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1 Leveraging resources and working with government and partners helped Health, WASH, CP and C4D in getting better results.

Situation in Numbers

Key Highlights • Pakistan continued to show a downward trend of COVID-19 cases in its fourth

wave. On 1st November, the positive cases were 445 and on 30th November

the positive tested cases dropped to 414 with a positivity rate of 0.6 per cent.

(https://covid.gov.pk/stats/).

• Over 71.6 million people have been reached with messages on COVID-19

prevention and on access to services.

• Through UNICEF supported health sites, 64,372 children (35,126 girls) have

been admitted for Severe Acute Malnutrition treatment.

• Over 5 million people benefited from continuity of primary healthcare services

at UNICEF supported health facilities.

• UNICEF has reached 380,704 caregivers, children and individuals with psychosocial support through trained social workforce.

• Through UNICEF support, 2.2 million people have been reached with

handwashing behaviour change programmes.

• A total of 33.2 per cent of Pakistan’s target population (12 years and above) is

fully vaccinated, with 53.2 per cent partially vaccinated.

UNICEF Appeal for Preparedness and Response

US$ 61.4 million

1,284,365 confirmed

corona virus cases in Pakistan (on 1st November).

1.7 million Children and women require nutrition services

Pakistan Humanitarian

Situation Report No. 31

UNICEF’s Response and Funding Status

5.9 million

children in need of humanitarian assistance

11 million people in need

© UNICEF/ Muslima, 8 years (right to left), Sadiqa 5 years, Arifa 4 years old and a young nomad boy proudly show the ink mark on the tip of their finger after MR campaign.

Reporting Period: 1st – 30th November 2021 (monthly)

96%

12%

96%

18%

85%

17%

15%

16%

144%

62%

66%

19%

0% 20%40%60%80%100%

People reached (throughnational Media channels)…

Funding status

People at high risk supportedwith hygiene promotion…

Funding status

People, including childrenreceiving PSS

Funding status

Children accessing safeformal and non-formal…

Funding status

Children and womenaccessing primary health…

Funding status

Children provided with MMN

Funding status

C4D

, C

Eand A

AP

WA

SH

Child

Pro

tection

Ed

ucation

Health

Nutr

itio

n

Humanitarian funds, $3m

Other Resources,

$4mCarry-

forward, $7m

Funding gap, $48m

Funding Status (in US$)

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Funding Overview and Partnerships

UNICEF Pakistan requires US$ 61.4 million to support the in-country humanitarian response. To date, US$ 13.46 million

(22 per cent) have been received to provide humanitarian assistance in the country. United Kingdom Committee for

UNICEF (Unilever) has provided in-kind support of hand sanitizers for COVID-19 vaccination centres. A significant

funding gap of over US$ 47.94 million (78 per cent) persists in provision of essential emergency services throughout the

country, especially for preparedness, nutrition, RCCE and education programmes.

In addition to the humanitarian resources received during the year, US$ 3.76 million of existing resources have been re-

purposed to support the on-going response. This includes funds received from the United Kingdom, Canada, UNICEF’s

set-aside funds, Global Thematic Funds, and regular resources.

UNICEF expresses its sincere gratitude to the Governments of United Kingdom, United States, Austrian Committee for

UNICEF, Asian Development Bank, Central Emergency Response Fund (CERF), World Bank, ECHO, Global

Partnership for Education, Gavi - The Vaccine Alliance, United Kingdom Committee for UNICEF, Solidarity Fund,

Standard Chartered, along with all its public and private donors for their contributions.

Situation Overview and Humanitarian Needs

Consequent to emergence of Omicron variant of COVID-19 in South Africa and its spread to adjoining countries, complete ban has been imposed on direct/indirect inbound travel from South Africa, Lesotho, Eswatini, Botswana, Mozambique, Namibia and Hong Kong from 29th November till further notice.

Pakistani passengers travelling from the above-mentioned countries due to extreme emergency will only be allowed after following strict health/testing protocols, including vaccination certificates, negative PCR test result, Rapid Antigen Test (RAT) on arrival, three days quarantine in case of negative RAT, and 10 days quarantine on positive RAT.

Planning underway for providing free booster shots for frontline workers, people over 50 years of age and immuno-compromised to enhance the protection against the new variant.

Communication messages are being shared with emphasis on getting complete vaccination and following SOPs (mask, handwashing, social distancing, avoiding crowded places) for protection against Omicron.

UNICEF Pakistan’s humanitarian interventions are aligned closely with the interagency Humanitarian Response Plan

(HRP), 2021. The humanitarian community aims to provide integrated lifesaving services to some 4.3 million most

vulnerable people affected by shocks ensuring living conditions, resilience, and protection, whereas the overall

humanitarian needs amount to 11 million people across the country.

0Political, social and economic uncertainty in Afghanistan, especially for women and girls, since the takeover by Taliban,

could potentially lead to refugees entering neighbouring countries, including Pakistan, for which UNICEF is taking

preparatory measures for a potential response to help protect the refugees’ human rights and address immediate needs

of children and women, including in host communities.

EPIDEMIOLOGICAL OVERVIEW Pakistan continues to show a downward trend of COVID-19 cases in its fourth wave. On 1st November the positive

cases were 457 and on 30th November the positive tested cases dropped down to 414 with a positivity rate of 0.6 per

cent. In total, there have been 1,284,365 confirmed COVID-19 cases and 28,709 deaths have been reported. Pakistan

conducted an overall of 21,913,668 laboratory tests (figure below).

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COVID-19 Vaccine Updates: COVID-19 vaccination started in Pakistan on 3 February 2021. Vaccination is being

carried out in a phased manner, with priority first given to frontline health/workers, senior citizens to people in lower age

brackets. Starting from 2nd October, the vaccination is opened for population above 12 years of age. From 14th to 27th

November COVID-19 vaccination stopped for children aged 12-15 years, resuming all over the country following the

conclusion of the Measles and Rubella Campaign.

Pakistan has received 179,804,280 vaccines doses through 30th November 2021. Details of the different vaccines that

have arrived in Pakistan through COVAX and bilateral agreements are given in table below.

