Non - Food Meher Final Report (2023)

Non-Food Meher Assessment report Tigray Dec 2023
Tigray Annual Meher Assessment Report 2023

(Health)
Conducted in Northwest zone Tigray,

from Nov- Dec 2023
pg. I
Figure 1: Map of Tigray and the location of Assessed woredas, June 2023
Figure 2: Map of Tigray and the location of Assessed woredas, June 2023
Table 1: Description of the 2023 Meher assessment area
Regional name Tigray

Zones northwest Tigray
Northwest: 1) Tahtai Adiabo, 2) Seyemti Adiabo, 3) Laelay Koraro, 4) Tsimbla, 5) Shire

Woredas
Date of assessment
22 Nov 2023- 5 Dec 2023
started/completed
Table 2: List of Meher Assessment Team Members, Tigray, Dec 2023
S/N Name Organization Mobile Email

1 Ataklti Gebretsadik TRHI O914122801 atakltigeberttsadik@gmail.com
2 Yirgalem IRC, Shire 00920017500
3 Haile Tensay WHO 0914765140 tensayh@who.int
4 Dr Bethelhem UNICEF 0906101313
pg. II
7 Tr Ahimed Mohammed BoE 0914753967

8 Kassa Tsehaye MWIE 0913315060
9 Hagos Hiluf Regional water resource 0914758897
ACRONYMS AND ABBREVIATIONS
AFI Acute Febrile Illness

AURTI Acute Upper Respiratory Tract Infection
AWD Acute Watery Diarrhea
CMAM Community Management of Acute Malnutrition
CSB++: Corn Soybean
CHD Community Health Day
CM Centi metre
CTC: Cholera Treatment Center
Co WASH Community Water Sanitation and Hygiene

DD Due date
EC Ethiopian Calander
EFY Ethiopian Fiscal Year
ENCU Emergency Nutrition Coordination Unit
EWRFSS Early Warning, Response and Food Security Sector
FGD: Focus Group Discussion
pg. III
FMOH Federal Ministry of Health

GAM Global Acute Malnutrition
GBV: Gender Based Violence
GC Gorgorian calendar
HC Health Center
HEW Health extension worker
HHs House Holds
HP Health Post
HCWs Health Care Workers
IRC International Rescue Committee
LLITNS Long lasting Impregnated Treated nets
MAM Moderate Acute Malnutrition

Mm Month
MHNT Mobile Health and Nutrition Team
MUAC Mid Upper Arm Circumference
N No
NGO Non- Govermental Organization
NF Non Functional
OTP Out-patient Therapeutic Program

PHEM: Public Health Emergency Management
PLW: Pregnant and Lactating Women
pg. IV
RHB Regional Health Bureau

RDT Rapid Dignostic Test
RUSF Ready to Use Therapeutic Supplementary Food
RUTF Ready to Use Therapeutic Food
SAM Sever Acute Malnutrition
SC Stabilization Center
SIA Supplementary Immunization Activities
TFP Therapeutic feeding program
TSFP Target Supplementary Feeding program
TFU/SC Therapeutic Feeding Unit/ Stabilization Center
UNICEF United Nations Children’s Fund
Vit A Vitamin A
WASH Water Sanitation and Hygiene
WHO World Health Organization
Y Yes
Contents
ACRONYMS AND ABBREVIATIONS..............................................................................................................III
List of tables................................................................................................................................................X
List of figures.............................................................................................................................................XII
pg. V
1. Executive summary...........................................................................................................................XIII
 WASH........................................................................................................................................................................................................... XIII
 Education.................................................................................................................................................................................................... XIV
 Social protection....................................................................................................................................................................................... XIV
1.1 Nutrition.................................................................................................................................................................................................... XXI
2. OBJECTIVES..........................................................................................................................................1
3. METHODOLOGY...................................................................................................................................1
3.1 Study area and Period.................................................................................................................................................................................. 1

3.2 Data collection procedure:........................................................................................................................................................................... 2
3.3 Data management and analysis:................................................................................................................................................................... 2
4. Major findings......................................................................................................................................3
4. Health.............................................................................................................................................................................................................. 3
4.1 Coordination:............................................................................................................................................................................................... 4
4.2 Leading Causes of Morbidity:..................................................................................................................................................................... 8
4.3 Status of outbreak prone diseases and occurrence of outbreak:..............................................................................................................8
4.4 Disease Outbreak:................................................................................................................................................................................ 10
4.5 Risk factors for outbreak prone diseases:..........................................................................................................................................10
4.6 Preparedness - Emergency drugs and supplies:......................................................................................................................................10
4.7 Challenges outlined by wereda health office heads and experts:............................................................................................................11
Recommendations:........................................................................................................................................................................................... 12
4.2 Nutrition.......................................................................................................................................................................................................... 14
pg. VI
WASH......................................................................................................................................................21
4.4 Overview.......................................................................................................................................21
4.4.1 Overall situation of Water, sanitation and hygiene...............................................................22
4.4.2 Water supply coverage by % of the 6 Belg assessed Districts Tigray, June 2019............................................................................23
4.4.3 Woreda water supply coverage southeast and southern zones of Tigray region.............................................................................24
4.4.4 Situation of sanitation and hygiene promotion among the belg assessed woredas...............................................................24
4.4.5 Overall sanitation of sanitation facilities of the Belg Assessed Weredas, Tigray, June 2019..........................................................25
4.4.6 Latrine covarage (%) by woreda in the belg assessed woredas................................................................................................26
4.5 Current WASH related Emergency /Hazard.............................................................................26
4.5.1 Communities currently affected /at risk of WASH emergency, Tigray, June, 2019.......................................................................27
4.5.2 Communities affected and at risk population for water shortage.............................................................................................28
4.6 Status of water supply schemes...........................................................................................................................................................28
4.6.1 Status of water supply schemes by wereda, Tigray, June 2019........................................................................................................29
4.6.2 Average quantity of water and walking time/ distance among Belg assessed districts........................................................31
4.7 Copping strategies.................................................................................................................................................................................. 32
4.8 Coordination at all level........................................................................................................................................................................32
4.9 Challenges................................................................................................................................................................................................ 32
4.10 Recommendations............................................................................................................................................................................. 32
4.10.1 Temporary emergency response activities...............................................................................................................................33
4.10.2 Long term sustainable solutions.................................................................................................................................................33
5 Education........................................................................................................................................34
pg. VII
5.4 Objective of the assessment.................................................................................................................................................................34

5.5 Schools Enrolment and drop out.........................................................................................................................................................34
5.5.1 Raya-Alamata.................................................................................................................................................................................. 34
5.5.2 Enda-Mekoni................................................................................................................................................................................... 36
 2.2.3. Ofla................................................................................................................................................................................................. 38
5.5.3 Raya-Azebo...................................................................................................................................................................................... 40
5.5.4 Alaje.................................................................................................................................................................................................. 42
5.5.5 Hintalo-Wajrat................................................................................................................................................................................ 43
5.6 Summary.................................................................................................................................................................................................. 45
5.7 Situation of institutional WASH...........................................................................................................................................................46
5.8 Challenges................................................................................................................................................................................................ 47
5.9 Recommendations:................................................................................................................................................................................ 47
6 Social protection............................................................................................................................48
6.4 Hintato Wojerat:..................................................................................................................................................................................... 48

6.4.1 Response:......................................................................................................................................................................................... 48
6.4.2 Challenges:....................................................................................................................................................................................... 48
6.4.3 Early Marriage:............................................................................................................................................................................... 49
6.4.4 SGBV:................................................................................................................................................................................................. 49
6.4.5 Child Labor:..................................................................................................................................................................................... 49
6.4.6 Child Trafficking:............................................................................................................................................................................ 49
6.5 Alaje:......................................................................................................................................................................................................... 49
6.5.1 Response:......................................................................................................................................................................................... 49
pg. VIII
6.5.2 Challenges:....................................................................................................................................................................................... 50
6.5.3 Early Marriage:............................................................................................................................................................................... 50
6.5.4 SGBV:................................................................................................................................................................................................. 50
6.5.5 Child abuse/exploitation:.............................................................................................................................................................50
6.5.6 Response:......................................................................................................................................................................................... 50
6.5.7 Elderly:............................................................................................................................................................................................. 51
6.5.8 Vulnerable female headed households:.....................................................................................................................................51
6.5.9 Response:......................................................................................................................................................................................... 51
6.5.10 Migration:........................................................................................................................................................................................ 51
6.6 Ofla:........................................................................................................................................................................................................... 51
6.6.1 IDPs:.................................................................................................................................................................................................. 51
6.6.2 Response:......................................................................................................................................................................................... 52
6.6.3 Challenges:....................................................................................................................................................................................... 52
6.6.4 Child Protection:............................................................................................................................................................................. 52
6.6.5 Response:......................................................................................................................................................................................... 52
6.6.6 SGBV:................................................................................................................................................................................................. 52
6.6.7 Early marriage:............................................................................................................................................................................... 53
6.7 Enda-Moheni:.......................................................................................................................................................................................... 53
6.7.1 Response:......................................................................................................................................................................................... 53
6.7.2 Challenge:............................................................................................................................................................................................ 53
6.7.3 SGBV:.................................................................................................................................................................................................... 53
6.8 Raya-Alamata:......................................................................................................................................................................................... 53
pg. IX
6.8.1 Response:......................................................................................................................................................................................... 54
6.8.2 Challenges:....................................................................................................................................................................................... 54
6.8.3 SGBV:................................................................................................................................................................................................. 54
6.8.4 Early Marriage:............................................................................................................................................................................... 54
6.9 Raya-Azebo:............................................................................................................................................................................................. 55
6.9.1 Response:......................................................................................................................................................................................... 55
6.9.3 SGBV:................................................................................................................................................................................................. 55
6.9.4 Elderly:............................................................................................................................................................................................. 56
6.10 Summary Table:.................................................................................................................................................................................. 56
 3.8. Number of community Care Coalitions in the Belg producing woredas...................................................................................59
6.11 CCC support vulnerable groups.......................................................................................................................................................59
6.12 Resource mobilized by CCC..............................................................................................................................................................60
6.13 One child for one organization........................................................................................................................................................60
 3.10.1. Number of support vulnerable children...............................................................................................................................60
6.14 Enabling Environment/Opportunities for GBV and social protection......................................................................................61
6.15 Challenges............................................................................................................................................................................................ 61
6.16 Recommendations:............................................................................................................................................................................ 62
List of tables
pg. X
Table 1: Description of the 2019 belg assessment area.......................................................................................................................II

