1

Strategic Cross-Sectoral C4D Framework UNICEF Eritrea Country Programme

2015-2016

GOVERNMENT OF THE STATE OF ERITREA

MINISTRY OF INFORMATION

UNITED NATIONS CHILDREN’S FUND ERITREA

2

Acknowledgements

Asia-Pacific Development & Communication Centre (ADCC) would like to put on record our

appreciation and thanks to UNICEF Eritrea Country Office in entrusting to us the important task of

drafting this Strategic Cross-Sectoral Communication for Development (C4D) Framework for the

remaining two years (2015 – 2016) of the Country Programme. The ADCC Team especially thanks Ms.

Awet Araya, C4D Officer for her technical leadership and placing her trust with ADCC.

ADCC would also like to acknowledge and thank those government line ministries and department

officials who contributed their inputs during and following the C4D Training Workshop held in Asmara

from 15 – 19 December 2014. This Strategic Cross-Sectoral C4D Framework builds on the various C4D

sectoral strategies already developed or being revised. This Framework is not a C4D strategy by itself

but can be used to develop a full-fledged Cross-Sectoral C4D strategy for the remaining years of the

country programme and in preparation for the next Country Programme of Cooperation.

ADCC would like to recognize the support given by its dedicated Team including Ms. Emily Samuel,

C4D Specialist and Mr. Javed Ahmad, Senior C4D Consultant who facilitated the C4D Training

Workshop in Asmara. Mr. Kritsada Udomsukh, Programme/Finance Assistant and Mr. Phanuwat

Hanyuth Administrative Associate for providing logistics support. As Team Leader for the Consultancy,

Dr. Peter F. Chen, Executive Director, had been involved throughout from the very beginning including

outlining the C4D Framework structure, reviewing the numerous drafts and its finalization.

Peter F. Chen, Ph.D., MPH, MA

Executive Director

ADCC

February 2015

3

Contents Acknowledgements ................................................................................................................................. 2

Acronyms ................................................................................................................................................ 4

Executive summary ................................................................................................................................. 5

Background and Rationale ...................................................................................................................... 5

Purpose of the Framework .................................................................................................................. 5

The situation in Eritrea ............................................................................................................................ 6

Situation of Children and Women ...................................................................................................... 6

UNICEF Programme Structure ............................................................................................................... 7

Focus Areas and Issues ........................................................................................................................... 8

Focus 1: Health and Nutrition ............................................................................................................. 8

Focus 2: Basic Education .................................................................................................................... 8

Focus 3: Child Protection .................................................................................................................... 9

Focus 4: Water, Sanitation and Hygiene ............................................................................................. 9

Current UNICEF Major Partnership, Convergence &Communication for Development (C4D) ........... 9

Bottlenecks, Challenges and Risks faced by C4D ............................................................................ 10

Model for the Cross-Sectoral Strategic C4D Framework ..................................................................... 13

Strategic C4D Approaches .................................................................................................................... 14

Planning and Coordination ............................................................................................................... 14

Advocacy and Partnership ................................................................................................................ 15

Capacity Strengthening ..................................................................................................................... 15

Media Engagement ........................................................................................................................... 15

Community Mobilization .................................................................................................................. 15

Social Mobilization ........................................................................................................................... 16

Recommended Steps for C4D Cross-Sectoral Partnership Formation.................................................. 16

Phased Approach for Rolling out the Cross-Sectoral C4D Framework (2015-2016) ....................... 17

Suggested Monitoring Tools ................................................................................................................. 18

Behaviour Monitoring Checklist ....................................................................................................... 18

Annex-1: Summary of Programme Units Analysis .............................................................................. 21

Annex-2: Proposed Communication Objectives and Communication Indicators for the Programme

Sectors ................................................................................................................................................... 27

ANNEX 3: Analysis of existing KABP, Perceived Barriers and Desired Changes for Programme

sectors ................................................................................................................................................... 29

4

Acronyms

ADCC Asia-Pacific Development & Communication Centre

BCC Behaviour change Communication

BE Basic Education

C4D Communication for Development

CBO Community Based Organizations

CLTS Community Led Total Sanitation

CP Country Programme

ECD Early Childhood Development

EPHS Eritrea Population & Health Survey

EPI Expanded Programme of Immunization

FGM Female Genital Cutting

IMAM Integrated management of Acute Malnutrition

IMCI Integrated Management of Childhood Illness

IYCF Infant and Young Child Feeding

MDG Millennium Development Goals

MOE Ministry of Education

MoH Ministry of Health

MOI Ministry of Information

MoLWE Ministry of Land and Water Environment

MoND Ministry of National Development

NUEW National Union of Eritrean Women

NUEYS National Union of Youth and Students

ODP Open Defecation Practice

SPCF Strategic Partnership Cooperation Framework

UXO Unexploded Ordinance

WASH Water, Sanitation and Hygiene

5

Executive summary This document is an overall Cross-Sectoral Strategic Communication for Development (C4D)

Framework and not a full-fledged C4D Communication Strategy. It draws on a number of

communication strategies for the different sectors which are already in place to make it multi-sectoral

and cross-cutting. The framework seeks to create synergies and harmonize current efforts by different

programme sectors and stakeholders to work towards a common goal -- to inspire and empower children

and adolescents, women, communities and institutions to become role models and leaders for positive

social change. The C4D Framework also seeks to identify problems, design solutions and involve

decision-makers at all levels. It integrates behaviour and social change approaches in the health,

nutrition, water, sanitation and hygiene, protection and education sectors. Concurrently, it also

addresses discriminatory practices and harmful social norms across issues.

The C4D Framework has identified some key behavioural results, barriers and desired changes and

strategic approaches that, taken together, can contribute to a broad social and behaviour change. The

framework finally integrates the different strategic approaches that link different programmes and

partners to ultimately work towards a common goal that will benefit the household, community and the

villages.

As a cross-cutting discipline, all programme sectors should utilize C4D to provide technical support

and capacity building focusing on a limited number of high impact programme areas (flagships), and

geographic locations based on country priorities and resource availability. In addition, Government

ministries and other national stakeholders can be equipped with knowledge and skills to be able to take

responsibility for their own C4D initiatives through institutionalized C4D in national policies and

processes.

Background and Rationale

Communication for Development (C4D) is articulated as one of the cross-cutting Country Programme

(CP) strategies in the UNICEF Eritrea Programme of Cooperation with Government of the State of

Eritrea (2013-16). Majority of the CP outcomes are dependent on behaviour and social change to

improve key family practices for child survival, growth and development, hygiene, sanitation,

HIV/AIDS, education, harmful traditional norms and nutrition education. Some Programme specific

communication strategies have been developed to articulate communication inputs, objectives and

approaches in line with the CP for 2013-2016. However, cross-sectoral linkages have not been made.

Hence, there is a need to draft a Cross-Sectoral Strategic C4D Framework based on the country office

programme.

UNICEF Eritrea Country Office sought technical assistance from Asia-Pacific Development and

Communication Centre (ADCC), a unit of Dhurakij Pundit University in Bangkok, Thailand to conduct

the first national C4D training workshop in Eritrea and to develop the Cross-Sectoral Strategic C4D

Framework for the remaining two years (2015 and 2016) of the Country Programmes with emphasis

on social/behaviour change, monitoring and evaluation, applying Results-Based Management and other

C4D principles.

Purpose of the Framework

The purpose for developing the Cross-Sectoral Strategic C4D Framework is;

To identify synergistic entry points to maximize C4D impact in programmes e.g. prevention of

stunting, child survival and development (hygiene and sanitation promotion, breastfeeding,

immunization, IYCF etc.)

6

To identify areas for evidence generation, bottleneck analysis of social norms, KAPB surveys

and evaluation of existing C4D strategies and;

Suggest mechanisms to strengthen the coordination/management structures for C4D at Ministry

level.

The situation in Eritrea

Eritrea has an estimated population of 4 million (MoH 2014) of which nearly half are under 15 years of

age (EPHS 2010)1. An estimated 15 per cent of the population is aged under five years of age. Large

variations in population estimates carry long-term consequences for essential public services such as in

education, health, water, housing and transport.