Vaccine # Doses received

Cansino 2,841,200

PakVac 6,997,320

Sinopharm Covax 8,845,200

Sinpharm Bilateral/Donations from China 30,920,000

Sinovac 77,500,000

Pfizer Covax 20,121,260

Pfizer Bilateral 6,259,500

AZ Covax 8,071,800

Moderna Covax 9,248,000

Sputnick 9,000,000

As per Nation Command and Operation Center (NCOC) database, COVID-19 vaccine related statistics are given below2

through 29th November, 2021. The number of fully vaccinated persons in Pakistan is at 33.2 per cent of the target

population and 53.2 per cent of the population is partially vaccinated.

The gender gap of COVID-19 vaccination is shown in the graph below for both first and second doses of vaccine as of

30th November 2021.

Cold Chain Expansion and dry storage expansion:

The deployment of COVID-19 vaccines is being implemented through the Expanded Program on Immuniztion (EPI)

vaccines storage system. EPI, with support of UNICEF, enhanced the cold chain capacity through installation of 41 Ultra

Cold Chain (UCCs) equipment for storage of vaccines, such as Pfizer BioNTech. Moreover, dry storage capacity is

enhanced through renting dry storage in Islamabad. UNICEF is supporting further enhancement of dry storage capacity

at Punjab and Karachi, where two big dry stores will be constructed. The construction plan is underway. In addition,

Federal EPI, with procurement support from UNICEF, is in process of procuring 100 more UCCs to accommodate

2 https://ncoc.gov.pk/

39%, 26,987,782 39%, 18,920,204

61%, 41,508,150

61%, 28,979,153

-

20,000,000

40,000,000

60,000,000

80,000,000

Dose I Dose II

Male

Female

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upcoming shipment of Pfizer and other COVID-19 vaccines which require minus temperature for storage. These 100

UCCs will be delivered after mid of December.

Summary Analysis of Programme Response

1. Communication for Development, Community Engagement and Accountability to Affected People:

Coordination: UNICEF continued to provide leadership, coordination and technical support to the Ministry of National

Health Services Regulation and Coordination (MONHSR&C) and its Risk Communication and Community Engagement

(RCCE) partners. Both the National and UN RCCE task force teams were established in March 2020. These RCCE

forums provide the strategic direction for RCCE efforts in the country. The UN task force team that includes eight UN

agencies, meets monthly. In addition to coordination at the federal level, UNICEF is also co-lead in all provincial RCCE

task-force teams, aiming to strengthen coordination, planning, monitoring and ensuring timely implementation at both

provincial and district levels.

As of November 2021, UNICEF’s COVID-19 survey reported an increase in vaccination compliance, increasing from 74

per cent in August 2021, to 81 per cent in November, representing citizens who have either received at least one vaccine

dose or are planning to receive the vaccine. During the same period, there has been a corresponding drop in vaccination

non-compliance. Decreasing from 26 per cent in August 2021, to 19 per cent in November.

There has been an improvement in female compliance with COVID-19 vaccination, with an increase of 31 per cent in

female compliance to vaccination from August to November. Among males and females, the figures are now more

comparable, ranging around the national average of 81 per cent and 73 per cent respectively. There also has been an

improvement in the youth’s compliance with COVID-19 vaccination. In August 2021, 29 per cent of the youth – aged 18

to 30 – did not comply with vaccination, while in November, youth non-compliance fell to 19 per cent. Among rural

populations, compliance with COVID-19 vaccination also increased by 21 per cent.

The survey, however, confirms that specific provinces still maintain high levels of vaccination non-compliance.

Provincially, Balochistan uniquely persists with high levels of vaccination noncompliance, falling from 48 per cent in

August 2021 to only 43 per cent in November 2021. Balochistan’s vaccination non-compliance is 2.3 times higher than

the national average, while vaccination compliance is 1.4 times lower than the national average. Recommendations

include to continue developing provincially specific public communication on COVID-19 vaccination, and to conduct new

rapid assessments, specifically in households of low socio-economic settings.

Concerning public satisfaction with vaccination services, UNICEF’s COVID-19 RCCE survey shows moderate-to-high

levels of satisfaction with the government’s COVID-19 vaccination services. On a scale of 0 to 10, overall satisfaction

with the government services ranged around 7. Satisfaction was highest for government vaccination centres, at 7.9.

This specifically high level of satisfaction is also in response to the successful Mass Vaccination Centre at the F-9 Park

in the federal capital of Islamabad.

UNICEF’s COVID-19 RCCE survey shows extremely low levels of awareness of COVID-19 ‘variants’. Only 5 per cent

of Pakistanis have heard of COVID-19 variants. Nearly 75 per cent of these Pakistanis inaccurately believed that the

variants were less or equal to the wild COVID-19 virus in terms of likelihood and severity of infection and likelihood of

death. Similarly, 72 per cent of these Pakistanis also inaccurately believe that COVID-19 vaccines and preventative

measures were also effective against the different variants. This feedback further explains that Pakistanis have

inadequate knowledge and biased risk perceptions about COVID-19 variants because of low levels of health literacy

about both viruses and their treatment and prevention. Recommendations in process of implementation include the

development of culturally high-comprehensive messages and communication materials specifically on the COVID-19

variants. These messages promote stricter compliance with COVID-19 vaccination and prevention in relation to variants.

Community engagement approaches focusing on face-to-face and interpersonal communication will be central in

addressing the effect and impact of the new variants and why we should continue to observe preventive SOPs.

Religious leaders’ engagement: With particular focus on high-burden districts, and through health alliances and RED

approach, 1,590 more religious leaders have been engaged and mobilized to promote a higher risk-perception towards

COVID-19 and its hidden dangers - increasing the cumulative number of religious and community leaders engaged to

91,398. Preaching from local mosques, religious leaders reminded followers to complete all COVID-19 vaccination

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doses, encourage and promote female uptake for vaccines, abide by Standard Operating Procedures (SOPs), and to

limit social gatherings.

Media, social-media and production of educational materials (print/video): Television and radio remain the primary

sources of trusted information on the COVID-19 in Pakistan. Although TV and radio have the highest outreach, social

media is catching up with them in terms of outreach.

On social media, Facebook continue to be the major platform for UNICEF Pakistan. During the reporting period, UNICEF

received 8,019,809 total impressions and 126,470 engagements. On average, each post received 334,158 impressions

and 5,269 engagements. On Twitter, the total impressions were 476,345 and total engagements were 8,878 during the

reporting period. On Instagram, the total impressions were 121,156 and total engagements have been 3,136.