Table 2: List of Belg Assessment Team Members, Tigray, June 2019......................................................................................................II
Table 3: Profile of visited woredas of Belg assessment, Tigray region, June 2019..................................Error! Bookmark not defined.
Table 4: Description of the PHEM coordination mechanisms in the visited six woredas, Tigray Region, June 2019 Error! Bookmark
not defined.
Table 5: Meningitis & Measles mass vaccination data in the six Belg assessed woredas, Tigray, June 2019.......Error! Bookmark not
defined.
Table 6: Malaria Risk Factors in the six Belg Assessed Woredas, Tigray, June 2019..............................Error! Bookmark not defined.
Table 7: Availability of emergency drugs and supplies enough for 1 month? Or easily accessible on need?.......Error! Bookmark not
defined.
Table 8: Emergency budget required for Health Emergency, Belg Assessment, June 2019.....................Error! Bookmark not defined.
Table 9: screening coverage of children 6-59 months’ children and pregnant and lactating women from Nov 2018- Apr 2019............15
Table 10: Nutritional status of 6-59 months children and pregnant and lactating women (from Nov 2018- Apr 2019...........................15
Table 11: Facilities with SAM management services and reporting rate for April 2019 in the assessed woredas...................................17
Table 12: TFP admission trend Nov 2018- Apr2019................................................................................................................................17
Table 13: Performance of the therapeutic feeding program for SAM management April 2018/2019......Error! Bookmark not defined.
Table 14: CMAM training status for HEWs and HWs in belg woredas, Tigray June 2019.....................................................................19
Table 15: Availability of therapeutic supplies in all 6 belg woredas, Tigray, June 2019.........................................................................19
Table 16: MAM admission from Nov- Apr 2008 and Nov – Apr 2009 in the TSF project woredas........Error! Bookmark not defined.
Table 17: Proposed WaSH intervention with budget (‘000 birr), Tigray, June 2019................................Error! Bookmark not defined.
Table 18: 2009 School children registered on September 2009 Vs actual attended school children up to June 2009 (G1-12) in the six
Belg producing weredas, June 2019..........................................................................................................Error! Bookmark not defined.
pg. XI
Table 19: Number of Schools and Students enrolled and attended in the 6 assessed Weredas by category, Belg Assessed Woredas,
Tigray, and June 2019................................................................................................................................Error! Bookmark not defined.
Table 20: Number of teachers working in the Belg growing assessed Weredas, Tigray, and June 2019. Error! Bookmark not defined.
Table 21: Number of Schools with WASH facilities, Belg Assessed Woredas, Tigray June 2019..........Error! Bookmark not defined.
Table 22: the number of school children living with disability in the Belg assessed woredas..................Error! Bookmark not defined.
Table 23: Summary of Budget Estimate, Education, Belg Assessed Woredas, Tigray, June 2019..........Error! Bookmark not defined.
Table 24 : Source of information...............................................................................................................Error! Bookmark not defined.
Table 25: Main protection and GBV findings...........................................................................................Error! Bookmark not defined.
Table 26: % breakdown of the woredas which indicated each risk...........................................................Error! Bookmark not defined.
Table 27: Violence cases reported as per type...........................................................................................Error! Bookmark not defined.
List of figures
Figure 1: Map of Tigray and the location of Assessed woredas, June 2019...............................................................................................II
Figure 1: Map of Tigray and the location of Assessed woredas, June 2019...............................................................................................II
Figure 2: Malaria case load of the belg producing area, June2019...........................................................Error! Bookmark not defined.
Figure 3: Monthly Malaria case load in R/Azebo......................................................................................Error! Bookmark not defined.
Figure 4: Malaria case load of R/Alamata.................................................................................................Error! Bookmark not defined.
Figure 5: Trend of Malaria cases by month from November to April 2008 Vs 2009 EFY, H/wajirat......Error! Bookmark not defined.
Figure 6: Vitamin A and De-worming coverage of the assessed woreda for the month of April 2019....................................................16
Figure 7: Water supply and un-improved latrine coverage of the 6 Belg assessed weredas, Tigray, June 2019....Error! Bookmark not
defined.
Figure 8: status of water supply schemes..................................................................................................Error! Bookmark not defined.
pg. XII
Figure 9: Number of Schools and Students status in assessed weredas, Tigray June 2019.....................Error! Bookmark not defined.
Figure 10: Membership of CCC in the belg producing area......................................................................Error! Bookmark not defined.
Figure 11: Amount of resource and supported beneficiaries.....................................................................Error! Bookmark not defined.
1. Executive summary
Introduction: In all sectors, the results are organized and presented at regional level and covering all the five basic social services
namely health, nutrition, WASH, education and social protection. In total, 2 zones and 6 woredas were visited by the assessment team.
Objective of the assessment is to assess the extent, type, magnitude, severity and likely of the different hazards (drought, human
epidemics, conflict, floods, etc) and risks to the populations in the most vulnerable woredas (including identifying the most vulnerable
populations) for health, nutrition, WASH, education and social protection related emergencies in Tigray region.
 WASH
Safe Water supply coverage of the assessed districts was critically affected by drought as result total of 128,066 people affected and
113,117 people is on at risk for safe water shortage. The water supply coverage of the districts ranges from 58% to 70.4% (relatively
higher in Emba-Alaje and lowest in Raya-Azebo). Non-functionality rate varies from 14% to 38.59% highest in Hintalo-Wejerat and
lowest in Raya -Azebo district.
The sanitation and hygiene situation of the visited weredas was also assessed. Accordingly, the average household latrine coverage is
found to be 5.18%, which indicates that there is very poor sanitation practice (open defecation practices). 94.82 % (772,243) people in
all belg assessed woredas and 94.9 % (326, 403) in all belg assessed Keble's haven't improved house hold latrine.
The assessment team recommends to continuation of water trucking in Hintalo-Wajrat, Construction of new water supply schemes
including at institutions like schools and health facilities, Rehabilitation of non-functional schemes, to recharge the depleted ground
pg. XIII
water potential should have to implement proper integrated water shade management such as constructing ponds, water rain harvesting
systems, small dams and to strengthening the capacity building activities at all levels.
 Education
School enrolment in the six ‘Belg’ growing rural woredas of southern (R/Alamata (14,155), R/Azebo (16,076), E/Mekoni (13,829),
Ofla (6,398) E/Alaje (4,524) and south eastern (H/Wajrat , 12,847were respectively enrolled in all the primary schools.
Assessment was conducted in 48 Keble’s, and 180 primary schools in six Belg growing woredas i.e, five woredas from the southern
zone and one from the south eastern zones. According to the assessment, there are nearly 67,829 students enrolled at the beginning of
the academic year of 2011 in 180 assessed primary schools from grades 1-8. These are 34,930 male s and 32,899 are female students.
The actual students who have been learning up to the Belg assessment are a total of 65,434 (33,440 M; 31,994 M). In general, the
dropped out students in the 180 belg assessed primary schools are 2,395 (3.5%).
Among the assed 180 schools 116 schools have water access, 124 schools have separate latrines and 75 schools have communal
latrines within their compound.
 Social protection
• From the 111,456 total IDPs in the Tigray regional state, 17,637 IDPs are in six woredas of the South and South eastern zones which are the
biggest recipients of IDPs in Tigray following Mekelle and Eastern zone
• During the course of the year there are 5 rape cases (from the age of 9 months up to 70 yrs elderly) and 151 underage marriage suspects and 15
confirmed illegal marriages
• Around 104 illegal migrations was reported in two woredas and human trafficking was reportedly resulted to 3 deaths and 5 disabilities in one
woredas
pg. XIV
• Most vulnerable part of the community i.e. elderly, women headed households, disable, HIV are linked to different support programs i.e.
PSNP direct support and CCC
Contents
ACRONYMS AND ABBREVIATIONS..............................................................................................................III
List of tables................................................................................................................................................X
List of figures.............................................................................................................................................XII
1. Executive summary...........................................................................................................................XIII
 WASH........................................................................................................................................................................................................... XIII
 Education.................................................................................................................................................................................................... XIV
 Social protection....................................................................................................................................................................................... XIV
1.1 Nutrition.................................................................................................................................................................................................... XXI
2. OBJECTIVES..........................................................................................................................................1
3. METHODOLOGY...................................................................................................................................1
3.1 Study area and Period.................................................................................................................................................................................. 1

3.2 Data collection procedure:........................................................................................................................................................................... 2
3.3 Data management and analysis:................................................................................................................................................................... 2
4. Major findings......................................................................................................................................3
4. Health.............................................................................................................................................................................................................. 3
pg. XV
4.1 Coordination:............................................................................................................................................................................................... 4
4.2 Leading Causes of Morbidity:..................................................................................................................................................................... 8
4.3 Status of outbreak prone diseases and occurrence of outbreak:..............................................................................................................8
4.4 Disease Outbreak:................................................................................................................................................................................ 10
4.5 Risk factors for outbreak prone diseases:..........................................................................................................................................10
4.6 Preparedness - Emergency drugs and supplies:......................................................................................................................................10
4.7 Challenges outlined by wereda health office heads and experts:............................................................................................................11
Recommendations:........................................................................................................................................................................................... 12
4.2 Nutrition.......................................................................................................................................................................................................... 14
WASH......................................................................................................................................................21
4.4 Overview.......................................................................................................................................21
4.4.1 Overall situation of Water, sanitation and hygiene...............................................................22
4.4.2 Water supply coverage by % of the 6 Belg assessed Districts Tigray, June 2019............................................................................23
4.4.3 Woreda water supply coverage southeast and southern zones of Tigray region.............................................................................24
4.4.4 Situation of sanitation and hygiene promotion among the belg assessed woredas...............................................................24
4.4.5 Overall sanitation of sanitation facilities of the Belg Assessed Weredas, Tigray, June 2019..........................................................25
4.4.6 Latrine covarage (%) by woreda in the belg assessed woredas................................................................................................26
4.5 Current WASH related Emergency /Hazard.............................................................................26
4.5.1 Communities currently affected /at risk of WASH emergency, Tigray, June, 2019.......................................................................27
4.5.2 Communities affected and at risk population for water shortage.............................................................................................28
4.6 Status of water supply schemes...........................................................................................................................................................28
pg. XVI
4.6.1 Status of water supply schemes by wereda, Tigray, June 2019........................................................................................................29

4.6.2 Average quantity of water and walking time/ distance among Belg assessed districts........................................................31
4.7 Copping strategies.................................................................................................................................................................................. 32
4.8 Coordination at all level........................................................................................................................................................................32
4.9 Challenges................................................................................................................................................................................................ 32
4.10 Recommendations............................................................................................................................................................................. 32
4.10.1 Temporary emergency response activities...............................................................................................................................33
4.10.2 Long term sustainable solutions.................................................................................................................................................33
5 Education........................................................................................................................................34
5.4 Objective of the assessment.................................................................................................................................................................34

5.5 Schools Enrolment and drop out.........................................................................................................................................................34
5.5.1 Raya-Alamata.................................................................................................................................................................................. 34
5.5.2 Enda-Mekoni................................................................................................................................................................................... 36
 2.2.3. Ofla................................................................................................................................................................................................. 38
5.5.3 Raya-Azebo...................................................................................................................................................................................... 40
5.5.4 Alaje.................................................................................................................................................................................................. 42
5.5.5 Hintalo-Wajrat................................................................................................................................................................................ 43
5.6 Summary.................................................................................................................................................................................................. 45
5.7 Situation of institutional WASH...........................................................................................................................................................46
5.8 Challenges................................................................................................................................................................................................ 47
5.9 Recommendations:................................................................................................................................................................................ 47
6 Social protection............................................................................................................................48
pg. XVII
6.4 Hintato Wojerat:..................................................................................................................................................................................... 48

6.4.1 Response:......................................................................................................................................................................................... 48
6.4.2 Challenges:....................................................................................................................................................................................... 48
6.4.3 Early Marriage:............................................................................................................................................................................... 49
6.4.4 SGBV:................................................................................................................................................................................................. 49
6.4.5 Child Labor:..................................................................................................................................................................................... 49
6.4.6 Child Trafficking:............................................................................................................................................................................ 49
6.5 Alaje:......................................................................................................................................................................................................... 49
6.5.1 Response:......................................................................................................................................................................................... 49
6.5.2 Challenges:....................................................................................................................................................................................... 50
6.5.3 Early Marriage:............................................................................................................................................................................... 50
6.5.4 SGBV:................................................................................................................................................................................................. 50
6.5.5 Child abuse/exploitation:.............................................................................................................................................................50
6.5.6 Response:......................................................................................................................................................................................... 50
6.5.7 Elderly:............................................................................................................................................................................................. 51
6.5.8 Vulnerable female headed households:.....................................................................................................................................51
6.5.9 Response:......................................................................................................................................................................................... 51
6.5.10 Migration:........................................................................................................................................................................................ 51
6.6 Ofla:........................................................................................................................................................................................................... 51
6.6.1 IDPs:.................................................................................................................................................................................................. 51
6.6.2 Response:......................................................................................................................................................................................... 52
6.6.3 Challenges:....................................................................................................................................................................................... 52
pg. XVIII

6.6.5 Response:......................................................................................................................................................................................... 52
6.6.6 SGBV:................................................................................................................................................................................................. 52
6.6.7 Early marriage:............................................................................................................................................................................... 53
6.7 Enda-Moheni:.......................................................................................................................................................................................... 53
6.7.1 Response:......................................................................................................................................................................................... 53
6.7.2 Challenge:............................................................................................................................................................................................ 53
6.7.3 SGBV:.................................................................................................................................................................................................... 53
6.8 Raya-Alamata:......................................................................................................................................................................................... 53
6.8.1 Response:......................................................................................................................................................................................... 54
6.8.2 Challenges:....................................................................................................................................................................................... 54
6.8.3 SGBV:................................................................................................................................................................................................. 54
6.8.4 Early Marriage:............................................................................................................................................................................... 54
6.9 Raya-Azebo:............................................................................................................................................................................................. 55
6.9.1 Response:......................................................................................................................................................................................... 55
6.9.3 SGBV:................................................................................................................................................................................................. 55
6.9.4 Elderly:............................................................................................................................................................................................. 56
6.10 Summary Table:.................................................................................................................................................................................. 56
 3.8. Number of community Care Coalitions in the Belg producing woredas...................................................................................59
6.11 CCC support vulnerable groups.......................................................................................................................................................59
6.12 Resource mobilized by CCC..............................................................................................................................................................60
pg. XIX
6.13 One child for one organization........................................................................................................................................................60

