Submission Date: Aug 17, 2018

Second Submission: Sept 04, 2018.

Contract Number: AID-696-A-16-00001

Submitted to: AOR Name: Mary de Boer

Submitted by: Alemayehu Gebremariam, Chief of Party Catholic Relief Service - USCCB Nyarugenge - 2nd Floor, Chadel House Tel: +250 788 309 289 Email: Alemayehu.Gebremariam@crs.org

This document was produced for review by the United States Agency for

International Development Rwanda (USAID/Rwanda).

Gikuriro Program

ANNUAL WORK PLAN Oct 1, 2018 to Sept 30, 2019

1. ACRONYMS AND ABBREVIATIONS BIAT Bio-Intensive Agriculture Techniques CBEHPP Community Based Environmental Health Promotion Plan CBF&NP Community Based Food and Nutrition Plan CGS Community Giant Scoreboards CIP International Potato Centre CHW Community Health Workers DPEM District Plan to Eliminate Malnutrition DQC Data quality checklist ECD Early childhood development EHO Environmental and Hygiene Officer FBO Faith Based Organization FFLS Farmer Field Learning School GMP Growth Monitoring and Promotion HBM Health Belief Model HMIS Health Management Information Systems IEC Information Education Communication IGA Income Generating Activities IPC Interpersonal communication KSPI Knowledge Skills Practice and Incentive LCSO Local Civil Society Organizations MCH Maternal and Child Health MUAC Mid-Upper Arm Circumference NECDP National Early Childhood Development Program OFSP Orange Fleshed Sweet Potato PSP Private Service Provider RAB Rwanda Agricultural Board RHCC Rwanda Health Communication Center RURA Rwanda Utilities Regulatory Authority SBC Social and Behavior Change SCT Social Cognition Theory SEDO Social and Economic Development Officers SHC School Health Clubs WASH Water Sanitation and Hygiene WQAP Water Quality Assurance Plan YWCA Young Women Christian Association

2. ACTIVITY DESCRIPTION 2.1 Activity information

Activity Title GIKURIRO – Integrated Nutrition and WASH Activity

Contract/Agreement Number AID-696-A-16-00001

Name of Prime Implementing Partner CRS – USCCB

Name(s) of Subcontractor(s)/Sub awardee(s)

Sub-recipient: SNV

Local Partners: CARITAS, FXB, AEE, YWCA, FVA, DUHAMIC

Activity Start Date November 10th, 2015

Activity End Date November 9th, 2020

Work Plan Period October 1, 2018 – September 30, 2019

2.2 Activity theory of change

There are no major changes in Gikuriro Theory of Change (ToC) for the FY19 implementation. However, slight modification in the content of the “IF”, “THEN”, and corresponding results chain due to additional inputs through creation of community water supply and management systems and capacity strengthening efforts to central government which will be aligned with Gikuriro expansion activities.

The program’s ToC states that if GoR’s CBF&NP (Community Based Food and Nutrition Plan) and CBEHPP (Community Based Environmental Health Promotion Plan) programs are fully implemented at district, sector and community levels by skilled and equipped district staff and volunteers; if civil society contributes to these programs in complementary, coordinated and sustainable ways; if central government through NECDP (National Early Childhood Development Program) is assisted to strengthen coordination efforts, if more resources are leveraged to strengthen community water supply and management, if each household member participates fully and equitably in promoting positive nutrition and hygiene behaviors; then sustained demand for nutritious, diverse and fortified foods, as well as hygiene and sanitation supplies and materials will be high enough to attract broad-based community mobilization and private sector investment. With these conditions in place, the nutritional status of women of reproductive age and children under five will sustainably improve. These ToC statements are captured in the following diagram in a logical sequence:

Nutritional status of women of reproductive age and children under five will improve sustainably.

IF

The GoR community-based programs are strengthened and fully implemented at district, sector and community levels by Gikuriro trained, coached, supervised and equipped district staff (district health unit and hospital staff) and volunteers motivated to conduct community activities.

Gikuriro Local Civil Society Organizations (LCSOs) and local partners contribute to these programs in complementary, coordinated and sustainable ways.

Each household (HH) member participates fully and equally in promoting (adopting) positive nutrition, agriculture, saving culture, environmental health, nutrition and hygiene behavior change.

The Gikuriro program team continues to deliver concrete and robust formal and informal capacity building to strengthen all levels of service delivery and activity implementation.

NECDP and Districts are strengthened to coordinate nutrition and WASH services including community water supply system

THEN

The demand and supply for nutritious, diverse and fortified foods, as well as hygiene and sanitation materials, will be high enough to attract broad-based community mobilization and private sector investment.

The adoption of positive behavior change in nutrition and WASH at individual and community level will be realized.

Sustainable systems of coordination and service delivery in place

ULTIMATELY

Gikuriro FY19 interventions will be aligned with the following results chain ranging from inputs, outputs, outcomes to the project’s goal statement:

NECDP and other social cluster ministries assisted to coordinate and lead nutrition and WASH responses Funding for program, facilities and materials provided in a prompt manner. Training programs for key stakeholders and service providers funded. Technical assistance and mentoring provided for technical service delivery, Monitoring, Evaluation, Accountability and Learning (MEAL), financial and program management, as well as general organizational systems strengthening. Curriculum/best practices/lessons identified. Enhanced inter-sectoral commitment for DPEM, Nutrition and WASH in the districts. Increased understanding of vulnerable populations and risk factors for and predictors of poor nutrition and Water, Sanitation and Hygiene (WASH) in the districts. Local partners’ fully coordinating and strengthening service delivery at community level. Enhanced understanding of districts sanitation and waste management challenges through situational analysis. Districts and central government supported to address issues related to access

Effective systems and tools in place to coordinate Nutrition and WASH programs including community water supply DPEM Coordination Committees have strengthened capacity to plan, monitor, evaluate, report and analyze data for effective implementation. District staff technical capacity to implement protocols of CBF&NP and CBEHPP is strengthened. Districts have the skills and systems necessary to support and motivate community workers (CHWs and CHC members). Gikuriro sub-partners and USAID LCSOs staff have nutrition and WASH technical competencies to implement CBF&NP and CBEHPP. Gikuriro sub-partners and USAID LCSOs staff have competencies to effectively take gender dynamics and opportunities into account when implementing nutrition and hygiene programming. Gikuriro sub-partners and USAID LCSOs have the institutional capacity to implement CBF&NP and CBEHPP. HHs equitably access a diverse and quality diet. HHs adopt optimal maternal, infant and young child nutrition practices. Children under five receive all primary care services under CBF&NP. Husbands support women of reproductive age to practice recommended health seeking behaviors. Men, women, boys and girls practice key hygiene, sanitation and water handling behaviors. HHs have increased access to improved sanitation facilities. HHs have improved access to drinking water, water treatment and storage inputs.

Changed/improved capacity of district and Gikuriro sub-partners and USAID LCSOs staff and behavior or practice including increased uptake of nutrition and WASH best practices. Capacity of service providers and districts to achieve improved nutrition outcomes is strengthened. HH level nutrition and WASH behaviors are improved in the eight districts.

Nutritional status of women of reproductive age and children under five years of age will be improved in the eight districts.

2.3 Overarching activity objectives and expected key result areas

Besides the original four sub-intermediate results and 13 outcomes, Gikuriro included a fifth sub-intermediate result to strengthen the capacity of GoR at central level where three specific outcomes have been articulated. Furthermore, one additional outcome each has been added to sub-IR 1.1 and 1.2 respectively to reinforce the local government and partners’ capacity on community water supply system. In FY19, Gikuriro will align its interventions to a total of 18 outcomes under five sub-IRs, all of which are ultimately geared towards improving nutritional status of children and women of reproductive age. Below is an outline of these broader objectives and descriptions of how the proposed FY18 activities are envisaged to strengthen the delivery of nutrition and WASH services.

Goal: The goal of Gikuriro is to improve the nutritional status of women of reproductive age and children under five years of age, with an emphasis on the 1,000-day window of opportunity from pregnancy until a child’s second birthday.

Strategic Objective: In line with the USAID multi-sectoral nutrition strategy, Gikuriro strategic objective is to have the nutritional status of women of reproductive age and children under five years of age improved.

Expected results: Gikuriro will implement activities that will lead to two intermediate results.

● IR1 Capacity of service providers and districts to achieve improved nutrition outcomes strengthened.

● IR2 Household level nutrition and WASH behaviors improved.

FY19 marks a critical stage in Gikuriro implementation as the program activities are expected to mature and outcome level results should burgeon across intervention domains. The following highlights from routine data demonstrate remarkable progress against many output and outcome level indicators from the first three years of implementation.

● 12,625 children under the age of five and their caregivers were enrolled into VNS sessions for follow up and focused BCC interventions

● 4,563 children under the age of five rehabilitated from moderate malnutrition through VNS

● Over 134m Rwf in savings and social funds among 1340 Savings Groups where much of the resources have been redistributed in loans to finance over 8000 IGAs (Income Generating Activity) and address critical HH social/economic needs

● 5,069 Community Health Workers trained on the VNS methodology and Maternal Infant and Young Child Nutrition (MIYCN)

● 47,700 improved latrines constructed ● 77,733 handwashing stations established ● 12,702 CHCs’ facilitators trained on CBEHPP across 3000 villages in the eight districts

Findings from Gikuriro annual beneficiary survey also confirmed that significant positive changes have been recorded against major indicators including increased HH assets, nutrition service uptake, dietary diversity, access to sanitation facilities, hand washing practice.