About 80 per cent of the population lives in rural areas. Geographically, Eritrea can be roughly divided

into three geographical zones, comprising the central highlands, the western lowlands, and the eastern

coastal plain. The highland provinces of Debub and Maekel are the most populated. The lowland areas

are usually sparsely populated with most communities living far and wide apart, as evidenced by parts

of Anseba, Gash Barka, Northern Red Sea (NRS) and the Southern Red Sea (SRS). These are areas

inhabited by the nomadic populations that are estimated at about 15–30 per cent of the population (Carr-

Hill, 2005).

Eritrea has nine ethnic groups: the Afar, Bilen, Hedareb, Kunama, Nara, Rashaida, Saho, Tigre and

Tigrinya. Tigrinya and Tigre make up the largest two groups. Each group has its own language and

every child receives basic education with mother tongue as the medium of instruction at primary

education level ( Grades 1-5). Tigrinya, Tigre and Arabic are widely spoken andEnglish, Tigrinya and

Arabic are the working languages. Some of the policies and strategies developed or reviewed in the last

five years are:

• Road Map for Maternal and Newborn Health, 2012-2016 (MoH);

• National Maternal Health Policy Strategic Plan 2012-2016 (MoH);

• Health Sector Strategic Development Plan (HSSDP) 2010-2014 (March 2010) (MoH);

• National Water Strategy 2013-2017 (Ministry of Land, Water and Environment (MoLWE));

• National Health Policy 2010 (MoH)

• National Education Policy, 2011 (MoE);

• Strategic Plan on Injury Prevention2 2013 (MoH)

• Girls education Communication Strategy 2010 (MoE)

• Female Genital Mutilation Strategic communication framework 2012 (MoH)

• Hygiene and Sanitation Communication Strategy 2013 (MoH)

• School Health Policy (draft) 2014 (MoE and MoH)

•

•

Situation of Children and Women

There is little current data on the situation of women and their Children in Eritrea. The most current

demographic and health data are from 2010 (data collection) which were published in 2013 as the Eritrea

Population and Health Survey (EPHS). It can be compared to previous DHS rounds in 2002 and 1995.

Judging from these data, the country has made progress in key indicators. Maternal mortality has

steadily gone down. In 2010 it was at 486 out of 100,000 live births, a reduction by half compared to

1995. The infant mortality rate has also been reduced from 72 to 42 and the under-5 mortality rate from

1 Country Programme Action Plan 2013-2016 between The Government of the State of Eritrea(GOSE) and UNICEF 2 Situation Analysis of Children in Eritrea: 2012 (Final Draft: 12 July 2012)

7

136 to 63 (1995 to 2010, deaths per 1,000 live births). Eritrea has effectively reached the goals for MDG

4 and 5. HIV prevalence is comparatively low, at 0.93 per cent in 2010 among the general population

compared to 2.4 per cent in 2002.

Despite these successes in improving key indicators, indicators for child development are less

encouraging. Elementary school enrolment rate is still low at 81.1 per cent in 2012/13. Middle school

enrolment declined from 38.3 per cent in 2011/12 to 29.3 per cent in 2012/13, providing little incentive

for elementary school completion. Generally, more boys than girls are enrolled in elementary and other

levels. The quality of education is still weak, with large fluctuation in teachers and consequently high

levels of untrained or under-trained teachers in schools. Girls marry early in Eritrea, with 20 per cent of

women aged 15-49 married by the age of 15 and 49 per cent by the age of 18 years. Early marriage is

also a key factor in dropping out of school. FGM remains prevalent at 83 per cent nationally, but with

clear reductions in some regions of Eritrea. With landmines and unexploded ordinance (UXO) a

continuing problem for some areas, injuries and death from these are significant threats to children's

wellbeing. Eritrea has a significant proportion of orphaned children. In 2010, seven per cent of under

15 year olds grew up as orphans. About 39 per cent of the population still relies on unimproved sources

of water. Open defecation is a strongly ingrained practice along with 86 per cent (2008) of the

population not having access to improved sanitation facilities. A food-scarce country with below

average daily consumption of water, Eritrea has high rates of stunting affecting 50 per cent of children

(2010) while 15 per cent of children are malnourished (wasted). Open defecation, limited understanding

of nutrition issues and limited service-seeking behaviour demarcate bottlenecks on the demand-side of

basic services3.

UNICEF Programme Structure

The UNICEF Country Programme works within the Strategic Partnership Cooperation Framework

(SPCF) between the UN and the Government of the State of Eritrea (GOSE). The SPCF in its five

strategic areas follows the government's priorities, and translates them into eight Outcomes at the

agency level. UNICEF contributes to seven out of these eight outcomes, with a strong focus on the

social services and environmental sustainability outcomes (1, 2, 3, and 7). Table 1 summarizes this

relationship.

Table 1 – UNICEF Programme Structure and relationship to the SPCF

S

PC

F

1. Basic Social Services 2. National Capacity

Development

3. Food

Security and

sustainable

livelihoods

4. Environmental

sustainability

5. Gender Equity

and Advance-

ment of Women

Outcome

1:

Health and

Nutrition

Outcome

2:

Education

Outcome

3:

Protection

Outcome 4:

Capacity

building

Outcome 5:

Stronger

DRR

Outcome 6:

Food and

livelihood

opportunities

Outcome 7:

Access to water,

renewable

energy,

conservation,

environmental

management,

sanitation

Outcome 8:

Gender

responsive

planning and

empowerment of

women

UNICEF Programme Components

U

NIC

EF

Advocacy and Partnerships

Health and

Nutrition

Basic

Education

Child

Protection

Advocacy

and

Partnerships

Child

Protection

WASH Child Protection

WASH WASH PME Basic Education

M&E, Communication for Development C4D

3 ibid

8

Focus Areas and Issues

There are five Country Programme components 1) Health and Nutrition, 2) Basic Education, 3) Child

Protection, 4) Water, Sanitation and Hygiene, and 5) Advocacy and Partnership for Children. This

framework recognises the need to focus on fewer and higher impact issues that can add value to the

efforts in strenthening the different sector’s performance. Key issues to be addressed under each focus

area are presented below.

Focus 1: Health and Nutrition

C4D communication objectives for this area are:

To increase knowledge of women of reproductive age about access and utilization of the improved

basic child health interventions (IMCI, EPI) with priority accorded to hard to reach and remote

areas by 2016;

To increase the number of women and primary care giver’s knowledge, attitude and behavior about

the benefits of delivery at health facilities, with priority to hard to reach and remote areas;

To increase the knowledge of mother’s about the IMAM services;

To use multi-media to promote positive social norms around childbirth and child care through the

use of entertainment-education sessions about health through the lifecycle for adolescents;

To improve health service providers’ skills on interpersonal communication, behaviour change

counselling and community mobilization. In the process shifting gender norms and increasing

demand for required services and policies.

Existing cross-sector cooperation are a basis for more coherent programming (e.g. the joint work on

hygiene in schools and health facilities, and the joint work on mine reduction)4 There are more entry

points for strong cross-sector linkages around stunting involving Community Led Total Sanitation

(CLTS), Infant and Young Child Feeding (IYCF), and Early Childhood Development (ECD), to obtain

the desired outcomes. The involvement of Ministry of Health (MOH), Ministry of Education (MOE),

Ministry of Land, Water and Environment (MLWE) and National Union of Eritrean Women (NUEW)

would also be important player in the cross-sectrol partnership along with UN agencies. Health and

Nutrition and Child Protection programmes can combine to use Advocacy and Social Mobilization

initiatives to reduce incidence of FGM/C

Focus 2: Basic Education

C4D communication objectives for this area are:

To create awareness among parents and communities to change attitudes and take specific action to

send children (girls and ODG) to school to complete their basic education through Nation-Wide

Movement by 2016.

To create a paradigm shift in the way girls are viewed and treated by promoting an environment

where girls, ODG and all children completing their education becomes the norm, and are valued.

