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ANNUAL REPORT 2010PAKISTAN

Text: Fatima RajaEditing: Loa Magnusdottir & Pamela LedbetterCoordination: Margaretha Francia & Ban DhayiDesign: Muhammad Ali HashmiPhotography: Marta Ramoneda, A. Sami Malik, Shehzad Noorani, Zafar Ahmad Khan & Asad ZaidiAll photographs © UNICEF/Pakistan

ANNUAL REPORT 2010PAKISTAN

ContentSFOREWORD......................................................................................................................... 1

2010: YEAR IN REVIEW ..................................................................................................... 5

MATERNAL AND CHILD HEALTH CARE ............................................................................ 9 g Action .......................................................................................................................11 g Emergency Response ............................................................................................. 13 g Plans for 2011 .......................................................................................................... 14 g Partnerships ............................................................................................................. 15 g Case study: UNICEF supports efforts to fight malnutrition in Pakistan’s flood-

affected Sindh province ........................................................................................... 16

WATER, ENVIRONMENT AND SANITATION................................................................... 19 g Action ...................................................................................................................... 20 g Emergency Response ............................................................................................. 23 g Plans for 2011 .......................................................................................................... 23 g Partnerships ............................................................................................................. 24 g Case study: In tribal Bajaur, school sanitation and hygiene brings girls

back to school.......................................................................................................... 25

PRIMARY EDUCATION ..................................................................................................... 29 g Action ...................................................................................................................... 30 g Emergency Response ............................................................................................. 32 g Plans for 2011 .......................................................................................................... 33 g Partnerships ............................................................................................................. 33

g Case study: Temporary learning centres offer opportunities for children in Pakistan camps ....................................................................................................... 34

CHILD PROTECTION ......................................................................................................... 37 g Action ...................................................................................................................... 38.

g Emergency Response ............................................................................................ 40 g Plans for 2011 .......................................................................................................... 40 g Partnerships ............................................................................................................. 41 g Case study: Flash floods carry landmines from conflict zone .................................. 42

INNOVATIONS .................................................................................................................. 45 g Third party monitoring in humanitarian situations.................................................... 45 g GAVI support for strengthening civil society organizations ..................................... 47

CHILDREN OF THE FLOODS ............................................................................................. 48 g Sobia’s story ............................................................................................................ 49 g Umair’s story ........................................................................................................... 51

RESOURCE MOBILISATION ............................................................................................. 55 g Financial Resources ................................................................................................. 55 g Supplies ................................................................................................................... 56 g Human Resources ................................................................................................... 56

ACRONYMS ...................................................................................................................... 62

ANNUAL REPORT 2010 | 1

UNICEF Pakistan faced unprecedented chal-lenges in 2010, as did the government and people of my country. These challenges, howev-er, also brought opportunities to reach women and children who had previously not been reached with key services, such as health care, water and sanitation, education and protection.

In 2010, a natural disaster and the lasting effects of insecurity dominated UNICEF’s work with children in Pakistan. The massive floods during the monsoon season in July-September 2010 proved to be the greatest humanitarian disaster in the country’s history. The floods followed ongoing activities to assist the thou-sands of families affected by conflict in the country’s north-west, and came in the midst of efforts to improve Pakistan’s progress in fulfilling its commitments to children and women under the Millennium Development Goals (MDGs).

The devastating flooding of 2010 covered, at its height, one-fifth of the country, affecting 20 million people, and caused massive damage to key infrastructure. Relief efforts immedi-ately became UNICEF’s top priority. The sheer number and geographical spread of the popula-tion affected by the flooding was a major chal-lenge to humanitarian efforts, as was the pre-existing poverty, lack of coping mechanisms, and the limited capacity of partners. Insecurity and lack of access also posed challenges. Even in the face of these daunting problems, UNICEF Pakistan responded quickly and effectively when the floods began to make their way down the length of the country.

UNICEF Pakistan nearly doubled its staff temporarily in 2010, established emergency field offices in Multan, Sukkur and Hyderabad, and procured supplies worth nearly US$ 90 million, including local procurements worth US$ 41 million. By positioning staff members at the new emergency field offices, UNICEF

was able to identify and act upon needs and gaps in services with urgently needed speed and efficiency.

Major accomplishments included the vaccina-tion of 9.2 million children against polio and 8..2 million against measles. Safe drinking water was provided to 3.2 million people and sanita-tion facilities to 1.5 million. Another 1.9 million received hygiene messages to help protect themselves and their families against water-borne diseases. About 354,000 children and 111,000 women were screened for malnu-trition. To minimise disruption to schooling, 208.,000 children received school supplies, and 2,790 temporary learning centres were set up for 164,500 children. Over 223,000 children received psychosocial support and a safe envi-ronment for learning and recreation at 926 child-friendly spaces.

In a joint effort to alleviate the impact of emergencies on children and meet long-term development challenges, 2010 was a year in which UNICEF built new partnerships and strengthened old ones. Key collaborative part-nerships continued with government, and also within the humanitarian system. In responding to the floods, UNICEF was the lead agency for the Water, Sanitation and Hygiene Cluster, the Nutrition Cluster and the Child Protection sub-Cluster, and UNICEF co-led the Education Cluster with Save the Children. UNICEF also supported the Health Cluster and the Gender sub-Cluster. UNICEF deployed over 60 Cluster coordinators and information management staff to improve coordination during what turned out to be one of UNICEF’s largest humanitarian efforts in history.

UNICEF initiated the Cross-Cluster Survival Strategy with the World Health Organisation (WHO) and the World Food Program (WFP), to strengthen the joint response to health, water

FoReWoRD

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and sanitation, and nutrition issues. This inter-agency Survival Strategy enabled UNICEF and partner agencies to identify high-risk commu-nities, specific health risks and service gaps and ensure that life-saving assistance delivery was delivered.

In addition to the flood relief and recovery efforts, UNICEF continued to respond to the aftermath of earlier emergencies, including the displacement crisis of 2008.–2009 and recon-struction following the devastating earthquake of 2005. In addition, UNICEF responded to development challenges by supporting the national, provincial and district government on strengthening policies and standards, and filling urgent needs and capacity gaps by providing services to children and women through both government and civil society.

Pakistan is one of the eight countries pilot-ing the One UN Programme, which seeks to provide development assistance more effec-tively through improved coordination between the UN sister agencies. UNICEF participated actively in the programme, co-chairing the joint programmes on education and environment, and contributing to two other joint programmes.

UNICEF participated regularly in media brief-ings as a credible source of information on the ground in 2010. In addition, hundreds of media interviews and human interest stories were produced as part of UNICEF’s advocacy efforts. The country office’s website proved an impor-tant resource, receiving 26,000 hits in a single day. A presence on social networking sites was developed at the end of 2010.

Advocacy initiatives and campaigns to support the UNICEF Country Programme over the course of the year included the Healthy Hat Trick initiative, which conveyed key messages on good nutrition, improved sanitation and girls’ education with the engagement of the Pakistani cricket team. UNICEF advocated for a national sanitation programme targeting 48. million

people, with 18. million flood affectees as the first priority.

Freeing Pakistan from the scourge of polio remains a major challenge. In line with the agreed division of labour among polio partners, UNICEF took the lead on public advocacy, social communication and vaccine supply manage-ment. A notable success was achieved in advocacy when a gathering of religious leaders committed to polio immunisation.

The Multiple Indicator Cluster Survey (MICS) report for Khyber Pakhtunkhwa province was published, and the Balochistan MICS is nearing completion, while those for Punjab and Sindh were delayed by the flood emergency but are now under way.

The UNICEF-supported Multi-Cluster Rapid Assessment Mechanism (McRAM) enabled rapid assessments to be made of the situation of the flood affected population, and the results were used to prepare response plans, flash appeals and other donor proposals. It demon-strated, for example, that due to restricted mobility and lower literacy rates, women had less information than men on the floods and on the resources available to them, and limited access to aid. An important field monitoring initiative was introduced to strengthen monitor-ing the emergency response and early recovery in terms of UNICEF’s Core Commitments to Children in Emergencies, especially in access-constrained areas.

Nutrition surveys in flood-affected areas were conducted during the last quarter. They revealed emergency level global acute malnutrition (GAM) rates in Sindh and South Punjab, leading to intensified response in 2011.

Pakistan’s progress in achieving the MDGs by the target year of 2015 has been further jeopar-dised by the immense setbacks caused by the floods. According to World Bank estimates, the floods caused damage worth US$ 9.7 billion.1

1 World Bank. 2010. Press release 2011/134/SAR, 14 October 2010, “ADB-WB Estimate Pakistan Flood Damage at $9.7 Billion”.


About 1.9 million homes were damaged, and it is estimated that child mortality in the affected areas may rise by 10 per cent in the coming year.2 Primary school enrolment and completion were already low in many affected areas, and these will suffer further with 10,000 schools damaged in the floods, the interruptions in the academic year, and losses of livelihood, which may cause many families to withdraw their chil-dren from school. Protection issues of concern in the coming months include trafficking, early marriage and child labour, as well as violence and exploitation. In areas affected by the conflict, children also require protection from unexploded ordnance and child recruitment.

A major constitutional development, which UNICEF is adapting to in 2011, is the passage of the 18.th Amendment to the Constitution of Pakistan, which significantly decentralised revenue and service delivery responsibilities to provincial governments. This will require policy work at the provincial level, to mirror achievements at the national level, and new modes of planning to mitigate the risk of inequality due to diverse resource distribution between provinces.

At UNICEF Pakistan, we are turning the many challenges that we faced in 2010 into opportu-nities. During relief work following the floods and the displacement crisis, we were able to reach many children who had not previously attended school or had access to health care, immunisation services or nutrition support. When insecurity and lack of access cut off people, we developed innovative new means of reaching the unreached, using cars, boats, heli-copters, planes, donkeys and our own feet to bring services where they were most needed. My colleagues and I at UNICEF Pakistan are committed to working closely with our partners; government, civil society, donors, and, most importantly, the people and communities, to fulfil all rights of all Pakistani children.

Dan RohrmannRepresentativeUNICEF Pakistan

2 United Nations Pakistan. 2010. “The Human Cost of the Floods in Pakistan”.


2010: YeAR In ReVIeW

The year 2010 brought new challenges and achievements for UNICEF’s mandate in Pakistan. The worst natural disaster in

the country’s history called for a coordinated and strategic response by UNICEF, government counterparts and local and international part-ners to respond immediately and at scale to the flood that affected nearly 18. million people. While some communities still required relief assistance, early recovery and rebuilding can be prioritised in many flood affected areas in 2011.

Prior to the July-September floods, UNICEF’s ongoing work to improve the lives of children and women included two Mother and Child Weeks held in cooperation with government partners, community health workers and local civil society organisations and reaching 3.5 million children and a million pregnant women with low cost yet potentially lifesaving interven-tions and information. National guidelines were developed to help support children affected by HIV, and UNICEF supported the endorsement of an ordinance to promote better nutrition and feeding practices for children. Successful advo-cacy and technical assistance helped develop government policies and action plans on sanita-tion and water quality.

School sanitation and child-centred educa-tion were prioritised through the endorse-ment of national standards for child-friendly schools. During 2010, legislation, policies and services were put in place to create a structure that helps protect children from exploitation, violence and abuse at the federal and provincial levels. These included the Khyber Pakhtunkhwa and Pakistan Administered Kashmir Child Protection Policies and Child Complaint Offices established through the Children’s Ombuds-man’s Office.

The passage of the 18.th Amendment to the Constitution in March increased provincial

autonomy in sectors such as health, education, water and sanitation, and child protection. As provincial governments take up new responsi-bilities with new authority, UNICEF is restructur-ing its staff and budgets to ensure even stron-ger support to provincial governments.

UNICEF’s work in 2010 was dominated by the torrential monsoon rains that began in July 2010 resulting in six weeks of massive flood-ing. Over 18. million people, more than half of them children, were affected in a vast swathe

Map showing the extent of the damage brought by the floods. Source: OCHA, 16 August 2010

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of the country. At the height of the flooding, the water covered one fifth of the country, an area the size of Austria, Switzerland and Belgium combined.

According to government estimates, 1.9 million homes were damaged or destroyed. Key services, such as water, sanitation, health care and education, suffered serious damage and may take months or years to restore. A disaster needs assessment, focusing primarily on infra-structure, estimated that building back would cost US$ 7 billion, but building back with better designs and materials that would be resistant to flooding and earthquakes would cost at least US$ 10 billion.

As with most natural disasters, women and children suffered disproportionately. Prior to the floods, women had limited access to education and health care and limited means of generating income in the flood affected areas. The difficult conditions increased the risk of domestic abuse and gender-based violence. As families struggle to rebuild their livelihoods, children are at heightened risk of early marriage, removal from school to work or exploitative abuse.

Even before the floods, many areas were extremely fragile due to prior humanitarian crises and long-term development challenges. An estimated 36 per cent of the population of Pakistan, or 62 million people, live below the poverty line. Many others live just above the poverty line, and are extremely vulnerable to shocks. In particular, many of the flood affected areas suffer from entrenched inequalities in access to education and health care, and scant livelihood opportunities. The damage caused by the floods requires significant effort from every sector to address both immediate and longer-term needs.