In FY19, Gikuriro will consolidate the ongoing initiatives to maximize nutritional outcomes and establish a strong foundation for sustainability of services and systems beyond project life. The consolidation and refinement of systems and services will be informed by existing and new

evidence including findings from Gikuriro mid-term evaluation, internal learning exercises, external relevant studies and guidelines. Accordingly, ongoing nutrition and WASH services will be further strengthened through enhanced technical mentoring and accompaniment of service providers, increased motivation of project participants through concerted SBCC and enhanced quality of services, and improved linkages and integration of service delivery both at community and higher levels. In FY 19, additional inputs will be provided to project participants to increase agricultural productivity, SILC engagement, HH asset diversification, adoption of positive nutrition and WASH behaviors through innovative VNS and CHC interventions. One of the innovations will include creating linkages between the VNS and GMP activities and home-based ECD (Early Childhood Development) services by utilizing the contact opportunities to promote positive parenting education and child stimulation/play activities during these sessions. The program will incentivize group members by introducing productive activities (e.g. group IGA, food processing skills, handcrafts) into VNS and FFLS (Farmer Field and Learning School) sessions and making nutrition and WASH BCC messaging more tailored, interactive, administered to smaller and more organic groups, and actions oriented.

Gikuriro will put more measurable efforts to strengthen coordination and partnership initiatives (including CHAIN platform) centrally and across the decentralized structures to galvanize resources for effective and sustained nutrition and WASH responses. In FY19, more inputs will be given to DPEM structures in terms of assessing functionality gaps, supporting coordination meetings, organizing cross-learning events, reviewing action plans and strengthening the linkages between districts and lower structures. Gikuriro will provide technical and financial assistance to support NECDP and other relevant actors’ coordination efforts at national level. Based on consultations with the NECDP leadership, Gikuriro will support coordination and review meetings, development of robust monitoring and evaluation systems, linkages between coordination structures at national and decentralized levels, and revision or development of nutrition and WASH related strategies and guidelines.

As part of its expanded WASH activities, Gikuriro will collaborate with local partners and relevant stakeholders to increase access to safe drinking water. In FY19, the program will establish and strengthen water supply management system at decentralized level including supporting WASH board, community water supply committee and linking them to Community Health Club structures for sustainable functionality. Community water supply needs will be explored, and the communities and districts will be supported to leverage water supply infrastructures where critical gaps are identified.

While detailed description of Gikuriro FY19 activities are presented in subsequent narratives and in the budgeted work plan, the above paragraphs summarize key priorities, which will have significant impetus to achieving the programs overarching objectives.

2.4 Links of activity objectives to strategy

Gikuriro interventions will continue to feed to USAID’s Multi-Sectoral Nutrition Strategy vision for 2025 that aims for a world where countries, communities and families have the capacity to achieve and sustain healthy, well-nourished populations. This vision includes reductions in rates of childhood stunting (low height for age) and wasting (low weight for height) and improved nutrition for women, to save millions of lives, increase resilience and realize significant benefits to broad-based economic growth and development. Improvements in WASH and nutrition confer benefits on their own, but their complex interactions are inextricably linked (USAID Water and Development Strategy & Implementation Brief October 2015). The Gikuriro activities

are also aligned with GoR’s CBF&NP and CBEHPP including the seven strategic directions and 23 core nutrition actions.

In FY19, the program will continue to connect with USAID’s vision and integrate nutrition-specific and nutrition-sensitive actions that positively influence nutrition outcomes. These actions vary from the implementation of the CBF&NP and MIYCN to Bio-Intensive Agriculture Techniques (BIATs) through Farmer Field Learning Schools (FFLS), economic strengthening through Saving and Internal Lending Communities (SILC), promoting WASH through the CBEHPP, strengthening community water supply system, ensuring good coordination among stakeholders and delivering evidence based BCC messaging to address the multifaceted aspects of malnutrition at individual and community levels.

2.5 Target beneficiaries

In FY19, Gikuriro will continue to serve project participant HHs that were identified in the previous years through its established eligibility criteria:

● HHs that have had a malnourished child based on Weight-for-Age (WfA) or Mid-Upper Arm Circumference (MUAC) regardless of Ubudehe categories.

● HHs that are categorized as Ubudehe 1 or 2 with a child under the age of five at the time of selection.

● HHs in Ubudehe 1 or 2 with pregnant women

These group-based services are being delivered in over 2,040 villages across the five districts where integrated activities are implemented. Approximately 45,000 HHs have been targeted with one or more of the group interventions. In FY19, Gikuriro group-based interventions including FFLS, SILC and VNS will continue among these existing HHs to increase nutrition favorable knowledge and practices. While prevention work during the previous years has strong effect in reducing incidence of malnutrition, any new cases emerging from the ongoing community and facility level assessments in FY19 will be enrolled into groups in respective villages to receive appropriate service packages.

Gikuriro SBCC and WASH interventions will continue to target all villages (over 3000) in the eight districts in FY19. Similarly, the community water supply system will leverage resources to support increased access to safe drink water for approximately 36,000 HHs in 360 villages of the eight target districts during this period. Community water management systems will be established and strengthened in these sites and respective districts will benefit from Gikuriro capacity strengthening interventions. Overall, Gikuriro will continue to reach approximately 2.4M beneficiaries directly or indirectly through its nutrition, WASH, and SBCC interventions in FY19.

3. IMPLEMENTATION APPROACH (2-5 pages)

3.1 Key Activities

3.1.1 Capacity of Central Government, Districts and LCSOs strengthened to implement Nutrition and WASH activities

3.1.1.1. Strengthening DPEM coordination committees’ capacity to plan, monitor and evaluate, report and analyze data for effective implementation

During FY19, Gikuriro will focus on activities that address the issue of DPEM functionality from various angles and improve their capacity to plan, monitor, and analyze data for decision and action. Gikuriro will assess district DPEM implementation progress and functionality of the coordination committee to date in the eight districts and identify challenges and bottlenecks encountered in the implementation. Results of the assessment will be disseminated in a national consultative meeting that will be organized with the support of NECDP with high level district authorities. The meeting will propose solutions on the improvement of the DPEM functionality in supporting nutrition interventions and proposed solutions will be cascaded to district and sector level. Gikuriro will support biannual coordination monitoring meetings for districts, quarterly coordination meeting at sector level to analyze nutrition data for decision making and discuss on coordination and reporting issues. Bi annual and quarterly supervision and monitoring at all level by the coordination committee’s will be strengthened for experience sharing and support on improvement. In addition, the village DPEM committee functionality will be reinforced by delivering an orientation on their roles and responsibilities to improve the DPEM committees’ abilities and skills to follow-up nutrition activities at community level. These meetings and other follow ups will be conducted in close collaboration with NECDP and district Scaling Up Nutrition (SUN) committee’s representatives.

3.1.1.2. Strengthening district staff technical capacity to implement protocols of CBF&NP

In FY19, Gikuriro will reinforce supervision mechanisms of district staff on the implementation of CBF&NP protocols with linkages and reporting to DPEM committees. Quarterly Review and planning meetings with partners, hospitals and health center staff involved in monitoring of nutrition activities will be organized to evaluate the level of implementation of CBF&NP activities, discuss challenges and the ways to overcome them. During these coordination meetings, the program emphasis will be on enhancing staff knowledge, skills and ability to implement nutrition interventions by providing an

in-service training to Environmental and Hygiene Officer (EHO) who have replaced the in charge of CHW (Community Health Worker) in monitoring community interventions and to newly hired nutritionists. To support health center level to monitor nutrition interventions, heads of health center will be trained for three days on nutrition indicators and during this training, each head of health center will plan on the follow up of CBF&NP interventions at health center.

3.1.1.3. Strengthening district staff technical capacity to implement protocols of CBEHPP

Gikuriro program will continue building the capacity of district government staffs on CBEHPP to enhance their involvement in monitoring and improvement of data quality submitted by CHC. The training targets the Cell Social Economic Developments Officers (SEDO) in the eight Districts. Gikuriro will consolidate the lessons obtained from sixteen schools and continue scaling up School Health Club approaches to additional thirty-two schools in FY19. The project further provides training of trainers targeting Education Officers at District and Sector level, Environmental Health Officers/ Sanitation and Hygiene Officers (District hospital, Health Centre and Sector), Head Masters/ Mistresses and Teachers in Charge of Hygiene and Sanitation to enhance their knowledge and skills to deepen hygiene and sanitation promotion activities in schools through establishment of School Health Clubs (SHCs) and monitor their functionality. This in turn contributes to improved hygiene and sanitation practices at household levels.

Moreover, Gikuriro will organize an orientation meeting for district staffs and religious leaders to increase basic knowledge on WASH to contribute in the implementation of the revised MOH CBEHPP program at community level. It is expected that the oriented staffs/religious leaders will conduct regular follow up and monitoring to ensure the functionality of CHCs for improving hygiene and sanitation standards in the community.

3.1.1.4. Districts have the skills and systems necessary to oversee and monitor community water systems

Gikuriro will work with the Ministry of Infrastructure (MININFRA) to establish and operationalize District WASH Boards (DWASHB) and water user committees from sector to village level in eight target districts. The DWASHB will coordinate program planning and implementation consisting of smaller projects of the rural water supply interventions by applying regular procurement, contract management, and financial and reporting procedures. An assessment of existing Knowledge, Practices, Skills and Incentives (KPSI) of district staff will be conducted to design capacity building activities targeting the district water engineers as well as other district and sector staff in consultation with UNICEF which is supporting Rwanda Utilities Regulatory Authority (RURA) to conduct a study on water management system and find out what is needed to support water private operators for better management and sustainability of water infrastructures. More emphasis will be put on tariff compliance so that the population can access and afford water at the household level. More importantly, Gikuriro will advocate and work closely with the districts to develop district investment plans, where these are lacking, following a district-wide approach and developing performance standards with potential collaboration with Isuku Iwacu as required. To promote sustainability, one of the key strategies of the project is to build local capacity for future interventions in WASH promotion.