The C4D strategic approach in this area will include mobilization of the communities in raising

awareness on the value of education especially girl’s education. Also multi-media campaigns to

promote Girls and ODG children education campaigns to send children to school, to enhance the quality

of education advocacy for enabling policy environment and supporting the development or review of

relevant education sector policies and strategies. Child protection and Education Programmes can work

together to use advocacy, social mobilization and SBCC to delay marriage of girls.

4 GOSE-UNICEF Country Programme 2013-2016, Mid Term Analysis, 29 November 2014, pg 14

9

The above results can be achieved in partnership with the MOE’s Department of General Education,

Department of Adult and Media Education, Department of Research and Human Resource

Development and its regional and local administrations. Besides, other entry points for strong synergy

can be established with (CLTS, IYCF, ECD), hygiene education, (Basic education and CLTS), and

school enrolment hygiene education and UN agencies.

Focus 3: Child Protection

C4D communication objectives in this area include change in attitudes and behaviours about FGM/C

and ending early marriage among communities that have taken it for granted as a traditional practice.

Strategic approaches in this area will include use of multi-channel and multi-media social and behaviour

change communication with equal emphasis on the use of mass media, local media (including traditional

and modern communication aids) and interpersonal communication by peer educators.

Advocacy for child rights, legal provision and implementing the law; Social mobilization initiatives,

including use of peer education, involvement of Child Marriage Eradication Committees, child clubs

and developing leadership among young girls.

The main implementing partners will be MOE, MOH and MLHW. UNICEF can support MOH on the

boarder integration of prevention of FGM/C and early marriage into the reproductive health

programmes. Through the health promotion and public health debates public awareness and community

social dialogue can be promoted. Involving Ministry of Information (MOI) and civil society partnership

with NUEW and NUEYS can create strong cross sectrol foundation.

Focus 4: Water, Sanitation and Hygiene

C4D communication objectives for this area is to increase the levels of knowledge, attitudes and

behavioural practices related to sanitation and hygiene especially water handling, latrine use, hand

washing and personal hygiene by 2016.

The strategic C4D approaches in this area will include scaling up of the CLTS programme through use

of multi-channel communication. CLTS can be packaged and promoted as the key sanitation and

hygiene concepts and used as tools for advocacy, programme visibility, community mobilization and

programme acceleration. Specific attention will be given to sustainability of ODF. Interventions will

need to address sanitation from the perspective of social norms so that open defection becomes an

unacceptable social behaviour. WASH in schools can develop and disseminate IEC materials to

promote proper WASH practices.

The main implementing partners are zoba infrastructure departments, targeted communities, MOLWE,

MOE and Ministry of Environmental health (MOH), (UNICEF, WHO, UNDP).

Current UNICEF Major Partnership, Convergence &Communication for Development (C4D)

There are opportunities for joint programming under this framework. Harnessing of partnerships for

improved sustainability of behaviour change cut across many areas emphasizing on participation of

families, children and key local personnel, e.g. teachers and health workers to build sustainability

toward improved self-reliance5. UNICEF has major partnership with individual Ministries on specific

activities within each programme component. Other key partners include the National Union of Eritrean

Youth and Students (NUEYS) and the National Union of Eritrean Women (NUEW) especially in areas

of implementation, advocacy and capacity strengthening. This occur with overall coordination via the

Ministry of National Development (MoND).

5 UNICEF Draft country Programme document, E/ICEF/2012

10

UNICEF also collaborates with other UN agencies and other international and national partners in

Eritrea. Key international partners include GAVI, Global Fund and Global Partnership for Education.

UNICEF facilitates the engagement of the Government with the latter. This includes UNICEF’s

leveraging of associated resources from international development cooperation partners.

Programme convergence, where multi-sector problems are tackled through cooperation across

programme components is not easy to accomplish in a country with strict separation between sector

ministries. However, there are some promising examples of convergence around issues that are a good

basis for capitalizing on opportunities in this regard. There is cooperation between the WASH, Health

and Nutrition, and, Education Programmes through the Education Working Group where officials from

the Ministry of Health and the Ministry of Education worked together on improving hygiene through

and in schools. The ministries of Water Resources, Health, and Education also jointly participated in

the 2014 Programme Review and Planning for WASH. Building on this will strengthen the effectiveness

of the programme. The Child Protection (CP) Programme works closely with the Basic Education (BE)

Programme on mine risk education. The Ministry of Health, with joint support from the UNICEF

WASH and the Health Section combines hygiene and basic health services at health facility level.

As an enabler of behaviour and social change elements, the UNICEF C4D Specialist provides technical

support to all Sections. Behaviour and social change communication is also a main focus of sector

convergence in the programme. In advocating for children's participation, the Country Programme

works closely with the National Union of Eritrean Youth and Students (NUEYS), a relationship that

had to overcome substantial hurdles in the first two years of the Country Programme which has only

just taken off at the time of the review6. UNICEF C4D provides technical support to the following

ministries and NGOs:

- MOH: on BCC, community based health promotion, construction of community based water

projects and water management;

- MOI: Child-to-child media programmes, multi-media message dissemination;

- MOE: Creating demand for education, especially girls’ education, and addressing social norms

around early marriage;

- MLHW: Child participation; and

- MLWE: Community participation and water management

- NUEW/NUEYS: Gender/Youth Empowerment and Participation in partnership with (Joint

Programme with UNFPA, UNAIDS,UNDP,UNHCR)

Bottlenecks, Challenges and Risks faced by C4D

While the stated outcome for the Advocacy and Partnerships for Children and the

Communication for Development components were approved by GoSE in the 2013-2016

CPAP, GoSE did not grant approval for the Ministry of Information (MoI) and NUEYS as

implementing partners with UNICEF. After sustained negotiation between UNICEF and GoSE,

the Government approved partnership through the Ministry of Labour and Human Welfare

(MLHW). This complicated working modality has significantly affected implementation of the

workplan.

Eritrea does not have a national communication policy which makes media engagement

difficult and sensitive. Deeply rooted social norms and cultural practices related to child

marriage, girls’ education, female genital mutilation (FGM) remains a challenge to sustain

positive behaviour and social change in the hard to reach communities. The need for

empowering rights holders, increasing demand for improved social services, encouraging

6 GOSE-UNICEF Country Programme 2013-2016, Mid Term Analysis, 29 November 2014

11

utilization of existing services is paramount in pushing the C4D agenda in Eritrea. Facilitating

individual behavioural, social and norms changes, promoting engagement and participation of

children, families and communities, and strengthening capacities of national and sub-national

counterparts for long-term and sustained social change will be articulated in the 2015-16 joint

work plan.

Limited knowledge about C4D among partners has also contributed to delays in rendering

support from government Ministries. This requires UNICEF’s commitment, leadership and

investment for optimal integration of C4D into government systems and programmes, enhanced

capacity of government staff on C4D, increased allocation of resources for C4D, and greater

involvement of civil society partners and other stakeholders in social and behaviour change

initiatives.

Lack of sufficient human resources also affected MoI’s capacity in programme management

and delivery of quality results. It’s also noted that the Minister of Information position has not

been re-instated since July 2013.

A planned nationwide media survey could not be completed as a result of inadequate funding

which affects major parts of the sector. This survey would provide information on audiences

and measure impact of media programmes that would guide future programming. The lack of

local research institutions also hampered the implementation of the audience research planned

this year.

