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Co-financing is unavailable, therefore SC requests 100% funding from ECHO for the proposed project in Puntland. Urgent actionYes If yes: No
ECHO Primary emergency decision ECHO Emergency decision Other ECHO decision
Please justify:
At proposal stage fill the numbered paragraphs, except those which start with [INT] (to be filled in at intermediate report stage) or with [FIN] (to be filled in at final report stage). At intermediate and final report stage, modify only key data in the numbered paragraphs (using strikethrough).
Control mechanism to be applied: A Proposal and reports Initial proposal Revised proposal N1 ECHO reference A/ Intermediate report Final report
P date: date: date: date: date 10-02-2010 23-02-2010 dd-mm-yy dd-mm-yy dd-mm-yy
NEEDS ASSESSMENT
Date(s) of assessment; methodology and sources of information used; organisation/person(s) responsible for the assessment A. Save the Children Emergency Assessment Report for Somaliland and Puntland, August 2009 B. FSNAU Food Security and Nutrition Quarterly Brief Focus on Post Deyr Season Early Warning, January to June 2010 (17 December 2009) C. FSNAU 2009 Post GU Technical Series Report No VI.24; 29 September, 2009) D. FSNAU 09/2010 Post-Deyr Assessment Result Presentation; 29 January 2010 E. Save the Children Karkaar Health Baseline Survey Report, September 2008 F. Somali Knowledge, Attitude & Practices Study, Infant & Young Child Feeding and Health Seeking Practices (December 2007) G. Save the Children Weekly/Monthly - Internal Situation Reports, NGO SPAS Updates and Advisories & UNHCR Protection Monitoring Reports H. UNOCHA Somalia Weekly Humanitarian Bulletin Issue No 3 (15-22 January 2010) I. UNHCR Somali Refugee and IDPs January 2010 SC conducted a multi-sectoral emergency assessment in urban areas of Puntland and in the Golis/Guban livelihoods zone and Togdheer Region of Somaliland in August 2009 with focus on livelihood, nutrition and protection. The assessment also covered health and WASH. Methods used during the assessment included Focus Groups Discussions with men, women and children (boys and girls) and interviews with key informants from UN agencies, NGOs and local authorities on the ground. Since the information obtained during the field trip has been of a marked qualitative nature, a combination of direct observation in the field and desk review and analysis of secondary, more quantitative data was used. A total of 87 men, 81 women, 62 boys and 63 girls were interviewed during the focus groups discussions. Items B to D above were collected by the Food Security and Nutrition Analysis Unit for Somalia (FSNAU) in collaboration with different local and international NGOs. FSNAU, a project funded by the European Commission and USAID (donors), and implemented by the UN FAO is a leading body in providing integrated analysis of Somali food, nutrition and livelihood security to enable both short-term emergency responses and long-term strategic planning to promote food and livelihood security for Somali people. FSNAU bases its assessments on the understanding of food, nutrition, and livelihood security in four key dimensions: Access, Availability, Utilization, and Stability. The FSNAU has developed a Food Security and Nutrition Analysis System (FSNAS) that holistically integrates both conceptual and analytical aspects of its work, and is underpinned by livelihoods analysis. With regard to nutrition, the information focuses on the key factors that influence nutritional status: the fragile socio-economic and political environment, food insecurity, unfavourable care practices, and the health environment. 2
With regards to nutrition assessment, FSNAU includes both anthropometric and nonanthropometric data for integrated analysis. FSNAU also conducts nutrition surveillance that utilizes a diverse range of information sources on nutrition. These include detailed nutrition assessments, health facility information, rapid assessments, sentinel site surveillance and intervention data. Information on the wide range of factors affecting nutrition is also collected from partners in other sectors of health, food security, water and security. Save the Children conducted a baseline health survey in Karkar region of Puntland in September 2008 to understand the existing health situation of women and children, their knowledge and health care and health seeking practices, coverage of essential health services using qualitative and quantitative methodologies. Items E-G are periodic documents produced by Save the Children for internal and/or external circulation to update on the situation. They are mainly based on the agencies operation in the areas. Problem statement and stakeholder analysis Somalia has suffered from conflict and lack of a functioning government for 19 years. As a result Somalia is one of the poorest and failed states with a Gross Domestic Product of US$ 291.1 per capita with 43.2% of its 8.7 million population living on less than US$1 per day and currently going through the worlds worst form of humanitarian crisis. According to the State of the Worlds Children 2009 published by UNICEF, the average life expectancy of Somalis is just 45 years, one of the lowest in the world. Somalia has one of the highest maternal mortality ratios (1400/100,000) and under five mortality rate (142/1000). Similarly, 38% of Somali children are stunted and 36% are under weight. Stunting is a result of poor nutrition, which prevents normal physical and mental development. Food insecurity results in (and is also a result of) reduced access to health care and education services by poor children and their caregivers. The combination of drought, economic collapse, intensification of conflict, and subsequent mass population displacement during 2009 has resulted in a massive humanitarian crisis. According to UN estimates, 3.69 million people are in crisis including 1.55 million internally displaced people. Like in most humanitarian crises, women and children are in the most vulnerable situation with their level of vulnerability further compounded by the existing socio-cultural context in Somalia. During 2009, Puntland was one of the main zones/regions in Somalia receiving IDPs displaced due to the escalation of fighting in central and southern Somalia. According to the UNHCR, as of January 2010, there are 104,000 IDPs living in Puntland. Most of these IDPs are settled in the urban areas of Bosaso and Garowe. The influx of the IDPs has contributed in the deterioration of the humanitarian situation in the area. According to the Food Security and Nutrition