UNICEF Kenya Annual Report 2008

Kenya Annual Report 2008

In 2008, due to political conflict, untold numbers of Kenyan children and women were killed, raped, displaced and separated from their loved ones. The Government of Kenya made remarkable efforts to ensure continuity of services.

UNICEF provided urgently-needed supplies to camps for the internally displaced people and helped to restore essential services as well as supported overstretched partners on the ground with technical and financial assistance.

Cover photograph: Š UNICEF/James Elder. Yvonne (right), eight, and her friends at the UNICEF tent school at the Nakuru showground where their families were living since being displaced in the election violence.

© UNICEF/Sara Cameron

Contents 03

Foreword

05

Kenya’s Children & Women

13

Programmes Health • 13

© UNICEF/Giacomo Pirozzi

© UNICEF/Giacomo Pirozzi

Nutrition • 19 Water, Environment & Sanitation • 23 Education & Youth • 29 Child Protection • 33 Communication, Partnerships & Participation • 41 Strategic Planning, Monitoring & Evaluation • 45

49

Moving Forward

51

Finances

55

Staff

© UNICEF Kenya Country Office, May 2009 Text: Tamara Sutila Stories: James Elder and Pamella Sittoni Design: Handmade Communications

Annual Report 2008 1

Š UNICEF/Wendy Stone

Above: Children in class at Jaribu Garissa Primary School in North Eastern Province.

2 Annual Report 2008

© UNICEF/ George McBean

Foreword

2008 was a challenging year for UNICEF in Kenya. The country saw its worst civil conflict since independence where untold numbers of children and women were killed, raped, displaced and separated from their loved ones. While some social services were suspended in affected areas, the Government of Kenya made remarkable efforts to ensure continuity of services. UNICEF provided urgently-needed supplies to camps for the internally displaced people and helped to restore essential services as well as supported overstretched partners on the ground with technical and financial assistance.

Despite the grim start to the year, 2008 had its success stories. Unique opportunities to advance children’s rights emerged from the crisis. These included the development of a peace education programme for primary and secondary schools and the inclusion of youth participation and development in national plans and programmes. UNICEF worked with the government and partners to set up tracing services to reunite children with their families and helped to strengthen disaster management strategies at national and local levels.

A cause for celebration was the government’s announcement that child mortality had declined significantly in selected districts, thanks to improvements in malaria prevention and treatment. Also commendable were several social budgeting initiatives that promise to channel greater resources towards early childhood development, maternal and newborn survival, secondary education and the reduction of regional disparities in mother and child outcomes.

Important partnerships were established to build alliances around children’s rights and to deliver better services. UNICEF helped to engage the private sector around food fortification and to advance a policy brief on early childhood education.

Joint programmes with UN sister agencies helped to deliver real results for children, including a programme with WFP that expanded coverage of services for the treatment of child malnutrition from 24 per cent in 2007 to 60 per cent in 2008.

Meanwhile UNICEF and UNFPA joined forces to address female genital mutilation, an effort that secured commitments from Parliamentarians to advance legislation and support mobilisation against

this inhumane practice. Additionally, a campaign for marking the International Year of Sanitation, spearheaded by the government, with support from UNICEF, civil society and other stakeholders, was very successful in placing hand washing with soap on the national agenda.

As UNICEF embarks on a new country programme in 2009, a continued focus on the most disadvantaged parts of the country and the most vulnerable of Kenyans will be of critical importance to creating a more equitable and inclusive society. Our overall goal for the next five years is to help Kenyan children, women and young people realise their rights to survival, development, protection and participation and rebuild a peaceful, democratic and prosperous Kenya.

I take this opportunity to thank our donors for their generosity, our partners for their dedication and the UNICEF staff who work tirelessly to make Kenya a better place for children and women.

Olivia Yambi UNICEF Kenya Representative

Annual Report 2008 3

Š UNICEF/Sara Cameron

Above: Children receive basic education at the UNICEFsupported Early Childhood Development Centre in Balambala Division of Garissa District.

Facing page: Children stand amidst the rubble at Murindika Centre in Molo where shops were burned down during the violence.

4 Annual Report 2008

Kenya’s Children & Women

Caught up in violence 2008 was a dark year for Kenya. The country, once a shining beacon of democracy in Africa, exploded into violence following a disputed presidential election in December 2007.

By the time a power sharing deal was struck on 28 February 2008, the devastation on children, women and families was untold: • About 1,500 Kenyans lost their lives.

• More than 400,000 people fled their homes and became displaced.

• An unknown number of children and women were raped, abused and exploited.

• More than 5,000 children were separated from their families.

• Many of the separated children were left alone in internally displaced person (IDP) camps or in other accommodation to carry on with school while their parents looked for a safe place to resettle.

• Property worth millions of Kenyan shillings, including schools, health clinics and water supply systems, were destroyed. development and protection.

The government launched an operation called ‘Rudi Nyumbani’ (‘Return Home’ in Swahili) in May 2008 in an attempt to rapidly resettle displaced families.

However, many Kenyans did not take up this opportunity for fear of their safety if they returned to their home communities. Hundreds of thousands of people remained in camps or with family and friends, putting extreme pressure on

© UNICEF/Guillaume Bonn

• Thousands of children and women were denied their rights to survival,

already overstretched services and infrastructure in host communities.

Annual Report 2008 5

Back to school after the horrors of post-election violence

Classroom as sanctuary As Kenya’s crisis continues, UNICEF is urgently seeking $6.6 million for emergency services. Much of the money would go toward protection, education and assistance for more children.

“The classroom is a sanctuary for so many children like little Yvonne,” said UNICEF’s Representative in Kenya, Olivia Yambi. “It’s safe, secure and somewhere they can begin to play and learn, and move beyond the horrors that they’ve experienced.”

In the first six weeks of the year, more than 300,000 Kenyans had had to flee their homes and as many as 1,500 had been killed.

The number of reported cases of rape had doubled. UNICEF estimates that 150,000 children are in makeshift camps spread across the country – and more than half of these are children under the age of five.

6 Annual Report 2008

great logistical challenges,” said Ms Yambi. “But we have many more children who need our help, and they need it today.”

© UNICEF/J. Otieno

When Yvonne’s family fled the violence that ravaged their village, the eight-year-old lost her home, her precious plastic necklace, her school uniform and her classroom.

“We don’t have much,” she said, “but we always had our school.”

The violence that swept through Kenya after December 2007’s disputed presidential election occurred as children like Yvonne sought to start a new school year. As UNICEF strives to provide safety and stability to hundreds of thousands of Kenyan children, education is fundamental.

In mid-February this year, Yvonne was finally back in school – in a UNICEF tent classroom at one of the camps in the conflict-torn Rift Valley.

She was elated. “I have two dresses that my mother saved from our burning house,” she said. “This one is my favourite. It’s my Sunday church dress, but coming back to school was special so my mother allowed me to wear it to school.”

A Form One class in session at the UNICEF tent school at the Eldoret showground in Rift Valley Province.

Real progress in difficult times So sudden was the eruption of violence that many families fled their homes with only what they could carry. Now living temporarily in fields, showgrounds, schools and churches, the children play in dusty patches amidst the elderly sleeping on their mattresses and those who simply sit, reliving the terror that befell them. Families’ meagre dinners burn over open fires, and toilets are overcrowded and unsanitary. These are the people UNICEF seeks to support.

By February 18, 2008, UNICEF had: • Provided nutritious foods to 70 per cent of the children in the camps.

• Ensured that more than 15,000 children were going to school in UNICEF tents.

• Provided over 50,000 people with access to safe water.

• Supplied 50,000 family kits, which offer shelter materials, cooking pots and utensils.

“We have made real progress in a short space of time and amid

Selfless acts provide safety While Yvonne was back in school and talkative, her friend’s fearful expression told another story.

“She saw her uncle cut up and killed by youths with machetes,” one of the girl’s teachers said. “She hid with her auntie, but she saw it all.” In response, the teacher visits the girl most nights in the camp, tries to help with her homework and gives her what food she can.

It is a selfless act, like others that are being repeated across Kenya daily. Despite having their lives thrown into disarray, Kenyans are ceaselessly stepping up to help each other. Here are just a few examples.

Francis, 17, spends his days helping children in a newly established camp next to his hometown. “This is a time for forgetting about me and looking after others,” he said.

In Kibera, Kenya’s largest slum and the scene of much fighting, a teacher, Leah, housed and fed 20 children for two weeks when the violence threatened their lives. “These children live in horrid conditions every day of their life,” she said.

“How could anyone seek to make their pain even greater? There was no question that I would do everything I could to keep them safe.”

And then there’s Anna, nine, who goes from door to door with her friends asking neighbours for any socks they can spare. She then hands them out to girls in the camps. “Socks keep your feet warm at night,” she said. “Next, I want to collect shoes for them.”

That would greatly please Yvonne.

“Some of my friends have no spare clothes, no books, no shoes,” she said. “Some are in school, but some still aren’t. I just want us all to be together again, safe in school and in church.”

An Escalating Refugee Crisis Elsewhere in the country, other humanitarian challenges emerged during 2008.

More than 60,000 new Somali refugees entered Kenya, bringing the number of refugees in the Dadaab camps in the northern part of the country to over 200,000.

The camps, originally designed for 90,000 people, strained to provide adequate services to the newcomers. The number of acutely malnourished children in need of therapeutic feeding doubled while those requiring supplementary feeding increased six times.

UNICEF applied for an internal grant that would provide much-needed funding for refugee assistance in the first three months of 2009. UNICEF continued with work to ease tensions between refugees and host communities through a joint UN programme that brought water and sanitation and educational support to the villages surrounding the refugee camps.

Business Not as Usual Though a fragile peace has prevailed in Kenya, several challenges have arisen.

Kenya’s good track record in social sector allocation, especially in education, has been compromised by the post-election crisis. This has resulted in social spending cuts. During the crisis, resources were reallocated to fund emergency relief for the hundreds of thousands of people affected and displaced by the fighting. Before the presidential rivals agreed to a peace deal, the international donor community adopted a ‘business not as usual’ stance to pressure the government to reconcile, accept mediation and adopt reforms. Millions of US dollars worth of development assistance was put on hold, including substantial funding for UNICEF in the water and sanitation sector and for the Joint UN AIDS Programme.

The Challenge of Poverty and Hunger The post-election violence damaged Kenya’s prospects for sustained economic growth and poverty reduction. Economic growth, which had soared to more than seven per cent in 2007, plummeted to 1.7 per cent in 2008. Poverty, especially income poverty, remained at high levels and continued to present the country with a formidable challenge.

The 2005/6 Integrated Household Budget Survey reported that 16.2 million people had been lifted out of poverty, which represents a decline in poverty from 56 per cent of the population in 2003 to 46 per cent in 2005/6. However, more recent estimates by the World Bank’s Kenya Poverty and Inequality Assessment 2008 suggest that poverty has increased by 22 per cent.

Kenya is unlikely to achieve the Millennium Development Goal (MDG) of halving poverty and hunger by 2015: • High inflation, which hit 26.6 per cent in April 2008, will continue to stunt economic growth.

• With thousands of families still displaced from post-election violence, the ranks of the poor are set to increase.

• An estimated 1.36 million people are expected to go hungry in early 2009 as

Opportunities amidst crisis The post-election crisis presented a number of opportunities to advance the rights of children.

One of these is the opportunity to put the youth on the national agenda. In parts of the country most affected by violence, disenfranchised youth were incited to loot and burn homes. The government and its partners quickly recognised the importance of creating space for the youth to participate more actively and positively in Kenya’s social and economic development, which is now a key theme in the government’s Medium Term Plan for Vision 2030.

The youth agenda also features strongly in the updated United Nations Development Assistance Framework 2009–2013, which was revised in light of the post-election violence, and in UNICEF’s new Country Programme for 2009–2013.

Child tracing services were set up to help children who had been separated from their families during the crisis. The tracing programme, which is run by the newly formed Ministry of Gender, Children and Social Development in partnership with civil society, will continue to provide support to unaccompanied children and families for many years to come.

The crisis exposed limitations in the government-led emergency response system, which was geared towards natural catastrophes, but could not cope with civil conflict.

Partners, including UNICEF, worked with the authorities to strengthen disaster management strategies.

Nationwide student riots and arson attacks in June 2008 contributed to the fast tracking of student participation in primary and secondary school governing councils.

a result of declining food productivity and rising food prices. Up to a fifth of the land in the main breadbaskets of the Rift Valley was taken out of production due to the crisis.

• Children and women are most vulnerable to food insecurity, especially those coming from destitute pastoralist communities, rural households with no land to farm, slum-dwelling communities, displaced and refugee families and

Annual Report 2008 7

households affected by HIV and AIDS. There is a real danger that families will place their children in childcare institutions as a way of coping with hardship, poverty and hunger.

• Malnutrition is on the rise and affects large numbers of women, and children under the age of five.

Protecting the Vulnerable In the midst of the chaos of civil strife, ongoing efforts to protect children in the poorest and most vulnerable households continued. The government substantially increased funding for the Cash Transfer Programme for orphans, from US$2.25 million to over US$8 million. The programme provides a monthly © UNICEF/Mariella Furrer

cash grant to the poorest households looking after orphaned and vulnerable children to protect them against various risks and shocks such as HIV and AIDS, extreme poverty, drought and destitution.

By the end of June 2009, the Cash Transfer Programme is expected to reach more than 70,000 households with 210,000 orphaned and vulnerable children in 47 districts. This puts the programme well on its way to meeting the 2012 target of 100,000 households.

The government has also prioritised displaced children within its programmes and started setting up systems to assist separated children and provide alternative family care.

WHAT IS VISION 2030?

Vision 2030 is Kenya’s development blueprint for 2008–2030. It plans to transform the nation into a middle-income country where all Kenyans will be able to enjoy a high quality of life. Developed through an all-inclusive consultative process involving Kenyans from all parts of the country, the vision is anchored on three “pillars” – economic, social and political – and will be implemented in successive five-year Medium Term plans with the first plan covering the period 2008–2012.

Improvements in Child Survival On a positive note, Kenya has made tremendous progress in child survival: • The infant mortality rate has declined by 22 per cent, from 77 deaths per 1,000 live births1 to 602 deaths.

• Under-five mortality has decreased by 20 per cent, from 115 deaths per 1,000 live births3 to 92 deaths 4.

