iCCM/ integrated Community Case Management, and malaria

iCCM and malaria

© UNICEF/NYHQ2006-2248/Pirozzi

A five-month-old baby with malaria and a severe respiratory infection lies in a hospital in Mozambique.

Across Eastern and Southern Africa, pneumonia, diarrhoea and malaria are the biggest killers of children. In 2012, an estimated 197,000 children died from pneumonia, 115,000 from diarrhoea and 84,000 from malaria. Most of these deaths are preventable, and the treatments are simple and cost-effective. Yet, they remain out of reach for many children, particularly those in the most disadvantaged and marginalized communities. 

Since 2005, governments in the region, with support from UNICEF and other partners, have rolled out an ambitious strategy – integrated Community Case Management, or iCCM - to save children from dying unnecessarily from these killer diseases.

The core of iCCM is the Community Health Workers (CHWs), who are trained to prevent and treat these common childhood diseases, and also provide referral services to the families they serve. They are equipped with rapid diagnostic tools, and low-cost, but life-saving medicines, such as artemisinin combination therapy (ACT) drugs for malaria; amoxicillin for pneumonia; and oral rehydration salts and zinc tablets for diarrhoea.

By reaching the most excluded and marginalized children, CHWs play a critical role in narrowing the gap of inequity in a country’s health systems. Over the past two years, some countries have also started training CHWs to provide care for newborn babies and children, including detecting early signs of malnutrition, and providing ready-to-use therapeutic food for severely malnourished children. 

Malaria control

Malaria not only kills, it also leads to high levels of anaemia in children and pregnant women, increasing the number of babies born with low birth weight – one of the key underlying causes of infant mortality and developmental delays in children. It is a disease of poverty, affecting mainly the poor living in malaria-prone rural areas that offer few, if any, barriers against mosquitoes.

In addition to treatment of malaria through iCCM, malaria can be prevented through the use of Insecticide-Treated Nets (ITNs), which can effectively reduce child mortality by 20 per cent, and indoor spray with insecticides. Since 2005, more than 80 million ITNs have been provided to rural families in across the region, and millions of houses have been sprayed with insecticides. These investments have successfully cut malaria cases by more than half in ESA, contributing greatly towards reaching the Millennium Development Goal (MDG) 4 of reducing under-five mortality by two thirds by 2015.

UNICEF in action

© UNICEF/NYHQ2007-1789/Nesbitt

A nurse distributes insecticide-treated mosquito nets to prevent malaria at a health centre in Angola.

In countries throughout ESA, UNICEF is at the forefront of expanding iCCM to halt pneumonia, diarrhoea and malaria at the community level. To improve diagnosis and treatment of these diseases, UNICEF plays a vital role in the procurement, distribution and management of rapid diagnostic tools and essential medicines, as well as ITNs. Support is also provided to help countries train and manage tens of thousands of Community Health Workers to ensure children - especially those who otherwise have no access to treatment - can have a chance to survive pneumonia, diarrhoea and malaria.

Despite the availability of CHWs and the life-saving treatments they provide, thousands of children in need are not benefitting from such services. Lack of demand is a major reason. To this end, UNICEF works actively in health education and social and behaviour change to increase the uptake of these services at community level.

As a founding member of the Roll Back Malaria (RBM) initiative, UNICEF often supports countries’ fundraising efforts to sustain and expand iCCM and malaria control. This includes assisting countries to develop proposals for donors such as the Global Fund, the World Bank, the Presidential Malaria Initiative, and many bilateral donors.

Results for children

In countries with limited access to health care facilities, iCCM has helped expand treatment for pneumonia, diarrhoea and malaria to millions of children, especially in hard-to-reach areas.

• A number of malaria-prone countries have shown 50 per cent decline in malaria cases, including Botswana, Eritrea, Ethiopia, Madagascar, Namibia, Rwanda, South Africa, Swaziland, Tanzania and Zambia. Among them, Rwanda, Tanzania and Zambia are three countries with highly endemic malaria areas.

Immunization (UNICEF)

© UNICEF/NYHQ2006-1081/Figueira

A child receives a dose of oral polio vaccine during a UNICEF-supported immunization campaign, Namibia.

Immunization, one of the most cost-effective public health interventions, has been protecting children everywhere against common yet potentially life-threatening diseases over the past two centuries. In Eastern and Southern Africa, immunization has long been a standard health care service in all countries, and enormous progress has been achieved. 

The vaccines under the current routine immunization programmes protect children against a wide range of common childhood diseases, including tuberculosis (BCG), diphtheria, pertussis (whooping cough) and tetanus (jointly referred to as DPT), polio, measles, hepatitis b (HepB) and meningitis (Hib). 

Regional coverage for each of the vaccines is above 70 per cent, with some countries achieving 90 per cent of coverage for DPT3 [1].

In recent years, new vaccines have  been introduced to ESA and developing countries around the world to protect children from pneumonia (PCV) and diarrhoea (rotavirus vaccine), two of the biggest child killers, and the human papillomavirus (HPV).

Still, many children are not reached, particularly those from the most marginalized and excluded communities. In 2012, out of the 14.3 million children under the age of one covered under routine immunization in all 21 ESA countries, 13 per cent, or 1.8 million, were left unprotected. Most of these children were from rural and remote areas, as well as from urban slums. Children affected by conflict, and those whose families and communities refused to have them immunized, were also part of that group. Nearly 90 per cent of all un-immunized children lived in nine countries –Angola, Ethiopia, Kenya, Madagascar, Somalia, South Sudan, Tanzania, Uganda and Zambia.

The Horn of Africa had been polio-free for years, but with the confirmation of a two-year old child infected with the virus in Somalia in May 2013, that record no longer holds. To date, some 200 children and adults have been affected, mainly in Somalia, and also Kenya and Ethiopia. Thanks to the rapid responses by the region’s governments and their partners, the progression of the outbreak has been significantly eased off. The risk of the virus continuing to spread, however, remains high, particularly with close to one million children, most of them in Somalia, have never been immunized or have not received the required number of doses.

© UNICEF/NYHQ2009-1235/Pirozzi

A health worker vaccinates a pregnant woman against tetanus in a health centre in Madagascar.

UNICEF in action

In response to the challenges in global immunization, WHO and UNICEF developed the Global Immunization Vision and Strategy (GIVS). Launched in 2006, GIVS is a 10-year framework (2006–2015) aimed at controlling illness and death from vaccine-preventable diseases, and helping countries immunize more people with a greater range of vaccines and innovative technologies.

