one after 9 month only since this allows more time to make corrections;5 Timely payments-both of DFID to management agent and of management to grantees;6 Decentralized management model with emphasis on BSF’s secretariat in Juba;7 Intensive field monitoring by BMB MM TA team with the grantees (Annex 16);8 Open-door policy of BSF’s secretariat to maximize opportunities for consultation between BMB Mott

MacDonald TA team and the grantees.

14


3. Assumptions and RisksBSF’s logical frame works include numerous assumptions but most of these are not real assumptions since they describe situations that fall within the influence and responsibility of grantee and/or management agent. A real assumption is an external factor which could affect progress, but over which project management has no direct control. Therefore BSF-IAe’s assumption with output 2 :“NGO provide minimum required standard of support” is not a real assumption since the grantee’s standard of support falls within the mandate of the grantee and management consultant.

An assumption is positively formulated, for example “Primary School teachers receive their salaries by the end of the month”. When formulated as negative statements, assumptions become ‘risks’ (i.e. salaries are not paid).

BSF dealt with actually only one overriding circumstance that meets this criteria, namely that the operational budgets of the relevant ministries are on course to meet running costs and salaries by the end of the project (exit strategy).

For example the payroll of MoH; this is a real assumption since it is outside the influence of grantee and management consultant but at the same time it effects the project’s implementation. In short the conclusion is justified that BSF’s extensions (from the original small grant fund of GBP 8m meant as a short bridge to the MDTF to what became a total of seven years of consecutive phases of grant funds amounting to a total of £ 105 m GBP) became necessary because the main assumption, that GOSS would pay salaries in basic services, was not met. The fact that the CPA would hold was also an important assumption that, in spite of severe security crisis, did come through.

3.1 Austerity budgetIn the period 1 January-31 December 2012 (BSF-IAe) two national budgets applied: The first one for FY 2011/12 from 9 July 2011 -8 July 2012 and the second from 9 July 2012 -8 July 2013 and BSF overlapped with 6 month. Both budgets for the FY 2011/12 and FY 2012/13 were austerity budgets to deal with the reduced oil revenues since GOSS stopped the oil production early in January 2011 (and production only resumed in March 2013). The influence of these austerity budgets on basic services is difficult to quantity but should not be underestimated.

Initially BSF-IAe planned to disburse 12m GBP for Primary Health and 6m GBP for Primary Education. In the course of the budget consultations it became clear that PH needed 14.8m GBP to meet extra demand for payroll (more and higher stipends); for extra drug supplies and for overall price increases. Since June 2011 the border between Sudan and SS has been closed. As a result prices of essentials (diesel etc.) doubled and in Upper Nile tripled; there are also food shortages (grantees have to ship in food for their staff at a high cost in for example Baliet and Kodok).

There are several issues with MoH salaries. Firstly, the electronic payroll is relatively new, secondly the conditional transfers are under-budgeted and thirdly the last 3 years salaries have not increased. Besides this, MoH is not yet fully compliant with MoFEP instructions that only classified staff (professional Grade 5 and up of enrolled nurses) are included and all non-classified (un- and semi-skilled) staff are excluded from the payroll.

Additionally, the allocation for Primary Health increased to provide a reserve for six bridging grants to 4 former USAID/SHTP grantees (IRC, SCISS, CCM and John Snow int.) in the states where the new HPF would be implemented for the five month period between1 August -31 December 2012 when HPF started.) .

15


4. Unit CostsThe unit costs for construction are recorded in Annex 18 a-18d. These costs do not easily lend themselves for benchmarking and analysis of value for money mainly because:(i) there are no construction blueprints for schools and health facilities and as a result standards and size vary; (ii) South Sudan is a big country with an exceptionally poor transport infrastructure; (iii) geological conditions differ: foundations in soft sub soils increase construction costs compared with rocky undergrounds that do not require foundations. Security also played an important role in the costs of transport in particularly when, in early 2011, the border with Sudan closed and essentials like fuel had to be flown in.

But one conclusion stands out: compare a unit cost of £8,000 for a newly drilled borehole with the cost for repair/rehabilitation of £1,400-3,700. All cost incurred in the past for a drilled but broken borehole are so called “sunk cost” and these sunk costs need not be included in the economic cost benefit analysis. This makes repair and rehabilitation three to four times as cost-effective compared with newly drilled boreholes

.

16


Annex 1a. Logical FrameworkPROJECT NAMEIMPACT Impact Indicator 1 Baseline Milestone 1 Milestone 2 Milestone 3 Target (date)Improved health and education particularly in communities hosting large numbers returnees

Maternal Mortality Rate (MMR)

Planned 2,054 per 100,000 births - - - 3% reduction (2012)

AchievedSource

South Sudan Health Household survey 2006, the target data will be from LQAS 2012

Impact Indicator 2 Baseline Milestone 1 Milestone 2 Milestone 3 Target (date)Child Mortality Rate (<5y) Planned 135 per 1,000 - - - 7% reduction (2012)

AchievedSource

South Sudan Health Household survey 2006, the target data will be from LQAS 2012

Primary school drop-out rate Baseline Milestone 1 Milestone 2 Milestone 3 Target (date)Planned M: 26.8

F:28.2T:27.3

- - - M: 22.4F: 23.2T: 22.8

AchievedSource

EMIS 2010

17


OUTCOME Outcome Indicator 1 Baseline

Milestone 1 Milestone 2 (6/2012) Milestone 3 Target (date) Assumptions

Improved access to effective primary health services and primary education, particularly for vulnerable groups and in priority host communities for returnees

Outpatient consultations Planned 0 380,000 760,000 (Dec 2012) Other service providers achieve similar improvements in access to services as BSF. No major adverse external events affect health, e.g. epidemics, security breakdown, famine

AchievedSource

BSF Quarterly ReportOutcome Indicator 2 Baselin

eMilestone 1 Milestone 2 (6/2012) Milestone 3 Target (date)

Primary pupil enrolment for classrooms constructed through BSF-2012

Planned 0 0 8,000 (Dec 2012)

AchievedSource

BSF Quarterly ReportINPUTS (£) DFID (£) Govt (£) Other (£) Total (£) DFID SHARE (%)

20m 0 0 20m 100INPUTS (HR) DFID (FTEs)

18


OUTPUT 1 Output Indicator 1.1 Baseline Milestone 1 Milestone 2 (6/2012)

Milestone 3 Target (date) Assumption

Strengthened primary health services, particularly for vulnerable groups and in priority host communities for returnees

Women attending 1 ante-natal care visitsPlanned 0 15,000 29,000 (Dec

2012)MoH and NGOs provide minimum required standard of support for health facility operation.-Inflation and its affect on the budget does not have an impact on achievement of results.

AchievedSource

BSF Quarterly ReportOutput Indicator 1.2 Baseline Milestone 1 Milestone 2

(6/2012)Milestone 3 Target (date)

Women attending 4 ante-natal care visitsPlanned 0 7,500 15,000 (Dec

2012)Achieved

SourceBSF Quarterly Report

Output Indicator 1.3 Baseline Milestone 1 Milestone 2 (6/2012)

Milestone 3 Target (date)

Births attended by skilled health workers Planned 0 2,500 5,000 (Dec 2012)Achieved


IMPACT WEIGHTING (%)



60 Under 1s completing DPT 3 Planned 0 16,500 33,000 (Dec 2012)

AchievedSource RISK RATING

BSF Quarterly Report LowINPUTS (£) DFID (£) Govt (£) Other (£) Total (£) DFID SHARE (%)

13.1 0 0 13.1 100INPUTS (HR) DFID (FTEs)

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OUTPUT 2 Output Indicator 2.1 Baseline Milestone 1 Milestone 2 (6/2012)

Milestone 3 Target (date) Assumptions

Strengthened primary education services particularly for vulnerable groups and in priority host communities for returnees

Classrooms constructed (with 2 latrines per classroom, adequate offices, teacher quarters, latrines and water points on school site)

Planned 0 0 160 (Dec 2012) -MoE and NGOs provide minimum required standard of support for school operation- That the impact of the closed border between South Sudan and Sudan, which is having an impact on prices of essential goods, does not affect achievement of these results.

Achieved




Teachers completing pre-Service Training (completion of final year of a 4 year course)

Planned 0 0 133 (Dec 2012)Achieve

dSource

BSF Quarterly ReportIMPACT WEIGHTING (%)



40 Teachers completing in-service Training begun under BSF-IA

Planned 0 0 900 (Dec 2012)Achieve

dSource RISK RATING

BSF Quarterly Report mediumINPUTS (£) DFID (£) Govt (£) Other (£) Total (£) DFID SHARE (%)

6.9 0 0 6.9 100INPUTS (HR) DFID (FTEs)

20


Annex 1b. Source table for Logframe

1 2 3 4 5 6BSF IAe Value Source Formula 26 February comments/corrections by BSF secretariat

1 PopulationHPF statesCounty based

1,476,976 These estimates are based on Census county population figures, but BSF-IAe rarely covers a full county - therefore new estimates are based on Payam population figures

2 PopulationNon-HPF statesCounty based

1,115,595 These estimates are based on county population but BSF-IA rarely covers a full county - therefore new estimates are based at Payam level.

3 Total population in BSF IAeproject areaCounty based

2,595,571 1,476,976 + 1,115,595

Figure is based on Census 2008 data and corrected for population growth.

4 Under fivesCounty based

410,105 15.8% (SSHS) 2,595,571 x 15.8 /100

The percentage is based on age group specific figures of the Census 2008.

5 BSF IAepopulation in project area Payam based

1,892,954

6 CBR 50.5 /1000 WHO / SSHHS A crude birth rate of 5% seems high (see note below). Different sources provide different figures ranging from 3% to 5%

7 Number of expected births

95,594 5.05% of 1,892,954

8 Children under 1 95,594 5.05% of 1,892,954 With a child / under one the mortality rate of 106/1000 the children reaching 1 year are 86,035.

Available key documents on demographic data state that the CBR is high: 50.5/1000 while the under 5 groups represents 16% of the population according to the South Sudan Household Survey 2010. Thus only 64% reach the age of 5 year. This does not correspond with the U5 mortality figure of 250/1000 (UNFPA April 2007) or 135/1000 (MNRH Strategy 2009 / SSHH survey 2006). According to the BSF-primary health consultant the CBR may be lower, rather 4% than 5%. This corresponds with demographic figures used by the EPI departments of the MoH. Births: 4%, age group 12-23 months: 3.5%

9 Primary school age group (5-18)

717,254

21


Targets outputs

Value Source Formula 26 February comments/corrections by BSF secretariat

10 Children under one year immunized with DPT-3

33,000 (logframe)

SSDP target for DPT 3 is 60% by the end of 2012BSF IAe has set a lower target of 35%

95.594 / 100 x 35 If at least 33,000 children will be immunized with DPT3 in BSF IAe a 35% DPT-3 coverage is achieved.

The grantees have set a total target of 53,894 children to complete DPT3 = 63%. If this is achieved, the SSDP target of 60% is reached.

11 Births attended by skilled health workers

5,000(log frame)

SSDP target = 30% by end 2012

Target BSF-IAe was initially set at 15% but seemed too ambitious. Reduced to 5% by DFID

5000 = approximately 5% of all expected births

5% of all births = 4779.

1,892,954/1000 and x 50.5 (CBR) =95,594 births5% of this CBR =4779 so target is 5,000 (rounded) based

Amended by DFID: to 5000 births attended by a skilled health worker.

BSF-IAe will closely monitor the developments with regard to attended deliveries by other trained health personnel with proven delivery skills such as community midwives and MCHW. The observed trend in BSF-IA is that these health workers are staffing the first line facilities; enrolled MW are very scarce.

8a Pregnant women paying 1st ANC visit

29,000 BSF-IAe target for 2012 is 30% first ANC

29,000 = 30% of 95594 (all pregnant women / CBR)

HMIS / DHIS record 1 and 4 ANC and BSF-IAe database needs to be consistent. Log frame therefore includes 1st ANC and 4th ANC visit. BSF IA only recorded ANC 2 or more.

BSF-IAe grantees set a total target of 57,526 1st ANC = 60%

22


8b Pregnant women paying 4 ANC visits

15,000 BSF-IAe target for ANC 4th visit : 15%

SSDP target =30% by the end of 2012

15% of 95,594 = 14,339, rounded off to 15,000

BSF-IA recorded only the number of pregnant women with 2 or more ANC visits and achieved 45,345 in 12 months.BSF-IAe grantees set a total target of 28,449 = 30%

9 Number of OPD consultations per person per year / utilization rate

1,892,954 x 0.4 =757,181Rounded 760,000

SDDP target = 0.4 by the end of 2012

BSF-IAe target : 0.4

The BSF-IAe grantees have set a total of 1,786,601. If this is achieved, it would mean a utilization rate of 0.94, twice as high as the SDDP target. The grantees targets may therefore be too ambitious and deserve close monitoring

10 Pupil enrolment BSF-IAe target: 8000

160 classrooms x 50 pupils = 8000

11 Number of classrooms constructed

BSF-IAe target: 160

12 Teachers completing pre-service training

BSF-IAe target : 133

13 Teachers completing in service training

BSF-IAe target : 900

The target is 900 ( these are the students enrolled in BSF-IA (target 1043) that will complete their ( 4 stage ) training in 2012

The education impact indicator is now "Drop out Rates." DFID

Disclaimer recommended by BSF secretariat: since June 2011 the border between Sudan and SS is closed. As a result prices of essentials (diesel etc) have doubled and in Upper Nile tripled; There are

also food shortages (grantees have to ship in food for their staff in for example Baliet and Kodok) . This emergency situation will affect the BSF-2012 budgets for Primary Health; the targets for education

cannot therefore be confirmed until the new budgets for 2012 are approved

23


Annex 2. Grantee OverviewLEAD AGENCY

CONSORTIUM MEMBERS

START DATE END DATE MONTH

Contract amount

Addendum 1

BUDGET GBP

ADRA CDS, AMA 01-Jan-12 31-Dec-12 12 600,655 24,924 625,579ARC SUH, KDI,CLCP 01-Jan-12 31-Dec-12 12 750,959 750,959

AVSICatholic Diocese of Torit 01-Jan-12 31-Dec-12 12 597,736 28,470 626,206

CARE 01-Jan-12 31-Dec-12 12 999,129 999,129CCM 01-Jan-12 31-Dec-12 12 644,469 191,554 836,023CMSI ECS 01-Jan-12 31-Dec-12 12 120,000 30,000 150,000Concern 01-Jan-12 31-Dec-12 12 707,000 707,000

CordAidCatholic Diocese of Tambura-Yambio 01-Jan-12 31-Dec-12 12 345,009 345,009

GOAL 01-Jan-12 31-Dec-12 12 1,363,584 1,363,584HealthNet CRM 01-Jan-12 31-Dec-12 12 1,187,367 22,377 1,209,744IMA (UN) JDF 01-Jan-12 31-Dec-12 12 711,654 711,654IMA (JON) JDF 01-Jan-12 31-Dec-12 12 766,447 (56,635) 709,812IMC PRDA, NHDF 01-Jan-12 31-Jan-13 12 775,480 95,520 871,000Malteser 01-Jan-12 31-Dec-12 12 616,486 616,486Merlin 01-Jan-12 31-Dec-12 12 698,550 698,550

OVCICatholic Archdiocese of Juba 01-Jan-12 31-Dec-12 12 398,893 398,893

Tearfund 01-Jan-12 31-Dec-12 12 1,099,775 1,099,775World Vision

Catholic Diocese of Tambura-Yambio 01-Jan-12 31-Dec-12 12 600,001 (38,070) 561,931

JSI see note) 01-Aug-12 31-Dec-12 5 233,341 (100,000) 133,341IRC 01-Aug-12 31-Dec-12 5 654,226 654,226SciSS 01-Aug-12 31-Dec-12 5 705,121 705,121TOTALS: Primary Health: 20 GRANT RECIPIENTS 14,774,022WTI 01-Jan-12 31-Dec-12 12 454,584 25,307 479,891

ACROSSYei Teacher Training College 01-Jan-12 31-Dec-12 12 400,328 400,328

MRDA 01-Jan-12 31-Dec-12 12 399,351 399,351WR ECS 01-Jan-12 31-Dec-12 12 406,699 406,699HARD 01-Jan-12 31-Dec-12 12 998,022 18,394 1,016,416FFH SDA 01-Jan-12 31-Dec-12 12 892,735 21,769 914,504TOTALS: Primary Education: 6 GRANT RECIPIENTS 3,617,189GRAND TOTAL: 27 GRANT RECIPIENTS 18,391,211Underspent: -43,921GRAND COMPONENT: 18,347,290

1. CCM received a BSF contract amendment for an increase to £ 836,023 to support the facilities previously covered under the SHTP-2 grant in Warrap-State, Tonj South-County.

2. JSI, IRC and SCiSS are ex USAID SHTP grantees funded by BSF from August 2012-31 December 2012..

24


Annex 3. Grantee Disbursement

NGO

Contract amount (GBP)

Contract period Actual expenditure

Budget remaining

(GBP)PeriodNo.