The most impressive evidence of this trend comes from a new study in Kilifi district, Coast Province, where a 75 per cent reduction in under-five mortality due to malaria was reported. This happened as a result of the massive expansion in the use of insecticide-treated bed nets (ITNs), which is one of the most effective ways of preventing malaria.

However, there are several challenges to Kenya’s hope in achieving the MDG targets on reducing child mortality: • There are major geographic disparities in child survival, with children in Nyanza Province four times more likely to die before the age of five than children born in Central Province5. Several reasons, such as poverty, cultural practices and unequal access to healthcare are behind this.

• Kenyan children continue to die from easily preventable, but deadly, diseases.

Neonatal causes, acute respiratory infections and diarrhoeal diseases are the top three child killers in the country. Up to 50 per cent of child deaths would not have occurred if the children had not been malnourished.

• Malnutrition, one of the main causes of child mortality, is increasing (see next page).

• Access to safe water is not equally spread among the population, with only 1 Kenya Demographic and Health Survey 2003 2 Kenya Integrated Household Budget Survey 2005/6 3 Kenya Demographic and Health Survey 2003 4 Kenya Integrated Household Budget Survey 2005/6 5 Kenya Demographic and Health Survey 2003

8 Annual Report 2008

22 per cent of Kenyans living in the North Eastern Province able to access safe water compared to the national average of 61 per cent.

• Access to proper sanitation is low, at 57 per cent of the population.

• Hygiene practices are poor with only 25 per cent of mothers and primary care givers washing their hands with soap during ‘critical moments’ such as after using the toilet or before feeding a child.

High Levels of Malnutrition It is well known that malnutrition is one of the direct causes of death of children under the age of five in developing countries. Child malnutrition not only fuels illness but also affects learning through diminished IQs, reduces human productiv© UNICEF/Shezad Noorani

ity and ultimately compromises the development and prosperity of a country.

The Kenya Integrated Budget and Household Survey (2005/6) showed marginal increases in malnutrition. Children under the age of five continue to suffer from high rates of malnutrition: • 33 per cent of children under the age of five are chronically malnourished or stunted.

• Six per cent of children under the age of five are acutely malnourished or wasted.

• 20 per cent are underweight.

Micronutrient deficiencies are prevalent and continue to compromise children’s health, learning and productivity. High levels of Vitamin A and iron deficiency have been found among preschoolers and women, with significant regional disparities.

The last micronutrient survey was conducted in 1999 and more updated information is urgently required to tailor a comprehensive response to the problem.

The lack of progress in reducing child malnutrition is generally attributed to the very low rates of exclusive breastfeeding (only three per cent of mothers exclusively breastfeed their babies for the recommended six months while bottle feeding has increased from 12 per cent in 1998 to 27.6 per cent in 2003), the low priority given to nutrition by the government and other stakeholders and limited understanding among different sectors of the role nutrition plays in child survival and development and ultimately in human productivity and national development.

Saving Mothers, Saving Babies Pregnancy is usually a cause for celebration. But in Kenya, like in other developing countries with high maternal mortality rates, pregnancy can be a death sentence.

An average of 20 women die every day as a result of complications related to pregnancy and childbirth. Though these complications are life-threatening, they can be prevented or treated if women have timely access to antenatal, postnatal and emergency obstetric care.

One of the most effective ways of improving the chances of a mother and

LACKING IN MICRONUTRIENTS Vitamin A: 76 per cent1 of Kenyan pre-schoolers are deficient in this vital vitamin. Vitamin A deficiency compromises the immune system and causes night blindness. If left unresolved, the condition will lead to 300,000 deaths over the next nine years.

Iron: 43 per cent2 of pre-schoolers and 43 per cent of women3 are iron deficient in Kenya, which leads to anaemia.

Iodine: 6 per cent4 of Kenyans are iodine deficient, an improvement from 16 per cent in 1994. Around 25 per cent5 of children have moderate to severe iodine deficiency. If no action is taken to reduce this deficiency, more than 80,000 Kenyan children will be born with varying degrees of cretinism.

her baby surviving a high-risk pregnancy is to ensure that the baby is delivered by a midwife or doctor and that transport is available to a health facility with emergency obstetric care. However, recent data published by the Ministry of Medical Services shows a decline in skilled attendance at birth, from 42 per cent in 20036 to 37 per cent in 20087. This is a powerful statement about inequity and access to quality reproductive healthcare.

6 Kenya Demographic and Health Survey 2003 7 Ministry of Medical Services, ‘Facts and Figures 2008’

1 ‘Anaemia and the Status of Iron, Vitamin-A and Zinc in Kenya’, The 1999 National Micronutrient Survey Report, Ministry of Health, University of Nairobi, KEMRI, SOMA-NET, UNICEF 2 Ibid 3 Ibid 4 KEMRI, 2004, Survey on Iodine Deficiency 5 Data based on urinary iodine extraction rates.

Annual Report 2008 9

© Dramstime/Nicoletta Maiani

© UNICEF/Mariella Furrer

Above: A well breast-fed baby sleeps soundly at Pumwani Maternity Hospital in Nairobi.

Right: Tabitha Eregai, aged five years, in the pre-primary class at Lokkiggio Girls Primary School.

Also of concern is that most women give birth in their homes or communities yet it is here where the healthcare system is failing mothers. Primary healthcare and prevention at community level is grossly under-funded, receiving around nine per cent of the national health budget compared to 60 to 75 per cent for other levels of the system.

These trends are likely to prevent Kenya from reaching the MDG targets of reducing maternal and child mortality by 2015. The government is, however, trying to find ways of delivering better services to women and children at the grassroots level. Towards the end of 2008, the Ministry of Public Health and Sanitation announced that it would make a community-based healthcare strategy a flagship programme for the upcoming years. If the programme receives the funding it needs, it has the potential to make a major difference in the health and survival of children and women.

Rising HIV Infection Rates The worrying news is that an ever-increasing number of Kenyans are becoming infected with HIV every year. The Kenya AIDS Indicator Survey (KAIS) released new figures in mid-2008, which provided fresh evidence of a growing HIV epidemic: • Among 15-49 year olds the HIV prevalence changed from 6.7 per cent in 2003 (KDHS) to 7.4 per cent.

• A higher proportion of women aged 15-64 (8.7 per cent) are living with HIV compared to men (5.6 per cent).

Furthermore, marriage or regular partnership no longer safeguards couples from infection. The 2008 Modes of Transmission (MOT) study found that 44 per cent of new infections were among married people. It is evident that new ways of stemming the tide of HIV and AIDS need to be found. Both the KAIS

10 Annual Report 2008

© UNICEF/Sara Cameron

and MOT findings are now being used

81 per cent of children complete primary

friendly index’ to rate countries, based

to design an evidence-based national

school at the national level, there are

on the three key dimensions – protec-

HIV prevention strategy that focuses

big regional differences. For example,

tion through law and policy making,

on the groups of Kenyans that are

only 36.8 per cent of children completed

child-focused budgets and positive

most vulnerable to the disease.

primary school in the disadvantaged

outcomes for children.

North Eastern Province. Similarly, the

Kenya has done especially well in

Mixed Results for Education

national net enrolment rate for second-

developing appropriate laws to protect

Kenya has high enrolment rates for

ary school is 24.4 per cent while it drops

children from harmful traditional prac-

primary education with 91 per cent of

dramatically to 4.3 per cent in North

tices, trafficking and sexual exploitation.

children of primary school age enrolled

Eastern Province.

It is one of the few African countries

in 2007. This represents a 50 per cent

The ever-increasing enrolment in

where corporal punishment has been

reduction in the number of children

schools has made the issue of water,

banned in schools, where a juvenile

who are out of school, from 1.2 million

sanitation and hygiene of national sig-

justice system is attempting to address

in 2005 to approximately 700,000 in

nificance. Hand washing facilities are

the needs of young offenders, and

2007. Close to a half of enrolled chil-

largely absent in most public schools.

where there is a policy of free primary

dren are girls. A decline in enrolment

The average pupil-stance ratio for pri-

education.

rates was likely in 2008 owing to the

mary schools is still much higher than

disruption caused by the post-election

the set standard of 40:1.

violence.

Much of the foundation for creating a child friendly nation exists. If partners such as UNICEF can work

A Child Friendly Nation

with the Kenyan government to put the

start school, regular attendance and

It is a great credit to Kenya that despite

necessary energy, time and resources

completion of the eight-year primary

the huge challenges faced in 2008, the

to accelerating the implementation of

school cycle is a major challenge for

country was ranked as the sixth most

policies and programmes for children

many children, especially those who are

child friendly nation in Africa by the

and women, Kenya can once again

orphaned and vulnerable, those with

Africa Child Policy Forum. The Africa

claim its position as the continent’s

special needs, and those living in urban

Child Policy Forum is a pan-African

haven of democracy, prosperity and

slums and remote rural areas. Although

advocacy organisation that uses a ‘child

peace.

While a high number of children

Annual Report 2008 11

Š UNICEF/P Sittoni

A baby receives polio drops during a polio immunisation campaign supported by UNICEF.

12 Annual Report 2008

Programmes

Health

Though Kenya has made great strides in improving child survival in the past few years, a number of challenges remain. Maternal mortality is still high and a large portion of infant deaths happen in the first month of life – the neonatal period. This points to the need for improved reproductive healthcare for women and paying more attention to newborn and neonatal care.

The UNICEF Health Programme addresses these challenges through two broad areas: 1. Child Health, with its focus on increasing the availability, demand and use of integrated healthcare services for children under the age of five, including increased coverage of paediatric HIV treatment and care.

2. Safe motherhood where emphasis is put on increasing public demand for, and use of, reproductive healthcare and neonatal health services, including greater uptake of Prevention of Mother-to-Child Transmission services.

The programme provides strategic ‘upstream’ support to policy development and advocacy to leverage resources for child health. It uses evidence-based strategies to help Kenya achieve the MDGs whilst continuing to strengthen health systems in the disadvantaged northern areas.

THE STATS 60 Infant mortality rate (per 1,000 live births) 30% Infant deaths that occur in the first month of life 92 Under-five mortality rate (per 1,000 live births) Neonatal causes, pneumonia, diarrhoeal diseases, malaria and HIV Main causes of death in children under five 414 Maternal mortality ratio (per 100,000 live births) 69% Children fully immunised 150,000 Children under the age of 15 living with HIV and AIDS

Annual Report 2008 13

Post-election violence severely disrupted service delivery in the health sector. Health workers of opposing ethnicity were forced to flee, exacerbating already severe human resource shortages. The conflict also stalled the development of the health sector’s Sectorwide Approach to programming (SWAp). Coordination mechanisms weakened. To add to this, newly established districts lacked basic health infrastructure. UNICEF, along with other partners, stepped in to address some of these critical gaps.

Technical support was extended to provincial and district health teams in affected regions. Assistance was also given to the health ministries to recruit 65 assorted health workers in the areas affected by the post election violence. Medical supplies, vaccines and ITNs were delivered to IDP camps and health facilities serving displaced and host populations. To ensure harmonised coordination, UNICEF helped the health authorities to prepare a national response plan, establish coordination mechanisms and monitor the humanitarian crisis.

UNICEF worked closely with the newly-formed Ministry of Public Health and Sanitation and began strengthening its collaboration with the Ministry of Medical Services. The two ministries drafted new strategic plans for 2008–2012, which are expected to guide UNICEF programming for the health sector in the new country programme.

© UNICEF/Guillaume Bonn

How the crisis affected health

A mother holds her baby, who is being inoculated against polio in Kangemi health centre, Nairobi.

Child Health Policy Development In 2008 several key policies that will provide strategic direction to child healthcare programmes in Kenya were developed. The Ministry of Public Health and Sanitation, with support from UNICEF and WHO, finalised the Child Survival and Development Strategy. The strategy aims to provide a framework for partnership involvement and advocate for increased political will and financial commitment to child health. The strategy was validated by all key stakeholders and will be printed in early 2009.

Work continued on the Child Health Policy, which will be ready in 2009. The National Guidelines for Newborn Care were completed and used to train health workers in a drive to build national, provincial and district capacity.

The Expanded Programme for Immunisation The Expanded Programme for Immunisation experienced a setback in 2008, with immunisation coverage dropping to 69 per cent in 2008, down from 72 per cent in 2007. This was largely as a result of post-election violence, which left health clinics in affected districts without staff.

UNICEF supported the Division of Vaccines and Immunisation (DVI) at the Ministry of Public Health and Sanitation to clear several vaccine shipments and helped to build the capacity of government staff through training. Training was provided to build local capacity in this area. UNICEF also procured vaccines to replenish the stocks used up during the crisis.

A memorandum of understanding was signed in August 2008, for the government to use UNICEF procurement services for vaccines. Other efforts to improve vaccine procurement included: • Support to the Ministry of Public Health and Sanitation to oversee the

14 Annual Report 2008

implementation of a US$10 million grant from The Glo-

2008. The initiative aims to increase public demand and use

bal Alliance for Vaccines and Immunisation (GAVI). The

of routine health services in an effort to help Kenya achieve

grant is being used to strengthen health systems from

health-related MDGs.

2007 to 2010.

The participation of children under the age of five, the

• Technical assistance for a US$20 million proposal on

initiative’s target group, has progressively increased from

introducing the Pneumoccocal vaccine to the Kenyan

the first round held in June 2007. It peaked at 27.6 per cent

immunisation programme from 2010. Pneumococcal

during the third round in May 2008.

disease is the leading vaccine-preventable killer of young children worldwide.

• Preparations to advocate for duty free status for all vaccines for children in 2009.

UNICEF supported the development of a monitoring and evaluation system that measures the publice awareness.

This system will be integrated into a national monitoring and evaluation framework to make sure that there is coherence in data collection and reporting.

Tetanus Protection Maternal and neonatal tetanus (MNT) is a swift and pain-

Malaria Prevention

ful disease that kills newborns and mothers as a result of

Malaria is one of the top causes of death in young children

unhygienic and unsafe childbirth practices. Kenya’s efforts to

and women in Kenya. Its prevention and control are major

eliminate MNT are carried out through mass immunisation

priorities for the government. In 2008, a US$20 million

campaigns. UNICEF provided US$2.4 million towards the

malaria proposal was prepared for Round Nine of the Glo-

procurement and distribution of vaccines and related supplies

bal Fund to fight Tuberculosis, AIDS and Malaria. UNICEF

as well as operational costs and social mobilisation.

provided technical support to the drafting of the proposal,

In 2008, the first round of the campaign reached 57 per cent

which included provision of 8.5 million insecticide-treated

of its target, with large variations between districts. Results

mosquito nets, home-based management of malaria and

from the second round held in November 2008 showed

antimalarial drugs for children.

a 55 per cent coverage. Speculation about the vaccine’s quality as well as poor public turnout in the newly created

Paediatric HIV and AIDS

districts that lacked the experience and logistical capacity

An estimated 150,000 children are living with HIV in Kenya.

to manage the campaign accounted for the low coverage.

