 Performance monitoring of clusters to assess effectiveness & efficiency of cluster against 6 deliverables; ensure accountability; demonstrate added value of cluster approach Somalia experience  Preparations in October and survey in December  Conducted at two levels: National & Sub-National.  Possible overlap in NGOs responses avoided by asking for one response / NGO.  Results came out in January  GC presented the results in Nairobi and Mogadishu in February 2013.

Green = Good Yellow = Satisfactory, needs minor improvements Orange = Unsatisfactory, needs major improvements Red = Weak

Indicative Characteristics (Good) Good practice Recommendation Established coordination mechanism recognizing national systems, subnational and co-lead aspects; stakeholders participating cluster coordinator active in inter-cluster and related meetings. Regularity of the meetings improved. Cluster forum is not the place for discussing long term planning. DoH participates More cluster meetings at the regional level. Further improve adequate seniority and decision making authority of partners attending.

Indicative Characteristics (Good) Good practice Recommendation Cluster partners engagement in dynamic mapping of presence and capacity (4W); information sharing across clusters in line with joint Strategic Objectives. Make more use of the available information, as the 4W, in cluster meetings to analyse gaps.

Indicative Characteristics (Satisfactory) Good practice Recommendation Use Assessment tools with minimum standards. Share results of assessment Many coordinated assessments Need more effort lead by local authorities with partners. Not always feasible.

Indicative Characteristics (Satisfactory) Constrains Recommendation Joint analysis for risks, needs, gaps and constraints; cross cutting issues addressed from outset. Capacity of partners is a factor Disability is only considered important with emergencies of high trauma case load. Environment and human rights are not given enough acknowledgment HIV and GBV are given some discussion time. Consider workshops with partners to improve capacity. Consider which cross cutting issues are relevant and what is realistic how they could be taken into account in practice in assessments and programming

Indicative Characteristics (Satisfactory) Constraints Recommendation Joint analysis supporting response planning and prioritization in short and medium terms. Capacity of partners is a factor Environment and human rights are not given enough acknowledgment Consider workshops with partners to improve capacity. Consider which cross cutting issues are relevant and what is realistic how they could be taken into account in practice in assessments and programming.

Indicative Characteristics ( Satisfactory ) Constraints Recommendation Strategic plan shows synergies with other sectors. Strategic plan incorporates exit strategy Strategic plan is developed jointly. Plan is updated regularly. Plan guides response. National strategic plan does not exist (at survey time) Capacity of partners is a constrain. Environment and human rights are not appreciated. Partner involvement improved through regional meetings. Explore possibility to align cluster plan with the national health strategic plan.

Indicative Characteristics ( Good ) Good practice Recommendation Use of existing national standards and guidelines. Standards and guidance are agreed to and reported against. The government assessed 120 facilities, with assistance from the Health Cluster using the essential services package standards. Those that failed to meet markers would be closed.

Indicative Characteristics (Good) Constraints Recommendation Funding requirements determined with partners, Allocation under jointly agreed criteria and prioritization. Status tracked and information shared. More attention to better reflect the gender marker e.g. if the gender marker is low then a partner is not funded.

Indicative Characteristics ( Good ) Constraints Recommendation Concerns for advocacy identified with partners, including gaps, access, resource needs.

Indicative Characteristics (Satisfactory) Constraints Recommendation Common advocacy campaign agreed and delivered across partners. Many regions remain inaccessible Cluster offices and focal agencies in main cities should attempt to reach all partners and implement what is agreed upon on the national and subnational levels

Indicative Characteristics (Satisfactory ) Constraints Recommendation Use of monitoring tools in accordance with agreed minimum standards, regular report sharing, progress mapped against agreed strategic plan, necessary corrections identified. There is Disconnect between Nairobi and Somalia. Gap analysis exercises should increase, and be a priority issue in the Cluster strategy. Some information submitted by partners is not processed or shared enough. A need for partner capacity building: knowledge of filling forms and reporting consistency. Proposal criteria for large NGOs with implementing partners to include proven reporting strategies. Increase participation of local authorities. Increase partner involvement in targeted areas.