The program will also include activities to create opportunity for the private sector entrepreneurs to develop viable businesses in the water supply service domain. The capacity of private operators at the district level in water management, operation and maintenance will be strengthened. Gikuriro will support MININFRA to review the manual on water management, operation and maintenance as sustaining the functionality of rural water supply infrastructure is a key challenge. The choice of technology, the quality of design and execution, adequate user involvement (ownership), and the appropriate use of water resources will be considered during the development of project implementation guidelines, by-laws and Standards of Operations (SoPs). To this end, Gikuriro will provide technical and financial assistance to the DWASHBs, district technical team and partners’ staff through joint development of relevant technical tools including SOP, skills training on community water supply management/operations and maintenance, dissemination of water supply policy and strategies.

3.1.1.5. Continued strengthening of institutional and technical capacity of Local Civil Society Organizations (LCSOs)

Gikuriro provides capacity strengthening to local partners implementing integrated nutrition and WASH in 8 districts. This support is based on CRS global partnership principles, which recognizes and values the skills, resources, knowledge, and capacities of communities and local institutions. Gikuriro strengthens capacity of district governments, USAID LCSOs and Gikuriro sub-partners to enable them to implement high quality nutrition and WASH programming.

At the beginning of the project, Gikuriro conducted a Knowledge Skills Practice and Incentive (KSPI) assessments, to identify capacity gaps and used the results to orient its interventions. In response to the findings, the program organized various competency-based trainings to ensure service providers, district governments, USAID LCSO’s and Gikuriro sub-partners’ knowledge and skills are continuously improved.

In FY18, Gikuriro continued the support based on the progress achieved in FY17 and continued the needed capacity strengthening for GoR stakeholders, LCSOs, and sub-partners. The cycle of capacity assessment that includes generating data on areas that require capacity strengthening, developing capacity strengthening plans and monitoring of the implementation of capacity building plans has been key in FY18. Joint monitoring visits allowed to enhance districts capacity on their intended oversight role and to strengthen the relationship between local partners and district staff. The developed capacity building plans have been implemented by addressing identified gaps throughout partners’ capacity assessments. However, the partners’ high scores from partners’ capacity assessments exercise did match perfectly with the level of performance in Gikuriro program implementation observed during external joint supervision, internal supportive supervision and data quality assessment. Some challenges were observed and Gikuriro has oriented partners on the review of capacity building plans and advised them to integrate observed issues during joint monitoring, supportive supervision and DQA.

CRS and Global Communities (GC) are sharing 5 partners (AEE, CARITAS, DUHAMIC, FXB and YWCA) which are implementing Gikuriro and Twiyubake programs. The 2 international organizations funded by USAID have been providing similar capacity building support. Two unshared local partners are FVA/CRS & EPR/GC. In FY 18, CRS & GC worked together to harmonize capacity strengthening approach and tools to enable them to provide capacity building support with more effectiveness and efficiency. A joint tool and same calendar will be used by the 2 organizations for the 5 partners and a joint support will be provided. Common

gaps will be addressed through joint capacity building activities from CRS & GC and this will be cost effective and minimize duplicity of efforts.

Based on experience and learning, the partners’ capacity strengthening in FY19 will be more focused on technical capacity to enable effective implementation of programs. The capacity assessment will be conducted jointly (with GC) once a year. Monitoring of capacity building plans’ implementation will be conducted quarterly. To enhance program implementation, ongoing mentoring, coaching and supportive supervision will be conducted, leaning sessions, exchange visits and community of practice will be organized to empower partners capacities in areas that need empowerment and partners will be given opportunities to learn from their peers’ best practices and innovations.

3.1.1.6. Local Civil Society Organizations (LCSOs) have the institutional capacity to implement protected springs

Gikuriro will utilize its expertise in spring protection for community water supply through building the capacity of the LCSOs. The local partners’ staff capabilities in the domain of water supply management and maintenance will be assessed and its result will help to identify training needs for water supply provision according to the water supply standard guidelines manual. The local partners, in collaboration with district staff, will conduct quality control of water supply during the construction phase up to the daily operation, ensuring access to safe water by the community. The local partners will be oriented on water service indicators and consequent reporting system to track the performance of the project in water supply service. Gikuriro will support institutional capacity building and organizational development, considering the different capacity levels of LCSOs. Consequently, LCSOs will play key role in planning managing water supply systems including spring protection and water kiosk establishment through community mobilizations and additional resources such as supporting institutional capacity building and organizational development, considering the different capacity levels of each organization. CRS/SNV will build the technical capacity for LCSOs staff based on needs assessment, report and preparation of bids for water supply infrastructure. Some of the Gikuriro partners have adequate expertise in water supply system which will be tapped in through experience sharing visits and cross-learning events to strengthen the capacities of others with limited expertise in this area. Then, the LCSOs will cascade trainings and motivate Water committees on how to manage the existing/new water schemes for sustainable use.

3.1.1.7. Capacity of central government to plan and implement high quality nutrition and WASH policy and programming strengthened

The Rwanda government Cabinet established the NECDP to coordinate ECD policy implementation. One of the priority areas and mandates of NECDP is hygiene and sanitation, implemented through CBEHPP, among the six pillars/priorities1. After nearly three years of implementation experience, including carrying out barrier analysis, Gikuriro has already

1 Rwanda National Early Childhood Development (ECD) Policy enacted in May 2016, MIGEPROF as Coordinating Ministry

identified key areas of improvement in the implementation of CBEHPP. One of the challenges identified was the duration of the CBEHPP, which was too short to successfully deal with behavior change in hygiene and sanitation adoption at household level. In addition, the CBEHPP lacks important components such as Menstrual Hygiene Management, animal waste management, and mother-baby WASH components. Furthermore, the number of members in CHC is too big to be effectively managed and ensure regular engagement.

The Ministry of Health (MOH) has developed a draft national water quality surveillance strategic plan. The Gikuriro project will support the MOH to finalize and validate the draft. It is therefore critical to review and incorporate the above mentioned key issues in the CBEHPP with Gikuriro project support:

It is observed that there is a coordination gap between central government and districts hampering the smooth implementation, monitoring, evaluation, and reporting from the village level to central line ministries of WASH interventions. Gikuriro will provide technical assistance to the Coordination Team to institutionalize coordination mechanisms with the districts and strengthen and/or establish systems to ensure functional monitoring, reporting and feedback mechanisms between the central and district level. To facilitate feedback mechanisms, Gikuriro will support (training, technical assistance, field-testing) the development of the government’s WASH MIS platform, which is expected to be operational in Fiscal Year 2018/19.

2.1.2 Nutrition

2.1.2.1 Strengthening VNS and Growth Monitoring and Promotion

In FY19, nutrition activities will focus on activities that strengthen DPEM coordination committee capacity, district staff technical capacity to implement CBF&NP protocol, and support household adoption of best practices. This will be achieved through:

1. Strengthening growth monitoring and promotion 2. Reinforcing household adoption of best practices with a focus on integrating ECD

education. 3. Strengthening positive parenting education in VNS and link VNS and existing ECD

intervention specifically home based ECD

Strengthen GMP activities

The early identification of malnourished children will be reinforced at community and health center level by improving supervision and monitoring of GMP activities by hospitals, health centers and Gikuriro staff.

To attract and encourage parents to participate in GMP, sites for growth monitoring will be equipped with attractive games for children and GMP will be done along with cooking demonstration organized at village level and BCC messaging at village level.

Counselling and anthropometry measurement skills for CHW will be improved through on job coaching and mentoring by hospital nutritionist. The CHW who will achieve 100% of children in GMP will receive an incentive (t-shirts, boots, water tanks, cooking stove, small livestock etc.) through their SILC groups.

The integration of length for age measurements will be strengthened by supporting transport and per diem for a nutritionist who will jointly conduct outreach activities with the immunization team to measure children participating in the immunization.

With the support of M&E team, a quarterly analysis of data reported from growth monitoring at community and health center will be done and compared to show the situation in all districts. This will help to respond to the gaps and plan a follow up.

Support households’ adoption of optimal maternal infant and young child nutrition practices

Gikuriro will support Parents Lumières to build knowledge and skills including making handcraft like mats, carpets and basketry for household use after evaluation on the implementation of new skills supported in FY18. VNS with Successful skills will be supported and strengthened. In addition, all VNS will continue to rehabilitate malnourished children using locally produced food. Cooking demonstration to build skills of household in the preparation of balanced diet with a focus on the preparation of complementary feeding for children will be organized monthly in all VNS sites.

Using MIYCN knowledge acquired in FY18, Parents Lumiere will be supported through mentoring and supervision by health centers/hospital and Gikuriro staff in providing counselling on nutrition of children and pregnant women to increase the adoption of best nutrition practices.

Training on food processing and food cooking skills will be provided for remaining cohort 2 parents Lumiere to increase appropriate use of agricultural products and build skills in preparing diverse recipe from locally produced nutrient-rich food stuff for HH consumption.

The best VNS per district in adoption of Gikuriro best practices will be awarded after evaluation of all VNS by DPEM coordination committees and an exchange visit will be organized to these best VNS for experience sharing

Strengthening positive parenting education in VNS and link VNS and existing ECD intervention specifically home based ECD

Gikuriro nutrition interventions to date have put more focus on nutrition education or messaging on improved MIYCN and breastfeeding practices. In FY 19, Gikuriro will reinforce promotion of activities that integrate nutrition and ECD through positive parenting education. For instance, responsive feeding when done correctly allows the caregiver to be attentive to the children with hunger and her/his feeding needs and preferences; and improves communication between the child and the caregiver, which helps develop the child’s nonverbal and verbal communication skills.

Activities will be focused on responsive stimulation, appropriate play and responsive feeding. These activities will be delivered through teaching the concepts to parents by trained mamans Lumières, practicing the ECD-stimulating behavior with the child. Trained Health Center (HC) staff will reinforce the good practice with parents attending HC.

To create complementarity and linkage between VNS and ECD, Gikuriro will map intervention implemented in the district. The mapping result will inspire on how to link activities done by ECDs, with VNS.