About 60,000 of these children require treatment. Since June 2008 the number of children receiving antiretroviral

Strengthening Supply

therapy (ART) has increased from 15,000 to 22,000. The

To help address operational shortcomings of the Kenya

goal is to reach at least 80 per cent of children in need of

Medical Supplies Agency (KEMSA), UNICEF supported

treatment in 2009. UNICEF’s contribution to these efforts

specialised training for two members of staff who are now

involved:

able to efficiently manage and dispatch essential medical

• Support to the Joint UN AIDS Programme Review 2008

supplies. The Ministry of Medical Services appointed a

where HIV and AIDS issues relating to women and children

task force to review KEMSA’s procedures. With UNICEF’s input, recommendations on how to improve the agency’s efficiency were made and accepted by the Ministry.

took centre stage.

• Support to the training of 110 doctors, clinical assistants, pharmacists and nurses in seven districts to improve the care and treatment of children exposed to, or living

Emergency Support to Northern Kenya UNICEF continued to strengthen the delivery of essential

with HIV. Mentorship visits strengthened the impact of the training.

health and nutrition services in the northern areas. This was

• Provision of CD4 machines to four district hospitals to

done by contributing to the salaries of 175 health workers

strengthen early infant diagnosis and to initiate HIV care

to increase the capacity of under-staffed health services.

and treatment of mothers. Forty districts are able to

UNICEF began negotiations with the Ministry of Public

diagnose HIV infection in babies, including all UNICEF-

Health and Sanitation to absorb these workers from the

supported high prevalence districts like Turkana, Isiolo

next financial year.

and Mwingi.

• Revision of paediatric ART and PMTCT guidelines to

The ‘Malezi Bora’ Initiative

improve the efficacy of drug treatments for pregnant/

The third and fourth rounds of the ‘Malezi Bora’ (Good Nur-

lactating women with HIV and infants exposed to the dis-

turing) public awareness took place in May and November

ease. Implementation of the new guidelines is expected to

Annual Report 2008 15

Community and religious leaders join child survival initiative

© UNICEF UNICEF/P.Sittoni

developing the comAgnes Mangolo smiles munication strategy. as she lifts five-monthIt supports the soold baby Elizabeth off cial mobilisation and the weighing scale at works closely with the an outreach clinic at Ministry of Health to Mbita primary school ensure that medicine in Kinango district in and other equipment is Kenya’s Coast Provavailable in all health ince. The nutritionist facilities. UNICEF staff has just confirmed that also helped to monitor the child’s weight is the implementation of within the recommendMalezi Bora and proed levels for her age, vided feedback to the and advises the young ministry. mother to continue exThis year, UNICEF clusively breastfeeding brought on board anthe baby for one more other important partner month before introduc– Kenya’s religious leading her to other foods. ers and the faith groups Closely watching the they represent. Under interaction is the area the auspices of the chief, Chai Mkala, who has mobilised over 300 A mother and her baby wait to be attended to during a ‘Malezi Bora’ Inter-Religious Council clinic in Kinango District, Coast Province. of Kenya, the religious mothers and fathers to groups used their turn up for services at indicators of the country. According networks to encourage Kenyans of the outreach clinic. all faiths to turn up for services at to the latest available data, Kenya’s “I heard about this clinic from the the health facilities, both during the under-five mortality is 92 deaths chief, who sent a message to the Malezi Bora weeks and afterwards. per 1,000 live births. whole village for all parents with A letter from all the major faith “Before, we used to organise children under five years to bring groups, including the Catholic, Protspecific campaigns to immunise them here today,” says Agnes. estant, Muslim and Hindu commuchildren, or to give them Vitamin Some of the other mothers say nities, urging parents to take their A supplementation. But these they heard about the outreach children to the health centres for campaigns were very expensive clinic from their religious leaders, services was published in the two and unsustainable. With Malezi who encouraged them to take their main national daily newspapers.

Bora, all the services are available children to the clinic, while others The letter was also read to congreat the health centre or hospital,” heard announcements over the ragations across the country. dio urging them to go to the nearest says DrSwaleh Shahbal, the district As part of the partnership with medical officer of health. health centre.

UNICEF and the Ministry of Health, The Ministry of Health sets aside The Mbita outreach was organrepresentatives of the Inter-Relitwo sets of two weeks to focus the ised by Ndavaya health centre to gious Council of Kenya participated country’s attention on child survivbring child healthcare closer to in mobilising the public to turn up al, by declaring the period “Malezi residents. The health centre is 60 for services, as well as monitoring Bora Weeks”. The first two weeks kilometres away and some of these of Malezi Bora implementation in mothers would have had to walk for were from 19–31 May. During this different parts of the country. time, parents are encouraged to more than six hours to get there.

“This year, mobilisation has take all children under five years Today’s outreach coincides with been more intense because of the old to health centres and hospitals the end of two weeks of countrypartnership with both religious and for immunisation, growth monitorwide mobilisation to increase the community leaders, and our other ing, Vitamin A, deworming and use of routine child survival servlocal partners,” says Dr Shahbal. to receive an insecticide-treated ices. The initiative, aptly named “It is easier for people to believe mosquito net to protect them from Malezi Bora (Swahili for Good what the religious leaders tell them malaria, a major killer of children Nurturing) was adopted by the because they know and trust them. in Kenya. All these services are Ministry of Health, in partnership This partnership is very important provided free. with UNICEF and WHO, last year, for Malezi Bora’s success.”

UNICEF was instrumental in to address the poor child survival

16 Annual Report 2008

reduce transmission of HIV from mother to child by more than 30 per cent.

• Revision of training curricula for pre-service and in-service health staff to reflect new treatment regimens.

• Support to a national review of cotrimoxazole use in paediatric HIV management. Cotrimoxazole is an antibiotic that is used as a prophylaxis against opportunistic infections in children living with HIV.

Safe Motherhood and Neonatal Health The Voucher Scheme The government, in collaboration with UNICEF, has been implementing a voucher scheme in northern Kenya, which aims to increase deliveries by trained midwives and nurses. This part of the country has one of the highest maternal mortality rates in the country. An estimated 1,000 maternal deaths are registered for every 100,000 live births compared to the national average of 414 deaths.

Since it began in 2005, the voucher scheme, under which women receive free skilled delivery at participating health centres, has contributed to improvements in antenatal attendance. While skilled attendance at birth has decreased nationally, the proportion of deliveries taking place in health clinics in remote parts of the north increased from an average of eight per cent 8 to 25.3 per cent 9.

The Ministry of Public Health and Sanitation has set up a task force to review the scheme’s success. A position paper was prepared in 2008 to guide policy development in this area.

The Community Health Strategy Kenya’s second National Health Sector Strategic Plan (NHSSP II 2005–2010) defined a new approach to the way the sector will deliver healthcare services to Kenyans – the Kenya Essential Package for Health (KEPH). As part of this package, the Community Health Strategy was developed and plans for its scale-up prepared in 2008. The government envisages this strategy, with its emphasis on empowering families and communities to prevent and treat common yet deadly childhood illnesses, to become a flagship project in the Medium Term Plan (2008-2012). However, low priority given to community healthcare presents a major challenge. The community strategy was launched in 2006 but only reaches a meagre 1.5 per cent of the country’s population. The plan is

PARTNERS • African Medical Research Foundation • Aga Khan Foundation • Catholic Secretariat • Centre for African and Family Studies • Christian Health Association of Kenya • Danish International Development Assistance • Gertrude’s Children’s Hospital • International Medical Corps • Kenya Red Cross Society • HLSP • Kenya Medical Association • Kenya NGO Alliance Against Malaria • Kenya Obstetricians and Gynaecological Association • Kenya Paediatrics Association • Merlin International • Micronutrient Initiative • Ministry of Local Government • Ministry of Medical Services • Ministry of Public Health and Sanitation • Moi University Teaching Hospital • Nairobi City Council • National Coordinating Agency for Population and Development • Population Service International • Sustainable Health Foundation • UK Department for International Development (DFID) • United Nations High Commissioner for Refugees • United Nations Population Fund • World Food Programme • World Health Organisation

to increase its coverage to 5.5 per cent by June 2009 and thereafter cover an additional 10 per cent of the population every year.

Maternal and Newborn Care To address the high levels of maternal and newborn deaths, UNICEF assisted the Ministry of Public Health and Sanitation to develop a training package on essential newborn care for community health workers. The course teaches simple techniques that can save lives such as infant Cardio Pulmonary Resuscitation, keeping newborn babies warm, helping mothers to initiate breastfeeding within the first hour of birth and educating women to recognise the first danger signs of ill health for early referral to a health clinic. The training module was field tested in 2008 and the training programme will be rolled out in 2009.

8 Kenya Demographic and Health Survey 2003 9 Voucher Scheme Evaluation 2008

Annual Report 2008 17

Š UNICEF/Guillaume Bonn

A child gets weighed at the African Inland church health centre in Lokichoggio in northern Kenya.

18 Annual Report 2008

Nutrition

The most serious malnutrition happens in a child’s first two years of life. It is caused by diseases such as malaria or worm infestation; poor sanitation and personal hygiene, which lead to diarrhoea; and inadequate childcare practices such as early weaning and mixed feeding.

The early years are critical to a child’s growth and development. The tragedy is that for so many children malnourished in these formative years, their physical and mental development lags are irreversible and become permanent. This represents a huge loss in human potential. Malnutrition is a direct cause of child mortality and diminishes intelligence, impairs learning and weakens human productivity.

Tackling malnutrition needs focused action on all levels – from policy making to community-led initiatives – and the involvement of all stakeholders. Reversing Kenya’s high levels of malnutrition in children under the age of five also requires a great amount of commitment, broader partnerships and substantially higher resources than previously dedicated to the nutrition sector.

In 2008, the UNICEF Nutrition Programme in Kenya focused its support and resources on two main levels – the national and the district. By addressing malnutrition from the top and bottom, a more holistic approach is taken to ensure that real change happens for children.

THE STATS 33% Stunted children under the age of one 6% Acutely malnourished children under one 20% Underweight children 3% Women who exclusively breastfeed their babies for 6 months 27% Children under five who have received at least one Vitamin A supplement 90% Kenyan households that use iodised salt

ECONOMIC LOSSES Between 2007 and 2015, Kenya’s economic development will be negatively affected if nothing is done to reduce the high levels of malnutrition in children under five.

Stunting: A loss of Ksh 80 billion Iodine deficiency: A loss of Ksh 24 billion Anaemia: A loss of Ksh 96 billion

Annual Report 2008 19

Policy and Advocacy at National Level UNICEF and its partners made significant progress in creating an enabling environment for improved service delivery in nutrition: • The government increased its budget allocation to nutrition from Ksh 3 million in 2007/8 to Ksh 40 million in 2008/9. UNICEF support to national planning and budget processes, including sector plans for Vision 2030, played a major role in this achievement.

• Key policy and strategy documents were developed, including the National Food and Nutrition Strategy and the Child Survival and Development Strategy.

© UNICEF/Guillaume Bonn

In 2009, UNICEF will support the monitoring of the implementation of both strategies.

• UNICEF provided support to improve government coordination and technical expertise in nutrition. This was done by establishing and strengthening the Nutrition Technical Forum and involved a broad range of NGOs. • Technical input to the Micronutrient Deficiency Control Council, the Infant and Young Child Feeding Steering Group and the Nutrition HIV and AIDS Technical Working Group continued.

• Key technical guidelines, standards and tools were developed to improve the A man tries to salvage whatever grain is left in the aftermath of burning in Murindiko, Molo, where shops were burned on the night of January 17.

delivery of nutritional services.

• Evidence-based decision-making in the nutrition sector was strengthened through the establishment of a nutrition information system. It included a website, an integrated nutrition database and a quarterly nutrition bulletin.

• UNICEF support to the Kenya Medical Supply Agency ensured that the country had adequate supplies of Vitamin A and multiple micronutrients for routine and mass supplementation.

How the crisis affected nutrition 2008 proved to be a challenging year for the Nutrition Programme. Major government resources were diverted from core nutritional activities to deal with the post-election crisis.

Rising food prices meant that more Kenyans faced hunger and malnutrition and needed assistance, placing strain on already limited UNICEF resources. High levels of malnutrition continued to plague women and children under the age of five in arid areas of the country, a clear sign that much more needs to be done for the most vulnerable members of the Kenyan society.

Twenty health and nutrition surveys carried out in crisis-affected areas helped the government, UNICEF and other partners deliver timely and appropriate services to malnourished children and women.

More than 300 camps and host communities serving over half a million IDPs were reached.

20 Annual Report 2008

• The new Ministry of Public Health and Sanitation, with technical support from UNICEF, renewed its commitment to the Code of Marketing of Breastmilk Substitutes. The code protects and promotes breastfeeding by providing comprehensive information on appropriate infant feeding and regulating the marketing of infant formula, baby bottles and teats. It is an important vehicle for Kenya to increase its exclusively breastfeeding rate.

Support to District Systems The UNICEF Nutrition Programme uses a comprehensive and multi-sectoral approach to address malnutrition at ground level. Priority was initially given to nutritional services for vulnerable children and women living in 11 arid and semi-arid districts of north and north-eastern Kenya but material and technical support was extended to most provinces as well as Nairobi’s slums.

In 2008: • The proportion of severely malnourished children under five years living in the arid and semi-arid districts who were diagnosed and admitted for treatment increased to 60 per cent from 24 per cent in 2007. Almost a half recovered in 2008. Of a further 46 per cent of moderately malnourished children in the same age group who underwent treatment, 23 per cent were cured.

• Up to 50 per cent of pregnant women attending antenatal care received appropriate micronutrient supplements.

• About 1,350 healthcare and nutrition providers in six out of eight provinces, and 1,600 community health workers in four out of eight provinces were trained in basic management of infant and young child feeding, helping them to promote and support optimal feeding practices in the home.

• Reporting rates for district nutrition data increased from less than 50 per cent of districts to 65 per cent following support from UNICEF that included the allocation of one full-time data expert to the Ministry of Public Health and Sanitation.