Assessment Unit (FSNAU)s 2009 Post Deyr Analysis Report, 65% of 107,181 urban population of Bosaso are in either Acute Food and Livelihood Crisis (AFLC) or Humanitarian Emergency (HE). Similarly, 45% of 33,395 urban population of Garowe are either in AFLC or HE. It means about 70,000 people of Bosaso town and about 15,000 people of Garowe town are in AFLC or HE. The health and nutrition situation of these populations especially children are of major concern for the humanitarian community. Even though according to the FSNAUs post Deyr report the malnutrition situation of children in the northeast Somalia looks comparatively better than the situation in other regions, the presence of huge IDP population which have already a worst malnutrition situation demands an urgent interventions to prevent worsening of the situation and excess morbidity and mortality among vulnerable children. Based upon the FSNAUs reported malnutrition rate among under five children (2% SAM and 8% GAM for Northeast; 3.5% SAM and 13.75% GAM in IDP) an estimated annual case loads of over 3,500 under five children acutely malnourished in Bosaso and Garowe towns. Of these, an estimated 952 are suffering from severe acute malnutrition. These children are at great risk of diseases and deaths without effective lifesaving interventions. UNICEF and WFP have been distributing plumpydoz and general food rations in partnership with Relief International (RI) and the Danish Refugee Council (DRC) respectively in Bosaso and 3
Garowe. WFP food aid distributions were discontinued in October 2009. Severely malnourished children are treated inpatient at the local hospital in the area. The coverage and the quality of the available services are not meeting the needs of the vulnerable children. Moreover, Infant and Young Children Feeding (IYCF) activities are not adequately addressed. The local hospitals and other government health facilities lack capacities in terms of staff, skills, supplies, and management and are not able to cover the essential health and nutrition needs of the population. SC will coordinate with the existing stakeholders to avoid duplication and fill existing gaps effectively. Summarise findings of the assessment (include full report in annex, if relevant) and link these to the Action The SC rapid assessment field trip to the proposed project areas confirms that the urban populations of Bosaso and Garowe, especially the IDPs and urban poor in the host communities, are suffering from a severe humanitarian crisis. Children under 5, pregnant and lactating women and the elderly are hard hit. Main causes are a severe food security and livelihood crisis, poor or total lack of access to health services, poor or lack of access to safe drinking water, poor sanitary conditions and poor knowledge of infant and young child feeding and health seeking practices. The government currently lacks the capacity to respond to the needs. Response from different INGOs and UN agencies is insufficient and suffers from poor overall coordination, leaving large pockets of populations uncovered. The continuous influx of new IDPs from central and southern Somalia is putting an increasing strain on already inadequate basic services. Sub-optimal breastfeeding and complementary feeding practices are contributing to the poor nutritional status of children. Though in general women understand the need for dietary diversity and sufficient meals, they lack the income to purchase nutritious foods for their children or sufficient quantities to feed their children throughout the day. Though the youngest children are kept with the mothers while they are out begging or scavenging, older children (typically older than 6 months) are left on their own and therefore do not receive adequate care. There is heavy marketing of powdered milk in towns and most women feel that they are not able to produce enough breast milk since they are not eating enough themselves; they therefore believe it is best to give the child powdered milk. As water quality is poor, this is resulting in increased risk of diarrhoea and thus increased risk of malnutrition. Services provided by MCH clinics are limited, as drugs are routinely unavailable, staff frequently are unpaid, clinics are closed during the hours that the mothers are able to visit, and health staff lack understanding of Infant and Young Child Feeding (IYCF) beliefs and practices among their communities. Another factor causing malnutrition among the IDPs is marginalisation, particularly of IDPs from central and southern Somalia. IDPs report being denied access to basic health services, including treatment of malnutrition, or are charged twice the price that other patients are charged. Some IDPs do not receive General Food Distribution (GFD), though other IDPs and the host community do. They report being verbally harassed and children are physically abused by host community children when they leave the IDP camps. Oromo refugees from Ethiopia also face the same discrimination as the southern and central Somali IDPs and do not have legal status in Somalia. An SC baseline health survey in Karkaar, Puntland revealed that over two thirds of infants are born without adequate antenatal care during their prenatal lives and without assistance of skilled health workers during their delivery. Similarly, during their early infancy, only about a third of the babies are exclusively breastfed and their immunization coverage for routine antigens ranges between 12-43% only. Only 24% of children aged between 12-23 months were found to be vaccinated against measles. The survey also reported about the high incidence of diarrhea, fever and acute respiratory infection and poor access to clean drinking water, basic sanitation and appropriate care during illness. Though this study was done in Karkaar region, the pattern of the problems and the situation is reflective of the entire northeastern region. The Somali Knowledge, Attitude & Practices Study, Infant & Young Child Feeding and Health Seeking Practices (December 2007) found that knowledge, attitude and practices on breastfeeding are mainly controlled by culture through maternal grandmothers and other elderly 4
women in the community and are generally unsatisfactory. Most children are put on breast 2-3 days after delivery and colostrum is not fed to children by the majority of mothers. Exclusive breastfeeding does not exist in most parts of Somalia. The early introduction of complementary foods was reported, a lack of variety in complementary diets was also noted and there was no special dietary attention for children after 24 months of age.