2.1.2.2 Strengthening and sustaining Agricultural Productivity of Target HHs

Gikuriro program will strengthen the agricultural interventions that have been done through Farmer Field Learning School (FFLS) groups as a decentralized agricultural extension channel to ensure the effective adoption of practical skills on kitchen gardening techniques using Bio-intensive Agriculture Techniques (BIATs) with the aim of ensuring the year-round availability of good quality foods for Gikuriro targeted families.

Promotion of BIATs at household level through community engagement

Through community campaigns, Gikuriro Program in partnership with local authorities will continue to sensitize the beneficiaries and the entire community to adopt the BIATs at household level. The seasonal agriculture-launch events (season A & B) will be organized at village level by the farmer promoters with the support of other Gikuriro community volunteers (Community Health Workers, Parents lumières, CHC facilitators) in the form of “Community work” under the coordination of the sector agronomists and the supervision of partner’s agronomists. The local authorities at village and cell level will be involved to strengthen the community ownership. Gikuriro beneficiaries, in addition to other willing community members will split into small groups and help each other to accelerate the adoption of BIATs in their households. To ensure a permanent maintenance of home gardens, another campaign will be organized during the dry season to sensitize the beneficiaries in watering and mulching the kitchen gardens to make them productive continuously the dry seasons notwithstanding.

During FY19, more focus will be put on promoting the adopting of other types of BIATs (double dug, sunken bed, Mandala, zay pits and container gardens because they are suitable to produce different types of vegetables to poor HHs, very easy to maintain and can improve soil fertility in a sustainable manner, they are less time and labor consuming but also can provide a good production and productivity on a limited space2. In addition, the volunteers will also be motivated based on their performance/one per cell. Those who will be able to facilitate the Households to adopt best practices (Kitchen garden well maintained with different rich nutrient crop including the biofortified)

The best performing FFLS groups in terms of high level adoption of good quality BIATs as well as their maintenance throughout the whole year will be motivated (one FFLS per cell) by providing materials such as plastic sheeting, iron sheets, nails and plastic pipes. The materials will be used to install a locally made rain water harvesting facility in one performing FFLS member’s household neighboring the FFLS demonstration plot with the aim that the facility will help the group have sufficient water for watering crops during the dry season. The beneficiaries will be requested to give their contribution in digging the pit, making the bricks and constructing the walls. On the other hand, the best performing farmer promoters/FFLS facilitator (one per cell) who will be able to support many FFLS members in his/her village to adopt and maintain the home garden with diversified vegetables, biofortified crops and other nutrient dense crops, will be motivated by giving them a pig for those working in rural villages while the Farmer Promoters working in the urban villages will be provided with plastic water tanks of 500 liters each.

2 CRS findings

Supply of fruit seedlings and seeds for bio-fortified crops and other high nutrient rich crops

Planting good quality seeds is a key component for improving the productivity of nutrient dense crops. This is the reason why, Gikuriro program in partnership with CIP, Harvest plus and RAB has been providing FFLS groups with the biofortified seeds (Iron Beans, Vitamin A Maize) to be multiplied in the consolidated lands with the purpose of availing improved seeds in sufficient quantities at the planting time to the targeted beneficiaries. The program will also promote the soybean which is highly rich in proteins and micro-nutrients and has many health benefits, by providing seeds to FFLS groups that will be multiplied in the demonstration plots and then be disseminated to all members to help them improve the nutrition of their under five children by reducing the micronutrient deficiencies and hence prevent the stunting for under two children.

Gikuriro program in collaboration with local private fruit seedling dealers will provide fruit tree seedlings to the beneficiaries who were not served during FY18. They will be provided with Maracuja (passion fruits), Tree tomato and Papaya seedlings because of their short production cycle with significant outcome of increasing access to minerals and vitamins from fruit consumption to improve the health of targeted beneficiaries. However, households will receive advices through FFLS groups and will be linked to seeds multipliers to diversify the fruit tree farming.

Small livestock distribution

The small livestock (chickens, rabbits and pigs) will continue to be promoted because of their impact on human nutrition and health status in increasing the amount of animal source protein intake, increasing household income and production of organic manure for agriculture production. This activity will aim at beneficiaries from rural villages mostly from the rural districts. Apart from the 10 beneficiaries who were already served previously, additional 5 beneficiaries from each FFLS will be selected and supported through a new methodology of transferring cash to the beneficiaries through SILC groups. Five additional beneficiaries who will be selected among FFLS & SILC group members based on the vulnerability criteria (most vulnerable beneficiaries) will be provided with 10,000 RwF that will be used to buy the small livestock. The new methodology enables the beneficiaries to choose and buy locally the healthy livestock at reasonable prices and that best correspond to the individual needs and capacity to keep them.

Offspring sharing: Families receiving animals agree to pass on some of the young animals from the first offspring to other families not yet served to start the distribution chain that will allow all FFLS members to get the small livestock in short time. In addition to the small livestock promotion, the program will continue to provide the technical assistance to the FFLS groups implementing the pilot fish farming activities in Kayonza district and to monitor closely this activity to ensure the positive results that will be replicated in other groups in the future.

Community sensitization on consumption of home garden produces and animal products

The sensitization will be done in close collaboration with local authorities during regular group meetings and through various events including FFLS Field Days and agriculture launch campaigns. The sensitization will also be done within the Village Nutrition School (VNS) groups with significant involvement of the Program nutritionists and the community volunteers including the Community Health Workers (CHWs) and Parents Lumières who will use various messages from BCC team to sensitize the beneficiaries on nutrition value of the crops promoted and will promote the consumption of the kitchen garden produces as well as animal source foods including eggs and meats from small livestock and fish.

Kitchen gardening activities in schools supported with WASH interventions

During FY19, Gikuriro program will integrate WASH activities in 46 schools supported with water plastic tanks by the program for roof rain water collection. The targeted schools that have 9 years basic education will be supported to run gardening activities that will be implemented by students from upper level (Grade 7-Grade 9) and will be maintained using the rain water harvesting facility. In each school, one Junior Farmer Field Learning School (JFFLS) group will be created, and the farmer promoter (already trained) from the hosting village will regularly provide the technical assistance to the group with emphasis on some specific BIATs (Double dug bed, Sunken bed, Zay pits and vegetation compost) because they are affordable to the students. The program will provide agriculture tools (hoe, rake, shovel, watering cane, pumps) and vegetable seeds in addition to the biofortified seeds (OFSP, Iron beans, Orange Maize) and the fruit tree seedlings to the groups. As a result, the children will disseminate the acquired knowledge in their community and will become actors of change towards nutrition and wash impact.

Enhance local ownership to ensure the sustainability

The Local Government technical staff (sector agronomists, SEDOs), the community trained volunteers (Farmer promoters) in collaboration with local leaders (heads of the villages, executive secretaries of sectors and cells) will be involved to mobilize the community through community meetings and other events to adopt the BIATs and nutrient dense crops at household level with emphasis on the techniques appropriate to the local agro-ecological conditions (sunken beds, Mandala garden and Zay pits in the dry areas and double dug beds in the high altitude areas). In addition to this, there will be the Gikuriro week once per each month in two districts, which will be organized by Gikuriro staff jointly with sub partner staff and the local authorities in the selected villages to promote and boost the adoption of the integrated package of WASH and NUTRITION including the kitchen gardens at household level.

Especially, the Social and Economic Development Officers (SEDOs) at cell level will be integrated in the monitoring of FFLS activities along with the farmer promoters and will always be invited to attend the quarterly meetings with farmer promoters as a way of reinforcing the monitoring of activities and ensuring the accountability and the sustainability of the program interventions.

2.1.2.3 Economic strengthening

Strengthen the Performance of SILC Groups

Gikuriro uses SILC/Private Service Provider (PSP) approach to strengthen beneficiaries’ groups economically hence cope with household needs including nutrition and WASH.

In FY19, Gikuriro will continue to strengthen the technical capacity of district and partner staff to enhance the performance of Field Agents (FAs) and SILC groups through focused follow up and support.

Currently 142 CHW SILC groups have been established among 57 cooperatives in 5 districts. The priority in FY19, will be to monitor more than 1800 groups from Gikuriro beneficiaries plus 142 established from CHW to provide them with technical support. The team will sensitize CHWs that are not in SILC groups to form the groups. Given the big number of groups to follow a join

effort from different stakeholders will be needed. It is in this regards that the staff in charge of cooperatives at district and sector level together with those in charge of Economic and social Development (SEDO) at cell level will join Program staff on quarterly basis in monitoring activity.

Gikuriro economic strengthening advisor together with relevant partner staff in the target districts will undertake close monitoring of the SILC activities during FY19 to facilitate the first share-out of savings among second cohort SILC groups, certify the FAs as PSPs, and to support all SILC groups intensify implementation of the SILC approaches. Monitoring visits will be conducted to ensure groups are correctly applying the SILC methodology and are ready to be graduated. The groups will be advised on starting and successfully running Income Generating Activities (IGA) during these monitoring visits.

Certification of the second cohort of field agents

Before being certified as PSPs working on fees for services, FAs undergo examinations to test their capability of operating on their own after certifications. The test is composed of an oral exam, a Focus Group Discussion (FGD) comprised of community members and an examination of the quality of the core SILC group’s performance indicators.

A certification ceremony of PSPs is an important event where they are awarded with certificates, in front of local authorities. This is to recognize the PSPs’ capability to support, not only existing SILC groups from Gikuriro beneficiaries, but also to expand their services to new groups from surrounding communities on saving activities which will lead to sustainability of the initiatives. Accordingly, Gikuriro will work with partners and local authorities to certify all eligible FAs in the five districts as PSPs during the year.

In FY 19, the team will conduct a workshop with sub partner staff on PSP networks aimed at: Providing valuable services to members (PSP), to support them in their work and develop their income, ensure the continued availability of SILC services through mutual support for existing PSPs and certification of new ones and finally create, support and improve SILC groups in the area covered.