• National capacity in the implementation of nutrition surveys was improved.

Twelve government workers were trained to review and validate nutrition survey data and reports while twenty officials were enabled to plan and © UNICEF/Duncan Willetts

execute nutrition surveys to international standards.

• Up to 60 per cent of district and provincial hospitals completed their BabyFriendly Hospital Initiative self-assessment. This included over 90 per cent of health clinics in ten remote arid areas. Self-appraisal is the first stage in becoming designated ‘baby-friendly’ and allows healthcare managers and staff to decide whether their facilities are ready to apply for an external assessment. External assessments are planned for February 2009.

Improved services in Dadaab refugee camps as a result of UNICEF support Indicator/year

2006/7 (%)

2008 (%)

Coverage of vitamin A supplementation

88

100

Coverage of deworming activities

60

98

Reduction in global acute malnutrition

22

11

Reduction in severe acute malnutrition

4

1.2

Coverage of therapeutic feeding

44

90

Coverage of supplementary feeding

63

85

Recovery – severe malnutrition

80

80

Recovery – moderate malnutrition

90

90

Increase in infant and young child feeding groups

41

52

Improving service delivery Evidence-based guidelines and protocols are an important and indispensable part of quality healthcare. They describe the optimal care for a specific group of people or patients and when properly applied improve the quality of service delivery. The following were developed with UNICEF support to improve

A woman carries food provided by the government from a distribution point at Madogo Primary School in North Eastern Province.

PARTNERS • • • • • • • • • •

nutritional services in Kenya.

National Nutrition and Mortality Assessment Guidelines with: • Training and Quality Control Tools • Community Infant and Young Child Feeding Training and Monitoring Package • Infant and Young Child Feeding Research Protocol

• • • •

• Integrated Infant and Young Child Feeding/Baby-friendly Hospital Initiative Training Curriculum • Guidelines on Community Salt Monitoring • Curriculum and National Monitoring and Evaluation Framework on Nutrition and HIV and AIDS • Drft National Guidelines on the Integrated Management of Acute Malnutrition and a related training package.

• • • • • •

Action Against Hunger Concern Family Health International Food for the Hungry GTZ International Medical Corps International Rescue Committee Merlin Micronutrient Initiative Ministry of Public Health and Sanitation Ministry of Medical Services Ministry of Planning National Bureau of Statistics Office of the President (Arid Lands Project) Oxfam Samaritan’s Purse Save the Children United Nations High Commissioner for Refugees World Food Programme World Vision

Annual Report 2008 21

Š UNICEF/Michael Kamber

A man drinks from a small pool that is the sole water source for the Bulla Maki settlement in North Eastern Province.

22 Annual Report 2008

Water, Environment & Sanitation Water and sanitation are at the basis of life.

Without access to these vital resources and services, societies cannot survive or flourish.

UNICEF believes that investing in water and sanitation pays enormous dividends.

THE STATS 83% Urban Kenyans with access to safe water 48%

The returns are very high because the impact of water and sanitation cuts across so many aspects of people’s lives. Water and sanitation are fundamental human rights that are vital prerequisites for health, livelihoods and education, and therefore underpin the achievement of all the MDGs. This is why the UNICEF Water, Environmental and Sanitation (WES) Programme in Kenya focuses on providing services to the most deprived communities located primarily in informal urban settlements and the arid and semi-arid regions of northern Kenya. The programme has two focus areas: • Service delivery, which aims to stimulate demand and improve governance in order to expand delivery and increase use of improved water supply and sanitation facilities in households, schools and heath facilities.

• Policy development and advocacy, which supports child friendly policy-making and implementation at national and district level.

Rural Kenyans with access to safe water 57% Population with access to improved sanitation 25% Caregivers who wash their hands with soap during critical moments 19% Children under the age of five who die from diarrhoeal diseases 70% Schools in remote rural and impoverished urban areas with no toilets and safe water 30–60 Number of days girls miss school when they menstruate owing to lack of toilets and hygiene facilities

Annual Report 2008 23

© UNICEF/Shehzad Noorani

© UNICEF/George Mulala

Above: Girls carry jerry cans of water drawn from a water pump in Kalokol in Turkana.

Centre: A boy drinks water from a hand pump installed by UNICEF in Nabute village in Turkana District.

24 Annual Report 2008

How the crisis affected water and sanitation The post-election conflict delayed the start of the UNICEF WES Programme until the second quarter of 2008. Government contributions to the water and sanitation sector of US$1.7 million were held back following the re-allocation of resources to the emergency response. A 50 per cent shortfall in funding for the WES programme had an adverse impact on what could be achieved during the year.

On a positive note, emergency activities to address the plight of displaced and affected Kenyans received adequate funding. This allowed UNICEF and its partners to: • Construct 404 permanent latrines in 61 schools in districts affected by the post-election crisis and by floods, benefiting 30,000 school children.

• Install 260 mobile toilets and 2,000 latrine slabs in violence-affected areas benefiting schools, IDP camps and churches.

• Install rain water harvesting systems in 58 schools with more than 20,000 students.

• Distribute more than seven million aquatabs and 500,000 PUR sachets to IDP camps and host communities.

• Provide 1,700 ceramic water filters to families in host communities and more than 90,000 jerry cans and 108,000 buckets to households in IDP camps.

• Distribute water quality testing kits to partners to enhance water testing and surveillance in the violence-affected areas.

• Provide a technical training course on practical planning and management of emergencies to 25 government and NGO staff.

In spite of the difficult year, WES partners carried on working and made an effective emergency response possible. Mechanisms to coordinate the work of the many organisations and state agencies involved in the relief effort were strengthened using a cluster approach. A testament to the success of these efforts is the fact that children and women’s lives were protected from water-borne diseases that so often characterise humanitarian emergencies.

© Dramstime/Andrea Presazzi

Service Delivery

• Work also continued on rehabilitating

Another treatment method is PUR, a

dilapidated community water supply

powdered household water disinfect-

Access to Safe Water

systems. Major repair work on nine

ant that comes in small, affordable,

• The UNICEF programme began

systems in Isiolo, Mandera and Koru

and easy-to-use sachets. In Busia

work in 2008 with an ambitious

restored a supply of safe water to

district, PUR is at the heart of a pilot

goal: to reach 1.3 million new us-

approximately 60,000 people. Minor

micro-enterprise project. Some 6,000

ers with safe water by 2013. Though

rehabilitation of community water

community members and 1,500 school

the post-election violence severely

schemes in Samburu, Wajir, Garissa,

children have been taught to use it to

disrupted the programme, 30,000

Mandera East, Kisumu, Uasin Gishu,

treat water while 45 women’s groups

of the planned 50,000 new users for

Trans Nzoia and Nyando districts

have been mobilised to sell PUR to the

the year were reached in Mandera,

brought water to around 40,000

community as an income-generating

Kisumu, Rachuonyo, Bondo, Siaya

Kenyans.

scheme.

and Nyando districts. In addition, district authorities were supported

Water Quality

Water Management

to complete a comprehensive gap

UNICEF worked with the Ministry of

It has been long recognised that good

analysis for each locality, which was

Water and Irrigation to test different

local governance is necessary to de-

used to develop annual and five-year

kinds of household water treatment

liver sustainable water and sanitation

district action plans for water and

systems.

services. Institutions responsible for

One of these is solar water disinfection

water, sanitation and hygiene at the

• Other tools were finalised to improve

(SODIS), which is being used in Wajir

local level often lack the necessary

programme implementation. These

district. SODIS involves using the sun’s

capacity, skills and resources to fulfil

included a new set of manuals on

radiation and heat to destroy disease-

their governance responsibilities

Standard Technical Designs for

causing bacteria in contaminated water.

effectively.

Water and Sanitation Technologies

Around 5,000 community members in

To address these weaknesses, UNICEF

and hygiene promotion tools to

the district were trained to treat water

is helping the Ministry of Water and Ir-

sensitise communities on disease

using this simple and cost-effective

rigation to match resources and support

prevention.

method.

with the increasing responsibilities that

sanitation.

Annual Report 2008 25

© UNICEF/Juliett Otieno

Above: UNICEF Kenya Representative Olivia Yambi and Public Health and Sanitation Minister Hon. Beth Mugo march with children during the inaugural celebrations to mark the Global Hand Washing Day in Kisumu in Nyanza Province.

the local sphere is taking on to manage community-based water and sanitation systems.

In 2008: • More than 322 community representatives from Garissa, Ijara, Tana River, Mandera, Wajir and Marsabit districts were sensitised on water rights and good governance. With the knowledge that safe water and other basic services are their human right, communities were able to demand these services.

• More than 700 Water Users Association representatives were trained on governance, book keeping and auditing.

• About 200 community group representatives were familiarised with techniques in environmental conservation.

Hygiene Promotion Most of the health benefits of water supply projects stem from changes in people’s hygiene practices. While access to ‘hardware,’ such as water points and latrines, is an important part of improving health, it is equally important to devote resources to promoting recommended hygiene practices that have greater impact on health than the hardware alone.

UNICEF’s support to hygiene promotion in Kenya resulted in the following achievements in 2008: • Increased advocacy through highly publicised Child Alive Campaign.

26 Annual Report 2008

• Information material produced and disseminated through newspapers, radio and TV. • More than 2,500 posters with key messages on hygiene, safe water and sanitation were distributed to schools and communities in flood-affected and cholera-hit areas.

• School health clubs were established in 20 schools in informal settlements in Nairobi and in semi arid areas, reaching 7,000 pupils with messages on healthy hygiene practices.

• More than 30 NGOs working in Nairobi’s Kibera informal settlement were briefed on water, sanitation and hygiene. Several organisations began implementing activities in their localities. Another 55 participants from various agencies were trained in Community Led Total Sanitation (CLTS) and have committed to implementing the initiative.

Advocacy and Policy Development The National Sanitation and Hygiene Policy A key focus in 2008 was fast tracking the dissemination and implementation of the Water Act 2002 and the new National Sanitation and Hygiene Policy in selected arid, semi arid and flood prone districts. District Public Health Officers and other stakeholders were briefed on the policy in public forums, including © UNICEF/Juliett Otieno

those organised by local administrators and politicians. An implementation strategy for the School Health Policy was completed with roll-out set to begin in 2009. Work on developing a strategy for the National Sanitation and Hygiene Policy also kicked off.

Improved Coordination and Legislation Water and Sanitation Coordination Committees and the Environmental Sanitation and Hygiene Working Group meetings strengthened inter-sector coordination at district level. UNICEF facilitated these meetings and provided technical advice and support.

PARTNERS

Joint action planning on all UNICEF-supported activities has improved participation and linkages between stakeholders such as the National Environment Management Authority (NEMA), local authorities and NGOs. Prosecution of violators of the Public Health Act took place in several districts. More than 20 cases were successfully prosecuted in 2008 with only one case lost. Another 15 new officers were trained in prosecution.

Sector Reforms In collaboration with the Northern Water Services Board, the Coast Water Services Board and the Water Resources Management Authority, more than 200 communities in 10 arid and semi-arid districts were engaged in dialogue on sector reforms and institutions. In each of these forums community members interacted directly with the water boards, providing an opportunity for information sharing with more than 12,000 community members.

The forums also provided an opportunity for board members to influence policies and strategies in the water and sanitation sector. This approach also created opportunities for women and children to voice their opinion on how communities can improve water management and hygiene practice at household level.

• • • • • • • • • • • • • • • • •

Action Against Hunger ActionAid Athi Water Services Board Community Empowerment and Development Services Coast Water Services Board Institute of Water and Environment of the EAWLS Global Missions Kenya Red Cross Society Kenya Water Initiative Lake Victoria South Water Services Board Ministry of Education Ministry of Public Health Ministries of Water and Irrigation Northern Water Services Board Practical Action for Solutions Water Resources Management Authority World Vision International

Annual Report 2008 27

Š UNICEF/Shehzad Noorani

Barnabas Masai, 15, enjoys his studies at Napeililim Mixed Primary School in Lodwar town, Turkana District.

28 Annual Report 2008

Education & Youth

The UNICEF Education and Youth Programme works with the Ministry of Education to ensure that every child – regardless of gender, ethnicity, socioeconomic background or circumstances – has access to quality education.

To tackle under-representation of some children in school, particular attention

THE STATS

is given to girls, orphans, street children, children with special needs, child labourers, nomadic children and children living in urban slums.

The Programme covers three main areas: • Early Childhood Education, which focuses on stimulation and learning for preschoolers in the four to five age group.

• Primary Education, which is aimed at increasing primary access and completion rates for both girls and boys while ensuring that children are offered quality education in an environment that is conducive to learning.

• Complementary Education, which works to increase the enrolment of out-ofschool children in non-formal education.

Early Childhood Education UNICEF recognises that what happens to a child in early life is critical to their immediate well-being and lays the foundation for the future. At no other time in a child’s life does one learn and develop as fast and intensely as in the early years. The Early Childhood Education component of the UNICEF Education and Youth Programme offers opportunities for four and five year olds to engage in quality early learning.

In 2008, several activities sought to improve the quality of early childhood

33.6% Net enrolment rate for early childhood development 91.6% National primary net enrolment rate 0.94 Gender Parity Index 81% Net primary school completion rate 700,000 Estimated number of children who are not in school 24% Children of secondary school age in secondary school

education services in the country:

Annual Report 2008 29

How the crisis affected education Post-election violence in Kenya had a devastating effect on education. While hundreds of thousands of families fled their homes to avoid being attacked, other areas saw a heavy burden placed on already overstretched schools as displaced people joined their populations. In some areas, schools stood abandoned, without pupils and teachers. In other areas, school buildings were destroyed.

Many displaced children were only able to continue their education by remaining unaccompanied in camps while parents searched for places to resettle.

Spurred by the belief that education plays a unique role for children in emergencies and that continued school attendance and routine helps to restore a sense of normality in extraordinary situations, UNICEF prioritised initiatives that improve access, retention, quality curriculum and school completion. Behind this push was the strong belief that attending school protects children from violence, abuse and exploitation.

During the crisis: • UNICEF raised an additional US$1.8 million for essential education supplies, capacity building and advocacy.

• Over 50,000 displaced children continued their schooling.

• Peace Education materials and radio broadcast materials were developed for the Kenyan context. More than 4,000 focal points and peace education trainers of trainers were trained to produce and implement the peace tools.

It must be acknowledged that unexpected opportunities to advance the rights of children arose out of the crisis. One of these was the development of a peace-ineducation teaching and learning module, which is being integrated into primary and secondary curricula across Kenya.