Table 2 – Key Bottlenecks

Determinant Identified Bottlenecks

Enabling

Environment

• Government is conservative about receiving funds and extending beyond its

self-funded capacity

• Poor data availability and low complexity of data

• Government has been reluctant to agree to surveys and evaluations

• Horizontal communication between sector ministries is very low, while some

Programme Sections (e.g. Child Protection) work with several ministries –

additional obstacle

• There is no international NGOs in the country

• Exposing ministry staff to learning from other countries through travel is often

not possible due to a number of difficulties within ministries

Supply • Qualified staff regularly leave government services at all levels for better

opportunities, and new staff have to be trained constantly to even maintain a

status quo in services

• Facilities are often in poor condition

• Telecommunications and electricity are inadequate

• Basic construction materials are imported through government agency,

sourcing therefore takes a long time and is expensive

Demand • Social norms and traditional behaviours hinder progress in a number of areas

such as:

Nutrition – resulting in poor childcare and feeding practices attributable

to social norms, existing low levels of awareness of proper practices

Early marriage

FGM/C

Girls’ education

Open defecation

Use of traditional healers

Quality • Field Monitoring is difficult and very restricted

• Available data are not sufficiently disaggregated and mostly facility-centred

12

CURRENT UNICEF POGRAMMES & CROSS SECTORAL COLLABORATION – AT A GLANCE

Health &Nutrition

Section

MOH:

EPI,

Child health,

C/IMCI,

PMTCT,

Maternal and

Neonatal health,

IMAM,

Micronutrient,

IYCF and blanket

feeding

MOE

Hygiene in school

Child Protection

Section

MOH:

FGM/C and

prevention, adolescent

development of child

injury

MOE:

Mine Risk education

MLHW:

N/OVC, Community

based rehabilitation

(MRE and disability),

‘donkey for schools’,

Street children,

Child justice

Basic Education

Section

MOE: Quality

education, Policy

Nomadic and

girls education

Out-of-school children

MOH:

Hygiene in school

WASH Section

MOH: Sanitation(CLTS),

Hygiene and Menstrual

hygiene management

MLWE: Construction

of community based

water projects and

water management

MLG: Coordination of water

and sanitation projects

NUEW: WASH and

C4D

Menstrual hygiene

management

Advocacy & Partnership

Section/C4D

MOH:

BCC/community based

health promotion/

Emergency,

Construction of community

based water projects and

water management

MOI: Child-to-child media

programmes,

Multi-media message

dissemination

MOE: Creating demand for

GE/ social norms around

early marriage

MLHW: Child

participation

MLWE: Community

participation and water

management

NUEY/NUEW:

Gender/Youth

Empowerment participation

13

Model for the Cross-Sectoral Strategic C4D Framework

The overall Cross-Sectoral Strategic C4D Framework is multi-sectoral and cross-cutting. The

framework seeks to create synergies and harmonize current efforts by different stakeholders to work

towards a common goal -- to inspire and empower children and adolescents, women, communities and

institutions to become role models and leaders for positive social change; to identify problems, design

solutions and involve decision-makers at all levels. It integrates behaviour and social change approaches

in health, nutrition, water, sanitation and hygiene, protection and education. Concurrently, it addresses

discriminatory practices and harmful social norms across issues. The framework lays out key

behavioural results, barriers and desired changes and strategic approaches that, taken together, can

contribute to broad social and behaviour change. The framework finally integrates the C4D strategic

approach that links different programmes and partners to ultimately work towards common goal that

will benefit the household, community and the villages.

14

Strategic C4D Approaches

The approaches for C4D are linked to the communication objectives. They are also aligned with existing

successful communication initiatives of the GoSE, UNICEF and other development partners for Health

& Nutrition, Hygiene and Sanitation, Basic Education and Child Protection. Figure below illustrates the

communication approaches that can be used across the various levels.

These modalities build on the Socio Ecological Model (SEM) model. The following section explains

how each of the modalities have been defined and provides a brief overview of activities that fall under

each category

Planning and Coordination

Planning and Coordination of Cross-Sectoral C4D interventions should be vested in the Ministry of

National Development along with a smaller Task Force to manage day-to-day operations. The C4D

Framework has been designed keeping in mind diverse partners and stakeholders who will contribute

towards achieving the communication objectives and lead certain components or take on initiatives in

specific Zobas. The Coordination Committee and Task force will provide oversight and leadership,

conduct quarterly meetings and manage the transition from Phases-1 to Phase-2. A Creative

Communication Task Force can be established to plan and produce creative materials and media

campaigns. A Monitoring and Evaluation Task Force should be established to roll out the

behavioural monitoring plan and to oversee the mid-term and end-term reviews.

•Form inter-agency and partners coordination mechanism

•Launch the strategic C4D Framework at national and zoba level

•Management and oversight by C4D cross sectoral coordination group

•Establish Creative Communication and M&E Task forces

Planning and Coordination

•Generate high level national political commitment

•Generate multi-sectoral partnerships

•Generate commitment at Zoba levels

Advocacy and Partnership

•Train health workers and WASH promoters (ToT)

•Train community groups on Child Protection (ToT)

•Train teachers on issues related to ODG, FGM/C,WASH in schools

•Train media on child friendly and gender sensitive reporting

Capacity Strengthening

•Carry out media blitz through MOI

•Sustain media coverage on C4D Cross sectoral collaboration

•Develop trans-media Entertainment Education programme

•Utilize IPC, traditional folk media

Media Engagement

•Train and organize children and adolescents

•Engage men and boys

•Mobilize community and religious leaders

Community Mobilization

•Mobilize govt, educational institutions, civil society & UN agencies

•Mobilize law enforcement and protection bodies

•Engage girls and boys for C4D interventions

Social Mobilization

15

Advocacy and Partnership

In order to achieve high level commitment and ownership, the cross-sectoral C4D interventions require

concerted advocacy and partnership building. This will entail bringing together relevant ministries and

national bodies such as MoH, MOE, MLHW, MLG, NUEW and NUEY among others. Advocacy will

also need to include Zobas and systems and structures. Partnerships need to be strengthened between

the UN and bilateral agencies working in the country. These high-level partnerships and initiatives will

provide support and financing for what is essentially a decentralized, bottom-up and community-led

initiative.

Capacity Strengthening

Capacity strengthening of stakeholders across all components of the Country Programme is required to

implement the cross-sectoral C4D interventions to achieve the desired behaviour and social changes.

This modality focuses on strengthening capacities of key implementers such as health workers, teachers

and existing community groups (e.g., Children’s and Youth Clubs, Women’s groups, etc.). These actors

will need to be oriented and trained in the focus areas as well as the cross-cutting issues. For instance,

teachers will need to be trained on positive discipline techniques, HWs on inclusive interpersonal

counselling and engaging men and boys. The media will also need to be trained to enhance their skills

in child friendly, gender sensitive and inclusive reporting. This will be a prerequisite for the media

engagement and community mobilization to take place. Once these groups are trained and their

capacities are strengthened, they can in turn train others and the knowledge and skills will reinforce

positive behaviours at the family and individual levels.

Media Engagement

Participatory communication and media engagement are core elements of C4D interventions. They

include mass media, local and digital/social media channels and interpersonal communication (IPC).

They can be used across the SEM levels, contributing to national level advocacy, visibility as well as

changing individual level knowledge, attitudes and behaviours. The media will inform, influence and

will also serve as a feedback mechanism to elicit stories and inputs from children and their families.

C4D recognizes that the boundary between various media platforms is increasingly blurring and aims

to link different media platforms with common messages, themes and story lines. Recognizing that

motivating people to change behaviours and social practices is also dependent on interpersonal

communication, the mass media, social media and IPC components are designed to be mutually

reinforcing and a two-way process. Mass mediated messages will spur dialogue and action and local

level dialogue, voices, and experiences will feed into mediated messages.

Community Mobilization

Mobilizing communities will entail engaging children and adolescents, women, men and community

leaders to promote the key behaviours. Orientation and training on the focus areas as well as select

communication/media skills and Behaviour Monitoring tools will be essential. It is envisioned that these

community members will serve as “triggers” for social change and will promote as well as role model

positive practices. They will also undertake community level behavioural monitoring. Community

mobilization builds on participatory communication models whereby awareness spurs community

dialogue and ultimately leads to community level actions to denounce harmful practices and enforce

new norms. Such an approach is considered empowering as individuals and communities gain both self

and collective efficacy to take positive actions.