2.1.3 High-quality WASH programming implemented

To raise awareness on WASH best practices and behavioral change, Gikuriro will disseminate WASH messages using strategies that will attract large number people using; mobile video screening, hiring local artist to deliver messages using songs, organize WASH campaign focusing on home visit /handwashing and celebration of Global handwashing day. Besides signpost/billboard in the health facilities with evidence based key messages on hygiene and sanitation will be installed; and using mass-media particularly radio (Urunana) will be another channel to reach target community. To promote safe drinking water at household level, available brand water treatment chemicals will be promoted in collaboration with social marketing organizations like Society for Family Health (SFH) and outreach activity using road shows/mobile van will be one of the strategies for community to access the products. As for the previous FY18, Gikuriro supported Districts to organize exhibitions and open day, the same activity has been put into consideration to increase the visibility of Gikuriro interventions and events will be organized upon the request of the Districts.

In order to motivate, keep the momentum on the functionality of CHCs and meet Gikuriro key WASH targets, in collaboration with sub partners, selected CHC who reported to have completed CBEHPP topics and home works, and declare ZOD in their village, will be graduated in

FY19. In addition, Gikuriro will award best performer CHCs and model households adopted WASH and Nutrition best practices.

For sustainability of community behavior changes, WASH officers will be trained on production of soap, who will in turn build the capacity of CHC facilitators to apply same knowledge to maximize affordability of soap for handwashing practices. The Gikuriro team is communicating with Sundara fund and SOAP AID which recycle old hotel soap into new bars, giving them a second life. It is done through providing training on soap recycling to selected local women to do this work at the community level and distribute the soap to their communities with low cost, lifting them from poverty with fair wage livelihoods. It is expected that this intervention will contribute to poverty reduction and promote the practice of handwashing with soap. It is also important to boost messaging through a variety of channels and reach the largest portion of the population to intensify and sustain behaviors in the community. To sustain handling of safe water at household level, the project will provide ‘jerrycans’ with faucets to encourage communities to practice safe water storage and provide orientation on how to keep their jerrycan’s’ clean in their daily lives. Moreover, the project links with Vestegaard-Frandsen to access to LifeStraw household water filters to complement the beneficiaries of the program.

Gikuriro also provides direct support for water supply to school communities through construction Rainwater harvesting (RWH) technologies for thirty-two selected schools in the project districts during the FY19. In the meantime, Gikuriro will assess availability of water sources and needs through consultation with relevant district focal points before constructing boreholes and spring tapping to access safe water supply at community level.

During this FY 19, one of the key Gikuriro priorities is to improve sanitation facilities and menstrual hygiene management in schools. Gikuriro program will assist technically and financially in rehabilitation of toilet blocks in thirty-two schools (selected for RWH) and girls’ rest rooms to prevent the nonattendance during monthly menstruation. In addition, Gikuriro will continuously support the Ministries of Health and Education to finalize and organize workshop to review and validate SHC training manual and guideline including printing. Access to improved latrine and hand washing stations will continue to be Gikuriro priorities as reflected in third Health Sector Strategic Plan (HSSP III). Jointly with sub partners, CHC will be mobilized to construct latrines and hand washing stations for beneficiaries and support selected vulnerable households with iron sheets, nails, and with slab. Furthermore, WASH campaign focusing on sanitation will organized most especially during the world toilet day.

2.1.4 Behavior Change Communication

In FY 19, Gikuriro will strengthen the capacity of district health service providers to implement National SBCC Strategy, strengthening community mobilization efforts at community level and developing new SBCC materials and messages based on findings from barrier analysis (BA) and other studies carried out by Gikuriro.

Roll out of the National SBCC strategy to increase the capacity of services providers

In FY19, Gikuriro will roll out National SBCC Strategy developed in FY18 in collaboration with Rwanda Health Communication Center (RHCC) and National Early Childhood Development Program (NECDP). A 2-day’s orientation meeting will be conducted in November 2018 at National level with District Hospital service providers on National SBCC Strategy. Oriented staffs

will conduct 2 days’ orientation sessions in December 2018 for Health staffs in their respective districts, who will roll out a SBCC session through cascaded trainings and during regular community meeting opportunities at lower levels. As an outcome of this activity, all district health service providers will be able to implement effectively BCC activities and each District will elaborate an SBCC Implementation plan. This will significantly increase the adoption of positive nutrition and WASH behaviors at household levels and creates demand for facility-based health, nutrition and WASH services among community members. District CHAIN partners will also be included in the process.

Develop new BCC/Information Education Communication (IEC) materials and message

Based on Gikuriro Barrier Analysis (BA) and beneficiary’s assessments findings conducted in FY18, in collaboration with Rwanda Health Communication Center (RHCC) and National Early Childhood Development Program (NECDP), Gikuriro will develop new SBCC /IEC materials to address nutrition and WASH related behavior gaps among Gikuriro targets. The materials include story telling with pictorials on dietary diversity (DD) and meal frequency (MF) practices. The facilitators including Parent lumières and CHW will teach using these stories during VNS, GMP sessions and home visit and the face to face discussion will follow with targeted mothers on related barriers and come up with solutions to overcome them. Gikuriro will explore the use of nudges to increase uptake of SBC messages in the community, thus changing behaviors.

Strengthen community mobilization to improve nutrition and WASH activities at community and HH level

In FY19, Gikuriro will strengthen community mobilization through most appropriate communication channels targeting identified gaps in knowledge, attitude and practice among the different segments of population. Nutrition and WASH messages will be delivered with evidence based from beneficiary assessment, Barrier Analysis (BA) and mid -term evaluation carried out in FY18.

Thus, Weekly radio pre-recorded magazines and daily radio will be aired through community radios to increase knowledge, attitude and practices. Listening groups will be established under each VNS group and the facilitators will be encouraged to carry a radio during meetings to listen together and moderate post discussion around the topic of the day. Six Weekly radio magazines and two daily radio spots over four consecutive weeks in each quarter will be aired with integrated nutrition and WASH messages.

To increase awareness around nutrition and WASH services, Gikuriro will conduct district campaigns including among others the Maternal and Child Health (MCH) week, world breastfeeding week, milk campaign, agriculture season A and B launch, international saving day, world water day, global handwashing day, international women’s day, and world toilet day. These campaigns will be launched at district level and followed by door to door mobilization activities through group facilitators and CHWs. The door to door activities will focus on nutrition and WASH campaigns theme to reinforce household adoption of positive nutrition and WASH behaviors through focused one-on-one discussions with the family members. The campaigns will be organized in collaboration with relevant ministries and districts’ departments. Campaigns planned include among others the Maternal and Child Health (MCH) week, world breastfeeding week, milk campaign, agriculture season A and B launch, international saving day, world water day, global handwashing day, international women’s day, and world toilet day. This year, Gikuriro will work closely with National Early childhood development (ECD) Program to integrate the messages related to Early childhood development (ECD) in all community mobilization

activities. In additional, Interpersonal communication (IPC) and edutainment approach will be promoted in this FY 19 and used to deliver effectively nutrition and WASH message during VNS, CHC and GMP sessions

Gikuriro will continue to increase public awareness through the Community Giant Scoreboards (CGS) approach, which was piloted in FY 18 in selected villages. The nutrition and WASH related indicators including GMP attendance rate and number of improved latrines constructed will be monitored monthly in collaboration with DPEM to track the number of mothers attending GMP sessions and new latrines constructed.

Through existing communication platforms such as DPEM coordination meetings, Inteko z’abaturage, Monthly Community Works, Evening Parent Forum, Faith Based Organization (FBOs) and community-based schools, Gikuriro will reinforce the sensitization of local and opinion leaders to mobilize and encourage mothers of under-five children to participate in GMP and other CBF&NP services. The local challenges around GMP and other nutrition activities will be discussed through meetings opportunities and a quarterly mobilization plans including different strategies to overcome the challenges related to low uptake will be elaborated.

In FY19, Gikuriro will build on Cell Women Council (NWC) platform to strengthen the importance of household decision making aiming at improving nutrition and WASH behaviors. Couples will be reached with integrated message through Evening Parent Forum. Quarterly meeting with Cell Women representatives at sector level will be organized and a quarterly mobilization plans including different strategies to overcome the challenges related to male engagement will be elaborated.

Gikuriro in collaboration with group facilitators and local leaders will create a group of “Gikuriro Champions “at Sector level including best performing group members with a good household adoption among VNS, SILC, FFLS and CHC members to sensitize the whole community on positive nutrition and WASH best practices through edutainment approach. This group will perform once a quarter through a dramatic performance, song, poems and testimonies at one selected place to sensitize the whole community at the ground on integrated nutrition services. That day is called “Gikuriro community day.”

Sensitize the community through mHealth to reduce malnutrition in rural area

In FY19, in addition to the existing communication channels, Gikuriro will explore ICT driven platforms to deliver behavior change messages on nutrition and WASH topics aiming at increasing knowledge, attitude and practices related to nutrition and WASH behaviors. Based on the results from pilot project carried out in FY18 in Ngoma and Kayonza district , Gikuriro in collaboration with VIAMO Company hired by CRS , will develop around 30 messages for each of key priorities area of MIYCN package and upload them on toll free service where by the callers will simply dial the toll free short-code 8-4-5 at a moment of need, free of cost and listen to a welcome message in Kinyarwanda with their topic of interest . A quarterly follow up voice survey will be carried out among 150 callers to track the changes. The beneficiaries will be sensitized to dial into information hubs using a toll-free number to listen to pre-recorded messages in Kinyarwanda from anywhere and at any time. Parents lumières will be encouraged to facilitate such call-in exercises during VNS sessions to make the message delivery more interactive and fun

Monitoring and evaluation of BCC activities:

During National SBCC Strategy orientation meetings, Gikuriro in collaboration with district health service providers will elaborate a SBCC District Monitoring plan. A BCC Task Force at District level including Gikuriro sub partners, district and health service providers will be set up to track the implementation progress. Furthermore, regular monitoring and supervision activities will be conducted using among others FGDs, family cards, quarterly sensitization meetings follow up, ICT platforms, quarterly surveys and beneficiary’s assessment. Gikuriro will provide technical support to the services providers and sub-partners to ensure that the BCC services are increasing the adoption of positive nutrition and WASH behaviors at household level.