Under GIVS, the goal for every country is to ensure that at a national level, 90 per cent of children under one year of age are reached through routine immunization, and at least 80 per cent in every district or equivalent administrative unit. Another goal is to reduce deaths by measles by 90 per cent compared to the 2000 level. In addition, UNICEF, together with partners under the Global Alliance for Vaccines and Immunization (GAVI), helps introduce new and improved vaccines to all countries.

For the children who are missed during routine immunization, UNICEF and WHO use a number of strategies to close the gap, including advocacy with faith-based leaders. Bi-annual Child Health Days, which combine immunization with vitamin A supplementation, de-worming, and other health interventions, also contribute greatly to the overall immunization efforts.

Results for children

• Botswana, Burundi, Eritrea, Malawi, Rwanda, Swaziland, Tanzania and Zimbabwe reached the GIVS national DPT3 coverage of more than 90 per cent in 2011. Eight other countries - Angola, Comoros, Kenya, Lesotho, Madagascar, Namibia, Uganda and Zambia - are moving towards this target, with DTP3 coverage between 80 and 89 per cent. 
• Angola, a country where poliovirus was re-introduced in 2005, made significant progress, with no cases reported since 2012. 
• All countries in ESA now conduct periodic follow-up immunization campaigns as part of the regional strategies to control and eliminate measles.
• Fifteen countries in the region have been validated for the elimination of maternal and neonatal tetanus, with Tanzania being validated the latest in 2012. 
• Six countries - Burundi, Ethiopia, Kenya, Malawi, Rwanda and South Africa -added the pneumococcal conjugate vaccine (PCV) to their routine immunization programmes. Three countries - Botswana, Rwanda and South Africa - introduced the rotavirus vaccine to protect children against diarrhoea. 
• Rwanda has become the only country in the region to have introduced the human papillomavirus vaccine (HPV) for girls aged 9–13, to protect them against cervical cancer, among other diseases, when they become sexually active.

Water, sanitation and hygiene in emergencies

© UNICEF/NYHQ2010-0397/Hyun

Children collect water from a UNICEF-supported storage tank at a camp for people displaced by mudslides in Uganda.

When emergency strikes, and access to safe drinking water, adequate excreta disposal and means to undertake good hygiene behavior, are all compromised, children become more susceptible to illness and death as a result of diarrhoea and other water, sanitation and hygiene (WASH) related diseases. 

Eastern and Southern Africa is a region especially prone to natural disasters, including drought, floods, landslides, as well as political upheaval.

In recent years, emergencies in this part of Africa have increased dramatically, and become more complex, with many of them involved cross-border issues.

In 2011-2012, the Horn of Africa region experienced one of the worst droughts in 60 years, affecting some 13 million people in Somalia, Kenya, Ethiopia and Djibouti. While in the Great Lakes region, intense fighting and prolonged conflict in the Kivu region of the Democratic Republic of Congo has forced tens of thousands of families abandoning their homes, and many crossing over to neighbouring countries, such as Rwanda, Uganda and Burundi. 

The period during and after disasters signifies a time of great risk in the transmission of WASH-related diseases. Conditions are often unsanitary, conducive to disease outbreak.  Early identification of appropriate, technically sound WASH interventions is, therefore, critical, for a fast and effective response to disasters.

UNICEF in action

Guided by its Core Commitments for Children in Humanitarian Action (CCCs), UNICEF responds to emergencies by ensuring girls, boys and women have protected and reliable access to sufficient and safe water and sanitation and hygiene facilities. 

UNICEF commits to ensuring:

• effective leadership and coordination in the WASH sector;


• access to sufficient safe drinking, cooking and personal hygiene water;


• access to toilets and washing facilities;


• access to critical hygiene information that will prevent especially diarrhoeal disease; and,


• access to safe WASH facilities for children in learning environments and child-friendly spaces.

In these roles, UNICEF is heavily involved in emergency preparedness and planning, and in support to post-emergency reconstruction efforts.

Results for children

UNICEF’s long presence in the region, working alongside governments and other partners, means that we are there before, during and after a crisis.

• During the Horn of Africa response, close to 4.9 million people were provided with an improved water source through newly constructed or rehabilitated sources of water, as well as water treatment and trucking.
• A similar number of people were reached through handwashing and safe drinking water campaigns, as well as the distribution of soap and other hygiene items. These interventions were critical to prevent outbreak of cholera and other acute watery diarrhoeal diseases.
• As the WASH coordinator and leader, in 2011-2012, UNICEF led the preparedness and responses in Kenya, Somalia, Ethiopia, Zimbabwe, South Sudan, Madagascar, Mozambique and Comoros. 
• Supporting governments in the region, UNICEF also takes the lead in developing standards of approach and implementation, mapping capacity and gaps, and preparation of funding appeals.

The Sanitation and Hygiene Learning Series (UNICEF)

 

 
The Sanitation and Hygiene Learning Series was designed to improve knowledge of best practice and lessons learnt in sanitation and hygiene programming across the Eastern and Southern Africa Region. The series has been funded by the Bill & Melinda Gates Foundation in support of improved knowledge management in the sanitation sector.

The documents in this series cover the following topics:

• CLTS in fragile contexts
• CLTS at-scale
• Small towns sanitation
• Mobile-enabled sanitation and hygiene programming
• Regional supply chains for sanitation
• Sanitation marketing
• Handwashing with soap

Going Beyond ODF: Combining Sanitation Marketing with Participatory Approaches to Sustain ODF Communities in Malawi (March 2015) [PDF]

CLTS in Fragile and Insecure Contexts: Experience from Somalia and South Sudan (Dec 2014) [PDF]

Triggering Handwashing with Soap in CLTS: Insights on What Works from Malawi [PDF]

Real-Time Monitoring of Rural Sanitation at Scale in Zambia Using Mobile-to-Web Technologies [PDF]

Micro-Planning for CLTS: Experience from Kenya

Sanitation in Small Towns: Experience from Mozambique [PDF]

Evaluation of the SOPO School Handwashing Promotion Programme: Nyanza and Rift Valley Provinces, Kenya [PDF]

Key Findings of a Sanitation Supply Chains Study in Eastern and Southern Africa [PDF]

Water, sanitation and hygiene (UNICEF)

© UNICEF/NYHQ2009-1244/Pirozzi

Children use soap attached to a string to wash their hands before lunch at a public school in Madagascar.