Community mobilization should build on the vast existing communication networks in collaboration

with the two government owned CBO’s (NUEY & NUEW) and the presence of a sizeable number of

diverse community groups. There are health volunteers, community-based schools, health facilities,

Water Supply Management Committees as well as social mobilizers. These community groups will be

encouraged to join the C4D cross-sectoral initiatives and serve as important channels to promote social

16

change. Community mobilization has been operationalized as community driven participation and

engagement of community level groups and actors and is differentiated from social mobilization

described below.

Social Mobilization

Social mobilization is the process of bringing together diverse and inter-sectoral partners and allies, to

raise awareness, demand and promote the desired change. This includes eliciting participation of formal

institutions and structures to promote the key behaviours. In addition to local governance structures,

educational institutions (e.g., Teachers Association, Universities), law enforcement and protection

bodies (Army, Police,) should be engaged to promote the key behaviours.

Recommended Steps for C4D Cross-Sectoral Partnership Formation

Working in partnerships, collaborations and coalitions can be challenging. However, it is a powerful

tool for mobilizing stakeholders to action, bringing community issues to prominence and developing

policies. These associations are also effective means of integrating health services with other social

issues so that resources are not wasted and efforts are not needlessly duplicated. Cross sectoral

collaborations are often best equipped to utilize the resources and findings of participants and apply

them more effectively than any single group or organization.

This C4D Framework recommends a step by step approach for making collaboration work efficiently

by building effective partnerships. Rather than creating new projects or programmes, C4D cross sectoral

alliances can harness existing resources to develop a unique community approach and achieve results

beyond the scope of one single institution or organization.

Discuss and analyze the group’s objectives and determine the partnership need(s): A multi-

sectoral approach is a prevention tool, so groups must be specific about what needs to be

accomplished. After the needs have been determined, the group must consider if this approach is

the best approach to meet the identified needs. Groups must ask the following questions:

- What are we trying to accomplish?

- What are our common objectives, expected results and outputs and types of activities

that can be synergized?

- What are community’s strengths and needs that can be jointly addressed?

- What are the pros and cons associated with the proposed collaboration?

Adopt more detailed activities and objectives suiting the needs, interests, strengths, and

diversity of the membership: A key to successful cross-sectoral collaboration is the early

identification of common goals and benefits of working together. The partnership must avoid

competing with its members for funding. An important consideration for adopting specific

collaborative activities is to identify some short-term outcomes. For example, if a joint objective

is boarder integration of prevention of FGM/C and early marriage, the main implementing

partners that can work together will be MOE, MOH and MLHW. UNICEF can support MOH on

integrating this issue into the health programmes. Through the health promotion and public health

debates public awareness and community social dialogue can be promoted. Involving Ministry

of Information (MOI) and partnership with NUEW and NUEYS can create strong cross-sectoral

foundation.

Convene C4D cross-sectoral members: A meeting, workshop or a conference can be

convened. The lead agency such as Ministry of National Development (MND) can plan the first

meeting using a time-specific prepared agenda, a comfortable and well-located meeting area,

and adequate refreshments. It is appropriate to prepare a draft mission statement and proposal

along with structure and membership.

17

Develop budgets and map agencies resources and needs: Lead agencies usually provide staff

time to keep the partnership up and running and to handle detailed work. Though these kinds

of partnerships can usually run on a minimal budget, each member’s time is a valuable

contribution.

Design the C4D cross-sectoral structure: Structural issues of the include:

- Drafting of a ToR

- how long the cross-sectoral partnership will exist,

- meeting locations,

- meeting frequency and length,

- decision making processes,

- meeting agendas,

- membership rules and participation between meetings by subcommittees or planning

groups. (i.e. Task Force on M&E, behavioural research)

- Templates of different structures should be collected prior to the meeting and presented

for discussion to reduce the time needed to make management decisions.

Plan for ensuring the C4D cross-sectoral partnerships vitality: Methods for noting and

addressing problems, sharing leadership, recruiting new members, providing training on

identified needs, and celebrating success can help ensure viability and success. It is very

important to recognize both the individual and organizational contributions each step of the

way.

Evaluate programmes and improve as necessary: Each joint activity and event should

include evaluations. This can be as simple as a satisfaction survey or it could be the more formal

use of pre- and post-tests of specific focus areas or issues.

Phased Approach for Rolling out the Cross-Sectoral C4D Framework (2015-2016)

The strategic C4D Framework is programmed in two phases toward achieving the intended behaviour

and social change results for 2015-2016. This section provides an outline for Phase-1 and broad

directions for Phase-2. Close monitoring and evaluation between the phases will enable programme

managers to review results and accordingly develop the subsequent phase. Detailed implementation and

behavioural monitoring plans will have to be developed prior to each phase.

Phase-1 (2015) Phase-2 (2016)

Sustain and scale up cross-sectoral C4D

approaches

Implement local solutions

Include additional behaviours

Shift from child survival to protection,

development & participation

Intensify local initiatives and actions

Engage children and community in decision-

making

Intensify community & media engagement

Conduct end term review

Formation of C4D cross-sectoral partnership

Set up coordination mechanisms

Conduct Formative Research

Address few joint cross-sectoral issues for

intervention in one selected zoba and

implement local solutions

Pre-test/Pilot concept

Build capacities

Develop and pretest creative, cross-sectoral

C4D media campaigns

Engage communities and promote role models

Pilot tools for behaviour monitoring

Conduct mid-term review

18

Phase-1: – Mid 2015 – This phase is devoted to formation of the C4D cross-sectoral

partnership core group and establishing coordination mechanisms, building capacities to

address essential family behaviours and social practices selected as priorities across the focus

areas in selected pilot Zobas which will be determined.7 In collaboration and consensus with

cross-sectoral partners a high level multi-media campaign should be launched and be

accompanied by advocacy campaigning across diverse media to create a “buzz” at the national

level. Community engagement should also include celebrity role models and generating locally

contextualized solutions during Phase-1. Behavioural monitoring will need to engage multiple

community groups and institutional members and ensure regular feedback mechanisms to

further improve and adapt the interventions. In addition, a mid-term review should be conducted

by UNICEF and partners towards the end of Phase-1 to determine the specific modalities for

Phase-2. A more detailed implementation plan, revised strategic approach, creative materials

and a behavioural monitoring plan would need to be developed for Phase-2.

Phase-2: – 2016 onwards – This phase will include long-term vision beyond the current

country programme cycle and post-2015 MDGs. Phase-2 will entail scaling up and sustaining

the strategic C4D interventions that have effectively gained momentum and traction. It will

also pave the way for piloting additional local initiatives that would evolve from Phases-1.

Community engagement will need to be further enhanced with the community generating and

owning many of the social change initiatives and processes. Overall, it is envisioned that there

will be a shift from the child survival focus to address more issues related to child development,

protection and participation. The strategic approaches for Phase-2 will be identified with

participating cross-sectoral groups and decided upon during the GoSE-UNICEF end of present

Country Programme of Cooperation evaluation/review.

Suggested Monitoring Tools

Record keeping and reporting of C4D activities plays an important role in getting “evidence-base” for

the success of C4D interventions. Daily activities can be recorded in a diary. The reporting forms will

determine what should be recorded in the diary. Below are some suggested areas to monitor.

Behaviour Monitoring Checklist

During monitoring visits to project sites, it is useful to take along a monitoring checklist. Example of

some points to be considered in a behaviour monitoring checklist is given below.

Checklist 1: Audience segmentation.

The primary audience for the activities (it can be an advocacy, social mobilization or SBCC activity) in

this place is: (tick one or more)

□ In-school adolescents □ Out-of-school adolescents

□ Healthcare Workers (doctor, nurse, ANM) □ Community Workers

□ Educators / Teachers □ Parents

Checklist 2: Participation.

The activities (it can be an advocacy, social mobilization or SBCC activity) in this place encourages

participation: (tick one or more)

□ There is evidence of discussion among community members

7 UNICEF and counterparts will define pilot/priority zobas for local implementation and scope of national campaign.

19

□ The intended primary audiences take active part in suggesting activities that they like

□ Audiences are free to speak up

Checklist 3: Behaviour monitoring indicators.