2.2 Collaboration and Coordination

2.2.1. Collaboration with CHAIN partners Gikuriro, as a CHAIN member will collaborate with other CHAIN implementing partners working in nutrition and WASH to achieve improved results. In FY19, Gikuriro will strengthen these collaborations with other CHAIN partners through several activities.

Under CHAIN FY19 work plan, Gikuriro will lead the Social and Behavior Change (SBC) task force and will work on the harmonization of CHAIN SBC messages and tools related to nutrition and WASH in collaboration with Breakthrough Action (BA), Gimbuka, Hinga Weze, Isuku Iwacu, RSMP, Turengere Abana, Twiyubake, Tworore Inkoko and Ubaka Ejo. Still under the CHAIN FY19 work plan, Gikuriro will collaborate with Global communities, FXB and Caritas to review the framework for Graduation of CBEHPP and harmonize the graduation methodology that will be included in the CBEHPP manual.

Gikuriro will also participate in the CHAIN activities led by other CHAIN IPs such as the tools harmonization group led Global communities, WASH task force led by Isuku Iwacu and nutrition sensitive agriculture task force led by Hinga Weze. In this later task force, Gikuriro Agriculture Advisor, who worked on the MINAGRI review of kitchen gardens previously, will be an active member of the task force that will develop comprehensive kitchen garden guidelines.

In FY 18, Gikuriro went through a lengthy process of developing an SBCC strategy for ECD, nutrition and WASH that is awaiting national validation. Gikuriro will explore collaboration with BA around the use of behavioral data in SBC design, the use of evidence-based SBC interventions and tools and improvement of coordination of SBC activities.

Gikuriro will continue collaboration with Global Community/Twiyubake in Kayonza and Nyarugenge to avoid duplication of beneficiaries and ensure complementarity of interventions. Gikuriro will continue to reach out to Twiyubake youth SILC groups with nutrition and WASH messages. Furthermore, the collaboration will continue around the harmonization of the local partner capacity building interventions, considering both organizations share Five local partners. The partner capacity assessment tool has been harmonized and a common plan for the capacity assessments has been elaborated, where institutional capacity will be assessed together both at central and field office level and technical specificities will continue to be assessed individually. For the 2 non-shared partners (EPR & FVA), CRS &Global Communities will conduct capacity

assessment exercise individually but will use harmonized guidelines and tools and respect same timelines as for shared partners.

In FY19 Gikuriro and Isuku Iwacu will continue to work together and implement activities that are in the annual collaboration plan. Gikuriro focuses on hygiene and sanitation demand creation while Isuku Iwacu focuses on the sanitation supply chain. Once hygiene and sanitation demands are created at the community level by Gikuriro, Isuku Iwacu facilitates the link for the community to access sanitation products, thus access to improved latrine. Gikuriro and Isuku will continue to work closely on saving and lending groups to avoid any duplication and conflict between project beneficiaries as well as in IGA. Both projects will be meeting on semester basis to evaluate the collaboration level, implementation progress as well as come up with a joint plan for the semester. Gikuriro and Isuku Iwacu will work closely to track shared indicators to avoid any appropriation and double counting.

Gikuriro will continue the collaboration with Hinga Weze (HW) in Kayonza and Nyabihu. In the sectors where the two organizations are present, HW will not conduct nutrition activities to avoid duplication. However, it will provide nutrition education targeting youth/adolescents while Gikuriro will provide BCC nutrition messaging targeting the U5 children, women of reproductive age. The two organizations will also collaborate on complementary agriculture interventions where Gikuriro beneficiaries can benefit from access to markets through HW interventions. The two organizations will also collaborate in providing support to the Coordination mechanism at district level (DPEM at all levels) to avoid duplication of effort and resources.

2.2.2. Collaboration with other USAID partners

In FY 19, Gikuriro program will continue working with MSH to build capacity of CHW cooperatives through trainings, coaching and monitoring visits of cooperative and Saving groups established after training of their representatives in FY 18. The two organizations will also explore the possibility to select few cooperatives and saving groups that have good records management and cash flow and that have built up some capital and link them with the loan guarantee that USAID supports at Banque Populaire du Rwanda (BPR). The collaboration will include supporting the cooperatives, saving groups develop a business plan and directly connect them to the bank.

2.2.3. Government of Rwanda stakeholders The Government of Rwanda has put in place under MIGEPROF, the National Early Childhood Development Coordination Program (NECDP), an entity in charge of coordination of all ECD related interventions including nutrition and WASH. Gikuriro will work with the NECDP and support various interventions from policy review, capacity building, human resources, to the strengthening of coordination mechanisms at national and decentralized level through the expanded Gikuriro scope. The decentralized coordination mechanisms involve strengthening the capacity of DPEM coordination committees to implement nutrition and WASH interventions.

3 MONITORING, EVALUATION, & LEARNING 3.1. M&E Systems In FY19, similarly to FY18, MEAL will focus more on continuous quality improvement through supportive monitoring and supervision visits as well as coaching of partners’ staff. Moreover, we are placing a lot of effort on ensuring data quality addressing the five data quality dimensions. Gikuriro will continue conducting quarterly DQA activities to ensure data sources are well documented, stored and reported. The team will work to strengthen the HMIS system data flow from the community, to cell, health center, hospital and to National system to ensure data shared at national level is consistent and of utmost integrity from the continuum.

In FY 19, with a change in the WASH indicators, MEAL team will design a system for collecting the indicator on the use of handwashing facility with soap and water every quarter. The current reporting systems did not capture this indicator routinely and only through cross-sectional surveys. The team will ensure routine data collection system is in place and will work with sub-partners and CHCs to ensure this is entrenched in quarterly reporting.

In addition, results of the Mid-Term Evaluation will serve as basis addressing program gaps and compared to the baseline results to observe the change. To generate more evidences on the contribution of the program, more assessment and studies will be conducted to measure the effectiveness of the integrated approach.

In FY19, Gikuriro is planning to have a program level learning session based on the Mid-term evaluation findings and comparing them to the baseline results to focus activities and address findings from the evaluation aimed at improving service delivery and ultimate high-level indicators.

In FY19, Gikuriro has several research opportunities that the MEAL team will be overseeing. The aim is to add to the body of knowledge and evaluate the effect and impact of some noble innovative development activities that stakeholders fund and technically support to bring lasting change to the communities served.

3.2. Evaluation and Research Plan

Title Research type Purpose of research Intended use of research

Expected dates of implementation

Using health behavior models to test effectiveness of behavior change messages of Gikuriro around nutrition and WASH.

Qualitative research study

As part of implementing the SBCC strategy and to strengthen evidence-based BCC interventions, Gikuriro will apply health behavior theories like Health Belief Model (HBM), Social Cognition Theory (SCT), and Theory of Reasoned Actions to test how individual, social, cultural, and environmental constructs influence Behaviors related to MIYCN and WASH among target community and

Customize BCC messages and communication materials accordingly.

Jan-Mar 2019

to

Periodic BCC Formative Research

Qualitative research study on BCC channels that have been implement by Gikuriro

In planning to communicate BCC messages, a study to analyze appropriate messages and messaging channels

Align BCC messaging to the needs of the communities

Periodic

USAID LCSOs and Gikuriro sub-partners Capacity Assessment

Participatory qualitative assessment

To systematically assess USAID LCSO and Gikuriro local sub-partners technical, institutional and program management capacity

To identify areas where capacity strengthening is most needed for the development of LCSO capacity building plans

Periodic

Beneficiary Assessment

Quantitative Cross-sectional household study

Assess Gikuriro beneficiary uptake, utilization and impact of the program

Annually Inform programming for the remaining life of the project

Aug 2019

Effectiveness of integrated WASH and nutrition to prevent stunting in Gikuriro project

Quantitative longitudinal study

To assess the effectiveness of integrated WASH and nutrition to prevent stunting in Gikuriro project (work in progress).

To inform the programming for the remaining life of the project

Oct 2018

Assessment of HHs gender relationship and parenting education on nutritional outcomes.

Qualitative research study

Assess gender influence and relationship with parenting education on nutritional outcomes.

To inform the programming for the remaining life of the project

Jan-Mar 2019

Building evidence in support and expansion of the CBEHPP in Rwanda

Randomized Control trial

Assess the impact of the CBEHPP program on targeted practices (including household water treatment), drinking water quality in the home, and diarrhea and stunting among young children.

To inform the Government of Rwanda adopt the intervention and encourage its inclusion in the CBEHPP at a national level.

1st October 2018 to 31st October 2020

4 CROSS-CUTTING ISSUES 4.1 Gender Equality and Female Empowerment

Gender equality and female empowerment are core development objectives, fundamental for the adoption of positive nutrition and WASH behavior at household level. In FY19, Gikuriro will

build on District Gender Officers trained in FY17 in collaboration with sub partner staff to roll out the gender integration module in all cascaded trainings to ensure the integration of gender related messages and activities during group sessions. To strengthen communication and the couple relationship toward nutrition outcomes, Gikuriro in collaboration with Rwanda Men’s Resource Center (RWAMREC) will train district health service providers on Couple communication in November 2018 to foster a sense of learning together and increase men’s investment in understanding how to improve household nutrition and WASH outcomes. The trained people will integrate couple communication sessions in all cascaded trainings and meeting opportunities at lower levels. Furthermore, Gikuriro will incorporate gender-related messages about male engagement into nutrition and WASH programming including specific messages on the importance of male engagement in the first 1,000 days of life during sensitization meeting with local leaders, Evening Parents Forum and events surrounding International Women’s Day which is scheduled in March 2019.