Poor access to water and sanitation facilities, and unsafe hygiene practices are the main causes of diarrhoea, one of the biggest child killers in the world. Without addressing the problems in water, sanitation and hygiene (WASH), children's rights to an adequate standard of living and the highest attainable standard of health, as enshrined in the Convention on the Rights of the Child (CRC), can never be entirely fulfilled. Because of this, WASH is regarded as a central component of the millennium development agenda. Progress in this area is closely related to that of child mortality, primary education, and poverty eradication. 

“Safe drinking water and adequate sanitation are crucial for poverty reduction, crucial for sustainable development, and crucial for achieving any and every one of the Millennium Development Goals.” –Ban Ki-moon, UN Secretary-General

Not only WASH impacts on children’s health and wellbeing, it impacts on their ability to learn and thrive. In Eastern and Southern Africa, on average, less than half of schools have adequate water supply and sanitation facilities. In many communities, women and girls are burdened with the responsibility of collecting water, a household chore that can take up large parts of their day. Poor water and sanitation can make girls especially vulnerable, especially for those who start menstruating. Many are forced to skip classes and even drop out when their schools do not have separate toilets for boys and girls. 

School children with disabilities are also disadvantaged. Although there are no sufficient data, many education professionals attest to the lack of access to WASH services for students with physical disabilities.

Progress towards the MDGs

As a region ESA still has a long way to go to achieve the Millennium Development Goals (MDGs) of improving access to safe water and sanitation. Only five of the 21 countries in the region - Botswana, Malawi, Namibia, South Africa and Uganda - are on track to meet the MDG target of reducing the proportion of the population without access to safe water by half by 2015. Geographical disparities are vast, with 87 per cent of people in urban areas having access to improved drinking water sources, compared to 52 per cent in rural areas.

Access to sanitation is lagging even further behind. Only three countries - Angola, Botswana and South Africa - are on track to meet the MDG target of reducing the proportion of people without sanitation by half. Open defecation – the unhealthiest sanitation practice of all – is still common in some countries. In Ethiopia, Namibia and Mozambique, for example, the proportion of people who practice open defecation stands at 46, 52 and 41 per cent, respectively. Disparities are enormous. In Namibia, for example, only 10 per cent of the poorest families have access to improved sanitation, compared to 89 per cent coverage among the wealthiest households. 

UNICEF in action

© UNICEF/NYHQ2007-1350/Pirozzi

Two girls with pails walk towards latrines at a primary school, which is supported by UNICEF with child-friendly teaching and learning, and has separate latrinte for boys and girs, Rwanda.

Working directly with communities and families, UNICEF helps increase access to clean and secure supply of water, and safe and convenient sanitary facilities. While maximizing health benefits that WASH programmes bring, particularly to the survival, growth and development of young children, UNICEF also supports efforts to make schools  a more conducive learning environment to children. Separate and decent sanitation facilities in schools can reduce dropout rates, especially among girls, and hygiene promotion not only benefits children but empowers them to be agents of change in their families and communities.

Behaviour and social change is critical to sustainable access to water and sanitation. UNICEF, therefore, works on changing unhealthy behavior such as open defecation, and promoting healthy behaviours such as handwashing with soap, and safe water handling, water treatment and storage. Communities are also supported to be drivers of change through programmes such as community-led total sanitation. 

At the global level, UNICEF is the lead agency in water, sanitation and hygiene in emergencies. In line with its own mandate in emergencies – the Core Commitments for Children (CCCs) in Humanitarian Action - UNICEF supports countries in emergency preparedness and response, with WASH as a critical component.

Results for children

• In 2010 alone, about 4.5 million people in 14 countries in ESA got access to water, and 2 million to sanitation facilities through UNICEF-supported programmes. In 2012, the number of new users of sanitation, attributable to UNICEF programming, is well over 7.6 million.


• In 2012, 11 countries in ESA had sanitation-specific policies compared to only three countries at the start of the International Year of Sanitation in 2008. Eleven countries now have a national plan towards achieving the MDG target for sanitation, and a number of countries made progress in allocating discrete budget lines for sanitation and hygiene. 


• The number of countries with national behaviour change communication programmes that promote handwashing with soap is gradually increasing. In 2012, a total of 15 UNICEF country offices in the region supported the commemoration of the Global Handwashing Day, reaching more than 20 million children.


• UNICEF promotes and supports the implementation of the Community Approach to Total Sanitation (CATS) – an approach that triggers a change of mindset and social norms to encourage entire communities to abandon open defecation. Countries such as Zambia, Zimbabwe, Eritrea, Ethiopia, Madagascar, Malawi, Angola, Kenya and Mozambique have adopted CATS as a key national strategy to scale up sanitation.


• UNICEF has made significant progress in scaling up household water treatment and safe storage, particularly in emergency settings. During the Horn of Africa crisis in 2011, UNICEF was instrumental in supporting hygiene promotion, and providing safe drinking water to the affected population, including schools and feeding centres.

Nutrition (UNICEF)

Proper nutrition is a powerful good: children who are well nourished are more likely to be healthy, productive and able to learn. Malnutrition is, by the same logic, devastating. It blunts intellect, saps productivity, and perpetuates poverty for any family and society it touches.      

While significant progress has been made in ensuring proper nutrition for children, challenges remain throughout the world. For Eastern and Southern Africa, stunting, also referred to as chronic malnutrition (low height for age), is of a particular concern with more than 25 million, or 40 percent of children under five years of age suffering from it.

“One of the most compelling investments is to get nutrients to the world’s undernourished. The benefit from doing so – in terms of increased health, schooling, and productivity – are tremendous.” - Vernon Smith, Nobel laureate economist

In addition, 18 per cent of under-fives are underweight (they weigh too little for their age); and 7 percent are suffering from acute malnutrition (also called wasting, a rapid loss of weight because of illness or insufficient food intake). Unlike underweight and wasting, stunting is largely irreversible, and it is affecting more children than the first two conditions combined in the region.

There are many factors contributing to malnutrition. One of the most significant is the low rate of exclusive breastfeeding from birth to six months of a child’s life. Studies have shown that exclusive breastfeeding is one of the single most effective interventions to combat child mortality. Yet, in ESA, just over half of infants are being exclusively breastfed in that crucial period.

Furthermore, inadequate complementary feeding for children older than six months, low consumption of iodized salt by households, low vitamin A coverage for children under-five, and anaemia during pregnancy, all contribute to malnutrition in children.

As data have confirmed, malnutrition starts in utero and increase markedly from three to 23 months of age. Ensuring adequate nutrition during this “1000 days window of opportunity”, therefore, is critical in preventing long-term and irreversible damage to children’s health and cognitive and physical development.