 3.10.1. Number of support vulnerable children...............................................................................................................................60
6.14 Enabling Environment/Opportunities for GBV and social protection......................................................................................61
6.15 Challenges............................................................................................................................................................................................ 61
6.16 Recommendations:............................................................................................................................................................................ 62
Even though all weredas had indicated the presence of multi-sectorial PHEM coordination forum, there is no a regular meeting
documented by minutes, all weredas reported of having irregular/ad-hoc meetings when there are some concerns happened without
documentation of any minute. Public Health Emergency preparedness and response plan for EFY2011 is available at all woredas but
not addressing all PHEM activities including reproductive health(RH). No major disease outbreak was reported except malaria at Raya
Azebo. Generally, the burden of malaria morbidity in the visited Weredas showed a decline in 2011 E.C compared to 2009 E.C except
R/azebo woreda leads to 5236 people affected within three months. However, due to the presence of risk factors for malaria outbreak
there is a possibility that malaria and other communicable diseases outbreak may occur in the future. Moreover, basic emergency
drugs and supplies like Ringer Lactate (to treat AWD cases), ORS, TTC eye ointment, Coartem, RDT for malaria are available
available at health facility level not at woreda and absence of supplies like LP Set, RDT for Meningitis, Male condom kit, rape
survivors kit weredas at all woredas.
The following recommendations are forwarded to alleviate the above problems,
 PHEM coordination forum in all weredas need to be more functional. The forum needs to have regular meeting with minute and
shared plan.
 The Emergency preparedness and response plan claimed to be present in all visited weredas needs to include RSH issues up to
the level it can help emergency RH problems of the areas,
pg. XX
 To control risk factors for outbreak prone diseases water supply coverage in all weredas needs to be improved, LLINs coverage
should be lifted up above the minimum standard 80%, and efforts needs to be made to abolish possible malaria breeding sites
through different means specially R/azebo, and
 All emergency drugs and supplies needs to be prepositioned to weredas and health offices to ensure rapid response.
1.1 Nutrition
All visited woredas have relatively good screening coverage in Nov- Apri 2011. Admission of SAM cases has shown increment by
132 cases in 2019 (Nov- Apr) compared to 2018 (Nov-Apr). Outcome of TFP of the assessed woreda was good based on the sphere
standard for the performance indicators. Cure rate of the assessed woreda was above the sphere acceptable standard. The risk factors
for emergency nutrition are aggravating factors (Diarrhea and malaria), inadequate safe water supply and poor personal and
environmental hygiene. The recommendations are improve monthly screening to cover all children 6-59 months & PLW, strengthen
coordination, under take close monitoring and follow and strengthen CBN activities.
pg. XXI
2. OBJECTIVES
The purpose of the Belg assessment for the non-food or social sector includes:
 Assess the extent, type, magnitude, severity and likely of the different hazards (drought, human epidemics, conflict, floods, etc)
and risks to the populations in the most vulnerable woredas (including identifying the most vulnerable populations) for health,
nutrition, WASH, education and social protection related emergencies in Tigray region (From July up to Dec, 2019).
 Assess the existing capacity of the basic social services such as health, nutrition WASH, education and social protection to address
the emergencies likely to occur. It also determines the short coming (gap) in the capacity of the existing services to address the
problem.
 Identify areas where emergency assistance might be needed and come up with reasonable estimates of the size of the population
needing emergency assistance and the duration of assistance.
 Based on the findings on the assessment of risks for, and the need to address, potential emergencies and develop necessary plans
for fostering preparedness sectors to adequately address the potential emergencies;
3. METHODOLOGY
3.1 Study area and Period
The Belg assessment was conducted in the six Belg producing woredas of Tigray - 5 in southern and 1 in south-eastern zone. These
include Raya Azebo, Raya Alamata, Ofla, Emba Alaje, Enda Mekoni (in southern zone) and Hintalo Wejerat (in south east zone). The
average distance from Mekelle ranges from 40 to 180 kms. The 2019 Belg assessment was conducted from 6-15 to June 2019.
pg. 1
3.2 Data collection procedure:

The Belg seasonal multi-agency assessment was conducted through discussion with zone and wereda administration, briefing by the
assessment team on the mission of the team, and which is followed by wereda admin and respective sector offices overview
description of the Belg situation in each wereda.
After joint general briefings by zone administration, the assessment team traveled to respective weredas in southern zone starting its
mission with wereda administrator or delegate and sector representatives’ general briefing and discussion. After wereda level briefing,
the food and non-food teams were assigned in to their respective sector offices to collect the required data based on the prep-prepared
checklist and discussion guides. Socio- demographic, health profile, epidemic risk factors, health, nutrition, WaSH and education data
were collected using nationally standardized non-food Belg assessment questionnaire through semi structured interview.
The assessment was conducted by multi-sectoral collaboration composed of federal and regional government bureaus (ministry of
water, irrigation and electricity, EWRFSS/ENCU, BoLSA) UNICEF, UNFPA, IRC and CWW. Finally, briefing discussions were
conducted with the Southern and South-eastern zone administration offices and to the Regional DRM TWG.
Variables: gender, age group, number of cases and deaths, risk factors, SAM cases, number of population at risk or stressed
3.3 Data management and analysis:

The analysis was done using Ms-excel 2007after the data was cleaned. Finally, it was presented in the form of graphs and tables and
narrated based on thematic areas.
pg. 2
4. Major findings
4. Health
An estimated population of XXXX is living in the studied XXXX weredas with male to female ratio of XX: XX. Of this total
estimated population, the number of women in the reproductive age group and number of pregnant and lactating women were
estimated to be XXXX (xxxx%) and XXXX (xxxx%) respectively. Similarly, in the XXXX weredas it was reported that there are
XXXX health centers and XXXX health posts with building, of which xxxx % health centers had access to pure water supply. The
remaining XXXXhealth centers and XXXX(xxxx%) of health posts were reported of not having access to water supply. (Table 1)
Table 1: Profile of the visited Weredas for Meher Assessment, Tigray region, Nov – Dec 2023.
pg. 3
Woreda Populatio Male Female U5 # WRA( 15- #PLW # HCs # HPs #M #HEWs #HC with #Hp with water
n Children 49 Yrs) HN water and and latrine
T latrine availability
availabilit
y
Tahtai 96100 48991 47109 11223 17680 17680 5 12 3 0 0
Adiabo
Seymeti 52706 25931 26775 7689 12375 2530 1 7 1 20 1 0
Adiabo
Laelay 80485 11742 18898 3863 2 10 2 35 0 0
Koraro
Tsimbla
Shire
Total
4.1 Coordination:
At zonal level there is health cluster coordination mechanism in which 18 partners regularly attend , for health where all relevant
government, NGOs and UN agencies represented. Northwest zone of Tigray health cluster meets regularly on bi-weekly basis and
RHB lead the cluster while WHO reported as colead agency.
pg. 4
In the assessed five weredas it was reported that presence of multi-sectoral PHEM coordination forum , establishment and activation
of RRT, and assignment of PHEM officers performed. However, looking at the presence of regular meeting documented by minutes,
all weredas reported of having irregular meetings when something is happened on their, without documentation of any sort of minute.
Out of five weredas four of them had reported the presence of public health emergency preparedness and response plan but there is no
accessible emergency response fund to respond to emergency health in five of the woredas.
Functionality of OTP services in the assessed woredas showed that Tahtai Adiabo XX%, Seyemti Adiabo 86%, Laelay Koraro 100%,
Tsimbla XX% and Shire XX%(Table 2)
Table 2: Description of the PHEM coordination mechanisms in the five visited Weredas for Meher Assessment, Tigray region,
Nov – Dec 2023.
Coordination and Name of WoHO

Management system
Tahtai Adiabo Seymeti Adiabo Laelay Koraro Tsimbla Shire
Is there a PHEM Y Y Y
Officer at Woreda
1 1 1
Health Office level?
How many PHEM

officers are there?
Is there RRT in Y Y Y
Woreda health office?
pg. 5
If yes Number 5 7 2
Are there PHEM Y Y Y

Officers/focal persons
7 1 2
at HCs? If yes No.
________
Does the Woreda Y Y Y

Health Office
regularly report
PHEM report as
scheduled dates?
Observe copies and
comment
Do the health Y Y Y
facilities and HEWs
regularly report
PHEM report as
scheduled dates?
Observe copies and
comment
Is there a multi sector Y Y Y

Health
Emergency/PHEM
coordination forum?
pg. 6
If yes, how frequently 1 per month 2 per month

meet?
Is there a Public N Y Y
Health Emergency
preparedness and
response plan for
EFY 2016? Observe
and comment
(Observe and
comment) __
Is there accessible N N N
emergency response
fund? If yes, how
much allocated?
The percentage of 86% 86% 100%

Kebeles in the
woreda with
functional OTP
services
pg. 7
4.2 Leading Causes of Morbidity:

Top five morbidity causes for under five children in the assessed five woredas per magnitude of order were malaria, Non-bloody
diarrhea, pneumonia, acute upper respiratory tract infections, skin infection. Similarly, top five causes of morbidity for above five
years age found to be malaria, Non-bloody diarrhea, Pneumonia, Acute Upper Respiratory Tract Infection (AURTI and ARI), and
Acute Febrile Illness for majority of the assessed woredas.
4.3 Status of outbreak prone diseases and occurrence of outbreak:

4.3.1 Acute Watery Diarrhea/ Cholera:
There is reported no reported cases at T/Adiabo, S/Adiabo and L/koraro woredas in the 2015 G.C to date. Despite the latrine coverage
of all visited four woredas was very low (XX%), there is no AWD cases happened. However, low water supply coverage (XX % -
average coverage for the four woredas) may put the population at some degree of risk of having AWD in the future. (Figure 2)
pg. 8
Figure 3: Coverage of Latrine utilization and water Supply in the four Meher assessed Woredas, Tigray, Dec 2023
4.3.2 Malaria:
Comparison of the distribution of malaria cases in the visited woredas from May 2023 to October 2023 shows that there were a total
of ( 452XXXX cases and last year in the period there were a total of 5,898. Generally, the burden of malaria morbidity in the visited
Woredas portrayed an increment in 2011 E.C compared to 2010 E.C. This increment might be explained by there was no LLINs
distribution at all visited woredas and unprotected irrigation & mosquito breeding sites around the railway at XXX woreda that leads
to malaria epidemic for the cause of morbidity to 5236 cases within two months. No death due to malaria was reported from October
to May both in the year 2010 and 2011 E.C. (Figure 3)
pg. 9
Figure 4: Malaria cases per woreda from May 2023-October 2023; Tigray, Dec 2023
4.3.2 Meningitis:
There was no report of meningitis case from any of the visited four Woredas in the last three years.
4.3.3 AWD
There was no report of AWD case from any of the visited four Woredas in the last three years.
4.3.4 Measles:
In the last quarter of 2015/2016 EFY (from 1 July 2023 – 30 Sep 2023) there was no any SIA.
4.4 Disease Outbreak:

XXXX
4.5 Risk factors for outbreak prone diseases:

Five of the assessed woredas have major risk factors for malaria such as being endemic to malaria, presence of malaria breeding sites,
interrupted or potentially interrupting rivers, unprotected irrigation and no accessible emergency response fund in the visited woredas.
Despite LLITNs coverage report in the visited woredas showed greater than 85%, information on utilization of LLITN not available.
This result shows that with the presence of most of the risk factors almost in all woredas, an estimated population living in XXX
malarious kebeles are at risk of having malaria outbreak in the near future unless stringent attention is given for the control and
prevention measures. There was malaria outbreak in all Woreda during the period XXX to XXX, 2016 EC. The trend showed unusual
upward increase or doubling of number of cases compared to the same months in the previous year of 2015 E.C.
pg. 10
4.6 Preparedness - Emergency drugs and supplies:

Per the assessment facilitated in five of the woredas in northwest zone of Tigray, emergency medicines and other medical supplies
which were available in most of the woredas to respond to potential outbreak of cholera were ringer lactate, ORS, doxycycline,
consumables (syringe and glove), Amoxil syrup, TTC eye ointment, Vitamin A, Coartem, Lab and RDT for malaria. WHO Shire field
office prepositioned CTC kit which can test and treat xxx clients in case any AWD outbreak in northwest zone of Tigray.
However, supplies like LP Set, RDT for meningitis, and CTC kit, were not found in all visited woreda Health Offices (WoHO) and
government health facilities within the visited woredas.
4.7 Challenges outlined by woreda health office heads and experts:

The visited five wereda health offices have outlined the following points to be their challenges encountered in the past six months:
 Shortage of medicines and medical Supplies (emergency medicines and medical supplies, program drugs, vaccines for routine
immunization & NCD medicine, oxygen for critically ill neonates, HIV test kits).
 Lack of laboratory reagents and supplies for the region. The laboratory confirmation of suspected cases of disease remains a major
challenge.
 Shortage of ambulances out of 269 only 90 available.
 Very limited budget of RHB to strengthen HEWs program and limited number of partners supporting this course of action.
 Huge budget required for rehabilitation of government health infrastructure.
 Risk of zoonotic diseases remains high, and cases reported (suspected rabies, anthrax) every week.
 Access to some woredas is still challenge.
 Higher risk of cholera outbreak, malaria and ARTI are the top leading causes of morbidity and a decrease of MHNT deployment
due to funding constraints despite huge needs at community, IDP site and health facility levels.
pg. 11
 Woreda health office challenged with shortage of vehicles to provide supportive supervision to front line HCWS, transportation of
emergency medicines and other medical supplies, to respond to alert/ rumor of potential outbreak disease.
 High staff attrition in which recruitment is frozen.
 Unpaid salary of HCWs for 17 months
 No budget for emergency response fund
 No budget to revitalize HMIS.
4.8 Conclusion:
Findings of the Meher assessment revealed the presence of different problems in the area of coordination, morbidity and mortality of
diseases, status of outbreak prone diseases, Preparedness, and challenges out lined by the health sector. All the identified problems
require urgent response to avoid any risk of disease outbreak. Health sector related problems and needs have been evidently identified
at different levels including at facility, community, wereda regional health bureau levels. Generally, from the study the following
major problems were found:
 Presence of weak PHEM coordination forum without regular meetings and TOR,
 Presence of emergency preparedness and response plan without including all components including reproductive issues in it,
 Presence of un-ear marked budget to sector offices at wereda administration office level and absence of emergence response
fund at all woredas.
 Presence of risk factors for outbreak prone diseases like AWD and Malaria, (Low water supply coverage, presence of malaria
breeding sites, No LLINs distributed for all woredas,)
 Absence of emergency drug like LP Set, RDT for Meningitis, CTC kit, Male condom kit and Rape survivors kit in all woredas),
 Water transportation problem in woredas.
pg. 12
 Absence of transmitting weekly PHEM reports from wereda to region, from Health center to Wereda and from H.P to H.C
electronically.
Recommendations:
To avert the existing problems/gaps identified in the health sector, the following specific recommendations were forwarded:
 The existing PHEM coordination forums in the visited woredas need to be strengthened. The forum needs to have regular meetings
with minute and TOR.
 The Emergency preparedness and response plan claimed to be present in all visited weredas needs to include all components and
RSH issues up to the level it can solve emergency RH problems of the areas,
 Wereda administration in all visited weredas needs to allocate enough budgets to support emergency activities in the wereda.
Moreover, Weredas who have reported of have budget at wereda administration level should ear mark the available emergency
budget to relevant sector offices so as to ensure fair allocation and utilizations by all.
 To control risk factors for outbreak prone diseases water supply coverage in all weredas needs to be improved, LLINs coverage
should be lifted up above the minimum standard 80%, and efforts needs to be made to abolish possible malaria breeding sites
through different means by communicating with stakeholders.
 Providing and make available some key emergency drugs and medical supplies such as Meningitis RDT, LP set, CTC kits, etc.
 Multi-sectoral integration and coordination work in all weredas in general needs to be strengthening for timely and effective
emergency preparedness and response work.
 Strengthen disease surveillance system. There is a need to provide supportive supervision to provide support on data recording,
analysis and reporting. Also, there is need to strengthen the weekly reporting system.
pg. 13
4.2 Nutrition
4.2.1 Nutritional screening
The overall purpose of the Meher assessment process is to verify the effect of unseasonal rains on the livelihoods of the community
(both food and non-food components) and identify potential gaps to ensure appropriate and effective humanitarian planning and
responses for both food and non-food components which will lead to reducing morbidity and mortality in the most vulnerable areas.
Nutrition is one part of the non-food planned to be assessed to know the nutritional status in the five woredas. As the assessment is
shortly planned and required to bring as fast as possible current status, basic data was collected on nutrition with same field
observation and discussion at kebele and woreda level with kebele and woreda level service providing communities.
The screening coverage of 6-59 months of children of the assessed woredas for May 2023 ranges from 10% in Shire Endaslase to
100% in Laelay Koraro. The screening coverage of the assessed woreda for the month of October ranges from 21 % (S/Adiabo) to
100% (L/koraro) (Table 3). The screening report showed that 18% of children have a proxy of Global Acute malnutrition (GAM) in
Laelay Koraro Woreda and 14.5% with proxy of Global Acute malnutrition (GAM) in Seyemti Adiabo woreda for the month of
October 2023 (Table 4). Proxy SAM rate of the Meher assessed woreda is high in Seyemti Adiabo and Laelay Koraro than the rest
woredas (Table 4). Vitamin A and De- worming coverage for the months of May to October was good for Seyemti Adiabo, Shire
E/Slase and L/koraro (figure 5). While screening coverage of Pregnant and lactating Women (PLW) showed 100% in T/Adiabo
woreda and 82.5 5 % in L/koraro. S/Adiabo is the lowest screening coverage from the assessed woreda with 7.3 percent them
Screened (Table 3).
pg. 14
Table 3: Screening coverage of children 6-59 months’ children and pregnant and lactating women from May 2023- October 2023
T/Adiabo S/Adiabo L/koraro Tsimbla Shire E/slase

6-59 6-59 6-59 6-59 6-59
months months months months months
Months children PLW children PLW children PLW children PLW children PLW
May 2023 - no data 48 37.7 100% 91.4 no data no data 10 29
June 2023 - no data 60 44.4 100% 90 no data no data 49.7 69.8
July 2023 87% 100 22 8.3 100% 88 70 84 36.4 83
August 2023 54% 100 31.5 15.9 100% 77 71 71 9.1 21
September 2023 46% 100 80 59.3 100% 89 85 78 24.4 44.4
October 2023 54% 100 20.8 7.3 100% 82.5 no data 25.2 43.6
Table 4: Nutritional status of 6-59 months children and pregnant and lactating women (from May 2023- October 2023
T/Adiabo S/Adiabo L/koraro Tsimbla Shire E/Slase

GAM%
GAM%
GAM%
GAM%
GAM%
SAM%
SAM%
SAM%
SAM%
SAM%
MUAC
MUAC < MUAC < MUAC < < 23 cm MUAC <
Months 23 cm % 23 cm % 23 cm % % 23 cm %
no data no data no data 17% 1.6% 51% 16.5 1.5 48.4 no dat no data no data 14.5 0.15 18.7
May 2023
June 2023 no data no data no data 15.4% 2.1% 66% 20.2 1.6 49.7 no dat no data no data 27.7 0.4 60.5
July 2023 no data no data no data 11% 2.8% 41% 17.8 1.5 54 24.1 3.2 41 17.7 0.7 47
August no data no data no data 14.6% 2.9% 45.5% 17.7 1.9 61.6 13 2.4 51 19.1 0.4 47.5
2023
September no data no data no data 21.6% 2.3% 63.5% 17.7 1.8 60.8 9 1.8 30 20.6 0.7 56
2023
October no
2023 no data no data no data 14.5 18 1.9 60.8 data no data 16.6 1 48.5
% 2.5% 47%
pg. 15
Figure 5: Vitamin A and De-worming coverage of the assessed woreda from May 2023- Oct 2023.
4.2.2 Admission of the therapeutic feeding program for SAM management
In the assessed woreda there are a total of 45 TFP sites (42sites are OTP and 3 TFU/SC). From the total health posts 95 % health
posts are giving OTP services. This shows that there is good access of coverage in OTP services in the assessed woredas (Table 5).
pg. 16
Table 5: Facilities with SAM management services and reporting rate for October 2023 in the assessed woredas
Woredas OTP SC TFP Reported RR

T/Adiabo 8 1 9 9
S/Adiabo 6 0 6 6
L/koraro 12 1 13 13
Tsimbla 11 0 11 11
Shire E/slase 5 1 6 6
Average/total 42 3 45 45
4.2.3 TFP Admission

The Therapeutic Feeding Program (TFP) for SAM admission has shown reduction by 190 cases in October 2023 compared to May
2023 for T/Adiabo woreda (table 6).
Table 6: TFP admission trend May 2023- Oct 2023
May June July August September October Total

202 202 202 202 202 202 202 202 202 202 Differ
Woreda 2 2023 2 2023 2 3 2 3 2 3 2022 2023 2 3 e %
No
T/Adiabo data 302 266 198 120 112 998
S/Adiabo 54 87 41 62 24 36 304
113
L/koraro 182 171 168 204 201 213 9
No No
Tsimbla data No dat 55 161 183 da 399
Shire 20 12 46 31 51 28 188
pg. 17
E/slase
pg. 18
Non-Food Meher Assessment report Tigray December 2023
Outcome of the therapeutic feeding program for SAM of the assessed woreda was good at T/Adiabo and L/koraro for the
performance/outcome indicators. Cured rate of Oct 2023 for T/Adiabo and L/koraro woredas was 62% and 100% respectively; this
indicates that there is better quality and effective functioning of TFP for both inpatient care and OTP. Similarly, death rate and
defaulter rate of the assessed woredas was acceptable.
4.2.4 CMAM management skill
To provide key information on public health emergency nutrition activities, all woredas were reporting SAM cases weekly. The
CMAM services are provided at HP, HC and primary hospitals managed by different level of professionals from the HEWs at the HP
to other health workers in health centers and primary hospitals. The four assessed weredas have 140 HEWs working at health posts of
which 68% (95) are reported to have received SAM management training as indicated in table 7 . In the assessed woreda a total of 110
health workers were trained on SAM management to improve the CMAM services quality in the different health facilities
pg. 19
Table 7: CMAM training status for HEWs and HWs in the assessed woredas, Tigray December 2023
HEWs and Hws

S/N Woreda Total # # of SAM % # of HWs
existing trained trained trained on SAM
1 T/Adiabo 21 12 57% 12
2 S/Adiabo 20 20 100% 25
3 L/koraro 35 35 100% 45
4 Tsimbla 31 8 26% 8
5 Shire E/slase 33 20 60% 20
Total 140 95 68% 110
4.2.5 CMAM (TFP) Supply:
The necessary CMAM supplies are available in all weredas of except water availability and storage for SAM treatment. The
qualitative status of CMAM supply in the visited woredas is summarized in table 8 below.
Table 8: Availability of therapeutic supplies in all 5 woredas, Tigray, Dec 2023.
Description of therapeutic supply Yes No
Is there sufficient supplies for 3 months of :
RUTF Y
F100 Y
F75 Y
2nd line drugs Y
Is there sufficient wereda level storage for SAM treatment at wereda level? N
water availability at stabilization center (SC) N
pg. 20
4.2.6 MAM management and TSFP service delivery:

To recover moderately malnourished children, provide an adequate intake to support pregnancy and lactating women and prevent
deterioration of nutritional status of those who are most nutritional vulnerable Therapeutic Supplementary Feeding Program (TSFP)
program is ongoing in the hotspot priority woredas. TSFP are available in 5 assessed woredas. In the TSFP woreda there was TSFP
distribution in the last month and have big shortage in supplies of CSB ++ in the last six months. In the TSFP woreda children
discharged from OTP were refer to TSFP and CSB++ shortage was the biggest challenge in the past six months.
4.2.7 Risk factors for Emergency Nutrition:

 Aggravating factors (Diarrhea and malaria).
 Inadequate safe water supply
 Poor personal and environmental hygiene practice
4.2.8 Challenges for emergencies nutrition response