When the floods struck, Pakistan was still strug-gling with a pre-existing humanitarian crisis. In addition to hosting about 1.6 million Afghan

refugees, more than three million people have been displaced over the past two years due to insecurity in north-western Pakistan, particularly in the Federally Administered Tribal Areas (FATA) and in Khyber Pakhtunkhwa3 province. While some families and individuals have returned to stabilised areas, over 1.3 million people remained displaced at the end of 2010.

Pakistan faces significant challenges in achiev-ing the Millennium Development Goals (MDGs) by 2015, especially those relating to education, poverty reduction and the health of mothers and children. Nearly one out of every ten Paki-stani children does not live to see his or her fifth birthday. Of these, half do not complete even a single month of life. Malnutrition is widespread, particularly in remote areas, contributing to this high mortality rate.

View of the flooded town of Ghari Khairoo in interior Sindh. © UNICEF Pakistan/2010/Ramoneda

3 Formerly known as the North-West Frontier Province (NWFP).


Pakistan reported a total of 140 wild poliovirus cases in 2010, higher than any other endemic country or country with re-established polio transmission. Challenges in polio eradication due to restricted access from the ongoing insecurity in Federally Administered Tribal Areas (FATA) and Khyber Pakhtunkhwa, and limitations in the quality of management and supervision of immunisation activities in Sindh and parts of Balochistan were also greatly exacerbated by the devastation and large-scale population displacement following the floods in 2010.

The 2010 floods are likely to increase poverty, keep more children out of school, reduce access to safe water, increase the spread of diseases, and reverse the advances in gender equality. It is estimated that in affected areas, child mortality may increase by 10 per cent following the floods. Nutrition surveys of flood affected areas in late 2010 showed shockingly high levels of stunting and emergency levels of moderate and acute malnutrition. It is likely that a large proportion of the population were already malnourished prior to the floods, and the concomitant shortages of food, clean water, and the prevalence of disease in the aftermath of the floods aggravated the nutrition situation. A grim reality is that over 2.8. million children under the age of five were affected by the floods. Expectations are that newborns, children and mothers will now be even more vulnerable to disease and malnutrition than they were before the floods.

At present, about 276 women are estimated to die from pregnancy-related causes for every 100,000 live births. This high maternal mortality rate could be lowered if women have access to skilled birth attendants as well as antenatal and postnatal care. The flood impact is expected to

reduce the pre-flood rate of skilled birth atten-dance from 39 per cent to 36 per cent, poten-tially increasing the maternal mortality rate.

Although Pakistan has made modest gains in improving the supply of clean drinking water and sanitation coverage in recent years, the setbacks caused by the floods makes it unlikely that the country will achieve its water and sani-tation-related MDG targets by 2015. Before the floods, only 75 per cent of the population had access to safe drinking water. In flood affected areas, this figure fell to only 55 per cent, greatly increasing children’s risk of contract-ing waterborne diseases, including diarrhoea, hepatitis and polio.

Almost half (43 per cent) of Pakistani chil-dren are out of school. With 10,000 schools damaged by the floods, and displacement affecting students and teachers alike, the education system is under severe strain. School enrolment and completion are likely to fall, especially for girls, as families keep their daughters at home due to economic reasons, lack of women teachers and inadequate sanita-tion facilities at schools.

Less than a third of children in Pakistan are registered at birth, which may exclude them from vital services, such as access to health care, education, and protection from child labour and trafficking. Many children are involved in child labour, and a third of girls are married before reaching 18. years of age. The floods increased the risk of exploitation, especially for children who are out of school. Major risks include gender-based violence, child labour, early marriage, sexual exploitation, traf-ficking, and psychosocial issues.

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MAteRnAL AnD CHILD HeALtH CARe

Nearly one out of every ten children born in Pakistan dies before his or her fifth birthday; half of these children

die before completing their first month of life. Though Pakistan experienced a decrease in infant mortality (deaths of children under one year of age) between 2002 and 2007, the rate of decrease is not enough to achieve the Millennium Development Goal of reducing child mortality by two thirds by 2015.

More than 2.8. million children under five years of age were affected by the floods in 2010. It is estimated that the flood devastation in some of Pakistan’s most deprived districts may cause child mortality in affected areas to rise by 10 per cent in the next year. The effects of this emer-gency are added to those caused by population displacement and ongoing insecurity in various areas in recent years.

Even before the floods, a major underlying cause of deaths amongst children under five years of age was poor nutrition, which is esti-mated to contribute to a third of child deaths worldwide. Chronic malnutrition is widespread in Pakistan, and the worst affected are children in remote and insecure areas where access is difficult and education levels are low, particular-ly amongst women. In Sindh and Punjab prov-inces, 18. per cent and 12 per cent of children suffer from wasting respectively, and about 6 per cent suffer from severe acute malnutrition, the most serious form of malnutrition.

A major contributor to malnutrition among young children is the low rate of exclusive breastfeeding. Only 37 per cent of children are fed exclusively on breast milk for the first six months of life. Many mothers are simply unaware of the importance of this prac-

Expenditure 2010 (US$)

69.50 million Total

9.01 million Core UNICEF Resources

19.88 million Resources from donors for development work

40.61 million Resources from donors for emergency and recovery work

Opposite: Mir Dadi, 22, sits with her twin babies in her tent in Bypass Camp for people displaced by flood on the outskirts of the city of Dera Allah Yar in Jaffarabad district of Balochistan province. The twins were delivered four days before her village was hit by floods. © UNICEF Pakistan/2010/Noorani

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tice or do not receive the support they need to breastfeed their babies.

Aside from the high rates of malnutrition amongst Pakistani children, iodine deficiency is common in many parts of the country. In children, iodine deficiency can result in impaired mental growth and development as well as learning difficulties. This can, however, be easily prevented if families use iodised salt.

Other contributors to Pakistan’s high child mortality rate include poor hygiene and sanita-tion, which can lead to infections and diseases. Vaccination rates are low, and children are vulnerable to preventable childhood diseases such as measles. Pakistan remains one of the four countries where polio is still endemic; indeed, the number of reported cases increased between 2009 and 2010. One reason for this is often lack of awareness among parents of the importance of taking preventive steps for their children. Weak local health care and immuni-sation management, preventing vaccination campaigns from reaching vulnerable children has also contributed to the problem.

A high proportion of Pakistani women die due to causes related to pregnancy and childbirth, with a maternal mortality ratio of 276 deaths per 100,000 live births. This figure, as well as the rates of child mortality, varies dramatically by residence, socioeconomic status and educa-tion. According to the Pakistan Demographic and Health Survey, Balochistan province has the highest maternal mortality in the country, with 78.5 deaths per 100,000 live births.

Maternal and newborn mortality rates fall dramatically if women receive regular antena-tal care from trained health workers who can monitor the progress of the pregnancy and give guidance on infant care. Yet only a third of pregnant women receive regular antenatal care, and 61 per cent give birth with the assistance of unskilled attendants (family members or traditional birth attendants) who are not trained in clean delivery practices and cannot recognise serious complications or know where to refer women for facility-based care.

At present, HIV is concentrated amongst high-risk groups comprising those using intravenous

A mother breastfeeds her baby at a breastfeeding corner located inside a UNICEF-supported Basic Health Unit in Basti Shahdu Khan village in Layyah district of Punjab province. © UNICEF Pakistan/2010/Marta Ramoneda


drugs and sex workers. Unfortunately, there is little understanding of the disease in Pakistan, necessitating awareness raising on HIV trans-mission and prevention.

ACTIONUNICEF’s Maternal and Child Health Care Programme aims to ensure that Pakistani moth-ers and children are informed about, and can easily access, health care, nutrition and immuni-sation services. The 2010 floods had a catastrophic effect on already weak local health systems, and on the health status of children living in some of the country’s most impoverished areas. During the floods, UNICEF’s emergency health and nutri-

tion response was activated around its Core Commitments for Children, in partnership with the member agencies of the Health and Nutri-tion Humanitarian Clusters. UNICEF reached nearly eight million children with measles vaccinations and 500,000 children under five and their parents with treated mosquito nets. UNICEF also continued strengthening routine immunisation services, distributed one million mosquito nets and 47,000 health kits.

Basic services provided by lady health workers were severely interrupted by the flood crisis. Lady health workers are a cadre of community-based health professionals who provide health care services and information on prevent-ing and treating diarrhoea, malnutrition and pneumonia to mothers at their doorstep. To maintain a continuum of care, UNICEF directly supported over 10,000 of these vital communi-ty workers. In addition, the health and nutrition programme supported training for over 60,000 lady health workers.

MOTHERS AND NEWBORNSMother and Child Weeks are large-scale campaigns that reach thousands of families in focus districts with information and low-cost, high-impact interventions. In 2010, Mother and Child Weeks were scaled up to cover 136 districts across the country with information on better care for children. During the summer campaign, messages on basic diarrhoea treat-ment were emphasised, while management services for pneumonia were highlighted in the winter campaign. About 3.5 million children and a million pregnant women were reached in each campaign. These campaigns increased the use of clean delivery kits for hygienic childbirth from 53 per cent to 65 per cent. Coverage of the BCG tuberculosis vaccine and mothers’ understanding of the use of oral rehydration salts also improved. NUTRITIONIn 2010, UNICEF supported the endorsement of the Rules on Child Nutrition and Breast Milk

Amna Khatun holds her 11 month old daughter, Laila Allahdatta, as she speaks with Lady Health Worker Taslim Kausar in Basti Nowshera in Layyah district, Punjab province. Laila suffers from severe acute malnutrition and anaemia. She is being re-ferred to a rural health clinic for treatment. © UNICEF Pakistan/2010/Noorani


Ordinance to protect breastfeeding practices. UNICEF also supported the endorsement of a legislation to help address iodine deficiency. Nearly half a million children now benefit from the programme for community management of acute malnutrition, which seeks to treat severe-ly malnourished children at home by providing families with highly nutritious therapeutic foods, reducing the burden on health facilities.

Following the 2010 floods, nutrition surveys were carried out in flood affected areas in four provinces, and a national nutrition survey is planned for 2011. The Flood Affected Nutri-tion Survey (FANS) data released by the Sindh and Punjab Departments of Health indicates a nutrition crisis. Sindh recorded a Global Acute Malnutrition (GAM) rate of 23.1 per cent in

children aged between 6–59 months in flood-affected areas of Northern Sindh and 21.2 per cent in Southern Sindh. This rate is well above the World Health Organization’s (WHO) 15 per cent emergency threshold level which triggers a humanitarian response. The Global Acute Malnutrition (GAM) rate of flood affected areas of Punjab was found to be 13.9 per cent, indi-cating a serious situation. To respond to the findings, UNICEF and other nutrition partners are working with the provincial governments to carry out robust response plans.

A total of 55 master trainers and 1,230 health care providers were trained in infant and young child feeding, a strategy to ensure that children receive adequate nutrition, including exclusive breastfeeding during their first six months of life.

Vitamin A, which increases children’s resistance to disease, was provided as a supplement during national immunisation days to 8.0 per cent of the 30 million children in Pakistan aged 6–59 months.

IMMUNISATIONIn 2010, 144 cases of polio were reported, of which over half were from FATA, where inse-curity and violence render access extremely difficult for technical and managerial support and oversight. Polio is now increasing in Sindh province due both to in-migration from worse affected areas and low rates of immunisation.

Government, with WHO and UNICEF support launched a polio immunisation campaign seek-ing to reach children in the most vulnerable areas. More than 90 per cent coverage was achieved in 8.2 per cent of the districts targeted for supplemental polio immunisation. Locally appropriate public advocacy to eradicate polio was a major area of work. To help navigate the complex political, cultural and religious issues facing vaccination campaigns in FATA and Khyber Pakhtunkhwa, UNICEF pioneered part-nerships for social mobilisation with religious

A baby is screened for malnutrition at a UNICEF-supported Basic Health Unit near a camp for people affected by the floods in Nowshera district, Khyber Pakhtunkhwa province. © UNICEF Pakistan/2010/Ramoneda


leaders in these areas. A notable success was a convention of religious leaders who endorsed vaccination against polio in Khyber Pakhtunkh-wa and FATA. Nevertheless, in light of the rising number of polio cases in 2010, the programme is now revising its communication strategy for future campaigns.

Coverage of Penta III (which combines protec-tion against hepatitis B, Hib [haemophilus influenzae type b], diphtheria, pertussis and tetanus, for children aged 14 weeks) reached 92 per cent of the targeted population. Measles vaccination achieved 8.2 per cent coverage and tetanus toxoid II achieved 72 per cent of the targeted population.

HIV AND AIDSDuring 2010, UNICEF entered into a new part-nership with the National Association of People Living with HIV and AIDS and also helped ensure that children in over 500 families living with HIV received care and support.

The first national anti-retroviral treatment adherence training and paediatric clinical management training were completed in 2010. UNICEF also supported the revision of the national guidelines for anti-retroviral treatment and prevention of parent-to-child transmission (PPTCT) of HIV, with consensus reached on early breastfeeding. The ’Guidelines for the Care and Support of Children Affected by HIV and AIDS in Pakistan’ were developed, and UNICEF also supported the development of a national training curriculum on the preven-tion of parent to child transmission of HIV for district hospitals.

EMERGENCY RESPONSEUNICEF delivered health and nutrition services to populations affected by crises in Khyber Pakh-tunkhwa and FATA. A total of 1.2 million children were vaccinated against measles and provided Vitamin A supplementation while an additional 272,000 children were vaccinated against polio. UNICEF also supported the establishment of 11 Mother and Child Health Centres, and equipped 36 health facilities with Expanded Programme on Immunisation (EPI) equipment benefitting 316,000 children.

