REPRODUCTIVE HEALTH SUB-PROGRAMME

Project Document between

The Government of Lebanon
and
UNFPA

1. Goal, Purposes and Outputs

The Country Programme for Lebanon under the second UNFPA cycle (2002-2006) is comprised of two sub-programmes that were developed in line with UNFPA thematic areas, namely Reproductive Health (RH), and Population and Development Strategies (PDS). The RH sub-programme provides a comprehensive and unifying approach framework based on the Country Population Assessment exercise (CPA) that succeeded in identifying needs and gaps, and thus determining priorities and strategies for improving RH particularly in underserved areas. These priorities and strategies also build on the lessons learned of the previous RH sub-programme.

Through the newly developed RH framework, four interrelated RH projects were formulated and will aim at complementing each other for the achievement of the outputs and thus will contribute to the realization of the goals and purposes.

1.1 Programme goal
The RH goal under this programme cycle (i.e. 2002-2006) aims at contributing to improving quality of life of the Lebanese people through (a) improved Reproductive health status; (b) reduced gaps in socio-economic sectors; (c) balance between Population dynamics and socio-economic development. It is worth noting that the country programme particularly the RH sub-programme will focus its interventions and activities in under-served areas where the majority of the ICPD and ICPD+5 indicators are still to be realized. A number of relevant indicators were identified for assessing he success of the goal by the end of the cycle. Those indicators area the following: Decreased Maternal Mortality Ratio (MMR); Decreased Infant Mortality Rates (IMR); Reduced Total Fertility Rate (TFR); Increased Human Development Index (HDI); Increased Gender Development Index (GDI); Increased adult Literacy among Females; Reduced HIV prevalence 15-24 years; Decreased poverty incidence

1.2 Reproductive Health sub-programme purpose
The purpose of the RH sub-programme under this programme cycle (i.e. 2002-2006) is to have contributed to improved utilization of quality Reproductive health services and information by women, men, and youth. A number of indicators were determined and agreed upon that would be essential for measuring the purpose. These indicators are the following: Increased Contraceptive Prevalence Rate (CPR); Reduced Unmet needs; Improved Contraceptive Mix; Increased percentage of births attended by trained health providers; Decreased obstetric and unsafe abortion complications; Increased utility of STIs /AIDS services; Increased user satisfaction from RH services; Increased RH services delivery visits by Men, Women and youth.

1.3 Reproductive Health Sub-programme outputs
The purpose of the RH sub-programme will contribute to the realization of the following two outputs:

By the end of these four projects, quality, affordable and accessible RH services and information that are aimed primarily at underserved areas and specific groups will be fully integrated within a Reproductive Health package.

This project with the Ministry of Education (MOEd) and Center for Educational Research and Development (NCERD): Advocacy activities for the integration of Population Education in school curricular and extra-curricular educational activities, was designed to contribute to the realization of the second output. It is worth noting that the three IEC projects in support of RH (i.e. Ministry of Social Affairs, Ministry of Education, and Ministry of Youth and Sports) are concerned with the second output related to increased availability of information and enhanced awareness of the youth on Reproductive and Sexual health issues. The Ministry of Public Health will be mainly concerned with the realization of the first output with input provided by the Ministry of Social Affairs.

2. Linkages between Outputs and Activities

The activities under the RH sub-programme have been designed to complement each other and to deliver the outputs which will, in turn, contribute to the RH-sub-programme purpose of: "to have contributed to increased utilization of quality RH services and information by men, women and youth". Hence the two RH sub-programme outputs defined in the earlier section will be delivered on basis of interrelated activities as follows:

A series of objectively verifiable indicators (OVI) have been identified and selected in the RH logframe that are necessary for measuring progress and evaluating the success of the interventions, and for contributing to the realization of the purpose and country programme goal. In the absence of data and benchmarks, a series of situation analysis will be undertaken at the inception of the programme with the aim of making available baseline data.

