The “Change Statement” for this Somalia is based on our ability to provide, or support the provision of basic health, nutrition and education services. Within this theory we are not looking directly at longer term developmental change within the area of operations but rather, a sustainable change within the programme – building governance capacity, gender equality and community resilience within the three core programmes of Health, Nutrition and Education (creating a multi-sectoral approach to Resilience).
This approach is based on an understanding of Resilience as “the ability of an individual, a household or a community exposed to hazard to withstand, adapt to and recover from the effects of the hazard in a timely and efficient manner”, but it extends it – in line with definitions of Resilience adopt by the UN International Strategy for Disaster Reduction (The ability of a system, community or society exposed to hazards to resist, absorb, accommodate to and recover from the effects of hazard in a timely/efficient manner ) and The Resilience Alliance (The capacity of a system to absorb disturbance and reorganize while undergoing change ); where the definition includes systems & society.
There are three core programmes (Health, Nutrition and education), each of which has its own specific Theory of Change – practically designed to focus on the provision, or support for the provision of basic services to the population as the Somali national political structures develop, the federal states form and the local authorities move to a status of political representation. This will take many years so under the first of what will be several Theories of Change the focus is on building the capacity of the Staff, Systems and Structures within these basic services as a foundation for future programming, including specific opportunities to consolidate the three programmes around:
• preventative and protective programming that aligns the target beneficiaries across each programme,
• prioritising the Governance and Gender elements of each programme,
• target TB patients. HIV is not that prevalent in southern Somalia where as TB as a communicable disease that requires daily, prolonged treatment (8-12 months) has a greater impact on marginalisation of the person and disrupted livelihoods as the patient (and family) becomes an informal IDP for the duration of the treatment,
• humanitarian readiness (given the continuing humanitarian crisis in Somalia)
• building resilience through the systems and structures that support both basic services and the surge capacity to respond to the ill-health and malnutrition consequences of a humanitarian crisis.
The Humanitarian Readiness approach focuses on the Theories of Change for the three programmes – building the Staff, Systems and Structure so that the capacity exists to increase services should the demand increase. This is in line with the Resilience approach, outlined for our Nutrition programme and based on the experience of Trócaire in East Africa in Resilience-grounded programmes.
This application of a Resilience Theory of Change is based on the overall Health & Nutrition programme. Drawing on the research conducted in the aftermath of the 2011/12 drought in East Africa, which defined resilience in a humanitarian context as “the ability of an individual, a household or a community exposed to hazard to withstand, adapt to and recover from the effects of the hazard in a timely and efficient manner”.
There is a link between the capacity (building & delivery) element of the Health Theory and that of the Nutrition Theory. This captures the inter-dependency at staffing level within the District Health services for all illness-types and the acknowledgement that nutrition is a medical condition and that nutritional treatment (through fortified foods and stabilisation services) is a medical/health service and that it is their responsibility to provide these services. And there is a link between the Health Theory and both the Education and Nutrition Theories in encouraging a change in attitude – within the:
• family towards good diet, domestic hygiene, breast-feeding, etc.
• community-based health workers that work directly with families in indentifying malnutrition and so, who are best placed to support families in addressing poor nutrition and hygiene practices as a preventative/protective approach to malnutrition; and
• District Health staff in their acceptance of malnutrition as an illness and their responsibility to manage the supplies as they would drugs and treat the patients as they would any other
And, to fully integrate the sectoral based programmes, there are key linkages between the Education programme and both the Health and Nutrition programmes at the capacity-to-attitude stage of the theory of change. The education theory allows us to target beneficiaries more effectively and reach them in a more protective/preventive way, complementing the response capacity of the Health & Nutrition Programmes.
When building resilience in a humanitarian context it is vital that the relief acts as an accelerator to existing longer-term programming and not simply as a standalone intervention.
It is most likely that Somalia will encounter another humanitarian crisis during this strategic period – whether political, security or environmental as drought is forecast and Somalia is still at Crisis levels from the 2011 famine).
Readiness and Resilience will form the basis of the response to humanitarian crisis leveraging the established programmes – Health providing care to those suffering ill health from any crisis, Nutrition being the surge-response providing protective and responsive assistance to malnourished people and Education as a targeting mechanism to identify those most vulnerable through the community structures and the school capacity.
The Readiness approach focuses on the Theories of Change for the three programmes – building the Staff, Systems and Structure so that the capacity exists to increase services should the demand increase. This is in line with the Resilience approach, outlined for our Nutrition programme and based on the experience of Resilience-grounded programmes