OPERATIONAL FRAMEWORK
Exact location of the Action (include map of project location) Bosaso town of Bari Region and Grower town of Nugal region in Northeast Somalia as shown in the Somalia country map below:
Beneficiaries Total number of direct beneficiaries: Given the complexities of the situation, it is difficult to present the precise number of beneficiaries at this stage. However, based on the demographic structure, number of people in humanitarian crisis (AFLC and HE) and malnutrition rate reported by FSNAUs latest report, we expect an estimated total of 9,248 under five children from 85,000 people who are in acute humanitarian needs (AFLC and HE) for different specific interventions as follows (malnutrition rates reported for IDPs have been used for this calculation and from the estimated annual case loads of over 3,500, the projects targets to cover 80% of the estimated case loads for 10 months project period): Direct nutrition interventions for treatment of acute malnutrition: OTP (Outpatient Therapeutic Programme) ; 635 severely malnourished under five children (523 in Bosaso & 112 in Garowe)
SFP (Supplementary Feeding Programme): 1813 moderately malnourished under five children (1493 in Bosaso & 320 in Garowe) IYCF (Infant and Young Child Feeding) for nutrition promotion and prevention of malnutrition targeted to under 2 years aged children through their mother and care takers: 6,800 children under 2 years of age in the population in crisis, Training of health staff on malnutrition management and IMNCI for treatment of common diseases: 9,248 under five children Status of the direct beneficiaries (multiple options possible) IDPs Returnees local population Others (e.g. for Grant Facility, thematic funding, etc.) Refugees
Specificities of direct beneficiaries (please elaborate; refer to groups as appropriate, e.g. unaccompanied minors, disabled, children, ex-combatants) The direct beneficiaries include children of IDPs living in Bosaso and Garowe towns and host population children under the age of 5, especially those from poor and marginalised communities who are facing humanitarian crisis Children with special needs such as unaccompanied minors, with disability, orphans etc will be given special priority. Mothers, or caretakers of children under the age of two years, are also targeted for improving IYCF practices among IDPs and host communities who are in humanitarian crisis. Health workers from local health facilities and IDPs will also be targeted for training to improve their skills for treatment of malnourished children and common childhood illnesses. Direct beneficiary identification mechanisms and criteria Children of IDPs living in the IDPs camps and children of poor and marginalised families from the host communities will be the direct beneficiaries. They will be identified on the basis of their settlements and their humanitarian needs. Specific criteria to be used for beneficiary selection will include, but will not be limited to: Populations with a significant number of children suffering from acute malnutrition (SAM/GAM) Absence of intervention by other agencies vs. needs determined through the clusters and consultation with local health authority and health facilities Displaced populations living without shelter and other essential household items Observance of Do No Harm principles, with a focus on averting conflict Proportion and equity in targeting different vulnerable groups 7
Beneficiaries will be identified through screening using anthropometric measurements at community and Outpatient Therapeutic Programme (OTP) sites. Malnourished children fitting the following criteria will be admitted to the programme: Severe acute malnutrition (SAM): Children with <115mm MUAC AND/OR <-3 z-score (new WHO reference data) AND/OR bilateral pitting oedema admitted to OTP Moderate acute malnutrition (MAM): Children with >=115mm & <125mm MUAC AND/OR >= -3 z-score & <-2 z-score (WHO) admitted to SFP Severely malnourished children with medical complications will be referred to the local hospital in Bosaso and Garowe for treatment of medical complication Moderately malnourished children in will be referred to the nearest SFP Unvaccinated children and those with minor illnesses will be referred to the nearest MCH/mobile clinic
Admission criteria follows internationally accepted standards (WHO, UNICEF, Valid International) and Somalia nutrition cluster recommendations. For IYCF practices, mother of young children (aged under-two years) will be identified on the basis of childs age. Local health staff for training on IMNCI will be identified in coordination with local MOH. Describe to what extent and how the direct beneficiaries were involved in the design of the Action Between21-28 August 2009, assessment teams from SC conducted an assessment in order to among others determine if emergency needs did exist in selected areas of Puntland and made recommendations on the key findings of the assessment mission. The assessment process ensured the involvement of the community and local key stakeholders through the use of Focus Groups Discussions with men, women and children (boys and girls) and interviews with key informants from UN agencies, NGOs and local authorities on the ground. As a result of their involvement it emerged that implementing emergency nutrition projects focusing on the provision of OTP services through the MoH, and the provision of OTP services and IYCF activities in collaboration with other stakeholders, would maximize impact. In programme implementation, activities will build on SCs wider strategy of engaging the local community in all planned interventions. For this intervention, SC will work with the local health authority, health facilities and local community leaders and the beneficiaries themselves to tailor assistance appropriately. Activities will recognize local customs and aim to minimize the burden on daily household and community routines. Community and beneficiary participation will be required at different stages of the project to ensure transparency and allow for adjustments based on feedback. Community mobilization through public meetings involving community representatives and other members of the community will be held to discuss the proposed project. This will help to maintain transparency with the beneficiaries and non-beneficiaries throughout the project period. Other potential beneficiaries (indirect, "catchment", etc.) The catchment area includes the total urban population of 107,181 in Bosaso and 33,395 in Garowe with particular concern to 70,000 people in Bosaso and 15,000 people in Garowe who are currently in humanitarian crisis (AFLC or HE) according to FNSAU Post Deyr 209/2010 report.
Direct beneficiaries per sector: Sector Nutrition: OTP SFP IYCF Health
Number of beneficiaries 635 children with SAM 1813 children with MAM 6800 mothers of children under 2 years of age 17,000 under five children 50 health staff from local hospital and health facilities
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Objectives, Results and Activities Operational Overview of the Action: Log-frame2 (max. 3 pages)
Title of the Action Principal Objective Emergency Nutrition and Health Support to Crisis-Affected Populations in Somalia To reduce nutrition-related morbidity and mortality among under five children in Somalia Intervention Logic Objectively Verifiable Indicators
Sources of Verification
Specific Objective
To improve the nutritional and health status of children under five years old in Bosaso and Garowe in Puntland with emergency nutrition and health interventions. 1. Under five children with acute malnutrition have access to appropriate nutritional treatment through OTP and SFP 2. Mother or caretakers of children under two years of age have improved feeding and care practices for their children to promote their nutrition and prevent malnutrition 3. Under five children from IDP and poor host population have improved access to quality treatment for common childhood illnesses.
catastrophes during the project implementation period affecting security and access to the area
Results
have recovered is >75%, died is <10% and defaulters is <15% and for SFP proportion of exits who have recovered is >75%, died is <5% and defaulters is <15% (as per SPHERE standards)
CNVs are able to effectively find
continue
Supplies are available from
reports
Monthly CTC statistics Review of OTP cards Training report Ext interview and case
review
cooperatively with SC
Continued partner ability to absorb
made for eligible malnourished children with medical complications to hospital-based inpatient therapeutic care
70% of the mother of children under
This table will be annex I of the signed Agreement. It has to give a comprehensive overview of the different elements of the Action. It will only contain concise information on results and activities. Any changes made to the log-frame at intermediate report or final report stage will be done using strikethroughs.
