Provision of integrated primary health care services including reproductive health, MHPSS, and nutrition in Nuristan Province ltpgtltspan style="text-align: justify"gtIn the
eastern region, AYSO has already been implementing projects in various sectors.
There are two AYSO offices in the central and west of Nuristan which allow AYSO
to reach out to the remote parts of the province where the project is to be
implemented easily. It is the intention of AYSO to provide essential health,
nutrition, and psychological services to rural and isolated populations who
would not otherwise have access to these services. The project's overall
objective is to improve access to primary health care, nutrition, and
psychosocial services in remote locations of six districts (Barge Matal, Kamdish, Mandol, Duab, Wama, Waygal, and Noorgram) of Nuristan province. Through this
project, AYSO plans to deliver planned services to 40199 people (10440 women,
9258 girls, 10866 men, 9636 boys). In consultation with the PPHD, AYSO proposed
to establish nine Sub Health Centers (SHC) in the white areas of six targeted
districts. Furthermore, the project will increase community awareness of the
prevention of communicable diseases, malnutrition, psychosocial problems, and
hygiene promotion among local communities. Each SHC team will consist of six
members, including one MD, one MW, one Nutrition counselor, one health
promotor/PS counselor, one vaccinator, and one guard/cleaner. The service
delivery points (SDP) and location of SHCs have been identified together with
the PPHD in close coordination with the BPHS implementing partner to avoid
duplication and cover all the white areas. In order to improve the quality of
health services in HFs, AYSO will keep the communities engaged throughout the
project lifecycle, monitor the project activities, and provide constructive
feedback to the HFs' staff during monthly meetings. The project activities will
be implemented for a duration of 06 months with 15 days inception phase and 5.5
months for implementation. To avoid negative effects/harms, AYSO will take some
mitigation measures to address the below potential risk:lt/spangtltbrgtlt/pgtltpgtltspan style="font-family:"gt

lt/spangtlt/pgtltp class="MsoNormal" style="margin-bottom:0intext-align:justify"gtltspan style="font-family:"gtltspan style="mso-bidi-font-family:Calibrimso-bidi-theme-font:minor-latin"gtProject
activities will take place over a period of six months, with an inception phase
of 15 days and an implementation phase of 5.5 months. In order to mitigate the
potential risks listed below, AYSO will take the following measures:lt/spangtlt/spangtlt/pgtltpgtltspan style="font-family:"gt

lt/spangtlt/pgtltp class="MsoNormal" style="margin-bottom:0intext-align:justify"gtltspan style="font-family:"gtltspan style="mso-bidi-font-family:Calibrimso-bidi-theme-font:minor-latin"gt1. Limited
awareness: Lack of knowledge about health and hygiene practices may hinder the
success of the project. Possible mitigation measures include:lt/spangtlt/spangtlt/pgtltpgtltspan style="font-family:"gt

lt/spangtlt/pgtltp class="MsoNormal" style="margin-bottom:0intext-align:justify"gtltspan style="font-family:"gtltspan style="mso-bidi-font-family:Calibrimso-bidi-theme-font:minor-latin"gt-
Conducting community outreach: Engage with local community leaders, religious
figures, and influencers to raise awareness about the project and its benefits.lt/spangtlt/spangtlt/pgtltpgtltspan style="font-family:"gt

lt/spangtlt/pgtltp class="MsoNormal" style="margin-bottom:0intext-align:justify"gtltspan style="font-family:"gtltspan style="mso-bidi-font-family:Calibrimso-bidi-theme-font:minor-latin"gt-
Utilizing local media channels: Leverage local radio stations, posters, and
other visual aids to disseminate information about the project.lt/spangtlt/spangtlt/pgtltpgtltspan style="font-family:"gt

lt/spangtlt/pgtltp class="MsoNormal" style="margin-bottom:0intext-align:justify"gtltspan style="font-family:"gtltspan style="mso-bidi-font-family:Calibrimso-bidi-theme-font:minor-latin"gt- Hiring
local community health workers: Train and employ individuals from the community
who can educate their peers about health practices and project
objectives. lt/spangtlt/spangtlt/pgtltp class="MsoNormal" style="margin-bottom:0intext-align:justify"gtltspan style="font-family:"gtltspan style="mso-bidi-font-family:Calibrimso-bidi-theme-font:minor-latin"gt2.
Cultural sensitivity and local practices: Cultural practices may impact the
acceptance and adoption of health interventions. Mitigation measures could
include:lt/spangtlt/spangtlt/pgtltpgtltspan style="font-family:"gt

lt/spangtlt/pgtltp class="MsoNormal" style="margin-bottom:0intext-align:justify"gtltspan style="font-family:"gtltspan style="mso-bidi-font-family:Calibrimso-bidi-theme-font:minor-latin"gt- Engaging
local leaders and influencers: Seek their support and involve them in project
planning and execution to ensure cultural sensitivity.lt/spangtlt/spangtlt/pgtltpgtltspan style="font-family:"gt

lt/spangtlt/pgtltp class="MsoNormal" style="margin-bottom:0intext-align:justify"gtltspan style="font-family:"gtltspan style="mso-bidi-font-family:Calibrimso-bidi-theme-font:minor-latin"gt-
Designing context-specific interventions: Tailor health messages and practices
to align with the local culture and incorporate traditional healing practices
where appropriate.lt/spangtlt/spangtlt/pgtltpgtltspan style="font-family:"gt

lt/spangtlt/pgtltp class="MsoNormal" style="margin-bottom:0intext-align:justify"gtltspan style="font-family:"gtltspan style="mso-bidi-font-family:Calibrimso-bidi-theme-font:minor-latin"gtA similar
project was undertaken by AYSO in six districts of Nuristan under the reserve
allocation in 2022. To avoid double counting, AYSO will use the available
medical and non-medical equipment, medicines, and IT equipment from the
"reserve allocation 2022" applied in the same districts.lt/spangtlt/spangtlt/pgtltpgt





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