There are also linkages that exist between the RH and the PDS sub-programme purpose and outputs namely that the RH strategy stems form the Population policy document and hence the operationalization of the RH strategy is expected to contribute to the implementation of the Population policy. In addition data collection, nationwide surveys or situation analysis in target areas, as well as data analysis concern both the PDS and RH. Furthermore, the advocacy components and related activities under the PDS sub-programme cater for not only PDS related outputs but also in support of RH and rights.

3. Linkages between RH Sub-programme and Component Project
(Advocacy activities for the integration of Population Education in school curricular and
extra-curricular educational activities)

The related interventions under this project LEB/04/P01 that will be undertaken in support of RH will include mainly advocacy activities in support of the integration of Population Education including Gender and Reproductive health in the school curricula of the secondary classes. These interventions will focus mainly in the formal sector as well as extra curricular programmes with national coverage. The activities are divided into three parts. The first, are activities related to the review of textbooks and the undertaking of a survey and focus group discussion in Population education issues and needs. The second part are activities related to capacity and institutional building, and the third are advocacy and awareness creation activities of Population matters, Gender as well as Reproductive health concepts and issues. To attain the second RH output and to the extent possible, the interventions and activities implemented under this project LEB/04/P01 will be interactive, participatory and coordinated with the other IEC related projects such as the ones implemented by the Ministry of Social Affairs, the Ministry of Youth and Sports, and Ministry of Public Health. Advocacy activities will be conducted in order to build support for Adolescents RSH among parents, teachers, communities, and national decision and policy makers.

The implementation of the project LEB/04/P01 regarding Advocacy activities for the integration of Population Education in school curricular and extra-curricular educational activities will build on a number of aspects as follows:

The interventions under this project LEB/04/P01 with MOEd/NCERD will aim at contributing to the realization of the second output mainly through the following activities:

The prescribed IEC interventions under this project as well as the other projects as mentioned earlier will aim at assessing the need and advocating for the integration of Reproductive and Sexual Health information for Adolescents through a variety of formal as well as non formal channels and will be undertaken on basis of detailed activities within a coordinating mechanism.
Therefore, the first set of interventions would entail to collect the needed baseline information and as such to determine target indicators that will be further defined and refined. This will be followed by organizing and implementing a series of advocacy activities targeting parents, opinion leaders, policy makers, and school administrators, with the aim of raising awareness and sensitization on these issues. Efforts will be made to build the capacity of the concerned staff at the MOEd and NCERD in areas of Population, Adolescents RSH and Gender for the sake of programme continuity and sustainability.

Lastly, it is worth noting that all the IEC projects under the RH sub-programme including this one with the Ministry of Education/NCERD will benefit from and support the regional UNFPA projects on HIV/AIDS prevention targeting mainly the youth population. As such, a coordination mechanism will be established to ensure complementarity and harmonization of activities.

4. Component Project Execution, Implementation, Monitoring and Evaluation Modalities

This new project will expand over a period of 34 months starting March 2004 and ending December 2006. While this project is fully funded by UNFPA, it would be desirable for the National Center for Educational Research and Development to explore the possibility of committing partial funding for specific activities with the aim of ensuring continuity and sustainability of the project.

The project LEB/04/P01 – Advocacy activities for the integration of Population Education in the curricula and extra curricular educational activities - will be nationally implemented through the MOEd/National Center for Educational Research and Development (NCERD). The MOEd and NCERD were previously involved in Population Education programme with the LFPA as well as the School Health and Environment education programme implemented by WHO in collaboration with other UN agencies. Hence, it is presumed that the MOEd/NCERD has already established a network of concerned national partners and alliances both within the public and civil society levels, which was expanded to encompass capacity building and coordination.

The implementation of the project will be carried out through the MOEd/NCERD. However involvement of the public institutions will be requested to the extend possible in order to further strengthen their capacities and their involvement in IEC. In its capacity as the executing agency, the NCERD, in coordination with the UNFPA, will sub-contract some components of this project to academic institutions, NGOs, media institutions, national programmes, and national consultants/experts. Specifically, the following will be sub-contracted: review of past experience in Population education, content analysis of the text books, assessing needs and attitudes of teachers and youth, orientation workshops to school writers and coordinators, selected advocacy activities. The selection of the sub-contractors will be subject to specific indicators on basis of well established terms of reference and pre-definition of the required tasks and responsibilities that will be previously agreed upon by the executing agencies and in close consultation with the UNFPA. The UNFPA, and upon the request of the NCERD, will also sub-contract. In addition, the NCERD in its capacity as the executing agency, will be accountable for the achievement and completion of the agreed upon activities.