The below are some Process Indicators that can be used as proxies for monitoring behaviour change

Related to Advocacy, Planning and Supervision

No. of C4D planning, supervision and coordination meetings conducted

No. of C4D partners per state/district

No of health workers, teachers, etc. trained on IPC

No of social mobilization activities conducted at state/regional/district levels

No of advocacy activities conducted at state/regional/district levels

Related to cross-sectoral implementation:

No. of health workers, teachers and volunteers with improved IPC skills and knowledge of ANC,

breastfeeding, nutrition, sanitation and hygiene

No. of health education talks conducted at the health centres

No. of health workers with user friendly materials for health education talks

No. of health workers trained on Interpersonal Communication skills

No. of teenage marriage in the state/region/district over 12 months compared to the previous

12 months

No. of health facility deliveries by skilled birth attendants

Reports from health centres on the number of pregnant women’s knowledgeable about high

risk signs and when to seek care

Related to Nutrition:

Reports from health centres on the increased practice of exclusive breastfeeding for at least six

months after delivery

Reports from health centres on trend in consumption of IFA and deworming tablets through

monitoring of stocks (rapid decrease or unchanged distribution on a monthly basis).

Related to Community level:

No. of community mobilisers trained on IPC, community dialogues, data collection, etc.

No. of community activities implemented (Meetings, dialogues, dramas) etc.

No. of households reached per month

Related to WASH:

Reported No. of improved drinking water sources

Reported No. of villages becoming defection free

Reported No. of gender sensitive WASH facilities installed and utilized within 30 selected

elementary schools in rural areas.

20

CROSS-SECTORAL STRATEGIC CONVERGENCE for C4D

Health & Nutrition

Results/outcomes that can be achieved together

• increased proportion of people who are willing

to use latrines and knowledge of sanitation and

hygiene

• reduction in incidents of FGM/C

reduction in incidence of early marriage of girls

Strategic approaches that can work together

• WASH, H/N and Education programmes can

combine through SBCC to increase the

proportion of people who are willing to use

latrines and knowledge of sanitation and

hygiene

• H/N and Child Protection (CP) programmes

can combine to use advocacy, social

mobilization and SBCC to reduce incidents of

FGM/C

• CP and Education programmes can work

together to use advocacy, social mobilization

and SBCC to delay marriage of girls

Partners who can be brought together to

achieve this goal

MOH, MLHW, MLG, MOE, MOI, NUEY,

NUEW, Adult Education Classes, Radio Bana, all

mass media channels, MOC, PTA, NUEYS,

NUEW, Eritrean Union of Workers, Creative

group such as; Association of Eritrean artists,

Music, Theatre and Traditional media practitioners

and UN agencies

Entry points for strong cross-sector linkages

around stunting (CLTS, IYCF, and ECD), hygiene

education (Basic Education and CLTS), and

school enrolment (Community social assistance

and Basic Education)

Sanitation & Hygiene

Communication Objective:

To increase knowledge of women of reproductive age about access

and utilization of the improved basic child health interventions

(IMNCI, EPI) with priority to hard to reach and remote areas by

2016.

To increase the number of women and primary care giver’s

knowledge, attitude and behaviour about the benefits of delivery at

health facilities, with priority to hard to reach and remote areas.

To increase the knowledge of mother’s about the IMAM services

Desired Outcome:

Increased knowledge and practice of EB

Increased knowledge and attitudes for institutional birth deliveries

Increased knowledgeable about a high risk signs and when to seek

care

Key Strategies

multi-media campaigns to promote positive social norms around

childbirth and childcare

entertainment-education sessions about health through the lifecycle

for adolescents

Communication Objective

increase knowledge about sanitation and hygiene especially water

handling, latrine use, hand washing and personal hygiene by

2016.

Desired outcomes

80 selected communities have knowledge of handling water

supply

Increase the proportion of people who are willing to use latrines

in 300 villages

Key Strategies

scale up CLTS programme through multi-channel communication

Package and promote the key sanitation and hygiene concepts and

use them as tools for programme visibility, community

mobilization and programme acceleration

Basic Education Child Protection

Communication Objectives

To create awareness among parents and communities to change

attitude and take specific action to send children (girls and ODG)

to school to complete their basic education through Nation-Wide

Movement by 2016.

To create a paradigm shift in the way girls are viewed and treated

by promoting an environment where girls, ODG and all children

completing their education becomes the norm, and are valued.

Desired outcome

Change of attitudes to accept and increase Girls and Other

Disadvantaged Groups children going to school

Key Strategies

multi-media campaigns to promote Girls and ODG children education

Communication Objective

to change attitudes and behaviours about FGM/C and early

marriage among communities that have taken it for granted as a

traditional practice.

Desired Outcome

Increased knowledge and change of attitudes towards effects of

FGM/C and early marriage

Key Strategies

Advocate child rights, legal provision and implementing the law

and act.

Social mobilization initiatives, including: peer education; Child

Marriage Eradication Committees; child clubs and developing

leadership among young girls

Behaviour change communication multi-channel

communication approach with equal emphasis on mass media,

local or other types of media (including traditional and modern

communication aids) and interpersonal communication by peer

educators

21

Annex-1: Summary of Programme Units Analysis Summary of Programme Units Analysis

Programme

Unit

Importance of

this area

Goals

2013-2016

Hard to reach

and remote areas

Expertise

brought to

collaborative

Assets &

Strengths

Current key

strategies

Desired

outcomes

Data Partner-

ships

Benefits of

participating in

this

collaboration

Health &

Nutrition

- Neonatal

deaths

- Low level of

skilled

assisted

delivery

- breastfeeding

- Iodine

deficiency

disorder

- stunting

- poor quality

of basic

services

- limited

access to

health

facility

- insufficient

referral

capacity.

1. access and

utilization of

basic package of

child health

services and

interventions

(IMNCI and EPI

services)

improved

2. access and

utilization of

basic package of

maternal health

services &

interventions

improved

3. underweight

prevalence

among under-

five children

reduced

EPI, Child

health,

C/IMNCI,

PMTCT,

Maternal &

Neonatal

health,

IMAM,

Micronutrient,

IYCF and

blanket feeding

Training,

Funding,

Technical

support in Health

& Nutrition

inter-sectoral

approach to

health;

involving

community

participation;

ownership of

policies

partnerships

with donors.

(ODI, 2011, p

27)

Increased

practice of

exclusive

breastfeeding for

at least six

months after

delivery

More health

facility deliveries

by skilled birth

attendants

Mother are

knowledgeable

about high risk

signs and when

to seek care

EPHS

2010,

NSSS

2010,

HMIS

2010

KAP

Child &

Nutrition

2010

MOH,

MLHW,

MLG,

MOE,

MOI,

NUEY,

NUEW,

Support all

important child

health issues

policy.

FGM/C and

prevention,

adolescent

development of

child injury,

Sanitation

(CLTS), Hygiene

and Menstrual

hygiene

management,

BCC/community

based health

promotion/

Emergency,

Construction of

community

based water

projects and

water

management

22

Programme

Unit

Importance of

this area

Goals

2013-2016

Hard to reach

and remote areas

Expertise

brought to

collaborative

Assets &

Strengths

Current key

strategies

Desired outcomes Data Partner-

ships

Benefits of

participating in

this

collaboration

Basic

Education

54% of OOSC

are females,

Nomadic

education

Equity of access to basic education

for about 100,000

children (emphasis

on girls) in

Anseba, Gash

Barka, Southern

Red Sea, Northern

Red Sea and

Debub through

formal and NFE.

Quality:, learning

outcomes

improved for all

children

successfully

advocated for

nomadic

education ,

mainstreamed

Nomadic

Education into

the Education

Management

Information

System (EMIS)

of MOE

Funded the

capacity

building

workshops for

national and

Zoba level

education

officials

Supporting the

MOE to

conduct the

Out of School

Children

initiative in

collaboration

with UNESCO

Institute of

Statistics and

UNICEF

ESARO.