UNICEF interventions supported the screen-ing of 520,165 children and mothers, of whom

A health worker vaccinates an infant against polio during Polio National Immunisation Day in Sherpow in Landhi town, Karachi. © UNICEF Pakistan/2010/Zaidi


32,400 moderate and severely malnourished children and mothers were referred for further treatment. Additionally, UNICEF provided nutri-tion supplies for 76,200 children and 26,000 mothers and de-worming tablets for 53,000 children between two to five years of age. Furthermore, 34,000 mothers and caretakers in the IDP camps, host districts and areas affected by instability received information about the importance of breastfeeding and child feeding best practices.

The 2010 floods caused extensive damage to Pakistan’s rural health care infrastructure in all four provinces, not only damaging health facili-ties, but also displacing frontline staff, including lady health workers and vaccinators. In many areas, capacity and number of implementing partners were lacking.

To support health and nutrition initiatives in flood affected areas between August 2010 and July 2011, UNICEF requested a sum of US$ 78..4 million. By the end of 2010, 8.3 per cent (US$ 65.2 million) had been received.

As part of UNICEF’s emergency response, 8..2 million children were vaccinated against

measles and 9.2 million against polio. To bring health workers back to work, UNICEF equipped about 10,600 lady health workers and support-ed them with financial incentives.

UNICEF supported malnutrition screening of 399,000 children between six months and five years of age and 140,000 mothers. Of these, 23,8.00 severely malnourished children, 47,700 moderately malnourished children and 43,300 pregnant and lactating women considered at risk were enrolled in feeding programmes. UNICEF also supported the establishment of 337 nutrition centres, 306 outpatient thera-peutic feeding programmes and 31 inpatient stabilisation centres for malnourished chil-dren suffering from complications. UNICEF worked in partnership with the World Food Program to support 167 supplementary feeding programmes.

PLANS FOR 2011In 2011, UNICEF and its partners will concen-trate on:g Promoting innovative approaches to reach-

ing all children with immunisation and health care services, with a special emphasis on polio eradication.

A mother plays with her child in Haji Jan Mohammad Shoro vil-lage of Jamshoro dis-trict in Sindh province. Most homes in this village were made with mud that collapsed when the village went underwater during the flood.© UNICEF Pakistan/2010/Noorani


g Advocating that nutrition be a govern-ment priority at both the national and the provincial levels. UNICEF, WFP, FAO and WHO are jointly supporting the Pakistan Integrated Nutrition Strategy to simultane-ously address the proximate underlying and root causes of undernutrition. For UNICEF, this will include a sustained emergency response until acute malnutrition levels fall significantly, expanding education and train-ing, expanding community management of acute malnutrition, and conducting a nation-al nutrition survey.

g Supporting lady health workers and commu-nity midwives in order to scale up commu-nity integrated management of neonatal and childhood illnesses.

g Strengthening capacity of local CBOs and Departments of Health for behaviour change communication.

g Sustaining programming for at-risk popula-tions living with HIV, and scaling up the PPTCT Continuum of Care.

PARTNERSHIPSUNICEF’s main partner in implementing the Maternal Health and Child Care programme in Pakistan is the Ministry of Health. UNICEF also works closely with the Inter-Religious Council for Health; parliamentarians; media; traffic police; civil society organisations and NGOs; salt producers; other UN organisa-tions, such as WHO, UNESCO, WFP, FAO and UNFPA; and several implementing and research organisations.

Key donors to UNICEF’s maternal and child health care programme include:

Canada (CIDA), Japan, Netherlands, New Zealand, Saudi Arabia, Sweden (SIDA), United Kingdom of Great Britain and Northern Ireland (DFID), United States of America (USAID),

Center for Disease Control (CDC), Consoli-dated Funds from National Committees, the Netherlands National Committee for UNICEF, the United Kingdom National Committee for UNICEF, the United States Fund for UNICEF, Bill and Melinda Gates Foundation, Micronutri-ent Initiative (formerly IDRC), Red Crescent Society UAE, Rotary International, GAVI Fund, United Nations Foundation, Global – Immuni-sation Plus, Global – Thematic Humanitarian Response, HIV-AIDS and Children, Young Child Survival and Development, UNAIDS, UNDP (Joint Programme), UN-OCHA, WHO.

Donors who contributed to ‘Thematic Fund-ing: Global Humanitarian Response’: Andorran National Committee for UNICEF, Australian National Committee for UNICEF, Austrian National Committee for UNICEF, Belgian Nation-al Committee for UNICEF, Canadian National Committee for UNICEF, Czech National Commit-tee for UNICEF, Danish National Commit-tee for UNICEF, Finnish National Committee for UNICEF, French National Committee for UNICEF, German National Committee for UNICEF, Hellenic National Committee for UNICEF, Hong Kong National Committee for UNICEF, Icelandic National Committee for UNICEF, Italian National Committee for UNICEF, Japan National Committee for UNICEF, Korean National Committee for UNICEF, Luxembourg National Committee for UNICEF, Netherlands National Committee for UNICEF, New Zealand National Committee for UNICEF, Norwegian National Committee for UNICEF, Portuguese National Committee for UNICEF, Spanish National Committee for UNICEF, Swedish National Committee for UNICEF, Swiss Nation-al Committee for UNICEF, Turkish National Committee for UNICEF, United Kingdom Nation-al Committee for UNICEF, United States Fund for UNICEF.

The devastating monsoon floods that recently affected more than 20 million people in Paki-stan – including 2.8. million children under the age of five – have brought many underlying problems to the surface. In a country that already had alarmingly high rates of malnutri-tion, the floods have made the situation worse.

Even before this crisis, about a third of Paki-stan’s children were born with low birth weight. The challenge now is not just to scale up nutrition interventions but, in some areas, to establish them for the first time.Children in Sindh province, for example, are particularly vulnerable to malnutrition. Even before the floods, stunting rates in Sindh were higher than the national average. A recent survey of the flood-affected population revealed that Sindh’s Global Acute Malnutrition (GAM) rate is 23.1 per cent in children aged between 6–59 months in flood-affected areas

of Northern Sindh and 21.2 per cent in South-ern Sindh. This rate is well above the World Health Organization’s (WHO) 15 per cent emergency threshold level which triggers a humanitarian response. The Sindh government estimates about 90,000 children aged 6–59 months are malnourished.

To combat the problems of malnutrition and stunting, UNICEF and its partners screen chil-dren through outpatient therapeutic feeding programmes, where their weight, height and mid-upper arm circumference (a key indicator of growth and development) are measured. When necessary, children are referred to mobile units or stabilisation centres. Mobile units and stabilisation centresUNICEF has established the first stabilisation centre in a district civil hospital in Thatta district to treat malnourished children with serious

Case Study: UNICEF supports efforts to fight malnutrition in Pakistan’s flood-affected Sindh province

Above: Nine-year-old Khatidja feeds her 11-month-old sister, Laila Allahdatta, a ready-to-eat therapeutic food at a rural health clinic. Laila is severely malnourished and anemic. © UNICEF Pakistan/2010/Noorani


medical complications. The centre was set up as a public-private partnership. With beds for children and their caregivers, the centre receives nutrition supplies and medicines from UNICEF, as well as training for staff. Hameed, 2, was recently admitted to the Thatta centre, suffering from high fever and diarrhoea. “We had no idea what was wrong with him. The village doctor gave him drips, which caused swelling all over his body,” says his grandmoth-er. Today, Hameed’s condition is beginning to show marked improvement as a result of therapeutic feeding and medical treatment.

Demand exceeds capacityThe stabilisation centre in Thatta is the first of its kind, and the demand for its services exceeds capacity. “At the moment, we have six children admitted here, and until now we have treated 51 patients in two months,” says Shagufta Samoo, a staff nurse at the centre. “We have had to refer children to other hospi-tals because we had no space.”

Thatta’s Deputy District Health Officer, Dr. Khaled Navaz, explains that much more work is needed to improve the nutritional status of children – especially girls – and women. “In our society, males are given higher priority than females, so we see many more malnour-ished girls than boys,” he says. “More health education sessions are needed as mothers are also malnourished, and we should provide nutrition support in schools.” The high percentage of malnourished women and low birth weight babies is evidence that much more attention should be given to women’s nutrition.

Through the government’s extensive ‘Lady Health Worker’ programme, local women

deliver maternal and child health and nutrition messages to pregnant women and lactating mothers. “We are telling the lactating mothers that for six months they must breastfeed and nothing else, after which semi-solid and solid food should be given,” says health worker Maqbool Ahmed.

UNICEF has provided extensive support to this programme, particularly since thousands of Lady Health Workers were themselves affected by the flooding. Meanwhile, UNICEF continues to work closely with the govern-ment, WFP and non-governmental and community-based organisations, to deliver life-saving and sustaining nutrition supplies to children and women affected by the flooding.

During a home visit to identify children with moderate or severe malnutrition, Lady Health Worker Taslim Kausar speaks to a young mother who holds her child in her arms. © UNICEF Pakistan/2010/Noorani



UNICEF works with partners and the government of Pakistan to improve water quality, sanitation and hygiene

throughout the country. Safe drinking water, adequate sanitation facilities and proper hygiene all have a significant impact on quality of life, particularly for young children, whose health and well-being are affected by these factors. Many diseases, including polio, are related to poor sanitation.

The level of water and sanitation services in Pakistan is not acceptable, especially in rural areas, with inappropriate operation and main-tenance systems, poor water quality and the absence of safe hygiene practices. These prob-lems are compounded by water scarcity, pollu-tion and environmental damage. As a result, diseases related to hygiene and water quality, such as diarrhoea, contribute to Pakistan’s high child mortality rate, accounting for 11 per cent

of all deaths to children under the age of five, a total of over 40,000 deaths every year. Poor hygiene is also a factor in the high number of deaths of mothers and newborns during or soon after childbirth, and it contributes to the high rate of potentially deadly infections, such as pneumonia. Older children who suffer from illnesses caused by lack of clean water and sanitation are more likely to miss school or drop out. In addition, many sources of drinking water are contaminated with industrial waste, bacte-ria, or high proportions of arsenic.

About 48. million people around the country practice open defecation, and good hygiene practices – such as washing hands with soap after defecating – is low. According to the 2010 joint report by WHO and UNICEF,4 access to proper sanitation facilities increased from 28. per cent in 1990 to 45 per cent in 2008., only a 17 per cent increase in almost two

WAteR, enVIRonMent AnD SAnItAtIon


49.85 million Total




Opposite: A girl drinks from a newly installed hand pump in the village of Jinnah Colony in Muzaffargarh, one of the worst flood-affected districts in Punjab province. © UNICEF Pakistan/2010/Noorani

4 WHO and UNICEF 2010. WHO/UNICEF Joint Monitoring Programme on Water and Sanitation. Progress on Sanitation and Drinking Water: 2010 Update. ISBN 978. 92 4 156395 6. Available at:

http://www.wssinfo.org/fileadmin/user_upload/resources/1278.061137-JMP_report_2010_en.pdf


decades. Contributing factors include rapid population growth, an insufficient enabling environment to promote sanitation, lack of education and poverty.

It is estimated that health costs and lost earn-ings due to preventable diseases related to water and sanitation cost Pakistan over US$ 3.5 million a day.5 Simply improving water and sani-tation services and adopting safe hygiene prac-tices could reduce water-related disease by as much as 50 per cent, making it among the most cost-effective health interventions. Depending

on the region and the level of services provided, the economic gains from every Rs 100 invested range from Rs 500 to Rs 2,8.00.6

Poor sanitation has a particular negative impact on girls. To preserve modesty, women and girls may have to wait until after dark in areas where open defecation is the only option, making the process of utilising proper hygiene more diffi-cult and even dangerous. Similarly, in emergen-cies, women and girls are disproportionately affected by inadequate sanitation and washing facilities, especially when living in camps or other crowded accommodations.

When schools lack sanitation facilities, girls are less likely to enrol and less likely to complete their education. At present, 43 per cent of schools in Pakistan do not have an accessible source of clean drinking water, and 48. per cent lack toilet facilities.

The 2010 floods caused great damage to the limited water and sanitation infrastructure in affected areas. Before the floods, only 75 per cent of Pakistanis had access to a source of safe drinking water; in flood affected areas, this proportion has fallen to 55 per cent.7 This is likely to result in increased morbidity and deaths in the affected areas.

ACTIONUNICEF’s Water Sanitation and Hygiene (WASH) programme aims to improve water quality and resource management, promote household latrines, sanitation and improved hygiene practices in rural areas, and to contrib-ute to increased enrolment and retention in primary school, especially for girls. In response to the emergencies faced by Pakistan in the last six years, enhanced emergency prepared-

4 WHO and UNICEF. 2010. WHO/UNICEF Joint Monitoring Programme on Water and Sanitation. Progress on Sanitation and Drinking Water: 2010 Update. ISBN 978. 92 4 156395 6. Available at: http://www.wssinfo.org/fileadmin/user_upload/resources/1278.061137-JMP_report_2010_en.pdf

5 World Bank, 2006. Pakistan Strategic Country Environmental Assessment. Available at: http://siteresources.worldbank.org/SOUTHASI-AEXT/Resources/Publications/448.8.13-118.8.777211460/pakceavolume1.pdf

6 Ibid7 UNDAC. 2010. Multi-Cluster Rapid Assessment. Available at: http://www.pakresponse.info/LinkClick.aspx?fileticket=7cXrpRTKX8.M%3

d&tabid=8.6&mid=526.