Indicative Characteristics ( Good ) Constraints Recommendation National contingency plans identified and shared; Risk assessment and analysis carried out, Multisectoral readiness enhanced; Regular distribution of early warning reports. Seasonal influences in Somalia might have changed due to global warming. The short, heavy rains are leading to flooding and increased malaria and AWD. Risk of drought. Risk of malnutrition. Further attention for contingency planning and preparedness. The process should be communicated to partners in clear steps. Training on risk assessment and analysis.

Indicative Characteristics (Satisfactory) Constraints Recommendation Disaster-affected people actively participate in meetings on how to organize and implement the response; Agencies have investigated and acted upon feedback received about the assistance provided Difficulties due to access. Political / cultural sensitivity. Guaranteeing safety and security of agency workers. Tools are available to show how accountability is included in programs. Provide a simple toolkit (e.g. 5 practical ways how to improve accountability). Provide a menu of options for partners and encourage mapping of experiences and good practice. Common mechanism across clusters. Strategy to highlight accountability to communities.

 TOR for cluster and coordinator  Minimum standards for service delivery – national BPHS  Cluster strategy  Road map (2010) for strengthening of EPR national mechanism  Cluster strategic plan – each year defined together with cluster members (voluntary participation to workshops) included into the HAP, CAP, and CHAP. Identification of gaps, targets indicators, partners, prioritization of actions. Acted upon the feed back from partners  Participatory review and prioritization of projects – peer review committee.  Midyear report against targets and revision when necessary (example – last year target increased and advocacy for implementation a measles campaign – emergency approach  Risk analysis conducted (district level) based on the health data, partners contributions, assessment of access, hazard risks – helped identify the population groups that are in need of humanitarian support

 Epidemiological profile of the country – 2012 – revision ongoing – draft will be circulated for comments soon  Health resources availability – map of all HFs, and status- revision ongoing.  3Ws updated regularly.  Support of coordination structures at regional and provincial levels  Contingency plans compiled and revised every year based on each province inputs  Implementation of contingency plans – stock, additional teams, pre-defined responsibilities, coordination mechanism  National disaster management plan health sector linked with – ANDMA plan drafted  Guidelines development – national – endorsed, translated, training module,  Trainings plan jointly defined each year based on cluster suggestions and sessions organized at all levels:

 Monthly reports compiled and included into humanitarian bulletin done by OCHA  Quarterly reports – published  Advocacy in the name of all sector – resulted in pushing health as one of HCT priority, and improvement of the funding through CERF and other donors; measles campaign, mass casualty, NNS, IDS  Adequate surge capacity maintained  IDS and NNS initiated linking relief with development  DEWS distributed regularly.  Multi-sectoral contingency/readiness enhanced through Regional Humanitarian Team and Provincial PDMC – nutrition, WASH (water quality testing)  To do urgently:  Strengthen the provincial capacity for coordination – training, communication means, development of SOPs with MOPH, etc

 Mass casualty  Maintain surge capacity  Early warning – community level – standards, training module endorsement of MoPH – ARCS?  No systematic mapping and sharing of good practices and lesson learned MASS CASUALTY MANAGEMENT MECHANISM 3 components; 1. Plans: regional, provincial and hospital targeting highest risk areas; Kabul, Helmand, Nangarhar, Kunar, Langhman, Nuristan Paktya, Paktuka, Khost, Logar and Maidam Wardak a) Compile the plan Regional linkages, SOPs for all levels b) Support the implementation of the plan with quality inputs c) Train the staff Simulate the provincial/hospital plans in 10 locations

 Human Resources (hospital) capacity building on trauma stabilization, and management; a) Adapt a training module and endorse it by MoPH b) Conduct trainings (EMERGENCY NGO hospitals and MoPH Kabul)  Strengthen the capacity of mass casualty management system at PHC and community level This year only in Kunar a) Need development of training modules for community level and PHC – endorsed by the MoPH b) B) training of the trainers c) Linkages with existing networks – ARCS CHW ?

 Need to establish a technical working group on for preparation and implementation of this vital project Tasks (tentative)  Target areas – provinces, hospitals,, etc  Define list of essential medical supplies and equipment necessary o deal with mass casualty at different levels  Training modules adaptation PLEASE CONTRIBUTE TO THE REVISION OF THE HF MAP, 3WS, AND RISK ANALYSIS