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two years of age have improved feeding and care practices for their children
75% of health staff working in local
access situation
health facilities treated according to IMNCI protocol R1. Activities CTC sites identified and established CTC staff recruited and trained Community Nutrition Volunteers identified and trained Communities mobilized Active case finding R2 Systematic treatment and ration distributed Health and nutrition education conducted IYCF (volunteers/midwives trained; breastfeeding support groups formed; curriculum developed; development/distribution IYCF materials) Local health staff trained on IMNCI R3 Local health facilities supported with essential supplies for treatment of common childhood illnesses Treatment of malnourished children for common childhood illnesses Ongoing supervision
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More detailed information per result3 More detailed information per result4 4.3.3.1: Result 1: Under five children with acute malnutrition have access to appropriate nutritional treatment through OTP and SFP. At proposal stage Total amount: 336,615 EUR Sector: Nutrition Related sub-sector: Community Therapeutic Care (CTC) Beneficiaries (status + number): Acutely malnourished under five children from IDPs and vulnerable host communities who are facing an Acute Food and Livelihood Crisis (AFLC) and Humanitarian Emergencies (HE) in Puntland, Somalia; total project target 2,448 Indicators for this result: Proportion of exits from OTP who have recovered is >75%, died is <10% and defaulters is <15% and for SFP proportion of exits who have recovered is >75%, died is <5% and defaulters is <15% (as per SPHERE standards) Activities related to the result SC will train the nutrition volunteers from the local host communities and IDP communities on screening of children for acute malnutrition. They will visit door to door to inform about the nutrition screening and support nutrition staff for organising nutrition screening camp in the community to detect acutely malnourished children. Children who are severely malnourished will be enrolled in OTP and provided with appropriate medical care as necessary. Those children having moderate malnutrition will be enrolled in the SFP and provided nutritional and medical support as necessary. Standard protocol will be used for management of these malnourished children including follow up and discharge criteria
Per result identified in the log-frame, more detailed information necessary for a good understanding of the proposal/ report will be completed here. A specific sub-section per result at proposal, intermediate report and final report stage has been foreseen (don't update information from a previous stage in this section, comment the change in the appropriate sub-section of the result). See also the guidelines for more information (e.g. for the list of sectors and related sub-sectors). Also the main foreseen procurement procedures will have been identified (as well as in section 4.4 work plan).
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Per result identified in the log-frame, more detailed information necessary for a good understanding of the proposal/ report will be completed here. A specific sub-section per result at proposal, intermediate report and final report stage has been foreseen (don't update information from a previous stage in this section, comment the change in the appropriate sub-section of the result). See also the guidelines for more information (e.g. for the list of sectors and related sub-sectors). Also the main foreseen procurement procedures will have been identified (as well as in section 4.4 work plan).
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Human Resources - 186,185 including 100% cover for programme implementation staff, 30 % for child survival coordinator and partial coverage of the cost of programme management staff at national, regional and project levels as detailed in the main budget sheet. Technical training and mentoring for staff - 13,507 including initial induction and project start-up training, technical trainings for staff and volunteers, mentoring meetings with senior project staff Nutrition commodity, soap, nets, and other project supplies 386,620
Intermediate report Total amount: .... EUR Update6 on indicators Update5 on beneficiaries (status + number) Update5 on activities Update5 on means and related costs Final report Total amount: .... EUR Indicators for achieved result Final state on beneficiaries (status + number) Activities accomplished Finally committed means and related costs Result 2: Mother or care takers of children under two years of age have improved feeding and care practices for their children to promote their nutrition and prevent malnutrition: At proposal stage Total amount: 224,877 EUR Sector: Nutrition Related sub-sector: Infant and Young Child Feeding (IYCF) Beneficiaries (status + number): Children under two years of age from IDPs and vulnerable host communities who are facing an Acute Food and Livelihood Crisis (AFLC) and Humanitarian Emergencies (HE) in Puntland, Somalia through their mothers and care takers; total project estimated target:6,800 Indicators for this result:
70% of the mother of children under two years of age have improved feeding and care practices for their
children
Activities related to the result SC will mobilize mothers or care takers of children under tow years of age and support them to establish support groups for infant and young child feeding and care practices. SC will support these groups to organise awareness campaigns in the communities targeting mothers of children under two years for breast feeding, complementary feeding, immunization, care of sick child at home and care seeking practices.
5
The main means and costs (the sum of the indicated costs has thus not to be equal to the total amount for that result) have to be identified to ease understanding how the results will be reached and the activities implemented.
6
Update and explanation to be provided on progress as well as on changes made to the proposal.
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Means4 and related costs Human Resources - 156,718 including 100% cover for programme implementation staff, 30 % for Child Survival Coordinator and partial coverage of the cost of programme management staff at national, regional and project levels as detailed in the main budget sheet. Technical training and mentoring for staff - 10,159 including initial induction and project start-up training, technical trainings for staff and volunteers, mentoring meetings with senior project staff Hygiene promotion supplies specially soap and other project supplies 49,500
Result 3: Under five children from IDP and poor host population have improved access to quality treatment for common childhood illnesses At proposal stage Total amount: 318,959 EUR Sector: Health Related sub-sector: Treatment of common childhood illnesses Beneficiaries (status + number): Children under five years of age from IDPs and vulnerable host communities who are facing an Acute Food and Livelihood Crisis (AFLC) and Humanitarian Emergencies (HE) in Puntland, Somalia through their mothers and care takers; total project estimated target:17,000 Indicators for this result: 75% of health staff working in local health facilities trained on IMNCI
70% of children attending the local health facilities treated according to IMCI protocol
Activities related to the result In collaboration with local MOH, selected health staff responsible for treatment of children will be trained on IMCI. Necessary materials, tools and guidelines will be provided to each facility for use during the service provision. Effective supervision system will be established with local MOH. Besides training, essential drugs and supplies necessary for the treatment of common childhood illnesses will be provided to the target health facilities. System will be established to monitor the utilisation and management of the supplies. Means4 and related costs Human Resources - 143,306 including 100% cover for programme implementation staff, 100% for emergency health manager and partial coverage of the cost of programme management staff at national, regional and project levels as detailed in the main budget sheet. Technical training and mentoring for staff - 17,343 including initial induction and project start-up training, technical trainings for staff and volunteers, mentoring meetings with senior project staff Medical supplies and equipments 146,454 Medical referral cost for malnourished children with complication and other severely ill children: 11,856
Update7 on indicators Update5 on beneficiaries (status + number) Update5 on activities Update5 on means and related costs Final report Total amount: .... EUR Indicators for achieved result Final state on beneficiaries (status + number) Activities accomplished Finally committed means and related costs
Other costs8
Initial amount Visibility Support services including core support staff of the country, regional and field offices) Office Costs (Nairobi, Hargeysa, Garowe, Bosaso, sub-offices) and communications Transportation, including vehicle rental (6), field fuel and maintenance, truck rentals Equipment (radio communications, security kits, field trauma kits, laptops, thuraya sets generator, camera for monitoring) Bank Transfer Fees @ 1% of total cost Indirect cost (7% of total direct cost) Total other costs 3,392 104, 124 47,821 89,072 20,748 Intermediat e amount Final Committed
Work plan (e.g. annex Gantt chart) The project is proposed for a total of 10 months, one of which is dedicated to data analysis, evaluation and reporting. Costs associated with month 10 are limited to three project staff (Child survival Coordinator, Emergency Programme Manager, Deputy Emergency Project Manager and Project Officers) that will be responsible for final activities around analysis and reporting.