 There was shortage of supply.
 Unavailability of water at SC.
 Shortage of SC supplies
4.2.9 Conclusion
Screening coverage of the visited woredas looks good, while it needs some improvement to reach the regional target. Outcome of
TFP of the assessed woreda was good based on the sphere standard of the performance indicators in all the assessed woredas. There
was distribution of CSB++ in the TSFP woredas in the last month. Monthly screening coverage should be improved to cover all
children 6-59 months & PLW and strengthen follow up of nutrition activities and integrated emergency nutrition with developmental
nutrition.
pg. 21
4.2.10 Recommendation
 Strengthen Coordination mechanisms at all levels.
 Undertake close monitoring and follow up of nutrition programs at all levels.
 Provide timely reporting on activities (weekly & monthly reports) request of nutrition supplies.
 Improve monthly screening coverage of 6-59 months children and PLW.
 Strengthening CBN activities
 Continue TSFP in the affected woredas.
 Integrated emergency nutrition with developmental nutrition.
WASH
4.4Overview
Due to the current drought, the main water sources for both human and livestock consumption in the region which includes; shallow
wells, boreholes, pipeline systems, protected springs, ponds/dams, and rivers both perennial and seasonal rivers has been seriously
affected.
pg. 22
In the assessed districts safe water supply coverage is vary from 58 % to 70.4 % (highest in Emba-Alaje and lowest in Raya-Azebo
district). Latrine coverage is between 3% and 9.2%, very low coverage in all woredas. Non- functionality rate varies from 14% to
38.59% highest in Hintalo-Wejerat and lowest in Raya- Azebo district.
Due to the coordinated effort made by the government in the drought response many people who have been affected by the drought
has been able to provide water, thus Hintalo-Wajrat was providing water to the needy community by water trucking and significant
effort also made to rehabilitate malfunctioning schemes.
A total of 110,805 (55,331M; 55,474F) are people affected in 6 Weredas with potable water shortage. There are 119 of Keble’s in the
6 districts which 48 Keble’s are benefited from Belg rainy season. In all woredas the belg rain was very poor as a result due to the
poor belg rain there is a negative impact on humans and livestock so temporary and sustainable water supplying solution need to be
strengthened.
4.4.1 Overall situation of Water, sanitation and hygiene

 Assessment team deployed in 6 districts in 2 zones and identified that the water supply sources are highly affected by the drought
and the communities living in these Woreda are discouraged not only by the shortage of water for human consumption but also
for livestock consumption which was improved by rainfall from Belg season.
 The non-functionality rate for all Weredas increased unusually due to the decreasing of ground water level associated with the
drought, as a result submersible pumps, generators, and switch boards are not functioning properly. A significant number of
shallow, wells hand dug wells and springs decreased their yield.
 The communities living in the 48 Keble’s in the visited 6 Weredas unusually fetch water from a distant water supply sources
which spends 96 min (1.6 hr) on average, in some Keble’s cueing time also increased.
pg. 23
 In general, the average safe water supply coverage among the assessed weredas vary from 58% to 70.4% accordingly the least
coverage is Raya-Azebo and the highest coverage is Emba-Alaje. Regarding the non-functionality of water schemes also vary
from woreda to woreda relatively Raya-Azebo is low in non-functionality and Hintalo-Wajrat is high non-functionality rate which
is 39%.
4.4.2 Water supply coverage by % of the 6 Belg assessed Districts Tigray, June 2019
Table 9 Water supply coverage by % of the six Belgi assessed woredas
Name of Water Functional Non-functional
S/N Remark
Districts coverage (%) schemes % schemes %
1 Emba-Alaje 70.40% 55 9
2 Enda-Mkoni 68.08% 172 56
3 Ofla 65.50% 208 44
4 Raya-Alamata 67.50% 157 40
5 Raya-Azebo 58.00% 40 6
Hintalo-Wajerat 59.00%
6 184 71
pg. 24
4.4.3 Woreda water supply coverage southeast and southern zones of Tigray region
Figure 6 Water supply Coverage (%) by Wereda in the belg Assessed woredas, Tigray June 2019
4.4.4 Situation of sanitation and hygiene promotion among the belg assessed woredas
The sanitation and hygiene situation of the communities in the visited weredas was also assessed. Accordingly, the average household
latrine coverage is found to be 5.18 %, which indicates that there is poor sanitation practice (open defecation practices). However,
weredas such as Hintalo-Wajrat and Raya-Alamata are relatively with better latrine coverage compared to other visited weredas.
pg. 25
4.4.5 Overall sanitation of sanitation facilities of the Belg Assessed Weredas, Tigray, June 2019
Table 10 the overall situation of sanitation facilities of the six Belg assessed woredas
Solid Waste Disposal in the
Number of house hold Number of communal belg beneficiary Keble’s Average of latrine Woreda
Name of
S/N latrines in belg latrines in the belg coverage among belg latrine
Weredas
beneficiary Keble’s beneficiary Keble’s Pit Burn beneficiary Keble’s % coverage %
1 R/Alamata 388 5 106 988 3.3% 9.20 %
2 Ofla 2082 0 263 2,508 2.61% 3.00%
3 R/Azebo 3653 18 0 0 6.26% 3.00%
4 E/Mokeni 2498 0 1640 0 6.92 % 3.20%
5 E/Alaje 346 0 1367 0 3.19 % 4.00%
Total 5 8,967 23 3,376 3,496 4.46% 4.48%
6 H/Wejerat 4591 0 832 6107 7.92% 8.70%%
G. 6 13,558 23 4,208 9,603 5.1% 5.18%

total
The above table indicates that the average latrine coverage at woreda level is 5.18 % relatively higher in Hintalo-Wajrat (8.7 %) and
least in Ofla and Raya-Azebo woredas (3%) and the average latrine coverage among belg beneficiariy kebles is 5.1% relativey higher
in Hintalo- wajrat (7.92 %) and lesast in Ofla (2.61%). Accordingly 5.1% (326,403) people are at risk for oro-fecal diseases due to
open deification.
pg. 26
4.4.6 Latrine covarage (%) by woreda in the belg assessed woredas

The average latrine coverage among the belg assessed woredas is 5.18%. Due to this 94.82 % (772,243) people in all belg assessed
woredas and 94.9 % (326, 403) in all belg assessed Keble's haven't improved house hold latrine.
Figure 7 Latrine Coverage (%) by Wereda in the belg Assessed woredas, Tigray June 2019
4.5Current WASH related Emergency /Hazard

As specified in the overview this year Belg rain season is reported as late onset and early cessation compared to the normal Belge
rainfall situation. The assessment has identified that 48 Keble’s in 6 Weredas with an estimated of 128,066 people are currently
affected by potable water shortage and 113,117 people are at risk mainly in parts of in the above Weredas.
pg. 27
4.5.1 Communities currently affected /at risk of WASH emergency, Tigray, June, 2019
Table 11 Communities currently affected /at risk of emergency WASH
Emergencies
Total no of Total no of Belg Population at
# of Drought # of population # of population at risk
Zone Wereda Keble’s in Keble’s in the risk for
affected Keble’s in affected by shortage for potable water
the wereda wereda sanitation
the woreda of safe water access access
problems
A/ Alaje 20 2 2 3,440.00 3,440.00 15,342
E/Mekoni 19 9 9 11,408.00 11,408.00 46,378
South
Ofla 21 10 10 32,177.00 32,177.00 67,231
R/Alamata 15 10 10 17,380.00 17,380.00 71,050
R/Azebo 21 9 9 34,700.00 19,751 75,766
S/East H/Wajrat 23 8 8 28,961.00 28,961 50,636
Total 119 48 48 128,066.00 113,117 326,403
pg. 28
4.5.2 Communities affected and at risk population for water shortage
Figure 8Affected and at risk population among the assessed woredas
4.6Status of water supply schemes

It is obvious that the region is highly vulnerable to recurrent drought and water, sanitation and hygiene related diseases emergencies
which are highly aggravated by poor water supply and sanitation coverage of the region. Moreover, significant numbers of existing
water supply schemes are also not functional. Accordingly, the assessment finding showed that 226 water supply schemes (24.63%)
are not functional mainly because of lowering of ground water table; broken/damaged schemes due to poor operation & maintenance
of schemes, water quality problems, mismanagement and high exploitation of water supply schemes. Lack of spare parts, operation &
maintenance tools to maintain/replace the non-functional water supply schemes, lack of budget to establish new water supply schemes
pg. 29
and/or maintenance activity, inadequate follow up & inventory on the status of existing water supply schemes, and limited/absence of
NGO’s working on WASH are common problems identified in the assessed weredas (See the detail on the below table).
4.6.1 Status of water supply schemes by wereda, Tigray, June 2019

Deep Well Shallow Well HDW Spring Total
Total
Wereda non
Non Functiona Non Functiona Non Functiona Non Functiona TOTAL
Functional function
functional l functional l functional l functional l
al
R/Alamata 28 10 123 21 6 8 0 1 157 40 197

R/Azebo 31 4 5 1 3 0 1 1 40 6 46
E/Alje 0 0 25 1 12 4 18 4 55 9 64
E/Mokoni 1 0 64 17 34 10 73 29 172 56 228
Ofla 0 0 106 15 60 13 42 16 208 44 252
H/Wajrat 6 0 57 21 93 41 28 9 184 71 255
Total 66 14 380 76 208 76 162 60 816 226 1,042
pg. 30
Figure 9 Water Analysis in drought affected Keble’s in selected weredas, Tigray, June 2019
pg. 31
Figure 10 Water schemes analysis in Belg assessed woredas
4.6.2 Average quantity of water and walking time/ distance among Belg assessed districts
Sr # Zone Name of Woreda Average Quantity of water L/P/D Average walking time/distance required to collect water
1 Emba-Alajie 12.5 150 min/10 km
2 Enda-Mekoni 21.6 33.8 min/2.3 km
3 Ofla 21 51 min/3.4 km
4 Raya-Alamata 15.9 102 min/ 6.8 km
5 South Raya-Azebo 25 30 min/ 2 km
6 South East Hintalo-Wajrat 10.5 210 n/ 14 km
pg. 32
As shown on the above table almost all of the assessed Keble’s from the assessed woredas are out of the standards in terms of water
quantity and walking distance to collect water from the water schemes. The communities living in the 48 Keble’s in the visited 6
Weredas unusually collect water from a distant water supply sources which spends 96 min (1.6 hr) on average, in some Keble’s
cueing time also increased.
4.7Copping strategies
 The communities living the affected Keble’s in the visited Weredas are sharing the nearby functional water schemes/sources
both for human and livestock consumption.
 Wereda administration jointly with regional water bureau has allocated considerable budget for water trucking in Hintalo-
Wajrat woreda.
4.8Coordination at all level

 There was a good coordination in responding the emergency at with regional level but there is a gap at woreda and Keble level.
The regional water bureau jointly woreda administration has allocated budget for water tracking in order to cope the existing
drought in Hintalo-Wajrat. However the assessment team identified that WASH coordination at Wereda to Keble level needs
to be strengthened, although there are encouraging initiations.
4.9Challenges
 Water supply source depletion.
 Lack of budget for the maintenance of non functional water schemes.
 Lack of emergency WASH supplies and kits
4.10 Recommendations
 Strengthening coordination at all level
 Capacity building activities which includes, strengthening WASH coordination up to the Keble level
pg. 33
 Data quality management, especially in the visited Weredas the management of data needs improvement and this requires
WASH stake holders to support and strengthen Weredas in improving WASH data management.
 Emergency budget should allocate at each level. Allocate adequate budget to establish new water supply schemes and for
maintaining/ rehabilitating existing non-functional schemes.
 Community awareness raising activities on maintenance, fencing of water schemes and on sanitation and hygiene promotion
activities
4.10.1 Temporary emergency response activities

 Continuation of water trucking in Hintalo-Wajrat selected Keble’s with critical water problem,
 To recharge the depleted ground water potential should have to implement proper integrated water shade management such as
constructing ponds, water rain harvesting systems, small dams
 New water schemes need to be constructed to address the affected population.
 Rehabilitate the non-functional water schemes (76 shallow wells, 76 Hand dug well, 60 springs and 14 deep wells). As a result
of these interventions a huge number of people will be benefited.
 Provision of sanitation and hygiene promotion activities for communities living in drought affected Weredas.
 Establish/strengthen and train WASH committee’s for every water supply schemes considering the representation of women.
 Provision of WASH emergency supplies, such as water treatment chemicals, Tool Kit, pumps and generators, etc.
4.10.2 Long term sustainable solutions

 Construction of new water supply schemes,
 Provision of adequate operation & Maintenance tools, supplies & spare parts to maintain/replace the non-functional water
supply schemes.
 Establish/strengthen and train WASH committee’s for every water supply schemes considering the representation of women.
pg. 34
 Provision of hygiene promotion activities for communities living in drought affected Weredas.
 Strengthen supportive supervision and monitoring activities
 Provision of adequate household water treatment chemicals with proper orientation & demonstration.
5 Education
5.4Objective of the assessment
The assessment covered two zones and 6 woredas with the following objectives:
• To identify number of schools and students affected by emergency.
• To identify the type of emergency affected students in region.
• To identify level of local capacity to respond and propose doable recommendations.
5.5Schools Enrolment and drop out