Routes to better nutrition:
- Adequate food and nutrient intakes through promoting agriculture and food security;
- improving social protection, including emergency relief;
- ensuring access to health care, including maternal and child health care, water, hygiene and sanitation, immunization, education, family planning, among others.

Together with more than 100 organizations and groups, UNICEF is a partner in the Scaling Up Nutrition (SUN) movement, a global effort to advance health and development through improved nutrition at country levels. The partnership focuses on implementing evidenced-based nutrition interventions and integrating nutrition goals into broader health, development and agricultural efforts.

To tackle the widespread and growing problem of malnutrition, UNICEF, together with the European Union launched Africa’s Nutrition Security Partnership (ANSP) to improve nutrition security among women and young children on the continent. The partnership aims to address the root causes of malnutrition, and create an environment of pro-nutrition policy and programmes.

UNICEF also works in the following areas:
Infant and young child feeding
Under the Guiding Principles for Complementary Feeding of the Breastfed Child, UNICEF advocates exclusive breastfeeding in the first six months of life and continued breastfeeding up to two years and beyond.

Micronutrient deficiencies
Many lives can be saved and improved through a range of cost-effective interventions, including micronutrient supplementation and fortification. To this end, UNICEF supports countries to deliver vitamin A supplementation to children 6-59 months through routine health programmes and also campaigns such as the Child Health Days. It also fosters partnerships to support countries on salt iodization, and leverages funding, commitment and innovations for better essential vitamin and mineral intake of children.

HIV and nutrition
HIV has a profoundly negative impact on the nutritional status of children. While the interactions between HIV and nutrition exist at many levels, nutrition programmes are often rolled-out in a more vertical fashion. In response, UNICEF, together with partners, works on integrating service delivery for prevention and treatment of HIV and under nutrition in children.

Integrated management of severe acute malnutrition
Given the lack of a systematic approach to the scale up of community-based management of acute malnutrition, a framework for integration of management of severe acute malnutrition (IMSAM) into national health systems has been developed and is being piloted in the region.

Results for Children
Over the years, awareness of nutrition issues, particularly stunting, has increased, thanks to advocacy informed by researches and partners. Sixteen out of the 21 countries in ESA now have improved nutrition plans that no longer treat nutrition as a standalone sector, but one that needs to be integrated with health, agriculture, sanitation, welfare, education and others. Most countries in the region have bi-annual mass vitamin A supplementation as part of the Child Health Days campaign, together with other high impact interventions such as de-worming, immunization and distribution of insecticide-treated mosquito nets.

Countries are increasingly recognizing Integrated Management of Acute Malnutrition (IMAM) as part of the minimum core package of nutrition interventions. Seventeen of the 21 countries in the region have begun to build national capacities to scale up this approach.

UNICEF in action: Strategies and priorities

UNICEF is supporting all countries in the region with a combination of strategies aimed at strengthening national and local health systems, promoting high-impact interventions, as well as improving the capacity of communities and families to prevent diseases and treat them adequately when necessary.

The focus is on reaching the most deprived and disadvantaged children, which has proven to be the most effective way to reduce maternal and child mortality and achieve progress towards the health-related MDGs.

Strategies include:

‘Continuum of care’
The ‘continuum of care’ is a core organizing principle for health systems that emphasizes seamless linkages between healthcare packages across time and through various service delivery points. It aims to integrate essential maternal, newborn and child health and nutrition packages, since evidence has shown that such services are most effective when they are delivered at critical points in the life cycle of mothers and children. The continuum of care thus focuses on adolescence, pre-pregnancy, pregnancy and childbirth, postpartum and newborn periods, up into infancy and childhood. It combines essential health care services at household and community level to health centres and hospitals. UNICEF promotes this holistic approach as an efficient, cost-effective way to accelerate progress on child survival in Eastern and Southern Africa.

Strengthening health systems
UNICEF supports governments to strengthen their health systems. Priority is placed on investments based on demand and on reliable data related to under-nutrition and disease patterns. The aim is to narrow the gaps in coverage, quality and equity. UNICEF assists countries in reducing financial barriers to healthcare access through, for example, cash transfer programmes, voucher schemes and results-based financing.

Child Health Days
Child Health Days (CHDs) are a platform to deliver integrated interventions and achieve high coverage. Services are delivered free of charge and reach out to households and communities beyond health facilities. In the past, safe motherhood and child survival programmes often operated separately, leaving disconnections in care that affected both mothers and newborns. Now it is being recognized that delivering integrated interventions at pivotal points in the continuum of care has multiple benefits.Twice a year, they bring a set of high-impact, life-saving health interventions to young children, including immunization, vitamin A supplements, growth monitoring, and de-worming. The package also includes antenatal care for women, immunization against neonatal tetanus, distribution of insecticide treated nets, and the promotion of practices that lead to better family health overall. Today, CHDs are being implemented in almost all 20 countries in the region as an effective strategy to reduce child mortality.

Community case management 
Because most children die outside of health facilities, and families in most rural and poor communities do not have access to treatment of killer diseases, UNICEF aims to prevent child deaths by ensuring that illnesses are diagnosed and dealt with where children live. UNICEF supports a community-based approach to identifying and treating pneumonia, diarrhoea, malaria and acute malnutrition in Eastern and Southern Africa. Through the Integrated Management of Childhood Illnesses and Acute Malnutrition, health workers and members of the local community are trained in identifying signs of deteriorating nutrition and of illnesses and to provide appropriate care including timely referral to hospitals. In the area of water, sanitation and hygiene, UNICEF works with communities to increase household access to safe drinking water, adequate sanitation facilities, and help them master simple household water treatment and safe storage techniques to prevent water-borne diseases and unnecessary deaths.

Behavior change communication
There is a direct link between healthy behaviors and good health. Health-promoting practices in homes and communities can address many of the preventable causes of disease and death. Working in partnership with health authorities, health workers and communities, UNICEF helps to promote practices at the household and community levels that are proven to save children’s lives and help them thrive. These include breastfeeding, improving nutrition and care, managing diarrhoea and strengthening personal hygiene. Just helping a community adopt hand washing with soap can lower diarrhoea by almost 40 percent.

Strategic partnerships
No single actor can take on the challenge of achieving the health MDGs alone. Reaching every child with a basic package of essential, proven interventions requires joint efforts of governments, bilateral and multilateral agencies, NGOs, civil society, researchers and the private sector. UNICEF therefore works in close cooperation with a number of stakeholders, using these partnerships to scale up programmes, leverage resources and generate evidence for policy and programming.

