1. Update from the RH Sub-cluster 11 th May, 2015 MoHP

2. Estimates of affected population (14 districts) Affected PopulationHMIS (1 year) 2071/72 Total population5,623,800 WRA1,584,100 MWRA1,200,800 Adolescents girls637,000 Estimated number of pregnant women138400 Estimated number of delivery10, 000 (1month) Women with complications & C-section need (MISP calculator)8, 400 (3 months) Women likely to experience sexual violence (MISP calculator)2,800 (3 months)

3. Situation update C-section service is available in all DHs except Ramechap (in Nuwakot, Rasuwa & Sindhupalchowk through FMTs. In the 305 severely damaged HFs it is expected that all SRH and MNCH service delivery has been disrupted (although FMTs and local teams are providing these services in a few VDCs). Out of 360 HFs with established BEONC/BC in 14 districts, 112 are severely damaged and 144 are partially damaged.

4. Immediate RH Response RH sub-cluster formed to facilitate coordination & implementation of RH & MNCH services. RH situation assessment conducted using a format developed by the RH sub-cluster, including HF’s status, and functionality. A system has been established for co-ordination through the RH sub-cluster. Partners mapping & identification of focal partner completed. Currently there are 13 developmental & 6 humanitarian partners working on RH & MNH.

5. Immediate RH Response Equipment, medicines & supplies has been sent to selected districts to initiate MNH, RH & Child health services: RH kits adequate for providing SRH services (FP, EmONC, sexual violence, STI, and miscarriage) for up to 90,000 over 3 months have been dispatched [need is for 1.5 million]. 45 tents have been sent 10 most affected districts [need is for much more]. Clean delivery kits (+ miso + CHX) have been reported to have reached 1100 pregnant women in Sindhupalchowk, Gorkha, Rasuwa, Dhading and Lalitpur (Thulodurlung VDC) [Need: 20,000]

6. Immediate RH Response Mobile RH & integrated camps are being conducted. UNFPA through FPAN have reached 2215 affected women and girls with RH services in Kathmandu, Lalitpur, Bhaktapur and Kavre. Simplified guidelines and protocols have been developed (based on the national standards) & distributed to service providing agencies and other sub/clusters. Advocacy on inclusion of SRH & MNCH services in all immediate lifesaving response ongoing.

8. Challenges & Gaps Availability of accurate information on HFs & HWs from seriously affected sites. Addressing health workers’ & FCHVs’ emerging need- shelter, food, psychosocial stress, etc. Availability of logistics and their transportation, particularly to remote places. Availability of resources : given that existing resources are depleted & emergency funds are limited. Shelter needs in preparation for the approaching monsoon rains and bad weather.

9. Interim Response & Plan (within the next 3 months) Establish RH sub-cluster in the 2 humanitarian hubs within 2 weeks. Distribute appropriate RH kits targeting different vulnerable groups (WRA including pregnant women, newborn babies and adolescents). Re-establishment of RH & MNCH services in selected sites using existing infrastructures or temporary structure.

10. Interim Response & Plan (within the next 3 months) Establish transition homes (for pregnant, recently delivered women & her baby, injured under 5 children): 2 per district in the 14 most affected districts. Strengthen inter-sectoral coordination for SGBV prevention and management, as well as to ensure WASH & Sanitation facilities and nutrition.

11. Interim Response & Plan (within the next 3 months) Prevent & manage risk of sexual violence through distribution of post-rape kits, establishing referral mechanism to appropriate services- psychosocial, legal and shelter, linking them with OSCMC where feasible. Develop and implement a package for health workers including psychosocial counseling & special allowance for facilitating rehabilitation of health workers.

12. RH response between 3 -6 months Rehabilitation of health facilities (including infrastructures, equipment, supplies and drugs): prioritization of HFs to be done based on population settlement, levels & functions of HFs. Strengthen health service delivery (including HR & their rehabilitation and capacity building)