List of woredas, Keble’s schools and number of students who are registered at the beginning of this academic year and these who have been in
attending class up to the end of this year that is up to the time of Belg assessment
5.5.1 Raya-Alamata
Name of Name of Register at the beginning 2011 At the time of Assessment
Zone Woreda Level
Kebele School M F T M F T
South R/ Selam Birhan 1-8 283 288 571 254 278 532
Alamata Bikalsi
G/mola 1-8 266 231 497 246 224 470
S/Berhe 1-8 267 204 471 253 196 449
pg. 35
A/Birhan 1- 8 325 393 718 304 381 685
Limat 1- 8 347 302 649 321 284 605
Limat Kilisha 1- 8 265 269 534 237 249 486
Walka 1-8 99 100 199 89 107 196
S/amora 1-4 91 71 162 87 71 158
Bora 1-4 76 60 136 75 59 134
Hulugizela Facha –hara 1–4 83 88 171 80 85 165

mlam adisKign 1- 4 101 92 193 99 84 183
B/hintset 1–8 176 0 176 107 0 107
Fignangoma 1-4 91 87 178 88 85 173
Ga/Jala 1–8 329 303 632 322 297 619

Gerjele
Gerjele 1- 8 444 395 839 403 373 776
Tetecha 1-4 97 50 147 93 48 141
Bube 1-4 83 95 178 82 94 176
L/dayu Aulaaula 1–8 261 175 436 256 173 429
Kosim 1- 8 156 101 257 141 84 225
pg. 36
Selam 1- 4 55 33 88 54 30 84
Tsion 1-8 150 149 299 133 142 275
Chemaro 1–4 131 135 266 122 127 249
Humo 1- 8 154 170 324 140 159 299

Tao
Ma/Adi 1–4 102 75 177 100 69 169
Fenkil 1–8 497 421 918 475 403 878
K/Dirba 1–8 430 465 895 429 452 881
K/Dirba No2 1–4 85 94 179 81 90 171
Selenwuha Marta 1- 5 124 158 282 115 147 262
S/wuha 1–8 254 280 534 239 262 501
Gedera 1–7 215 192 407 199 186 385
Harle Hrle 1–8 231 233 464 206 214 420
Genet 1–4 37 46 83 36 45 81
Ha/hiwot 1–8 197 201 398 166 181 347

Timuga
K/Rensa 1–4 37 49 86 33 47 80
Vitimo 1–8 246 254 500 231 244 475
pg. 37
TimugaWaj
Timuga 1- 8 559 552 1111 535 536 1071
a
Total 1 10 36 7344 6811 14,155 6,831 6,506 13,337
5.5.2 Enda-Mekoni
Wored Register at the beginning
Zone Keble School Name Level At the time of Assessment
a 2011
Serenga 1–8 367 359 726 351 346 697
Gereb-Abdela 1 -8 260 280 540 247 269 516

Simret
Etio/Nigdi M/d 1-4 88 84 172 88 84 172
Adi-beri 1-4 58 50 108 58 50 108

E/mekoni
Adi-Arbate 1 -8 135 118 253 135 118 253

South Hiziba Ajra 1-4 51 49 100 50 49 99
Menkere 1 -4 43 30 73 43 30 73
Shibta 1-8 472 455 927 461 449 910
Shibita Keniyat 1 -8 139 140 279 137 140 277
JanAmora 1-4 112 74 186 112 74 186
Gelawsa Gelewssa 1-8 183 206 389 183 206 389
pg. 38
Wegido 1-8 131 137 268 131 135 266
Beta guga 1-4 79 72 151 79 72 151
Qanfa 1-8 223 239 462 216 232 448
Awropa 1-8 149 142 291 145 139 284
Ayi 1 -8 112 100 212 109 98 207
Gerad 1-8 99 91 190 97 88 185
Gedged 1-8 37 50 87 37 50 87
Endirqan 1-8 244 202 446 236 195 431
Tekera 1-8 130 111 241 130 111 241
AdiGeba 1 -8 123 113 236 119 112 231
Lakema 1- 4 66 68 134 65 68 133
Tekarie 1-8 268 261 529 259 259 518
Nebyat 1-8 493 483 976 483 473 956
Gedefena 1 -8 177 196 373 176 195 371
Zeneya 1-4 95 78 173 95 78 173
Dum 1-8 250 226 476 249 223 472
Tesliya 1 -8 104 114 218 96 114 210
pg. 39
Shameda 1-4 57 53 110 57 53 110
Felfel 1-4 75 46 121 75 46 121
Jir 1-8 117 117 234 115 116 231
Karanjig 1-8 215 196 411 210 192 402
Abozot 1 -8 211 168 379 208 166 374
Jibrir 1-4 50 53 103 50 53 103
Embega 1 -8 167 134 301 162 128 290
Beliya 1-8 76 74 150 76 73 149
Tsigeba 1-8 133 113 246 133 113 246
Jemma Tserkaba 1-8 115 116 231 106 112 218
Shigo 1-8 98 104 202 97 103 200
Wa-ereb 1-8 84 102 186 84 102 186
Weyna-Mariam 1 -8 241 261 502 239 259 498

Wuhidet
Wulema 1-8 164 149 313 164 149 313
Adi-meazu 1-8 95 78 173 89 76 165
Total 1 9 43 7033 6796 12705 6853 6676 13,529
pg. 40
 2.2.3. Ofla
Wored Type of Registered at the beginning At the time

Zone Kebele School
a Schools of 2011 E.C of this assessment
South 1 to 8 M F T M F T
Hayalo 194 145 339 188 139 327
Hayalo
Delesa 46 31 77 45 31 76
Hawula 22 26 48 19 26 45
Wonberta T/Emni 92 86 178 84 81 165
Tsiliya 27 63 90 25 63 88
Ad/golo 208 182 390 208 182 390
A/golo
Ad/goba 82 81 163 76 80 156
Ofla Menkere 141 107 248 139 104 243
Tse/berki 52 42 94 47 41 88
Menkere
Kerencheae 78 71 149 75 70 145
Asewald 123 94 217 116 93 209
Hashenge 276 193 469 273 190 463
Mewura 159 148 307 155 143 298
Hashenge Debri 135 110 245 131 107 238
Sheka 112 97 209 108 94 202
H/birda 41 75 116 41 75 116
pg. 41
Andedo 82 194 276 76 190 266

H/birda Adidewuta 171 123 294 163 114 277
Degol 32 22 54 26 15 41
F/welda 214 192 406 211 189 400
F/welda
Sensah 66 64 130 44 49 93
Lat 113 119 232 110 117 227
A/metae 69 54 123 50 39 89
Lat
Adifelesti 64 42 106 64 42 106
A/cherkos 76 51 127 75 50 125
Kidana 130 112 242 116 105 221
Kidana
A/hasti 61 86 147 61 86 147
Tselgo 196 146 342 173 141 314
M/mesanu 184 149 333 164 135 299
Tselgo
Askula 55 67 122 50 67 117
Agazi 69 56 125 68 55 123
Total 1 10 31 3,370 3,028 6,398 3,181 2,913 6,094
5.5.3 Raya-Azebo
School Registered at the beginning of 2011
Zone Woreda Keble School At the time of this assessment
level E.C
M F T M F T
South R/azebo Egiae Wainale 514 490 1004 512 490 1002
pg. 42
Wejig 94 76 170 94 76 170

Z/das 121 140 261 121 141 262
Hawel 510 518 1028 505 517 1022
G/abah 94 108 202 96 111 207
Hawelti Mane 108 87 195 104 86 190
Boye 512 481 993 487 466 953
Gerarisa 117 104 221 113 98 211
Abnet 399 411 810 385 409 794
Aebo
mahigo 234 222 456 185 190 375
F/qal 637 596 1233 627 582 1209
Soleke 105 117 222 105 117 222
Mechare
Dande 81 73 154 79 72 151
dadariba 233 199 432 225 196 421
Genete 420 334 754 412 343 755
Dwealga 131 133 264 131 133 264
Genete
Waekel 264 249 513 262 249 511
Minaro 186 132 318 186 132 318
Wargiba 307 317 624 305 315 620
Warigiba
Fanaweyane 384 334 718 375 340 715
A/man 102 124 226 100 123 223
Kara
Koban 229 243 472 225 236 461
pg. 43
Kara 295 219 514 295 219 514

Jimila 86 110 196 84 110 194
fondel 100 112 212 100 112 212
H/alga 430 383 813 421 382 803
Q/tekili 142 146 288 138 146 284
H/alga
A/tela 193 170 363 176 156 332
Dalate 58 75 133 58 75 133
Late 392 338 730 392 338 730
Werobaye 495 396 891 495 396 891
Werobay
Wudase 165 145 310 165 145 310
Badsha 189 167 356 188 167 355
Total 1 9 33 8,327 7,749 16,076 8,146 7,668 15,814
5.5.4 Alaje
Indicate no of students
Type/ level Registered at the beginning of
Zone Woreda Kebele School Name At the time of this assessment
of schools 2011 E.C
M F T M F T
South Alaje Selat Selat !_8 469 575 1044 455 561 1016
D/Selat 1_4 36 39 75 31 39 70
Elbat !_8 412 422 834 390 416 806
pg. 44
F/Siwuat !_8 238 194 432 237 187 424

Birhanlekatit !_8 575 554 1129 555 551 1106
Worebt 1_4 43 49 92 43 49 92
Ayba
Arera !_8 233 243 476 225 241 466
Ayni may !_8 206 236 442 200 232 432
Total 1 2 8 2212 2312 4524 2136 2276 4412
5.5.5 Hintalo-Wajrat
Students
Zone Woreda Kebeles Name of schools Type At the beginning of 2011 EC At the Time of Assessment
M F T M F T
Adikeyih 1-8 677 576 1253 648 558 1206
Gragereb 1–4 199 124 323 197 123 320

Adikeyih
Mamaet 1- 4 82 78 160 78 75 153
Hintalo-Wajrat
South eastern
Zigedele 1- 4 62 40 102 60 40 100
Adimesno Adimesno 1-8 554 448 1002 509 434 943
Allelibat 1-4 139 174 313 136 172 308
BerheRiso 1-4 151 148 299 148 145 293
pg. 45
Adihajaro 1- 4 74 73 147 72 73 145
Sebebira 1 -8 237 242 479 212 215 427
Zegaw 1-4 74 58 132 74 58 132

Sebebira
DaraYta 1-4 316 267 583 309 261 570
Gereigam 1 -8 44 46 90 36 41 77
Tsehafti 1 -8 333 288 621 317 280 597
Atsimba 1-8 171 196 367 161 192 353
Tsehafti Agawe 1-8 226 224 450 218 218 436
Woren 1 -8 211 199 410 199 192 391
Degawaren 1-4 45 37 82 45 37 82
Bahirtseba 1-8 148 129 277 146 126 272
Debub 1–4 697 696 1393 692 692 1384
Bahirtseba Shekabda 1 -8 247 199 446 222 191 413
Kiaen 1 -4 205 185 390 197 178 375
Gemaesa 1 -8 36 31 67 35 31 66
Genti Genti 1- 8 282 289 571 257 270 527
pg. 46
KahisuKiros 1-8 186 198 384 166 176 342
Gonka 1- 8 260 302 562 245 289 534

Gonka
Granberom 1 -6 93 106 199 88 87 175
Senaele 1-8 497 500 997 449 471 920
Senaele Hidawudi 1–4 74 58 132 71 56 127
Hadale 1-8 324 292 616 306 274 580
Total 1 8 29 6644 6203 12847 6293 5955 12248
5.6Summary
Registered
Woreda
# of Keble’s # of schools at the beginning 2011 At the time of Assessment Diff %
M F T M F T
R/Alamata 10 36 7344 6811 14155 6831 6506 13337 818 6.1
E/Mekoni 9 43 7033 6796 13829 6853 6676 13529 300 2.2
R/Azebo 9 33 8327 7749 16076 8146 7668 15814 262 1.7
Alaje 2 8 2212 2312 4524 2136 2276 4412 112 2.5
Ofla 10 31 3370 3028 6398 3181 2913 6094 304 5.0
Total 40 151 28286 26696 54982 27147 26039 53186 1796 3.4
H/Wejerat 8 29 6644 6203 12847 6293 5955 12248 599 4.7
Grand total 48 180 34930 32899 67829 33440 31994 65434 2395 3.5
pg. 47
This assessment shows that there are a total number of 65,434 (33,440 male, 31,994 female) students who are likely to be at risk
due to the drought in these belg growing six woredas.
Dropout of students in the assessed schools