MonthsAmount (GBP) %

up until

Month

No. of month

s (%)ADRA 625,579 01.01 - 31.12.12 12 621,408 99 Dec-12 12 100 4,171

ARC 750,959 01.01 - 31.12.12 12 750,959 100 Dec-12 12 100 0

AVSI 626,206 01.01 - 31.12.12 12 626,206 100 Dec-12 12 100 0

CARE 999,129 01.01 - 31.12.12 12 962,788 96 Dec-12 12 100 36,341

CCM 836,023 01.01 - 31.12.12 12 835,960 100 Dec-12 12 100 63

CMSI 150,000 01.01 - 31.12.12 12 149,896 100 Dec-12 12 100 104

CONCERN 707,000 01.01 - 31.12.12 12 707,000 100 Dec-12 12 100 0

CORDAID 345,009 01.01 - 31.12.12 12 344,986 100 Dec-12 12 100 23

GOAL 1,363,584 01.01 - 31.12.12 12 1,363,584 100 Dec-12 12 100 0

HealthNet TPO 1,209,744 01.01 - 31.12.12 12 1,180,643 98 Dec-12 12 100 29,101

IMA (UN) 711,654 01.01 - 31.12.12 12 693,258 98 Dec-12 12 100 18,396

IMA (JON) 709,812 01.01 - 31.12.12 12 709,812 100 Dec-12 12 100 0

IMC 871,000 01.01 - 31.01.13 13 833,399 68 Jan-13 13 92 37,601

MALTESER 616,486 01.01 - 31.12.12 12 616,102 100 Dec-12 12 100 384

MERLIN 698,550 01.01 - 31.12.12 12 698,550 100 Dec-12 12 100 0

OVCI 398,893 01.01 - 31.12.12 12 398,834 100 Dec-12 12 100 59

TEARFUND 1,099,775 01.01 - 31.12.12 12 1,099,460 100 Dec-12 12 100 315

World Vision 561,931 01.01 - 31.12.12 12 532,507 95 Dec-12 12 100 29,424

WTI 479,891 01.01 - 31.12.12 12 479,891 100 Dec-12 12 100 0

ACROSS 400,328 01.01 - 31.12.12 12 399,927 100 Dec-12 12 100 401

MRDA 399,351 01.01 - 31.12.12 12 399,351 100 Dec-12 12 100 0

World Relief 406,699 01.01 - 31.12.12 12 406,699 100 Dec-12 12 100 0

HARD 1,016,416 01.01 - 31.12.12 12 1,016,416 100 Dec-12 12 100 0

FFH 914,504 01.01 - 31.12.12 12 914,504 100 Dec-12 12 100 0

JSI 133,341 01.08 - 31.12.12 5 132,583 100 Dec-12 5 100 758

IRC 654,226 01.08 - 31.12.12 5 629,923 96 Dec-12 5 100 24,303

SCiSS 705,121 01.08 - 31.12.12 5 670,013 95 Dec-12 5 100 35,108

Under spent by NGOs -43,921 -43,921Total allocated BSF IAe

18,347,290 18,174,659 99 172,631

Unallocated 0

25


Annex 4a. Primary Health Targets and Achievements in all 4 phasesBSF-1 ( 33 months ) BSF-2 (18 months) BSF-IA (18 months) BSF-IAe (12 months)

Target Achieved % TargetAchieve

d % Target Achieved % Target Achieved %

New PHCC 18 7 39 5 3 60 10 12120 1 1

100

Rehabilitated PHCC 0 6 0 8 0 15 - -

PHCC services supported 6 9 21 19 52 32 62 70 70100

New PHCU 36 18 50 12 23192 40 35 88 1 1

100

Rehab PHCU 0 11 0 6 0 22 - -

PHCU Services supported 5 15300 75 60 80 142 101 71 201 201

100

Hospital Services supported 0 3 0 1 0 1 1 1

OPD Consultations (< and > 5) 0 (1) 742,914 0 (1) 755,146 1,857,744 (3) 1,511,756 81 760,000 (4) 1,367,084180

Catchment Population) (2)1,815,00

0 1,910,0002,605,00

02,885,00

0 2,851,149

(1) Logframe for BSF-1 &2 set no OPD consultation targets. Only actual OPD attendance figures of each facility were recorded. (2) Catchment populations in BSF-1 & 2 were calculated in accordance with BHPS of 50,000 beneficiaries for a PHCC and 15,000 for a PHCU. As a

result the catchment population estimates proved too high.(3) In BSF-IA the target for OPD consultations was calculated as follows: 0.5 consultations per year per capita in payam population for newly established

health facilities; 0.7 consultations per year per capita in payam population for already supported facilities. Payam population data based on 2008 Census - National Bureau of Statistics.

(4) The OPD consultation target for BSF-IAe was based on the SSDP target for 2012 of 0.4 consultations per person per year: 1,892,954x0.4=757,181 so target is 760,000 rounded (see also annex 1c Source Doc)

The table below shows the OPD consultation rate for each of the phases, corrected for the duration of the grants

PhaseNo. months in thegrant

facilities

catchment pop

catchment pop acc toOPD consultations

OPD consultations per year

OPD consultationsper HF

OPD attendance rate

26


BSF-1 33 69 1,815,000 50,000 per PHCC15,000 per PHCU

742,914 270,151 3,915 0.15BSF-2 18 120 2,605,000 755,146 503,431 4,195 0.19BSF-IA 18 195 1,857,774 payam population NBS 1,511,756 1,007,837 5,168 0.54BSF-IAE 12 272 2,851,149 payam population NBS 1,367,084 1,367,084 5,637 0.53

27


Annex 4b. Primary Education Targets and Achievements in 4 PhasesStudent Beneficiaries Primary Education BSF 1-IAe BSF-1 BSF-2 BSF-IA BSF-IAe Cumulative

AchievedTarget Achieved % Target Achieved % Target Achieved % Target Achieved %

New Classrooms constructed 152 160 105 161 192 119 220 218 99 48 48 100 618School services 51 47 92 63 40 63 17 17 100 - - - -Beneficiaries (pupils) ( 1) 28,000 26,800 96% 33,250 25,600 77% 17,800 17,700 99% 2,400 2,400 100% -

%: Percentage of target achieved

(1) Beneficiaries are calculated as 50 pupils per classroom or per school support service

Teachers trained

(1) The figures for CEDs and Head Teachers trained were only in BSF-IAe disaggregated(2) ELT – 389 teachers passed the ELT stage of training versus 425 enrolled in the course

28

Primary Education BSF 1-IAe ISTT PSTT CED (1) Head Teachers (1) ELTBSF-IAe 214 158 231 164 389 (2)BSF-IA 718 133 373 1,180BSF- 2 1,248 6 736 39BSF-1 812 0 22 0


Annex 4c. WATSAN Targets and Achievements in 4 Phases

WATSAN BSF1-IAeBSF-1 BSF-2 BSF-IA BSF-IAe Cumulativ

e AchievedTarget

Achieved % Target

Achieved % Target

Achieved % Target

Achieved %

New boreholes 195 156 80 138 148107 214 250

117 28 25 89 579

Rehab boreholes 84 55 65 110 155141 234 303

129 47 37 79 -

Total boreholes 279 211 76 248 303122 448 553

123 75 62 83 -

Other water sources (1) 1 110

0 10 6 60 148 171116 11 18

164 196

Water beneficiaries (users) (2) 69,750 52,750 76 62,000 75,750122

112,000 138,250

123 18,750 15,500 82 -

Institutional latrines (stances) - - - 234 360154 791 780 99 107 113

106 1,253

Household latrines - - - 1,756 1,246 71 4,246 3,309 78 0 0 4,555

Total latrines 763 1,19315

6 1,990 1,606 81 5,037 4,089 81 107 11310

6 5,808

Sanitation beneficiaries (3) 3,815 5,96515

6 20,480 24,230118 60,780 55,545 91 5,350 5,650

107 -

(1) This includes hafirs, sand filters, rainwater harvesting system, small water distribution system etc. As the number of beneficiaries varies for each system, it has not been estimated.

(2) Borehole beneficiaries were originally calculated on the basis of 500 beneficiaries per unit, as per the SPHERE handbook (estimate for emergency situation). BSF reduced this estimate to 250 in accordance with the MWRI's Technical Guidelines for construction and management of boreholes and hand-pumps (2009)

(3) Sanitation beneficiaries are estimated as 5 people per household latrine and 50 beneficiaries for institutional latrines.

29


Annex 5a. Steering Committee Meeting RecordNo.

Date Place Agenda Participants

1 28 October 2005 Rumbek

BSF and TOR SC n.a.

2 10/11 January 2006

Juba Capacity building of SC and selection proposals 20

3 6, 7 April 2006 Juba Update on progress and 2nd call for proposals 204 6, 7 Sept 2006 Juba Evaluation of BSF NGOs, procedure for 2nd call 185 17 October 2006 Juba Pre-selection 2nd call 96 13 December 2006 Juba Selection of short listed proposals7 7 May 2007 Juba Progress on implementation 158 22 August 2007 Juba Progress on implementation 149 6 December 2007 Juba Progress on implementation 1410 10 January 2008 Juba Briefing MTR 1511 19 January 2008 Juba De-briefing MTR 2012 14 May 2008 Juba Progress on implementation and future of BSF13 27 May 2008 Juba BSF and TOR SC 1514 15 July 2008 Juba BSF extension 1215 19 August 2008 Juba Planned16 15 Sept 2008 Juba 3rd round priorities (special session on planning) 1217 4 November 2008 Juba 3rd round concept papers pre-evaluation 1418 10 December 2008 Juba 3rd round proposal ranking 1119 10 March 2009 Juba Update on closing down Phase-1, starting up

Phase-216

20 13 July 2009 Juba Update on implementation and exit strategies 2021 26 August 2009 Juba Annual review debriefing22 20 October 2009 Juba Progress on implementation and future of BSF 2523 27 January 2010 Juba Implementation update 2524 24 March 2010 Juba Disbursement update, revised SC ToR, application

procedures new round of proposals18

25 14 May 2010 Juba BSF-2 & BSF-IA 1726 1 June 2010 Juba BSF-2 & BSF-IA 2527 8 Sept 2010 Juba BSF-IA 2128 9 December 2010 Juba BSF-IA 2029 30 March 2011 Juba BSF-IA; debriefing MTR 2011 2730 9 May 2011 Juba BSF-IA 1331 6 July 2011 Juba BSF-IA 2232 26 August 2011 Juba BSF-IA 2033 4 November 2011 Juba BSF-IA 2234 20 January 2012 Juba BSF-IAe 1835 4 April 2012 Juba BSF-IAe 1636 25th May 2012 Juba BSF-IAe 1637 11th September

2012Juba BSF-IAe 16

38 9th November 2012 Juba BSF Review mission 2339 31 January 2013 Juba BSF-IAe progress and closing down No quorum

30


40 26 March 2013 Juba BSF-IAe closing down 27

31


Annex 5b. Key DatesYear Date Event and details

2005 September DFID Khartoum contracts the IDL group (UK) and Skills for Southern Sudan to help prepare the establishment of the Basic Services Fund

October First Steering Committee Meeting in Rumbek announcing the launch of the Basic Services Fund

November Skills for Southern Sudan launches first call for proposals

December DFID invites 6 consultancy companies to tender for the provision of management consultancy services to the BSF

2006 January Second SC meeting to decide on selection of projectsDFID informs selected NGOs about award of contract

February Deadline for the submission of tenders for the proposals for the management consultant

March DFID Khartoum signs accountable grant agreements with NGO grant recipients

Q2 Grant recipients receive first advance payments directly from DFID

August DFID signs contract with selected management consultant BMB Mott MacDonald (formerly Arcadis BMB)

Q 4 BMB MM starts transfer of contracts with grant recipients from DFID to BMB MM; DFID closes all grant agreements by Dec. 2006

September BMB MM launches 2nd call for proposals

October Information workshop in Juba with pre-selected NGO

December Steering Committee meeting to decide on selection of NGOsBMB MM informs selected NGOs about award of contract

2007 January Second round project contracts signed between Grant recipients and BMB MM and effective 1 January 2007

February DFID and BMB MM sign contract amendment no.2 which includes £14.94m in NGO programme funds (omission in initial contract)

March BMB MM starts to reimburse first claims from NGOs

November Planned Mid Term review gets delayed until December and later until January 2008

2008 January Post-election crisis in Kenya delays return of many international staff NGO staff

January BSF-1’s Mid Term Review (originally planned for Nov 2007) takes place

April DFID extends contract with BMB MM with 8 months until 31 December 2008 and tops up programme funds with £1.68m

Q1-2 Contracts with NGOs are extended till 30 September 2008; all receive a cost extension, except AMREF, SC-US and SC-UK due to delays with implementation

July Fieldtrip from Lessons Learnt analysis Primary Education

12 August Start dissemination Lessons Learnt workshop Primary Education

Q3 Contracts with NGOs are extended till 31 December 2008; this is a no-cost extension, without additional funding

Q 4 Decision to extend all first and second round BSF Grant recipients in primary health

September BMB MM launches 3rd call for proposals

Launch SRF (verify date) 1st call proposals (relevant to BSF?? WG)

26-29 October GOSS-second National Health Assembly (BSF consultant assisted in preparing the proceedings (on website)

November Information workshop in Juba with pre-selected NGOs

December Steering Committee meeting to decide on selection of NGOsBMB MM informs selected NGOs about award of contract

2009 January DFID as lead donor signs agreements with NORAD and DGIS for additional contributions to BSF.

January DFID and BMB MM sign contract amendment no.9 which includes extension till 31 August 2010 (phase 2) and new programme funds of £17.4m

February Phase 2 project contracts signed between Grant recipients and BMB MM and effective 1 January 2009 for a duration of 18 months

12 February Start dissemination and sharing Lessons Learnt in Water & Sanitation

32


Year Date Event and details

April CIDA contribution is confirmed and DFID and BMB MM sign contract amendment no. 10, which includes additional programme funds of £3.9m

4th April Kick-off meeting with third round BSF grantees

April Field work on follow-up lessons learnt Primary Education

April BMB MM signs contracts with 4 additional grant recipients selected as runners-up during the third call evaluation process; projects have a start date of 1 April 2009 and a duration of 15 months

20 May Financial reporting workshop

June Closure of all contracts signed with grant recipients selected in calls 1 and 2 (phase 1)

5 June Financial reporting workshop

16 June Closing workshop on first Peer Review that took place in Q 4 of 2008 (presentation of main findings and conclusions)

22 September DFID and BMB sign contract amendment no. 11 including a reduction of the CIDA contribution (due to sterling – dollar exchange rate fluctuations) plus a transfer of unspent programme funds from phase 1 to phase 2

October Third GoSS Health Assembly was planned but did not take place (BSF will assists again with consultant for the drafting of proceedings)

26 October Submission of Phase 1 Final Report

2010 20 March Closing down workshop for BSF Implementing Partners

13-15 April National Elections

March-April Round of negotiations with NGO Implementing Partners to re-allocate budgets

1 March-30 June BSF-IA Inception phase

April-May Contract amendments (budget revisions) with NGO Implementing Partners

30 June End of contracts Primary Heath extension (round 1 and 2)

30 June End of contracts Round 3A and 3B

July - August BSF grantees submit final completion report, updated asset list, expenditure verification report (audit) and final invoice

1 July ( 31 December 2011)

Start BSF-Interim Arrangement

31 August End of contract DFID-BMB MM

30 September Submission of Phase 2 Final Report

15 October DFID-BMB contract BSF-IA

2011 14 March-1 April BSF-IA Mid Term Review

9 January Referendum on status of Southern Sudan

9 July 2011 First independence Day for South Sudan

9 July Ends 6 year CPA Interim Period ( 9 July 2005-9July 2011)

9 July 2011 Start of 4 year Transition period (9 July 2011-9 July 2015)

11 July GOSS & DFID decide on extension of BSF-IA into a BSF-IA extension phase ( 1 Jan-31 December 2012

1 August Returnees allocation

September Drafting of DFID’s business case for BSF-IA extension

Quarter 4 Internal assessment of grantees for BSF-IA extension

5 December Deadline submission budget & work-plan for BSF-IA grants

31 December BSF-IA grants close

December/January Budget consultations with BSF-IA extension grantees

2012 1 January-29 February

Closing down (completion reports and final audits)

1 January Start of BSF-IA extension grants

15 January Contracts BSF-IA extension signed

January South Sudan Government stops oil production

January Sudan-South Sudan border closed

Transition from BSF to MoH’s Rapid Results Health Project (financed by World Bank) Jonglei and Upper

33


Year Date Event and details

Nile

March Refugee crisis due to conflicts in South Kordofan and Blue Nile

1 August Transition contracts. Ex. SHTP2 grantees in HPF states were integrated into the BSF fund.

4 August Draft agreement South Sudan –Sudan on oil production and other (CPA) outstanding issues

27 September Agreement on oil production, citizenship, trade and security (1,800 km long and 15 km wide demilitarized buffer zone)

18 October Planned mobilization new HPF Fund manager

4-9 November BSF review mission

31 December Last day of grant period (grant expenses after midnight of 31 December are not eligible)

2013 1 January-31 March

BSF fund manager closing down period

15 April Deadline BSF-IAe Completion report

26 March 40th and last Steering Committee

34


Annex 6a. Summary Table – Primary Health ServicesT=Target, A = Achieved, F=Female

Lead Agent

Facility Services (Cumulative) Consultations (Cumulative)

PHCC PHCUTotal

Consultations >5 years

Total Consultations < 5

yrs

ANC client 1st

visit

ANC client 4th or more visits

EPI; No.