A child washes his face at a water pump built with UNICEF support in a camp for people affected by the floods in Charsadda district, Khyber Pakhtunkh-wa province. © UNICEF Pakistan/2010/Ramoneda


ness and response and disaster risk reduc-tion have been integrated into all three areas of the WASH programme. UNICEF is co-chair of the One UN Environment Programme, which includes water and sanitation. In 2010, UNICEF completed a study on how the WASH programme could be adapted to deal with the impacts of climate change.

In 2010, in response to multiple emergencies, UNICEF provided safe drinking water to 4.75 million people, including 2.63 million children. About 1.34 million people, including 720,000 children, received access to adequate sanita-tion, and hygiene messages were disseminated to 2.95 million people of whom 1.76 million were children.

A national communication strategy was formu-lated to promote better hygiene and sanitation messages. The Global Hand Washing Day, cele-brated on 15 October 2010, reached over 2.4 million people (including 1.24 million children) with messages on better hygiene behaviour. Messages on sanitation were also conveyed through the regional Healthy Hat Trick initiative, which promotes good nutrition and girls’ educa-tion along with improved sanitation, with the

involvement of the Pakistani cricket team.UNICEF supported the formulation of the Nation-al Sanitation Action Plan, as well as the official approval of the National Drinking Water Quality Standards and the National School WES Design Standards. UNICEF also supported training for 2,770 government officials and community members (969 of them women and 1,8.01 men).

In addition to a management information initia-tive implemented across Pakistan, UNICEF advocated successfully with the government of Punjab province to contribute its management information system to all other provinces so that the software, worth US$ 1.5 million, could be utilised nationally.

Thanks to UNICEF advocacy, a national sanita-tion programme to address the sanitation crisis is ready to be launched; the programme will target 48. million people, with 18. million flood affected people targeted during the first phase. This community-led total sanitation programme aims to improve sanitation for entire communi-ties at a time. UNICEF’s support has already enabled 8.6,500 people (of whom nearly 45,000 are children) to benefit from living in communi-ties free of open defecation.

A baby is bathed under a water point at the relief camp for people displaced by the floods in Sukkur.© UNICEF Pakistan/2010/Ramoneda

7 UNDAC. 2010. Multi-Cluster Rapid Assessment. Available at: http://www.pakresponse.info/LinkClick.aspx?fileticket=7cXrpRTKX8.M%3d&tabid=8.6&mid=526.


The school WASH programme, which aims to provide safe drinking water, adequate gender-sensitive sanitation facilities and hygiene educa-tion to primary schools, had to be temporarily suspended midway through the year because of the flood emergency. Prior to this, UNICEF had successfully completed work on renovat-ing water and sanitation facilities in 240 of the 1,500 target schools, benefiting about 25,200 children, of whom 14,8.00 are girls. A total of 48.0 teachers had been trained to provide hygiene education to their pupils as part of life skills training, and the members of 600 school management committees, comprising of parents and local influentials, had been trained to operate and manage the schools’ renovated water and sanitation facilities.

In partnership with the Earthquake Recon-struction and Rehabilitation Authority (ERRA),

UNICEF participated in a major project to monitor and improve water quality in areas of Khyber Pakhtunkhwa province and Pakistan Administered Kashmir, which were affected by the October 2005 earthquake. Out of the 94 water supply schemes targeted by the project, 8.5 were rehabilitated providing 118.,000 people, including 61,400 women, with access to improved drinking water. In total, 3,500 water schemes are to be mapped for water qual-ity and sanitation. Of these, 1,600 have been completed, with 1,300 still underway. Following the mapping exercise, which identified water schemes supplying poor quality water, govern-ment agencies are preparing plans to improve 1,200 water schemes. There have been some delays in this project, due to the slow release of government funds. UNICEF also led support for the establishment of 305 water supply schemes, which were completed by June 2010.

Along with these initiatives, seven UNICEF-sup-ported partners provide training and awareness in the 1,700 villages where the water supply schemes are located. To date, over 3,200 water management committees have been formed, with 9,900 community members, including 1,400 women, trained to manage, operate and maintain village water supply systems. Over 48.,100 people, including 15,600 women and 13,545 children, have attended a total of 1,732 information sessions on community and school hygiene. Radio broadcasts were also used to disseminate hygiene messages and to reach communities in Shangla and Kohistan districts of Khyber Pakhtunkhwa province, where access was restricted due to insecurity.

In Pakistan Administered Kashmir, UNICEF provided equipment for nine water quality labo-ratories in order to make them fully functional. Government agencies developed action plans to strengthen water quality monitoring, surveillance and improvement in focus districts of Pakistan Administered Kashmir and Khyber Pakhtunkhwa, and a management information system is being tested in Pakistan Administered Kashmir.

Carrying pots of water collected from an under-ground water supply pipeline, children walk home in the village of Sadra Sharif in Dera Ismail Khan district of Khyber Pakhtunkhwa province. © UNICEF Pakistan/2010/Noorani


EMERGENCY RESPONSEDuring the conflict in Khyber Pakhtunkhwa and FATA, UNICEF supplied over two million indi-viduals with clean drinking water, exceeding the initial target of 1.2 million, through the installa-tion and rehabilitation of infrastructure including tube wells, water systems and hand pumps, as well as through water trucking. In addition, hygiene kits were distributed to over 1.6 million individuals. Over 2 million people affected by instability received hygiene messages, and over 300,000 individuals benefited from latrine instal-lation. WASH facilities were provided for health units in IDP camps to serve 165,000 individuals.

The floods left 14 million people urgently need-ing access to safe drinking water and sanita-tion. To support water, sanitation and hygiene initiatives for a 12-month period, UNICEF required US$ 123.8. million, of which 65 per cent, or US$ 8.0.5 million, had been received by the end of 2010.

In 2010 UNICEF provided safe drinking water to nearly 3.2 million people and sanitation facilities to nearly 1.5 million people affected by

the floods. UNICEF promoted improved

hygiene through hygiene promotion messages, which reached 1.9 million people (including 970,000 women), and hygiene kits, which were provided to 1.6 million people (including 8.20,000 women). About 30 million water purifi-cation tablets and sachets sufficient to provide 300 million litres of safe drinking water were distributed. UNICEF also assisted local govern-ments to clean reservoirs and conduct chlori-nation campaigns in order to control disease outbreaks.

UNICEF’s emergency response was challenged by the lack of capacity among the implement-ing partners to respond to such a large-scale emergency, suggesting the need to broaden the range of partners in the future. Because adequate baseline statistics did not exist for many areas, accurately assessing damage and needs was a challenge.

PLANS FOR 2011In 2011, UNICEF and its partners will concen-trate on:

Sitting outside her tent, a woman assists her young child to wash hands in a temporary camp in the village of Kharbella in Charsadda district in Khyber-Pak-htunkhwa province. © UNICEF Pakistan/2010/Noorani


g Implementing the Flood Work Plan to reach 3.69 million flood affected people in the relief phase, and 5 million flood affected people in the early recovery phase.

g Addressing the needs of approximately 100,000 IDPs still living in camps and other persons returning or displaced in Khyber Pakhtunkhwa and FATA.

g Strengthening partner capacity and leading the transition of partners from relief to early recovery work in the sector.

g Maximising efforts to ensure that policies and strategies relevant to water, sanitation and hygiene are approved.

g Scaling up rural sanitation following the total sanitation strategy.

g Strengthening water quality monitoring and surveillance systems.

g Strengthening and operationalising manage-ment information systems in all provinces.

g Scaling up school water, sanitation and hygiene facilities.

PARTNERSHIPSUNICEF’s main WASH partners in Pakistan at the federal level are the Ministry of Environ-ment, Ministry of Science and Technology, Ministry of Education, and the Ministry of Health at provincial and district levels. UNICEF works with other partners, including UN organi-sations, in particular the World Health Organi-sation, as well as rural development depart-ments, public health engineering and health departments, directorates of education, tehsil management administrations, local and interna-tional NGOs, civil service organisations, and the private sector.

Key donors to UNICEF’s water, environment and sanitation programme include:

Australia (AusAID), European Commission/ECHO, Ireland, Japan, Luxembourg, Nether-lands, New Zealand, Republic of Korea, Saudi Arabia, Sweden (SIDA), Spain, United Kingdom of Great Britain and Northern Ireland, United States of America (USAID), the French National Committee for UNICEF, the Netherlands Nation-al Committee for UNICEF, Global – Thematic Humanitarian Response funds, UNDP (Joint Programme), UN-OCHA.

Donors who contributed to ‘Thematic Fund-ing: Global Humanitarian Response’: Andorran National Committee for UNICEF, Australian National Committee for UNICEF, Austrian National Committee for UNICEF, Belgian Nation-al Committee for UNICEF, Canadian National Committee for UNICEF, Czech National Commit-tee for UNICEF, Danish National Committee for UNICEF, Finnish National Committee for UNICEF, French National Committee for UNICEF, German National Committee for UNICEF, Hellenic National Committee for UNICEF, Hong Kong National Committee for UNICEF, Icelandic National Committee for UNICEF, Italian National Committee for UNICEF, Japan National Commit-tee for UNICEF, Korean National Committee for UNICEF, Luxembourg National Committee for UNICEF, Netherlands National Committee for UNICEF, New Zealand National Committee for UNICEF, Norwegian National Committee for UNICEF, Portuguese National Commit-tee for UNICEF, Spanish National Committee for UNICEF, Swedish National Committee for UNICEF, Swiss National Committee for UNICEF, Turkish National Committee for UNICEF, United Kingdom National Committee for UNICEF, United States Fund for UNICEF.

Amna left school for what she thought then would be the very last time. That was in 2008., when she was a Grade 2 student and only 11 years of age. She started working at home, cleaning the house, taking care of her younger siblings, and helping tend the family’s crops.

Amna lives in Jan Kili, a farming village of 1,400 inhabitants located in Bajaur Agency of the Federally Administered Tribal Areas (FATA) of Pakistan. FATA is amongst Pakistan’s least developed areas, and education levels are very low. A 2007 study showed that only 22 per cent of people over 15, and 7 per cent of women, were literate. Only 28. per cent of chil-dren were enrolled in primary school, includ-ing 17 per cent of girls. Since the survey was completed, FATA has experienced increasing uncertainty and violence in which schools, especially for girls, have been targeted by mili-tants. Bringing children to school, and keep-

ing them there, is thus doubly challenged by poverty and violence.

“When my friend Aisha told me that water and latrines are now available at the school I was delighted,” says Amna. “I was fed up of working at home, and I wanted to contin-ue my schooling.” Here, she could learn, play and grow with other children her age instead of spending all her time working at home. “In these areas, we have to work with parents to convince them that their children should

Case Study: In tribal Bajaur, school sanitation and hygiene brings girls back to school

Above: While a young boy helps pump, a girl washes her hands with water from a hand pump in a village in Shado Khan Union Council of Layyah district in Punjab province. © UNICEF Pakistan/2010/Noorani


have a full course of primary education,” says Ishaq Israr of Just Peace International, a UNICEF local partner working in Bajaur Agency. “But an essential prerequisite is to ensure that schools have basic facilities. This includes trained teachers, school equipment and a functional structure, including a lavatory.”

Through the help of partners, UNICEF offers children, women and their families in crisis affected areas greater access to safe water and sanitation facilities. Under this partner-ship, early recovery Water, Sanitation and Hygiene Promotion (WASH) interventions in conflict affected districts of Malakand Division and Bajaur and Mohmand Agencies of FATA hopes to benefit nearly 1.5 million individuals, including 8.2,500 school children.

Amna’s school was one of those that lacked a latrine, and pupils were forced to use the open fields instead. “As I was then a grown girl, I felt uncomfortable going outside into the open when I needed to use a latrine,” she says.Her parents were also uncomfortable. “We live in a Pashtun culture where the privacy of women and girls is of primary importance,” says her father, Jan Bahadar. “I could not toler-ate my daughter having to visit the open fields to attend to the call of nature.”

Then, in 2010, Just Peace International came to Jan Kili. While, as a village elder explained, the girls’ school had been eagerly attended since its establishment, recently numbers had dwindled. A major reason was the lack of sani-tation infrastructure: many children like Amna had dropped out. The Jan Kili Government

Girls’ Primary School thus became a key focus in a project to support education in remote Bajaur Agency by ensuring that 50 primary schools had functioning water and sanitation facilities, and students, teachers and parents were informed about good hygiene practices and their impor-tance. Amna and her parents were delighted.

“When my friend Aisha told me that water and latrines are now available at the school I was delighted,” says Amna. “I was fed up of working at home, and I wanted to continue my schooling.” Here, she could learn, play and grow with other children her age instead of spending all her time working at home. Mr Bahadar, Amna’s father, was also delight-ed. “I am a poor man and want to educate my children,” he says. “I am very pleased that Amna can go back to school.”

Project schools have hygiene sessions in which children and school staff learn about good hygiene and how to maintain a healthy school environment. Children are encouraged to take their newfound knowledge home, thus contributing towards greater awareness in the community. In Ganji Kali Village, this aspect of the project has gained the support of the prayer leader, Maulvi Abdullah.