UNICEF supports the development and implementation of national health policies and helps governments access major funding from innovative public-private partnerships such as the Global Alliances for Vaccines and Immunization (GAVI) or the Global Fund to fight AIDS, Tuberculosis and Malaria. It works with regional bodies like the African Union on the development of strategies to improve child nutrition and combat maternal mortality, and with international NGOs such as Oxfam or Plan International in the area of water and sanitation. As Co-Chair of the health team of the UN Development Group for Eastern and Southern Africa, UNICEF works to ensure that activities are harmonized and countries receive technical support based on their demand and needs.
Moreover, UNICEF is a founding member of the Harmonization for Health in Africa partnerships. In that role, UNICEF works with partners to support countries in developing health sector plans which are based on evidence, and which include cost estimates and mechanisms for monitoring results.

Equity-focused data collection and monitoring of progress
Effective programme development and implementation needs to be informed by reliable and accurate data and continuous monitoring of progress. UNICEF supports governments and other partners in strengthening their capacity to generate evidence related to maternal, newborn and child survival and development, putting particular emphasis on collecting disaggregated data to analyze the impact of factors such as gender, residence and the education level of mothers on health outcomes.

Children’s rights (UNICEF)

The full list of rights for children and young people under the age of 18 is set out in the United Nations Convention on the Rights of the Child, the most accepted standard on children’s rights in the world. Ireland committed to promote children’s rights when it signed up to the Convention in 1992.

Children’s rights include the right to health, education, family life, play and recreation, an adequate standard of living and to be protected from abuse and harm. Children’s rights cover their developmental and age-appropriate needs that change over time as a child grows up.

There are four general principles that underpin all children’s rights:

• Non-discrimination means that all children have the same right to develop their potential in all situations and at all times. For example, every child should have equal access to education regardless of the child’s gender, race, ethnicity, nationality, religion, disability, parentage, sexual orientation or other status
• The best interests of the child must be "a primary consideration" in all actions and decisions concerning a child, and must be used to resolve conflicts between different rights. For example, when making national budgetary decisions affecting children, Government must consider how cuts will impact on the best interests of the child
• The right to survival and development underscores the vital importance of ensuring access to basic services and to equality of opportunity for children to achieve their full development. For example, a child with a disability should have effective access to education and health care to achieve their full potential
• The views of the child mean that the voice of the child must be heard and respected in all matters concerning his or her rights. For example, those in power should consult with children before making decisions that will affect them. Children’s Rights Alliance improves the lives of all children and young people by ensuring Ireland’s laws, policies and services comply with the standards set out in the United Nations Convention on the Rights of the Child.

Fighting for the rights of the world's children (UNICEF)

It was a time when young people believed in change and we thought anything was possible.  Some of us still believe it! Half way from there to here was 1989.  This was also a year of revolutions, with the fall of the Berlin Wall and the official end of the Cold War. For me though, the most important revolution was the adoption on 20th November of the Convention on the Rights of the Child.  For the first time the world made a set of promises to all its children and young people backed by the force of international law.  It is a document of staggering power and simplicity and well worth a read.  Its 54 Articles offer a unique set of global values, that every child should be brought up “in the spirit of peace, dignity, tolerance, freedom, equality and solidarity”.
The education of the child shall be directed to:

• The development of the child’s personality, talents and mental and physical abilities to their fullest potential;
• The development of respect for human rights and fundamental freedoms
• The development of respect for the child’s parents, his or her own cultural identity, language and values, for the national values of the country in which the child is living, the country from which he or she may originate, and for civilizations different from his or her own;
• The preparation of the child for responsible life in a free society, in the spirit of understanding, peace, tolerance, equality of sexes, and friendship among all peoples
• The development of respect for the natural environment”.

In essence, the Convention (the CRC) made a number of vital promises to every child:  the promise of  protection from violence, exploitation, abuse and adult responsibilities, with social security, safety and play; the promise of education for all, according the values of Article 29; the promise of survival beyond infancy and the highest attainable standard of health; the right to be treated equally, regardless of “race, colour, sex, language, religion, political or other opinion, national, ethnic or social origin, property, disability, birth or other status”; and the right to be heard – not only to be able to express oneself freely, but for the child’s opinions to be given “due weight” in matters that affect them.

Yet, 20 years later, in 2009, violence against children is widespread, childhoods are damaged or denied by war, work and abuse; a billion children live in poverty, including 4 million in the UK; 9 million under 5s die annually, most from preventable causes; 100 million children are out of school.  Discrimination is rife and children’s voices are still not heard as they should be.  In our own society, young people are vilified in the media and in politics for the sake of a quick soundbite.  In short, the promises made 20 years ago continue to be broken.  20 years is too long.  It is time for the promises to be kept.
It is still possible to change the world for the better, there can be no greater cause than fighting for the rights of the world’s children.

2009 is another special year.  Will we really meet the challenge of climate change? Will it be the year when global recession heralds a positive change in corporate, social and political values – or not?  Will the G20 decide that we should manage the global economy for the benefit of the most vulnerable?  And it is the 20th anniversary of the Convention on the Rights of the Child.  Will the promises be kept?  Not if we stand by and do nothing!  It is also a time when the power of online social networking to mobilize change has become reality.  The need and the opportunity for social action has never been greater.

The school years in Indonesia (UNICEF)

The school years

There has been significant progress in Indonesia towards achieving universal primary - or basic - education. Primary school enrollment rates reached 97 per cent in 2009, and currently some 26 million children attend primary schools.

There are few differences between enrollment rates of girls and boys at primary level, and overall little difference between urban and rural areas. However the gap between the worst performing province - Papua - and the best - Aceh - is some 15 per cent.

Most children do complete primary education - latest official data shows that 'drop-out'rates during the first six years of education have fallen to under 2 per cent.

Quality of learning remains cause for concern, with one in ten children having to repeat their first year of primary study to attain the required standards, and 6 per cent repeating their second year. Just 55 per cent of primary school teachers hold the minimum qualifications required by the government.

Beyond primary education

A significant number of children stop their education after completing primary level. One-third of children who should be in classes at junior secondary level are not enrolled.

More positively, the gap in attendance between rural and urban areas - which was 20 per cent ten years ago - has reduced to just 4 per cent. More girls than boys also attend junior secondary school.

Drop-out trends continue into senior secondary school; again, more than a third of children who complete the junior level fail to continue into the final years of their education.