With additional support from the Polio teams and local CSOs, community mobilization activities continued in high-risk

districts throughout the country. Focus was on completing both vaccine doses, promoting the importance of female

vaccination, encouraging younger generations to get vaccinated, to continue to wear masks, and to limit social

gatherings. During the month of November, nearly 147,921 people have been reached with COVID-19 preventive and

vaccination related messages.

Partnerships: UNICEF is working with the federal and provincial governments as well as implementing partners which

include: WHO, UNHCR, UNDP, FAO, UNAIDS, UNESCO, UNODC, UNWOMEN, UNFPA, UN HABITAT, UNRC, WFP,

ICRC, PRCS, GRASP/ITC, Digital Pakistan, UNILEVER, Daraz.pk, Zong4G, AKF, HANDS, Pakistan Medical

Association, Rural Support Programme Network (RSPN), Pakistan Alliance for Early Childhood (PAFEC).

2. Water, Sanitation and Hygiene:

Coordination: UNICEF works in close collaboration with the Government of Pakistan, WHO and other sector CSO

partners. UNICEF advocated and supported the Ministry of Climate Change to convene coordination meetings with

WASH partners at the federal level, while the provinces also held regular coordination meetings with WASH partners in

collaboration with the provincial departments. WASH sector coordination meetings at federal level brought together over

70 organizations and government representatives from all the provinces. The same support was extended to the

departments of local government in the four provinces to hold similar coordination meetings on weekly basis. All

participating organizations regularly report their progress through the 4Ws matrix (Who is doing what, where and when),

ensuring effective coordination and efficient use of resources by avoiding duplication.

The Infection Prevention and Control (IPC)/WASH sector, with support from UNICEF and the Global WASH Cluster,

has developed an online dashboard which gives a visual view of the 4Ws matrix analysis, showing progress by each

partner in each location.

Response: UNICEF is implementing country-wide WASH/IPC interventions, focusing its efforts in COVID-19 high

burden districts. UNICEF rehabilitated and installed WASH facilities, which included ultraviolet water filters, toilets, and

handwashing stations in 111 healthcare facilities (HCFs) - 33 in Sindh, 24 in KP and 54 in Balochistan. To date, more

than 686,551 people (336,410 men and 350,141 women), including 233,328 during the reporting period, have gained

access to safe drinking water and sanitation facilities in these HCFs, contributing to reducing the risk of COVID-19

infection among healthcare workers and general public especially caregivers and children seeking essential health

services.

UNICEF utilized existing WASH programmes such as Clean and Green Pakistan and communication networks of

volunteers to undertake hygiene promotion and support RCCE efforts. Given the travel restrictions, UNICEF used digital

and social media platforms to engage with communities, including with religious leaders in hygiene promotion. To

promote handwashing by the public as one of the critical COVID-19 prevention and control measures, UNICEF

supported an overall fabrication and installation of 1,070 handwashing stations (64 during the reporting period) placed

at strategic points in cities and communities enabling over 2.39 million people thus far (68,000 during reporting period)

to wash hands properly. Almost 2.2 million people have been (233,328 during reporting period) supported with hygiene

promotion services including COVID-19 prevention and control information.

To date, UNICEF has supported the training of 5,101 frontline sanitary and health workers (276 during the reporting

period) on WASH/IPC in HCFs and high-risk communities on WASH/IPC. UNICEF reached an overall of 378,784

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children (193,180 girls and 185,604 boys), including 51,604 during the reporting period in the 712 schools (KP 571 in,

30 in Balochistan and 111 in Sindh) with WASH/IPC services (97 schools during the reporting period).

Gaps and Challenges: Healthcare waste management remains an area requiring urgent attention from the authorities.

UNICEF is therefore engaging the Ministry of Health to coordinate waste management efforts and mobilize all concerned

stakeholders and donors to support the proposed initiatives. Given the lack of resources hindering UNICEF`s capacity

to address IPC/WASH needs in emerging high-risk areas, it has focused on hygiene promotion and ensuring

functionality of already installed facilities.

Partnerships: UNICEF worked with the federal and provincial governments as well as with implementing partners

including: AKF, Islamic Relief Pakistan, HANDS, Sarhad Rural Support Programme, Water and Sanitation Agency

(WASA) Lahore, Water and Sanitation Services Company (WSSC) Swat, WSSC Abbottabad, The Water and Sanitation

Services Peshawar, Peshawar, Balochistan Rural Support Programme, Unilever and Foreign, Commonwealth and

Development Office, WHO, UNFPA and UN-Habitat.

3. Child Protection:

Coordination: coordination of the child protection area of responsibility continued under the joint leadership of the

government and UNICEF at national and sub-national levels; however, with a decrease in COVID-19 cases in the

country, the working group on child protection was not very active during the reporting period. In KP, the Psychosocial

First Aid (PFA) handbook for humanitarian workers has been finalized by the Child Protection Sub Working Group and

submitted to PDMA for notification. In Sindh and Punjab, annual review meetings with all child protection partners and

stakeholders were also conducted to review the progress and challenges faced during 2021, this also included the child

protection response during the COVID-19.

Response: UNICEF and its partners have trained a total of 11,843 social workforce professionals (7,245 women

and 4,598 men) in psychosocial support and stigma prevention in all the provinces through a package developed by

UNICEF, reaching to 994 social and care workers (735 women and 259 men) during the reporting period in KP. A total

of 380,704 children, caregivers and other community members (74,660 girls, 64,103 boys, 125,412 women, 116,529

men) received psychosocial support by trained social workforce professionals in Punjab, KP, Sindh, Baluchistan, GB

and AJ&K with 35,583 reached within the reporting period (Punjab: 640, KP: 1,828 and Sindh: 33,115). This includes

965 individuals (30 girls, 40 boys, 408 women and 487 men) who received specialized counselling sessions in all the

provinces.

Messages on stigma and violence against children have reached a total of 13,648,757 people including

1,244,121 people during the reporting period. The total number of children who received child protection services

supported by UNICEF has reached 4,265 children (1,784 girls and 2,481 boys), including 172 children (58 girls and 114

boys) who received child protection services during the reporting period.