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Update and explanation to be provided on progress as well as on changes made to the proposal.
The last table groups the costs that have not been dedicated to one specific result (support costs, feasibility studies, audits etc. as explained in the guidelines). The total of the total amonts mentioned per result and in this table will correspond to the subtotal direct eligible costs in the table section 11.
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Activities related to each the results: Result-1. Under five children with acute malnutrition have access to appropriate nutritional treatment through OTP and SFP 1. Recruitment and training of nutrition staff 2. Identification of sites for OTP and SFP 3. Identification and training of Community Nutrition Volunteers 4. Community mobilization 5. Active case finding 6. Systematic treatment and ration distributed 7. Supervision, monitoring and reporting Result 2. Mother or care takers of children under two years of age have improved feeding and care practices for their children to promote their nutrition and prevent malnutrition 1. Recruitment and training of IYCF staff 2. Identification and training of IYCF volunteers 3. Community mobilization and formation of Mother's support groups 4. Development and printing of IEC materials on IYCF and care practices 5. Launch of awareness campaign on IYCF and care practices targeting mother of children under 2 years 6. Supervision, monitoring and reporting Result 3. Under five children have access to quality treatment for common childhood illnesses. 1. Identification of health staff, their training needs in collaboration with MOH 2. Training of health staff on IMNCI in collaboration with MOH 3. Post training supervision, monitoring and follow up 4. Procurement and provision of essential drugs and supplies to health facilities for treatment of common childhood illnesses Others: Procurement of supplies MOU with UNICEF/WFP and MOH
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Monitoring, evaluation, audit and other studies Monitoring of activities (explain how, by whom) There will be regular collection and analysis of project relate information, in order to inform decision making, ensure accountability and provide the basis for evaluation and learning. The monitoring involves the regular review of a project's performance on both a quantitative basis (i.e. measurable like time spent, expenditure etc) and a qualitative basis (i.e. more general attributes such as how smoothly the project runs, the satisfaction of those involved etc). Monitoring will help SC answer questions about projects progress and will be crucial when it comes to the final evaluation. By use of the health teams attached to the project to the check progress of the project against the set objectives and indicators, timely changes and readjustments will be done to keep the project on track. The Emergency Programme Manager (international) based in Hargeysa with frequent visits to the project areas, will be responsible for the overall management of the programme and monitoring progress against planned activities and reporting. S/he will be responsible for ensuring that the programme is coordinated and implemented in accordance with the programme document, timetable, and budget. The operational implementation and day-to-day monitoring of the 17
programme is the responsibility of the Project Manager, Deputy Programme Manager and three Project Officers based in project sites. The Manager of Partnerships and Quality Programmes will support them to set up and manage an effective monitoring system. The Nairobi-based Alliance Cooperation in Emergencies (ACE) Manager will provide significant technical and management support to project implementation. He is responsible for representation and operational support at the Nairobi level. The Regional Manager for the North will provide strategic management support and the monitoring for project operation through the Head of Office in Puntland who is responsible for day to day management of the operational aspect of the project. The regional Manager will also provide strategic inputs at national level. An Emergency Health Advisor will be employed for the duration of the project and will be responsible for monitoring and ensuring quality; the Nutrition Advisor will also be responsible for providing all required technical support and back-stopping to the Puntand-based nutrition team. These positions are intended to ensure that adequate technical support for field teams is in place and available on a regular basis, as well as to ensure that field teams activities are performed to technical standard. With the current operational environment in Puntland, SC can provide adequate support from all levels to the project ensuring an effective implementation and monitoring of the project. If the security situation worsens and should problems arise with implementation of planned project activities, for insecurity, access or other reasons, SC will inform ECHO of challenges and the proposed way forward. However, to ensure that project implementation and management are undertaken to a high standard, SC also proposes to continue to invest significantly in training of field staff from the beginning to build their capacity for implementation of the project with minimal international presence as a precaution in case security deteriorates, preventing international staff to visit the field for monitoring and support. Initial project start-up trainings include, but are not limited to:
Induction into SC for new staff members (and refresher for existing staff) SC Child Safeguarding Policy Technical training Humanitarian principles and do no harm approaches Security protocols Procurement protocols Training on donor requirements, including reporting (financial and narrative) and procurement Agreement on monitoring and evaluation plans and responsibilities
Initial trainings will be followed up by regular meetings with field teams that revisit each of the subjects described above and others as required (as identified by the field team and senior management staff). With regard to the financial management, SC has standard financial management system which is applied globally. It includes up to date monitoring, internal control and risk management mechanism. SC also provides two week-long financial management trainings for all staff with budget management or support responsibilities. So, all staff dealing with grants or general funds will have a refreshed thorough understanding of SC financial management systems and donor reporting requirements. Currently, the main SC financial management office is based in Hargeysa which provides financial management support capacity to field programmes. SC also monitors all grants on a monthly basis in order to ensure better controls of expenditure. For this, the team in Hargeysa reports to Finance team in Nairobi who in turn reports to SC Head office in London. SC also has internationally standardised procurement policy and guidelines. These policy and guidelines will be applied while procuring goods and services for the project. A well established 18
system for internal and external audits of all the expenditure for any project within the organisation is also another layer of financial control mechanism SC has. Tick the box if one of the following studies will be undertaken: an external evaluation during the Action an external evaluation after the Action an external audit during the Action an external audit after the Action an internal evaluation or internal audit related to the Action Other studies: please elaborate: (Please remember that for external evaluations, audits and studies financed by the Commission the Terms of Reference have to be agreed by DG ECHO before launching the selection procedure)