children < 1 full DPT

Birth attended

by skilled

workers

T A T A Total F Total F Total Total Total Total

ADRA 2 2 14 14 34,849 19,324 22,913 12,051 2,788 1,667 3,975 103

ARC 6 6 2 2 24,843 14,555 16,795 8,793 1,600 803 5,054 191

AVSI 3 3 7 7 42,966 21,975 26,824 13,645 1,675 444 339 74

CARE 9 9 5 4 76,244 44,590 53,225 30,024 10,058 2,451 4,962 68

CCM 3 3 15 15 92,942 47,349 56,783 28,824 7,270 2,211 5,011 75

CMSI 1 1 4 4 10,825 7,484 9,035 4,176 3,135 1,024 1,731 0

CONCERN 2 2 16 20 77,187 42,454 42,952 21,495 9,987 5,013 4,967 124

CORDAID 2 2 6 6 18,779 9,094 10,939 5,299 1,159 741 571 32

GOAL 2 2 6 6 49,122 28,023 30,597 16,766 2,608 1,092 3,177 106

HealthNet 6 6 28 28 95,479 53,613 59,878 30,489 4,695 3,036 8,781 27

IMA (JON) 3 3 9 9 20,624 10,972 9,766 5,118 656 348 281 63

IMA (UN) 1 0 5 5 39,475 22,332 23,516 12,087 2,204 1,634 3,346 188

IMC 2 2 10 10 39,837 21,403 25,496 12,911 2,067 684 445 66

IRC 2 2 13 13 27,950 17,281 16,320 8,451 2,143 346 913 0

JSI 6 7 6 5 25,495 15,427 11,492 5,459 2,315 1,498 375 3752

MALTESER 4 4 20 20 41,156 21,621 19,781 10,031 1,373 1,474 1,135 0

MERLIN 7 7 2 2 36,645 20,598 26,663 13,753 1,714 709 2,441 15

OVCI 1 1 0 0 10,952 6,273 5,865 2,423 922 876 419 161

SCiSS 2 2 13 13 15,949 7,942 9,412 4,779 1,558 302 1,620 40

TEARFUND 2 3 9 9 42,220 23,916 34,729 19,815 2,859 3,924 2,888 0

WORLD VISION 2 2 8 8 20,776 10,846 9,788 4,759 1,281 1,140 1,128 41

Total 68 69 198 200844,31

5467,07

2522,76

9271,14

8 64,067 31,417 53,559 1,749- HealthNet: Bonyo PHCU has not been sending reports – status unclear, Timsah PHCU (Raga County; WBeG)

has not been accessible and reporting in Q4 due to insecurity. Maluil PHCC (Jur River, WBeG) closed because the SMoH were not able to supply staff.

- JSI: 6 PHCCs targeted, 7 Achieved. The 7th PHCC is support to the ANC clinic operated by Wau Midwifery School, with additional ANC attendance returns only.

- OVCI runs Usratuna PHCC and provides technical assistance to the maternity services of three urban MoH PHCCs: Kator, Nyakuron & Munuki. OVCI also conducts EPI outreach in close collaboration with the CHD

- Tearfund: Kodok PHCC was not targeted for Tearfund support since its handover to SMoH but has been consistently supported with 9 key staff, medical equipment, utilities, training etc. by Tearfund, hence included in achievements.

2 JSI reported a too high number of skilled attended births and skilled attended staff. BSF Secretariat corrected the staffing figures

but could not correct the delivery figures due to lack of information in spite of repeated requests to JSI. The real figure is likely to be

approximately 150 skilled attended births instead of 375

35


Annex 6b. Summary Table – all PH targets versus achievementsTargets in the table were set by grantees in their contracts with BSF Secretariat

Grantee

Facilitiessupported

Payam based catchment population

OPD consultationstotal ANC 1st visit ANC 4th visit DPT3

Delivery in facility assisted by skilled staff< 5 > 5

Target achieved Target achieved achieved Targetachieve

d Target achieved Target achieved Target AchievedADRA 16 173,832 25,000 22,913 64,460 34,849 57,762 1,435 2,788 1,076 1,667 9,894 3,975 718 103ARC 8 244,547 28,798 16,795 69,154 24,843 41,638 4,320 1,600 2,160 803 6,911 5,054 1,080 191AVSI 10 76,379 28,000 26,824 38,000 42,966 69,790 2,700 1,675 400 444 400 339 400 74CARE 13 213,114 31,214 53,225 128,198 76,244 129,469 4,981 10,058 3,944 2,451 3,094 4,962 1,328 68CCM 18 171,536 13,646 56,783 76,608 92,942 149,725 4,590 7,270 1,945 2,211 4,096 5,011 400 75CMSI 5 210,771 4,000 9,035 3,300 10,825 19,860 2,000 3,135 500 1,024 500 1,731 500 0Concern 22 130,058 31,166 42,952 101,288 77,187 120,139 5,319 9,987 2,660 5,013 5,192 4,967 603 124Cordaid 8 60,143 17 10,939 34,682 18,779 29,718 844 1,159 337 741 1,388 571 253 32GOAL 8 95,164 23,891 30,597 52,253 49,122 79,719 3,175 2,608 2,699 1,092 3,175 3,177 454 106HealthNet 34 262,442 38,900 59,878 111,000 95,479 155,357 8,000 4,695 2,800 3,036 3,350 8,781 1,700 27IMA (DUK) 6 70,730 7,400 9,766 12,700 20,624 30,390 250 656 0 348 175 281 80 63IMA (Melut) 12 7,506 17,840 23,516 32,800 39,475 62,991 4,320 2,204 0 1,634 1,260 3,346 880 188IMC 12 160 21,686 25,496 122,314 39,837 65,333 4,046 2,067 2,832 684 1,248 445 809 66Malteser 24 100,231 13,000 19,781 52,000 41,156 60,937 2,300 1,373 1,500 1,474 2,000 1,135 270 0Merlin 9 147 17,535 26,663 92,055 36,645 63,308 2,740 1,714 1,370 709 4,110 2,441 1,096 15OVCI 1 100 7,000 5,865 13,500 10,952 16,817 580 922 350 876 350 419 0 161Tearfund 10 58,973 11,235 34,729 42,265 42,220 76,949 2,140 2,859 1,712 3,924 2,140 2,888 428 0World Vision 10 90,073 12,000 9,788 45,000 20,776 30,564 3,786 1,281 2,164 1,140 3,786 1,128 500 41JSI 12 155,329 13,200 11,492 14,400 25,495 36,987 1,667 2,315 800 1,498 934 375 975 375IRC 15 93,902 8,226 16,320 27,420 27,950 44,270 1,452 2,143 400 346 4,980 913 550 0SCiSS 15 161,661 21,396 9,412 24,008 15,949 25,361 2,200 1,558 1,090 302 2,069 1,620 482 40

Totals 268 2,851,149 392,474 522,769 1,157,405 844,315 1,367,084 62,845 64,067 30,739 31,417 61,052 53,559 13,506 1,749OVCI supported the maternity services in 3 PHCC of the MoH ; skilled deliveries (161) in the 3 PHCC included in this table

JSI over-reported skilled attended births and availability of skilled attendants. Acting DG of Wau informed BSF on correct number of skilled staff but JSI did not send additional info in spite of requests.

36


3 ex-SHTP grantee figures relate to 5 months implementation period

37


Annex 7. Summary Table – Primary Health facilities Staffing (1)

Lead Agent

No. ofHF

Classified staff Un-classified staff (Quarterly Data)Total

Facility Staff

Clinical Officer

Enrolled nurse

Enrolled midwife

Community midwife

Lab. Technician

Lab. Assistant

Pharmacy technician

Pharmacy assistant

Auxiliary nurse

EPI vaccinator

MCHW or trained

TBACHW

ADRA 16 2 4 1 2 2 1 1 2 3 22 28 27 95ARC 8 7 11 2 3 5 3 18 17 17 24 107AVSI 10 5 12 2 2 2 2 0 3 9 6 15 27 85CARE 13 10 4 2 4 4 4 0 3 0 14 43 15 103CCM 18 1 1 2 1 6 15 1 43 25 18 113CMSI 5 1 1 1 3 2 8Concern 22 3 6 2 3 2 2 18 3 46 35 20 140Cordaid 8 1 5 2 1 1 8 9 16 43GOAL 8 5 4 2 2 1 1 4 12 22 16 69HealthNet 34 2 13 1 17 3 3 16 5 48 51 55 214IMA (UN) 6 1 18 3 10 1 1 1 33 24 12 5 109IMA (JON) 12 2 2 1 1 2 2 1 2 2 5 4 24IMC 12 1 2 2 1 13 9 8 17 8 61Malteser 24 4 9 3 2 1 1 31 29 80Merlin 9 6 9 2 5 1 2 4 3 16 2 50OVCI 1 7 3 4 3 3 2 2 2 4 0 30Tearfund 10 3 2 1 3 3 2 2 1 29 17 13 76World Vision 10 2 1 1 1 4 4 11 11 31 66JSI 12 6 29 5 38 2 4 7 2 5 9 8 115IRC 15 4 5 5 2 2 1 5 2 18 26 8 78SCiSS 15 3 5 3 7 2 2 1 2 1 31 32 39 128Total 268 76 144 38 107 35 47 5 102 102 346 427 365 1,794

Total Classified Staff: 554 Total Unclassified Staff: 1,240% Classified staff: 31% % Unclassified staff: 69

38


Annex 8. Summary Table – Primary Health Staffing and payroll (2)

Lead AgentStaff Payroll

Total Facility Staff

Classified staff on MoH payroll

Unclassified staff on MoH payroll

% staff on MoH Payroll

Classified staff on NGO payroll

Unclassified staff on NGO payroll

% staff on NGO Payroll

Classified staff on other

payroll

Unclassified staff on other

payroll

% staff on Other Payroll

ADRA 95 21 22% 15 59 78%ARC 107 14 33 44% 8 4 11% 9 39 45%AVSI 85 3 34 44% 13 11 28% 12 12 28%

CARE 103 9 69 76% 22 1 22% 0 2 2%CCM 113 1 12 12% 25 75 88% 0 0 0%CMSI 8 3 5 100%Concern 140 5 7 9% 31 97 91%CordAid 43 9 26 81% 1 7 19% 0 0 0%GOAL 69 8 2 14% 7 52 86% 0 0 0%HealthNet 214 40 73 53% 15 59 35% 0 27 13%IMA (UN) 109 27 48 69% 8 26 31% 0 0 0%IMA (JON) 24 1 10 46% 10 3 54% 0 0 0%IMC 61 0 0 0% 19 42 100% 0 0 0%Malteser 80 10 39 61% 9 22 39%Merlin 50 20 21 82% 9 18%OVCI 30 10 1 37% 12 7 63% 0 0 0%Tearfund 76 0 0 0% 16 60 100% 0 0 0%World Vision 66 11 8 29% 2 45 71% 0 0 0%JSI 115 80 14 82% 11 10 18%IRC 78 0 2 3% 24 52 97% 0 0 0%SCiSS 128 1 1 2% 24 65 70% 0 37 29%

Total 1,794 249 421 37% 273 692 54% 32 127 9%Total on MoH Staff 670 Total on NGO payroll 965 Tot on Other payroll 159

Analysis: of all classified staff only 46% are on MoH payroll and 34% of all unclassified staff. Classified staff constitutes 31% of the facility staff while 69% are unclassified.

39


Annex 9a. Summary Table – Primary Health Training (Long Term)

Lead Agent Category of Trainees Total Female Training Days Total Training Days FemaleADRA Midwives (enrolled, CMW) 4 4 1,200 1,200CMSI Clinical Officer 1 0 305 0IMA (JON) Clinical Officer 1 0 90 0IMA (UN) Midwives (enrolled, CMW) 1 0 90 0

TEARFUND Midwives (enrolled, CMW) 12 9 3,960 2,970Nurses 2 0 540 0

Grand Total 21 13 6,185 4,170

BSF-IAe funded the full time long term training of 2 CO for 3 months and 19 midwives/nurses for a full year

Annex 9b. Summary Table – Primary Health Training (Short Term)

Lead Agent Total Female Total onMoH Payroll

Females onMoH Payroll

TrainingDays Total

Training DaysFemale

ADRA 175 56 22 2 549 196ARC 604 266 243 124 1,522 679AVSI 169 50 30 1 710 227CARE 128 55 61 13 599 248CCM 438 147 17 1 1,258 358CMSI 258 146 14 3 165 54CONCERN 1,004 219 0 0 4,477 942CORDAID 151 45 58 16 819 238GOAL 581 183 40 24 1,482 417HealthNet 443 96 182 33 1,744 472IMA (JON) 18 0 5 130 0IMC 474 180 5 0 474 180IRC 390 127 39 4 674 152JSI 28 20 2 2 84 60MALTESER 252 65 112 10 888 65MERLIN 465 195 49 11 898 446OVCI 217 183 111 79 1,115 1,021SCiSS 1,052 600 2 0 1,486 718TEARFUND 236 89 24 12 1,124 439WORLD VISION 822 337 175 47 3,078 1,335Total 7,905 3,059 1,191 382 23,276 8,247

* High number of health workers trained by Concern and SCiSS concerns the training of community based cadres: Home Health Promoters, Peer Educators, Boma Health Committee and Community Conversation facilitators.** Not all people trained are facility based staff but all participants play an active role in the health system: VHC, school health clubs, HHP, CHD staff etc.

40


Annex 9c. Summary Table – Primary Health Training (Categories of trainees)

Categories Of Trainees Total Female

Total Training

Days

Female Training

DaysCHD team members 288 86 1,475 477CHWs / MCHWs 965 238 3,145 838Clinical Officer 184 82 1,060 267EPI vaccinators 425 72 1,867 346Health Facility clerks, registrars etc. 55 7 228 24HHPs, peer educators etc. 1,727 777 3,552 1,151Laboratory staff 25 5 202 5Midwives (enrolled,CMW) 218 172 5,875 4,668Nurses 140 44 1,073 139Others ( note 1) 1,695 581 4,173 1,053Pharmacy staff, dispensers 95 4 373 20SMoH team members 1 1 5 5TBAs, Village Midwives 665 663 2,765 2,547Village/Boma health committees 1,443 340 3,668 877Total 7,926 3,072 29,461 12,417

Note 1:this category in includes a wide range of training; for example: nutritionists, lab auxiliaries, vaccinator default-tracers, campaign trainers, and hygiene promotors; grantees trained facility-based staff and members of the community involved in preventive activities and facility support, for example HHP, Peer Educators, BHC/VHC. Community case management;

This are the team in community are trained in how to identify a miner disease in community, and how to give a first aid e.g. ( diarrhea, fever, upper respiratory truck infection ( URTI), skin diseases eye infection etc , so this group have ORS, eye ointment, skin ointment and for fever they have paracitamol and they refer the child early before the condition get

Hygiene promoters/ health educator;They give health education in the health facility before they are attended to by clinical officer.

Nutritionist;He/she also give health education on good diet and identify the malnutrition children by use of MUAC and observation if the center have nutrition program they are attended to, if not they are referred to feeding center .

41


Annex 9d. DHIS training 2012 BSF-IAe Cumulative DHIS training 2012

State CountiesFacilitating NGO

Beginner course Refresher Short course visits

CHD

SMOH

NGO Staff

CHD

SMOH

NGO

StaffCHD

SMOH

NGO Staff

WEQIbba

Cordaid/CDTY 2

NzaraCordaid/CDTY 1 1

Yambio 2 1 5Nagero IMC 1Mundri West AAH 1 1Mundri East 1 1Maridi Malteser/AAH 2 2Tambura World Vision 3 2Ezo World Vision 2 2Mvolo 1

CEQ Juba ADRA 4 8 1 3Terekeka ADRA 3 1

Eastern Equatoria

Budi ADRA 1Torit 1

NBEG Aweil North HealthNet 1Unity Abiemnom CARE 3

Bentiu CARE 1Guit CARE 1 1Rubkona CARE 1 4Parieng CARE 1 3Mayom CARE 1 2

Jonglei Akobo IMC 2WBeG Wau HealthNet 1 5 1 2 4

Jur river HealthNet 2 2Lakes Rumbek UNDP 1 2

Warrap

Abyei GOAL 1 13Twic 4 1Nasir ADRA 1Ulang GOAL 4 3Baliet GOAL 2 1

CES/UN/Warrap

Baliet, Juba, Twic roving GOAL 7

Short course in Juba Juba 7Total 2012 17 female 21 14 51 26 5 18 0 0 3

Table: Cumulative DHIS training achievements 2011-2012

Year

Beginners course (5 days)Refresher course (5

days)Mentoring on the job (few

hours)

CHD SMoH NGOs TotalCHD

SMoH

NGOs

Total CHD SMoH NGOs

2012 21 14 51 86 26 5 18 49 0 0 32011 14 2 35 51 0 0 5 5 0 0 0

Total 35 16 86 137 26 5 23 54 0 0 371% of all trainees were beginners; 28% were refresher course participants37% of beginners were CHD/SMoH staff; 57% of refresher trainees were CHD/SMoH staff

42


63% of beginners were NGO staff; 43% of refresher trainees were NGO staff17/138 participants in 2012 were female (18%) In 2011 the % of female participants was 10%

43


Annex 10. Summary Table – Primary Education

Lead Agent

School Construction 2012 Beneficiaries 2012

New Schools New Classrooms

Ideal Enrolme

nt1Actual Enrolment2 Attendance

Target A %

Target A % Target Tot F

% F

3

.ALP

Tot

4

.ALP F Tot F %F

HARD 4 4100 36

36

100 1800

2270 742

33%

1910 623

33%

FFH 0 0100 12

12

100 600

2215 818

37% 111 34

2112 761

36%

Total 4 4100 48

48

100 2,400

4,485

1,560 35 111 34

4,022

1,384 34

(1) Enrolment calculated as 50 children per classroom(2) Actual enrolment is the number of children registered to attend.The pupil to classroom ratio (PCR) for HARD is 53, and for FFH 176, (due to the influx of refugees especially in Upper Nile). Targets were all achieved, attendance figures in the last quarter showed a drop-out rate of 16% in HARD schools and 5% in FFH schools due to teachers salaries not being paid. Drop-out rate based on enrolment/attendance data for 2012 is 5% for FFH and 16% for HARD.

