Minimize the impact of COVID-19 at the community and primary care level in the high-risk areas of Baghdad, Sulaymaniyah and Kirkuk governorates As the numbers of COVID-19 reported cases are increasing in Iraq since the first case was confirmed in February 2020, it is essential to mitigate the further spread and impact of the disease, especially among the most vulnerable population with limited access to healthcare in out-of-camps and other underserved areas. MdM plans to support the Directorate of Health (DoH) existing response at the Primary Health Care (PHC) level, in partnership with the local NGO partner Doctors Aid for Medical Activities (DAMA). Based on a jointly developed MoU, and in order to have a sustainable response, MdM will contribute to strengthen DAMA staff capacities, mainly in program management and monitoring and evaluation through formal and on-the-job trainings (through monitoring, supervision visits and joint program meetings) and joint supervision visits to the supported program activities. 
To respond to the newly emerging needs, MdM and DAMA will be conducting activities within a total of 23 PHC Centers (PHCC) in Baghdad, Sulaymaniyah and Kirkuk governorates. Baghdad and Sulaymaniyah have relatively high numbers of reported cases which the Iraqi health system does not have the capacity to deal with. In Kirkuk MdM will support in the previously conflict-affected area in Hawija district, where DoH has expressed the need, as they have limited control nor capacity to respond to the crisis.
MdM and DAMA response will be based on basic assessment conducted as a first step in each identified PHCC in order to jointly discuss with the PHCC managers and DoH the specific COVID-19 needs. Based on identified needs, MdM and DAMA will primarily focus on the provision of trainings to the DoH staff at the PHCC level. The capacities of the DoH staff will be built on COVID-19 surveillance through the training of RRTs among DoH staff within the PHCCs as well as through the provision of a training package to the medical and non-medical staff in the PHCCs on triage, Infection, Prevention and Control (IPC), Personal Protective Equipment (PPE) use and disposal as well as medical waste management. The training topics will be adjusted and completed in order to be tailored to the provided services in each PHCC (i.e. Sexual and Reproductive Health (SRH), Infant and Young Child Feeding (IYCF), Expanded Program on Immunization (EPI), Gender Based Violence (GBV) sensitization, etc.). Supervisors among DoH staff at the PHCC and district levels will receive trainings in order to conduct supervision visits, supported by monitoring visits by DAMA and MdM. Refresher trainings will be organized depending on the supervision visits.
Some trainings might be done remotely due to access. While supporting the field staff with tools and guidance, regular technical debrief will be done to discuss what has happened during the day, challenges and action points. Strict IPC measures will be maintained (masks, social distancing).
The capacity building component will be complemented with awareness sessions and outreach activities in all selected areas in Kirkuk and 2 selected areas in Sulaymaniyah. Community Health Volunteers (CHVs) will share health and mental health promotion messages and basic preventive measures, based on the national and international COVID-19 related guidelines. CHVs will be trained before conducting the door-to-door activities based on a Standard Operating Procedure (SoP) on community awareness developed by MdM, which will be shared with DAMA. DAMA training skills will be strengthened though capacity building by MdM on a joint training manual. The main messages focus on prevention of COVID-19 infections, how to seek care and support in case of any doubt, mental health wellbeing in time of health crisis and how to cope with stress. These home visits will be followed by rapid Knowledge, Attitude and Practices (KAP) survey in order to identify behavioral changes in practice among the visited households and to inform the need for refreshers while ensuring the quality.