A girl drinks from a pump in in a village in Shado Khan Union Council of Layyah district in Punjab province. © UNICEF Pakistan/2010/Noorani


The reason, Mr Abdullah says, is that he had seen a change in the village children. He noticed that they were cleaning their teeth regularly, and keeping a bar of soap at the mosque to wash their hands. They would even ask adults to use the soap. When he asked the children how they had adopted such high standards of cleanliness, which were in full accordance with religious teachings, they told him about the hygiene education at school. “This is the Islamic message of hygiene,” says Mr Abdullah.

“Good school sanitation and hygiene help every aspect of a child’s growth and develop-ment,” says UNICEF WASH Officer, Moham-mad Shakaib Jan. “They prevent diseases such as diarrhoea and pneumonia which cause 40 per of all child deaths. They help prevent children, especially girls, from dropping out of school, especially in these areas where inse-curity has already taken a toll on education. By developing school sanitation infrastructure and hygiene education, we invest in the future of children like Amna.”

A facilitator uses a flipchart to teach health and hygiene messages to a group of women in the village of Jinnah Colony in Muzaffargarh, one of the worst flood-affected districts in Punjab Province. © UNICEF Pakistan/2010/Noorani



PRIMARY eDUCAtIon

Pakistan faces a difficult challenge in achieving universal primary education by 2015, as per Pakistan’s commitment

to the Millennium Development Goals. Even before the displacement of millions of people as a result of flooding and insecurity in 2010, only about half of Pakistani children attended school.

Many factors contribute to low enrolment and completion of primary school for boys and girls; these low educational attainment and income of parents, and school-related issues, such as the use of corporal punishment, lack of trained teachers and learning materials, and inadequate water and sanitation facilities. The problems, however, are most acute for girls who have traditionally faced serious barriers to completing a full course of primary education, such as societal pressures against educating girls, low awareness amongst parents of the benefits of educating girls, demand for domes-

tic labour in the home, lack of female teachers and separate sanitation facilities in schools. The impact of these issues can be most clearly seen in the Federally Administered Tribal Areas (FATA), where it is estimated that only 13 per cent of primary school-aged girls are enrolled in primary school.

The passage of the 18.th Amendment to the Constitution of Pakistan in 2010 led to a redefi-nition of the role of the federal Ministry of Education, as most of its responsibilities were devolved to the provincial governments. This, along with frequent changes in political leader-ship, a high turnover in the public sector, and the security situation created complications for project planning and implementation.

In recent years, Pakistan has weathered a series of tremendous challenges for primary education. These have included the 2005


21.69 million Total




Opposite: Sitting on floor in a UNICEF-supported Temporary Learning Centre (TLC), an older girl assists a younger girl child to write on a wooden board, in the village of Basti Bhaya in Rajanpur, amongst one of the worst affected district in Punjab province. © UNICEF Pakistan/2010/Noorani


earthquake, which damaged 6,000 schools in Pakistan Administered Kashmir and Khyber Pakhtunkhwa province, and increasing inse-curity in these two areas, preventing many children from attending school. The floods of 2010 negatively affected education in all four of Pakistan’s provinces and put immense strain on an already fragmented education system. With more than 10,000 schools damaged or destroyed, the devastation is likely to lead to a decline in school enrolment and in the rate of primary and secondary school completion, especially for girls.

ACTIONUNICEF’s Primary Education programme in Pakistan seeks to:

g Expand girls’ and boys’ enrolment and retention in primary and middle school.

g Improve the quality of primary education.g Strengthen the education system at the

national level and at provincial levels.

UNICEF also seeks to integrate education into emergency response and disaster risk reduc-tion activities to help ensure that affected chil-

dren are able to fulfil their rights to education.UNICEF is supporting primary school education in 30 focus districts in four provinces. During 2010, primary school enrolment increased in these districts from 350,000 to 530,000 children.

UNICEF has pioneered child-friendly schools that involve parents, teachers and communi-ties in a holistic and child-centred approach to providing quality education. In Punjab province, this approach contributed to a 64 per cent increase in enrolment. UNICEF established 501 new child-friendly schools, bringing the total to 2,8.10 schools with 399,000 students in grades 1 to 5; nearly 254,000 of these students were girls. In addition, these schools serve 97,700 pre-school students; nearly 62,000 of these students are girls. About 5,670 primary school teachers were also trained in child-friendly methods and early childhood education.

UNICEF also supported mass enrolment campaigns in Punjab and Sindh provinces that led to the enrolment of 1.4 million primary school aged children in Punjab and an additional 120,000 girls in Sindh. In Balochistan, 3,000 girls’ primary schools were opened through the

A girl practices her letters at a camp for flood affected families. Accessing education has been especially difficult for girls. © UNICEF Pakistan/2010/Ramoneda


Community Support Process, which helped reduce gender disparity in access to primary schooling and employed thousands of female teachers. In 71 remote public girls’ primary schools, middle schooling for girls (grades 6 and 7) was initiated, giving 2,200 girls the opportunity to receive this level of education for the first time.

Children’s health and well-being is at the centre of the child-friendly school approach. To ensure that schools have adequate sanitation and water facilities for children, UNICEF supported the finalisation of the National Standards on Water and Sanitation. Supported by evidence-based best practices in all provinces and areas, and with strong advocacy at the federal level, the National Child-Friendly School Standards

were developed and endorsed as the standards for quality education by the federal minister and secretaries for education in all provinces and areas. The Ministries of Health and Educa-tion developed and agreed on a school health framework, which is due to roll-out at the provincial level.

In order to strengthen pre-primary education and reduce the number of children who drop out at the pre-primary level, UNICEF partnered with UNESCO to develop an early childhood education toolkit and national standards on the development of pre-school children. UNICEF also provided training to master trainers in Punjab and established 33 resource centres for early childhood education.

In Balochistan and Khyber Pakhtunkhwa prov-inces, UNICEF supported surveys to establish a learning achievement baseline for grades 4 and 8.. This will help future efforts to improve learning assessments and quality of education. In Punjab province, two million students sat for annual examinations, based on learning achieve-ment standards.

To improve the collection of education data, UNICEF supported the development of a national-level education management informa-tion system (EMIS) prototype. The integrated EMIS will enable all provinces and districts to receive regular analytical reports to aid in plan-ning and monitoring activities.

Recovery efforts following the 2005 earth-quake continued in 2010, with 410 permanent earthquake-safe school structures built to child-friendly standards. Of these, 214 were in Khyber Pakhtunkhwa province and 196 in Pakistan Administered Kashmir. In addition, 28.1 transitional schools were constructed, bring-ing the total number of beneficiaries to 65,130 children. Ambassadors and diplomats from the European Union were given a tour of these sites to examine the quality of construction and the child-friendly approach.

A girl smiles as she solves a maths problem in a centre in Ghaniabad village of Dera Ismail Khan district, Khyber Pakhtunkhwa province. © UNICEF Pakistan/2010/Noorani


EMERGENCY RESPONSEThe emergency situation faced by Pakistan in 2010 required substantial support for educa-tion. UNICEF is presently supporting 32 primary schools attended by a total of 28.,500 children displaced by conflict; these include schools/ students in IDP camps and those in host communities in conflict affected areas, which provide second-shift education for IDP children. In addition, eight secondary schools for 28.9 students in IDP camps receive support. To increase parents’ involvement in their chil-dren’s education, 48.6 Parent-Teacher Commit-tees were re-activated and 18. Mother Support Groups were established. Members of both were trained on improving links between schools and the community.

The floods brought new challenges, such as rapid and unpredictable population movements, damage to infrastructure, and the difficulty of tracking children and ensuring they continued their education. Yet the floods also created an opportunity for many marginalised children, especially girls, to attend school for the first time. While responding to the emergency needs of flood affected children, UNICEF was able to promote the value of girls’ education.

In total, 2,790 temporary learning centres, including 120 dedicated to early childhood education, were established, benefiting 165,000 children in flood affected districts. Education supplies were distributed to centres benefit-ing 208.,000 children, and 3,700 teachers were trained on the use of emergency educational supplies and on teaching methods tailored to emergency situations.

Many people displaced by the floods took shel-ter in school buildings, making these facilities vulnerable to damage. UNICEF supported the Ministry of Education and the National Disaster Management Authority in the production and distribution of 50,000 posters with illustrated messages for IDPs on how they should care for the school buildings where they were sheltered.Meena storybooks and films were developed by UNICEF to help children learn about child rights, health, hygiene and other issues through the entertaining and appealing character of a young South Asian girl. Fourteen different Meena storybooks and films, translated into local languages, were produced for early recov-ery education activities and a comprehensive social mobilisation initiative, including interac-tive sessions with school children, is planned to continue as part of the flood response in 2011.

In the flood emergency, survival and protection aspects of the response commanded greater government priority than education and educa-tion was not initially included in the national appeal. To support education for 12 months in the aftermath of the floods, UNICEF required

A child writes in her textbook in the flood affected village of Musarraf Khan Khoso in Jaffarabad District, Balochistan Province. There are no schools within walking distance of this village. For many children, this is the first time in their lives that they are able to go to school. © UNICEF Pakistan/2010/Noorani


US$ 36.4 million, and received 8.9 per cent, or US$ 32.5 million, by the end of 2010. UNICEF served as the co-lead of the Education Cluster with Save the Children, and as such supported effective coordination mechanisms in the emer-gency response throughout the country.

PLANS FOR 2011In 2011, UNICEF and its partners will concen-trate on:g Promoting universal primary education and

focusing on enrolling the most disadvan-taged children, especially girls.

g Increasing access to education for flood affected children aged 4–12 years by estab-lishing transitional school structures and temporary learning centres.

g Promoting and implementing disaster risk management and school-based emergency preparedness activities at the federal, provincial and district levels.

g Preparing guidelines and manuals on child-friendly schools for provincial and district-level education authorities.

g Enhancing school readiness for primary school children by strengthening early child-hood education and development centres.

g Supporting a national survey to assess the learning achievements of primary school students.

g Evaluating experiences in community involvement, especially the involvement of mothers’ support groups.

g Lead the transition from flood relief to early recovery in the education sector.

g Strengthening Cluster coordination to effectively respond to humanitarian needs in Khyber Pakhtunkhwa and FATA.

g Completing the schools under reconstruc-tion following the 2005 earthquake.

PARTNERSHIPSUNICEF’s main partner is the Ministry of Education at the national and provincial levels. UNICEF also collaborates with other UN bodies, including UNDP, UN-Habitat, UNESCO, UNHCR

and WFP, within the framework of the One UN Programme, as well as national and internation-al NGOs and the private sector.

Key donors to UNICEF’s primary education programme include:

Australia (AusAid), Canada (CIDA), Czech Republic, Denmark, European Commission (EC), Ireland, Italy, Netherlands, New Zealand, Norway, Saudi Arabia, Sweden (SIDA), United Kingdom of Great Britain and Northern Ireland (DFID), Thematic Funding – Basic Education and Gender Equality, Thematic Funding – Global Girls’ Education, Thematic Global Funding – Humanitarian Response, and Joint Programme – UNDP.

Donors who contributed to ‘Thematic Funding: Global Humanitarian Response’ include:

Andorran National Committee for UNICEF, Australian National Committee for UNICEF, Austrian National Committee for UNICEF, Belgian National Committee for UNICEF, Canadian National Committee for UNICEF, Czech National Committee for UNICEF, Danish National Committee for UNICEF, Finn-ish National Committee for UNICEF, French National Committee for UNICEF, German National Committee for UNICEF, Hellenic National Committee for UNICEF, Hong Kong National Committee for UNICEF, Icelandic National Committee for UNICEF, Italian National Committee for UNICEF, Japan National Commit-tee for UNICEF, Korean National Committee for UNICEF, Luxembourg National Committee for UNICEF, Netherlands National Committee for UNICEF, New Zealand National Committee for UNICEF, Norwegian National Committee for UNICEF, Portuguese National Commit-tee for UNICEF, Spanish National Committee for UNICEF, Swedish National Committee for UNICEF, Swiss National Committee for UNICEF, Turkish National Committee for UNICEF, United Kingdom National Committee for UNICEF, United States Fund for UNICEF.

Sitting in her family’s tent, Reshma, 8., proudly shows her mother a textbook she received from the temporary learning centre – or TLC – here in a relief camp located at the Jaffarabad Flour Mill.

Reshma had no exposure to formal education prior to her arrival at this camp for people affected by recent flooding in Pakistan. Now, she is one of the regular students at the TLC. Before the floods, Reshma’s parents lived in Mala Bagan Baba village, near the city of Jhatpat in Jaffarabad district. When the flood waters came, they had to pack up their five

children and flee. Fortunately, the Jaffarabad Flour Mill camp had been set up only 3 km west of their village. Here, they were regis-tered and allocated a tent.

Window of opportunity for education In the midst of the crisis, Reshma’s parents scarcely could have imagined that this hard-ship would open a window of opportunity for their children – an opportunity for education. “Our house, village and all belongings have been lost in the floods,” says her mother. “We have come to this camp and our children are happily studying here. The rest we can withstand.”