30 Annual Report 2008

• Training of 36 officers from the Ministries of Education, Home Affairs and Gender, Children and Social Development took place to enable effective monitoring of early childhood development policy implementation.

• A School Readiness Assessment Tool was developed and will be piloted in 2009.

• Thirty teachers from three districts were trained as trainers in participatory storytelling to impart life skills to young children. This will enable the training of 250 pre-primary school teachers in 2009, with an opportunity to subsequently impart basic life skills to approximately 7,500 pre-primary school children on a yearly basis.

• The Early Childhood Development Parent Education Module was revised, strengthening parents’ capacity to support and play a stronger role in their children’s development.

• UNICEF supported the development of an implementation strategy for the Early Childhood Development Policy.

• Six early childhood learning centres in three districts were identified and supported by UNICEF for renovation and improvement.

• UNICEF supported the Ministry of Education to carry out a curriculum audit on the existing early childhood education teacher training curriculum and the primary school curriculum. The aim was to identify gaps and opportunities where knowledge, skills and positive attitudes on nutrition could be reinforced.

Primary Education Though the Free Primary Education policy in Kenya removed major barriers to children’s education, the education sector still faces huge challenges. Classrooms are overcrowded in some areas; high pupil-teacher ratios compromise the quality of teaching and learning; inadequate school infrastructure, including water and sanitation, discourage children from attending school; low access, retention and completion rates are common in the arid and semi-arid parts of the country with the widest gender gaps, and the high numbers of orphans and vulnerable children requires new ways of addressing their vulnerability and special needs.

Such challenges make it more important than ever for UNICEF to work with partners to establish secure, healthy and protective learning environments where children can learn and grow. UNICEF believes that the way to achieve this is through the Child-Friendly School (CFS) initiative.

The CFS model provides the ideal environment in which to offer rights-based, quality education where all pupils, and particularly girls, can feel safe, motivated to attend school and ready to learn. Bridging the gender divide by increasing the participation of girls in primary education has continued to influence policy and practice as has tackling the spread of HIV and AIDS through life skills education.

In 2008: • UNICEF supported the development of a draft Nomadic Education Policy and implementation plan, which will bring flexible and alternative modes of schooling to approximately one million nomadic children who otherwise have very limited access to education.

• Training of 220 senior staff from Teacher Training Colleges and 194 Education Officers on the CFS concept took place.

• A Child-Friendly School evaluation revealed better exam results in the Kenya Certificate of Primary Education, especially for girls, who were revealed to have a higher profile and more visible participation in Child-Friendly Schools.

• The Ministry of Education decided to scale up student participation in school councils and governance. Training was provided, and guidelines developed for head teachers to spearhead this initiative.

• UNICEF supported the development of a documentary video on nomadic education and a calendar of female role models from the arid and semi-arid parts of Kenya, with key messages to schoolgirls.

• UNICEF championed the development of a communication strategy for the Education SWAp. The Ministry of Education took full ownership of the strategy, which is helping to better communicate to the public the achievements, challenges, and stakeholder roles and responsibilities for the Education for All programme.

Complementary Education Children’s ability to access education is not evenly spread across the regions of Kenya. In some areas of the country, notably urban slums and remote rural © UNICEF/Sara Cameron

regions, efforts to improve the education of children are beset by challenges.

Children in these regions grapple with poverty and have low levels of educational attainment.

Complementary education aims to increase enrolment of children who are out of school. Programmes are designed specifically to extend the reach of nonformal public schooling to better serve the most disadvantaged and/or remote areas. By targeting traditionally under-represented populations, complementary education aims to provide effective schooling to areas where formal education is just not available. It is in these areas that children and young people seldom find the means to improve their lives.

An area of priority for UNICEF is finding ways to support the life chances of children in nomadic communities. This involves offering viable schooling options

Franklin, 10, studies diligently in the over-crowded Standard Three class at Loyo Primary School in Lodwar, Turkana District.

as well as developing life skills courses. Complementary education bridges the gap between formal public schooling and semi nomadic pastoral life.

The following achievements were made in 2008 to advance the complementary school programme: • A total of 47,120 learners in non-formal schools in informal settlements of Nairobi and Mombasa received free primary education grants from the Ministry of Education. The grants help children buy textbooks and other essential school material.

• Over 600 teachers improved their teaching skills following an orientation programme on non-formal education in eleven districts in North Eastern Province and in Nairobi’s informal settlements.

• The first drop-in centre for street children and vulnerable children was opened in Mombasa in November 2008. This UNICEF-supported initiative will enable the children to access services, care, education and rehabilitation.

• Some 60 new girls joined the scholarship programme, an initiative in North Eastern Province now in its third year, which targets disadvantaged girls for scholarships to enable them to complete secondary education.

• A total of 60 career women who serve as role models for girls were trained on mentorship skills, advocacy and support to equip them with skills to inspire girls in primary and secondary school to complete school.

Education and Youth PARTNERS • ActionAid • Forum for African Women Educationalists, Kenya • Ministry of Education • Ministry of Local Government • Ministry of Youth Affairs and Sports • Save the Children

Annual Report 2008 31

Š UNICEF/Guillaume Bonn

Narutom Esekon, 11 months, was admitted with moderate malnutrition and medical complications at the African Inland Church health facility; she is with her mother, Nangolol Esekon.

32 Annual Report 2008

Child Protection

Violations of children’s rights to protection take place in every country and Kenya is no exception.

These terrible acts of wrong are massive, underrecognised and under-reported barriers to child survival and development, in addition to being human rights violations.

THE STATS

Children who experience violence, exploitation, abuse and neglect are at risk

Orphaned and vulnerable children under the age of five

of death, poor mental and physical health, HIV infection, educational problems, displacement, homelessness and vagrancy. Children who are robbed of love, care and security, themselves fail to develop good parenting skills later in life and the cycle continues.

Child protection issues intersect with every one of the MDGs – from poverty reduction to getting children into school, from tackling gender inequality to reducing child mortality. The fact is most of the MDGs cannot be achieved if children are not protected.

UNICEF uses the term ‘child protection’ to refer to how the government, civil society, development agencies and other players prevent, and when they occur, respond to, acts of violence, exploitation and abuse against children as well as separation from families.

2.4 million Those of Kenya’s 15 million children who are orphaned and vulnerable 30%

13% Children below 15 fostered by relatives and friends 700,000 Children who have lost their parents to AIDS-related diseases 9% Percentage of Kenyans with HIV who are children under the age of 151

In Kenya, the UNICEF Child Protection Programme works with partners in three areas: 1. Justice for children and prevention and response to violence and exploitation of children, including during emergencies 2. National social protection systems for the most vulnerable children 3. Prevention of HIV infection among children and young people

1 Please note that this figure is a projection based on the 2004 Children on the Brink report.

Annual Report 2008 33

© UNICEF/Georgina Cranston

© UNICEF/Guillaume Bonn

Above: Residents of Molo town escape the fighting.

Centre: A woman carries roofing material from the plot that was her temporary home at a camp for displaced people in Burnt Forest town in Rift Valley Province.

Right: Children play outside their house in Migori District, Nyanza Province.

34 Annual Report 2008

How the crisis affected child protection 2008 was a difficult year for children.

The sheer level of violence seen in the post-election period had a serious impact on the safety and security of children and women. Many were killed or injured, raped and separated from their families.

Much of the year was dominated by emergency interventions. Cuts in development funding meant that insufficient money was available for critical protection of children during the conflict. Despite government efforts to rapidly resettle families, the stark reality is that by the end of 2008, many children still lived in a seemingly hopeless situation in temporary homes in camps, lodgings, and child-headed households or in charitable children’s homes. A great deal of assistance will be needed to ensure that large numbers of these children do not join the ranks of the destitute poor.

Despite the enormous challenges faced in 2008, the crisis did give way to several unique opportunities for advancing the rights of children: The government’s newly formed Ministry of Gender, Children and Social Development, established a vital separated children’s identification, tracing and family reunification programme with support from UNICEF and other child protection partners.

This collaborative programme: • Identified a total of 5,443 separated children.

• Identified 2,075 of the 5,443 children living in 352 charitable children’s institutions in 16 districts.

• Identified 3,368 of the 5,443 children living in child-headed households in nine of the 16 districts.

• Reunited 1,436 children of the 5,443 with their parents.

• Addressed the psychosocial needs of the separated children.

The programme is anticipated to provide support to families and separated children for many years to come.

The government increased the protection of children in the most vulnerable households by expanding its allocation to the Cash Transfer Programme, which will reach about 210,000 orphans and vulnerable children in 47 districts by mid 2009.

The post-election violence highlighted the importance of involving young people in UNICEF programmes. UNICEF helped mobilise youth for peace and supported opportunities for them to debate peace and reconciliation.

The emergency also created an opportunity to strengthen coordination among key partners on child protection with a mechanism established under the Department of Children’s Services.

© UNICEF/Bobby Model

Justice for children/ prevention and response to violence and exploitation of children

exploitation and abuse. It makes them vulnerable to HIV infection and violates their right to be protected. Ending trafficking needs close international, regional and national cooperation.

In 2008, progress was made in the development of anti

Justice for Children

trafficking legislation and joint strategy with neighbouring

UNICEF continued to build strong partnerships with various

countries. A child trafficking forum, held for magistrates

organisations to protect children from being exploited sexu-

and prosecutors working in border districts with Uganda,

ally and supported a number of initiatives to make justice

Tanzania and Ethiopia, called for the adoption of the Traf-

more child friendly and accessible to children, witnesses

ficking in Persons Bill, which was ready for tabling in Parlia-

and their families.

ment, as well as increased cooperation with neighbouring

• A Teddy Bear Clinic was inaugurated at the Nairobi Chil-

countries.

dren’s Court, giving children access to counsellors and lawyers.

• During 2008, children in 14 districts were entitled to free

Preventing Sexual Exploitation and Gender-Based Violence

legal aid through the services of two NGOs. This initia-

A 2006 government and UNICEF report found that thousands

tive reached 2,400 children, 150 of who were victims of

of Kenyan girls from all over the country were being sexu-

post-election violence. Towards the end of the year, the

ally exploited in the tourism industry in coastal areas. The

Ministry of Justice, National Cohesion and Constitutional

post-election violence also saw a significant increase in

Affairs launched the National Legal Aid and Awareness

the number of victims of sexual violence, including boys

programme that will start operating in 2009.

and men. Rape is a common characteristic of conflict and

• UNICEF supported the induction of 150 newly recruited

is used systematically as a weapon of war and as a means

Children’s Officers to improve their capacity to protect

to terrorise populations and destroy community ties.

children. In addition, training was provided to 150 com-

Humanitarian disasters also pose risks for poor girls and

munity paralegals in Nairobi, Garissa and Kwale districts,

women who may be forced into alliances with security

who in turn, sensitised approximately 700 community

forces, and even humanitarian personnel, as a means to

members on child rights and protection.

negotiate safety and survival.

In Kenya, UNICEF has partnered with civil society and the

The Fight Against Human Trafficking

government to address abuse and violence against children

Trafficked children are subjected to a number of abuses.

and women head on. The Swedish International Develop-

They are often forced into prostitution, or to perform cheap

ment Agency and the Italian Cooperation have generously

or unpaid labour. Trafficking exposes children to violence,

provided financial support for the project.

Annual Report 2008 35

© UNICEF/Giacomo Pirozzi

Left: Beatrice, 12, works as a maid in a relative’s home in Mombasa, Coast Province Facing page: Members of a women’s group in Moyale, Eastern Province, listen to a radio broadcast on the dangers of female genital Mutilation. They are campaigning against the harmful practice.

In 2008:

Mobilising Against Female Genital Mutilation

• Support was given to the Sexual Offences Task Force to

Female genital mutilation (FGM) is a violation of univer-

develop and publish regulations governing the imple-

sally recognised human rights. The practice damages the

mentation of the Sexual Offences Act.

physical and psychological integrity of girls and women and

• UNICEF joined with the Malindi-based Italian NGO, In-

inherently contradicts gender equality. It can cause shock,

ternational Committee for the Development of People,

trauma, infection, bleeding and death. The practice makes

to promote responsible tourism in partnership with 40

girls more vulnerable to HIV infection.

hotels and tour operator companies in the main tourist spots on the Kenyan coast.

In addition to legislation that bans FGM, UNICEF recognises the importance of enhancing the work of grassroots

• During the post-election crisis, UNICEF and partners worked

non-governmental and community organisations that are

together to develop Standard Operating Procedures for

concerned with the protection of human rights and dignity,

survivors and service providers. Support was also given

as these groups play an important role in the abandonment

to services providing post-rape care and post-exposure

of FGM.

prophylaxis (PEP) was provided for rape victims.

In September 2008, the Ministry of Gender, Children and

• UNICEF contributed to strengthening the delivery of

Social Development, with UNICEF and UNFPA support,

post-rape care services (PRC) in Rift Valley and West-

launched a programme to accelerate the abandoning of FGM

ern Provinces, Kenya. The local NGO, Liverpool VCT,

in one generation. This initiative serves as a springboard

trained counsellors and clinicians in 20 health facilities

to galvanise MPs around the issue, and provides a forum

in the delivery of post-rape care services, and provided

for anti-FGM actors to create policy, work plans and a

underserved centres with additional staffing to attend

monitoring and evaluation framework. Advocacy has led

to the needs of IDPs.

to MPs committing to an anti-FGM bill.

• UNICEF also contributed to the distribution of IEC materi-

In order to increase public awareness on FGM, UNICEF

als on rape. These included pamphlets for survivors with

trained 30 journalists to cover the subject in a sensitive

instructions on how and what to do in the event of rape,

manner. Sixty-nine chiefs and district officers in the North

as well as funds towards the printing of forms required

Eastern Province were mobilised to hold community dialogues

by hospitals, the police and the legal system in the event

on FGM. A further 19 Muslim scholars were supported in

of prosecution and their placement in health facilities.

their anti-FGM community mobilisation efforts.

• Over the course of the year, UNICEF also provided 1,900 PEP kits to hospitals and clinics. The kits included emer-

National Protection Systems

gency antiretroviral drugs, pregnancy kits, emergency

In 2008, as hundreds of thousands fled their homes, it was

contraception, and antibiotics for the treatment of STIs.

inevitable that many children would become separated

UNICEF also provided post-rape care kits, which included

from their families. An urgent need emerged to establish

necessary testing supplies for collecting specimens.

methods to identify and reunite separated children with

• UNICEF carried out integrated training in gender-based violence for key actors in health, legal, psychosocial and justice sectors.