CROSS-CUTTING ISSUES
Describe the expected level of sustainability and/or connectedness9 SCs current operations in Puntland have health, child protection and education sectors programme. To maximise the sustainability of the project, SC works closely with the local systems (where possible) and communities right from the beginning of the project development. Representatives of the local communities including women and children, organisations and the local health authority were consulted at the time of rapid situation assessment prior to the development of the concept note for this project. Their views have been incorporated in the strategies of this project. Accordingly, SC will provide capacity building support and technical inputs especially on health and nutrition wellbeing of children into communities and relevant local authorities. SCs experience has shown that creating effective models for participation in project design and implementation, as well as enhancing capacity at the local level, enables communities including children to raise their issues in different forums and at the same time to enable sustainability of the project outputs following the end of the project cycle. SC interventions in Puntland are designed in such a manner as to support longer-term goals, and eventually be managed by the communities themselves. Save the Children has implemented both emergency and recovery interventions in the Puntland mainly in the sectors of education, health and livelihoods. Our humanitarian and emergency work is as much as possible linked to longer term recovery and development. SC will provide capacity building support and technical inputs into communities and local governance structures. SCs experience has shown that creating effective models for participation in project design and implementation, as well as enhancing capacity at the local level, enables communities including children to raise their issues in different forums and at the same time to enable sustainability of the project outputs following the end of the project cycle. Continuum strategy (Linking Relief, Rehabilitation and Development) Given increasing humanitarian need, insecurity and more and more limited humanitarian access across central and southern Somalia and increasing trends of IDPs influx into the north, it is very likely that further emergency and development assistance will be required in the region, quite possibly during and beyond the 10-months proposed implementation period. This proposed project is part of a desired broader scaling-up of SC emergency operations in Somalia. With the existing and growing enormous gaps in health services, SC will try to continue this as more integrated health and nutrition programme by adding emergency health component into the programme. Simultaneous to scaling up of the emergency programmes designed to address the
9
Sustainability and connectedness are similar concepts used to ensure that activities are carried out in a context that takes longer-term and interconnected problems into account.
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growing acute humanitarian needs both for IDPs and vulnerable host population, SC aims to incorporate longer-term perspectives for sustainability, thus building on the positive changes/impacts achieved through emergency response. As mentioned, above, SC will work closely with the communities and local system to strengthen their capacities and sustain the positive changes achieved in terms of health and nutrition wellbeing of children and their families. Mainstreaming (e.g. Disaster Risk Reduction, Children, Human rights, Gender, Environmental impacts, others to be specified) Save the Children is a child-focused organisation and therefore issues of child protection and participation will be mainstreamed throughout its programmes. Project staff will provide appropriate awareness-raising sessions on the principles of child protection to partner staff, local authorities, and community members as per SCs global Child Safeguarding Policy. Gender is always mainstreamed in all SCs interventions. The project staff will enlist the participation of women and children in project activities as appropriate. Wherever possible SC will also mainstream the concept of disaster risk reduction into the project activities. During the project implementation, SC will look at the risk and vulnerabilities of the communities and take these into consideration while implementing the project activities. Risk reduction relies to a large extent on preparedness. SC will maintain a buffer stock of nutritional supplies in order to be in position to respond to deterioration in nutritional status. HIV/AIDS Mainstreaming: I. Minimum Activity for Partners SC will incorporate topics on HIV prevention and awareness in all its training for nutrition and health staff including the staff of local health facilities and community volunteers. HIV/AIDS awareness and prevention information will be made available to all the project staff at the project start-up workshop. Senior staff will be responsible for cascading information to support staff and to the community volunteers. SC will also reinforce the information and practices of universal precaution at health and nutrition care facilities. SC will procure high quality condoms and ensure that these are available to staff on an anonymous basis (most likely placed in toilets or another appropriate location within the office) in Bosaso, Garowe, Hargeysa and Nairobi. SC is an active member of the Health cluster and will also aim to participate in other relevant coordination forums in which HIV/AIDS is addressed. II. Minimum Activity for Beneficiaries SC will ensure that all CTC activities where injections are delivered adhere to universal precautions. Used sharps and other biohazard materials will be discarded safely through incineration sites. SC will not be undertaking any activities with beneficiaries involving blood transfusions. Some of the community members view strongly that HIV/AIDS awareness and other activities as promoting illegal sexual relations, making education of beneficiaries problematic from a security perspective. However, SC staff will continually monitor the social context, and provide awareness and prevention training to beneficiaries when possible. Beneficiaries requiring additional services will be referred to service providers where possible. The same security concerns extend to the distribution of free condoms to beneficiaries, however SC will continue to monitor the situation and will provide free condoms to beneficiaries as soon as possible without creating potential threat to staff members and beneficiaries. Given the current environment in Somalia and the existing health gap, there are limited opportunities for HIV/AIDS testing. If feasible, SC will refer beneficiaries for testing at the limited local health facilities available. Adapting protocols, commodities and exit-strategies for nutrition programmes in high prevalence contexts There is limited information available about current HIV/AIDS prevalence rates in Somalia. A 2008 UNGASS Country Progress Report on Somalia10 reports a prevalence of 0.6%.
10
Available at http://data.unaids.org/pub/Report/2008/somalia_2008_country_progress_report_en.pdf, p. 10
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However, given limited health services and widely prevalent strong stigma about HIV/AIDS, it is difficult to know how reliable this data is. SC adheres to standard, internationally accepted protocols for ensuring that health and nutritional rehabilitation services are available to all regardless of HIV/AIDS status.
