House of Commons - International Development Committee

DFID's Assistance to Zimbabwe - International Development Committee Contents

Written evidence submitted by World Vision UK

World Vision is a Christian relief, development and advocacy organisation dedicated to working with children, their families and communities to overcome poverty and injustice. Motivated by our Christian faith, and the belief that no child should live in poverty, we work with communities of all faiths and none to improve the lives of children. We are the world's biggest local charity, working in 100 countries and helping 100 million people worldwide. We have three million supporters and employ 40,000 locally based staff, 97% of whom are nationals of the country in which they work.

World Vision believes the best way to change the life of a child is to change the world in which they live. We see children and their communities as active participants in shaping a better future, empowering them to find sustainable solutions to poverty.

World Vision welcomes this opportunity to provide written evidence to the International Development Select Committee on DFID's assistance to Zimbabwe. Our evidence considers both the approach of the UK Government's Department for International Development (DFID) to assistance to Zimbabwe and some of the thematic areas in which it works.

1. WORLD VISION IN ZIMBABWE—OUR WORK AND RELATIONSHIP WITH DFID

1.1 World Vision started operating in Zimbabwe in 1973 mainly through supporting alternative care options for children. The organisation's main focus was to offer relief to Zimbabweans in holding camps and institutions. After independence in 1980, the focus changed to rehabilitation and small-scale development programs. World Vision Zimbabwe now has 24 Area Development Programs[153] across the country and 10 Relief Districts that are located in marginal areas. Major areas of programming are health, water and sanitation, food security, education, HIV and AIDS.

1.2 Our experience of working with DFID Zimbabwe has been, on the whole, very positive. World Vision has had a funding arrangement under the Protracted Relief Programme (PRP 1) since 2005 and is currently working under PRP II, to implement programming in food security, social protection, water and sanitation, partner capacity building and co-ordination in Bulawayo and the two adjacent rural Districts of Matobo and Insiza. Under PRP II, World Vision is working to prevent destitution and protect and promote livelihood opportunities of the poorest and most vulnerable households by focusing on building the resilience of vulnerable households to cope with transitory and chronic shocks to their current livelihood strategies.

1.3 Since 2007, World Vision's other area of direct engagement with DFID funding has been with UNICEF on the Programme Of Support to the National Action Plan for Orphans and Vulnerable Children (NAP POS for OVCs) to support the education, food security and the provision of health care for OVCs in 9 rural districts across Zimbabwe. Through implementing this programme, World Vision has worked to support and build capacity in Community Based Organisations (CBOs) through training and subgranting; thereby economically empowering communities to better care for OVCs. 11,508 OVCs are currently being supported by CBOs under this programme; through income generating activities, provision of educational supplies and social protection work. This programme also works to develop mechanisms for meaningful child participation and providing greater food security in the community.

2. DFID'S APPROACH IN ZIMBABWE

2.1 World Vision welcomes DFID's continued engagement in Zimbabwe in support of the nation's recovery. In particular, we welcome the announcement in 2009 that DFID's support for Zimbabwe would increase in the 2009-10 period from £40 million to £60 million with a focus on those who are most vulnerable. DFID programmes must be designed to facilitate government-to-government assistance when political conditions allow. As DFID moves towards a focus on long term recovery, every effort must be made to build the capacity of the Government of Zimbabwe to make the necessary social and economic reforms for sustainable development.

2.2 As a child focused non-governmental organisation (NGO), World Vision supports DFID's focus on supporting the vulnerable. Specific policies have worked to ensure that DFID addresses key vulnerabilities:

International Food Policy Research Institute

— DFID Sustainable Livelihood Framework.

— DFID paradigm of "Provision, Protection and Promotion".

Supporting children's rights

2.3 World Vision believes that children are among the most vulnerable populations in Zimbabwe. Zimbabwe has seen a worrying and rapid decline in children's rights indicators. Recent projections of the percentage of Zimbabwe's children orphaned due to AIDS in 2010 have been put at 88.8%.[154] The economic conditions have led to an increase in rates of child abuse, such as child labour, forced marriage and physical and sexual abuse.[155] Indeed, recent focus group discussions with children in one of World Vision's areas of operation confirmed that emotional and physical abuse, forced labour, forced marriage, lack of food and ill health were among the key issues they were facing (see annex 1).

