Operational Support to the Health Emergency Response in Ethiopia The proposed project follows on from a previous EHF-funded project to provide support to the Ethiopia Somali Regional Health Bureau (RHB), UN and NGO partners in their response to an outbreak of Acute Watery Diarrhoea (AWD) in the region (May-August 2017).  

The health crisis has evolved since the previous project began in May 2017.  The number of people affected with AWD per week has gone up and down, from 150 per week in April to 42 in June, and 135 in mid-July.  A resurgence of the number of AWD cases in Amhara and Tigray projected to affect 30,000 persons, and another in Gugi zone of Oromia may see a similar caseload.  In parallel, Ethiopia Somali Region is also grappling with an alarming rise in malnutrition levels among children and pregnant/lactating mothers, combined with the spread of communicable diseases, such as measles.

In response, this new project proposes to provide operational support and common services to the RHB, UN and NGO to facilitate the health, WaSH and nutrition response to the broadening health sector emergency in hotspot, remote and far to reach areas of the Ethiopia Somali Region, and to help Amhara RHB respond to new AWD outbreaks. As required, other regions such as Oromiya and Tigray can also be supported based on regular discussions and reviews with OCHA and other key stakeholders.

The proposed project has four key components:
1.	Fleet management services for response teams. So that health workers can visit remote parts of the region, UNOPS will assign vehicles (through service providers): Eighty five 4x4s and pickups for travel services to health workers. The vehicles will be in good condition (from 2010 or newer), with drivers who are familiar with the region. UNOPS will manage the vehicles, working with service providers and humanitarian partners to ensure vehicles meet the requirements of the emergency in terms of equipment, availability, and quality of service. An Operations Associate will be appointed under this component for troubleshooting, ensuring that the provider maintains vehicles, and facilitating the planning and work of response teams in the two regions and may extend to other regions as required.

2.	Supply chain management services. UNOPS will deploy seven 5MT trucks across the 2 regions to enable RHBs, UN and NGO partners to deliver supplies in support of response efforts.  These vehicles will deliver health, WaSH, education and nutrition supplies from the regional capital through to zonal logistics hubs for onward delivery to end-users in woredas and kebeles.  The fleet management Operations Associate will also manage the supply chain component.

3.	Disbursement of per diem payments. UNOPS will work with mobile payment company to ensure that the 423 RHB health workers travelling in UNOPS-supplied vehicles to remote, hotspot areas are paid per diem promptly, in accordance with MoH per diem rates. Disbursement through mobile payment companies is cost effective, as it reduces logistic and time costs. To manage this process, an Operations Associate will work at the command post in Jijiga and Addis Ababa to oversee per diem payments and assist with any changes or delays. Disbursements will include key loaders/unloaders assigned in the regions to cover their additional expenses, and avoid delays in service provision.

4.	Capacity building and knowledge transfer. This component includes three key activities: a broad capacity assessment of the RHB’s existing supply chain management systems, mechanisms and capacities, on-the-job training of RHB employees, and a workshop in Addis Ababa to present findings and recommendations for the way forward to stakeholders (see ‘Implementation Plan’ section for more details). Overall, this component is to make sure that government has the capacity in the future to respond to similar crises and emergencies using its own resources and systems, without depending on ad-hoc support from UN or other partners