Training,

Funding,

Technical

support in Basic

Education

Production &

dissemination

of curriculum

instructional

materials

Promoting co-

curricular

activities

including

learning

competitions,

Capacity

building of

untrained

teachers

through in-

service

programmes,

Affirmative

action for

females

teachers and

students, in

partnership

with NUEYS,

NUEW.

Advocacy to

deploy

qualified

teachers to

disadvantaged

areas.

Equity of access to basic education

for about 100,000

children (emphasis

on girls) in

Anseba, Gash

Barka, Southern

Red Sea, Northern

Red Sea and

Debub through

formal and non-

formal education.

Quality: by 2016,

learning outcomes

improved for all

children

EMIS

2011

MLA

MOE,

MOH,

MOI

MLHW,

MLG,

NUEY,

MOD

Policy on

FGM/C

Prevention of

early marriage

WASH to

provide child

friendly learning

spaces by

providing timely

information on

growing up and

water and

sanitation

facilities to

schools and

learning centres.

extend coverage

of the Mine risk

education in

collaboration

with Child

protection

programme

Education

interventions to

nomadic

education

centres,

Integrate former

street children

into the formal

school system.

23

Promote flexible

learning routes

for OOSC.

Leverage

partnerships with

communities to

foster and sustain

demand for

education

24

Programme

Unit

Importance of

this area

Goals

2013-2016

Hard to reach

and remote areas

Expertise

brought to

collaborative

Assets &

Strengths

Current key

strategies

Desired

outcomes

Data Partner-

ships

Benefits of

participating in

this

collaboration

Child

Protection

FGM/C

Prevention of

adolescent &

child injury ,

Early marriage

Mine Risk

education

N/OVC,

Community

based

rehabilitation

( MRE and

disability ),

‘donkey for

schools’,

Street children,

Child justice

By 2016, Children

and adolescents at

risk are protected

from harmful

practices,

exposure to

injuries, violence

and exploitation,

FGM/C practice

reduced among

under 15 girls,

Integrated

National Social

Welfare

Assistance System

strengthened.

Joint work plan

Advocacy for

finalization of

draft policies

and strategic

plans.

increase and

strengthen the

Child Protect-

ion data

collection

method and

management

information

Review and

develop relevant

Child Protection

and/or

Communication

strategies.

Training,

Funding,

Technical

support

comprehensive

and sector-wide

community-

based

programme on

prevention and

reduction of

child injuries

32 Adolescents

and Child

Friendly

Spaces

nationwide

villages

established,

Advocacy for

FGM/C free

villages

ongoing

promulgation

that banns

FGM/C

Abandonment

and abolition of

harmful

traditional

practices of

FGM/C

Ending of early

marriage among

girls under 15

years

HMIS

2013

MoH,

MOE,

MOI,

MLHW,

NUEW,

NUEYS

the local

administrat

ions in the

6 Zobas

Basic

education

Support all

important child

health issues

policy.

FGM/C and

prevention of

early marriage,

Mine risk

Education

25

Programme

Unit

Importance

of this area

Goals

2013-2016

Hard to reach

and remote

areas

Expertise

brought to

collaborative

Assets &

Strengths

Current key

strategies

Desired

outcomes

Data Partner-

ships

Benefits of

participating in

this collaboration

WASH Water is

extremely

scarce in

Eritrea.

Poor water

and sanitation

standards

directly linked

to leading

causes of

mortality and

morbidity –

notably,

diarrhoeal

disease

Overall,

access to safe

water and

sanitation in

Eritrea is still

low

80 selected

communities have

environmentally

sustainable

improved

drinking water

sources, through

construction of

appropriate and

environmentally

sustainable water

supply systems

and capacity

development of

GoSE.

300 villages

become open

defecation free.

Gender sensitive

WASH facilities

installed and

utilized within 30

selected

elementary

schools in rural

areas

Focus on

evidence base

and data

collection

Improve cross

sectoral

linkages &

synergies.

Greater focus

on real time

monitoring

(MoRES)

framework.

Capacity building

of GoSE

partners,

Advocacy for co

funding–

leveraging

resources,

High level

advocacy

Allocation of

greater

percentages of

GoSE

budgets,

capacity

building of

GoSE partners

for planning,

implementing

and

monitoring

WASH

programmes.

Recruitment

of additional

UNICEF

capacity to

conduct field

monitoring &

assessments.

80 selected

communities

have improved

drinking water

sources,

300 villages

become defection

free,

Gender sensitive

WASH facilities

installed and

utilized within 30

selected

elementary

schools in rural

areas.

(WHO/UNIC

EF, 2010, p.

43).

MoLWE,

2012, p. 90),

MOH:

MLWE:

MLG:

NUEW

MOE

MOI

Sanitation

(CLTS), Hygiene

and Menstrual

hygiene

management

Construction of

community based

water projects and

water management

Coordination of

water and

sanitation projects

26

Programme

Unit

Importance

of this area

Goals

2013-2016

Expertise

brought to

collaborative

Assets &

Strengths

Current key

strategies

Desired

outcomes

Data Partner-

ships

Benefits of

participating in

this

collaboration

Advocacy

&

Partnership

(handling

M&E,

External

Comm.&

Donor

Relations

Data for

development)

Cross cutting

program

supports all

above

programmes

Enhanced

Capacity of the

MOI & NUEW,

NUEYS

Enhance national

media capacity to

design and

monitor children

and youth

participation in

Intersectoral C4D

strategy and

communication

policy developed

and implemented

National media

capacity to design

and monitor

children and

youth

participation

programmes

C4D, M&E,

Capacity

building

Training,

Funding,

Technical support

Strategy

developed for

Girls

education,

FGM/C, EPI,

WASH.

Initiated

several

advocacy

meetings with

the (MoI) for

the

development of

a national

communication

policy.

60 youth media

journalists were

equipped with

message

design,

packaging and

broadcasting

skills

Enhance

capacity of

media

programmers

and health

promoters in

message design

and

dissemination;

child-sensitive

photography

and C4D

Activity Report MOH:

MOI:

MOE:

MLWE:

NUEW:

UNFPA,

UNAIDS,

UNDP

and

UNHCR

NUEYS

BCC/community

based health

promotion/

Emergency

Construction of

community

based water

projects and

water

management

Child-to-child

media

programmes,

Multi-media

message

dissemination

Creating

demand for GE/

social norms

around early

marriage

Community

participation and

water

management

Youth

empowerment

and participation

Gender related

programmes

27

Annex-2: Proposed Communication Objectives and Communication Indicators for the Programme Sectors

Health & Nutrition

PCR Outcome 1:- By 2016, access and utilization of basic package of child health services and interventions (IMNCI and EPI services )improved with priority to

hard to reach and remote areas

PCR Outcome2: By 2016, access and utilization of basic package of maternal health services and interventions improved with priority to hard to reach and remote

areas (PMTCT/MH)

PCR Outcome 3:-By 2016, underweight prevalence among under-five children reduced from 38% (2010) to 23% with focus on most disadvantaged groups and in

hard to reach and remote areas

Communication Objectives:

To increase knowledge of women of reproductive age about access and

utilization of the improved basic child health interventions (IMNCI, EPI)

To increase the number of women and primary care giver’s knowledge,

attitude and behaviour about the benefits of delivery at health facilities

To increase the knowledge of mother’s about the IMAM services.

Communication Indicators:

Proportion of women of reproductive age know where to get IMNCI & EPI services

Proportion of women who know the benefits of delivery at health facilities and are

favourable to having their deliveries in health centres

Proportion of mothers who know about IMAM services

Basic Education

PCR Outcome 4: Equity of Access: 95,000 out of school children aged 6-16 enroll into basic education by 2016 (with particular emphasis on girls) in Anseba, Gash

Barka, Southern Red Sea, Northern Red Sea and Debub.

PCR Outcome 5: Improved Quality of Education: Quality of education enhanced leading to improved learning outcomes for all children by 2016 (minimum

standards applied, with guidelines developed and used)

Communication Objectives (Immediate)

To create awareness among parents and communities to change attitudes

and take specific action to send children (especially girls and ODG) to

school to complete their basic education through Nation-Wide Movement

by 2016.