2.4 Given DFID's commitment to the most vulnerable in Zimbabwe, World Vision believes that a Child Rights Situational Analysis (CRSA) should be used to inform DFID's Country Assistance Plan (CAP) for the country.[156]

2.5 A CRSA is an analysis of the extent to which children's rights have been realised and the factors affecting this within a particular country. The benefits of undertaking a CRSA are:

— it would enable the status of children's rights and well-being to be monitored and can be used to guide the way in which DFID delivers and monitors the impact of aid in order to ensure that children are taken into account;

— it can challenge preconceptions about development and how it works and can provide a unique and illuminating perspective on "old" problems; for example, looking at child budget analyses can highlight discrepancies between resources allocated to fulfilling children's rights and resources allocated to military expenditure; and

— it provides a different perspective on governance structures and might flag up crucial areas of concern such as an erosion of space for children and young people to participate in society and to be involved in decisions taken by government which affect them.

2.6 Undertaking a CRSA as part of DFID's development of its CAP for Zimbabwe will also allow DFID to better engage with the Government of Zimbabwe on issues affecting the wider population in the country. A report in September 2007, commissioned by World Vision UK and others[157] in partnership with DFID, highlighted the fact that DFID Zimbabwe is already prioritising children's rights issues in its interactions with the Government of Zimbabwe, as the de-politicised nature of children's rights in Zimbabwe serves as a useful entry point for the discussion of wider issues. For example, an examination of the situation for children in prison enabled a discussion on the highly sensitive issue of the condition of prisons generally. Following a parliamentary committee report on this issue, World Vision Zimbabwe has been able to support efforts in this area.[158]

Coordinating with other donors

2.7 DFID Zimbabwe is currently leading the Donor Steering Committee in the country. World Vision commends their leadership in this but believes that coordination among donors needs to be further improved in order to address current inconsistencies and overlaps in donor funding. Though we are encouraged to see the formation of a Multi-Donor Trust Fund (MDTF) and DFID's pivotal role in the development of this, we urge DFID to go beyond this initiative and lead the development of a broader common strategy among donors for Zimbabwe which should include common needs and especially impact assessments for the whole country. Though the latter is happening to a certain extent through the cluster system, it should also be a factor of assessments for recovery in long term development.

Removing barriers to civil society effectiveness

2.8 Throughout our work with DFID, through their Management, Technical, Learning & Coordination Unit (MTLC) under PRP II, we have found them interactive, flexible and understanding of the context in which we work. The implementation of PRP II has been greatly helped by the highly participatory nature of DFID's design process, which takes into consideration local realities and changing contexts. Further, interaction with DFID in Zimbabwe has included work to build capacity for the monitoring and evaluation of World Vision's projects and the flexible channelling of additional funds in order to meet programme goals.

2.9 However, MTLC's impact measurement and meeting requirements are, at times, excessive and a symptom of a lack of internal coordination. For example:

— monthly and quarterly narrative and financial reports are required and training and data collection for Longditudinal Impact Monitoring & Evaluation (LIME) regularly requires two weeks for assignments of World Vision Monitoring and Evaluation staff to monitor other partner's programmes;

— monitoring and evaluation of the PRP II programme demands excessive requirements for meeting attendances with an average of three meetings and/or training programmes a month, called by various sectoral teams of MTLC. These meeting are often called at relatively short notice, which undermines World Vision's ability to make the journey to attend; and

— compliance and field visits to all the target districts by the various technical support units and monitoring and support visits of the PRP II technical partners are numerous and impacts upon World Vision's capacity to deliver quality programmatic work.

2.10 In order to cut back on the bureaucratic impediments to the delivery of PRP II, we strongly recommend that greater coordination within the MTLC is encouraged through simple systemic changes which address to the silo-ed nature of the unit. A coordinated approach to implementing partner cooperation would put less strain on capacity, whilst retaining the same high quality of monitoring and evaluation and consistent indicators.

2.11 In addition, the initial success indicators developed for the PRP II programme were both unrealistic and too numerous. Although this has been recognised and is now being revised, World Vision believes that DFID's design process should have picked up this issue and the initial success indicator logframe should have been much leaner. Future programme design should learn from this with more realistic targets based on in-depth context analysis.