44


Annex 11. Summary Table – Primary Education Long term Training Cumulative DataTot = Total, F=Female, %F=Percentage Female

Lead Agent

ISTT PSTT ELT

Target

Stage 1 Stage 2 Stage 3

TargetT F %F

Av. test score

increase %

T F %F

Av. test score

increase %

T F %FAv. test

scoreT F %F

Av. Test score

increase %

Target T F %F

Av. test score

increase %

WTI 45038

9 136 35% 6%ACROSS 100 100 16 16% 1%MRDA 63 58 8 14%WR 200 97 23 24% 16% 85 27 32% -9%FFH 32 32 0 0% 53%

Total 232 32 0 0% 53% 97 23 85 27 0 163 158 24 15% 45038

9 136 35% 6%

Course Total TraineesISTT 214PSTT 158ELT 389

(1) WTI- 389 is number that completed/passed the ELT stage of training

(2) Score Percentages in ISTT data represent the increased percentage points from the 1st test at the end of Phase 1 and the last test at the end of Phase 2.

(3) Score Percentages in ELT represent the increased percentage points from the 1st test at the end of the 1st Quarter to the last test at the end of the 4th Quarter

(4) WR Stage 3 average test score is low because the English capacity in Wau was low. Due to lack of funding, the cohort also had done Stage 2 two years prior, lack of continuity made comprehension of the materials

difficult.

(5) ISTT trainings run part time for 400 hours per stage of training, usually broken up into 2 phases of 6 weeks each.

(6) PSTT trainings run full time for 9 months of the year, full qualification is after 2 years of full time training.

(7) In-Service Teacher Training (ISTT) is training for unqualified teachers already in the classrooms. Training is broken into 4 Stages of curriculum designed by GoSS and is implemented usually in 3-4 years -1 stage per

year- ideally during the school holidays. Teachers are then monitored with follow up during their time in the classroom. Qualifications to enrol in an ISTT vary from P8 to secondary school.

(8) Pre-Service Teacher Training (PSTT) is training for unqualified teachers who are not yet in the classroom. Students enrolled in a PSTT programme are secondary leavers who study the GoSS teacher training

curriculum for 2 years full time.

45


(9) Currently the same GoSS approved curriculum is used for PSTT and ISTT trainings.

46


Annex 12. Summary Table – Primary Education Short term Training T= Target, F= Female, %= Percentage Achieved, Tot = Total, %F = Percentage Female

Lead Agent

CED3 PTA Members Head teachers (short term)

Target Trainees T F %F

Target days

Training Days

Target Trainees T F %F

Target days

Training Days T F %F

Training Days

MRDA 92 43 19 44% 3 129 180 240 7240% 2 480 66 14 21% 198

WR 150 108 8 7% 21 1620 70 192 7338% 3 576 98 7 7% 1470

HARD 30 30 10 33% 1 30 55 42 1331% 1 42

FFH 50 50 2 4% 1 50 120 162 6540% 1 162

Cumulative Total 322 231 39 22% 26 1,829 425 636 223

36% 7 1,260 164 21 13% 1,668

(1)In the logframes, targets for CED and HT are together, at the request of MoGEI they are broken out(2) HT and CED trainings vary in length. WR uses the MoGEI curriculum which runs for 21 days.

47


Annex 13. Summary Table WATSAN – Waterpoints

Lead agentNew

boreholesRehab

and Repair

Rehab Repair Other water sources Beneficiaries

Target Actual Target Actual

Actual Target Actual Target Actual

ADRA 10 8 2,500 2,000

AVSI (1) 30 3 15 7,500 4,500

CARE 1 1 250 250CCM (2) 1 0 250 0

CMSI 1 1 5 5 0 1,500 1,500

GOAL 1 1 0 0

IMC 12 0 12 3,000 3,000Malteser 11 11 2,750 2,750World Vision 7 7 0 0HARD 2 2 500 500FFH 3 3 0 0SCiSS 2 2 500 500Tearfund 2 7 0 500Total 28 25 47 10 27 11 18 18,750 15,500

(1) AVSI – have repaired two boreholes more than once, so the beneficiaries remain the same.(2) CCM are not building this borehole due to a change in priorities in the course of the project

48


Annex 14. Summary table – WATSAN Institutional Latrines

49

Lead agent

Institutional latrines

(cubicles) BeneficiariesTarget Actual Target Actual

ADRA 12 12 600 600AVSI 4 4 200 200CARE 4 200CCM 2 6 100 300IMC 12 11 600 550Malteser 26 26 1,300 1,300Tearfund 13 16 650 800World Vision 8 8 400 400ACROSS 10 10 500 500HARD 0 2 0 100FFH 12 12 600 600

SCiSS 4 2 100 100

Goal 4 200Total 107 113 5,250 5,650


Annex 15. Summary Table – WATSAN Training 2012Fem= Female, T. Days = Training Days

Water point sustainability (Cumulative)

Lead Agent

WUC members Borehole Caretakers Other

Target Trainees

Achieved Total

Trainees FemAchieved T. Days

Target Trainees

Achieved Total


Target Trainees

Achieved Total


ADRA 100 100 50 100 20 22AVSI 50 143 72 196 50 30 58 23 203CCM 100 2 1482 134 34 190CMSI 12 3 48 30Malteser 110 20 0 100 22 10 0 50 180 8 0 56World Vision 60 60 10 200 12 12 7 60 82 25 328FFH 45 60 16 120 80 40 160

Total 465 395 151 764 136 22 7 110 1,714 362 122 937

50


Annex 16. Field Visits RecordDates No. State NGOs visited Monitors

201227-30 Jan 95 Warrap CCM Hannan + Wim2-4 Feb 96 EE Torit MERLIN Hannan + Wim13-17Feb 97 Unity State CARE Hannan + Geertruid

20-24 Feb 98 Western Equatoria Malteser, Cordaid/DoTY, World Vision Hannan + Geertruid

22nd-27th Feb 99 NBG, WBG UMCOR, Windle, HARD Nic29 Feb. – 2 March 100 Jonglei IRD / IMA Wim6-8 March 101 Central Equatoria CMS-IRELAND Hannan16 – 17 March 102 Upper Nile Tearfund Wim18 – 20 March 103 Upper Nile IMA Wim21 – 24 March 104 Upper Nile ADRA Wim20-24 March 105 Upper Nile TearFund Hannan30 March – 2 April 106 Jonglei IMA / IRD Wim17-19 April 107 Upper Nile GOAL Hannan1st-2nd March 108 Central Equatoria ACROSS/YTTC Caroline/Fiona12-13th April 109 Western Equatoria MRDA Caroline30 April – 2 May 110 Eastern Equatoria ARC – Kapoeta programmes Wim

1-4 May 111 WBeG Concern, HealthNet Geertruid, Hannan and Jay Bagria

3 May – 4 May 112 Eastern Equatoria SCiSS – Kapoeta North Wim

7 May – 8 May 113 Eastern Equatoria AVSI; Ikotos Wim, Hannan, Geertruid

9 May – 12 May 114 Eastern Equatoria ADRA - Budi Wim, Hannan, Geertruid

14-15 May 115 WEQ Malteser, Cordaid and WVI Geertruid15th -17th May 116 Eastern Equatoria ARC Hannan28-31 May 117 Central Equatoria ZOA (for borehole survey) Lucie28 May – 4 June 118 WBeG Healthnet; Raga and Jur River Wim and Hannan6 June – 9 June 119 Lakes SCiSS; Wulu Wim and Hannan11 June – 16 June 120 Warrap CCM; (incl. ex. SHTPII programs) Wim and Hannan11th-15th June 121 NBG, WBG HARD, WR/ECS Caroline18th – 19th June 122 Central Equatoria CMS-I Hannan

21-29 June 123 Western EquatoriaMRDA (for borehole survey), Intersos (For Borehole Survey), World Vision, Malteser, UMCOR

Lucie

25th -30 June 124 Eastern Equatoria ARC, Merlin Hannan

26th-30th June 125 Upper Nile, Jonglei (Pigi) FFH, GOAL Caroline/Fiona

26 June -28 June 126 Jonglei IMC Akobo Wim4th-6th July 127 Jonglei-Bor FFH Caroline

1282 July – 5 July 129 Upper Nile IMA – Melut/Manyo Wim6 July 130 Upper Nile Tearfund Wim

6 – 10 July 131 Western Bahr-el Ghazal JSI - Wau County Hannan

7 – 10 July 132 Jonglei IMA – Duk Wim12 -15 July 134 Eastern Equatoria Caritas CH Lucie14 – 19 July 135 Unity State Care - Rubkona Hannan

24 -27 August 136 Western Bahr-el Ghazal JSI –Wau County Wim and Hannan

27- 29 August 137 Northen Bahr-el Ghazal ( NBeG) IRC Aweil South Hannan and Wim

4-9 Sept 138 Western Equatoria Malteser & Cordaid Wim and Hannan

51


21- 26 Sept 139 Western Bahr-elGhazal JSI and Healthnet TPO Wim + MOH

12-15 Sept 140 WBeG WTI Caroline17-22 Sept 141 WBeG & NBeG HARD Caroline24 -29 Sept 142 Lakes State Save the Children Hannan + dr. Orero27-29 Sept 143 Lakes State Save the Children Wim + dr. Orero2 – 4 Oct 144 Eastern Equatoria ARC & Save the Children Hannan and Wim3-5 Oct 145 WBeG HARD Lucie11 – 14 Oct 146 Upper Nile Goal / Tearfund Hannan + MoH21 -29 Oct 147 Nairobi Conference MCH handbook Hannan15-17 November 148 NBeG HARD Caroline16-17 November 149 Yambio; WES Joint review; WV, CDoTY, Malteser Geertruid19 – 27 November (Hannan)19 – 23 Nov. Geertruid

150 Unity State CARE HannanGeertruid

21 – 24 November 151 WBeG JSI Wim27-29 November 152 CEQ ZOA Lucie28-30 November 153 Upper Nile & Jonglei FFH Caroline6-8 December 154 CEQ ACROSS Caroline & Fiona

11 – 15 December 155 Upper Nile Tearfund – FashodaADRA – Nasir Wim + MoH

15-17 December 156 NBeG HARD Caroline201328-30 January 157 WEQ MRDA Caroline

28-Jan-1 Feb 158 NBeG IMC Hannan & Dr. George Edward

4-8 Feb 159 Unity CARE Hannan20-23 Feb 160 WES CORDAID HannanMarch 161 ….Raja Hannan

52


Annex 17 Technical Assistance (TA) Days Allocated

Budgeted Days Actual Remaining

Balance

Klaziena (Kate) Louwes 278 266.0 12.0

Lucie Leclert 192 186.4 6.1

Allard Jansen 296 290.0 6.0

Sarah Baba Lasuba 298 293.0 5.0

Wim Groenendijk 254 248.0 6.0

Hannan Yousif 349

349.0

0.0

Nicholas Ramsden 40 39.0 1.0

Caroline D'Anna 241 225.0 16.0

Fiona Bailey 259 259.0 0.0

Joseph Gama 265 245.5 19.2

Support TeamAdriana van Ommering 30 22.3 7.8

Patricia Schwerzel 50 52.0 -2.0

Wim Romp 6 6.0 0.0

Reinier Battenberg 5 3.0 2.0

Erik Holtus 64 64.8 -0.8

Short Term Experts

Geertruid Kortmann 79 77.0 2.0

Kate Hutton 25 25.0 0.0

Clarissa Mulders 17 16.3 0.8

Total Days 2,748 2,667.1 81.0

53


Annex 18a. Primary Health Unit Costs

Grant recipient Unit Cost PHCC

Unit Cost PHCU

Comments

BSF -1GOAL (Upper Nile) 35,116 Major rehabilitation of existing building, incl. latrines, rainwater collection & hand washing facilities etc.

30,744 Construction of new buildings, including latrines, rainwater collection and hand washing facilities etc.Merlin (EEQ) 49,000 Main new building (without staff “tukuls”)

26,000 Permanent 4-room building, including 3 “tukuls” for staff housingTearfund (Upper Nile) 26,667 New 7 room brick building; constructed with extensive community participation

8,889 New 3 room brick building; constructed with extensive community participationCCM 37,000 Large 7 room building; can be upgraded to PHCC, incl. medical furniture and -equipment, latrines etc.CARITAS (EEQ) 55,000 New 8 room building with piped water system etc., comprehensive furnishing.Medair (Upper Nile) 26,000 Rehabilitation and furnishing of an existing large PHCC building

25,000 New 4 room building with latrines, water tank etc.AMREF (CEQ) 49,000 New 9 room building, basic design

23,900 New 3 room buildingSave US (Upper Nile) 92,000 New 10 room building with furnishing, piped water system

23,150 New 4 room buildingOVCI 39,800 Rehabilitation of large urban PHCC in Juba and extension with a new wing for laboratory and maternity


Unit Cost PHCU

Comments

BSF-2CMS Ireland (CES) 34,670 New building incl. furnishing, latrines, borehole, electrical installation & generator, solar power systemsCONCERN (NBG) 26,667 Construction of complete 4 room buildingIRD (Jonglei) 26,600 Basic design 3 room buildingSwiss Red Cross (Unity)

46,875 Basic construction costs large building (no furnishing included)

21,875 Basic 4 room buildingMedair (Upper Nile) 27,700 Basic 4 room building with latrines etc.World Vision 16,000 Basic 3 room building with furnishing and basic equipment.

54



Unit Cost PHCU

Comments

BSF-IAADRA 50,700 New construction of maternity wing for a PHCC in Nasir Upper Nile

11.980 Rehabilitation of a PHCC in BudiARC 59,918 Major rehabilitation/extension of PHCC including latrines (3340GBP) and borehole (6700 GBP)

29,959 Newly constructed PHCU excluding the borehole (6741 GBP)Merlin 54,119 Loronyo PHCC: newly built 2 room maternity and 4 room OPD extensionOVCI 147,218 Large new 4 room extension of Usratuna PHCC in Juba town. High standards.Malteser 18,145 Basic modest 4 room construction incl. Rainwater collection system and latrineCORDAID 21,463 New 6 room constructions (PHCU) with large roofed waiting area including rainwater collection, latrinesWorld Vision 38,094 New maternity/inpatient wing of PHCC including rehabilitation of OPD building excl latrine ( 2.922 GBP)

14,836 Full rehabilitation of a PHCU including rainwater harvesting system (gutters + tank)HealthNet ** 148,794 New min. 10 room PHCC in Jur river (WBeG) (including 2 staff houses for midwife and home for guard)

74,397 New 4 room PHCU in Jur River (WBeG) including double staff house, fencingConcern ** 32,134 New 4 room construction (PHCU)

63,693 Rehabilitation including lighting of PHCCMalaria Consortium ** 18,996 Average costs of new construction of 4 room PHCU. Other facilities underwent repairCCM ** 32,134 New 4room PHCU. Average of 5220 GBP for toilets in few health facilitiesCARE ** 18,944 2 new 5 room PHCCIRD ** 82,191 Maternity, inpatient- and surgical unit as extension of Duk Lost Boys PHCCIMC ** 49,235 New 5 room PHCC in Thokliel

13,670 New .3.room constructed PHCU. To keep costs low adobe (mud wall) design was applied + community participation. Good quality

Tearfund ** 94,223 Accrual of former phase. Costs of 3 new PHCUs.Medair ** 64,994 Extension of Melut PHCC with TB ward. Costs exclude extension of Wadekona PHCC by 2 room OPD

block)32,497 Newly built 3 room PHCU.

Goal ** 42,825 5 room new facility including incinerator and water treatment system.AVSI 26,848 Newly constructed PHCU / 5 room

55



Unit Cost PHCU

Comments

BSF-IAeCordaid 26,394 Extension, upgrading and overall rehabilitation of Ringazi PHCCMalteser 38,653 Extension, upgrading and overall rehabilitation of Ngamunde PHCU to PHCC

Notes:‘Difficult access’ areas (with **) i.e. Upper Nile, Unity, Jonglei, Warrap, NBeG and WBeG were uesueally supplied with construction materials and fuel by (North ) Sudan. Mid 2011 when the borden between Sudan and South Sudan closed , this supply was reduced or stopped altogether. Alternative supplies routes were much longer and costs therefor increased. These difficult areas have soft sub-soils, requiring foundations and higher than average construction costs anyway. Construction completed before mid 2011 (e.g. ADRA, Concern) was less affected by rising costs, than those started late in 2011 (e.g. HealthNet and Tearfund).