Gaps and Challenges: Several challenges were observed during the reporting period, which have delayed or slowed

down the pace of implementation. In Punjab, difficulty was faced in conducting community sessions due to closure of

schools/institutes as per government recent directives due to dense situation of smog in Lahore. In Sindh, Mental Health

and Psychosocial Support (MHPSS) is still not recognized as an area of importance and this continues to hinder the

engagement of frontline workers in capacity building initiatives run by the Health and Social Welfare Department. In KP,

strengthening the delivery of non-specialized mental health services through frontline workers in various sectors remains

critical, and efforts are being made to systematise and improve capacity building of frontline workers for better results.

Partnerships: Ministry of Human Rights, Ministry of Planning, Planning Commission, Provincial Social Welfare

Departments, Child Protection and Welfare Bureau Punjab, Child Protection and Welfare Commission, Provincial

Departments of Health, National and Provincial Disaster Management Authorities (N/PDMA), Civil Society Organisations,

UNHCR, UNFPA among others.

4. Health:

Coordination: As a frontline partner of Government of Pakistan in COVID-19 response, UNICEF is working closely with

MONHSR&C, Provincial and Regional Health Departments, UN partner organizations, H5 partners, Health Development

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partners, Academia and CSOs since the start of the pandemic. UNICEF Health Section is closely working with supply

section and MONHSR&C on forecasting, planning, procurement and distribution of COVID-19 supplies including PPEs,

cold chain and oxygen equipment’s. UNICEF is very closely coordinating with National Ministry of Health and provincial

health departments on UNICEF procurement services for COVID-19 related supplies to the Government of Pakistan.

Response: UNICEF is supporting provincial and regional health departments to ensure continuity of essential primary

healthcare services including immunization, ante-natal care (ANC), post-natal care (PNC), delivery services, childcare

and curative care for adults in 136 targeted health facilities reaching 461,182 people during the reporting period

(Balochistan: 6,281; Sindh: 191,227; KP: 2,865; Punjab: 252,282, AJK: 8,000, GB 527) with a total reach of 5.1 million

people. Measles immunization reached a total of 5,477 children under one year old (Balochistan: 281; Sindh: 333;

Punjab: 4,863;) during the reporting period with a total of 138,487children vaccinated against measles in the 136

UNICEF supported health facilities to date. UNICEF has provided basic PPEs (gloves, sanitizers and masks) to 25,662

frontline health workers with 187 reached during this month.

UNICEF-supported IPC training reached 17,185 frontline health workers in total, with 1,533 health workers trained during

the reporting period. UNICEF supported the training of 10,387 frontline health workers and community volunteers on

COVID-19 and case identification and referral of suspected cases with 1,571 trained during the reporting period

(females: 723, males: 848). Clinical Management of Children with COVID-19 training was provided to a total of 1,732

paediatricians trained.

Gaps and Challenges: Vaccination coverage in some of the geographical areas like Balochistan is very low with only

6 per cent males and 2 per cent females fully vaccinated against the target population verses 40 per cent (men) for

males and 28 per cent (women) fully vaccinated against the target population in Islamabad Capital Territory. Gender

disparities in COVID-19 vaccine uptake are across the country where only 13 per cent women compared to 19 per cent

men, are fully vaccinated against COVID-19.

Non-Compliance to Public Health and Social Measures (PHSM) is continued also lifting of general restriction on markets

and opening of schools may put the country at risk of resurgence of new cases and the omicron variant, which can be

avoided with appropriate RCCE measure for PHSM compliance.

Partnerships: GAVI, MoNHSR&C, Federal and Provincial EPI and provincial and regional health departments and the

National EOC on polio. Health Service Academy, Pakistan Paediatric Association, Pakistan Medical Association, Public

Health Association, Family Physician Association of Pakistan, Sir Ganga Ram Hospital, SARHAD (a CSO), PHC Global,

Aga Khan Foundation and Agha Khan Development Network, in GB and Health Services Academy, Premier Advertisers,

for COVID-19 pandemic response.

5. Nutrition:

Coordination: Sector coordination continued under the joint leadership of the Government of Pakistan and UNICEF.

To coordinate and oversee the nutrition response to the COVID-19 pandemic, a total of 4 meetings of Nutrition Working

Group (NWG) took place during this period, 2 at National and 2 at the sub-national level (Punjab 1 and Baluchistan 1).

European Commission Humanitarian Aid and Civil Protection department (ECHO) top up funds have been received for

Afghan refugees and are programmed in KP and Balochistan.

National level consultative meeting held on the orientation of the National Nutrition Action Plan to nutrition key

stakeholders followed by dissemination and endorsement of Nutrition investment case on 4th November 2021.

National Emergency Operation Center schedule the plan to administer Vitamin A Supplementation (VAS) to children

along with Polio national immunization days in December 2021. The target calculated for VAS campaign is around 35

Million children from 6-59 months of age. Vitamin A Taskforce meeting conducted on December 1st 2021 to review the

VAS program and its challenges during 2021.

Response: In the reporting month, a total of 3,076 UNICEF-supported Outpatient Therapeutic Programme (OTP)

sites provided nutrition services (Balochistan: 183; KP: 125; Punjab: 1,755; Sindh: 1,013). Around 450,762 (boys:

224,489 and girls: 226,273) children of 6-59 months of age screened for malnutrition using mid upper arm circumference

at nutrition sites (Balochistan: 62,229, KP: 42,177; Punjab: 214,193 and Sindh: 132,163) in the reporting month. Similarly,

a total of 64,372 SAM children (boys: 29,246 and girls: 35,126) have been admitted for SAM treatment. In the reporting

month 7,103 (boys: 3,216; girls: 3,887) children newly enrolled for the treatment of SAM in OTP sites (Balochistan:

3,774; KP: 3,329 and Sindh: data not received). Moreover, a total 586,132 children 6-59 months (boys: 287,366; and

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girls: 298,766) received Multi-micronutrient supplementation, including 52,381 children (boys: 25,621 and girls: 26,760)

in the reporting period with the provincial breakdown as follows: Balochistan: 37,826; KP: 14,555 and Sindh: data on

MMS not received.

With UNICEF’s support, counselling on IYCF practices in the COVID-19 context through Lady Health Workers and other

community-based networks conducted in the community and reached 24,092 pregnant and lactating women

(Balochistan: 17,905; and KP: 6,187) during this period through community engagement efforts.