FIELD COORDINATION
Field co-ordination (indicate the Humanitarian Organisation's participation in coordination mechanisms with other relevant stakeholders, e.g. clusters, NGOs, UN agencies, others to be specified as well as the links with the Consolidated Appeal Process, when relevant) SC plays an important role in the coordination of humanitarian aid provision in Somalia. SC participates in all OCHA-organized coordination meetings at the regional level with the aim of ensuring effective coordination between agencies to avoid overlapping activities at the district level. SC also actively participates in health cluster and nutrition cluster at regional level in Somalia/Nairobi. Technical staff at the coordinator level that are associated with this project (including, ACE Manager) will represent SC and play an active roll in their relevant clusters and other coordination forums currently in Nairobi - in order to ensure coordination with other major humanitarian actors in the region. National and local authorities (relations established, authorisations, coordination) In the absence of a functional central government in Somalia, SC has established good working relationships and works closely with regional and district level government bodies in Puntland. With the past and current EC-funded health programme in Puntland, SC has established a good relationship with the local health authorities. SC is a member of the important coordination forum such as health cluster, Health Sector and Health system strengthening working groups at regional level with involvement of local health authorities and at Nairobi level. Given the long-standing status of ineffective central governance capacity, agencies have attempted to coordinate external support through the Inter-Agency Standing Committee (IASC), the Somalia Support Secretariat (SSS) and the cluster system based in Nairobi, Kenya. SC is an active member of both the IASC and SSS and contributes regularly to many of the cluster groups, which provide the opportunity for information sharing with other agencies. In implementing this proposed programme, SC will collaborate with a large number of actors including relevant clusters and working groups. In the design of this programme, SC has consulted extensively with the communities including IDPs, local government authorities, other NGO and UN actors working in Somaliland and Puntland to ensure that duplication is avoided and complementarity of programming is ensured wherever possible. Co-ordination with DG ECHO (indicate the Humanitarian Organisation's contacts with DG ECHO and its technical assistants in the field) SC Somalia communicates regularly with the DG ECHO Technical Assistant in Nairobi to apprise him of progress and challenges faced during project implementation, as well as to discuss potential upcoming project proposals. SC will continue to liaise closely with the ECHO Somalia TA according to a jointly agreed schedule and also as required, as well as with relevant technical experts within SC, during the implementation phase of the project, and especially with regards to the lessons learnt and/or challenges faced.
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IMPLEMENTING PARTNERS
Name and address of implementing partner(s) Not applicable for the proposed project; no implementing partners proposed.
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While generally, humanitarian access through Puntland is unhindered, increased security incidents targeting humanitarian assistance and workers have been reported since the beginning of 2007. In the last three years and particularly since mid-2006, the number of people spontaneously moving into Puntland has risen fleeing insecurity as well as economic reasons. IDPs and returnees occupy the major towns particularly Bosaso, Gaalkacyo, Garowe and Gardho. Reports suggest that this has detrimentally impacted on the standard of living of the host population who are obliged to assist (with whatever support they can) through the extensive Somali family network and putting great additional strain on the areas limited resources. The rule of law remains weak, vulnerable groups particularly IDPs, the urban destitute and poor, suffer regular infringements of their human rights. There have been reported rapes in camps for internally displaced persons (IDPs) in Bosaso, which are committed either by men from the host community or other IDPs. Furthermore, in the recent past, there has been reported targeting incidents against the Government officials in Bosaso, with a number of them loosing their lives. SC has in place security kits (for hibernation purposes: rations, kitchen utensils, water supply, hygiene products, etc. and Fast Grab Bags) and medical kits (medical trauma treatment kits to be kept in vehicles, office / guesthouse). In order to ensure the ongoing utility of these kits, they require regular maintenance and refresher stocks of consumables and drugs. SC is planning a review of communications systems as well. As part of security awareness, Security and Logistics trainings are planned for local and international staff working in Puntland and other regions of Somalia. In regards to collection, exchange and analysis of security information, SCs main interlocutors are NGO NSP, INGOs operating in Puntland, and UNDSS. The latter have been able to provide us with daily information collected on the ground, as well as on a provincial scale, owing to their coverage of the proposed area of intervention and all their consequent security field assessments. However, it is important to note that such information is used to cross-check SCs own information. NGO NSP, for example, acts as a relay of what NGOs and authorities communicate on. Security matters have been followed and dealt with according to SCs usual protocols and relying on national staff on site. Has a specific security protocol for this Action been established? Yes No Standard procedures If yes please elaborate: Any visit of international staff to Puntland region requires the establishment of temporary security and stand-by evacuation plans. These are developed by the SC Somalia Crisis Management Team through a rigorous and iterative process prior to travel and must be signed off by the SC Somalia Country Director. Regional and London Headquarters staff are also involved in the development and sign-off of these temporary arrangements. The security guidelines and procedures described in section 8.2.1 govern the management of national staff security. These are reviewed on an ongoing basis, in close collaboration with national staff in Puntland and Hargeysa, the country office Crisis Management Team, and relevant SC regional and headquarters staff members. Are field staff and expatriates informed of and trained in these procedures? Yes No Each international staff member is briefed and regularly updated on the prevailing security situation, as relevant to their expected work and travel. National staff are involved in the design of the security measures and evaluation of the situation as well as weekly security reporting to the expatriate staff. National staff security is followed up on by Security Focal Points (SFP) of the country programme. Specific security training is provided to key staff, especially those with a role in security management on the ground in Puntand. Additionally, national staff based in Puntland 23
have weekly and daily security meetings at the outset of each working day to compare notes on the situation and determine whether field movement is advisable on a given day.