36 Annual Report 2008

their families.

Faced with a national emergency, the only way to provide effective protection for children was through close cooperation

It happened to her 33 years ago, but Amina Abdi still recoils, tears forming in her eyes, as she speaks of the ordeal of undergoing “the cut”, the euphemism for FGM. She was only six years old when the brutal act was performed on her.

“It was a cold morning and I was sitting by the fire with my sisters and cousins on a special stool given to me by my grandmother. Then, my mother beckoned me. She asked me to take the stool with me. I was led to a spot under a tree, where my grandmother was waiting with other elderly women. She asked me to sit on the stool in front of her and grabbed me tightly as the circumciser started to cut. She first cut off a small flab of flesh, which she held up and declared, “this one hardly has anything to cut. Then she scooped out some more flesh… it was so painful, I must have passed out. The only thing I remember was sitting in a pool of blood. My thighs and feet were tied together with a rope and then… I stayed that way until I healed,” says Amina, the pain replaying on her face.

In the room are her friends and colleagues in the nursing profession, Fatuma, Halima and Jillo. Each of them has an equally horrifying tale of undergoing FGM and they all cringe as Amina tells her story.

The four women, all in their 30s, hail from different districts in north eastern and northern Kenya, where 90 per cent of girls and women are subjected to FGM. Now, they are part of a women’s group that is engaged in a campaign against the practice.

Some of them are setting an example by refusing to subject their daughters to FGM, following their own experience and the information they have acquired through a radio programme supported by UNICEF. After healing, Amina put the painful incident behind her and concentrated on her education. She trained as a nurse and was married off soon after completing her course. This is when she realised that the pain of FGM would haunt her forever.

© UNICEF/P Sittoni

Mothers protect daughters from female genital mutilation

“My wedding night was a nightmare. Intercourse was excruciatingly painful and it was like undergoing the cut a second time,” she says.

Among the Borana people, the type of FGM practiced is infibulation, which refers to the excision of part or most of the external genitalia and stitching or sealing of the labia majora. Culturally, this is to ensure girls preserve their virginity until they are married. A groom must force his way in, the pain and discomfort of the woman notwithstanding, to prove his manhood.

The next horror for her came when she went into labour to deliver their first child. The doctors at the first hospital she was taken to were unable to help and she had to be rushed to a major hospital in the city.

“I vividly remember the shock on the doctor’s face when he looked at my private parts. He exclaimed: “What happened to you? Who did this to you?”. That is when I realised how different I must look down there compared to other women who still have their bodies intact.”

Amina was having obstructed labour, a common complication among women who have undergone FGM. She was lucky to have had access to proper medical care, which saved both her and her daughter. All her three children were born by caesarean section and she says sex is still painful. She just resigned herself to her fate, which she knew was her people’s way of life.

Ironically, Amina still put all her three daughters through FGM. At that point, she says, she did not think

she had a choice not to. “My mother was threatening to come and take them to a traditional circumciser and I knew she would do it. Since I did not want them to experience that pain, I took them to a doctor, who performed the operation under anaesthesia. Now I really regret this action,” she says.

Amina now lives with three nieces that she rescued from FGM. “I will protect them from my mother at all costs,” she says.

Amina and her friends belong to a self-help group in Moyale district called Kotosi. Recently, they have added to their income-generating activities an awareness campaign against FGM. Theirs is one of ten groups working with the Association of Media Women in Kenya on the UNICEF-supported programme to create awareness on the dangers of FGM and to encourage the residents to abandon the practice.

They meet once a month to listen to a recorded radio programme on FGM, and discuss its contents. Each member is tasked with passing on this information to relatives, neighbours and friends. The group members have composed songs and folklore, which they use to preach the anti-FGM message. They also visit schools and community gatherings to discuss this seldom talked-about issue. In such a closed community, this is sometimes difficult.

“When I first told my mother to consider abandoning FGM, she was so scandalised, she threw a stone at me in anger. But slowly, she is beginning to understand the dangers of FGM. I keep giving her this information, and I am sure she will change with time,” says Jillo.

Although FGM was declared illegal in Kenya with the enactment of the Children’s Act in 2002, the last Demographic and Health Survey (2003) found that 32 per cent of women aged 15 to 49 years in Kenya have undergone some form of FGM. This represents a six per cent decline compared with the same survey carried out in 1998.

Annual Report 2008 37

between partners and the development

society organisations to do just that.

by June 2009, the programme will reach

of coordinated systems.

Following the post-election violence:

70,000 of the poorest households taking

Together with UNICEF and other child

• UNICEF provided support to the Min-

care of more than 210,000 orphans

protection actors, the Department of

istry of Health to draft and adopt

and vulnerable children. The increase

Children’s Services quickly responded

national guidelines on emergency

represents 70 per cent of the target of

to this crisis and established an Inter-

post-disaster psychosocial principles

100,000 households set for 2012.

Agency Database on Separated Children

and responses.

Steps taken to improve programme

and a response programme. Training

• Partners were familiarised with the

implementation and efficiency included

and collaboration took place so that

‘Inter-Agency Standing Committee

improvements to the Operational Man-

separated children were identified,

Guidelines on Mental Health and

ual, Management Information System

documented, traced and where possible

Psychosocial Support in Emergency

(MIS), a five-year capacity building and

reunited with family members.

Settings’. These help humanitarian

monitoring and evaluation plan, and

In 2008:

organisations to plan, establish and

expanded programmes for community

• In total, 2,075 children living in 337

coordinate a minimum package of

participation and caregivers, such as

institutions in the 13 most affected

interventions to improve and protect

linking the caregivers to health clinics

districts were registered for family

people’s mental health and psychoso-

via the Malezi Bora initiative.

tracing. Family mediation for the

cial well-being in times of crisis.

2,018 children still living in institu-

There is also a growing concern that children affected by HIV and AIDS

tions was an ongoing process and by

Protecting Orphans and Vulnerable

continue to lack the support and love

the end of January 2009, 554 children

Children

of parents or other caregivers. Besides,

were reunited with their families.

Kenya is well on its way to improving

it has became increasingly popular for

• Some 3,368 girls and boys were

the protective and legal environment

parents who face difficulty to hand

identified as living alone in child-

for its growing numbers of orphans

their children over to children’s in-

headed households in eight of the 13

and vulnerable children.

stitutions. Concern has been raised

most affected districts. By the end of

In response to recommendations

over the increasing number of insti-

January 2009, 882 had been reunited

made by the Committee on the Con-

tutionalised children. The emergency

with their families.

vention on the Rights of the Child, the

situation reconfirmed this fear. In the 13

The experience developed during the

Ministry of Gender, Children and Social

districts most affected by post-election

emergency to respond to separated

Development started drafting a national

violence, at least 2,075 children were

children further strengthened a national

Children’s Policy that will incorporate the

institutionalised.

system that identifies, documents,

needs and rights of orphans and vulner-

Most of the actors in the child protec-

traces and undertakes family mediation

able children. The policy will provide a

tion sector had indicated that there

and reunification in both emergency

legal basis upon which programmes for

was lack of a coordinated mechanism

and non-emergency situations.

orphans and vulnerable children will be

and limited opportunities to ensure

developed. In addition, the policy will

that children were provided with

Psychosocial Support During

emphasise family and community care

family-based alternative care such as

Emergencies

for orphans and vulnerable children

foster care, guardianship, adoption

Not everyone becomes traumatised,

as well as the provision of essential

and community care arrangement. To

depressed or severely disturbed during

services and legal aid.

establish the status, UNICEF supported

humanitarian emergencies. Many peo-

The year saw the expansion of the

the Department of Children’s Services

ple are resilient. However, experience

Cash Transfer Programme for Orphans

to carry out a technical assessment of

has shown that certain categories of

and Vulnerable Children from 37 districts

the legal provisions, structure, practice

people, such as women, children, the

to 47 districts. Initially, in response to

and awareness levels of alternative

elderly and very poor people are at

the post-election crisis, the programme

care. Based on the findings, and the

higher risk of mental health problems.

doubled its coverage from 12,500 to

experience of emergency, UNICEF

It is therefore important to provide psy-

25,000 households in 37 districts. An-

will work with the government and

chosocial services to these vulnerable

other expansion process identified

civil society to define and strengthen a

groups in the immediate aftermath of

45,000 additional families taking care of

national system that promotes alterna-

a crisis and beyond. UNICEF has been

orphaned and vulnerable children in 47

tive family-based care for orphans and

supporting the government and civil

districts. After the enrolment process,

vulnerable children.

38 Annual Report 2008

© UNICEF/Sara Cameron

UNICEF continued to support the

five years. A youth-oriented national

development of referral systems for

HIV communication strategy was also

child protection. Promotion of the

produced. On the ground, thousands

Department of Children’s Services’

of young people were reached with

Childline Kenya free 116 number during

messages and services to prevent HIV

the post-election crisis resulted in a 62

infection and promote peaceful conflict

per cent increase in calls to the helpline.

resolution:

In partnership with Barclays Bank, a

• About 200,000 youth took part

child protection centre was opened

in a peace street tournament in

in Mombasa, offering support to over

Nairobi.

400 vulnerable children.

• Over 700 youth became ambassadors

Keeping Children and Young People

• UNICEF supported four youth-friendly

of peace in their communities.

Safe from HIV

HIV counselling centres in Nairobi

Children’s life skills, knowledge and

and Kwale by providing training for

participation are important factors when faced with the threat or impact of HIV and AIDS. Children and young people will only avoid the risk of infection if they are

40 youths.

• Over 10,000 condoms were distributed during the Kick AIDS soccer tournaments involving 400 out-of-school teams, including 10,000 girls.

taught about sexual health and em-

• Information on HIV prevention and

powered to refuse unsafe sex, or to

the importance of Voluntary Counsel-

negotiate safe options. Those already

ling and Testing services was shared

living with HIV and AIDS benefit from

with over 100,000 soccer specta-

skills that help them to make informed

tors during the Kick AIDS soccer

decisions and protect themselves from

tournaments.

exploitation and abuse.

• More than 100,000 young people

As part of the HIV Prevention Strat-

between the ages of 12 and 25 were

egy a working paper was developed

reached by trained peer educators

to guide programming over the next

on the Kick AIDS programme.

Girls in the Kick Aids programme play football.

PARTNERS • African Medical and Research Foundation • African Network for the Prevention and Protection Against Child Abuse and Neglect • Barclays Bank • Children’s Legal Action Network • Childline • Coca Cola • Cradle – The Children’s Foundation Kenya • Child Welfare Society of Kenya • Kenya Alliance for Advancement of Children’s Rights • Kenya Red Cross • International Committee for the Development of People (CISP) • Italian Cooperation • Ministry of Gender, Children and Social Development • National Council of Churches of Kenya • Save the Children (UK) • Solidarity with Women in Distress • Swedish International Development Agency • Tetra Pak • Vodafone • UK Department for International Development (DFID) • UNAIDS • UNFPA • UNDP

Annual Report 2008 39

© UNICEF/George McBean

Above: UNICEF Deputy Executive Director, Hilde Johnson, talks with a mother at a treatment centre for malnourished children at Dadaab refugee camp in northern Kenya.

Right: Former Mozambican President Joaquim Chissano with a baby in Nairobi’s Majengo slum. He was in Kenya to launch the inaugural State of Africa’s Children report, which focused on child survival.

40 Annual Report 2008

Communication, Partnerships and Participation In 2008, the UNICEF Communication, Partnerships and Participation Programme gave high visibility to children’s issues in all UNICEF programme areas. This was especially vital during the postelection upheaval where children and women bore the brunt of the violence.

As well as advocacy for political, donor and media mobilisation, the programme supported the achievement of results for children and women in two other areas: • Partnerships, which build social and strategic alliances for children’s rights, and • Participation, which engages both groups and individuals in social development and protection through self-empowerment, healthy lifestyles and better use of social services.

Without effective communication, strong partnerships and participation, it would be impossible to achieve targets set out in the MDGs. For this reason, the Communication, Partnerships and Participation programme underpins and

Advocacy Children’s rights were placed high on the national agenda through publications, photography, films, media coverage and special events that highlighted child survival, education and child protection. UNICEF, WHO, the Division of Nutrition of the Ministry of Public Health and Sanitation and leading researchers worked together on a public information campaign to promote exclusive breastfeeding.

Following successful training for journalists on breastfeeding and HIV, a flood

© UNICEF/Pamella Sittoni

supports all other UNICEF programmes.

Annual Report 2008 41

communication, partnerships and participation during the crisis

© UNICEF/Juliett Otieno

During the first three months of 2008, the UNICEF Communication, Partnership and Participation programme focused almost exclusively on the post-election emergency, supporting the production and testing of communication materials to assist families most affected by the crisis, and engaging with the media to keep the spotlight on children and women.

UNICEF produced high quality situation reports focused on the impact of the crisis on children, including first person stories reported in the press, radio and the UNICEF website. Through regular joint UN press conferences and frequent print and broadcast interviews, strongly stated media briefs achieved broad global reach.

UNICEF managed several visits by UNICEF National Committees, the media and donors to parts of the country affected by the crisis.

A facilitator’s guide on child protection in IDP camps was developed, tested and distributed during the post-election emergency. It covered issues such as breastfeeding, child nutrition, immunisation, hygiene and sanitation, safety and protection from exploitation.

42 Annual Report 2008

of stories appeared in the media and

Award for being the most innovative

sparked intense public debate.

advocacy and fundraising strategy for

Advocacy for children’s rights was demonstrated in the ‘Look Out for

UNICEF in Africa, Asia and the Middle East.

Leaders Who Look Out for Children’

Child Alive 2008 was not without

campaign which secured commitments

its challenges and an analysis of the

from about half of current MPs to in-

two Child Alive campaigns (2007 and

crease investment in child survival,

2008) will define the way forward for

quality education and protection.

this initiative. New directions will be taken in:

Partnerships UNICEF recognises that partners are

• Raising advertising revenue from corporate partners.

critical to achieving results for children

• Engaging UNICEF Goodwill ambas-

and works with a broad range of gov-

sadors to attract audience numbers

ernmental, institutional, civil society,

and revenue for the telethon.

media and private sector partners.

• Using Swahili to raise mass-market appeal.