2.12 Partnering with UNICEF is an essential component of DFID's country engagement;[159] however, World Vision's interaction with UNICEF, in the NAP POS for OVC programme, has raised concerns about UNICEF's decision making and approval mechanisms—which are too centralised. As a result, processes are often lengthy and inflexible. Our projects have been, at times, negatively affected by UNICEF's slow procurement system; for example, motor cycles that were intended for use throughout the lifespan of the project were only delivered in the final year, whilst other vehicles were over a year late. Furthermore, disbursements can take up to three months after all the relevant documentation has been presented.

2.13 World Vision believes DFID should work with UNICEF to:

— streamline its decision making process, in order to ensure operational activities are not unnecessarily affected by bureaucratic impediments; and

— ensure that it provides a dedicated coordinator to oversee issues of disbursements and reports for PRP II.

World Vision also recommends more robust monitoring of UNICEF as a partner, in order to ensure programmatic success.

3. THEMATIC AREAS OF DFID'S WORK

Health and nutrition

3.1 Zimbabwe faces many long term complex issues in relation to health, including a high HIV prevalence rate, deteriorating livelihood conditions, pervasive poverty, environmental degradation, poor governance and economic shocks. Therefore DFID's attempts to support an improvement of health in Zimbabwe must look beyond the immediate humanitarian situation and also target the universal provision of basic health services, particularly for the most vulnerable members of the population.

3.2 During the past 10 years, the health system in Zimbabwe has been compromised by critical shortages of finance and declining infrastructure. Key health personnel have become demoralized by poor pay packages and their inability to practice their medical professions because of shortages of diagnostics, drugs and support systems. Many health professionals have left Zimbabwe, leading to a critical shortage of human resources especially in the rural areas. Many of the clinics established in rural areas during post-independence development are no longer functioning. Even in larger urban areas, health care has been dramatically compromised by the economic crisis in Zimbabwe. A number of District Hospitals have been closed in the past few months, and services at referral hospitals in major cities have been severely limited. The surveillance and monitoring of disease outbreaks depends to a great extent on having personnel in place at functional community health care clinics, so surveillance has also been severely compromised—to the extent that data completeness is estimated to be only 30%.

3.3 The impact of the decline in the health system is made clear by those statistics that are still being collected. A donor-backed Multiple Indicator and Monitoring Survey (MIMS), conducted in May 2009, reported an alarming 20% rise in under-five mortality compared to 1990 rates. Children in rural areas and those in the poorest section of the population are the worst affected and have least access to even basic health services. The 2009 survey also showed that half of pregnant women in rural areas are now delivering at home and that 40 % of all deliveries happen without a skilled attendant, posing huge dangers for both mothers and newborns. There have been suggestions that user fees and other financial barriers are limiting women's access to life-saving maternal health services.

3.4 World Vision believes that DFID's multi-country commitment to support access to quality health services free at the point of use[160] should be expanded to include Zimbabwe as a priority. Working within current limitations, DFID must continue to plan and implement health programmes in Zimbabwe that are designed to facilitate government-to-government assistance when political conditions allow. This is of particular importance with regards to DFID staffing in-country to ensure that sufficient technical health expertise is available, to support current and future health programming, and, for example, to facilitate assistance for Zimbabwe as required from the forthcoming Centre for Progressive Health Financing.

3.5 DFID's 2009 annual report attests the recent increase in child mortality and cites DFID efforts to address child mortality through vaccination and vitamin A supplementation. However, the majority of the child mortality burden in Zimbabwe is accounted for by HIV and AIDS, neonatal complications and infections, pneumonia and diarrhoea. World Vision believes it is important that DFID supports a comprehensive response to child health that is more systematic and thorough than can be delivered through biannual child health days.

3.6 Levels of chronic malnutrition have risen steadily over the past few years, with the latest data showing that one third of all children under the age of five in Zimbabwe are chronically malnourished.[161] As undernutrition contributes to over one third of child deaths globally, it will be almost impossible for Zimbabwe to reverse the worsening child mortality rates without addressing the critical issue of nutrition. DFID should ensure that they prioritise efforts to address the crisis of undernutrition in Zimbabwe, and that these are cross-sectoral in nature.

