AEI&CS Assessment Pilot Workshop Ayeyarwaddy Region

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AEI&CS Assessment Pilot Workshop Ayeyarwaddy Region Pathein, Myanmar September 29 October 2, 2014

1. Introduce the concepts of accountability, equity, inclusion and conflict sensitivity (AEI&CS). 2. Introduce 3MDG set of standards on AEI&CS. 3MDG AEI&CS 3. Start looking at how AEI&CS relate to each step of the project cycle in order to support practical implementation of these concepts. AEI&CS

4. Introduce the 3MDG AEI&CS assessment process. 3MDG AEI&CS 5. Build capacity of participants to conduct discussions with communities as part of the AEI&CS self-assessment process. AEI&CS

Agenda Day 1 9:00am 10:00am 10:00am 10:30am (Accountability) (Accountability) 10:45am 11:00am (Accountability) (Accountability) 11:00am 12:00pm (Equity) (Equity)

Agenda Day 1 1:00pm 1:45pm (Inclusion) (Inclusion) 1:45pm 2:45pm Sensitivity) (Conflict (Conflict Sensitivity) 2:45pm 3:15pm 3MDG AEI&CS 3MDG AEI&CS 3:30pm 4:30pm 4:30pm 5:00pm AEI&CS AEI&CS

Agenda Day 2 9:00am 9:45am 9:45am 10:30am 3MDG AEI&CS 10:45am 12:00am 3MDG AEI&CS 3MDG AEI&CS

Agenda Day 2 1:00pm 1:30pm 1:30pm 3:00pm Energizer 3:15pm 4:45pm 4:45pm 5:00pm Field Visit Field Visit

Agenda Day 3 Time Session Objective 8:00am 5:00pm (Departure time to be confirmed) Oo Yin Kone, Sint Oo Pho Out, Chan Kwin Villages

Agenda Day 4 Time Session Objective 9:00am 10:30am 10:45am 12:00pm 1:00pm 1:30pm Energizer (Good practices) improvement) AEI&CS practices) improvement) AEI&CS (Areas for (Good (Areas for

Agenda Day 4 Time Session Objective 1:30pm 3:00pm AEI&CS 3MDG AEI&CS 3:15pm 4:45pm AEI&CS AEI&CS 4:00pm 4:45pm

Accountability : Fix my Bike Role Play

Role Play

Accountability : Fix my Bike Role Play

Accountability Using power responsibly Listening (and responding) to the voices of people Being responsible and keeping your commitments to the people who use health services. Building empowered and informed communities and health system users.

More power Less power

Equity involves recognising that people are different and need different support to ensure their rights are realised. Equity is about being fair and just to people who use the health system.

Equity involves trying to understand and give people what they need to enjoy full, healthy lives. Equality, in contrast, aims to ensure that everyone gets the same things in order to enjoy full, healthy lives Like equity, equality aims to promote fairness and justice, but it can only work if everyone starts from the same place and needs the same things.

Let s think for a moment about runners sprinting around an oval track during a competition.

The concept of equality would have us treat the runners in exactly the same way, ensuring that they all start at the same place on the track. On the surface, this seems fair.

But we know that runners in the inside lanes have a distinct advantage over runners in the outer lanes because the distance they have to travel is shorter. As a result, equality starting at the same place doesn t result in fairness.

The concept of equity, in contrast, would lead us to stagger the starting positions of the runners in order to offset the disadvantages facing those in the outer lanes.

In this case, different or tailored treatment is a surer path to fairness and justice than the same treatment. The same distinction between equity and equality can be seen when it comes to health and care.

Ensuring the same access to care for everyone assumes that everyone has similar health status and similar health care needs. We know this is not the case. Some people, like the runners in the outside lanes of the track, live with social, political and economic disadvantages that contribute to poor health.

For instance, women and men, boys and girls who live in poverty are frequently less healthy than those with more resources. As a result, they may need additional services and programs rather than just the standard ones to offset the impact of substandard housing, limited access to fresh, nutritious foods, and exposure to unsafe environments.

This is equity: making sure that have what they need to achieve and maintain health and well-being. Oval track example and pictures: SGAB e-learning Resource www.sgba.resource.ca

Equality = Sameness Equity = fairness

Health equity All people have the opportunity to have the highest level of health. Understanding the different barriers to health that people face and working to address them. All people can access quality health care regardless of their socio-economic position, including age, disability, gender or other circumstances. Ensuring that health policies and services respond to the specific needs of different groups of people.

What is Gender? Gender consists of the socially constructed roles and relationships, personality traits, attitudes, behaviours, values, relative power and influence that society ascribes to men and women. Gender both describes and prescribes what it means to be female or male at a given time, in a given society.