The Child Alive Campaign The 2008 Child Alive Campaign

• Ensuring that promotional material is produced on time.

strengthened the relationship with the Inter-Religious Council of Kenya

Private Sector Alliances

through wider participation from the

The Kenya Private Sector Alliance

most significant religious leaders in

(KEPSA) is a key partner for private

Kenya. Child Alive is an integrated

sector engagement with UNICEF Kenya.

advocacy, communication and fun-

KEPSA hosted a lunch for Hon. Joachim

draising campaign in which UNICEF

Chissano, Mozambique’s former Presi-

partners with the Inter-Religious Council

dent, with leading corporate CEOs.

of Kenya, with strong support from

The respect and admiration the elder

the private sector and the Ministry

statesman commands elicited important

of Public Health and Sanitation. It is

commitments from some private sector

a flagship programme for UNICEF in

partners to support Accelerated Child

Kenya, focusing on child survival.

Survival and Development in Kenya.

The campaign received a boost in

The collaboration of the UNICEF Com-

2008 when media participation was

munication, Partnerships and Participa-

expanded to include 20 radio stations

tion programme with Deutsche Post

as well as 17 vernacular channels run by

World Net/DHL, which in three years

Royal Media and the Kenya Broadcast-

has contributed over US$1 million

ing Corporation, Easy FM, Nation TV

in communication support for child

and the Nation Newspapers.

survival programmes, was the focus

Child Alive 2008 ran on 20 radio sta-

of a partnership case study conducted

tions for four weeks and culminated in

by the London Benchmarking Group.

a 100-minute live telethon broadcast on

The study will be used to assist other

Nation TV, featuring competitions and

UNICEF offices that are engaged in

call-in programmes on child survival

developing corporate alliances.

issues. The audience size for the Child

Other corporate partnerships during

Alive 2008 telethon increased by 50 per

2008 saw key millers and food manufac-

cent from 2007 to 4.4 million, which is

turers committing to fortifying maize,

among the highest for any programme

flour and sugar to prevent micronutrient

broadcast on Kenyan television.

deficiencies in Kenyan children.

The programme won the Innovation

UNICEF already has an effective

partnership with salt manufacturers

Child Survival and Development initia-

to iodise salt.

tive by building capacity and creating

Other partnerships included:

opportunities for faith-based organi-

• DHL, which contributed US$100,000

sations to partner with the Ministry

towards the delivery of emergency

of Public Health and Sanitation on

supplies in the post election crisis.

Malezi Bora. Support was also given to

• The Oshwal community provided

the development of a comprehensive

dignity kits for girls and women

communication strategy for Infant and

worth US$50,000.

Young Child Feeding and the participa-

• Safaricom, whose US$50,000 dona-

tory development of communication

tion was put towards the national

materials to promote healthy hygiene

polio elimination campaign.

practices in the fight against cholera.

Product Sales

Communication for Education

UNICEF uses product sales to raise

In the past four years UNICEF has built

local funds for children’s programmes.

capacity in children’s participation

Through the sale of greeting cards,

within the National Council of Children’s

UNICEF reaches a range of private

Services and the Ministry of Education.

sector partners. The cards and products

In 2008, UNICEF successfully advocated

help to create visibility for UNICEF in

for a budget line for student participa-

Kenya.

tion in the education budget, supported research into children’s participation

Participation

in primary and secondary schools and

PARTNERS • Association of Media Women in Kenya • Barclays Bank • Imperial Bank • Inter-Religious Council of Kenya • Kenya Broadcasting Corporation • Kenya Private Sector Alliance • Ministry of Education • Ministry of Gender, Children and Social Affairs • Ministry of Planning • Ministry of Public Health and Sanitation • Ministry of Water and Irrigation • Nakumatt Supermarkets • National AIDS Control Council • National Council for Children’s Services • Nation TV • Royal Media • Safaricom Limited • Safaricom Foundation • Toyota East Africa • DPWN/DHL • Vodafone

supported the publication of National Communication for Child Survival

Guidelines on Children’s Participation

In 2008, UNICEF continued to support

in Kenya.

a number of communication initiatives aimed at promoting child survival.

Furthermore, in the aftermath of the outbreak of violence in Kenya’s schools,

Fast-tracking the Malezi Bora initiative

the participation of children in school

was a priority in 2008. The initiative

governance was mainstreamed as a

delivers a communication package on

core component of school governance.

breastfeeding, Vitamin A supplementa-

UNICEF began supporting teacher

tion, growth monitoring, de-worming,

training in the principles and guidelines

immunisation, malaria control, promo-

on children’s participation and the

tion of hand washing, antenatal care

introduction of the strategy in schools

and the management of diarrhoea.

across Kenya.

Below: Former Sierra Leonean child soldier and UNICEF Advocate for Children Affected by War, Ishmael Beah, at a press briefing. Ishmael’s best selling book and childhood memoir A Long Way Gone was featured in Kenya’s 2008’s Kwani Literature Festival.

During the course of two weeks in May/June and November 2008, a multimedia blitz and faith-based organisations targeted the public with key messages on the importance of using healthcare services.

Working with the Ministry of Public Health and Sanitation, UNICEF helped to develop new materials and radio messages on these themes.

UNICEF also helped to strengthen social mobilisation for the Accelerated

Left: UNICEF Representative, Olivia Yambi, watches as Eliud Iguku, the winner of the grand prize in the Child Alive 2008 Campaign, gets ready to start the car. The vehicle was donated to UNICEF for the campaign by Toyota East Africa.

© UNICEF/Juliett Otieno

In 2008, particular emphasis was placed on sanitation and hand washing.

Annual Report 2008 43

© UNICEF/Sara Cameron

Children look out of their classroom window at Pepo la Tumaini Jangwani School, (Wind of Hope in the Arid), an HIV/AIDS community support group in Isiolo, Eastern Province. The word “NEED,” painted over the window, is part of a larger message advocating love and support for people with HIV and AIDS.

44 Annual Report 2008

Strategic Planning, Monitoring & Evaluation The UNICEF Strategic Planning Monitoring and Evaluation programme supports the effective and efficient planning, implementation, monitoring and evaluation of the country programme.

This is done through two components: • Social statistics, which aims to provide high quality disaggregated data for effective, and efficient programme planning, implementation, monitoring,

How the crisis affected strategic planning

evaluation and reporting. • Social policy analysis, which supports programmes and the Kenyan government in the development of child friendly policies and thus encouraging increased state allocations to the national and district social sector development budgets.

Social Statistics On a global and national level, UNICEF measures the situation of children and women and tracks progress towards international benchmarks such as the MDGs by collecting and analysing data. It maintains and updates global and country-specific databases and promotes the dissemination of evidence-based data for planning and advocacy.

In Kenya, UNICEF is involved in a number of surveys, studies and evaluations, providing financial and technical support to national partners to carry out the groundwork.

UNICEF’s work in strategic planning and monitoring and evaluation was hampered by post-election violence, affecting in particular, the rollout of the KenInfo database to the provinces. Delays were also experienced in social budgeting activities in North Eastern Province due to the conflict. The programme nevertheless rose to the challenge of the post-election violence and supported UNICEF staff missions to affected areas.

Annual Report 2008 45

© UNICEF/ George McBean

Right: UNICEF Kenya Representative Dr Olivia Yambi shares a joke with a young friend.

The Annual Integrated Monitoring

among decision makers on how to

and presenting information in a variety

and Evaluation Plan

scale up the scheme.

of forms including tables, graphs and

The Annual Integrated Monitoring and

maps, KenInfo helps government deci-

Evaluation Plan (IMEP) was developed

Multiple Cluster Indicator Survey

sion makers, development partners,

and was used to provide support to

An UNICEF-supported Multiple Cluster

the civil society and the private sector

programmes undertaking studies and

Indicator Survey (MICS) was undertaken

partners to track trends in indicators

evaluations:

in all the districts of Eastern Province in

such as the MDGs and national pov-

Thirty-five studies and surveys were

collaboration with the Kenya National

erty reduction and economic recovery

planned as part of IMEP: 29 studies

Bureau of Statistics (KNBS). This is the

efforts.

and evaluations (83 per cent) were

second nationally backed district-level

ongoing or complete; 6 (17 per cent)

data collection initiative, conducted in

Data Gaps

were cancelled due to a lack of funding

an effort to provide high quality data

A data user’s conference was held in

or a change in focus and postponed

and to strengthen KNBS’s data col-

October 2008 to establish the data gaps

to 2009.

lection. The MICS interviewed 15,000

that exist with regard to measurement

• Support was provided to sector-based

households to collect information on

indicators on child participation and

child health and care practices.

protection in Kenya. As a result of the

situation analyses of education, nutrition, water and sanitation. This

Results are expected in January 2009

workshop, data gaps in relation to

contributed to the overall country

and will help to identify areas within

protection, children participation and

programme situation analysis.

the province with the poorest perform-

budgets were identified, and three

• An early draft of the Country Assess-

ance in delivery of essential services

papers were developed recommend-

ment of Essential Commodities was

for children and women. This exercise

ing that specific surveys need to be

developed in 2008. This draft made

is important, as these areas are often

conducted so that the gaps can be

recommendations on how to ensure

not visible at the level of provincial

integrated into national data collection

that essential supplies were available

aggregated figures.

initiatives such as Census 2009.

at all times for the achievement of KenInfo

Building Capacity in Monitoring and

• A desk review of the available lit-

The KenInfo database, which is hosted

Evaluation

erature on orphans and vulnerable

by KNBS, was web enabled in 2008 and

As part of the support to the Ministry

children in Kenya was conducted.

made available to the general public.

of Education, manuals on the Education

• Results of various evaluation studies

KenInfo is a database used to increase

Management of Information Systems

were put to good use: for example, the

access to data for advocacy, policy

(EMIS) were developed and used to

voucher scheme evaluation findings

development and programme planning,

train 120 district and provincial level

contributed to fruitful discussions

monitoring and evaluation. By analysing

focal points responsible for collecting

MDGs in Kenya.

46 Annual Report 2008

This document will be disseminated amongst these stakeholders to: • Help identify gaps and trends in the spending on children related activities.

• Make appropriate recommendations for spending that will help children realise their rights.

© UNICEF/Bobby Model

National Children Policy The National Children Policy (NCP) was developed in 2008 and awaited approval by the Cabinet. Inputs from the WFFC+5, 2nd State Party and Initial African Charter Reports, Children’s Act Review and African Charter Review Recommendations were provided to education data. A facilitator’s guide was

for children and women.

develop the National Plan of Action

also under development to augment

In Kenya, UNICEF supports the gov-

(NPA) for 2008–2012, which is based on

the training manuals. The results of

ernment to develop child and women-

the priority issues captured in the NCP.

the training are expected to translate

focused policies and reorient budgets

Members of Area Advisory Councils10

into better data collection and better

to increase resources for services that

and civil society members from more

data transmission from schools to

benefit children and women.

than 40 districts were made aware of

national level.

the NCP while giving their inputs into Social Budgeting Initiative

the NPA.

Kenya Demographic and Health

The Social Budgeting Initiative was

Survey

consolidated and expanded from the

Social Protection Strategy

UNICEF supported the 2008 Kenya De-

initial three pilot districts to four more

The Social Protection Strategy was

mographic and Health Survey. Technical

districts. A major achievement in social

developed and disseminated to all the

assistance was given to develop and

policy has been the institutionalisation

provinces for validation and feedback.

review the questionnaire, support was

of policy making mechanisms within

The resulting document will be used

extended to the enumerators conducting

the Ministries of Planning and Finance,

to develop a draft Social Protection

data collection in North Eastern Prov-

and the recruitment of a Social Policy

Policy. This policy is needed to provide

ince, and equipment such as weighing

Adviser (placed in the Ministry of Fi-

a framework for the future design and

scales were provided.

nance) to coordinate this work.

implementation of all social transfers

Social Policy

policy proposals, including a restruc-

Policy and budget analysis is an es-

tured district-planning framework, a

Situation Analysis

sential aspect of UNICEF’s work with

policy brief to address regional dispari-

A situation analysis of children and

governments, lawmakers, the media,

ties in achieving the MDGs, a policy to

women in Kenya was conducted with

civil society and other partners on behalf

scale up maternal and newborn services

the participation of a wide range of

of children and women. By analysing

and briefs on early childhood education

stakeholders. The document will be

economic, social and legal policies as

and secondary education. The proposals

ready for dissemination in 2009 and will

well as government budgets, a better

were under review in 2008.

be used as a basis of critical dialogue

These efforts resulted in four major

understanding of the circumstances

programmes in Kenya.

with the country’s policy makers.

and forces that affect the well-being of

Civil Society Engagement

children and women is achieved. This

Work continued on a document outlin-

analysis in turn helps to develop new

ing Social Corporate Responsibility

policy approaches and realign budgets

(SCR) investment for Nairobi-based

to improve the impact of programmes

companies and civil society partners.

10 These bodies are in charge of implementing the Children’s Act at district level.

Annual Report 2008 47

© UNICEF/Georgina Cranston

This family’s home was destroyed during the post-election violence. They stayed at a camp for internally displaced persons for months before being resettled under the government programme ‘Operation Return Home’.

48 Annual Report 2008

Moving Forward

In 2009, UNICEF will embark upon a new fiveyear country programme. The programme has been developed in close collaboration with the government, development partners and civil society to support national efforts in realising children and women’s rights in Kenya. The programme is budgeted at US$ 205 million for 2009–2013. Close to 80 per cent of the budget needs to be raised.

Four main components to the programme will ensure that a comprehensive

The UNICEF country programme is fully aligned with national strategies and plans, including the National Strategy for Transformation 2008–2013 and Vision 2030, as well as UNDAF 2009–2013. It is also guided by the UN Convention on the Rights of the Child, the World Fit for Children declaration, the Millennium Development Goals and the Millennium Declaration.

approach, covering all aspects of child and maternal survival, development and protection, is used to deliver quality services and support to the youngest and most vulnerable members of society.

Child Survival and Development: this programme component will focus on reducing maternal, neonatal, infant and under-five mortality. This will be achieved by providing an integrated package of mother-and-child services, including healthcare, nutrition and HIV prevention and treatment; increasing access to safe water and proper sanitation in schools, health clinics and vulnerable households living in disaster-prone districts; and improving childcare and hygiene practices in households. Special attention will be paid to women, children and other vulnerable groups affected by natural disasters, civil conflict and HIV. Education and Young People: the second component will promote increased access to early childhood development and primary education for children disadvantaged by poverty and residence in remote, arid and economically depressed provinces and locations. The Child-Friendly School concept will be used as a key tool to institutionalise inclusive, rights-based and protective

Annual Report 2008 49

© UNICEF/Liba Taylor

© UNICEF/Michael Kamber

Above: Three-year-old Kurasha Sahal and other children eat at a therapeutic feeding centre and medical clinic run

by SIMAHO (Sisters Maternity Home) in the village of Raya in North Eastern Province.

