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The double economic shocks of the Ebola Virus Disease (EVD) epidemic in Sierra Leone and the fall in commodities prices, had a severe social and economic impact on the country.  Recognising that recovery needed to go beyond usual practice and instead take a comprehensive approach to building in future resilience, His Excellency President Ernest Bai Koroma introduced a 24-month recovery process in March 2015, which would be divided into two phases.

 

The first phase - Early Recovery (6-9 months) - ended on 31st March 2016 and an independent evaluation was commissioned to assess the results achieved. It also identified challenges and lessons learned, to improve the implementation of recovery priorities during the second phase of the President’s Recovery Priorities (April 2016-June 2017).

 

The primary target group for this evaluation was direct beneficiaries of the initiatives implemented for the Early Recovery phase (6-9 months) of the President’s Recovery Priorities. Other targeted groups included indirect beneficiaries (i.e. local level population) as well as other stakeholders.

 

The evaluation is based on a desk review, focus groups and interviews, with a cluster sampling methodology used to select study sites, based on the level of concentration of 6-9 months’ Early Recovery plan activities, and beneficiaries to be surveyed.  The districts selected were:  Bo and Moyamba (Southern Region), Kono and Kailahun (Eastern Region), Port Loko and Bombali (Northern Region), and Western Area (Urban and Rural).[1]  

 

Key activities and findings by sector:

 

Health sector

 

Key activities:

Restoring Basic Health Services: Infection prevention and control (IPC), triage, isolation and integrated disease surveillance and response in all health facilities in the country; providing safe drinking water to a majority of community health centres; restoring and expanding the free health initiative; providing reproductive, maternal, new born and child health (RMNCH) services; HIV, tuberculosis and malaria treatment provision.

 

Key results: 

• Facilities are more likely to have received support for infection prevention control (IPC), malaria, supply chain and immunisation. In the case of IPC, frequent assessment of compliance has been done during the recovery period while NGOs have continued further training to improve compliance. 

• The application of a triage system to curtail the spread of infection seems well grounded. New isolation units have been built during the Early Recovery period at some sampled health facilities - Bombali, Kono and Kailahun.

• Even though WASH facilities are widely available, and bore holes have been constructed in some facilities, the pressing challenge is around availability of regular water supply. Some facilities with infrastructure for pipe borne water lack running water, while other facilities, which rely on wells, have to make contingency plans for periods during which wells dry up.

• Supply chain management (or drug availability) has improved, though feedback on drug stock out was also received at facilities visited in Moyamba and Kono, for example. In addition to stock out of some critical drugs, the supplies received during each distribution cycle may be substantially lower than that requested.

 

Key recommendations:

• Continued diligence in IPC education and training at the local level; adding an IPC monitor/quality assurance manager will ensure long-term sustainability, and will facilitate repeated trainings and knowledge transmission. 

• Intensify sensitisation activities to increase immunisation coverage especially in hard to reach and among mobile communities.

• Undertake a systematic evaluation of all WASH facilities in order to provide equal access at all facilities; construction and restoration of water wells, latrines and incinerators is necessary.

• Continued and regular training on IDSR, the construction of permanent triage and isolation units, or the provision of grants for health facilities to build these facilities will ensure the maintenance of correct procedures and standards.

 

Education

 

Key activities:

Returning Children to School Safely: WASH facilities in all of the country’s schools and tertiary institutions, with 100% protocol compliance; schools fees to be waived for all students in government supported schools; food to be provided for all primary school children; aim for 100% attendance rates; create special needs programmes; train teachers; reduce class sizes; decontaminate the educational institutions that were used as holding and treatment centres for EVD victims. 

 

Key results:

• Five of the seven indicators assessed - WASH in schools, accelerated learning, social mobilisation and school fee waiver - were earmarked for roll out on a national scale, during the Early Recovery period.  Two indicators- special needs initiative for pregnant school girls and the initiative to reduce overcrowding in classrooms - were targeted for selected areas.

• Special needs education for returning pregnant girls back to school rated a remarkable success and targets were far exceeded: Western urban, for example, planned enrolment was 204 girls- actual was 2,165, with > 1,800 already returned to school.

• At sampled schools: i) all have received accelerated learning materials from government, UNICEF or NGOs;  ii) all teachers have been trained in use of accelerated learning materials and this has helped to get them proficient in using the resources. 

 

Key recommendations:

• Prioritise the furnishing of all newly built classrooms. Classrooms should be utilised regardless of commissioning status, which can happen at a convenient time.

• Supply schools with more materials, and ensure that all teachers are trained in the use of materials and relevance of timely usage. This will ensure that educational gains made as part of this programme endure.   

• The GoSL to ensure that funds are delivered promptly to all schools across the country. School leadership on their part must put in place strong accountability systems to ensure funds received are properly accounted for and within the recommended reporting schedule. This is necessary to avoid interruption of funding flow to cover school fees.

• The GoSL and local governments must work in concert to build new WASH facilities at all schools.

• There is need to institute a tracking system for the special needs initiatives to monitor dropout and the reasons for dropout. The lessons learnt should be used to improve on expansion plans for the initiative in other schools.

 

 

Social Protection

 

Key activities:

Protecting the Vulnerable: Strengthen social protection information systems; provide income support for 150,000 households; develop social protection and support systems focusing especially on EVD survivors and orphans of EVD victims.

 

Key results:

• Both NaCSA and the Ministry of Social Welfare, Gender and Children’s Affairs, which are the two agencies coordinating Social Protection activities have functional data bases to track support provided to beneficiaries      

• Income transfer has taken place as confirmed by household beneficiaries as well as Ebola survivors.

• The amount received per cash transfer differs by respondent, location and organisation. Respondents also report receiving cash transfers from different organisations at different intervals.

• MSWGCA social workers are providing support to beneficiaries, including EVD survivors: Beneficiaries are counselled about how and where to seek health services, about personal care, as well as guidance on how to access income support

 

Key recommendations:

• Continue unconditional cash transfers, but improve on the targeting process.

• NaCSA should maintain an inventory of IPs implementing cash transfers, and should develop guidelines for disbursement given that recipients receive cash transfer from different sources and at different intervals.

• Increase local businesses and overall employment.    

 

Private Sector

 

Key activities:

Private Sector Recovery: Provide seed and fertilizer support for 100,000 farmers; improve market access for farmers by creating and transforming 50 agricultural business centres, refurbishing 20 rice and cassava processors; rehabilitating 1800 km of feeder roads; recapitalizing financial institutions and ensuring access to finance for 125,000 farmers and petty traders.

 

Key results:

• 73,000 farming households were supported with seeds; some with fertilisers, as well.

• While community interviews confirmed that the quantity of seeds supplied varied across locations, the overall view was that quantity of seeds supplied was inadequate.

• Farmers use local financial institutions and like using them.

• Only two sampled communities confirmed road work happened this period- Kamakwie and Kakamba, both Bombali district.

• Agricultural Business Centres (ABCs) are functional and are being used.

 

Key recommendations:

• Conduct an assessment to determine the quantity of seeds and fertilisers actually needed by farmers per community and ensure sufficient and timely supply.

• Prioritise feeder road construction.

• Establish new ABCs and delink access/right to purchase seeds, fertilisers and other facilities from ABC membership.

• Provide more loan opportunities for farmers in form of soft loans.

• Improve access to community banks

 

 

 

[1] Automatically selected because there are only two districts in the WA