Woreda Male Female Total Dropout in %
R/Alamata 513 305 818 6.1%
R/Azebo 181 81 262 2.2%
Alaje 76 36 112 1.7%
Ofla 189 115 304 2.5%
Enda-Mekoni 180 120 300 5.0%
Total 1173 681 1854 3.4%
Hintalo-Wajrat 351 248 599 4.5%
As indicated in the table above, R/Alamata has the highest dropout which is 818 (6.1%) whereas the lowest drop out is in R/azebo
woreda 262 (1.7%). In general, the dropped out students in the 180 belg assessed primary schools are 2,395 (3.5%). Therefore,
awareness raising discussion is needed at all level to minimize the risk of school dropout. This in return supports for the school
enrolment for the coming academic year.
5.7Situation of institutional WASH

# of schools having potable # of schools having latrine
Name of the woreda water
pg. 48
Separate latrine Common latrine
R/Alamata 25 13 13
R/azebo 15 13 2
Alaje 17 20 19
Ofla 25 25 28
E/mekoni 14 21 13
H/wajerat 20 32 0
Total 116 124 75
As can be seen from the table, there are only 116 schools having with functional potable water supply in assessed schools. Therefore, constructing,
maintaining and rehabilitating of dysfunctional water schemes at schools are needed. Likewise, there are 124 separate and 75 common
latrines in the 180 belg assessed primary schools. Therefore, constructing additional blocks of separate latrines at schools are needed.
5.8Challenges
 Budget limitation at regional and woreda levels
 Poor access to safe and adequate water supply
 Poor access to separate latrines for boys and girls at school level
 Absence of school feeding program at school level
 Poor data documentation at woreda level
 Interruption of power was observed that hinders to access the required the data
pg. 49
5.9 Recommendations:
• Awareness creation and follow up is required starting from now to pave a way to the 2012 school enrollment.
• School wash should be strengthened and needs attention from both government and nongovernment sides.
• Due attention is needed for safe water provision and improved hygiene and sanitation intervention to prevent wash related diseases.
• Maintain and rehabilitate nonfunctional water schemes and latrines ,
• Improve water supply and latrine coverage
• Under take close monitoring and follow up at all levels.
• Coordination among woreda sector offices is weak. This was well observed in some woredas where all the sectors were not equally aware
and prepared about the issue of emergency so as to show the image of their woreda emergency situations.
6 Social protection
6.4Hintato Wojerat:
There are about 2665 individual IDPs in the woreda. The demand of IDPs is very complicated and usually beyond the capacity of the
woredas. Their challenges are compounded and complex that make it very difficult to respond at woreda capacity. However, regardless of
the pertaining challenges, the woreda has tried its level best to address some of the needs. To illustrate some, see the below bullet points.
6.4.1 Response:
 CCC supports about 103 IDPs based on their dire needs
 Woreda cabinet supports about 215,000 to 911 HHs
 Zone supports 35 HH of women headed family with 70,000
 224 students have supported with school supplies and uniforms worth 42,881
 Market place were provided to 10 individuals
 140 HHs have received land for farming
 10 associations each consisting 24 individuals have been received for housing
pg. 50
 8 vulnerable HHs mainly of women headed family have given temporary housing.
6.4.2 Challenges:
 Relief assistance is very minimal in amount and is not received on time. Sometimes it delays for three months.
 IDPs request housing without saving
 IDPs expects special treatment which don’t conform with the capacity of the woredas
 Overall dissatisfaction and frustration of IDPs
6.4.3 Early Marriage:

 The woredas have identified 50 children planned to be married. Among which 42 has rescued but 8 was married illegally. The woredas
social affairs and women association are following up the case of the 8 perpetrators.
 The most difficult in relation to early marriage is that Keble leaders are engaged
6.4.4 SGBV:
 One case of rape was reported. The victim is 6 years old and the case is under investigation
 It is believed that sexual violence is reducing
 It however is under reported
 The overall all understanding and follow-up is not up to standard
 Delay of legal proceedings
 Female children are denied from pursuing their high school studies because families do not feel safe to send them to school at their
poverty age.
6.4.5 Child Labor:

 Many children are out of school engaged in sheep or cattle herding
 6 children have been identified engaged in stone crusher and was repetitively discussed with the owners and the family of the children
involving
pg. 51
 Three kebelles i.e. Dejen, Metkele, and Adi-woyane) are places where children are engaged in begging
6.4.6 Child Trafficking:

 The woredas is known for its high migration especially to Saudi and among many 9 children was reported to be trafficked
6.5Alaje:
 There are 386 HHs IDPs and of which 706 individuals are registered in the woreda. Currently there are 54 HHs arrived but not yet
registered for the woreda has received instruction from BOLSA topose registration.
6.5.1 Response:
 Relief assistance on monthly basis is distributed though it is not consistent due to delay on delivery
 The woredas cabinet has pass a decision that all IDPs to get housing in their respective Kebelles. As a result, 2000 corrugated iron sheet
was also prepared.
 So far, 44 HHs has received their housing with 20 corrugated iron sheets and 100 splits of poles for their housing construction.
 Loan was provided to 10 individuals. The total loan appropriated stands at 375,000 birr
 Market places for three households was also provided mostly for pity trade and shoat breeders
6.5.2 Challenges:
 New influx of IDPs are not being registered and they are creating challenges to the SA office
 15 Kg wheat or sorghum is very minimal to cover the needs of the IDPs and not delivered timely
 Distribution centers for relief assistance is not decentralized and considerable number of IDPs are forced to sale portion of their food to
cover transportation

 It is under reported. Throughout the year, eight cases were reported and the social affairs, women affairs and the woredas office of justice
have confronted the situation and rescued them all.
pg. 52
6.5.4 SGBV:
 No report this year and it is usually under reported either due to lack of functional structures at all levels or lack of trust by victims
 Types of sexual violence are not clearly understood by all stakeholders and experts
 Female circumcision is practicing but it is believed to be decreased but there is no any assessment conducted to confirm it.
6.5.5 Child abuse/exploitation:

 There are around 1619 vulnerable children that consists orphan, disable, mental illness, and who have dire economic challenges
 56 of them are the most vulnerable children with compounded challenges
6.5.6 Response:
 All children labeled as vulnerable was targeted in PSNP direct support
 1619 children in this category was provided with school supplies
 and 116 children received school uniform that worth 208,880 birr
 Counseling was provided up on needs
 The children with compounded challenges were linked with one child to one sector arrangement that provides 150-500 birr monthly and
follow up the overall situation of the child
 Sanitary napkins were distributed to 360 school children and contributed to open a menstrual cycle space within schools
6.5.7 Elderly:
 42(16 female) elder lies who were engaged in begging was supported to restore dignified life
 86 corrugated iron sheets were provided and their housing was constructed which also labor expenses that worth 600 each were covered
by the woredas.
 Loan was arranged which 20,000 birr was provided as a group and engaged in shoat breeding
 The social affairs office meets with the elders each month and continuously monitor their activities
pg. 53
6.5.8 Vulnerable female headed households:

 There are 856 women households in the woredas. Some of them are elderly, living with HIV/AIDs, prostitution, disability and critical
economic challenges
6.5.9 Response:
 106 of them were provided with interest free loan
 Humanitarian/development partners (livelihood/Climate Change) has provided them all with 3500 birr each
 In addition, 30 female households engaged in prostitution have provided with 3500 birr each and engaged in shoat breeding and pity trades
6.5.10 Migration:
 Youth and children migrate to Saudi for different reasons and this year 70 has reportedly migrated.
 Three was died, 3 disable and others are in heightened mental stress
 Some returnees are also becoming source of insecurity in the woredas for they involve in looting, and vandalism
6.6Ofla:
6.6.1 IDPs:
 There are 1308 IDPs in the Ofla woreda.
6.6.2 Response:
 46 HH was provided with land for farming
 56 HHs land for housing purpose
 Relief food assistance is being distributed based on availability
 Health is free of charge for IDPs in the woreda
 16 IDPs was provided with market places in the town
 Loan was arranged for 6 IDPs and took 300,000-birr
 23 of them were trained and employed in construction activities
pg. 54
 IDPs students were provided with school supplies that worth 17,000 birr
 40,000 birr was covered to housing rent to IDps from woredas budget upon arrivals
6.6.3 Challenges:
 Relief assistance delay up to three months. The last distribution was on April 2019.
 Land scarcity to equally appropriate land for IDPs in each kebelle
6.6.4 Child Protection:

 585 vulnerable children are there in the woredas
 Some children are out of school and are engaged in loading and offloading, water fetching, sheep herding and informal employment in
housekeeping and cafeterias
 Some are also reportedly migrating to Saudi and other towns of the country
6.6.5 Response:
 All students among the 585 vulnerable children were provided with school supplies and uniform that worth 114,248
 CCC has given them due attention and provided support on need basis
 13 children have been linked to sectors and are getting monthly support each 150 birr
 19 children have linked with Mudai-Adaption and are providing them each 450 birr on monthly basis
6.6.6 SGBV:
Is under reported though different forms of sexual violence is happening
6.6.7 Early marriage:

 Three children were rescued from illegal marriage by joint efforts of responsible sectors
6.7Enda-Moheni:
 There are 714 IDPs in the woreda and are living in all Keble’s.
pg. 55
6.7.1 Response:
 Monthly food assistance
 Housing for 189 IDPs
 Market Place for 11 IDPs
 49 IDPs were linked to different employment opportunities
 100,000 birr was used to purchase and distribute school supplies and uniform for IDPs students
6.7.2 Challenge:
 15 kg are very minimal to cover to the needs of IDPs
 Relief assistance is not delivered on time and distribute on time.
 Land scarcity in the woreda to fully provided housing or farmland to IDPs
In general, the woreda has targeted the most vulnerable part the community in PSNP direct support. Accordingly, 9017 elder lies, disabled, orphan
children, chronic diseases, and women headed households
6.7.3 SGBV:
 Two rape cases were reported and are under follow up
 In general, there is lack of knowledge and understanding to prevention and response activities
 There is unclear role among sectors and it remains un followed
 Circumcision is reportedly reducing but there is no any assessment or study to back this conclusion
6.8Raya-Alamata:
 IDPs: there are total 4998(3076) IDPs in the woredas.
6.8.1 Response:
 334 households have provided housing opportunities in nine Keble’s.
pg. 56
 534 individual IDPs mostly elderly, pregnant and lactating mothers were provided 10 kg of flour which received from World vision one-
time assistance
 CCC has supported three IDP women to open teashops by providing each 1000 birr
 50 IDP youths were provided with vocational skill training and created employment opportunities
 IDP children are supported with school supplies and uniforms
 The social affairs have supported 11 women with 16,500 birr after they were referred to Aider-referral hospital
6.8.2 Challenges:
 Currently IDP registration was stopped and becoming difficult when very vulnerable individuals report to the SA office and yet they don’t get
any support
 Lack of temporary shelter such as plastic sheets or emergency tents
 Lack of clarity of mandate between social affairs and early warning on relief assistance distribution
 15 kg relief assistance is minimal and unable to cover to the nutrition needs of IDPs
 IDPs from Oromia do not like to have wheat, instead they prefer maize or sorghum
 Lack of data clarity and double registration
6.8.3 SGBV:
Sexual violence is under reported. However, according informal information that the woreda gathered sexual violence is practicing widely in its all
forms.
 Rape: one case of rape was reported and it is under investigation. The case is of 70 years an old elderly woman was raped by youth.