The design of PHCCs and PHCUs varies . While the grant recipients require approval of their building plans from the respective State MoHs, no standard building plans exists, while adaptation to local climatic conditions and disease profiles is, as much as possible, included.

BSF also funded the construction of staff houses for several health facilities. Costs for a block of 4 units: 11,277 GBP (ARC)BSF also funded construction of 3 room CHD including equipping the CHD with solar energy supply system + latrine and bathroom

State NGO Location CHD DetailsWEQ Malteser Maridi CHD 3 room building with solar power

Cordaid Nzara CHD Basic 2 room building with solar power and some furnitureCordaid Ibba CHD Basic 2 room building with solar power and some furniture

CEQ ZOA/Compass Terekeka CHD New well designed structure with warehouse for ess drugs & medical suppliesWbeG HealthNet Raja CHDNbeG MC/HealthNet Aweil North CHD Existing 3 room skeleton completed by BSFJonglei IMC Akobo CHDUpper Nile Medair Melut CHD

Medair Wadekona CHD Rehabilitation of existing buildingWarrap CCM Romic Tonj East CHD CHD office + a warehouse for essential drugs & medical supplies

56


Annex 18b. Primary Education Unit CostsSchools ConstructionGrant recipient Output/schools Cost/unit

school (GBP)

Cost/unit classroom (GBP)

Comments

BSF- 1

BSF-1 HASS (CEQ) Primary Schools 120,000 15,000 Includes 8 class rooms, 4-roomed large administrative block, 3 latrine units, pupils' and teachers' furniture, training of PTAs.

BSF-1CARITAS (EEQ)

Primary Schools 150,000 18,750 Includes 8 class rooms, 3-room office administrative block, 4 teachers houses, 3 latrine units, chain link fencing, pupils’ and teachers furniture, 1 borehole, train PTAs.

BSF-1Save-UK (3 States)

Primary Schools 56,000 9,333 New 6 (on average)-class roomed schools, with some furniture and learning materials, and “gender-friendly” latrines

BSF-1 Average Cost 108,667 14,818

Grant recipient Output/schools Cost/unit school (GBP)


Comments

BSF- 2BSF-2 World Relief (2 States)

Primary Schools 53,333 13,333 New schools (4 class-rooms + office), latrines, kitchen, food-store, fencing.

BSF-2 AMA (Warrap)

Primary Schools 158,570 19,820 Standard design (8 classrooms and office-block, including furniture etc.)

BSF-2 AVSI I(Ikotos) Primary Schools 49,502 12,375 Construct 2 times 2 classroom block and school food store (one block total)BSF-2 CMS Ireland (CEQ)CMS Ireland

Primary SchoolsPrimary Schools

171,750148,145

24,53618,518

Average costs of 2 large schools (with 7 classrooms); including school boreholeAdditional budget to CMS-I (Panyana school); 8 classroom

BSF- 2Diocese of Rumbek

Primary Schools 160,000 10,000 Construction and/or main rehabilitation of school in Rumbek (total 16 class rooms)

BSF-2 IRD (Jonglei) Primary Schools 53,375 17,792 Construction to extend average Primary School with a 3 class-room blockBSF-2 Oxfam Novib/MRDA(WEQ)

Primary Schools 87,797 10,975 Construct 8-classroom schools (with 2-room school office), store, hand washing facilities

BSF-2 (WBG) Primary Schools 96,876 12,110 Construct 8-classroom schools (with school office) and latrines

57


BSF-2 UMCOR (NBG)

Primary Schools 51,724 12,931 Construct one 4-classroom school block (without cost of latrines)

BSF-2 World Vision (WEQ)

Primary Schools 120,000 15,000 Construct 8 classroom block, with offices etc. but without latrines

BSF- 2 Average Cost

104,643 15,739 (note; exclude DoR (extension and rehabilitation mixed)



Comments

BSF-IABSF-IA Caritas CH (EEQ)

Primary Schools 263,115 32,889 8 classrooms, office block, kitchen, store, latrines and borehole. Accessibility severely affected in wet season, black cotton soil in Lafon requires deeper foundations, materials easy to procure from close-by Kenya and Uganda.

BSF-IA CRS (CEQ) Primary Schools 230,217 28,777 8 classrooms in 2 blocks of 4 plus a separate office block of 2 rooms. Latrines, borehole, furniture not included. Accessibility to Terekeka town good all year round, though sandy soil requires deeper foundations, materials relatively cheap from close-by Uganda.

BSF-IA HARD (WBG)

Primary Schools 144,966 17,339 8 classrooms, separate office block, kitchen and store. Latrines and boreholes not included. Accessibility good all year round on main roads, material prices can be affected by supply routes from Northern Sudan. Firm rocky soil quality

BSF-IA SCISS (Lakes)

Primary Schools 142,094 23,682 4 classroom block with separate office and store block. Latrines and boreholes not included. Accessibility off the main road can be difficult in wet season, materials can be expensive from long supply routes.

BSF-IA UMCOR (NBG)

Primary Schools 99,778 12,472 4 classrooms only (Luka Aguat). Latrines and boreholes not included. Can suffer from flooding in wet season and soil quality can be sandy, material prices can be affected by supply routes from Northern Sudan.

BSF-IA Oxfam Novib (WEQ)

Primary Schools 67,913 16,978 8 classrooms in 2 blocks of 4 plus a separate office/store building. Latrines and borehole not included. Accessibility to most sites good all year round, though a few can be difficult to access in wet season, materials easy to procure from close-by Uganda, soil quality firm.

BSF-IA Food For the Hungry (Upper Nile)

Primary Schools 113,579 21,296 8 classrooms with office/store. Latrines, borehole and furniture not included. Very poor accessibility in wet season (only by boat), water-logged black cotton soil leaves only a 3 month window for foundations and requires deep foundations, material prices can be affected by supply routes from Northern Sudan.

BSF- IA CMS Ireland (CEQ)

Primary Schools 132,275 16,534 8 classrooms with office/store. Latrines and borehole not included. Accessibility good all year round, materials easy to procure from close-by Uganda, soil quality firm. Keji: 3 schools of 8 classrooms

BSF-IA Average 149,242 18,32358


Cost



Comments

BSF-IAeBSF-IAe HARD (NBG, WBG)

Primary Schools 160,462 20,053 School with 8 classrooms, staff room, office, store, kitchen, separate latrines for boys and girls. The provision of separate latrines for girls and boys will enhance safe and healthy environments and provide privacy especially for girls. Accessibility good all year round on main roads, material prices can be affected by supply routes from South Sudan. Firm rocky soil quality.

BSF-IAe Food For the Hungry (Upper Nile, Jonglei)

Primary Schools 90,836 22,709 12 classrooms with office/store. Latrines, borehole and furniture not included. Wunlieth, Lankien and Malakal South. Very poor accessibility in wet season (only by boat), water-logged black cotton soil leaves only a 3 month window for foundations and requires deep foundations, material prices can be affected by supply routes from South Sudan.

BSF-IAe Average Cost

Primary Schools 143,512 20,842

Teacher TrainingGrant recipient Output/Type of

TrainingCost/Per Training

Cost/Per Teacher

Comments

BSF-2BSF- 2 World Relief (8 States)

In Service Teacher Training

21,900 438 Average cost/person of 3-months fast-track training of 400 teachers, 1-month management training of 100 head-teachers, education resource centre access for 80 teachers and training of 20 youth-faciliators (total ± 40,000 training person/days)

BSF-2 Average 21,900 438

Grant recipient Output/Type of Training

Cost/Per Training

Cost/Per Teacher

Comments

BSF-IABSF-IA ACROSS (YTTC) CEQ

Pre Service Teacher Training

519,003 5,190 Figures are for costs of training 100 teachers at YTTC. Figure includes all travel to and from Yei from all 10 states of South Sudan, accommodation in Yei and all other per student overheads.

BSF-IA Oxfam Novib (KITE) WEQ

Pre Service Teacher Training

10,305 344 Figures are for costs of training teachers at KITE. Costs are for 30 teachers sitting intensive English course at KITE for 2 months. Figures do not include all operating expenses of KITE which are covered by several other donors.

59


BSF-IA Windle Trust (WBG,NBG,Warrap,Unity)

English Language Training

386,667 644 Figures are for 600 teachers to receive 18 months of ELT in groups of 75 teachers at country level. Cost includes tutors' salaries, training for tutors, all necessary materials, all transport and incentives for trainees. Figures do not include transport for tutors and other overheads.

BSF-IA World Relief (ECS) WBG,NBG,Unity,Lakes,WEQ

In-Service Teacher Training

439,908 677 Figures are for 650 teachers to complete 1 stage of GoSS ISTT curriculum over 2 x 6 week terms at some point during the 18 month grant period in 5 states of South Sudan at county level. Figures include tutors' salaries, feeding, transport of tutors from Juba to each session, and all training materials. Other resource development and monitoring is not included.

BSF-IA Caritas CH (EEQ) In-Service Teacher Training

78,120 1,302 Figures are for 60 teachers to complete 1 stage of GoSS ISTT curriculum over a 3 month period at some point during the 18 month grant period at county level. Includes tutors, transport and feeding.

BSF-IA CRS (CEQ) In-Service Teacher Training

68,226 1,083 Figures are for 63 teachers to complete 1 stage of GoSS ISTT curriculum over a 3 month period at some point during the 18 month grant period at county level. Includes tutors, transport and feeding.

BSF-IA HARD (WBG) In-Service Teacher Training

37,326 467 Figures are for 80 teachers to complete 1 stage of GoSS ISTT curriculum over a 3 month period at some point during the 18 month grant period at county level. Includes tutors, transport and feeding.

BSF-IA SCiSS (Lakes) In-Service Teacher Training

18,365 306 Figures are for 60 teachers to complete 1 stage of GoSS ISTT curriculum over a 3 month period at some point during the 18 month grant period at county level. Does not include transport.

BSF-IA UMCOR (NBG) In-Service Teacher Training

17,632 294 Figures are for 60 teachers to complete 1 stage of GoSS ISTT curriculum over a 3 month period at some point during the 18 month grant period at county level.

BSF-IA FH (Upper Nile) In-Service Teacher Training

22,272 557 Figures are for 40 teachers to complete 1 stage of GoSS ISTT curriculum over a 3 month period at some point during the 18 month grant period at county level. Includes tutors and incentives.

BSF-IA Average Pre-Service 159,782 1,086BSF-IA Average In-Service 85,231 666

Grant recipient Output/Type of Training

Cost/Per Training

Cost/Per Teacher

Comments

BSF-IAeBSF-IAe ACROSS (YTTC) CEQ

Pre-Service Teacher Training

146,728 1,467 Figures are for costs of training 100 teachers at YTTC. Figure includes all travel to and from Yei from all 10 states of South Sudan, accommodation in Yei and all other per student overheads.

BSF-IAe MRDA (WEQ) Pre-Service Teacher Training

69,727 1,107 Figures for 63 student teachers. Figures include travel, tuition, room and board at KITE .

BSF-IAe Windle Trust (WBG,NBG,Warrap,Unity)

English Language Training

48,900 109 Figures are for 450 teachers to receive 12 months of ELT in groups of 75 teachers at country level. Cost includes tutors' salaries, training for tutors, all necessary

60


materials, all transport and incentives for trainees. Figures do not include transport for tutors and other overheads.

BSF-IAe World Relief (ECS) WBG, NBG, Unity


130,997 164 Figures are for 200 teachers to complete 1 stage of GoSS ISTT curriculum over 2 x 6 week terms at some point during the 12 month grant period in 5 states of South Sudan at county level. Figures include tutors' salaries, feeding, transport of tutors from Juba to each session, and all training materials. Other resource development and monitoring is not included.

BSF-IAe Food For the Hungry (Upper Nile)


23,863 746 Figures are for 32 teachers to complete 1 stage of GoSS ISTT curriculum over a 3 month period at some point during the 12 month grant period at county level. Includes tutors and incentives.

BSF-IAe Average Pre-Service

108,228 1,287

BSF-IAe Average In-Service 56,501 435

61


Annex 18c. WATSAN Borehole Unit CostsConstruction of Boreholes

GBP/BH4,000-6,000 Low6,000-8,000 OK8,000-10,000 High>10,000 Very high

Grant recipients BSF-1Targeted cost/borehole [GBP]

Target No. of boreholes

Actual cost/borehole [GBP]

Achieved No. of boreholes

AMREF £ 10,333 20

CARITAS £ 6,951 19

Merlin / AVSI £ 6,133 10

IRC £ 4,853 21

MEDAIR £ 6,000 10

OXFAM GB £ 6,567 73

SC-US £ 7,524 3

Weighted average BSF-1 £ 6,820 156

Grant recipients BSF-2Targeted cost/borehole [GBP]




AMA £ 9,109 49AVSI £ 9,220 7CMS £ 7,907 8

HARD £ 9,965 3

OXFAM-GB £ 8,500 29

Intermon OXFAM £ 10,137 18

Swiss Red Cross £ 6,300 19

UMCOR £ 8,276 10

World Relief £ 8,000 1

World Vision £ 15,433 4

Weighted average BSF-2 £ 8,819 148

Grant recipients BSF-IATargeted cost/borehole [GBP]




ACTED £ 5,921 33 £ 5,955 39

ACF-USA £ 7,061 7 £ 6,370 7

ADRA 10 £ 13,144 10ARC £ 7,238 4 £ 6,337 5

AVSI cat II £ 6,333 - £ 9,639 4

Care - 1

CMS Ireland cat II £ 8,000 1 0CONCERN £ 9,763 7 £ 7,598 7

62


CRS £ 8,957 15 £ 5,236 15HARD £ 7,500 3 £ 7,408 4

Intermon OXFAM £ 9,945 17 £ 8,089 17

Intersos £ 9,306 18 £ 11,496 17

Malteser - £ 9,850 5

OXFAM GB £ 6,959 25 £ 4,791 21

TEARFUND £ 9,143 28 £ 7,961 28

SCiSS £ 7,508 3 £ 6,362 3

UMCOR £ 8,163 12 £ 7,582 24Oxfam Novib £ 9,002 - £ 9,000 6

World vision cat II £ 9,000 9 £ 9,879 5

ZOA £ 8,000 26 £ 8,502 29

Weighted average BSF-IA £ 7,550 247

Grant recipients BSF-IAeTargeted cost/borehole [GBP]




CCM £ 7,500 1 £ 7,500 0

Malteser £ 9,899 11 £ 8,362 11

Hard £ 8,333 2 £ 7,906 1

ADRA £ 8,000 10 £ 7,617 10

Care £ 10,056 1

CMSI £ 8,520 1 £ 8,851 1

SCiSS £ 8,799 2

Average BSF-IA £ 8,730 28 £ 8,047 23Weighted average BSF-IAe £ 8,040

Average cost per successful borehole per phasePhase Cost / Borehole [GBP] Number of

boreholesNumber of boreholes in Basement

Number of boreholes in sediments

boreholes in boundary zone Basement / sediments

BSF-1 £ 6,820 156 36 77 43BSF-2 £ 8,819 148 40 60 48BSF-IA £ 7,550 247 133 73 41BSF-IAe £ 8,040 23 11 0 0

Total number of boreholes invoiced 574Number of boreholes completed,

not invoiced yet 6

Phase

Number of boreholes in Basement

boreholes in boundary zone Basement / sediments

Number of boreholes in sediments

BSF-1 23% 28% 49%BSF-2 27% 32% 41%BSF-IA 54% 17% 30%BSF-IAe 48% 0% 0%

Rehabilitation of Boreholes

Description Unit Qty Unit price [GBP] Total [GBP]

63


Head assembly complete with chain/Handle Pc 1 £ 90 £ 90Water tank Pc 1 £ 30 £ 30Pedestal stand Pc 1 £ 90 £ 90Dia: 1 ¼ '' Galvanized Class B pipes, each 3m long with socket Pc 11 £ 20 £ 220Connecting rods (3m long) Pc 13 £ 20 £ 260Cylinder assembly Pc 1 £ 190 £ 190Cement Bags 10 £ 17 £ 170

Sand CUM 10 £ 14 £ 140Masonry Tool Box Set 0.1 £ 175 £ 19HD Mild Steel Molds for pump platform and Water Troughs set 0.1 £ 630 £ 35Bolt Cutter _Records size 24 Pcs 0.1 £ 120 £ 13Special tool kits for India Mark II pump repair set 0.2 £ 217 £ 48Standard tool Kit for India Mark II Pump installation set 0.1 £ 200 £ 22Fishing Tool Set 0.1 £ 90 £ 10Labour No 4 £ 50 £ 200