3.7 In line with the 2015 deadline of the MDGs, World Vision has launched a five year global campaign, Child Health Now, with the aim of galvanising support from communities to governments to renew commitments and progress towards MDGs 4 and 5 in particular—the two health-related goals that are currently furthest off track. World Vision is calling for a clear, costed and time-bound plan of action to address MDGs 4 and 5 for Zimbabwe, and all other countries with a high burden of child mortality. DFID and the international community have a duty of care to support national efforts to reach the MDG targets and to ensure that no national health plan is allowed to fail for lack of resources and support.

Humanitarian response

3.8 World Vision welcomes DFID's recognition and efforts to address the complex causes of vulnerability in Zimbabwe. DFID appropriately balances the needs of relief and transitional work in Zimbabwe; World Vision especially welcomes the focus on social protection and the rights of vulnerable groups. These policies have led the way for funding to be available to agencies not previously engaged with human rights issues. Across humanitarian contexts, funding that tackles the root causes, as well as the symptoms, of neglect and vulnerability is important for sustainability.

3.9 However, during the cholera outbreak in 2008-09 funding under PRP II was tailored more to mitigating the symptoms as opposed root causes. DFID should work together with other donors, NGOs, local councils and other frontline providers to ensure that humanitarian assistance is balanced with the developmental, particularly those addressed in sections 3.1 to 3.6. World Vision's analysis is that an innovative model of cooperation between these agencies to provide a holistic and coordinated humanitarian and development programme, would be very influential in tackling the proxy causes of humanitarian emergencies, such as the cholera outbreak.

3.10 The cholera outbreak has differed from previous outbreaks in being mainly urban and with a high case-fatality rate. Breakdown in the supply of clean water has been the main underlying cause but breakdown in health service delivery in Zimbabwe also contributed to the magnitude and severity of the outbreak.[162]

3.11 DFID's response was timelier than most donors and NGOs. However, all agencies, whether donor, NGO or Government, were slow to see the outbreak as a priority concern. A number of other factors contributed to the rapid spread of cholera. First, twice during 2008, the Government ordered a ban on all NGOs to stop operations. Second, available safe drinking water was increasingly difficult to access and sewerage was blocked due to poor maintenance. Finally, the poor health facilities and lack of awareness on how cholera spreads contributed to the lack of effectiveness in containing the epidemic.

3.12 Once the outbreak was seen as a priority, World Vision believes that the Cholera response, coordinated through the UNICEF-led WASH cluster, was well coordinated. PRP, in addition provided guidelines on a uniform approach to Participatory Health and Hygiene Education (PHHE) of PRP partners, especially in the promotion of the concept of "health clubs" for hygiene education and behaviour change. World Vision was lead agency for the responses in four clusters covering the provinces of Bulawayo, Mashonaland Central, Mashonaland East and Matabeleland South.

3.13 World Vision recommends that DFID promotes a community led response to any further humanitarian crisis in Zimbabwe. Communities are the first responders to any crisis and therefore there is a need to strengthen Community Disaster Preparedness Plans. Development must be done with disaster preparedness in mind for it to be sustainable, especially as many areas in Zimbabwe have poor access to clean water and sanitation facilities. In Bulawayo, the cases of cholera were very low compared with the cases of cholera in Harare. It is assumed that the reason for this is that since 2003, World Vision with partners have been working a) on a very large water and sanitation project in Bulawayo, b) on unblocking sewerage systems and c) garbage collection from the city council in all suburbs in Bulawayo, although the city council was on strike prior to the cholera outbreak.

Cash transfers and long-term recovery

3.14 World Vision recommends that DFID's programmatic focus should shift from short term relief to recovery. As part of this shift, we recommend that cash transfers should be a part of the PRP II. There is strong evidence that cash transfers protect and promote the livelihoods of households.[163] In conjunction with community level interventions, these projects would provide vulnerable households with cash for a certain period of time to enhance their ability to meet urgent food and non-food essential needs. Concurrently, these programmes would provide them with Income Generating Activity (IGA) support packages to enable them to move from cash transfer support. In addition, World Vision is pleased that DFID understand the benefits for cash transfers to the chronically vulnerable households with no or little capacity for IGA; the "exit" strategies for these households would be referral to government cash transfer/social protection programmes that have started in 2009 and that will likely be expanded during this and the following years.