UNICEF started supporting the 7,000 displaced soon after the camp was commis-sioned in early August. Through its partners, UNICEF is providing safe drinking water and

Case Study: Temporary learning centres offer opportunities for children in Pakistan camps

Above: Reshma, 8., is a student at the temporary learning centre in the Jaffarabad Flour Mill flood-relief camp, Balochistan Province, Pakistan. © UNICEF Pakistan/2010/Sami


sanitation facilities, child-friendly spaces for recreation and learning activities, and the TLCs for providing basic education. The TLCs are supplied with ‘School-in-a-Box’ kits, emergen-cy education and recreation kits, water coolers and school furniture.

Students eager to learnNadia, one of the teachers, was herself displaced when the floods hit.

“I have 103 students here. These girls are studying Urdu, English and Mathematics. They are eager to learn,” she says. “By seeing other children study, more are becoming attracted to

learning for the first time in their lives. Some of them were not going to school in their native village or city, but they are studying here and with a lot of eagerness.” UNICEF Education Specialist Sanaullah Panezai explains that the TLCs provide bene-fits that transcend schooling.

“Besides catering to the needs of children whose education was disrupted by the floods,” he says, “TLCs are designed to promote diver-sity and uphold inclusiveness.” Mr. Panezai adds that the centres provide opportunities for learning, socialising and recreation – includ-ing opportunities for children who were earlier excluded from the education system.

A teacher and students inside a temporary learning centre at the Jaffarabad Flour Mill relief camp in Pakistan’s flood-affected Balochistan Province. © UNICEF Pakistan/2010/Sami



There are nearly 79 million children under the age of 18. in Pakistan, and 24 million of them are under the age of five.

Because of widespread poverty and instability in Pakistan, many of these children face protec-tion issues, such as hazardous child labour, trafficking, child marriage, displacement, and institutionalisation. For children living in areas affected by conflict, child recruitment, conflict and unexploded ordnance are also major areas of concern.

The precarious situation of children in Pakistan was negatively impacted by natural disaster and insecurity in 2010. Displacements caused by the widespread flooding and by instability in some regions of the country affected millions of children, further increasing UNICEF’s concern for their safety and well-being. Even before the floods, 36 per cent of Pakistan’s population was living below the poverty line.8.

Many children are driven to work in order to supplement family incomes, or because of lack of awareness of the importance of educa-tion. These children, especially those working in hazardous occupations, rarely attend school and engage in long hours of difficult work in dangerous conditions. Lack of access to schools and the need to contribute to meagre family incomes makes it very difficult to break the inter-generational cycle of poverty and lack of education. Finding ways to address issues surrounding child labour and increase children’s opportunities to pursue an education (e.g., through legislative initiatives or raising awareness of children’s issues) is of significant concern to the UNICEF Child Protection section.

At present there is no universal birth registra-tion system in Pakistan. Nationwide, the birth registration rate is less than 30 per cent. When a child is deprived of their right to an identity,

CHILD PRoteCtIon


14.08 million Total




Opposite: Children participate in a physical exercise activity in a UNICEF supported Child Friendly Space in Charsada Station Camp in Charsada district of Khyber-Pakhtunkhwa province. © UNICEF Pakistan/2010/Noorani

8. State Bank of Pakistan. 2010 Annual Report.


the consequences last a lifetime, making it difficult for children and in adulthood, women, to claim important services and protection.

ACTIONUNICEF’s Child Protection section works towards the ideal of ensuring that all Pakistani children live in a protective environment, free from violence, abuse, exploitation and neglect. Creating a protective environment is not just about protecting children in immediate danger, but is also about seeking to ensure that all aspects of child protection, from policies and

legislation to services and resources, are in place to protect children at the national, provin-cial and district levels. This includes educating parents, teachers, community members, health care professionals, and others who come in

regular contact with children, about children’s rights and the need for, and benefits of, a protective environment for children.

In 2010, a major achievement in this area was the approval of the Khyber Pakhtunkhwa Child Protection Act and the Pakistan Adminis-tered Kashmir Child Protection Policy. In Gilgit Baltistan, a Social and Child Protection Reform Unit was established as the first step towards an integrated and comprehensive approach to child protection and social services. In addi-tion to these legislative achievements, Child Complaint Offices were supported under the Children’s Ombudsman’s Office to strengthen governmental accountability at federal and provincial levels.

About 40,000 children benefited from protec-tion and referral services supported by UNICEF. At the national level, UNICEF supported the establishment of a Gender and Child Unit in the National Disaster Management Authority. At the provincial level, UNICEF supported five Child Protection Units that identify, refer and support unaccompanied and vulnerable children through the provision of a wide range of protective services. At the district level, UNICEF support-ed 11 Child Protection Units.

Five child-friendly help desks were established in Balochistan police stations, and helplines were set up in Sindh and Khyber Pakhtunkhwa provinces to provide information and referral services to children and families. These units were in addition to five Child Protection Centres established under Pakistan’s Federal Investiga-tion Agency.

Child Protection Centres are an important cornerstone in the provision of child protection services for the children of Pakistan. In UNICEF-supported Child Protection Centres children and adolescents have the opportunity to take part in learning activities and are encouraged to join the mainstream educational and vocational learning systems. Child Protection Centres

Mubeen Ashraf and Aqsa Yaseen with their puppets in the Education Counseling Center of UNICEF-sup-ported Hayat Foundation in Rashidabad, Faisalabad of Punjab province. © UNICEF Pakistan/2010/Zaidi


provide a range of services through staff trained in protection and child-friendly skills. In Khyber Pakhtunkhwa and Punjab provinces, about 4,8.00 children working in brick kilns received formal or non-formal education and life skills training through 36 Child Protection Centres. Also, 1,8.70 children living and working on the streets were provided with non-formal education, life skills training and counselling through Child Protection Centres in Khyber Pakhtunkhwa, Balochistan and Sindh provinces.

In areas of Khyber Pakhtunkhwa affected by armed conflict, about 96,400 children (includ-ing 42,400 girls) and 11,400 women received services from 238. Child Protection Centres. In addition, 28. victims of unexploded ordnance (UXO) were identified and linked with services. UXO risk education was provided to 94,900 children (including 25,500 girls). Some 5,000 women and 19,000 men were also educated on the dangers of UXOs and to how to live more safely with the threat. One hundred and fifty children who had formerly been associated with militant armed groups received residential rehabilitation and support services at Sabaoon Academy through the provision of educational, recreational, psychological, vocational and health-focused services and referrals.

Two critical priorities in 2010 were the devel-opment of child protection service standards and improving government planning and over-sight. UNICEF supported the development of standard operating procedures and terms of reference for the government’s Child Protec-tion Units and for service providers in Child Protection Centres, Transit Centres and Child Friendly Spaces. UNICEF also supported train-ing for 1,150 child protection professionals from government departments and other stakehold-ers; 300 more were trained on child protection in emergencies.

UNICEF supported the Government of Paki-stan in reviewing and addressing the elements of legislation that were incompatible with the Optional Protocols to the Convention on the Rights of the Child. This is an important step that will support the ratification and imple-mentation of legislation and programmes that promote children’s rights.

During the course of the year, more than 150,000 children were registered at birth through district authorities, in parallel with UNICEF’s ongoing advocacy at all levels to achieve universal birth registration.

Children play in a UNICEF-supported Child Protection Centre in Taru Jabba of Nowshera district in Khyber Pakh-tunkhwa province.© UNICEF Pakistan/2010/Noorani


The child protection programme faced constraints that included the lack of capacity and continuity in the governance of federal and provincial bodies mandated to protect children’s rights. This added to the low awareness of child protection issues in the public sector. Challenges were also posed by inconsistent legal provisions, low budget allocations and delays in approving child protection policies, and establishing the structures needed to implement them.

EMERGENCY RESPONSEThe 2010 floods exposed millions of children to increased risks of exploitation, abuse, traffick-ing, separation, and other forms of violence, livelihoods, schools and social services were swept away or inundated.

As part of the flood response, UNICEF estab-lished 926 static and mobile Child Friendly Spaces and Child Protection Centres, where 223,000 children, 40 per cent of them girls, came to a safe place to play and learn. Almost 18.0,000 children received psychosocial support or were referred to other services. Some 250,000 children and their families were provided with clothes, blankets and other non-food items.

Some 550 separated and unaccompanied children were identified and registered through UNICEF supported facilities and services, and 354 of these children were reunited with their families. UNICEF also supported the establish-ment of 12 help lines and 369 community-based child protection committees to ensure that vulnerable children could be identified, referred and monitored at the community level.

UNICEF led the Child Protection sub-Cluster of organisations working to provide protective environments for children after the flood emer-gency. It also co-led the Gender-Based Violence sub-Cluster (with UNFPA) until November 2010.

US$ 26.5 million was required in order to provide child protection support for the conflict

and flood emergencies. By the end of 2010, 47 per cent of this funding (US$ 12.5 million) had been received.

PLANS FOR 2011In 2011, UNICEF and its partners will concen-trate on:g Strengthening the capacity of provincial

and district authorities to protect children as services and administrative structures become increasingly decentralised under the 18.th Amendment to the Constitution of Pakistan.

g Advocating for institutional reform and the creation of a National Authority for Chil-dren’s Rights.

g Accelerating the legislative reform process and advocating for the inclusion of children’s rights on the agenda of the national and provincial assemblies.

g Advocating for the adoption of the Optional Protocols to the Convention on the Rights of the Child.

g Assisting the Government of Pakistan to set up a child protection information manage-ment system for data collection, analysis and reporting.

g Assisting authorities to accredit child protec-tion service providers.

g Continuing advocacy and support to increase birth registration.

g Advocating for budgeting initiatives for social and child protection, such as condi-tional cash transfers to provide an incentive for working children and children living on the street to attend school.

g Providing protective services for flood affect-ed children during the early recovery phase and relief services for displaced children, especially in Khyber Pakhtunkhwa and FATA.

g Assisting government institutions at all levels in preparing to meet future emergen-cies. This is a key focus as the challenges posed by successive emergencies over the course of recent years threaten to under-mine development gains.


PARTNERSHIPS UNICEF’s main partners include the Ministry and Provincial Departments of Social Welfare, the National and Provincial Commissions for Child Welfare and Development, the Ministry of Human Rights, Pakistan Bait-ul-Maal, the Law and Justice Commission, the National Police Bureau, the Federal Investigation Agency, the National Database and Registration Authority, the Planning Commission, Provincial and Feder-al Children’s Ombudsman’s Offices, the National and Provincial Disaster Management Agencies, UNHCR and international and national NGOs.Key donors to UNICEF’s child and adolescent protection programme include:

Belgium, Canada (CIDA), European Commis-sion (EC), Italy, Japan, Norway, Sweden (SIDA), Spain, Switzerland (Swiss Agency for Develop-ment), United Arab Emirates, United States of America (USAID), Consolidated Funds from UNICEF National Committees, Thematic Global Funding – Humanitarian Response, Joint Programme – UNDP, UNMAS UN OCHA.

Donors who contributed to ‘Thematic Funding: Global Humanitarian Response’ include:

Andorran National Committee for UNICEF, Australian National Committee for UNICEF, Austrian National Committee for UNICEF, Belgian National Committee for UNICEF, Canadian National Committee for UNICEF, Czech National Committee for UNICEF, Danish National Committee for UNICEF, Finn-ish National Committee for UNICEF, French National Committee for UNICEF, German National Committee for UNICEF, Hellenic National Committee for UNICEF, Hong Kong National Committee for UNICEF, Icelandic National Committee for UNICEF, Italian National Committee for UNICEF, Japan National Commit-

tee for UNICEF, Korean National Committee for UNICEF, Luxembourg National Committee for UNICEF, Netherlands National Committee for UNICEF, New Zealand National Committee for UNICEF, Norwegian National Committee for UNICEF, Portuguese National Commit-tee for UNICEF, Spanish National Committee for UNICEF, Swedish National Committee for UNICEF, Swiss National Committee for UNICEF, Turkish National Committee for UNICEF, United Kingdom National Committee for UNICEF, and United States Fund for UNICEF.

Seven year old Javid takes a mobile picture of the social worker at the Rahbar Child Help Line in Peshawar. The helpline provides protection for chil-dren from all forms of abuse and help separated, missing and unaccompanied children during emer-gencies in Pakistan. © UNICEF Pakistan/2010/ZAK

Catastrophic flash floods scarred the lives of Tayyab, 4, and his family in more than one horrific way. His father, Mohammad Aslam, is a small farmer in the remote village of Sadra Sharif, located in north-western Pakistan’s Khyber Pakhtunkhwa Province.

In early August, as floodwaters receded in the village, Mr. Aslam went to the fields to assess the damage to his crops. “I saw this thing stuck in the field and I brought it home out of curiosity,” he remembers. “Not even for a moment did it cross my mind that I was bring-ing destruction to my family.”

Mr. Aslam had mistakenly brought home an anti-personnel landmine. His son and daugh-ter were badly wounded when the landmine exploded as they were playing with it. “I want to play, but it hurts,” says Tayyab, whose foot had to be amputated as a result of his injuries.“He cries all the time. He has lost a lot of weight and has become aggressive,” says

Tayyab’s mother, Naseem Bibi. “He is totally dependent and has to be carried everywhere.”

Lurking menace The receding waters have unearthed a lurk-ing menace of unexploded ordnance and landmines in Pakistan. The floods carried the explosives into Khyber Pakhtunkhwa from the mountains in neighbouring, conflict-stricken South Waziristan, one of the country’s Feder-ally Administered Tribal Areas.