N/A
HUMAN RESOURCES
Indicate global figures per function and status
Function Status11 Number of staff Number of man/ month in project Comments
Expat
Local
100%
24
(10 months)
oversee the detailed day to day management of the technical aspects of the project and the overall operational and programmatic issues on the ground. Directly responsible for implementation, management and monitoring of project activities in project districts. Garowe depending on the security situation will provide technical support to the team on IMNCI and other child health issues. S/he will be responsible for organising intensive training/onthe-job training of health staff both SC and MOH. Based in Bosaso and Garowe as per the planned activities, will be responsible for the implementation, management and monitoring of project activities including training and data compilation and analysis. 1 based in Garowe and 4 based in Bosaso, will be rresponsible for providing medical and nutritional care for OTP and SFP cases. They are responsible for recording and documenting all resources utilized. 3 based in Garowe and 9 based in Bosaso, will be responsible for taking anthropometric measurements (weighing weight, measuring height, and take MUAC 1 based in Garowe and 3 in Bosaso, will be responsible for mobilizing community to bring children to OTP and SFP sites and to raise community awareness on service provision 4 based in Bosaso and 1 based in Garowe, will be responsible for ensuring essential medical services to sick children both working closely with nutrition team and local health facility staff 3 based in Bosaso and 1 based in Garowe, will e responsible for implementing IYCF activities in the IDP and host communities including formation of mother support groups 3 based in Bosaso and 1 based in Garowe, will be responsible for
Expat
Project Officers (one for each of CTC/SFP, IYCF and health outcomes)
Local
100%
CTC Nurse
Local
100%
Local
12
100%
Community Mobilizers
Local
100%
MCH Nurse
Local
100%
IYCF Nurse/Midwife
Local
100%
IYCF Assistant/Workers
Local
100%
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supporting IYCF Nurse/Midwife about the IYCF activities in the communities Logistic Assistant (Pharmacy) Local 1 100% Based in Garowe, will be responsible for the logistic management of all the medical and nutritional supplies with support of Logistic Officer. Undertake maintenance of finance systems. Follow up on all financial matters. Responsible for managing accounting systems, assist the Finance Officer and budget holders in the operation of SC accounting systems including production of analytical reports Responsible for ensuring that appropriate logistical support provided to the project; undertaking monitoring, recording, storing, supplying, and accounting for all project commodities; project procurement and contracts including and services; transport management; management of radio; EC flight coordination in Garowe and Bosaso. Responsible for cleaning, cooking, etc., in SC facilities. Responsible for the maintenance of the generator Providing day to day human resource support to the team
Finance Officer
Local
30%
Accountant
Local
100%
Local
1 1
30% 100%
8 1 1
Nairobi-Based Staff
Country Director Expat 1 7% Overall management of the Somalia Country Programme provides overall leaderships and strategic operational inputs within national and international context. Overall responsibility for the programmes in Somalia, provide strategic management inputs in within national and international context Provides support for establishing M&E system and responsible to provide technical support to project team to achieve effective monitoring, evaluation, impact assessment, review, and reporting of their work. S/he will guide, advice, and support building of the capacities of field teams in these
Expat
7%
Expat
7%
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areas. ACE Manager Expat 1 30% Supports throughout the project period. Provides technical support for emergency response. Responsible for representation and coordination with regards to central and southern Somalia at the Nairobi level. In the absence of the security coordinator, serves as focal person for Somalia. Responsible for overseeing transition towards emergency programming in central Somalia. Ensure security protocols and procedures are in place and followed. Risk analysis and proposing mitigation measures. Responsible for all three zones, however central Somalia monopolizes more than half the Security Coordinators time. Insures coordination of the project activities with other child survival programme in Somalia Ensure logistics protocols are in place and followed. Ongoing assessment of country office logistics capacity and oversight of improving this capacity. Provides support to all field site logistics staff. Responsible for all three zones, but central Somalia requires more than half of the Logistics Coordinators time. Ensures that expenditures incurred are in line with the ECHO guidelines, provides support for periodic reporting and where required in financial matters Responsible for general oversight of the human resource functions of the country office and suboffices Undertakes procurement of equipment and organizes dispatch and transport for the programme. Responsible for providing management and coordination of procurement, transport, administration and IT services for Somalia programme in Kenya Responsible for management and sharing of informational documentation for the country programme
Security Coordinator
Expat
30%
Expat
10%
Logistics Coordinator
Expat
30%
Finance Manager
Expat, Hargeysa
7%
Local, Hargeysa
7%
7%
7%
Local, Hargeysa
7%
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Accountant
Local, Nairobi
7%
Responsible for managing accounting systems, assisting the Finance Officer and budget holders in the operation of SC UK accounting systems including production of analytical reports To facilitate the efficient running of the Nairobi Office operations both Treasury Management & Systems Maintenance of SC computerised accounting systems To support the country programme in strengthening and maintaining the integrity of finance systems, updating and generating timely financial information to senior managers, cash flow management, payroll administration and the smooth running of the finance department Manages country office IT matters; provides technical IT support to staff Responsible for general administrative duties including arranging meetings, receiving visitors, follow up on IT action, follow up on repair of office equipment Basic cleaning responsibilities
Assistant Accountant
Local, Nairobi
7%
Finance Officer
Local, Hargeysa
7%
IT Officer
7%
7%
Office Cleaner
Local, Nairobi
7%
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Direct revenue from Action Contribution by applicant Contribution by other donors Contribution requested from ECHO % of total funding:
1,235,096
0 0
1,235,096
1,235,096
Total Funding
1,235,096
12 13
The partner can use another representation of costs in line with the current practice in its organisation. These headings will become the chapters of the final financial reporting. In case personnel costs and the costs on information, communication and visibility are not explicitly available in section 4.3.2, these have to be explicitly mentioned in this table.
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ADMINISTRATIVE INFORMATION
FPA number (if applicable)
8-100 Signed in December 2007
Name and title of legal representative signing the Agreement Yolanda Weldring Regional Director, East and Southern Africa Tel: +251 911 760 412 Email: Y.Weldring@savethechildren.org.uk Save the Children (SC) East and Southern Africa Regional Office Kirkos Sub-city, Kebele 13, Debre Zeit Road, Addis Ababa, Ethiopia Name, telephone, e-mail and title of the person(s) to be mentioned in Article 7 of the Agreement Ben Foot, Country Director, Somalia/Somaliland Programme P.O. Box 39 664 - 00623 Nairobi, Kenya Tel: +254 20 2737201 Fax: +254 20 2737468 E-mail: b.foot@scuk.or.ke & Joseph Mulupi, Emergency Coordinator, Somalia/Somaliland Programme Nairobi, Kenya, Tel : +254 20 2737201 Fax : +254 20 2737468 Mobile : +254 (0)733 628 192 E-mail: j.mulupi@scuk.or.ke Name, telephone, fax and e-mail of the representative in the area of intervention Bank account Name of bank: National Westminster Bank Address of branch: Tavistock House, PO Box 83, London WC1H 9XA, UK Precise denomination of the account holder: The Save the Children Fund Full account number (including bank codes): Sort Code: 60-80-07; Account No: 63012006 550 00 IBAN account code, (or BIC country code if the IBAN code does not apply): IBAN: GB13 NWBK 6072 1463 0120 06
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