3.15 As DFID moves towards a focus on long term recovery, every effort must be made to build the capacity of the Government of Zimbabwe to make the necessary social and economic reforms for sustainable development.

4. SUMMARY OF RECOMMENDATIONS

DFID's approach in Zimbabwe

1. DFID programmes must be designed to facilitate government-to-government assistance when political conditions allow. As DFID moves towards a focus on long term recovery, every effort must be made to build the capacity of the Government of Zimbabwe to make the necessary social and economic reforms for sustainable development.

2. Given DFID's commitment to the most vulnerable in Zimbabwe, World Vision believes that a Child Rights Situational Analysis (CRSA) should be used to inform DFID's Country Assistance Plan (CAP) for the country.

3. We urge DFID to go beyond this initiative and lead the development of a broader common strategy among donors for Zimbabwe which should include common needs and especially impact assessments for the whole country.

4. In order to cut back on the bureaucratic impediments to the delivery of PRP II, we strongly recommend that greater coordination within the MTLC is encouraged through simple systemic changes which address to the silo-ed nature of the unit.

5. Future programme design should learn from this with more realistic targets based on in depth context analysis.

6. World Vision believes DFID should work with UNICEF to: streamline its decision making process, in order to ensure operational activities are not unnecessarily affected by bureaucratic impediments; and ensure that it provides a dedicated coordinator to oversee issues of disbursements and reports for PRP II. World Vision also recommends more robust monitoring of UNICEF as a partner, in order to ensure programmatic success.

Thematic areas of DFID's work

7. DFID's attempts to support an improvement of health in Zimbabwe must look beyond the immediate humanitarian situation and also target the universal provision of basic health services, particularly for the most vulnerable members of the population.

8. World Vision believes that DFID's multi-country commitment to support access to quality health services free at the point of use should be expanded to include Zimbabwe as a priority. Working within current limitations, DFID must continue to plan and implement health programmes in Zimbabwe that are designed to facilitate government-to-government assistance when political conditions allow. This is of particular importance with regards to DFID staffing in-country to ensure that sufficient technical health expertise is available, to support current and future health programming, and for example to facilitate assistance for Zimbabwe as required from the forthcoming Centre for Progressive Health Financing.

9. World Vision believes it is important that DFID supports a response to child health that is more systematic and thorough than can be delivered through biannual child health days.

10. World Vision is calling for a clear, costed and time-bound plan of action to address MDGs 4 and 5 for Zimbabwe, and all other countries with a high burden of child mortality. DFID and the international community have a duty of care to support national efforts to reach the MDG targets and to ensure that no national health plan is allowed to fail for lack of resources and support.

11. DFID should work together with other donors, NGOs, local councils and other frontline providers to ensure that humanitarian assistance is balanced with the developmental, particularly those addressed in sections 3.1 to 3.6.

12. World Vision recommends that DFID promotes a community led response to any further humanitarian crisis in Zimbabwe.

13. World Vision recommends that DFID's programmatic focus should shift from short term relief to recovery. As part of this shift, we recommend that cash transfers should be a part of the PRP II.

Annex 1

ISSUES AND HOPES IDENTIFIED BY CHILDREN IN A WORLD VISION-LED FOCUS GROUP IN ZIMBABWE IN NOVEMBER 2008

Age Group	Issues Identified	Hopes and Dreams	Comments and case stories (Through an interpreter)
8-12 year olds	"We think too much", emotional and physical abuse, illness, shouting and scolding, poverty	Adequate food, good furniture	The children said they think too much and used their local language to identify the emotional and psychological trauma they are experiencing from adults.
13-15 year olds	Beatings, lack of food, death of parents, forced marriage	School fees, food, jobs	A 15-year-old girl dreamed of being married with her truck driver boyfriend. She already has a small daughter. Since she told her story in her group (not interviewed), it is not known whether she is married or not, whether she was forced to marry, who the father of her child is.
16 year olds	Forced labour, poor transport network, poor education, poverty, lack of shelter	Clothing, good schools, good roads, clinics	Forced labour was not identified by adults during the visit.
17 year olds	Poor technical know-how, poor medical facilities, high inflation rate	Pass exams with high colours	It is interesting to see how this group have not also identified issues identified by younger children.
January 2010