“Sixteen cases have been reported during the last two months in flood-affected areas,” says UNICEF Child Protection Officer Farman Ali. “Seven victims, including women and children, have been injured leading to amputation.”

In response to the danger, UNICEF and its non-governmental partner, the Sustainable Peace and Development Organization, have expanded their mine-risk education (MRE) programme to flood-affected areas.

Case Study: Flash floods carry landmines from conflict zone

Above: Tayyab with his sister, Sadia and parents, Mohammad Aslam and Naseem Bibi, at their home © UNICEF Pakistan/2010/Shandana


An effective responseUNICEF initiated and has been leading an MRE Working Group in north-western Paki-stan to develop a concerted, effective land-mine response at the community level for two years. Today, UNICEF and its partners are now promoting precautionary measures among the flood-affected population in hazardous areas. An important component of the programme is selection and training of volunteers, who also receive first-aid kits for the provision of immediate medical assis-tance in case of an explosion.

“If I had information and awareness, this would not have happened to my family”, says Mr. Aslam, Tayyab’s father. Because he wants to make sure that no one else in his village suffers the pain that his family has endured, Mr. Aslam now assists in organising local MRE sessions taught by a team of social mobilisers.

Volunteers save livesUNICEF is also linking survivors like Tayyab with appropriate service providers for medi-cal treatment and rehabilitation. At the same time, school sessions are being conducted to help educate children about the dangers.

The impact of these interventions has been felt already, with casualties averted due to community volunteers’ identification of unex-ploded ordnance, which local bomb disposal squads have defused immediately.

“Floodwaters have contaminated vast areas,” says Inayat Ulah, a bomb squad official. “MRE training and awareness at the community level is very important, as we do not have the financial and human resources to comprehen-sively sweep these areas. Due to identification and timely reporting by community members, many lives have been saved.”

Shabana Bibi, a social mobilizer from the non-governmental Sustainable Peace and Development Organization, conducts a mine-risk education session with women and children in Budh village, a hazardous area of north-western Pakistan. © UNICEF Pakistan/2010/Shandana



InnoVAtIonS

Contracting third party field monitors during the flood emergency was an important component in UNICEF’s emergency flood response. Emer-gency flood relief needs required UNICEF’s operations in Pakistan to be quickly and radi-cally scaled up as existing systems and staff numbers were not sufficient to respond to the humanitarian relief efforts required to meet such a large-scale crisis. Staff coverage was also affected by Pakistan’s ongoing security situation, which restricts staff movement in some areas, and by local government’s resource constraints. Even with implementing partners reporting regularly, UNICEF Pakistan issued competitive bids for third party field monitors in the four flood affected provinces in order to ensure effective monitoring of activities and to improve transparency and accountability. The field monitoring contracts were awarded to specialist research organisations that are

not affiliated with UNICEF, government or NGO partners. These organisations provide moni-tors who are trained on indicators to measure UNICEF’s Core Commitments to Children in Emergencies, and can follow-up on the end use of UNICEF supplies.

Field monitors visit two to three sites per day, including schools, health units, water systems and communities supported by UNICEF, to perform qualitative and quantitative assess-ments of affected populations and UNICEF interventions. They also gather information on the needs of children, so that UNICEF can redi-rect resources to the areas of greatest need. UNICEF’s Planning, Monitoring and Evalua-tion (PME) units in each of the four provincial offices supervise the deployment of the field monitors, and compile the field monitors’ reports for use by the programme and supply


14.08 million Total




Opposite: Children laugh while standing outside a UNICEF supported Child Protection Centre in Taru Juba in Nowshera district, Khyber Pukhtunkhwa province. © UNICEF Pakistan/2010/Noorani

THIRD PARTY MONITORING IN HUMANITARIAN SITUATIONS


sections. The information the third party moni-tors collect is shared with UNICEF programme staff weekly. At the national level, the PME unit analyses common themes to share with UNICEF programmes nationally and in other provinces. The information is used to identify successes and to assess the implementation and appropri-ateness of a particular approach. Supply monitor-ing is emphasised, as is appropriate to the nature of this emergency. The information is then fed into the decision-making process for planning and managing the overall emergency response.

Additional examples of third party monitoring include the following activities:g Confirming the progress reports of imple-

menting partners before payment is autho-rised.

g Field-testing, for example the Child Friendly School Standards to support their adaptation.

g Identifying communities that were not reached by supplies, or confirming that supplies that arrived were distributed to targeted people and used appropriately.

Third party monitors are an effective perfor-mance and quality assurance mechanism in emergencies when there is a sudden and massive increase in the need for monitoring capacity. The third party monitors constitute an independent tool for UNICEF to validate their partners’ reports, and they provide regular updates on interventions, as well as the chang-ing situation of the population being assisted.

Future uses of research organisations as third party monitors will include: g Supporting regular programme monitoring,

especially in high-risk areas.g Supporting monitoring by the Clusters coor-

dinating an emergency response.g Informing ongoing work to develop the

global Core Commitments to Children in Humanitarian Action performance monitor-ing system and toolkit.

At the end of 2010, performance assessment of the contracted research organisations was done to inform decisions on improving performance

A health worker vaccinates a child against polio outside his home during Polio National Immunisa-tion Day (NID) in Bhutto Nagar in Lan-dhi town, Karachi. © UNICEF Paki-stan/2010/Zaidi


and continuing the initiative in 2011. Best prac-tices were shared between provinces and will feed into future plans.

GAVI SUPPORT FOR STRENGTHENING CIVIL SOCIETY ORGANISATIONSThe Global Alliance on Vaccines and Immunisa-tion (GAVI) has allocated US$ 4.5 million to Paki-stan to strengthen cooperation between govern-ment and civil society on health care services. In Pakistan, people who live in remote areas often lack access to health care services, as local governments lack the capacity to provide a full complement of health services. In some areas, the security situation is volatile, and access is limited. In Pakistan as a whole, but particularly in remote and insecure areas, the private sector, including civil society organisations (CSOs), are widely trusted to provide essential health servic-es to mothers and children.

UNICEF is providing support to a platform bring-ing government and civil society organisations together at the policy and implementation level. This takes advantage of the strengths of both parties: the government provides maternal and child health services from the central level, while CSOs have close links with the communi-ties in which they work.

CSOs work with communities to increase awareness and improve health care service delivery. CSOs have trained health care work-ers, provided equipment and established immu-nisation services in remote areas.

With support from UNICEF and GAVI, the Ministry of Health’s Expanded Programme for Immunisation (EPI) brought together 15

CSOs working on a range of activities, includ-ing immunisation and health services for mothers and children, in four provinces. Each organisation has signed agreements stating its activities, targets and budget. Quarterly reports ensure that issues are quickly tackled, and are supplemented by frequent monitoring visits. In addition, CSO staff also receive training.

Coordination meetings are attended by CSO staff, UNICEF, and representatives from the federal, provincial and local governments twice a year. At these meetings, CSOs can discuss their progress, concerns and challenges with government counterparts. The result of the inclusion of CSOs is that, instead of working in isolation, they build on and complement govern-ment initiatives.

This public-private partnership has had several benefits:g Duplication and gaps in coverage are

avoided as intervention areas are chosen in consultation.

g Accountability is improved as district advisory committees, consisting of CSOs, government staff and community members, link communities with govern-ment departments.

g Service delivery is coordinated, especially during mass campaigns, such as national immunisation days and Mother and Child Weeks.

UNICEF plays the role of the intermediary: managing and transferring funds, reporting results, and bringing together partners. There is great potential for expansion of this approach within Pakistan and in other countries and areas facing similar challenges.


CHILDRENOF THE FLOODSThroughout the flood emergency response, UNICEF has told the stories of many children who have suffered as a result of losing their loved ones, their homes and their schools. UNICEF went back to find these children to see how they are doing six months after the floods struck. Here are the stories of Sobia and Umair, children who have been reached with the support of the many UNICEF donors and supporters throughout the world.

Above: Sitting on the rubble of his house, Faizan, 5, plays with his sister Alezba, 6, in Taru Jabba Union Council of Nowshera district in Khyber-Pakhtunkhwa province. © UNICEF Pakistan/2010/Noorani


Sobia, 14, lives in a camp in Khyber Pukhtunkh-wa with her husband and in-laws. The young expectant mother has never been to school and was married when she was barely thirteen. It is hard to believe that she is nearly eight months pregnant, but that is what her medical reports state.

Sobia is living in a tent with her young husband, as well as his widowed father, and younger siblings. Very quiet and withdrawn, she is too shy to speak but the ravages of the floods are evident from her face. Suffering from severe anaemia and exhaustion, her eyes are completely devoid of any expression.

Her father-in-law, Noor Uddin tells us, “My wife died last year and there was no one to look after my young children. I married off my eldest son, 18. year old Rooh Ullah so that his wife could look after the home and my children.” With tears in his eyes he adds “I have lost everything. Whatever I had made for my son’s wedding was also lost. Many families have gone back and are rebuilding their homes but I am a poor man and have no resources to restart my life. I don’t know how I will look after my family”.

January 2011

“My beautiful daughter will go to school and have a job,” says fourteen year old Sobia, look-ing down lovingly at 10 week old Haseena. “I will make sure that she is not married at an early age. She will not suffer like me.”

Sobia, her young husband, Rooh Ullah and his family had lost all their household belong-ings when their rented house in Charsadda in Khyber Pakhtunkhwa province was washed away last year, in the worst monsoon floods to have ever hit the country. Her family had to move six times in the past six months, taking refuge in three different camps and two differ-ent rented accommodations. They are now living in a room provided by their relatives.

Sobia, then: Pregnant and suffering from severe anaemia and exhaustion, her eyes were completely devoid of any expression.© UNICEF Pakistan/2010/Zaidi

Sobia, then: Pregnant and suffering from severe anaemia and exhaustion, her eyes were completely devoid of any expression.© UNICEF Pakistan/2010/Zaidi

Sobia’s story October 2010


During this difficult time, child psychologist Nida Khan from Job Creation and Development Society (JCDS) an NGO and UNICEF partner has played a critical role in Sobia’s life. Her regular psychosocial support and her organi-sation’s strong child protection monitoring network ensured that Sobia could cope with the traumatic experiences and had access to life saving medical services. Her daughter was delivered safely in a public sector hospital in the nearby provincial capital Peshawar.

“The family was constantly on the move. It was very difficult to keep track and support them. But I am so happy that all the hard work is paying off. The young couple is coping well

and looking ahead to a prosperous future with their daughter,” says Nida Khan. “The young parents were provided intensive psychosocial counselling. Having a baby at such a young age and under very difficult circumstances has been very traumatic for Sobia as well as Rooh Ullah, who started taking drugs”, adds Ms. Khan.

Through the UNICEF-supported Child Protec-tion monitoring and referral system, the young man is now in a drug rehabilitation programme. “I feel much better. I go to work and provide for my wife and daughter”, says Rooh Ullah proud-ly. “I hope one day I will build a home where we can live safely”, he adds.

Sobia, now: Sobia and her husband Rooh Ullah speak about their dreams for their new family. © UNICEF Pakistan/2010/Zaidi


October 2010 Seven year old Umair sits with Nighat Sultan, a child psychologist, in a child friendly space in a football ground camp in Charsadda district, Khyber-Pakhtunkhwa province, Pakistan.

“Umair is severely traumatised. He lost his mother in the recent floods,’’ says Ms. Sultan. Umair and his mother, Uzlefat, a widow, lived with her mother and brothers in Kharbela village, Union Council Prang, an area badly damaged by the floods. Umair lost his father a few years back but his mother and maternal relatives took care of him. He was studying in Grade 2 before the devastating floods completely destroyed the family house and his life.

“While Umair and his mother were still inside the mud house, the roof collapsed on top of

them. Umair survived but his mother was hurt and later died because of complications as she was suffering from Hepatitis C,” says Ms. Sultan.

“Umair was identified in the camp by our Child Protection Monitor. He was withdrawn and mute and would turn very aggressive if approached.With intensive psychosocial support, including counselling sessions and play therapy at the UNICEF supported Child Friendly Space in Football Ground Camp Prang, his condi-tion has improved.”

January 2011In a nearby UNICEF-supported Child Protec-tion Centre, seven year old Umair plays happily. Umair, whose father died a few years back, now lives with his maternal grandmother and extended family.

Umair’s story

Umair, then: Severely traumatised because of the loss of his home and mother, Umair was aggressive and anxious. © UNICEF Pakistan/2010/Zaidi

Umair, now: After play therapy and counseling sessions his condition has improved. He now goes to school. © UNICEF Pakistan/2010/Zaidi


“Umair was very disturbed when he returned to the village. His small mud house was complete-ly razed to the ground. He was phobic, with-drawn and aggressive”, says Sania Gul, a child psychologist at the centre.

“But look at him now. It’s hard to believe it is the same Umair. He goes to school now and comes to the Center regularly, where through play therapy and group counselling his emotion-al conditional has improved remarkably”, adds Ms. Gul.

“I like drawing and playing on the swings”, says Umair. “I miss my mother but love my grand-mother. I will become a doctor and look after her”, he adds. “It has been very difficult looking after him”, says the old Shamuna Fazle Maula, Umair’s grandmother, whose eyesight has been badly affected after floods. “I love him dearly, as he is the only reminder of my daughter. I hope I live long enough to see him stand on his feet,” she adds tearfully.