Partnership with the following entities will be established for executing various components of the project: relevant universities; line ministries; and concerned NGOs as well as others. In addition, the project will pursue partnership and collaboration with selected national consultants/experts for undertaking of specific activities. Partnership with the private schools will be established on basis of common grounds within the objective of this project. In addition to the three other Ministries involved in the implementation and partial execution of the RH sub-programme (i.e. Ministry of Youth and Sports, Ministry of Social Affairs, and Ministry of Public Health), efforts will be exerted to establish collaboration with other concerned ministries such as the Ministry of Information.

The Ministry of Social Affairs will provide the necessary support and guidance to the project, when and if needed, given MOSA's experience in IEC related activities targeting primarily the youth Population and particularly as the MOSA will be chairing the IEC committee and will entrusted with the elaboration of the IEC strategy. This strategy will aim at providing cooperation and coordination with other relevant project mainlyLEB/04/PO1. Specifically, MOSA will provide support in one or more of the following areas: orientation workshops for the selected parents-teachers associations in SRH and Gender concerns; advocacy activities in support of integration of RH and Gender concerns into school curricula; and integration of priority themes in the school youth club. The latter activities will be coordinated with other concerned entities such as NGOs, universities, United Nations organizations and others on basis of their comparative advantage, previous involvement in these areas, and capability to provide the necessary support.

The collaboration with NGOs will be based on a set of criteria for selection and aiming at ensuring optimal delivery programme activities on basis of comparative advantage and existing added value for this collaboration. Their performance shall be subject to systematic monitoring and assessment to ensure compliance with quality standards in delivery of related outputs.

Collaboration with relevant specialized international agencies and United Nations Organizations will be strengthened to ensure that the IEC activities in support of RH particularly for the youth group are addressed within a life skill perspective.

UNFPA will be entrusted with the overall monitoring and evaluation of the project and will be responsible for executing some components of the project such as procurement of equipment, selected sub-contracts and others upon request. In addition, UNFPA will provide necessary support for advocacy activities that are mainly implemented under the PDS sub-programme. Finally, the UNFPA CO will, necessarily, shoulder some specific execution related to recruitment of national consultants in consultation with the NCERD, and build the national capacity in Results-Based Management (RBM) to optimize the use of resources and to manage results.

The UNFPA CO will also seek the provision of technical services of the Country Support Team (CST) advisors in critical stages of the project monitoring and evaluation as requested by the implementing agency. The UNFPA will recruit a National Professional Project Personnel (NPPP) to assist in the overall monitoring of the Reproductive Health programme implemented by various ministries in addition to the one with the MOEd/NCERD. It is expected that the NPPP will require her/him to have relevant IEC experience in addition to the overall RH dimension. Partial salary of the NPPP will be charged against this project. In addition, the part time services of a logistic/administrative support staff may be required for a selected period to support the RH programme and the project team in monitoring the day-to-day activities.

It is anticipated that the technical assistance and institutional building for concerned staff and employees, and which will be provided under this project in specific areas such as RBM, GEEW, ARSH, and other Population dimensions will contribute to ensuring sustainability of the project within the institutional setting.

Recruitment of new project staff will be carried out in accordance with the provisions of UNFPA Guidelines on recruitment and in accordance with well-developed Terms of Reference highlighting qualifications, tasks and competencies of the project staff that meet the needs of the required activities.