Right: A health worker vaccinates a child at a health clinic run by the NGO African Medical and Research Foundation in the remote western village of Entasopia.

education nationwide. The Youth component of the programme will put emphasis on the empowerment of disenfranchised youth and developing ways to use their energy and talents towards productive means and confidence building.

Child Protection: the focus of this programme component will be on a comprehensive child protection system, which will be set up to address a whole range of issues relating to the prevention of, and response to violence against children and women, including FGM and family separation. This will be done by establishing protective and child friendly legal and policy frameworks; creating a national protective services system to deal with cases of violence, abuse and exploitation of children; supporting families to look after vulnerable girls and boys and setting up alternative family-based care for children who cannot be cared for by their families; and working with communities to strengthen their capacity in preventing child abuse, family separation and HIV infection in children.

Policy Planning, Advocacy and Communication: this final component will strive to place children and women’s rights at the centre of national policies and budgets, in particular Vision 2030 and the Medium Term Plan. The use of research and data to generate evidence for programme design; participatory planning and monitoring; and partnerships with the media, private sector and civil society to leverage resources for children will be key strategies.

The country programme will use a number of overarching strategies to achieve results for children and women across the four programme components: • A strong rights-based approach will be used, focusing on the most disadvantaged geographical areas in the country and the most vulnerable groups of Kenyans such as IDPs and children and women living in slums. Priority will be given to districts with below-average indicators in children and women’s well-being and survival as well to disaster-prone areas.

• UNICEF’s technical support, using an evidence-based approach, will be extended to the government to tailor public policies, legislation and social spending to suit the real needs of children and women.

• Data generation and analysis will be used to better understand and address gender, social and ethnic inequalities and poverty and to sharpen support to the most vulnerable Kenyans.

• Capacity building of national partners to deliver services and of ordinary Kenyans to demand better services will be an important strategy in the fight against poverty and deprivation.

50 Annual Report 2008

Finances UNICEF Kenya was able to respond to the emergency created by the post-election crisis in time to minimise suffering of women and children, and carry on with regular programming, thanks to the availability of adequate resources from both Regular Resources, Other Resources and Emergency funds. We thank all donors who supported us through this difficult year.

Income to UNICEF Kenya 2004 to 2008 100

Amount (US$ – millions)

90 80 70 60 50 40 30 20 10 2004

2005 Regular resources

2006 Set aside

2007 Other resources

2008 Total

Annual Report 2008 51

Programme Budget 2008 (Totals for Each Programme – US$)

Water, Environment and Sanitation (5,000,063 – 11%) Communication (3,001,035 – 7%) Strategic Planning, Monitoring & Evaluation (3,504,045 – 8%) Education (5,049,807 – 12%) Child Protection (10,200,830 – 23%) Health (7,688,403 – 18%) Nutrition (6,444,494 – 15%) Cross-sectoral (2,789,026 – 6%)

Funding in 2008 by Type of Donor (US$)

National committees (2,559,934.89 – 6%) Governments (16,215,429.79 – 37%) UNICEF (15,273,774.54 – 35%) Thematic (6,556,781.38 – 15%) United Nations (2,777,323.64 – 6%) PSFR (294,457.73 – 1%)

52 Annual Report 2008

Thematic Contributions in 2008 (US$) Basic education and gender equality Child protection: preventing/responding to violence

977,664.92 2,056,922.41

Global – child protection (thematic fund)

73,987.40

Global – girls education (thematic fund)

231,874.79

Global – HIV/AIDS (thematic fund) Global – humanitarian resp (thematic fund)

1,087.81 2,578,110.86

HIV and AIDS and children

476,770.13

Policy advocacy and partnership

160,363.06

TOTAL

6,556,781.38

Natcom Contributions in 2008 (US$) Canadian Committee for UNICEF

64,439.14

Consolidated Funds from Natcoms

73,592.01

Finnish Committee for UNICEF

165,819.40

French Committee for UNICEF

263,169.76

German Committee for UNICEF

237,975.30

Norwegian Committee for UNICEF

721,922.23

Swedish Committee for UNICEF

7,395.84

United Kingdom Committee for UNICEF

667,261.64

United States Fund for UNICEF

358,359.57

TOTAL

2,559,934.89

Government Contributions in 2008 (US$) Australia AusAID CIDA CIDA/IHA International Humanitarian Commission of European Communities EU Denmark ECHO Iceland

523,239.30 1,486,371.15 39,501.19 1,527,151.83 617,518.80 2,319,850.85 74,103.52

Italy

294,271.14

Japan

591,061.60

Netherlands Republic of Korea Spain The United Kingdom of Great Britain

3,059,396.01 93,460.00 958,725.59 1,922,738.79

The GAVI Fund

1,014,224.49

USA (USAID) OFDA Office for Foreign Disaster

1,390,265.32

Micronutrient Initiative (formerly IDRC) TOTAL

303,550.21 16,215,429.79

Annual Report 2008 53

Š UNICEF/Betty Press

54 Annual Report 2008

Staff

UNICEF KCO STAFF AS OF JUNE, 2009 NO NAME TITLE OFFICE OF THE REPRESENTATIVE 1 Olivia Yambi Representative 2 Rachel Kuira Executive Assistant OFFICE OF THE DEPUTY REPRESENTATIVE 1 Juan Ortiz-Iruri Deputy Representative 2 Veera Mendonca HIV/AIDS Specialist 3 Susan Kiragu Monitoring & Eval. Specialist 4 Anthony Kinyanjui Snr. Budget Assistant 5 Susanne Kinyua Reports Officer 6 Anne Kibathi Programme Assistant OPERATIONS SECTION 1 Philip Wilson Chief Of Operations 2 Teeranuch Dibanuka Finance & Accounts Specialist 3 Zacharia Njuguna Finance & Budget Officer 4 Valentine Mulama Finance Officer 5 Margaret Njuguna Accounts Assistant 6 Daniel Githinji Accounts Assistant 7 Kareri Gichinga Finance Assistant 8 Margaret Mutuku Accounts Assistant 9 Francis Ochieng Budget Assistant HUMAN RESOURCES SECTION 1 Omayma Ahmed Human Resources Specialist 2 Sarah Walusimbi Snr. Human Resources Asst.

3 Gladys King’ang’i Snr. Human Resources Asst 4 Margaret Lusiji Snr. Human Resources Asst 5 Rose Chelule Human Resources Asst.

6 Jessie Bugo Human Resources Asst.

ADMINISTRATION SECTION 1 Francis Kaunda Administrative Specialist 2 Scholastica Madowo Administrative Officer 3 Susan Muigai-King’a Snr. Travel Assistant 4 Edith Ngugi Admin. Assistant Inventory 5 Isabella Kisina Administrative Assistant 6 Gordon Ochola Transport Assistant 7 Regina Gitau Registry Assistant 8 Mercy Njau Travel Assistant 9 Theodore Webuye Radio Operator 10 David Gitau Radio Operator

© UNICEF/Guillaume Bonn

UNICEF would like to thank all our staff for their passion, dedication and skill in making Kenya a better place for children and women.

Annual Report 2008 55

Š UNICEF/Guillaume Bonn

Pregnant mothers and their under-fiveyear-old children lining up to receive food after having been screened (children measured, weighed) as part of the supplementary feeding programme.

56 Annual Report 2008

11 Wilson Wainaina Radio Operator 12 Joseph Gathara Radio Operator 13 Victor Nagi Senior Driver 14 Francis Mwaura Senior Driver 15 Mworia Ikamati Driver 16 Henry Kareithi Driver 17 Japheth Bore Driver 18 Michael Ndungu Driver 19 Jacob Mwangangi Driver 20 Charles Odhiambo Driver 21 Justus Mugera Driver 22 Hassan Malambu Driver 23 Hosea Mondo Driver 24 Ephantous Ena Driver 25 Musa Suleiman Driver 26 Stephen Oduor Administrative Assistant 27 Rhoda Njagi Administrative Assistant 28 Stephen Okoth Registry Assistant 29 George Owak Driver 30 Joshua Owelle Driver 31 Samuel Otieno Transport Assistant SUPPLY SECTION 1 Kiriti Chowdhury Supply/Procument Manager 2 Monika Tschida-Spiers Procurement Specialist 3 Dorcas Noertoft Procurement Specialist 4 Peter Krouwel Logistics Specialist 5 Joel Libamira Supply Assistant 6 Timothy Wasilwa Procurement Assistant 7 Anne Lidonde Procurement Assistant 8 Margaret Ronoh Procurement Assistant 9 Esther Musumba Procurement Assistant 10 Issa Mohamed Logistics Assistant 11 Abbey Dahir Logistics Assistant 12 Doreen Kituyi Procurement Assistant 13 Florence Andale Administrative Assistant 14 Susan Ochieng Procurement Assistant 15 Josephine Waweru Supply Assistant 16 Isaac Oluoch Logistics Assistant 17 Jacob Murea Logistics Assistant 18 Mastura Chelangat Supply Assistant 19 Geoffrey Osubo Logistics Assistant 20 Geoffrey Nabwayo Logistics Assistant 21 Kennedy Changirwa Clerk/Messenger INFORMATION COMMUNICATION TECHNOLOGY SECTION 1 Wali Noor ICT Specialist 2 Thomas Mong’are ICT Specialist 3 Andrew Nyamwaya ICT Officer 4 Timothy Chivumbe ICT Officer 5 Joseph Kirunyu Senior ICT Assistant 6 Martha Maghanga ICT Assistant 7 Deborah Onyango Administrative Assistant POLICY, PLANNING, ADVOCACY & COMMUNICATION ADVOCACY & PARTNERSHIPS 1 Edita Nsubuga Chief of Communication 2 Pamela Sittoni Communication Specialist 3 Nazim Mitha PS Fundraising Specialist 4 Mary Oula Communciation Assistant 5 Juliett Otieno Media Assistant 6 Jacqueline Maritim Product Line Assistant COMMUNICATION FOR DEVELOPMENT 1 Suleman Malik Programme Communication Manager 2 Jayne Kariuki-Njuguna Prog. Communication Specialist (CSD) 3 Roselyne Wangahu HIV/AIDS Specialist (Behaviour Change for HIV/AIDS) 4 John Kennedy Obisa Prog. Communication Specialist 5 Patricia Muturi Programme Assistant Social Planning, Monitoring & Evaluation (SPM&E) 1 Rajeshwari Chandrasekar Chief, Planning & Evaluation 2 Bonee Wasike Planning M&E Specialist 3 Susan Govedi Snr. Project Assistant POLICY 1 Martina Makokha Programme Assistant

1 Hussein Golicha 2 Zeinab Ahmed 3 Mohammed Elmi 4 Ahmed Adan Hassan 5 Halima Sheikh 6 Abdi E. Affey 7 Gilbert Longolol 8 Elmi Abdi Rashid 9 Olow Mustafa 10 Farah Shabel 11 Mohamud Dabaso 12 Ali Abass Dagane 13 Shurie Gedow 14 Hussein Dae Eji OUTPOSTED (KISUMU OFFICE) 1 Margaret Oluoch-Gwada 2 Olga Nyanjom 3 Francis Odawo 4 George Odongo

Chief, Education & Young People Education Specialist Education Specialist Education Officer Education Officer Education Officer Education Officer Project Assistant Programme Assistant

Chief, Water, Sanitation & Hygiene WASH Specialist WASH Specialist WASH Specialist WASH Specialist WASH Specialist Project Assistant Project Assistant Chief, Health Cold Chain Specialist Health Specialist Health Specialist Health Specialist Health Officer Project Assistant Programme Assistant Senior Finance Assistant Health Officer

© UNICEF/Bobby Model

EDUCATION & YOUNG PEOPLE 2 Aminata Maiga 1 Yeshi Haile 2 Amina Ibrahim-Mohamed 3 Elias Noor 4 Jane Mbagi-Mutua 5 Kimanzi Muthengi 6 Hassan Adan 7 Violet Waweru 8 Violet Maleya CHILD SURVIVAL & DEVELOPMENT WATER, SANITATION & HYGIENE 1 Mohammed Yousif 2 Frederick Donde 3 Martin Worth 4 Ally Tifow 5 Tobias Omufwoko 6 Julia Karuga 7 Monica Okello 8 Eva Magondu HEALTH SECTION 1 Sanjiv Kumar 2 Isaac Gobina 3 Grace Miheso 4 Kennedy Ongwae 5 Christopher Ouma 6 Josephine Odanga 7 Joyce Kirubi-Mensah 8 Loise Oyugi 9 Kennedy Begi 10 Lilian Mutea NUTRITION SECTION 1 Noreen Prendiville 2 Linder Beyer 3 Dolores Rio-Onyango 4 Ruth Situma 5 Doris Kamawera 6 Elizabeth Waitha FIELD OPERATIONS 1 Megan Gilgan 2 Monica Ondijo CHILD PROTECTION 3 Birgithe Lund-Henriksen 1 Carlos Alviar 2 Veronica Avati 3 Stephanie Shanler 4 Catherine Kimotho 5 Agnetta Mirikau 6 Deogratias Iyadi 7 Esther Nyausi 8 Nancy Angwenyi OUTPOSTED (GARISSA OFFICE)

The mother of a child living with HIV holds up her daughter’s patient card at the Isiolo District Hospital Comprehensive Care Clinic.

Chief, Nutrition Nutrition Specialist Nutrition Specialist Nutrition Officer Programme Assistant Programme Assistant Chief, Field Operations Programme Assistant Chief, Child Protection Child Protection Specialist Child Protection Specialist Child Protection Specialist Child Protection Specialist Child Protection Specialist Programme Assistant Project Assistant Senior Accounts Assistant Resident Programme Officer (Garissa) Child Protection Specialist Health Specialist Education Specialist Administrative & Finance Assistant Driver Logistics Assistant Driver Driver Watchman Watchman Watchman Watchman Watchman Resident Programme Officer Adminstrative Assistant Driver Driver

Annual Report 2008 57

UNICEF Kenya P O Box 44145-00100 Nairobi Kenya Tel +254 (20) 762 2137 www.unicef.org