 Children out of school

According to the 2010 national census, some 3.5 million children were not attending primary or junior secondary school.

An estimated 2.7 million Indonesian children are involved in some form of child labour - roughly half of these are under the age of 13. While most working children do manage to participate in some form of schooling, time spent engaged in education is limited and impacts on their ability to reach their full potential. There is also a clear link between children being out of school as a result of a need to work - two-thirds of children who are out of school are involved in work, either paid employment or at home.

Working children are exposed to significant risks; almost half of children aged between 5 and 14 found to be in work are exposed to at least one of 14 serious hazards, ranging from working with dangerous objects to unhealthy working environments.

Children in Indonesia (UNICEF)

The early years (from birth to 5 years old)


Infant and under-5 mortality rates in Indonesia have halved since 1990, thanks to continued investment in health care. Progress in reducing maternal mortality has been slower, however, with an estimated 17,000 women losing their lives every year still due to complications in pregnancy and childbirth.

While mortality rates are improving, an estimated 190,000 Indonesian children still die every year before celebrating their fifth birthday. Almost half of under-5 deaths occur in the first month after birth  and can be attributed to complications from premature birth, still births and severe infections including pneumonia, meningitis and septicaemia.

There remain serious challenges to children's early development. Stunting – being below average height for one’s age – affects 36 per cent of children under five while 18 per cent of children below the age of five are underweight.

Many infants are left unprotected against disease because of low levels of breastfeeding – less than half of Indonesian children are exclusively breasted for the first six months of life . Moreover, only 37 per cent of children aged between 6 and 23 months are fed according to recommended practices.

One key protection for all children - the right to an identity - is also lacking for many Indonesian youngsters; only around 57 per cent of children under age 5 have an official birth certificate.

Risks for mothers

Mothers are at risk from preventable deaths in pregnancy and childbirth. While the number of women receiving ante-natal care has increased in recent years, more than half of all deliveries still take place at home without specialist facilities on hand to deal with complications. More needs to be done to improve standards of care, in both public and private sector facilities and amongst health care workers.

Early childhood education

While Indonesia has set a goal of three-quarters of children up to the age of 6 benefiting from early childhood education, today less than half of these children access such services.  Early childhood education is recognized as important for a child's overall growth and development, and improves their preparedness for school later in life.

Inequity in early childhood and motherhood

Data shows that behind improvements in national statistics, there are clear geographical and socio-economic disparities that affect Indonesia's youngest citizens.

For example, the infant mortality rate in East Nusa Tenggara province is 58 deaths for every 1,000 live births , almost double that of Yogyakarta province and much higher than the national rate of 40 deaths . Under-five and infant mortality rates among the poorest households are generally more than twice those in the highest income families.

There is a 17 per cent difference between the number of women in urban and rural areas who benefit from the attendance of a trained health worker during childbirth.  More than 68 per cent of the lowest income mothers give birth at home, compared to just 12 per cent among the richest families.

Evidence points to a divide in take-up of early childhood education services between the poorest and wealthiest families; while almost three quarters of children aged 5 or 6 from the wealthiest households attend pre-primary or primary school, less than half of those from the poorest families do so.

Child Survival and Development Specialist (CSD) in UNICEF

As Child Survival and Development Specialist (CSD),
the incumbent is accountable for quality technical expertise for:

• Formulation, 
• Design, 
• Planning, 
• Implementing, 
• Monitoring
• Evaluation of scaling-up cost-effective
• Replicable Child Survival and Development intervention packages
• Enhance coverage and quality of maternal, newborn and child health, nutrition, water, sanitation and hygiene (WASH) 
• Preventing mother-to-child transmission (PMTCT) intervention packages, through support of strengthening health systems, social and behaviour change
• Making services more accountable to users by reinforcing community-based quality assurance systems. 
• Provide support and supervision to CSD team Health Officer (Malaria & EPI NOB) Nutrition Officer (NOB), WASH Specialist (NOC), PMTCT Officer (NOB) and Programme Assistant (GS6).

Key Expected Results

• Timely, regular data-driven analysis for effective prioritization, planning, development and results-based management for scaling-up specific Child Survival & Development interventions under UNICEF programme of collaboration in Tanah Papua.
• Technical expertise on specific Child Survival & Development (maternal, newborn and child health, nutrition, WASH and PMTCT) interventions.
• Technical and operational guidance provided to key government and non-government partners on scaling-up and replication of best practices .
• Monitoring, evaluation and reporting on specific Health& Nutrition interventions carried out through various field visits, in a timely manner, efficiently, rigorously and transparently in compliance with the established guidelines and procedures.
• Government and non-government recipients accountable for UNICEF specific supply, non-supply and financial assistance.
• Effective knowledge management through documentation and dissemination of lessons learned and implementation of appropriate capacity building activities.
• Integration of rights-based approaches and humanitarian principles in related Child Survival & Development interventions.
• Effective communication, networking and leveraging achieved through partnership and collaboration with related government and non-government partners.

Qualifications of Successful Candidate

• Advanced university degree in one of the disciplines relevant to the following areas: Public Health, Medicine, Health Research, International Health, Health Policy and Management, Environmental Health Sciences, Family Health, Biostatistics, Socio-medical Sciences, Epidemiology, Health Education, Health Promotion and Disease Prevention, Educational Interventions in Health Care, Nursing or a field relevant to international development assistance in Health.
• Five years of relevant work experience and awareness of the technical support required in health related emergency and humanitarian preparedness.
• Experience working in the UN or other international development organization, and field work experience an asset.
• Background/familiarity with Emergency.
• Fluency in English and another UN language. Knowledge of the local working language (Bahasa Indonesia) of the duty station would be an asset.

Competencies of Successful Candidate

• Communicates effectively to varied audiences, including during formal public speaking.
• Able to work effectively in a multi-cultural environment.
• Sets high standards for quality of work and consistently achieves project goals.
• Has good leadership and supervisory skills; co-ordinates group activities, ensuring that roles within the team are clear.
• Translates strategic direction into plans and objectives.
• Analyzes and integrates diverse and complex quantitative and qualitative data from a wide range of sources.
• Quickly builds rapport with individuals and groups; maintains an effective network of individuals across organizational departments.
• Identifies urgent and potentially difficult decisions and acts on them promptly; initiates and generates team- and department-wide activities.
• Demonstrates, applies and shares expert technical knowledge across the organization.

UNICEF is committed to diversity and inclusion within its workforce, and encourages qualified female and male candidates from all national, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of our organisation.