Gaps and Challenges: Funding issues at KP and warehousing in Balochistan were major challenges during the

reporting period.

Partnerships: To respond to COVID-19, UNICEF is working with MONHSR&C, Provincial Health Departments, Ministry

of Planning Development and Reform, WFP, WHO, Nutrition Development Partners, CSOs UN, Scaling UP Nutrition

(SUN) networks, NDMA, PDMA, Pakistan Paediatrics Association and Pakistan Gynaecologist Association.

6. Education:

Coordination: UNICEF continued to support as co-lead of Education in Emergency (EiE) the response coordination

with Federal and Provincial Education ministries/departments and humanitarian organizations, UN agencies and

development partners for continuity of learning during school closure and adherence to SOPs (Standard Operating

Procedures) for safe re-opening of schools.

After a careful and independent review of seven grantee applications by the Grantee Selection Committee (GSC), three

organizations have been selected as a grantee for the Education Cannot Wait (ECW) MYRP (Multi Year Resilience

Programme) seed funding of 13.2 million. UNICEF is selected as one grantee in KP to support over 76,000 children for

three years with USDs 5.5 million. Inputs of three selected grantees, with the MYRP Development Committee and

grantees, are now collected to the finalization of the MYRP proposal to ECW.

With UNICEF support, a two-day capacity building training on EiE was conducted for ESWG (Education Sector Working

Group) members from 29th to 30th November in Quetta Balochistan with the collaboration of School Education

Department (SED) Balochistan. The training was focused to strengthening knowledge and skills of ESWG members on

coordination, preparedness, needs assessment /analysis, harmonized response planning, implementation, school

safety plan and monitoring of EiE. The training was attended by 30 EiE Sector Working Group (ESWG) members,

including representatives of Government of School Education Department of Balochistan, UN, INGO, CSO. Resource

persons of the training were from SED, Balochistan, Inter-agency Network for EiE, Global Education Cluster and

UNICEF. The next steps are to revamp EiE/DRR working group in Balochistan, develop contingency planning and, EiE

best practices document for Balochistan.

Response: UNICEF works with national and local education authorities to ensure safe school operations through the

implementation of SOPs, guidelines and the use of appropriate training manuals / packages. 5,233 teachers

and Education officers (2,782 women) accessed training in safe reopening and operation of schools, bringing the total

number of teachers/education officers trained on safe reopening /operation reached to 16,481 (6,732 women) across

Pakistan. In Sindh, 3,313 members of village education committee (462 women) were trained on safe reopening of

schools. In addition, 356 teachers and Education officers (129 women) accessed training on Mental Health and

Psychosocial Support, taking the total number of teachers/officials trained to 22,588 (10,158 women) across Pakistan.

To encourage learning activities of students, an additional 11,329 parents have been reached with encouraging

messages for enrolment/ attendance of children through SMS and different social media platforms, increasing the total

number of parents reached to 587,341 across Pakistan. In Sindh SMS on vaccination for teachers/education officials

and COVID-19 SOPs for safe school reopening sent to 40,589 teachers/education officials (15,412 females). SMS also

sent to 147,947 parents/guardians of students on vaccination and COVID-19 SOPs related to educational institutions.

UNICEF continued to support dissemination of student vaccination resources that include fliers, posters, and banners.

To support digital Learning Initiative, rubric for teachers and students under finalization and training of 10 pilot schools

to be carried out in the second week of December.

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Otermans Institute supported 17 weeks online training started from 17th November 2021, with online training is provided

to 100 students (39 girls) from Punjab and Sindh and focused on functional English, build basic soft skills and

communication skills.

Supply and Procurement Services

Under the COVAX facility, a total of 43,851,320 COVAX vaccines have been delivered to Pakistan, along with all

associated devices to undertake the vaccinations. A further allocation of 56,807,710 COVAX vaccines are anticipated

to be delivered during December 2021 and January 2022, this include 32,293,170 doses of Pfizer vaccine. There is a

global shortage of syringes currently, due to the high demand for this commodity type, however 0.5ml syringes required

for all vaccines (apart from Pfizer), are delivered or in pipeline. Pfizer requires a nonstandard 0.3ml syringe, of which 15

million are in pipeline and delivery information is awaited from Supply Division for the remaining quantity. Following

completion of the MR Campaign in the Government of Pakistan is planning a COVID-19 Campaign at the beginning

during December, with the aim of having 70 million people fully vaccinated by the end of 2021. There is therefore a push

to have all syringes available to match the allocation of vaccines made through COVAX, to enable this target to be met.

To add to the current UCC capacity of 41 units that are operational in Pakistan, an additional 100 UCC are being

procured by the Government of Pakistan through Procurement Service modality. The additional UCC are anticipated to

arrive in the country in late December; therefore, installation and commissioning is estimated to be completed by late

January/early February. Currently supply and installation is ongoing of generators and air conditioners that will be

needed to support the functioning of the UCC.

Humanitarian Leadership, Coordination and Strategy NATIONAL COORDINATION The National Security Committee, chaired by the Prime Minister, established a National Coordination Committee (NCC),

to formulate and implement a comprehensive strategy to stop COVID-19 transmission and mitigate its consequences.

The NCC established the NCOC to synergize and articulate a unified national effort to respond to the COVID-19

pandemic, and to implement NCC’s decision. It also designated the NDMA as the leading operational agency. In each

province, the Chief Ministers have convened task forces to coordinate the response, with the PDMA as the leading

provincial operational agency. Furthermore, the Emergency Operation Centre (EOC) at the National Institute of Health

has been activated as an Incident Command and Control Hub. A technical working group with three sub committees for

RCCE, supply/cold chain and vaccine logistic and surveillance of Adverse Event Following Immunization (AEFI) have

been established at Federal EPI. They regularly report on the readiness level to the MoNHSRC.

UNICEF contributed to the development of the National Vaccine Deployment Plan, prioritization of eligible populations

for vaccination and application for COVAX vaccines exercise, National Immunization Technical Advisory Groups

(NITAG) and National Interagency Coordination Committee (NICC).