 There are reportedly three cases of under age children this year. However, it has been reported that it is widely practiced in the woredas but
under reported.
Women Headed Households: There are 771 HH and 471 HH was supported with 209,050 birr
pg. 57
Vulnerable Children: From 1080 vulnerable children 1103 children IDPs included was supported with 203,380 birr
Elderly: CCC supports 217 elder lies were provided support that worth 96,900 birr
Disability: Disable individuals of 980 have provided with 41,100 birr supported by the woredas
HIV/AIDs: People living with HIV/AIDs were also supported 27,200 birr
6.9Raya-Azebo:
There are 7246 IDPs in the Raya- Azebo woreda which is one of the most populated in the region following Mekelle and Adi-Grat
6.9.1 Response:
 Monthly food assistance is provided without delay even though it is not delivered by NDRMC
 24 IDPs were provided loan up on proposal submission and request
 105 individuals have been linked with private sectors and got employment after they have received ILO training
 2597 HH IDPs from the total 2605 HHs have provided land for housing purpose
 750 IDP students have supported with school supplies and uniform
 800 blankets, shoes, trousers and T-shirts are being distributed to all most vulnerable IDPs
 Health is providing for free to IDPs upon the instruction of the regional government
6.9.2 Child Protection:

 57 children which are categorized with compounded challenges are linked to different sectors and 127,250 birr
 CCC supports around 97 children each 500
 Revolving fund targeted 30 children and 2500 birr was transferred to each of them
 Nine children living with HIV/AIDs are also receiving 172 birr every month
pg. 58
6.9.3 SGBV:
One ten year’s old girl was raped and the case is under investigation
Early marriage: 46 girls was suspected prepared to do under age marriage but upon investigation only eight of them found to be under the age of
18. Among which 2 have reportedly illegally married and is under investigation
6.9.4 Elderly:
56 elder lies with compounded problems were targeted in revolving fund and provide each 2500 birr
Disable: 50 individuals are targeted for revolving fund and each has received 2500 birr
6.10 Summary Table:

Number of IDPs, Response Provided, Pertaining Challenges, and Recommendations
Woreda No. of Response Challenge Recommendation

IDPs
H.Wojerat 2665  Relief Assistance  Relief assistance is not enough and is not received on  Relief assistance
 Housing for 10 associations time. should be
 Free health service  IDPs request housing without saving delivered on time
 IDPs expects special treatment  Distribution
 Overall dissatisfaction and frustration of IDPs centers should be
Alaje 706  Woreda cabinet has agreed to provide land for  New influx of IDPs are not being registered decentralized
housing and 2000 corrugated iron sheets  15 Kg wheat or sorghum is very minimal to cover the  Land for farming
 44 HHs have constructed their houses needs of the IDPs and not delivered timely and or for housing
 10 HHs have received loan  Distribution centers for relief assistance is not should be
 Market place was provided to three HHs decentralized and considerable number of IDPs are implemented
forced to sale portion of their food to cover consistently
pg. 59
transportation throughout the

zones
Enda-  Monthly food assistance  15 kg are very minimal to cover to the needs of IDPs  Rehabilitation of
Moheni  Housing for 189 IDPs  Relief assistance is not delivered on time and distribute IDPs should be
 Market Place for 11 IDPs on time. sought regionally
 49 IDPs were linked to different employment  Land scarcity in the woreda to fully provided housing for most IDPs
opportunities or farmland to IDPs interviewed are

not willing to
 100,000 birr was used to purchase and distribute
return
school supplies
 Mandate of relief
assistance
Ofla  46 HH was provided with land for farming and  Relief assistance delay up to three months.
distribution should
56 HHs land for housing  Land scarcity to equally appropriate land for IDPs in
be cleared as it is
 Monthly food assistance each kebelle
creating different
 Provision of free health services
challenges both to
 16 was provided with market places
staff and IDPs
 Loan was arranged for 6 IDPs
 A system should
 23 IDPs were trained in construction and
be established to
employed
recovere/
 School supplies were provided to IDPs students
reimburse medical
 40,000 birr was used to cover housing rent of
expenses for IDPs
IDPs upon arrivals
who don’
Raya  334 households have provided housing  Currently IDP registration was stopped and becoming
Alamata opportunities. difficult for vulnerable arrivals
pg. 60
 534 most vulnerable IDPs were provided 10 kg  Lack of temporary shelter such as plastic sheets or
of flour each as one-time assistance emergency tents
 CCC has supported three IDP women to open  Lack of clarity of mandate between social affairs and
teashops by providing each 1000 birr early warning on relief assistance distribution
 50 IDP youths were trained in vocational skills  15 kg relief assistance is minimal and unable to cover
and created employment opportunities to the nutrition needs of IDPs
 IDP children are supported with school supplies  IDPs from Oromia do not like to have wheat, instead
and uniforms they prefer maize or sorghum
 11 IDP women were supported in transportation  Lack of data clarity and double registration
cost for they have been referred to Aider-referral
hospital
Raya  Monthly food assistance is provided regularly  57 children which are categorized with compounded
Azebo  24 IDPs were provided loan challenges are linked to different sectors
 105 individuals have gotten employment  CCC supports around 97 children
 2597 HH IDPs have received land for housing  Revolving fund targeted 30 IDP children and 2500
 750 IDP students have supported with school birr was transferred to each of them
supplies
 800 blankets, shoes, trousers and T-shirts are
distributed
 Free health service is being provided
pg. 61
 3.8. Number of community Care Coalitions in the Belg producing woredas

S.No Name of woredas Number of CCC
1 Hintalo-Wejrat 23
2 Emba-Alaje 21
3 Enda-Mokoni 19
4 Ofla 21
5 Raya-Alamata 15
6 Raya-Azebo 22
total 121
6.11 CCC support vulnerable groups

vulnerable groups supported by CCC
S.No Name of woredas children elderly Diable women HHH HIV patient total
1 Hintalo-Wejrat 956 1,057 971 765 123 3872
2 Emba-Alaje 1267 1767 914 521 4469
3 Enda-Mokoni 146 694 1,012 78 749 2679

4 Ofla 585 377 314 401 160 1837
5 Raya-Alamata 546 217 466 471 230 1930

6 Raya-Azebo 127 156 113 158 344 898
Total 3627 4268 3790 1873 2127 15685
pg. 62
6.12 Resource mobilized by CCC

Resource mobilization of community care Coalitions in birr
Sr.No Name of woredas Plan Achieved %
1 Hintalo-Wejrat 645000 572,265.00 0.89
2 Emba-Alaje 494928 440285 0.89
3 Enda-Mokoni 362690 257110 0.71

4 Ofla 465000 537624 1.16
398808
5 Raya-Alamata 146142 0.37
6 Raya-Azebo 1300000 1299250 1.16

Total 3666426 3252676 0.89
6.13 One child for one organization

 This program is supporting more than 156 vulnerable children monthly and the amount of support is starting from 150-500 birr. In
addition, children in this category are also getting support on educational materials like pen, exercise books, uniform. CCC support is
expected to be continued until the children reach university. This program is supporting around 3000 vulnerable children (including full
orphans, half orphans, HIV positive, poor house hold) throughout the region.
pg. 63
 3.10.1. Number of support vulnerable children

S.No Name of woredas Number of supported vulnerable children
1 Hintalo-Wejrat 13
2 Emba-Alaje 34
3 Enda-Mokoni 19
4 Ofla 13
5 Raya-Alamata 18
6 Raya-Azebo 57
Total 156
6.14 Enabling Environment/Opportunities for GBV and social protection

 Presence of community Structures-Community Care Coalitions and women’s development army in each kebelle.
 Culture of supporting each other
 Presence of social protection policy
 Presence of trained personnel on child protection in emergency and gender based violence in some weredas
 Presence of committed government sectors offices like Social and Labor Affairs, Womens Affairs, Police, Education, Agriculture etc at
wereda levels
 Presence of trained Community Development workers
 Presence of paid social workers employed by the government at all tabias
 Presence of child protection policy
 Presence of one child for one organization
 Presence of PSNP program at rural and urban woredas that support the vulnerable groups
pg. 64
6.15 Challenges
 Coordination problem among concerned sectors in addressing child protection and GBV issues
 Limited trained man power on child protection and GBV
 Limited access for children with special needs
 CCC leaders have limited capacity on resource mobilization and financial management
 Absence of formal Case Management system/services to address CP/GBV
 Weak integration and less focus of stakeholders in addressing issues child protection and Gender Based Violence.
 Child labor and child trafficking is high almost in all visited woredas
 Child marriage and GBV is still highly practicing even though it is not reported
 Lack of information on child protection and GBV
 Absence of Child protection and GBV taskforce in each woredas and kebelles.
 Lack of child abuse and child protection monitoring, data, and reporting
 Lack of woredas level social affairs offices in planning and identifying the most vulnerable community during belg failure and emergency
6.16 Recommendations:
 Government and NGOs should play important role in capacitating CCC leaders on resource mobilization and implementation, financial
management, data base etc.
 Government, civil societies, religious leaders, community leaders and NGOs should work in a coordinated manner to best prevent and
response to SGBV, child abuses and IDP issues.
 To address the child protection and Gender Based violence issues, independent taskforce on child protection and gender based violence
should be established at woreda and kebelle level.In addition, at least one child protection and gender base violence officer should be in
place to reduce violence on women, girls, boys and men.
 In the assessed woredas the need of children with special needs is high, therefore, all actors are recommended to give it due attention and
work together in order to address the pressing needs.
pg. 65
 Child labor is a common practice in the assessed woredas, children are engaging in farming activities, rearing of animals, collecting of fair
wood and fetching of water for long hours beyond their capacity. Therefore, the local government, NGOs and the community at large
should do more on enabling environment so that every child go to school and participate in chores that requires less energy.
 Child marriage is a big problem in the belge assessed woredas, thus, in order to solve this issue, all stakeholders should contribute in
capacitating the government offices that are responsible to child protection and SGBV.
 Child trafficking occurred through different brokers and children are being trafficked to different towns and abroad. Thus, it is
recommended that
 Training should be provided to government sectors in evolving in social protection.
 Legal action/measure should be taken on traffickers and middle men.
 Report should be prepared on violence against children(VAC)
pg. 66

Non - Food Meher Final Report (2023)

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Non - Food Meher Final Report (2023)

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Non-Food Meher Assessment report Tigray Dec 2023

Tigray Annual Meher Assessment Report 2023

Conducted in Northwest zone Tigray,

Table 1: Description of the 2023 Meher assessment area

Regional name Tigray

Northwest: 1) Tahtai Adiabo, 2) Seyemti Adiabo, 3) Laelay Koraro, 4) Tsimbla, 5) Shire

Table 2: List of Meher Assessment Team Members, Tigray, Dec 2023

S/N Name Organization Mobile Email

7 Tr Ahimed Mohammed BoE 0914753967

ACRONYMS AND ABBREVIATIONS

AFI Acute Febrile Illness

CHD Community Health Day

CTC: Cholera Treatment Center

Co WASH Community Water Sanitation and Hygiene

FMOH Federal Ministry of Health

MAM Moderate Acute Malnutrition

OTP Out-patient Therapeutic Program

RHB Regional Health Bureau

ACRONYMS AND ABBREVIATIONS..............................................................................................................III

3.1 Study area and Period.................................................................................................................................................................................. 1

4.4.1 Overall situation of Water, sanitation and hygiene...............................................................22

5.4 Objective of the assessment.................................................................................................................................................................34

6.4 Hintato Wojerat:..................................................................................................................................................................................... 48

Table 1: Description of the 2019 belg assessment area.......................................................................................................................II

ACRONYMS AND ABBREVIATIONS..............................................................................................................III

3.1 Study area and Period.................................................................................................................................................................................. 1

4.4.1 Overall situation of Water, sanitation and hygiene...............................................................22

4.6.1 Status of water supply schemes by wereda, Tigray, June 2019........................................................................................................29

5.4 Objective of the assessment.................................................................................................................................................................34

6.4 Hintato Wojerat:..................................................................................................................................................................................... 48

6.6.4 Child Protection:............................................................................................................................................................................. 52

6.13 One child for one organization........................................................................................................................................................60

The following recommendations are forwarded to alleviate the above problems,

3.2 Data collection procedure:

3.3 Data management and analysis:

Coordination and Name of WoHO

How many PHEM

Are there PHEM Y Y Y

Does the Woreda Y Y Y

Is there a multi sector Y Y Y

If yes, how frequently 1 per month 2 per month

The percentage of 86% 86% 100%

4.2 Leading Causes of Morbidity:

4.3 Status of outbreak prone diseases and occurrence of outbreak:

4.4 Disease Outbreak:

4.5 Risk factors for outbreak prone diseases:

4.6 Preparedness - Emergency drugs and supplies:

4.7 Challenges outlined by woreda health office heads and experts:

T/Adiabo S/Adiabo L/koraro Tsimbla Shire E/slase

T/Adiabo S/Adiabo L/koraro Tsimbla Shire E/Slase

4.2.2 Admission of the therapeutic feeding program for SAM management

Woredas OTP SC TFP Reported RR

4.2.3 TFP Admission

May June July August September October Total

4.2.4 CMAM management skill

HEWs and Hws

4.2.5 CMAM (TFP) Supply:

4.2.6 MAM management and TSFP service delivery:

4.2.7 Risk factors for Emergency Nutrition:

 Inadequate safe water supply

 Poor personal and environmental hygiene practice

4.2.8 Challenges for emergencies nutrition response

4.4.1 Overall situation of Water, sanitation and hygiene