£ 1,538

Minor and Major Repairs of BoreholesWill contract the work out

Grant recipients BSF-2 NrActual

GBP/BH major repair

Intermon Oxfam 36 £ 1,724

IRD 15 £ 2,628

WORLD VISION 15 £ 2,015

Weighted average 66 £ 1,995

Grant recipients BSF-IA Nr GBP/BH major repair nr Actual

ACTED 15 £ 2,273 7 £ 37,232

ARC 3 £ 1,097

CRS 5 £ 1,300 2 £ 207

Intermon OXFAM 48 £ 944 45 £ 863

INTERSOS 3 £ 4,404 5 £ 3,400

OXFAM GB 9 £ 433 9 £ 1,227

SCiSS 3 £ 2,392 1 £ 212

ZOA 5 £ 4,136 5 £ 4,000

IRD 10 £ 2,266 -

WORLD VISION 15 £ 1,667 15 £ 1,315

Weighted average 101 £ 1,567 74 £ 4,133

Grant recipients BSF-IAe Nr GBP/BH major repair nr Actual

IMC 63 £ 114 12 £ 73

Weighted average £ 114 £ 73

Grant recipients BSF-2 NrActual GBP/BH minor

repairCOMPASS 8 £ 152

AVSI 13 £ 174

Oxfam GB 32 £ 404

SWISS RED CROSS 28 £ 130

64


IMC 38 £ 271

Weighted average 119 £ 255

Grant recipients BSF-IA Nr GBP/BH minor repair Nr Actual

ACF 35 £ 528 22 £ 883

OXFAM GB 30 £ 620 25 £ 147

ZOA 15 £ 300 15 £ 310

IMC 28 £ 184 18 £ 197

TEARFUND - health 2 £ 465 2 £ 300

Weighted average 110 £ 389 82 £ 208

Phase GBP/BH minor repair

Number GBP/BH major repair

number

BSF-1

BSF-2 £ 255 119 £ 1,995 66

BSF-IA £ 208 82 £ 4,133 74

BSF-IAe £ 73 12

Total number invoiced £ 463 201 £ 6,202 152Weighted average £ 236 £ 2,884

65


Annex18d. WATSAN Latrine Unit CostsInstitutional Latrines

GBP/latrine stance

< 500 Low

500 - 900 OK

900 - 1300 High

> 1300 Very high

Grant recipients BSF-2 GBP/stance nr stances Activity/ comment County State

COMPASS £ 1,213 4 VIP latrines at health facilities Terekeka C Equatoria

AMA £ 461 24 Costs might be hire, as also other construction budgetlines might have been used. Gogrial, Twic Warrap

AVSI £ 937 24 VIP latrines at schools Ikotos E Equatoria

CMS Ireland no data 78 Part of school construction budget Lanya, Yei, Morobo C Equatoria

CONCERN no data 6 Part of health unit/ centre construction budget Aweil West N BeG

INTERMON OXFAM £ 625 52 VIP latrines at schools Raga W BeG

IRD £ 2,681 35 Last minute over expenditure of budget. Poor flush latrines, therefore inc septic tank. Duk Jonglei

OXFAM GB £ 1,405 39 VIP latrines at schools Mabaan, Longuecok Upper nile

OXFAM NOVIB £ 393 48 VIP latrines at schools Mundri W Equatoria

SWISS RED CROSS £ 1,868 4 VIP latrines at health facility. Mayendit Unity

WORLD RELIEF no data 11 Part of school construction budget Yirol, Ezo Unity, W Equatoria

HARD no data 10 Part of school construction budget Jur River, Wau W BeG

IMC £ 816 20 VIP latrines at health facilities Akobo Jonglei

MEDAIR no data 8 Part of health unit/ centre construction budget Melut, Manyo Upper nile

UMCOR £ 908 12 Poor flush and VIP latrines Aweil South N BeG

WORLD VISION £ 656 14 VIP latrines at schools Tambura, Ezo, Yambio W Equatoria

Average £ 1,150

Weighted average £ 1,023

Average clay soil £ 1,536

Weighted average clay soil £ 1,666

66


Average non clay soil £ 653

Weighted average non-clay soil £ 601

Grant recipients BSF-IA GBP/stance nr stances GBP/built nr built Activity/ comment County State

ACF £ 1,150 40 £ 1,789 40

ACTED £ 1,903 42 £ 3,177 84Construction of pit and superstructure, doesn't include the digging of the pits. Unit price based on BoQ of previous constructed latrines in the area. Jur river

ARC £ 1,097 9 £ 736 9

CARE no data 6 £ 1,907 6 Part of health unit/ centre construction budget

CARITAS no data 24 24 Part of school construction budget

CORDAID no data 4 Part of health unit/ centre construction budget

CRS £ 1,188 48 £ 827 48

HARD £ 919 18 £ 983 18

Intermon OXFAM £ 985 24 £ 1,648 33

INTERSOS £ 389 9 £ 281 48

MALTESER no data 19 Part of health unit/ centre construction budget

OXFAM GB £ 1,000 16 £ 1,920 16

SCISS £ 1,477 54 £ 1,270 54

UMCOR £ 653 40 £ 518 40

ZOA £ 1,625 20 £ 915 50

FFH £ 640 12 £ 965 16

HEALTHNET no data 6 Part of health unit/ centre construction budget

OXFAM NOVIB no data 28 Part of school construction budget

TEARFUND - WATSAN £ 188

56 £ 647

23Superstructure of iron sheets. The pit will be lined, however total depth will not exceed 4 meter. Unit prices were discussed during contract negotiations.

AVSI no data 4 £ 840 Part of health unit/ centre construction budget

CCM £ 625 132 £ 2,033 74

CMS Ireland £ 1,000 8 £ 722 26

CONCERN No data 6 Part of health unit/ centre construction budget

IRD No data 4 Part of health unit/ centre construction budget

MEDAIR £ 868 24 £ 282 24

MERLIN £ 700 12

TEARFUND - HEALTH £ 420 22 £ 268 18

WORLD VISION £ 1,156 18 £ 1,458 18

67


Average £ 946 £ 1,159


Average clay soil £ 734 £ 988

Weighted average clay soil £ 709 £ 709

Average non clay soil £ 888 £ 969

Weighted average non-clay soil £ 927 £ 927

Grant recipients BSF-Iae GBP/cubicle nr cubicle GBP/built nr built Activity/ comment County State

ADRA £ 2,176 12 £ 1,500 12 Eastern Equatoria

AVSI £ 500 4 £ 294 4 rehabilitation of 4 Eastern Equatoria

CCM £ 8,000 5 £ 8,335 5 Warrap

CARE £ 8,422 2 £ 1,644 6 Unity

GOAL £ 234 4

IMC £ 189 12 £ 582 12 rehabilitation of 12 Jonglei

Malteser £ 1,492 26 £ 518 26 Western Bahr eQ

Tear fund £ 792 13 £ 971 16

WVI £ 4,621 8 £ 4,519 1 Western Equatoria

SciSS £ 4,000 4 £ 1,860 2

Across £ 1,299 10 £ 1,299 10 Central Equatoria

FH Int £ 5,586 12 £ - 12 Uppernile

Hard £ 836 0 £ 4,217 2 Western Bahr eQ

Average £ 3,159 £ 1,998

Weighted average £ 2,493 £ 1,226

Average clay soil

Weighted average clay soil

Average non clay soil

Weighted average non-clay soil

Phase Weighted average Weighted average clay soil

Weighted average non-clay soil

BSF-1

BSF-2 £ 1,023 £ 1,666 £ 601

BSF-IA £ 925 £ 709 £ 927

68


BSF-IAe £ 1,226

Average £ 1,058 £ 1,188 £ 764

Household Latrines

Grant recipients BSF-2 Total budget Achieved % of targetGBP per HH latrine

Original costs per HH latrine Comments

AVSI £ 32,178 250 50% £ 129 £ 64 Co-financed latrine slabs, hygiene kits, KAP survey, digging tools, IEC materials, hygiene and sanitation sensitisation sessions and workshops

INTERMON OXFAM £ 64,604 1064 304% £ 61 £ 185 Co-financed latrine slabs, hygiene kits, KAP survey, digging tools, IEC materials, construction hygiene centres, hygiene and sanitation sensitisation sessions and workshops. More hygiene activities under different budgets.

OXFAM GB £ 121,818 854 190% £ 143 £ 271 Plastic slabs, digging tools, KAP survey, IEC materials, training and incentives volunteers, training GoSS

SWISS RED CROSS £ 7,753 120 64% £ 65 £ 41 Mainly distribution of slabs

IMC £ 34,685 0 0% - £ 694 100% financed pit latrines, IEC materials and campaigns (also for public health), VHC training and incentives hygiene promoters

UMCOR £ 10,106 24 0% £ 421 £ 421 Concrete slabs, hygiene promotion, training and incentive volunteers

Grant recipients BSF-IA Total budget TargetGBP per HH latrine

GBP per HH latrine

Original costs per HH latrine Comments

ACF £ 44,615 150 £ 297 159 £ 133 Household latrine slabs, tools (?), intensive hygiene promotion community and schools, training teachers on hygiene

ACTED £ 70,308 400 £ 176 119 £ 279 Capacity building CBO, training of trainers, incentives trainers, IEC materials, slabs, slabs workshop, KAP survey

CRS £ 33,945 500 £ 68 410 £ 58 Capacity building CWD, training community hygiene promoters, school hygiene clubs, latrine slabs

INTERMON OXFAM £ 44,544 258 £ 173 397 £ 137 Capacity building CWD, co-financed latrine slabs, hygiene kit, intensive hygiene promotion community

INTERSOS £ 11,450 50 £ 229 113 £ 24 Capacity building CBO, training of trainers, IEC materials, slabs, KAP survey

OXFAM GB £ 81,526 300 £ 272 333 £ 78Training community volunteers, incentives volunteers, intensive hygiene promotion, digging tools, slabs, IEC materials, KAP survey

UMCOR £ 21,224 500 £ 42 £ 239 £ 28

ZOA £ 55,800 200 £ 279 222 £ 16

PSI £ 139,962 1320 £ 106 729 £ 9

TEARFUND WATSAN £ 43,036 200 £ 215 92 £ 149

AVSI £ 39,450 300 £ 132 310 £ 20

GOAL £ 9,400 50 £ 188 8 £ 678

IMC £ 19,629 56 £ 351 52 £ 68

69


MEDAIR £ 10,348 100 £ 103 66 £ 39


Weighted average (without values in grey) £ 186 £ 69

Phase Cost / HH latrine [GBP]

Number of HH latrines

BSF-1

BSF-2 £ 198 2,312

BSF-IA £ 64 3,249

BSF-IAe

Total number HH latrines 5,561

70


Annex 19. Grantee Project SummaryLead Agent & partners

State& Sector

County Overview 31 December 2012

ADRA / Christian Development Services

Primary

Health

Upper Nile

Eastern

Equatoria

Nasir/Luakpiny Budi Two PHCCs and 14 PHCUs supported with key health staff, joint supervision with the CHDs, training and medical

supplies / equipment. Accessibility problems in Nasir County, due to flooding, limited access from August to Dec., while

in Budi County, a washed out access road to Nagishod made access to 1 PHCC and 6 PHCUs only possible on foot

from April to end of year. Drugs, vaccines etc. were carried to health facilities on foot, by community participation.

2 PHCCs (Kiechkuon and Nagishod) facilitate assisted deliveries by enrolled midwives (skilled birth attendants) and

well equipped maternity departments but the uptake is low (103 in total), far below target (703). However, these

midwives also advise the local birth attendants (TBAs) in the communities on early referral of risky deliveries, through

their frequent meetings with these TBAs. The indirect impact of this is unquantifiable but bound to be significant.

EPI services were supported with routine services in two PHCCs and monthly outreach to all PHCUs, where possible,

but challenged by refrigerator break-downs, and unavailability of kerosene (fuel) or vaccines’ supply, resulting in a low

EPI coverage (DPT3 coverage 40%). ADRA supported an additional cold chain at Lorema PHCC (CDoT) in Budi

County. ADRA coordinates with both SMoHs for more (solar) refrigerators and repair of existing refrigerators.

Three community midwives graduated at Leer midwifery training school after 18 months with very good marks. Another

one had to stop training due to pregnancy, but will complete in 2013.

Borehole construction near health facilities (target 10 in Nasir County) planned early 2012 was challenged by flooding

but finally completed in January 2013 (with budget accrual). Four latrine units at health facilities built.

Capacity building of County Health Departments; facilitation of joint supervision visits to health facilities, joint Boma

Health Committee training, practical support of DHIS support etc.

ARC / Communication for Life Change Program (Magwi)

Primary

Health

Eastern

Equatoria

Magwi, Kapoeta

East

Kapoeta South

ARC supports 6 PHCCs and 2 PHCUs with regular supervision visits,staff mentoring (Continuous Medical Education),

and joint quarterly monitoring with CHD staff. All PHCCs have capacity for routine EPI, maternity departments and in-

patients care, but were, in general, constrained by lack of skilled staff (posed by SMoH).

To address this, ARC paid incentives to MoH staff. 53 staff in Kapoeta South / East received a 50% top-up and 25 staff

in Magwi a 35% top-up. This has been agreed in detailed MoUs with SMoH and the CHDs. In addition, 4 Clinical

Officers and 4 Nurses were ARC-deployed in the 4 supported HFs in Magwi. Their function was, besides upgrading

services, mentoring of staff.

ARC supported the CHDs with transport of (MoH) drugs from State MoH and/or CHDs to health facilities, vaccines

delivery during EPI outreach and campaigns, and with specific training on CHD leadership and management, dugs’

supply management and HMIS (proper register use). Clinical skills development is carried out through mentoring

71


Lead Agent & partners

State& Sector


during clinic visits, and short courses (on weekends, to avoid taking key clinical staff out of facilities).

Additional drugs’ procurement and – distribution to close essential drugs stock outs.

Repair and minor rehabilitation of health facility buildings.

A borehole drilling component in 2011 in Kapoeta zone was found not to be closed properly. The contractor had only

installed 5 boreholes instead of targeted + reported 6. ARC supplies essential borehole spare-parts to the County

water departments, to maintain existing boreholes.

AVSI /Catholic Diocese of Torit

Eastern

Equatoria

Ikotos Support 3 PHCCs and 7 PHCUs throughout 2012. St Theresa PHCC (CDoT owned and managed) has been gradually

upgraded to County Hospital, with ongoing CeMONC capacity at the end of the year. This upgrading has been

coordinated with SMoH.

Weekly supportive outreach programme to all PHCUs (with ANC, EPI, deworming, nutrition monitoring and health

education clinics) has been on-going, as well as monthly supervision visits (in coordination with the CHD). A gradual

shift to creation of ANC and (routine) EPI capacity in all PHCUs was reviewed and recommended with BSF team.

Payment of salaries of 23 key clinical staff; 8 of these in St. Theresa PHCC are employed by CDoT, others posted in

MoH facilities.

Apart from salaries, technical and logistical support to St. Teresa. Thus included upgrading and equipping of the

operations theatre, but also the training of 3 key staff in surgical / anaesthesia procedures at Lacor Hospital, Gulu,

Uganda 3 to 6 weeks). In addition, a consultant surgeon from Italy provided hands on training at ST. Theresa in

CeMONC procedures. From St. Theresa PHCC / Hospital, an exchange learning schedule (clinical diagnosis and Tx)

to Ikotos and Imatong PHCCs, with intensive staff coaching.

Essential drugs procurement and delivery to complement MoH drugs’ delivery in all supported health facilities, in

particular anti-malarials (AS/AQ), because anticipated MoH delivery schedule of standard PHCC and PHCU kits for 3rd

and 4th quarters were not delivered by end of year.

Delivery of medical equipment and furniture to all facilities, up to BPHS basic standards.

Health & Hygiene promotion by Watsan promoters. 209 household latrines were completed as an outcome, while the

repair of 23 boreholes was facilitated through these promoters.

CARE Primary

Health

Unity

Guit, Mayendit,

Rubkona

Pariang

Mayom

Abiemnhom

CARE supports 9 PHCCs and 5 PHCUs, in 6 Counties. Accessibility to some facilities (e.g. 4 PHCUs in Mayom

County) was only possible after floods receded by mid. November.

Drugs (to supplement SMoH deliveries) were procured and distributed, in particular anti-malarials, which in spite of this

support were frequently out of stock. Observations about possible “leakage” of drugs from CARE supported facilities to

the market were shared by BSF monitors. Rubkona PHCC has not been included in the MoH distribution list and

received only piecemeal some drugs from SMoH, over 80% supplies came from CARE.

72



State& Sector


UN provided some logistical support to drugs’ and vaccines’ delivery, with helicopter drops.

EPI support is ongoing. 7 PHCCs have functional refrigerators, but Mankien PHCC and 4 PHCUs in Mayom County,

and Abiemnhom PHCC, depend on vaccines’ supply on the EPI cold chain at Mayom PHCC (by cold boxes). Due to

accessibility problems, EPI in the latter facilities only became functional again by mid-November.

CARE supplied basic furniture to Rubkuai, Nhial Diu, Mayom and Mankien PHCCs.

Construction of health facility extensions at Rubkuay (one additional room) completed in Dec. and at Guit and Biu in

Jan. 2013. (postponed and on accrued budget from BSF_IA phase).

Reduced occasional access to some facilities due to insecurity, esp. Pariang and Mayom.

A detailed external evaluation of the (BSF-supported) health programme from July 2010 – Dec. 2012 identified main

challenges to attaining BPHS standard services, but also concrete progress and opportunities to improve services the

coming years.

CCM Primary

Health

Warrap

Tonj North

Tonj East

Tonj South

Health services in 3 PHCCs and 15 PHCUs in Tonj North, East, and South Counties. Out of these; 1 PHCC and 7

PHCUs were included w.e.f. 01/08/2013, extension of a SHTPII contract.