UN COORDINATION

The UN in Pakistan has established a Crisis Management Team comprising of: WHO; UNICEF; WFP; UNHCR; UNFPA;

IOM; UNOCHA; UNDP; UNAIDS; DSS and the RC which meets every Friday. For COVID-19 vaccine introduction,

together with national authorities, WHO, World Bank and donors, UNICEF is part of the country Technical working group

and sub committees on cold chain/vaccine logistics and RCCE. UNICEF is supporting the planning for cold chain and

vaccine need assessment and procurement, as well as RCCE.

UNICEF’s Response Strategy

UNICEF Pakistan is working through a multipronged response strategy which includes: (1) public health response to

COVID-19; (2) continuity of essential services; and (3) mitigation of the socio-economic impact of COVID-19. To support

breaking the current chain of transmission, the public health response is focused on the high burden cities which are

most affected with the highest number of new COVID-19 cases and high case test positivity rates since March 2021 –

the 4th wave of COVID-19 in Pakistan.

Public health response to COVID-19

• C4D, Community Engagement and AAP: to provide timely and accurate information to families and

communities and promote behaviour to reduce risk and limit transmission during the second wave of COVID-

10

19 cases. For the third wave response, particular focus will be given to adapt according to the epidemiology and

leverage four platforms including 1) Civil society (prioritizing AJK and GB), 2) Religious leaders’ engagement

and mobilization, 3) Polio Networks mobilizing the community-based volunteers and 4) Youth Groups to be

engaged for peer-to-peer awareness.

• Water sanitation and Hygiene through (a) Water Sanitation and Hygiene (WASH) support to targeted primary

health facilities, quarantine and isolation centres and in the communities and (b) protection of frontline health

workers.

• COVID-19 Vaccine introduction and Deployment: UNICEF as a member of technical working group is

providing support for preparation of COVID-19 vaccine, procurement and deployment including risk

communication and awareness raising as well as support for cold chain. UNICEF is also part of the COVAX

consortium comprised of GAVI, WHO, CEPI and UNICEF that is supporting Pakistan in the scale up of the

COVID-19 vaccination.

• Procurement services in support of the Government to ensure timely sourcing and availability of quality

essential medical supplies and personal protective equipment (PPE).

• Child protection, to ensure children and families of cases and contacts affected by COVID-19 are provided

with appropriate care and psychosocial support, and for stigma prevention.

Continuity of essential services

• Education to ensure teachers, parents and students are informed about COVID-19, continuity of learning and

facilitate safe reopening of schools and learning education institutions.

• Health for managing mild cases and referral of severe cases with the aim to strengthen primary healthcare

(PHC) system and ensure continuity of life saving basic health services like MNCH and immunization.

• Nutrition with the aim to ensure access to promotional, preventive and curative nutrition services to people

affected by and people at risk of Coronavirus infection, with a focus on nutrition vulnerable groups. Nutrition

Emergency: Similar approach is to be adopted to ensure nutrition services in selected high burden malnutrition

districts. It is also important to note that UNICEF in partnership with the government will functionalize nutrition

facilities across country by making them safe through provision of PPEs and thus will leverage recourses of

Government and secure same services for children with malnutrition.

Mitigation of the impact of COVID-19

• Advocacy through (a) parliamentary engagement on child sensitive budgeting, (b) national and provincial

advocacy, including joint advocacy with other un agencies and partners, in support of the COVID-19 socio-

economic impact framework and plan, and (c) implementation of the UNICEF Pakistan advocacy plan ‘response

and recover’ to COVID-19.

• Evidence generation on (a) multi-dimensional child poverty analysis to influence policy action and allocations,

(b) development of nutrition sentinel surveillance system to provide routine information on nutrition and inform

policy and programme action and (c) VAC study to identify and respond to violence against children due to the

COVID-19 response.

• Systems development: (a) continuing engagement in the finalization of the universal health benefit package

and tools that are covid-19 sensitive, (b) education sector analysis and planning, (c) provision of alternative care

for children without parental / family care and (d) positioning of Civil Registration and Vital Statistics (CRVS) in

the context of COVID-19.

• Social protection: technical / advisory support (studies) to the emergency cash transfer scheme on children to

inform medium term policy action on child-sensitive social protection programme in Pakistan.

Human Interest Stories and External Media UNICEF ROSA Regional Director George Laryea-Adjei joined a mission of the Polio Oversight Board to Pakistan. He

met with a wide range of officials and went on several field visits to see the ongoing Measles, Rubella and Polio

campaign targeting more than 90 million children across Pakistan; he visited a basic health unit where vulnerable

families can access an essential package of services as part of the Integrated Service Delivery model piloted by UNICEF

in districts at high risk of polio; he toured an alternative learning programme center where children who dropped out of

school, or have never been, can access primary and secondary education.

11

UNICEF documented the launch of a nation-wide measles rubella campaign was launched in presence of the Special

Advisor to the Prime Minister. One of the largest in history, it targets more than 90 million children and is led by

MoNHSR&C with support from UNICEF, WHO and GAVI. UNICEF is supporting communication efforts around the

campaign. A video featuring little Muhammad Raza, Hunza Mountains’ ’dancing boy’ calling on every child to be

immunized, was shared om social media.

As part of the ongoing COVID-19 response, UNICEF worked on closing

the gender gap in vaccination, as only one-third of people vaccinated

are women. A dozen video messages were recorded by Pakistan

celebrities, most of them women, to call on women to get the jab, and

broadcast on social media. UNICEF documented the delivery of more

than 2.3 million doses of US-donated Pfizer COVID-19 vaccines, 2.7

million doses of Sinopharm, 1.5 million doses of German-donated

Moderna and 393,000 doses of German-donated AstraZeneca - all

delivered via COVAX with UNICEF support.

On World Children’s Day, UNICEF organized an official event in presence of President of Pakistan Dr. Arif Alvi, Minister

for Human Rights Dr. Shireen Mazari, UNICEF Representative in Pakistan Ms. Aida Girma, and more than 20 children

and adolescents who came from across the country. The event was partially broadcast live on TV channels. Some of

the children and adolescents spoke on stage, and all of them

participated in several videos which were broadcast during the event and

will be disseminated online for UNICEF75. An Op-ed from the

Representative was published in media. In the evening of 20, UNICEF

turned 34 buildings in 6 cities across Pakistan, in partnership with the

Ministry of Human Rights. These included all Government ministries, the

Supreme Court, the national and provincial assemblies, private sector

buildings, historical landmarks (e.g. Lahore Fort, Lahore Walled City

Gate, Residency & Mausoleum of Pakistan's founding Father

Mohammed Ali Jinnah), universities, etc. resulting in wide coverage in

the press.