4.2 Environmental Compliance

5 MANAGEMENT ISSUES 5.1 Anticipated risks

No major risks are anticipated in FY19. Rwanda will undergo parliamentary elections in September 2018. However, no implications in terms of risks are expected and the socio-economic and political landscape will remain conducive to implement Gikuriro activities.

Gikuriro expansion of scope to include water supply in form of boreholes, water spring protection & rehabilitation and water kiosks may pose some district reluctant to accept boreholes as they say these tend to dry up during dry season. The technology that will be used by the organization digging the borehole has been proven to ensure enough water supply during dry season by for example digging around 300m deep. Gikuriro will conduct orientation of the community to ensure this is well understood.

The potential risks of water contamination will be managed by a Water Quality Assurance Plan (WQAP) to ensure that any new water system built under this project meets USAID and national standards. Gikuriro, in collaboration with MOH, will use mobile water quality testing kits for collection and analysis of water samples to identify contaminated water sources and take measures to improve water quality or decommission water sources where water quality cannot be improved.

5.2 Staffing Plan

1. Under the scope of the WASH activity expansion and the life of the project remaining the same, Gikuriro will hire Five (5) additional full-time staff to implement additional activities related to the new scope. Moreover, The MEAL Advisor position which is a key

staff that was designed to end in FY18 will continue through FY19.Technical Advisor for MEAL seconded to the National Early Childhood Program (NECDP)/MIGEPROF

2. Senior Advisor for Coordination and capacity Strengthening 3. SBCC Advisor 4. Sr. Officer for Collaboration and Coordination 5. Quality Assurance Advisor

5.3 Technical Assistance Needs

Organization and/or person(s) who will provide TA, if known

Type of TA Purpose of TA Dates of TA

CRS/HQ In country WASH TA

To support the implementation of quality water supply interventions under Gikuriro expansion.

FY 19 Q2

CRS/CARO Health and nutrition Advisor

In country and remote

To support elaboration of proposals for learning opportunities emerging from Gikuriro implementation especially on SBCC and use of nudges to increase uptake of key WASH and nutrition practices

November 2018

6 APPENDICES 6.1 Geographic coverage

There is no change in geographic coverage in FY19. The districts covered are shown in the map below with Nutrition and WASH activities happening in districts with lavender color and WASH only districts in white with black dots.

6.2 M&E plan matrix

Result Statement Proposed Indicator Unit of Measur

e

LOP Target

FY 2018 FY 2019 FY 2020 Data Source Frequency of data collection

Progress Progress Progress

IR1: Districts and Service Providers have capacity to achieve improved nutrition and WASH outcomes

% of DPEM priorities implemented by districts and LCSOs Percent 90% Target: 54% Target: 72%

Target: 90%

DPEM Assessment reports, Annual Learning events reports

Annual

Number of health professionals that have increased knowledge in child health and nutrition through USG-supported programs, disaggregated by sex

Number 10958 Annual target: 4384

Annual target: 1096

Annual target: 0

Training Reports, Pre-test and post test Results

Quarterly

Number of Men health professionals that have increased knowledge in child health and nutrition through USG-supported programs, disaggregated by sex

5,107 2043 511 0 Training Reports, Pre-test and post test Results

Quarterly

Number of Women health professionals that have increased knowledge in child health and nutrition through USG-supported programs, disaggregated by sex

5,851 2341 585 0 Training Reports, Pre-test and post test Results

Quarterly

S-IR 1.1: District governments have capacity to implement high quality nutrition and WASH programming

# of district and hospital staff in charge of nutrition and other health professionals that have increased knowledge on CBEHPP and CBF&NP

Number 530 Annual target: 212

Annual target: 53

Annual target: 0

Training Reports, Pre-test and post test Results

Quarterly

# of Community Health Supervisors and Hygiene Officers with improved management and leadership skills

Number 88 Target: 56 Target: 84

Target: 88

Training Reports, Pre-test and post test Results

Quarterly

Percent of service providers trained on CBF&NP and CBEHPP who apply the skills in the implementation of the protocols.

Number 100% Annual target: 90%

Annual target: 100%

Annual target: 0

Bi-annual assessment of the technical implementation of the protocols

Bi-annual

O 1.1.1 DPEM coordination committees have strengthened capacity to plan, monitor and evaluate, report and analyze data for effective implementation

# of DPEM coordination committee members with improved program management and coordination skills

Number 75 Target: 45 Target: 60

Target: 75

Training Reports, Pre-test and post test Results

Quarterly

# of Districts that use improved monitoring, evaluation, and reporting systems C12:C14

Number 8 Target: 4 Target: 6 Target: 8 Monthly Reports, Quarterly learning events, DQA Reports

Quarterly

# of revised or updated DPEMs Number 8 Target: 4 Target: 6 Target: 8 DPEM document Annually # of messages tailored to a specific target group and/or a specific action based on findings from Gikuriro analyses.

Number 18 Target: 5 Target: 5 Target: 3 Messages developed, Message transmission Reports

Quarterly

Number of BCC materials produced disaggregated by type of material (spot radio, brochures, fliers, magazines, poster etc.)

Number 36 Target: 10 Target: 10

Target: 6 Materials produced Annually

O 1.1.2 District Staff technical capacity to implement protocols of CBF&NP and CBEHPP is strengthened

# of district staff trained to implement improved sanitation methods, disaggregated by sex

Number 24 Target: 24 Training Reports, Pre-test and post test Results

Quarterly

# of district staff (disaggregated by sex) trained in the First 1,000 Number 24 Target: 24 Training Reports, Pre-test Quarterly

Days CBF&NP protocol and post test Results O 1.1.3 Districts have the skills and systems necessary to support and motivate community workers (CHWs and CHC members)

% of CHWs and CHCs who satisfactorily submit required reports on time

Percent 70% Target: 50% Target: 60%

70% Monthly CHW/CHC Reports

Quarterly

% of CHW cooperatives with improved IGA financial performance Percent 100% Target: 50% Target: 75%

Target: 100%

Quarterly Financial CHW Cooperative reports

Quarterly

Outcome 1.1.4: Districts have the skills and systems necessary to oversee and monitor community water systems

# of district staff trained to monitor and oversee implementation of community water systems

Number 3,374

NA 3347 0 Training Reports, Pre-test and post test Results

Quarterly

S-IR 1.2: LCSOs have capacity to implement high-quality nutrition and WASH programming

% of LCSOs supported by Gikuriro receiving positive feedback on programming from District Evaluation Committee

Percent 100% Target: 50% Target: 75%

Target: 100%

District committee evaluation reports

Annually

% of LCSOs staff with increased technical capacity to deliver quality nutrition programming

Percent 100% Target: 50% Target: 75%

Target: 100%

Training Reports, Pre-test and post test Results

Quarterly

% of LCSOs staff with increased technical capacity to deliver hygiene services

Percent 100% Target: 50% Target: 75%

Target: 100%

Training Reports, Pre-test and post test Results

Quarterly

O.1.2.1: USAID LCSO and Gikuriro sub partners staff have nutrition and WASH technical competencies to implement CBEHPP and CBF&NP

Average variance between pre- and post-training test scores measuring improved technical nutrition and hygiene knowledge among trainees

Percent 15% Target: 15% Target: 15%

Target: 15%

Training Reports, Pre-test and post test Results

Quarterly

Number of USAID LCSO and Gikuriro sub partner staff trained on CBF&NP and CBEHPP who apply the skills in the implementation CBF&NP and CBEHPP.

Percent 60% Target: 50% Target: 60%

Target: 60%

Bi-annual assessment of the technical implementation of the protocols

Bi-annual

O 1.2.2: USAID LCSO and sub partners staff have competencies to effectively take gender dynamics and opportunities into account when implementing nutrition and hygiene programming

Percentage of recommendations from Gikuriro gender analysis applied in programming

Percent 90% Target: 40% Target: 70%

Target: 90%

Program participant lists Cooperative Leadership lists

Annually

O 1.2.3: USAID LCSOs and Gikuriro sub partners have the institutional capacity to implement CBF&NP and CBEHPP

% of benchmarks achieved in institutional capacity strengthening plans on annual basis by each LCSO

Percent 100% Target: 50% Target: 75%

Target: 100%

Baseline Mid-term Final Evaluation

Every 2years

# of LCSO staff trained in implementation, monitoring, evaluation, and reporting specific to GOR requirements for CBF&NP and CBEHPP

Number 40 Target: 40 Training Reports Quarterly

Average variance between pre- and post-training test scores measuring improved knowledge of CBF&NP and CBEHPP monitoring and reporting structures acquired by the trainees during the training session

Percent 15% Target: 5% Target: 2%

Target: 0%

Training Reports, Pre and Post Test Scores

Quarterly

O. 1.2.4: LCSOs have the institutional capacity to implement protected springs

Number of USAID LCSO and Gikuriro sub partner staff trained on water resources management and protected spring who apply the skills in the implementation water systems.