Large area, with widely dispersed population who live long distances away from health facilities. The access to some

health facilities (Aliek, Langkap, Rualbet in particular) was limited between July until mid. Dec. due to flooding.

CCM introduced this year one-to-one coaching of health facility staff (CHWs) on IMCI during the once- to bi-weekly

supportive monitoring visits to all facilities.

EPI routine in most facilities (with cold chain; number extended from 7 to 10) and monthly outreach to others. A

measles outbreak in Tonj East was followed up by measles vaccination and closer monitoring. EPI outreach schedule

dry-season cattle camps.

A very intensive (and costly) frequent referral (total 634) of patients from supported facilities to Marial Lou hospital.

CCM actively collected and referred wounded (over 30) on 29 – 30 April, after a main cattle raid in Tonj East, and in

inter-clan clashes at Ananatak Feb. to April 2012.

All facilities carry out ANC and PHC, but all but two staffed by trained TBAs. CCM carries out regular supervision visits.

TBAs keep records of home-deliveries too, with emphasis on recognition of risky-deliveries with, where possible, timely

referral.

Intensive Reproductive Health / Family Planning promotion, with weekly education at all facilities. In total 19,636

persons listened and affirmed. In spite of this promotion and access to commodities, very low uptake yet of (new) FP

methods-users (27 only in Tonj East + North).

27 school health clubs (boys and girls) formed and trained in Tonj East and North, with training (conversational) on

personal/HH hygiene, reproductive / sexual health, GBV issues etc.

73



State& Sector


CMS-Ireland /Diocese of Yei (ECS)

Primary

Health

Central

Equatoria

Yei

Morobo The programme had two components; support Martha PHCC – a busy urban clinic in Yei, and a weekly mobile clinic

outreach to 5 communities, with a health / community development focus.

EPI outreach during weekly outreach. 3 solar fridges were procured, and were to be installed (Jan. 2013) installed at

PHCUs through the CHD, to facilitate routine EPI. At the end of the year, EPI outreach was challenged by

unwillingness of CHD / MoH employed vaccinators to carry out the work (without additional pay). This issue was not

yet resolved at the end of the year.

Mobile clinic outreach is has been ongoing throughout the year, with clinical case mgt. (outpatients) by Clinical Officer,

ANC, PNC and Family Planning clinic by a midwife, HIV/AIDS education and VCT by an AIDS counsellor, and EPI

outreach (though limited; see above). In addition, community health education was always given in collaboration with

local health resource persons (TBAs, CHWs etc.) and church communities. There has been significant impact in terms

of community awareness, early referral etc.

Martha PHCC was supported for over 4 months by a team of visiting UK-based doctors and other health professionals.

This exchange link benefitted also Yei Civil Hospital a lot.

The longer term continuation of the programme was challenged at the end of the year. CMS-I’s bid (in consortium with

other partners) for USAID/JHPIEGO funding did not win. However, CMS’s commitment to support health in Yei County,

in partnership with ECS-Yei, remains firm.

CONCERN Primary

Health

Northern Bahr

el Ghazal

Aweil West 2 PHCCs and 20 PHCUs operational, without interruptions (4 PHCUs were included w.e.f. 1/8/2012). This covers

about 90 % of all health facilities / services in the County. CONCERN adopted a County-wide health services support /

HSS approach, by agreement with CHD.

Integrated nutrition programme. Although the main nutrition activities were not BSF-funded, the context of Community

Management of Acute Malnutrition (CMAM) impacts a lot on the health services. A nutrition survey in April 2012

indicated GAM / SAM rates of 25.8% / 4.1% respectively, indicating need for integrated programming. This was

addressed by OTP services in all facilities (total 8917 beneficiaries < 5), Supplementary feeding targeting pregnant and

lactating mothers (25,195) and a stabilisation centre at Nyamlel PHCC (34 admissions).

Two PHCCs (Nyamlel, Marial Baai) offer BeMONC, with 124 assisted deliveries (target 603), assisted by skilled

(enrolled) midwives. However, in all facilities trained TBAs support assisted deliveries while reporting home deliveries

(total 3110), and were trained on timely referral of complicated deliveries. TBA refresher courses were ongoing of a

“trained” cadre of about 35.

The programme supported salaries of over 85% of health facility staff in the County. The CHD prepares payrolls and

physically pays staff, so that it is seen as paymaster and has a stronger position in Human Resources management.

This is reflected in MoUs.

74



State& Sector


Most facilities practised some form of cost-sharing at point-of-access, endorsed by the CHD and the SMoH. Boma

Health Committees are given a role in community-based monitoring, and are said to ensure access by vulnerable

households. CONCERN continued to principally object to the practise, and has been raising it at meetings while SMoH

and CHD, while trying to ensure access by vulnerable groups, through Boma Health Committee awareness raising /

training.

The main drugs’ supply has been provided by MoH. However, anticipated 3rd and 4th quarter kits were not delivered in

2012, leading to serious stock outs. CONCERN’s procured additional drugs, but not enough to prevent stock outs. BSF

monitoring observed also on-market sales of MoH issue drugs in Nyamlel, indicating need for monitoring by CHD with

support of CONCERN.

Support to community development through “Community Conversation” groups; groups (women and men) selected in

committees and trained by CONCERN with participatory methods on own needs identification ad action planning.

Common themes were malnutrition recognition and -action, reproductive health / FP, GBV issues etc. active.

CORDAID /CatholicDiocese ofTambura-Yambio

Primary

Health

Western

Equatoria

Ibba,

Nzara DoTY supported 2 PHCC's and 6 PHCUs that were functional this year, 4 in each County.

Monthly supervision of all facilities, with QSC supervision, together with the CHDs. However, coordination of visits

between DoTY staff and with the respective CHDs has been weak.

Ringasi PHCC has been extended and rehabilitated (upgraded from PHCU), according to plan, and completed just

before the end of the year.

EPI is supported, in coordination with SMoH campaigns in both Counties. However, the output (571 children < 1

vaccinated DPT-3) is far below target (of 1388) i.e. 41%. EPI is supported by various stakeholders; State MoH – EPI,

CHDs, Unicef/WHO and various NGOs, without good coordination. In particular Ibba County lacked coordination led

by MoH (CHD).

The installation of a solar refrigerator at the new Ringasi PHCC will enable routine EPI in 2013.

Drugs procurement in Dec. to close essential drugs’ out of stocks noted in facilities. These will be expected in Jan.

2013.

The programme supported DHIS in both Counties. Nzara CHD send DHIS reports by email to SMoH in Yambio (with

DoTY coaching and support) most months but Ibba CHD has not been able thus far. Personnel changes in the CHD

meant that training skills invested, earlier on, were lost to the CHD and new training of CHD staff is needed.

GOAL Primary

Health

Baliet,

Ulang Joint supervision schedules with CHD where possible, and supervision of facilities by GOAL support (health and

reproductive health officer) at least once a month. During supervision, staff is mentored on clinical and management

challenges

EPI outreach supported by solar refrigerators in all 8 facilities. GOAL continued to deliver the lion’s share of essential

75



State& Sector


Upper Nile drugs (80% to 90% of stock) facilities. 3rd and 4th quarter anticipated deliveries by SMoH delayed, but stock outs

effectively closed by GOAL supply.

Nutrition screening (by MUAC and WfH) with integrated OTP of all under 5s in all clinics was extended in Nov. 2012 to

Ying and Yomding PHCUs, so that effectively all 8 supported health facilities have nutrition support services. This is

gradually extended to a community-based model with “nutrition circles” (c.f. with CMAM approach by CONCERN).

Uncertainty about staff contract extensions, against the background of reduced funding in 2013 – in a support grant by

IMA / WorldBank -, led to understaffing of key positions before the end of the year. This did have impact on outreach

activities; EPI outreach, ANC support etc., and caused reduced achievements.

GOAL’s BSF grant includes supports for the position of coordinator for the NGO Healthforum and office coordination

costs, by agreement with MoH and DfiD. The coordinator (Dr. Ruth Goehle) worked in the office from Feb. to mid

November 2012, and contributed much to information sharing between MoH and NGOs. Erin Polich fills the office

since Dec. 2012.

HEALTHNET TPO / Christian Reaching Ministries

Western Bahr

el Ghazal

Northern Bahr

el Ghazal

Jur River,

Raga,

Aweil North

HNTPO supports 2 PHCCs and 7 PHCUs in Aweil North, 2 PHCCs and 12 PHCUs in Raga County, and 2 PHCCs and

9 PHCUs in Jur River County. Some facilities (3 PHCUs) were not operational, while others (2 PHCUs in Raga

County) could not be accessed due to insecurity.

Healthnet employed and seconded 46 key clinical staff in Aweil County, by MoU with the CHD. On the other hand, all

Health Facility staff in supported facilities in Jur River and Raga Counties is on MoH payroll. It has been difficult for HN

field staff – working together with CHDs – to maintain their morale and performance. The introduction in Oct. of

salaries’ payment by bank in Wau for Jur River MoH staff (with 50 SSP bank charges, as well as high travel cost)

further demotivated staff, leading to the temporary closure of several facilities.

To maintain minimal levels of EPI coverage, HN, by MoU with the CHDs, employed vaccinators for routine and

outreach services in Jur River and Raga. This markedly improved EPI coverage, further improved regular supervision

and repair + maintenance of refrigerators. EPI services in WBeG have been centrally managed by the EPI department

of the SMoH (and not by CHDs) leading to centralized but ineffective delivery, but was delegated to CHDs by end of

the year.

Access to facilities in Raga County was reduced due to insecurity relating to the SAF / SPLA conflict. Timsah PHCU

was not accessible the last 6 months. Aerial bombardments on 29 Dec. 2012 and 2nd Jan. 2013 on locations in

northern Raga, aggravated the insecurity situation.

A “pull system” of drugs’ supplies to health facilities is gradually introduced. Healthnet procured additional drugs are

supplied, based on the verified drugs’ consumption and records, which include both MoH and NGO supplied drugs.

Healthnet trained CHD staff in the methodology.

76



State& Sector


Christian Reaching Ministries (a local partner NGO) carried out a specific community health education activity in Aweil

North County, and developed some IEC materials.

IMA (JON) / John Dau Foundation

Primary

Health

Jonglei

Duk The range of clinical services at Duk Lost Boys Clinic (LBC) increased, after the opening of new buildings (completed

by IRD according to agreement by 1st March 2012). The PHCC has BeMONC capacity, but gradually introduces

CeMONC capacity.

A Clinical Officer was trained for this purpose in CeMONC task shifting at Kisumu University. This will enable e.g.

Caesarean Section operations. Other key functions, such as blood transfusion capacity, were already introduced by

JDF. Nutrition (OTP and if required stabilisation of severe malnutrition etc., TB treatment unit were introduced too,

while , the TB services at the PHCC were reviewed and subsequently licensed by the MoH (TB control programmes).

The PHCC+ has a VCT/PMTCT component. A limited amount of ARV drugs was procured and prescribed to ensure

continued ART of patients, who would not be able to access Bor State Hospital for 6 months in the rainy season.

IMA facilitated the shipment of the 2nd and 3rd quarter drugs supply from SMoH to Duk, by air charter in mid Dec. to

all 11 functional health facilities in the County. Together with complementary IMA procurement this ensured County-

wide pharmaceutical coverage, although at a very high cost per facility.

Duk CHD was formed (3 staff only yet) and gradually functional with much mentoring support by IMA’s health

coordinator. A limited number of joint supervision (with QCL) was carried out.

IMA (UN) Primary

Health

Upper Nile

Melut,

Manyo

Support to 3 PHCCs and 9 PHCUs facilities in Melut and Manyo County (except Athidwey Payam, served by

Tearfund) as continuation of Medair-implemented support in BSF-IA.

Payment of facility-staff in Melut County, through, and by agreement with, the CHD. Health facility staff in Manyo

County was on MoH payroll and received basic salaries, but incentives by IMA (also administered through the CHDS

at Wadekona).

At the end of the year, the staff of Melut PHCC demanded inclusion of their positions in NSSF coverage, which led to

its closure after 31/12/2012. In several cases, it was difficult to maintain staff morale and performance due to the

increased cost of living, but fixed salaries, while entitlements during “Medair’s period” were continuously claimed.

IMA procured and delivered drugs to complement MoH- kits (the last kits delivered were of Quarter 1 2012!), while

health facilities and stores tended to have carry over stocks after Medair’s handover (although some inappropriate).

Frequent o/s were still observed, especially of anti-malarials, but through rationalized monitoring (introduction of stock

cards, basic drugs’ consumption tracking) this gradually improved.

PMTCT services offered to women at Melut PHCC. Challenged by lack of test kits part of time.

TB unit at Melut was kept functional but with only a few in-patients (3 – 4 in 2012 as compared to 25 – 30 in 2013).

This was largely caused by the ending of food deliveries by WFP, which CHD / IMA were not able to extend, in

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State& Sector


coordination with SMoH.

EPI at all facilities in Melut County, but was inadequate in Manyo County, partly due to limited access due to insecurity

(limiting also other supervision functions).

Rehabilitation of the buildings of 4 PHCUs in Melut County. A partially collapsed wall of Paloich PHCU was repaired,

as well as cracks in walls, new cement floors etc. in 4 PHCUs. Shelves for drugs and equipment constructed at

Bushara PHCU in Manyo.

IMC /Nile Hope Development Forum

and Presbyterian Relief and Development Agency

Primary

Health

Jonglei

WBeG

Akobo

Raga

IMC with partners NHDF and PRDA supported 2 PHCCs and 10 PHCUs in Akobo County. The local partners have

long and strong historical links and this helps integration with local governance. But impact is reduced because NHDF

and PRDA delay reporting also financial reporting , have inactive supervision and support of facilities (on the part of

NHDF).

Insecurity due to inter-ethnic (Murle on Lou Nuer) conflict caused serious number of casualties (+/- 100, between 8 –

14 March). IMC provided emergency surgical capacity at Akobo to treat over 50 wounded. Also Walgak PHCC

provided emergency surgical care on two occasions.

EPI coverage has been low (DPT3 < 1 Target 2832, and achieved 684 i.e. coverage 24%), due to unavailability of

vaccines (supply link from SMoH in Bor to Akobo is very difficult; IMC closed this a few times by facilitating air

transport via Juba to Akobo), insecurity – causing temporary displacement of people out of reach of EPI sites, but also

inactive support by local partner staff.

Thokliel PHCC was completed on 2/7/2012 and handed over to CHD; implemented in BSF-IA but extended with

accrual into 2013. Staffing remained inadequate however.

Raga Hospital: In consultation and agreement with WBeG SMoH, DFiD and BSF secretariat, IMC received support, in

the form of a contract amendment, to keep Raga Hospital in WBeG operational. This is to close a critical funding and

services’ support gap between the exit and handover by MSF-Spain (on 30/11/2012) and the access of other funding

by IMC in Feb. 2013.

IMC supports / employs key staff (two doctors), and supports MoH-employed staff in this hospital, while carrying out all

basic logistical support. Emergency drugs’ kits placement etc.

The security crisis in starting on 12 Dec. in and around Wau, restricted access to Raga by road. This delayed some

crucial road trips.

Aerial bombardments by SAF on populated settlements in Raga County on 29/12/2012 and 4/1/2013 caused a high

number (> 30) wounded seen at Raga Hospital. IMC’s team carried out emergency surgery / care as well as referral of

complicated surgery cases to Wau Hospital.

IMC Western Bahr Raja hospital in Raja In November 2012 IMC received a BSF budget increase of GBP 95,520 to support Raja hospital for 3 month till 31

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State& Sector


el Gazal county January 2013. This became necessary because Raja hospital faced a funding gab due to the end of ECHO funding

and the subsequent departure of MSF-Spain in October 2012. Civil unrest delayed the start of activities but the project

made progress in the course of January 2013.

Staff is predominantly Arabic speaking and trained and this effects reporting and record keeping (MoH forms are in

English only).

The intention is that Raja hospital will be included in the HPF.

IRC Primary

Health

Northern Bahr

el Ghazal

Unity

Aweil South

Panyijiar Clinical and community health outreach in 15 health facilities in Aweil South (NBeG) and Panyijiar (Unity) Counties

from 01/08/2012 – 31/12/2012 (SHTP-2 bridging).

Detailed discussions held by IRC and BSF on 28th August, about the desired role of IRC (and its “skilled” maternal

health staff in particular) to support the local TBA networks in Aweil South County. The consensus was that TBAs

should always be engaged with by “skilled” staff, and refresher of existing TBAs can be held, but a clear focus on

recognition of complicated delivery and their timely referral to health facilities. TBAs should be supported with gloves,

razors, disinfectants etc. with continuous instruction on safe practise. This consensus was discussed and endorsed by

Aweil South CHD (on 28th August) and SMoH NBeG (on 29th August). It helped young, enthusiastic staff (two

Community Midwives) at Panthou PHCC to get assurance in their work, and IRC in general to develop guidelines to its

maternal health staff.

The Maternity ward of Panthou PHCC was upgraded. A considerable number of deliveries take place in facility but not

classified as “ skilled” (because CMWs are classified “unskilled”).

All (15) clinics treat common childhood morbidities according to IMCI guidelines. 16,320 children (<5) were treated. Vit.

A is routinely prescribed at EPI and at OPD in selected cases.