Working together for children

The principles of partnership

At UNICEF, we understand that one single organization cannot meet the needs of every child. That is why we are always looking for ways to match our own skills and resources with others, to maximize the impact on mothers and children across Indonesia.

We look especially at how partnerships can help to achieve three important goals to:

1. Improve public policy
2. Strengthen technical capacity and 
3. Develop innovative approaches and practices. 

Partnerships involving UNICEF Indonesia aim to add value to existing efforts. Partnerships require investments of management time and sometimes financial resources; so when identifying and exploring potential partnerships, we focus on how those partnerships can really change the lives of children.

Partners in Indonesia


Partnership with UNICEF Indonesia
UNICEF works with a wide range of partners in Indonesia - some examples are included in the links below, but this is far from being an exhaustive list.

We collaborate very closely with the Government of Indonesia – at national level and with its representatives at provincial and district level – to manage our overall work for women and children in Indonesia in support of the government's national development plan. This includes providing advice and guidance on how to strengthen policies and improve standards of services, and raising awareness within government on where child rights are not being fully upheld and where more inputs or resources are needed.

We work with civil society groups – such as faith-based organizations and community networks – to take advantage of their ability to reach out and influence others especially at grassroots level, and where their potential to advocate for child rights is substantial.

We partner with academic organizations, using the skills and expertise of high caliber institutions to provide better data and understanding of issues affecting women and children, and to raise technical standards among practitioners.

We engage with the private sector to benefit from their technical know-how and entrepreneurship to test innovative ways of improving services for the most vulnerable mothers and children, as well as to raise much-needed funds to support our work.

And we work with other specialist agencies, including those of the United Nations, donor agencies, and non-governmental organizations to help deliver programmer for children together and to ensure a range of skills and resources benefit children.

UNICEF..what we do

1. Health and Nutrition                                                                                                                    The number of children who die before their 5th birthday is falling in Indonesia, and less mothers lose their lives due to problems in pregnancy - but still mortality rates are too high, and too many children and women face unnecessary threats to their health. We work to improve knowledge of health and nutrition, support improved standards and quality of services, and help those responsible for health care to make informed decisions about how to allocate resources.
2. Basic Education For All                                                                                                           We work with the Government of Indonesia, educationalists, local communities and others to ensure more children stay in school to complete their education, support the quality of education and teaching standards, and look for innovative ways to help more children benefit from learning, both inside and outside formal classrooms.
3. Child Protection                                                                                                                 UNICEF works with a wide range of partners to ensure every Indonesian child is afforded full protection of its rights, in line with international standards, with special attention paid to the most vulnerable and at-risk children.
4. Fighting HIV/AIDS                                                                                                                  HIV and AIDS are a serious potential threat to the health and well-being of many Indonesians, but many people know little about the issue; we work to ensure that children and young people understand the risks of the HIV virus, how to protect themselves against it, and to promote respect and understanding for those living with HIV and AIDS.
5. Water and Environmental Sanitation                                                                                 Ensuring families in the most vulnerable communities have access to clean water and good sanitation, and know how to protect their health through effective hygiene are all critical parts of UNICEF's work in Indonesia.

MAIN TASKS AND RESPONSIBILITIES:

  Child Survival & Development (CSD) Specialist 

1. Child Survival & Development (CSD) Specialist is responsible for the development, coordination, management, planning and implementation of the health, nutrition, WASH and HIV services and system strengthening approach of UNICEF Indonesia.
2.  The post will provide strategic leadership in delivery of technical assistance of the programme, innovation and knowledge sharing in systems which respond to the survival and developmental needs of children and women in the eastern Indonesia. 
3. Accountable for effective technical and programme support to facilitate the evidence-generation, policy works and scaling up interventions with government partners and other stakeholders; 
4. Making sure that all will be aligned with UNICEF-GoI Country Programme Action Plan, and national programme priorities, including the attainment of the Sustainable Development Goals agenda. Provide support and supervision to zone office CSD team: Health Officer (Health System NO-B), WASH Officer (NO-B) and Nutrition Officer (NO-B) all based 
5. Timely sectoral analysis, input and support contribute to the Situation Analysis and its periodic update for effective programme planning, development and management.
6. Contributes to the preparation of the Situation Analysis by compiling, analysing and evaluating information and providing the technical input and support to child survival & development (CSD) interventions and its periodic update.
7. Prepares sectoral input to the Country Programme Document and all related documents (e.g., Country Programme Recommendation, Plans of Action, and Country Programme Summary Sheet). 
8. Contributes to the consultation and coordination with key partners at all levels.

United Nations Development Programme (UNDP

The United Nations Development Programme (UNDP) is the United Nations' global development network.Headquartered in New York City, UNDP advocates for change and connects countries to knowledge, experience and resources to help people build a better life. It provides expert advice, training, and grant support to developing countries, with increasing emphasis on assistance to the least developed countries.

The status of UNDP is that of an executive board within the United Nations General Assembly. The UNDP Administrator is the third highest-ranking official of the United Nations after the United Nations Secretary-General and Deputy Secretary-General.

To accomplish the MDGs and encourage global development, UNDP focuses on poverty reduction, HIV/AIDS, democratic governance, energy and environment, social development, and crisis prevention and recovery. UNDP also encourages the protection of human rights and the empowerment of women in all of its programmes. The UNDP Human Development Report Office also publishes an annual Human Development Report (since 1990) to measure and analyse developmental progress. In addition to a global Report, UNDP publishes regional, national, and local Human Development Reports.

UNDP is funded entirely by voluntary contributions from member nations. The organization operates in 177 countries, where it works with local governments to meet development challenges and develop local capacity. Additionally, the UNDP works internationally to help countries achieve the Millennium Development Goals (MDGs). Currently, the UNDP is one of the main UN agencies involved in the development of the Post-2015 Development Agenda.
UNDP works with nations on their own solutions to global and national development challenges. As they develop local capacity, they draw on the people of UNDP and its wide range of partners.[4]

The UNDP was founded on the 22nd of November 1965 with the merger of the Expanded Programme of Technical Assistance or EPTA and the United Nations Special Fund.[5] The rationale was to "avoid duplication of [their] activities". The EPTA was to help the economic and political aspects of underdeveloped countries while the Special Fund was to enlarge the scope of UN technical assistance.

Budget
In 2013, UNDP’s entire budget was approximately 5 billion USD.