Number 16 NA 16 0 Training Reports, Pre and Post Test Scores

Quarterly

Sub IR 1.3: Capacity of central government to plan and implement high quality nutrition and WASH policy and programming strengthened

Budget for nutrition in place (yes/no) Number 1 NA 1 1 Financial Reports Annual DHS/Multiple Indicator Cluster Survey/comparable national nutrition survey conducted during in the past three years

Yes/No 1 NA NA 1

O.1.3.1 The National Early Childhood Development Program (NECDP) Coordination team has strengthened capacity to plan and coordinate the NECDP for effective implementation

Number of nutrition-specific tools developed (policies, standards, guidelines, key messages and IEC materials) that reflect international best practices and learning

Number TBD TBD TBD TBD Activity Reports, Policy Document Produced

Annual

Number of nutrition-sensitive tools developed (policies, standards, guidelines, key messages and IEC materials) that reflect international best practices and learning

Number TBD TBD TBD TBD Activity Reports, Policy Document Produced

Annual

O. 1.3.2 Central ministry staff supported to plan, assess, design, and develop guidance for national-level strategies and plans

Percent of members from social cluster ministries that attend NECD coordination meetings

Percent 80% NA 70% 80% Meeting Minutes Quarterly

O. 1.3.3 Linkages between central and district level efforts and stakeholders established and enhanced

Presence of a multi-sectoral & multi-stakeholder coordination mechanism (yes/no)

Yes/No 1 NA 1 1 Coordination mechanism TOR

Annual

IR2: Household level nutrition and WASH behaviors improved

Number of female children under five reached by USG-supported nutrition programs

Number 141896 90289 92317 94346 Activity reports from Nutrition, WASH, Agriculture, Economic strengthening, BCC, MEAL

Annual

Number of male children under five reached by USG-supported nutrition programs

Number 135787 86401 88343 90285 Activity reports from Nutrition, WASH, Agriculture, Economic strengthening, BCC, MEAL

Annual

Number of children U5 who are admitted for treatment of Moderate Acute Malnutrition

Number 8,132 2896 2172 652 VNS Data Annual

Number of children under two (0-23 months) reached with community-level nutrition interventions through USG-supported programs

Number 110010 76415 78132 79849 Activity reports from Nutrition, WASH, Agriculture, Economic strengthening, BCC, MEAL

Annual

Number of female children under two reached by USG-supported nutrition programs

56216 39048 39925 40803 Activity reports from Nutrition, WASH, Agriculture, Economic strengthening, BCC, MEAL

Annual

Number of male children under two reached by USG-supported nutrition programs

53795 37367 38207 39046 Activity reports from Nutrition, WASH,

Annual

Agriculture, Economic strengthening, BCC, MEAL

Number of pregnant women reached with nutrition interventions through USG-supported programs

Number 31530 Target: 29945

Target: 30753

Target: 31530

Activity reports from Nutrition, WASH, Agriculture, Economic strengthening, BCC, MEAL

Annual

Number of pregnant women < 19 years of age reached with nutrition interventions through USG-supported programs

1703 1617 1661 1703 Activity reports from Nutrition, WASH, Agriculture, Economic strengthening, BCC, MEAL

Annual

Number of pregnant women > or = 19 years of age reached with nutrition interventions through USG-supported programs

29827 28328 29092 29827 Activity reports from Nutrition, WASH, Agriculture, Economic strengthening, BCC, MEAL

Annual

GNDR-2 Percentage of female participants in USG-assisted programs designed to increase access to productive economic resources (assets, credit, income or employment)

80% 80% 80%

GNDR-2 Numerator 32695 32695 32695 GNDR-2 Denominator 40869 40869 40869 Prevalence of anemia in Children 6-59 months Percent 0.15 Target: 25% Target:

20% Target: 15%

Baseline Mid-term Final Evaluation

Every 2 years

S-IR 2.1: High- quality nutrition programming implemented

Mean score among targeted populations on a test of nutrition knowledge (disaggregated by gender and age)

Percent 0.75 Target: 60% Target: 65%

Target: 75%

Baseline Mid-term Final Evaluation

Every 2 years

O 2.1.1 Households equitably access a diverse and quality diet

Household dietary diversity score Percent 0.7 Target: 65% Target: 68%

Target: 70%

Baseline Mid-term Final Evaluation

Every 2 years

O 2.1.2 Households adopt optimal maternal infant and young child nutrition practices

% of caregivers who regularly apply at least 3 recommended MIYCN practices

Percent 25% Target: 18% Target: 22%

Target: 25%

Baseline Mid-term Final Evaluation

Every 2 years

Prevalence of children 6-23 months who consume targeted nutrient-rich value chain commodities (IR Beans, Milk, OFSP, ASF)

TBD TBD TBD

Women's dietary diversity score Number 70% Target: 65% Target: 68%

Target: 70%

Baseline Mid-term Final Evaluation

Every 2 years

Prevalence of women of reproductive age who consume targeted nutrient-rich value chain commodities (IR Beans, Milk, OFSP, ASF)

TBD TBD TBD

% of Children 6-23 month receiving a minimum acceptable diet disaggregated by gender (Male & Female)

Percent 25% Target: 35% Target: 45%

Target: 60%

Baseline Mid-term Final Evaluation

Every 2 years

O 2.1.3 Children under 5 receive all primary care services under CBF&NP

% of children under five years attending monthly growth monitoring

Percent 90% Target: 85% Target: 88%

Target: 90%

HMIS Monthly Reports Quarterly

% of children under 5 with diarrhea who received oral rehydration therapy

Percent 70% Target: 60% Target: 65%

Target: 70%

Baseline Mid-term Final Evaluation

Every 2 years

% of children under-two who received vaccination in past reporting period who received LfA measurement at Health Centre

Percent 95.00% Target: 70% Target: 85%

Target: 95%

Health center data, HMIS Quarterly

% of children under-two who received last vaccination at age 0f 15 months attending follow on length for age measurements at the health facility at age of 18 months

Percent 75.00% Target: 50% Target: 65%

Target: 75%

Health center data, HMIS Quarterly

O 2.1.4 Husbands support women of reproductive age to practice recommended health seeking behaviors

% of pregnant women attending nutrition education and counseling at community level promotion sites

Percent 95% Target: 75% Target: BL + 85%

Target: 95%

Attendance lists for nutrition education sessions

Quarterly

% of women who attended 4 pre-natal visits Percent 70% Target: 57% Target: 64%

Target: 70%

Baseline Mid-term Final Evaluation

Every 2 years

% of women who attend at least 3 pre-natal visits with their husbands

Percent 50.00% Target: BL + (TBD)

Target: BL + (TBD)

Target: 50%

Baseline Mid-term Final Evaluation

Every 2 years

S-IR 2.2: High-quality WASH programming implemented

Mean score among targeted populations on a test of hygiene knowledge (gender and age disaggregated)

Percent 70% Target: 60% Target: 65%

Target: 70%

Baseline Mid-term Final Evaluation

Every 2 years

Number of people gaining access to a basic sanitation service as a result of USG assistance Disaggregated by gender, Wealth quintile and residence (Urban or Rural)

Number and Percent

60% Target: 100,628

Target: 125,786

Target: 150,943

Activity reports from Nutrition, WASH, Agriculture, Economic strengthening, BCC, MEAL

Annual

Number of Males gaining access to a basic sanitation service as a result of USG assistance

49207 61509 73811

Number of Females gaining access to a basic sanitation service as a result of USG assistance

51421 64277 77132

Number of urban people gaining access to a basic sanitation service as a result of USG assistance

10063 12579 15094

Number of Rural gaining access to a basic sanitation service as a result of USG assistance

90565 113207 135849

Number of people gaining access to basic drinking water services as a result of USG assistance.

Number TBD NA Target: BL + (TBD)

Target: BL + (TBD)

WASH Activity reports Quarterly

Number of people gaining access to safely managed drinking water services as a result of USG assistance.

Number TBD NA Target: BL + (TBD)

Target: BL + (TBD)

WASH Activity reports Quarterly

Number of people receiving improved service quality from an existing basic or safely managed drinking water service as a result of USG assistance.

Number TBD NA Target: BL + (TBD)

Target: BL + (TBD)

WASH Activity reports Quarterly

O 2.2.1 Men, women, boys and girls practice key hygiene, sanitation, and water handling behaviors

% of caregivers who wash hands before preparing food Percent 60% Target: BL + (TBD)

Target: BL + (TBD)

Target: 60%

Baseline Mid-term Final Evaluation

Every 2 years

% of households that safely dispose the feces of their child under 3 Percent 95% Target: 92% Target: 93%

Target: 95%

Baseline Mid-term Final Evaluation

Every 2 years

Number of CHC committee members trained on CBEHPP modules Number 180 Target: 90 Target: 135

Target: 180

Training reports Quarterly

O 2.2.2 Households have increased equitable access to improved sanitation facilities

% of HHs with improved sanitation facilities Percent 0.7 Target: 62% Target: 66%

0.7 Baseline Mid-term Final Evaluation

Every 2 years

% of households with soap and water at a handwashing station commonly used by family members in USG-assisted program disaggregated as either urban or rural

Percent 50% Target: 30% Target: 40%

Target: 50%

Baseline Mid-term Final Evaluation

Every 2 years

% of Urban households with soap and water at a handwashing 50.9% 67.8% 84.8% Baseline Mid-term Every 2 years

station commonly used by family members in USG-assisted program disaggregated as either urban or rural

Final Evaluation

% of Rural households with soap and water at a handwashing station commonly used by family members in USG-assisted program disaggregated as either urban or rural

25.6% 34.1% 42.6% Baseline Mid-term Final Evaluation

Every 2 years

O 2.2.3 Households have improved access to drinking water treatment and storage inputs

% of HHs who treat their drinking water properly Percent 0.75 Target: 60% Target: 70%

Target: 75%

Baseline Mid-term Final Evaluation

Every 2 years

# of HHs who store their drinking water properly Percent 0.75 Target: 68% Target: 72%

Target: 75%

Baseline Mid-term Final Evaluation

Every 2 years

Number of institutional settings gaining access to basic drinking water services due to USG assistance.

Number 40.00 40 0 WASH Activity reports Quarterly

Number of people educated on tools, approaches, and/or methods for water security, integrated water resource management, and/or water source protection.

Number 16,674

NA 10,004 6,670 WASH Activity reports Quarterly

Number of action plans implemented for water security, integrated water resource management, and/or water source protection.

Number >85% NA >85% >85% WASH Activity reports Quarterly

6.3 Budgeted Work Plan

Gikuriro FY 19 costed DIP final Sep