Opposite: Umair talks about his drawing to a UNICEF staff. He actively participates in various activities of the Child Friendly Space (CFS) in village Kharbela, Union Council Prang in Charsadda district, Khyber-Pakhtunkhwa province.

Sobia, now: Sobia and her husband Rooh Ullah speak about their dreams for their new family. © UNICEF Pakistan/2010/Zaidi


ReSoURCe MoBILISAtIon

FINANCIAL RESOURCESFor 2010, the UNICEF Executive Board approved resource mobilisation targets, not including emergency appeals, of US$ 29.5 million for health and nutrition, US$ 3 million for WASH, US$ 15.2 million for basic education, US$ 3.8. million for child protection, and US$ 6.2 million for cross-sectoral work. Almost all of this was to be mobilised under UN Joint Programmes. However, due to two large-scale emergen-cies in 2010, these targets were not reached. Instead, UNICEF, under two humanitarian appeals endorsed by the government, raised a large amount of emergency funds outside of the One UN Joint Programme framework. By the end of the year, the 2010-2011 budget for emer-gency and regular resources amounted to US$ 358..3 million, compared to US$ 102.8. million in December 2009. Of this, US$ 242 million was in humanitarian funds.

The first emergency appeal was the Pakistan Humanitarian Response Plan, which focused on assisting internally displaced persons (IDP) in the north-west of the country. This was operational throughout 2010, and by the end of the year, UNICEF had raised US$ 26.2 million to support affected IDPs.

The scale of the 2010 floods, combined with regular programme requirements, resulted in a need for immediate, large-scale resource mobili-sation, which the government approved in the Pakistan Flood Emergency Response Plan on 11 August 2010. During August and September, senior UN and UNICEF officials, including UN Secretary-General Ban Ki-moon, UNICEF Execu-tive Director Anthony Lake, UNICEF Regional Director Dan Toole and UNICEF Emergency Operations Director Louis-Georges Arsenault visited flood affected areas and reinforced the appeal for support.

As the flooding continued for nearly six weeks, with millions more displaced or affected, it became clear that the original appeal would have to be revised. This resulted in the launch of the Pakistan Flood Emergency Relief and Early Recovery Response Plan in November, totalling US$ 1.93 billion – the largest-ever humanitar-ian appeal in response to a natural disaster. UNICEF’s own appeal was revised from US$ 47.3 million to US$ 252.3 million to support activities through the end of July 2011.

By the end of 2010, UNICEF had received US$ 168..4 million, with an additional US$ 22.9 million

Opposite: Ahsanullah, 3, sits on a donkey cart that carries containers of water collected for reconstruction from a nearby canal in flood affected Waruki Kili village of Tank district in Khyber-Pakhtunkhwa province in Pakistan. © UNICEF Pakistan/2010/Noorani


in pledges, totalling US$ 191.3 million for flood relief activities. The remaining gap in funding amounted to US$ 61 million.

SUPPLIESSupply operations in 2010 far exceeded anything previously processed by UNICEF Pakistan. In addition to vaccine procurement for the govern-ment by UNICEF’s Copenhagen office, US$ 49.4 million in offshore procurement and US$ 40.9 million in local procurement also took place, and many donors contributed assistance in kind. There were major challenges to supply opera-tions during the flood response; in particular, the Peshawar warehouse was flooded, which led to the loss of a large amount of contingency stock and new temporary warehouses and logistical arrangements had to be quickly established.

HUMAN RESOURCESThe scale of the flood emergency required a significant and immediate increase in national and international staff, including bringing in the Regional Director for South Asia as Special Representative for the flood response. In less than three months, the Pakistan Country Office staff expanded by 8.8. per cent through a combi-nation of temporary posts, consultancies and surge staff from other offices and organisations. Also, dozens of existing staff were re-deployed to flood affected areas. The response benefited greatly from Surge capacity from standby part-ners, including CANADEM, Danish Refugee Council, Icelandic Crisis Response Unit, iMMAP, Oxfam GB, Norwegian Refugee Council and RedR Australia.

Programme Amount (US$)

Mother and Child Health Care 71,159,152

Water and Sanitation 51,717,455

Primary Education 38.,100,745

Child Protection 14,323,993

Monitoring and Evaluation 2,711,612

Cross-Sectoral and Operational Costs 12,269,995

Total 190,282,952

Donor Amount (US$)

Australia 20,094,626

Austria 1,360,540

Belgium 2,8.06,011

CIDA/HAND 278.,979

CIDA/IHA 1,8.99,340

Canada 5,679,573

Denmark 4,405,250

Finland 2,099,8.95

Ireland 318.,015

Italy 1,063,041

Japan 12,559,000

Kuwait 250,000

Table 1: Total Expenditure 2010 by Programme Area

Table 2: Total Funding Allocations 2010 by Donor


Donor Amount (US$)

Andorran National Committee for UNICEF 20,408.

Australian Committee for UNICEF 5,768.,398.

Austrian Committee for UNICEF 405,58.0

Belgian Committee for UNICEF 2,38.5,760

Canadian UNICEF Committee 2,459,255

Czech Committee for UNICEF 11,111

Danish Committee for UNICEF 2,040,949

Finnish Committee for UNICEF 8.55,650

French Committee for UNICEF 5,563,327

German Committee for UNICEF 10,573,907

Hellenic National Committee 204,8.19

Hong Kong Committee for UNICEF 128.,710

Iceland National Committee for UNICEF 8.3,535

Italian National Committee 6,332,315

Japan Committee for UNICEF 3,8.92,125

Korean Committee for UNICEF 1,294,960

Luxembourg Committee for UNICEF 127,065

Liechtenstein 97,466

Luxembourg 705,273

Netherlands 20,08.1,541

New Zealand 727,8.00

Norway 12,244,8.90

Pakistan 1,023,233

Republic of Korea 400,000

Russian Federation 1,000,000

SIDA - Sweden 2,140,900

Saudi Arabia 4,665,330

South Africa 137,419

Spain 4,667,98.4

Switzerland 8.50,000

United Kingdom 14,035,950

USA OFDA 19,396,977

USA CDC 441,362

USA USAID 11,717,692

Total 147,148,087

Table 3: Total Funding Allocations 2010 by UNICEF National Committees


Netherlands Committee for UNICEF 7,123,592

New Zealand Committee for UNICEF 290,411

Norwegian Committee for UNICEF 1,326,8.92

Portuguese Committee for UNICEF 317,662

Spanish Committee for UNICEF 1,594,8.91

Swedish Committee for UNICEF 1,919,649

Swiss Committee for UNICEF 1,572,743

Turkish National Committee for UNICEF 16,8.92

UNICEF Ireland 430,910

UNICEF Slovenia 153,106

United Kingdom Committee for UNICEF 10,305,538.

United States Fund for UNICEF 8.,645,604

Total 75,845,764

Table 4: Total Funding Allocations 2010 from Other DonorsDonor Amount (US$)

Agfund 50,000

Bill and Melinda Gates Foundation 3,38.6,707

European Commission/EC 105,28.6

European Commission/ECHO 9,667,08.6

International online donations 245,8.58.

Micronutrient Initiative 555,626

Red Crescent Society UAE 610,257

Rotary International 4,573,666

The GAVI Fund 1,548.,973

UNAIDS 105,601

UNDP - JP 1,351,121

UNDP - USA 2,628.,054

UNICEF Belgrade 78.0

UNICEF Argentina 5,08.8.

UNICEF Bhutan 642

UNICEF China 1,68.1

UNICEF Guyana 147,762

UNICEF India 2,932

UNICEF Malaysia 31,911

UNICEF Pakistan 8.00,000

UNICEF Philippines 2,498.

UNICEF Russian Federation 1,714

UNICEF Thailand 304,236


Table 5: Major Donors to UNICEF in PFRERP for Flood EmergencyDonor Amount (US$)

AgFund 50,000

Andorran National Committee for UNICEF 20,408.

Australia 15,111,570

Australian Committee for UNICEF 5,768.,398.

Austria 1,360,540

Austrian Committee for UNICEF 405,58.0

Belgian Committee for UNICEF 2,38.5,760

Belgium 2,628.,120

Canada 1,8.99,340

Canadian Committee for UNICEF 2,453,327

CERF 7,964,554

Czech Committee for UNICEF 11,111

Danish Committee for UNICEF 2,001,109

European Commission 5,256,240

Finland 1,292,355

Finnish Committee for UNICEF 8.55,650

French Committee for UNICEF 5,563,327

German Committee for UNICEF 10,504,095

Hellenic Committee for UNICEF 204,8.19

Hong Kong Committee for UNICEF 128.,710

Iceland Committee for UNICEF 8.3,535

International online donations 245,8.58.

Ireland 38.1,195

Irish Committee for UNICEF 430,910

Italian Committee for UNICEF 6,332,315

Italy 1,090,570

Japan 20,000,000

Japan Committee for UNICEF 2,000,000

Korean Committee for UNICEF 1,294,960

Kuwait 250,000

UNICEF Thailand EAPRO 2,323

UNICEF United Arab Emirates 155,924

UNMAS - New York 38.9,091

UNOCHA 10,042,479

WHO - Geneva 459,979

Total 37,177,275


Liechtenstein 97,466

Luxembourg 705,273

Luxembourg Committee for UNICEF 127,065

Netherlands 9,230,768.

Netherlands Committee for UNICEF 6,8.76,8.58.

New Zealand 727,8.00

New Zealand Committee for UNICEF 290,411

Norway 12,244,8.90

Norwegian Committee for UNICEF 1,326,8.92

Portuguese Committee for UNICEF 317,663

Republic of Korea 400,000

Russia 1,000,000

Slovenia Committee for UNICEF 153,106

South Africa 137,419

Spain 4,667,98.4

Spanish Committee for UNICEF 1,426,8.24

Sweden 1,38.7,300

Swedish Committee for UNICEF 1,919,649

Swiss Committee for UNICEF 1,202,8.77

Turkish Committee for UNICEF 210,440

UAE Red Crescent 610,257

UNICEF Argentina 5,08.8.

UNICEF Belgrade 78.0

UNICEF Bhutan 642

UNICEF China 1,68.1

UNICEF EAPRO 2,323

UNICEF Guyana 152,421

UNICEF India 2,932

UNICEF Malaysia 31,911

UNICEF Pakistan 8.00,000

UNICEF Philippines 2,498.

UNICEF Russia 1,714

UNICEF Thailand 304,236

UNICEF UAE 155,924

United Kingdom 14,035,950

United Kingdom Committee for UNICEF 9,710,752

United States 21,203,152

United States Fund for UNICEF 8.,8.43,968.

Total 198,291,269


Table 6: Major Donors to UNICEF in PHRP to support IDPsDonor Amount (US$)

Australia 1,792,120

Belgium 170,940

Canadian Committee for UNICEF 5,928.

Central Emergency Response Fund (CERF) 2,295,8.18.

Denmark 1,8.8.3,450

European Union/ ECHO 5,602,240

Finland 8.07,540

German Committee for UNICEF 69,8.12

Italy 3,463,8.46

Japan 3,042,8.05

Japan Committee for UNICEF 1,8.92,125

Netherlands 7,479,694

Saudi Arabia 4,665,330

Sweden 753,600

United Kingdom Committee for UNICEF 51,472

United States Fund for UNICEF 45,209

United States of America (USAID/OFDA) 3,373,8.25

UNMAS 38.9,091

WHO 459,979

Total 43,824,823

Table 7: Major Donors to UNICEF for UN Delivering as One Programme

Donor Programmable Amount (US$)United Kingdom (DFID) 1,8.77,999Norway 1,8.34,8.58.


ART Anti-retroviral TreatmentCCC Core Commitments for Children In EmergenciesCERF Central Emergency Response Fund (United Nations)CP Child ProtectionCSO Civil Society OrganisationEC European CommissionEMIS Education Management Information SystemEPI Expanded Programme on ImmunisationERRA Earthquake Reconstruction and Rehabilitation AuthorityFAO Food and Agriculture OrganizationFATA Federally Administered Tribal AreasGAVI Global Alliance on Vaccines and ImmunisationIDP Internally Displaced PeopleKP Khyber PakhtunkhwaMcRAM Multi-Cluster Rapid Assessment MechanismMDG Millennium Development GoalMICS Multiple Indicator Cluster SurveyMRE Mine Risk EducationNDMA National Disaster Management AuthorityNGO Non-Governmental OrganisationOCHA Office for the Coordination of Humanitarian Affairs (United Nations)PAK Pakistan Administered KashmirPDMA Provincial Disaster Management AuthorityPFRERP Pakistan Flood Relief and Early Recovery PlanPHRP Pakistan Humanitarian Response PlanPME Planning, Monitoring and EvaluationPPTCT Prevention of Parent to Child TransmissionUN United NationsUNDAC United Nations Disaster Assessment and CoordinationUNESCO United Nations Educational, Scientific and Cultural OrganizationUNFPA United Nations Population FundUNICEF United Nations Children’s FundUXO Unexploded OrdnanceWASH Water, Sanitation and HygieneWFP World Food Programme

WHO World Health Organization

ACRonYMS

United Nations Children’s FundPakistan Country OfficeP.O. Box 1063, IslamabadTel: +92-51-209-7700Fax: +92-51-209-7799www.unicef.org/pakistan

© UNICEF 2011

Cover photo credit:©UNICEF/PAK/2010/Noorani

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