UNICEF documented a visit of the Representative Ms. Aida Girma to Gilgit Baltistan, where she visited several projects

and participated in the launch of the results of the national Child Labour survey for Gilgit Baltistan, and of the Equity &

District profiles.

As part of the Education programme, UNICEF documented the launch of the five-year Balochistan Education Support

II (BESII) programme funded by the European Union (EU) and UNICEF, which follows up on the five-year Balochistan

Basic Education Programme (BBEP) initiated with EU support in 2016. As part of the Health programme, UNICEF

documented the donation of 23 Vaccination Vans to EPI and issued a press release about pre-term birth.

Press Releases

Pakistan to immunize more than 90 million children against measles and rubella

Government of Gilgit Baltistan launches Equity & District profiles with UNICEF support

Gilgit-Baltistan Child Labour Survey Report Launched

Balochistan Launches Education Programme supported by European Union and UNICEF

EPI Receives 23 Vaccination Vans from UNICEF

Preterm Birth Complications is One of the Main Causes for Under Five Child Mortality in Pakistan

Social Media LINKS

Regional Director’s Visit

Link 1 (English Post), Link 2 (English Post), Link (Urdu Post)

World Children’s Day 2021 posts

Video of the event: Link

Event: Link

Messages from 3 adolescents at the event: Link

Op-Ed from UNICEF Representative: Link

12

Turn the World Blue

Video: Link

Photo with children: Link

English thread with photos of all monuments: Link

Urdu thread with photos of all monuments: Link

Measles Rubella campaign

Video of Muhammad Raza, Hunza Mountains’ ‘dancing boy’: Link

Video of the launch: Link

English Posts:

English posts: Link 1,

Urdu post: Link 1, Link 2

COVID-19 vaccination campaign, videos from celebrities

Uroosa Sidiqqi: Link

Anmol Baloch: Link

Imran Abbas: Link

Nadia Hussain: Link

Natasha Baig: Link

COVAX COVID-19 Vaccine Shipments

US-donated Pfizer COVID-19 vaccines: English Link, Urdu Link

German-donated Moderna COVID-19 vaccines: English Link, Urdu Link

Sinopharm and German-donated AstraZeneca COVID-19 vaccines: English Link, Urdu Link

Visit of UNICEF Representative to Gilgit Baltistan: English Link, Urdu Link

Launch of the results of the national Child Labour survey for Gilgit Baltistan:

Video: Link

Post: Link

Launch of the Equity & District profiles survey in Gilgit Baltistan:

Video: Link

Press release:

Post: Link

Education

Launch of the World’s Largest Lesson in Pakistan: Link 1, Link 2

Next SitRep: 1st February 2022

Who to contact for further information:

Ms. Aida Girma Country Representative Pakistan Tel: +92 300 854 4275 Email: agirma@unicef.org

Mr. Innousa Kabore Deputy Representative Pakistan Tel: +92 345 500 6578 Email: ikabore@unicef.org

Dr. Hari Krishna Banskota Chief of Health Pakistan Tel: +92 301 856 4602 Email:hbanskota@unicef.org

13

Annex A Summary of 2021 Programme Results

UNICEF and Operational partners Task Force /Sector

Sector Target* Gender Results Change since last report ▲▼

Target Results Change since last report ▲▼

C4D, Community Engagement and Accountability to Affected People

People engaged through social media

550,000 Total 126,470 310,528▼

People reached (through national Media channels) with messages (on COVID-19 prevention and) on access to services

75,000,000 Total 71,685,566

11,500,000▲

At-risk populations reached through community engagement activities.

7,000,000 Total

15,244,913 1,200,000▲

Callers through the national Helpline who shared relevant concerns, received clarifications, and provided feedback.

3,000,000 Total 3,404,235 370,000▲

Water Sanitation and Hygiene

People at high risk of COVID-19 supported with hygiene promotion activities.

2,706,253

Males 1,102,714

Female 1,147,723

Total 2,250,437 233,328▲

Children accessing appropriate water, sanitation and hygiene facilities and hygiene services in learning facilities and safe spaces.

242,500

Boys 185,604 0

Girls 193,180 0

Total 378,784 51,604▲

Health facilities provided with essential WASH services.

430 Total 111 0

Community sites with handwashing facilities in the affected areas.

1,658 Total 1,070 64▲

Child Protection, GBViE and PSEA

Children and caregivers accessing mental health and psychosocial support.

445,333

Males 116,529 1,646 ▲

621,107

116,529 1,646 ▲

Female 125,412 1,595 ▲ 125,412 1,595 ▲

Boys 64,103 11,068▲ 64,103 11,068▲

Girls 74,660 21,274▲ 74,660 21,274▲

Total 380,704 35,583 ▲ 380,704 35,583 ▲

People reached with prevention messages on stigma and violence against children, including gender-based violence.

18,025,391 Total 13,648,757 1,244,121▲ 19,563,42

1 13,648,757 1,244,121▲

Children and adolescents who received child protection services, including gender-based violence services.

5,500

Boys 2,481 114▲

49,443

2,481 114▲

Girls 1,784 58▲ 1,784 58▲

Total 4,265 172▲ 4,265 172▲

Number of social and care workers trained on psychosocial support and stigma reduction.

10,234

Males 4,598 259▲

17,057

4,598 259▲

Female 7,245 735▲ 7,245 735▲

Total 11,843 994▲ 11,843 994▲

Education

Children accessing safe formal and non-formal education, including ECE.

533,451

Boys 38,393

0

1,040,803

0

Girls 40,738

0 106,131 0

Total 79,131

0 0

Schools (formal and non-formal) implementing safe school protocols (infection prevention and control).

5,335 Total 1,181 0 9,736 1,217 0

14

Teachers /education officials trained on MHPSS (Mental Health and Psychosocial Support)

10,675

Males 12,430 227

16,687

12,692 227

Female 10,158 129

10,462 129

Total 22,588 356 23,149 356

Teachers /education officials trained on safe reopening/operation of schools

10,675

Males 9,749 2,782

16,687

9,749 2,782

Female 6,732 2,451 6,732 2,451

Total 16,481 5,233 16,481 5,233

Parents reached with messages encouraging learning activities (through SMS and different social media).