Also, in accordance with the financial procedures, the NCERD will ensure that funds appropriated for this project budget, will be timely and befittingly disbursed against approved budget lines in order to implement project activities in conformity with the projects' workplan and with adequate recording of project expenditures. In this regard, a Memorandum of Understanding will be signed between UNFPA and the NCERD regarding the financial requirements in terms of advances, disbursements, reporting as well as any other related financial matters. As UNFPA requires that all projects be audited on a yearly basis, services of a Government/and or independent audit firm will be secured to provide a systematic examination of the project's accounting records and equipment. Auditors will be selected, subject to joint agreement of the Government and UNFPA. The NCERD is expected to meet all reporting and audit requirements for the Population Education project in the formal sector. Thus the supporting financial documents, statements, and vouchers will be furnished, as requested to UNFPA. Moreover, at the end of the each calendar year (from January 1st to December 31st), a financial statement of the expenditure of UNFPA regular funds as well as Government contribution, certified by an independent auditor, must be prepared and submitted to MOEd/NCERD and UNFPA.

The project will coordinate its activities with other UNFPA-supported projects under the RH sub-programme with the guidance of the Council for Development and Reconstruction (CDR) and support from UNFPA. A coordination mechanism will be established regarding this project along with its partners entrusted in the implementation and execution components as well as a mechanism between this project and other RH-related projects implemented by the other ministries. An IEC coordination committee will therefore be established and chaired by MOSA to oversee an optimal degree of coordination and collaboration between implementing partners (TORs to be established with all implementing agencies).

An Executive Committee will be established to follow up on the activities of the project LEB/04/P01. The President of the NCERD or a representative appointed by her will head it. The terms of reference and responsibilities of these committees will start upon project initiation. It will include a UNFPA representative in addition to a representation from other ministries, when needed.

The monitoring and evaluation exercises will follow the standard UNFPA guidelines. First and foremost, the RH logframe will be utilized by all partners for monitoring of the RH sub-programme activities implemented by each of the pertinent ministries. The indicators set forth in the logframe matrix will be used to assess both processes and performance of the sub-programme towards the attainment of its anticipated results. In addition, a common workplan of the 4 RH projects will be developed jointly with the 4 ministries with the aim of illustrating interlinkages and coordination among the partners. The project will be closely monitored by the UNFPA CO. To ensure effective operationalization of the results-based management approach, the UNFPA country office would in collaboration with the MOEd/NCERD develop a monitoring and evaluation plan. A standard form for results-based reporting would be developed on an annual basis at all levels of programme management. Field monitoring visits will be undertaken with the aim of identifying technical issues for backstopping missions, identifying technical and/or operational strengths and weaknesses, deciding with the implementing agency on corrective measure. In addition, the project- with the assistance of UNFPA- will develop further monitoring tools to follow up on activities in accordance with the project's workplan. Annual project review and sub-programme review meetings will take place annually to follow up on recommendations from previous year, to review progress made in the sub-programme outputs and activities (of all RH projects) on basis of the RH logframe, and to identify and discuss any reasons for problems encountered and determine corrective actions and recommendations indicating when, by whom and where they are to be taken. The mid-term programme review (MTR) is held in the middle of the programme and examines the status of implementation of the country programme based on the established outputs and respective OVIs and may propose changes in the programme directions and duration on basis of progress, achievements, constraints and obstacles in implementation.

A Final Project report is due at the end of the cycle that aims at recording all the activities undertaken by the component project and its contribution to achieving the RH sub-programme outputs by providing summation of the achievements of the component project and recommendations for the effective utilization of the component project experiences and results. The closure of the project will entail financial and operational completion of the project and will be carried out jointly with the UNFPA CO in accordance with the established UNFPA procedures which will be made available to the project in due time.

The end of programme/project evaluation would be conducted at the end of the cycle and aim at assessing the extent to which the RH sub-programme/component project has achieved its outputs in light of the OVI established and develops lessons learned from this analysis in terms of contribution, performance and complementarity of each component for the achievement of the sub-programme outputs. Monitoring and evaluation would be based on quantitative and qualitative indicators linked to each of the programme goals, purposes and outputs. UNFPA will exert maximum efforts to make use of national experts for the undertaking of various monitoring and evaluation exercises. During the monitoring and evaluation tasks, participation of CST advisors as well as Headquarters programme/technical staff may be envisaged.

UNFPA will make available to the project relevant guidelines and procedures regarding the status of the equipment procured by UNFPA in terms of transfer of equipment, disposal of equipment, etc.