Communication Objectives (Long Term)

To create a paradigm shift in the way girls are viewed and treated by

promoting an environment where girls, ODG and all children completing

their education becomes the norm, and are valued.

Communication Indicators

% Change in knowledge and attitudes of target audience to send children(girls &Other

Disadvantaged Groups(ODG)-Over aged out-of-school children (10-14yrs), children of

nomadic communities, children with disability to schools to complete basic education

% Expressed intentions of the target audience to send children (girls and ODG) to

school and complete their basic education

% Changes in behavior of the target audience in promoting an environment where

girls, ODG and all children completing their education becomes the norm, and are

valued

28

WASH

PCR Outcome 6: Rural Water Supply: 80 selected communities have environmentally sustainable improved drinking water sources. The emphasis is on service

provision, through construction of appropriate and environmentally sustainable water supply systems and capacity development of GoSE and communities improved

coordination, planning, operation and maintenance and sustainability of systems.

PCR Outcome 7: Sanitation & Hygiene: 300 villages become open defecation free.

PCR 8: WASH in Schools: Gender sensitive WASH facilities installed and utilized within 30 selected elementary schools in rural areas

Communication Objectives

• To increase the knowledge people have about

sanitation and hygiene, by developing positive

attitudes and motivate them to practice water

handling and latrine use, hand washing and

personal hygiene by 2016.

Communication Indicators8

• % Decrease in the proportion of people who believe that it is fine to defecate in the open

• %Increase the proportion of people who wash hands with water and soap after defecating, before

handling or preparing food and before eating

• %Increase the proportion of households that keep their food clean

• %Increase the proportion of schools with clean compounds and surroundings

Child Protection

PCR Outcome 9:. Children and adolescents at risk protected from harmful practices, exposures to injuries, violence and exploitation. Female Genital

Mutilation/Cutting (FGM/C) and (Early Marriage)

PCR Outcome 10: Integrated National social welfare system strengthened

Communication Objectives (FGM/C)

• The communication for development objective is to attain a permanent

change of attitudes and behaviours about FGM/C among individuals

and communities that have taken it for granted as a traditional practice

Communication Objectives (Early Marriage)

The communication for development objective is to reduce and

change of attitudes and behaviours about early marriage of

girls/boys before 18 years among parents and communities that

have taken it for granted as a traditional practice

Communication Indicators(FGM/C)

% of Individuals that have changed their attitudes towards FGM/C for their

daughters under 15 years

% of Communities that have attained changes in their behaviour and do not take

FGM/C of girls under 15 years as granted traditional practice

Communication Indicators (Early Marriage)

% of parents that have changed their attitudes towards early marriage and get

their daughters/sons married only after 18years

% of Communities that have attained changes in their behaviour and do not marry

their girls/boys before they become 18 years

8 Communication Strategy for Sanitation and Hygiene in Eritrea 2013-2016, Ministry of Health Eritrea, Asmara- January 2013

29

ANNEX 3: Analysis of existing KABP, Perceived Barriers and Desired Changes for Programme sectors

Programme Unit Existing KABP Perceived Barriers Desired Change Key Messages

Health& Nutrition 4 ANC visits by for mothers with no

formal education

Overall knowledge in breastfeeding was

high but did not translate into practice at

the household level

Low % of mothers had initiated

breastfeeding 24 hours after birth

Complementary feeding initiated earlier

around 4mths.

Majority of caregivers had knowledge that

a sick child should be given more food and

liquids, but the practice was to give less

thinking it would increase the diarrhea in

the children

Knowledge about Child complete

vaccination at 9 months is lower among

illiterate mothers

Gender Norms wherein women

tend to eat last and the least

Lack of awareness and knowledge

by families, communities and

women of the high risk signs and

when to seek care

Cultural practices surrounding the

feeding of pre-lacteal and those

negative health seeking practices

for a child who has diarrhoea

Increased knowledge and practice

of IMCI/EPI

Increased knowledge and attitudes

for institutional birth deliveries

Increased knowledgeable about a

high risk signs and when to seek

care

Increased knowledge about

immunization

Seek antenatal care

Breastfeed your baby

exclusively for six months

Get child immunized

Basic Education Lack of awareness and undervaluing the

benefits of formal education especially to

for girls,

Early marriage,

Son preference

Negative cultural practices like stigma

against children with disabilities,

Belief that formal education corrupts the

morals of children

Other hidden societal norms and values

that determine individuals’ and

communities’ mind sets and behaviour

regarding girls education and their status in

society

Girls do not have equal status in

society,

Girls are burdened with house hold

duties than boys

Temporary habitats of semi-

nomadic tribes,

Not enough facilities for disabled

children,

Lack of value for educating

girls/ODG,

Girls are vulnerable to sexual,

exploitation,

Lack of inspiring role models and

icons

Lack of community based early

learning opportunities

Every child in school learning and

attaining her/his full potential.

To increase Girls and Other

Disadvantaged Groups access to

education

“Our daughters are Pride for us

and the Nation”

“We take a vow that our

daughter will marry only after

she has completed her

education”

“Our daughter used to do lot of

household work, but now we

realize that is more important

for her to go to school”

“We want our children to go to

school, as they deserve better

life than we had”

30

Programme Unit Existing KABP Perceived Barriers Desired Change Key Messages

WASH Water Supply

People washing hands with water and soap

are only 50%, before handling food 40.9%,

before eating 46.6%

People draw water from unprotected water

source

Some water sources are not separated

from laundry and for animals to drink

People do not wash hands before drawing

water

Many people are not aware that it is

important to protect water sources

Sanitation & Hygiene

47.3% without access to latrines.

94.7% of the population desires to own

their own latrines, indicating a large unmet

demand.

61% of children living in the rural and

semi-rural areas defecate in the open

Urban areas have greater access to sanitary

fecal disposal facilities (92%) than semi-

rural areas (55.4%) and rural areas 24.9%.

30% believe that it is fine to defecate in the

open so long as you are hidden

The practice of open defecation is still in

place and many people defecate in the open

Some people say that defecating in the

open is good because it does not confine

you in a small space and allows people to

engage in conversation as they defecate

Lack of knowledge that water can

get contaminated and cause

diseases and should be treated

Some believe that bathing with

cold water makes children and old

people sick with colds and chest

pain

Lack of knowledge that not

washing hands can contaminate

water

Lack appropriate water storage

containers and drawing cups

People complain that they walk

long distances to get water so they

use water for more essential

purposes only

Sanitation & Hygiene

Lack of knowledge that OD can

lead to contamination of water

sources and diseases.

Boil or chlorinate drinking water

People washing hands with water

and soap before handling food

before eating

Increased awareness about latrine

use

Wash your hands with water

and soap:

After cleaning a baby who has

defecated,

Before handling or preparing

food

Before eating

Before breastfeeding or

feeding the baby

Construct and use a latrine for

faecal disposal, keep your

latrine clean

Train small child to defecate in

a potty, collect the faeces of

your child and throw in a

latrine

31

Programme Unit Existing KABP Perceived Barriers Desired Change Key Messages

Child Protection FGM/C

Traditional religious and cultural practice

12.9% FGM/C prevalence for under five

vis-à-vis 83 % for older women, with huge

regional disparities;

By doing FGM/C women will be more

faithful to their husbands

Early Marriage

Currently no direct intervention related to

child marriage

According to EPHS 2010, among women

aged 25-49, 20 % were married by age 15

and 49 % were married by age 18.

EPHS 2010 revealed that the main reason

for dropping out of school for 69 % of

women and 39% of men was early

marriage

Social Norms

Traditional religious and cultural

practice

Abandonment and abolition of

harmful traditional practices of

FGM/C among girls under 15 years

Abolition of Early Marriages

“FGM/C is harmful and

violates the rights of girls and

women”.

“Our daughters are Pride for us

and the Nation”

“ I will only marry when I have

finished my education”

“My vision for new Eritrea is

where everyone is educated”

32