1,067,541 Total 587,341 11,329 2,133,804 613,363 11,329

Health

Number of people benefitting from continuity of primary healthcare services at UNICEF supported health facilities

3,511,636

Males 151,469▲

Females 188,850▲

Boys 54,573▲

Girls 656,290▲

Total 5,060,368 460,655▲

Number of children < 1 vaccinated against Measles

247,242

Boys 2,791▲

Girls 2,686▲

Total 133,010 5,477▲

Number of frontline health workers reached with basic PPEs (masks, gloves and hand sanitizers)

150,000

Males 100

Females 87

Total 25,662 187

Health care facility staff and community health workers trained on infection prevention and control

20,000

Males 822▲

Females 711▲

Total 17,185 1,533▲

Number of frontline health workers and community volunteers oriented on COVID-19 and referral of suspected cases

50,000

Males 848▲

Females 723▲

Total 10,387 1,571▲

Number of Paediatricians & Family Physicians Trained on Clinical Management of Children with COVID

2,000

Males 3▲

Females 0

Total 1,732 3▲

Nutrition

Children aged 6 to 59 months with severe acute malnutrition admitted for treatment

102,413**

Boys 29,246 3,216▲

167,857

81,312 3,216▲

Girls 35,126 3,887▲ 99,640 3,887▲

Total 64,372 7,103▲ 99,640 7,103▲

Primary caregivers of children aged 0 to 23 months receiving infant and young child feeding counselling

1,607,460***

Total 909,101 109,332▲ 1,904,864 1,880,214 109,332▲

Children aged 6 to 59 months receiving multiple micronutrient powders

813,940

Boys 287,366 25,621▲

813,940

387,229 25,621▲

Girls 298,766 26,760▲ 388,183 26,760▲

Total 533,751 52,381▲ 775,412 52,381▲

Leveraging resources and working with government and partners helped Health, Education, WASH, CP and C4D in getting better results

Cumulative Response COVID-19

UNICEF Results Sector Results

Sector 2020 2021 Cumulative 2020 2021 Cumulative

Risk Communication and Community Engagement (C4D)

15

People engaged through Social Media 41,895 126,470 126,470

People reached (through national Media channels) with messages (on COVID-19 prevention and) access to services

83,000,000 71,685,566 154,685,566

At-risk populations reached through community engagement activities.

37,102,079 15,244,913 52,346,992

# of callers through the national Helpline shared relevant concerns, received clarifications, and provided feedback.

5,428,871 3,404,235 8,833,106

Infection Prevention and Control (WASH)

People at high risk of COVID-19 supported with hygiene promotion activities and facilities

10,247,624 2,250,437 12,498,061 28,330,000 2,250,437 30,580,437

Children accessing appropriate WASH facilities and hygiene services in learning facilities and safe spaces.

701 378,784 379,485 1,477 378,784 380,225

# of community sites with handwashing facilities in the affected areas

2,138 111 2,249 3,767 111 3,878

# of schools in targeted high-risk areas supported with IPC measures and improved water and sanitation

1,352 1,070 2,422 1,750 1,070 2,820

Psychosocial Support and Child Protection

Children and caregivers accessing mental health and psychosocial support

216,144 380,704 596,848 219,007 380,704 599,711

People reached with prevention messages on stigma and violence against children, including gender-based violence

57,532,480 13,648,757 71,181,237 63,863,751 13,648,757 77,512,508

Children and adolescents received child protection services, including gender-based violence services

1,176 4,265 5,441 1,176 4,265 5,441

Social and care workers trained on psychosocial support and stigma reduction

8,290 11,843 20,133 8,388 11,843 20,231

Education

Children accessing safe formal and non-formal education, including ECE.

79,131 79,131 158,262 8,814,507 1,040,803 9,855,310

Schools (formal and non-formal) implementing safe school protocols (IPC).

0 1,181 1,181 0 9,736 9,736

Teachers /education officials trained on MHPSS

28,258 22,588 50,846 538,494 16,687 555,181

Teachers / education officials trained on safe reporting/ operation of schools

3,035 16,481 19,516 3,035 16,687 19,722

Parents reached with messages encouraging learning activities (through SMS and social media).

278,857 587,341 866,198 354,864 2,133,804 2,488,668

Building Resilient Health Systems

Number of people benefitting from continuity of primary health care services at UNICEF supported health facilities

3,459,844 5,060,368 8,520,212

Number of children < 1 vaccinated against Measles

215,241 133,010 348,251

Number of frontline health workers reached with basic PPEs (masks, gloves and hand sanitizers)

104,565 25,662 130,227

Number of frontline workers trained on infection prevention and control

137,079 17,185 154,264

16

Number of frontline health workers and community volunteers oriented on COVID-19 and referral of suspected cases

92,273 10,387 102,660

Number of Paediatricians & Family Physicians Trained on Clinical Management of Children with COVID

0 1,732 1,732

Nutrition

Children aged 6 to 59 months with SAM admitted for treatment

161,702 64,372 226,074 228,819 99,640 328,459

Primary caregivers of children aged 0 to 23 months receiving IYCF counselling

1,575,965 909,101 2,485,066 1,898,018 1,880,214 3,778,232

Children aged 6 to 59 months receiving MM powders

0 533,751 533,751 0 775,412 775,412

Annex B

Funding Status:

Sector Requirements

Funds available Funding gap

*Humanitarian resources received in 2021

Other Resources used in 2021

2020 carry forwarded funds

$ %

Nutrition 18,235,897 300,000 115,000 3,011,199 14,809,698 81%

Health 6,822,354 1,885,763 0 2,326,955 2,609,636 38%

Water, sanitation and hygiene 13,267,318 0 1,956,868 376,892 10,933,558 82%

Child protection, GBViE and PSEA

11,310,084 85,749 921,950 882,589 9,419,796 83%

Education 4,708,089 0 762,913 9,731 3,935,445 84%

C4D, community engagement and AAP

5,886,000 290,597 0 444,509 5,150,894 88%

Emergency preparedness 1,177,200 64,251 0 28,787 1,084,162 92%

Total $ 61,406,942 $2,626,360 $3,756,731 $7,080,662 $47,943,189 78%

*Funding received in 2021 includes HQ allocations to HAC appeal.