Nutrition screening is systematically carried out of <5s, using WfH. MUAC and WFH methods are used to validate

observations.

IRC supports the delivery of SMoH drugs to facilities, coordinated with the respective CHDs. The 2nd. Quarter 2012

delivery, was delivered to Aweil South in July, but only in Oct. to Panyijiar, the latter was airfreighted into Ganyliel by

IRC. The 3rd quarter MoH deliveries are expected in Jan. 2013. To close essential drugs’ gaps, IRC procured drugs

scheduled to deliver in Dec. but flights cancellations caused delays until Jan. 2013.

JSI Primary

Health

Western Bahr

el Ghazal

Wau JSI BSF grant signed only on 21/08/2012 because of protracted budget consultations ( ratio direct/indirect costs). Re-

employment of technical staff (M&E coordinator, RH / HIV/ADS coordinator, maternal health coordinator), was

completed by 24th Sept 2012. JSI’s SHTP-2 grant ended on 31 July 2012 so these dealys created a funding and

implementation gab of several months and as such the transition was not seamless.

JSI signed a MoU with the State MoH (DG) on 6th Oct. Up to that date, JSI had supported some ongoing activities

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State& Sector


(joint supervision with CHD, delivery of vaccines to most health facilities etc.) but no structural programme

improvement, further delaying implementation. After thus signing, the SMoH (headed by DG) had a proactive role

advisory and M&E role. BSF facilitated this by ssssssssharing all project documents with SMoH (normally assured by

the grantee).

From 26th Nov. – 13 Dec. (interrupted by insecurity in Wau town) rehabilitation of Mukhta PHCC in Wau centre, with

construction of a perimeter wall, rehabilitation of electrical wiring / installation, genset repair, repairing roof etc., to

make the PHCC safe and equipped for assisted deliveries 24 hours per day. According to the DG SMoH, BSF met in

Juba on 11th Dec, good progress had been made with this within a 2 weeks period, but not completed.

Other investments were a new VIP latrine constructed at Lokoloko PHCC, and finishing touches and furnishing of

maternity departments at two PHCUs.

A 3-days training (5th – 7th Nov; 28 participants –midwives and clinical staff) on RH.

On 3 occasions at the beginning and during the programme, BSF monitors identified and shared concerns about the

vaccines’ delivery practice, carried out by JSI. Vaccines collected from the State MoH – EPI store and delivered weekly

to health facilities, should not have been used because ice packs were found melted and inside temperatures of cold

boxes too high. While this problem was attributed (by JSI team) on a number of causes, including lack of coordination

between SMoH – EPI and CHD, BSF emphasized the responsibility of JSI for clinical quality. This problem was not

addressed in the end, and concerns about viability of EPI standards in Wau County Aug. 2012 – Dec. 2013 need to be

shared with MoH at various levels.

A work-plan and budget revision of JSI’s programme was carried out in the week 28 – 30th Nov. Planned drugs

procurement, training and other activities were scrapped, because of a lack of implementation timeframe, and allowing

for greater focus on rehabilitation and supervision.

The quarterly and completion reports of JSI are very detailed but many outcomes were either not achieved within the

BSF-IAe timeframe, or are really carried out by CHD and SMoH and cannot be attributed to JSI’s support. A case in

point is a relatively effective pharmaceutical tracking system by Wau CHD, with rational re-distribution of drugs over

facilities.

Civil unrest in Wau, w.e.f. 12th Dec. halted outreach, and caused earlier leave of JSI team.

BSF corrected JSI’s reporting data in the final consolidated, through verification with the SMoH.

MALTESER Primary

Health

Maridi Support to 24 health facilities (4 PHCCs and 20 PHCUs) in the County, with rehabilitation / furnishing of health

facilities, employment of key staff, logistics (of e.g. EPI), supplementary drugs etc. This covers effectively all health

facilities in the County.

The rehabilitation phase of all health facilities was concluded with the upgrading of Ngamunde PHCU to PHCC,

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State& Sector


completed and handed just before the end of 2012.

While three PHCCs are well equipped for “assisted deliveries”, none took place because highest qualified staff posted

is CMW. They are often supported by MCHWs, a cadre previously trained for 18 months, at CHW level.

EPI coverage has remained inadequate. (DPT3 coverage 57%). This is to a large extent attributed to lack of

coordination between CHD and partner NGOs (Malteser and AAH) on the ground. In this (and some other Counties)

regular EPI at static sites is insufficiently supported because CHD’s attention (motivation by incentivization) is focused

on (WHO driven) campaigns.

The coordination between Malteser and CHD has been difficult. While Malteser consistently followed a HSS approach

in support of the CHD (with payment of salaries through CHD, additional drugs’ deliveries through CHD etc.) this has

not been reciprocated by the CHD with mutual accountability. During 2012, it became increasingly difficult to share

meetings.

Some joint supervision visits were carried out by Malteser and the CHD’s (2) PHC supervisors were carried, but below

target of at least one supervision with QCL per quarter. The 2 supervisors were also much engaged with the intensive

Malteser / CHD training programme.

DHIS is functional in County. A PHC supervisor does monthly data entry, with Malteser support.

BSF closely coordinated closely with Malteser on strategic advice towards more effective relationships with CHD and

SMoH. Three “WES BSF partners” meetings, together with CDoTY and World Vision staff and the respective CHDs

were held, which were considered very useful.

MERLIN Primary

Health

Eastern

Equatoria

Torit,

Lafon The actual achievements of main indicators varied a lot from targets set for 2012. While OPD achieved (26663) was

above target, the target for consultations (92055) was not achieved (36645). With such great differences, it is

worthwhile to re-visit target setting, in relation to the catchment population estimates, as basis for further analysis.

The greatest discrepancy is seen in numbers of assisted delivery. 15 assisted deliveries by “skilled” attendants were

reported, while the target was set at 1096. While all health facilities have basic maternity rooms (with delivery couch

etc.) only two PHCCs were consistently staffed by an enrolled midwife (in spite of Merlin’s consistent attempts to recruit

more). But besides lack of “skilled” midwives, inhibitive factors for health facility-based should be checked. Merlin made

an effort in this through popular awareness raising and health education at clinics.

Merlin carried out regular supportive supervision visits. This included a large number of clinical coaching workshops,

where PHC supervisor and / or MCH supervisor provide 3 to 4 days intensive staff coaching on clinical practise. This

approach replaced short refresher courses held in Torit. Early results show greater impacts, while routine clinical

practise that used to be interrupted by staff absence, are now ongoing.

Regular coordination with the SMoH and the two CHDs has been ongoing. Merlin has been pro-actively supporting

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monthly Health & Nutrition coordination at State levels.

While the capacity of Torit CHD gradually improved (evidenced by increasing joint monitoring with QCL), Lopa CHD

was hardly functional, due to inter-ethnic between Lopa – Pari and Imehejek – Lopit communities, which caused the

CHD director to work in Lafon and other team members in Imehejek, without communication. Reports from Lafon were

even send to the EES Governor’s office, bypassing CHD and SMoH channels. HMIS returns were incomplete for some

months, for this reason.

OVCI / Catholic Archdiocese of Juba

Primary

Health

Central

Equatoria

Juba Usratuna PHCC serves as referral PHCC with busy general (OPD) and antenatal clinics, but without admissions. In

addition, it is specialised in epilepsy and other mental disease treatment, and has a focus on disability (mainly of

children) rehabilitation with Juba-wide outreach.

The maternal health functions of 3 PHCCs (Kator, Nyakuron, Munuki) with whom OVCI has a long linkage, were

supported with access to training courses, medical materials and equipment and specific drugs. The ANC and delivery

data of these HCCs are included in OVCI’s reports.

The maternity referral network; from outlying health units / communities to main PHCCs in Juba, and from there to

Juba Teaching Hosp. for complicated deliveries, was extended, informing ad including more health facilities.

161 deliveries at 3 supported PHCCs were recorded by “skilled” attendants. However, a much larger number of

deliveries are carried out by “unskilled” attendants; Arabic “pattern” trained midwives (in-service), CMS, MCHWs etc.

with a Clinical Officer or enrolled Midwife “on call”. Especially at night, “trained” attendants appear not willing to work. If

these deliveries were to be included, numbers would multiply.

In coordination with Juba CHD, OVCI facilitated (transport, key staff) etc. for EPI at 7 outreach sites, in rapidly growing

population centres from Juba (Gudele) up to Rokon. This outreach is also used for health education, identify risky

pregnancies and screen children on disability etc.

Training of 4 community groups in areas on recognition, referral and community-based care of children with disabilities.

This is supported by regular broadcasts on Radio Bakhita FM.

Intensive clinical training programmes with short courses (Juba wide targeting) mainly by visiting Italian specialists.

SCiSS /Sudan Inland Development Forum

Primary

Health

Lakes,

Eastern

Equatoria

Wulu,

Kapoeta North Support of 1 PHCC and 7 PHCUs in Wulu County (Lakes) and 1 PHCC and 6 PHCUs in Kapoeta North (EES). SIDF is

implementing partner in the Wulu programme, but its role was limited to the formal employment of most health facility

staff (only a few are on MoH payroll), and HR follow up. The inadequate capacity of SIDF to supervise health staff and

to coordinate well with the County Health Department was observed, and discussed by BSF with SCiSS.

The programme in Kapoeta North is complemented by an active County-wide iCCM programme (identifying and

treating 3 key childhood diseases (malaria, diarrhea, respiratory tract infections) and by a nutrition programme with

OTP and one stabilization centre at Riwoto. Although non-BSF funded, these activities contribute a lot to integration of

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State& Sector


health services in the communities.

All but one of the health facilities in Kapoeta North are staffed by at least one Community Midwife (not categorized

“skilled” though). A generally upward trend in deliveries at health facilities is observed, but more importantly, referral of

pregnancies at risk. Obstetric complications are referred to Kapoeta.

Wulu PHCC has been extended over the last two years with an operating theatre, based on high aspirations by the

community and local partner SIDF. However, due to lack of staff (to be posted by MoH) the theatre is not used yet and

should be adapted to have capacity for comprehensive obstetric emergencies’ services. This is explored by SCiSS but

ownership and responsibility issues between SIDF and CHD / SMoH complicated the planning.

EPI support is ongoing. Seasonal flooding caused temporary inaccessibility in both Counties, interrupting EPI

schedules.

Kapoeta North CHD is functional and has DHIS capacity, although with regular support from SCiSS staff. The (small; 3

staff) Wulu CHD team was not yet DHIS trained, but keen to learn.

TEARFUND Primary

Health

Upper Nile

Fashoda, Manyo The Tearfund programme supported 3 PHCCs and 8 PHCUs. The PHCCs include Kodok PHCC which, although

formally handed over to SMoH in 2011, has been supported by TF with 9 key staff positions, essential materials etc.

Especially the ANC / maternity and VCT/PMTCT continued to receive much support.

The rehabilitation of Oriny PHCC was finally completed (in the aftermath of the 2011 pillage).

The construction of the Midwifery Training School was ongoing, as has been the completion of two PHCUs (Detwok

and Lul). A previous contractor left the Training Centre construction unfinished (at about 50% - 60%) and the

subsequent security crisis on 28th April (kidnapping of two key TF staff) and inaccessibility in latter part of the rain

season, meant that work resumed only from the beginning of December. Tearfund is committed to complete all

constructions by mid. Feb. 2013, and has been consulting closely on this with the BSF secretariat.

The training of 10 Community Midwives was completed in the first week of December with a graduation ceremony in

Malakal. They all passed the test and were going back to their communities for posting (by either MoH or NGOs) as

key health facility staff.

Tearfund continued to operate since end of April out of Malakal, and with reduced supervision of facilities. In general,

the local Boma Health Committees and communities have been very responsible, providing oversight and support to

the clinic staff. The role of the Fashoda CHD in this process was limited, due to severe understaffing. The CHD officer

was frequently absent.

Tearfund ended formally its health programme in Upper Nile on 31/12/2012. The local communities were well prepared

for this with community meetings. All facilities were formally handed over to the State Ministry of Health, as were most

“moveable” assets, on the contractual understanding that all facilities and assets remain allocated to use in Fashoda

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and Manyo County, and for public health purposes.

Tearfund keeps a logistics and administrative core staff in Malakal and Kodok however, until the final completion and

handover of all constructions.

WORLD VISION /Catholic Diocese of Tambura & Yambio

Primary

Health

Western

Equatoria

Ezo,

Tambura Support of all (10) Health Facilities with complementary drugs’ deliveries, based on needs and consumption patterns of

drugs. Essential drugs’ stock outs (e.g. AS/AQ) were closed with efficient drugs’ procurement, although occasional

stock outs occurred.

The rehabilitation of Banduguyo PHCU has been ongoing in 2012. Because of a collapsed bridge on the access route,

it was difficult to carry out the work in time.

Ongoing EPI in all 10 facilities. World Vision supports the SMoH with the transport of vaccines from Juba to Yambio,

and from there to the Counties, as well as weekly transport to facilities without own cold chain.

Home Health Promoters (community volunteers) had an important role in community case identification of malaria,

pneumonia and diarrhea in children (IMCI basic level), with timely referral to health facilities, counselling to mothers to

continue treatment at home, and recording of morbidity, as well as births / & deaths registration in communities.

Trainees were followed up with support visits. Several training courses were held for these HHPs.

In Counties with the reportedly highest HIV/AIDS prevalence of South Sudan, the programme staff trained health

facility staff in HIV/AIDS awareness, de-stigmatization of AIDS at community level etc. The programme identified need

and scope for integration of HIV/AIDS awareness and treatment services, e.g. coordination of access to ART at

nearest centres.

The two CHDs have been trained and equipped to carry out DHIS, but continuously found it hard to remedy hardware

and software problems. To remedy this, 7 CHD staff were further trained in basic computer skills, in order to give them

a basic skills set and the confidence to work with the DHIS software already installed and operational.

Watsan support has been ongoing with CLTS training of Community Owned Resource Persons in communities,

leading to community action plans on improved sanitation. This ws coordinated with the training of Home Health

Promoters.

ACROSS, YTTC All States

Primary

Education

Various 91 BSF sponsored students were among the graduates at YTTC's 2012 closing ceremony.

YTTC made strides with MoLPS in regard to the salary scale for entry teachers. Graduates from YTTC will now be

placed appropriately on the GoSS salary scale Grade 12, which is for entry level qualified teachers, instead of Grade

14, a level meant for unqualified teachers.

The BSF constructed Academic Tower will be a leader in the country with new facilities for learners, especially in the

area of science. Two laboratories were constructed to facilitate increased interest in the sciences.

HARD Western Bahr Jur River, HARD constructed a total of 36 classrooms across Northern and Western Bahr el Ghazal.

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State& Sector


el Ghazal;

Northern Bahr

El Ghazal

Primary

Education

Aweil Centre, Aweil

East, Aweil West PTA coordination was a highlighted success of the programme. In New Site, Western Bahr el Ghazal, the PTA rallied

the community to work together with HARD to construct a fence, providing labour and the poles. HARD provided the

wire fencing.

At the request of a PTA, a fence was also constructed around Pan Apoth Primary School in NBG because the school

grounds back into an army barrack. For the safety of the children, BSF and HARD agreed that a fence was

necessary.

WORLD RELIEF, ECS NBeG,

WBeG, Unity

Primary

Education

Various Through its local implementing partner ECS, WR trained 182 teachers through ISTT, 91% of targeted teachers.

In Raga, due to its proximity to the Northern boarder and strong Arabic patterned background, teachers performed

considerably better in their final example compared to the initial. WR/ECS provided intensive follow up to the teachers

in Raga between Phase 1 and Phase 2 of training, increasing exam scores by 35 points .

ECS/WR was a leader in providing MoGEI approved management trainings. Training a total of 206 County Education

Department officials and Head Teachers.

WINDLE TRUST NBeG &

WBeG; Unity;

Warrap

Primary

Education

Various Counties Enrolment of teachers across the four states at completion that passed the final English exam was 389, which is a

marked drop from overall target of 450 teachers. In prior quarters, the average number of teachers who attended the

training was 431.

Long delays in salaries forced many of the teachers to drop the course to find other work; however per diems given

to the female teachers worked as a successful incentive to keep them in the training.

All of the teachers trained in English were returnees.

FOOD FOR THE HUNGRY

Upper Nile,

Jonglei

Primary

Education

Ulang, Malakal;

Nyirol, Piji FFH constructed a total of 12 classrooms in Upper Nile and Northern Jonglei.

FFH was able to leverage the participate of the State and County Education departments, leading to high levels of

community participation in the construction- community dug the pit hole and made blocks under the supervision of an

engineer.

MRDA Western

Equatoria

Primary

Education

Mundri West In collaboration with the WES SMoGEI, MRDA helped to facilitate Primary Leaving Exams (PLE) for all of the P8

students in Greater Mundri. MRDA provided the printing of the tests and trained CED inspectors on exam facilitation

and grading.

120 scholarships and comfort kits were given to selected girls in Greater Mundri.

6 Girls' Education campaigns were conducted to encourage the community to send their girls to school, with a

special emphasis on discouraging early marriage. Through the Girls' clubs and the Girls' Education Campaigns there

was an increase in girl P8 leavers. In 2011, only two girls in Mvolo county took the PLE. In 2012, there were 18.

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13 05 09 BSF-IAe COMPLOT

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