Functions

• UNDP’s offices and staff are on the ground in 177 countries, working with governments and local communities to help them find solutions to global and national development challenges.
• UNDP links and coordinates global and national efforts to achieve the goals and national development priorities laid out by host countries. 

UNDP focuses primarily on 5 developmental challenges:
Democratic governance
UNDP supports national democratic transitions by providing policy advice and technical support, improving institutional and individual capacity within countries, educating populations about and advocating for democratic reforms, promoting negotiation and dialogue, and sharing successful experiences from other countries and locations. UNDP also supports existing democratic institutions by increasing dialogue, enhancing national debate, and facilitating consensus on national governance programmes.

Poverty reduction
UNDP helps countries develop strategies to combat poverty by expanding access to economic opportunities and resources, linking poverty programmes with countries’ larger goals and policies, and ensuring a greater voice for the poor. UNDP also works at the macro level to reform trade, encourage debt relief and foreign investment, and ensure the poorest of the poor benefit from globalisation.
On the ground, UNDP sponsors developmental pilot projects, promotes the role of women in development, and coordinates efforts between governments, NGOs, and outside donors. In this way, UNDP works with local leaders and governments to provide opportunities for impoverished people to create businesses and improve their economic condition.
The UNDP International Policy Centre for Inclusive Growth (IPC-IG)[1] in Brasília, Brazil expands the capacities of developing countries to design, implement and evaluate socially inclusive development projects. IPC-IG is a global forum for South-South policy dialogue and learning, having worked with more than 7,000 officials from more than 50 countries.
A 2013 evaluation of the UNDP’s poverty reduction efforts states that the UNDP has effectively supported national efforts to reduce poverty, by helping governments make policy changes that benefit the poor.[9] Nevertheless, the same evaluation also states there is a strong need for better measurement and monitoring of the impacts of the UNDP's work.[10] The UNDP’s Strategic Plan 2014-2017 incorporates the recommendations of this poverty evaluation.

Crisis prevention and recovery
UNDP works to reduce the risk of armed conflicts or disasters, and promote early recovery after crisis have occurred. UNDP works through its country offices to support local government in needs assessment, capacity development, coordinated planning, and policy and standard setting.
Examples of UNDP risk reduction programmes include efforts to control small arms proliferation, strategies to reduce the impact of natural disasters, and programmes to encourage use of diplomacy and prevent violence.
Recovery programmes include disarmament, demobilization and reintegration of ex-combatants, demining efforts, programmes to reintegrate displaced persons, restoration of basic services, and transitional justice systems for countries recovering from warfare.

Environment and Energy
As the poor are disproportionately affected by environmental degradation and lack of access to clean, affordable water, sanitation and energy services, UNDP seeks to address environmental issues in order to improve developing countries’ abilities to develop sustainably, increase human development and reduce poverty. UNDP works with countries to strengthen their capacity to address global environmental issues by providing innovative policy advice and linking partners through environmentally sensitive development projects that help poor people build sustainable livelihoods.
UNDP’s environmental strategy focuses on effective water governance including access to water supply and sanitation, access to sustainable energy services, Sustainable land management to combat desertification and land degradation, conservation and sustainable use of biodiversity, and policies to control emissions of harmful pollutants and ozone-depleting substances. UNDP's Equator Initiative office biennially offers the Equator Prize to recognize outstanding indigenous community efforts to reduce poverty through the conservation and sustainable use of biodiversity, and thus making local contributions to achieving the Millennium Development Goals (MDGs).

HIV/AIDS
HIV/AIDS is a big issue in today's society and UNDP works to help countries prevent further spreading and reduce its impact, convening The Global Commission on HIV and the Law which reported in 2012

Hub for Innovative Partnerships
Major programmes underway are:[13]

ART Global Initiative
World Alliance of Cities Against Poverty
Territorial Approach to Climate Change
Africa–Kazakhstan Partnership for the SDGs
Human Development Report[edit]
Since 1990, the UNDP has annually published the Human Development Report, which includes topics on Human Development and the annual Human Development Index.[3]

Evaluation
The UNDP spends about 0.2% of its budget on internal evaluation of the effectiveness of its programmes.[14] The UNDP’s Evaluation Office is a member of the UN Evaluation Group (UNEG) which brings together all the units responsible for evaluation in the UN system. Currently the UNEG has 43 members and 3 observers.[15]

Global Policy Centers
The UNDP runs six GPCs, including the Seoul GPC on partnerships, and the Global Center for Public Service Excellence that issues the influential 'Raffles Review' on developments in public administration research.

UN co-ordination role
UNDP plays a significant co-ordination role for the UN’s activities in the field of development. This is mainly executed through its leadership of the UN Development Group and through the Resident Co-ordinator System.

United Nations Development Group
The United Nations Development Group (UNDG) was created by the Secretary General in 1997, to improve the effectiveness of UN development at the country level. The UNDG brings together the operational agencies working on development. The Group is chaired by the Administrator of UNDP. UNDP also provides the Secretariat to the Group.
The UNDG develops policies and procedures that allow member agencies to work together and analyse country issues, plan support strategies, implement support programmes, monitor results and advocate for change. These initiatives increase UN impact in helping countries achieve the Millennium Development Goals (MDGs), including poverty reduction.
32 UN agencies are members of the UNDG. The Executive Committee consists of the four "founding members": UNICEF, UNFPA, WFP and UNDP. The Office of the High Commissioner for Human Rights is an ex-officio member of the Executive Committee.

Resident coordinator system
The Resident Coordinator (RC) system co-ordinates all organizations of the United Nations system dealing with operational activities for development in the field. The RC system aims to bring together the different UN agencies to improve the efficiency and effectiveness of operational activities at the country level. Resident Coordinators, who are funded, appointed and managed by UNDP, lead UN country teams in more than 130 countries and are the designated representatives of the Secretary-General for development operations. Working closely with national governments, Resident Coordinators and country teams advocate the interests and mandates of the UN drawing on the support and guidance of the entire UN family.It is now coordinated by the UNDG.[16]

Criticism
The UNDP has been criticised by members of its staff and the Bush administration of the United States for irregularities in its finances in North Korea. Artjon Shkurtaj claimed that he had found forged US dollars in the Programmes safe while the staff were paid in Euros. The UNDP denied any wrongdoing, and keeping improper accounts.

Disarmament and controversy
In mid-2006, as first reported by Inner City Press and then by The New Vision, UNDP halted its disarmament programmes in the Karamoja region of Uganda in response to human rights abuses in the parallel forcible disarmament programmes carried out by the Uganda People's Defence Force.