For example, women living in Myanmar around 1900 mainly worked in the home without pay caring for children and running households, while men engaged in paid employment or made money working outside the home. Today, the situation is different; more women work outside the home.

Gender is therefore what we think: What men and women should be How men and women should behave What men and women should do It is different from society to society and from time to time

Exercise: How We See Ourselves Think of one of your own characteristics or behaviours that is commonly associated with your sex.

For example: I am a woman who enjoys knitting I am a man who enjoys barbecuing As a woman, I find it easy to express my emotions As a man, I am committed to my career >>> BBQ

For example: I am a woman who loves looking after people, so I became a nurse. I am a man who loves playing football, so I coach my son s team.

Now, identify one of your characteristic(s) or behaviour(s) that is usually linked with a sex that is not your own.

For example: I am a man who stays home to look after my children. I am a member of the women s boxing team at school. I am an outspoken woman. I am a man who cries at the movies.

Exercise: How Others See Us

Gender has several implications in health since it will influence both men and women behaviours when it comes to health. For example: Men have to be strong. If they are sick, they just have to «tough it out». Why consult a doctor? Women are expected to take care of others and might not have the time to take care of their own health. >>>

In Indonesia, many men think that if they don t smoke, they are not «real men». Any other example from your experience?

Gender equity: Being fair to women and men. Taking specific actions to address historical and social discrimination and disadvantages in Myanmar that prevent women and men from otherwise operating as equals.

Let s all get in the back and do an inclusion exercise.

Inclusion Involves all people in decisions that affect their health. Understanding diverse experiences and preferences, and enabling people from many different circumstances (e.g. cultural, linguistic and geographic) to participate in health care planning. >>>

Inclusion Mutual respect, tolerance and making all people feel valued. Ensuring that all voices are included in decision-making processes.

WHAT IS CONFLICT SENSITIVITY? Conflict sensitivity is: the capacity of an organization to understand the context in which it operates; how its activities influence that context and viceversa; and to act upon that understanding to maximise positive impacts and avoid negative ones ( do no harm ). ( do no harm ). 44

CONFLICT SENSITIVITY What is conflict? The relationship between health & conflict What is conflict sensitivity? Definition and key steps Case study: assessing context, impacts of program 45

WHAT IS CONFLICT? Conflict is an incompatibility between two or more opinions, principles, or interests All conflict is not the problem, violent conflict is Peaceful, non violent forms of conflict are common and can be healthy 46

THE RELATIONSHIP BETWEEN HEALTH AND CONFLICT Impact of Conflict on Health, Wellbeing and Development Direct and indirect Examples Examples The Impact of Health Programs on Conflict 47

WHAT IS CONFLICT SENSITIVITY? Conflict sensitivity is: the capacity of an organization to understand the context in which it operates; how its activities influence that context and vice-versa; and to act upon that understanding to maximise positive impacts and avoid negative ones ( do no harm ). ( do no harm ). 48

ANALYSIS OF CONFLICT CONTEXT Health programs are not (perceived as) neutral but may worsen conflict Designed and implemented sensitively, programs can avoid harm and help mitigate conflicts >>> 49

ANALYSIS OF CONFLICT CONTEXT To see how, requires understanding who the stakeholders are & how conflicts arise and persist 50

CAUSES OF VIOLET CONFLICT Underlying root conditions Socio economic and historical conditions that are latent, but indirectly may increase the risk of violent conflicts Aggravating factors Processes, institutions, ideas and policies that activate the structural conditions 51

CAUSES OF VIOLET CONFLICT Triggers Immediate actions or events Occurrences that directly provoke and sustain violence No one causal factor will produce violent conflict (several factors combine & interact in the same place and time) 52

CONVERGENCE OF CAUSES: THE DRY WOODPILE ON A HOT DAY Susceptible Conditions + Catalysts + Sparks = Violent Conflict 53

POTENTIAL IMPACT OF PROGRAM ON CONFLICT Who is benefiting & who may be losing out? Location or type of services Timing of service delivery How information on services is communicated Can all be perceived to favor a certain group 54

POTENTIAL IMPACT OF PROGRAM ON CONFLICT Planning & implementation: Participatory, inclusive, impartial, transparent & partnership SH involvement in decisionmaking & management processes Joint ownership: positive impact on conflict 55

CASE STUDY PRACTICE INGO program in a post conflict setting Split into groups & discuss answers to 4 questions (30 mins): What do you identify as causes of conflict/tensions? Who are the main stakeholders? What are some of the potential areas of impact of the NGO program on the conflict/tensions? INGO 56

CASE STUDY PRACTICE What suggestions do you have for ways that the NGO could design or implement its program to improve its impact on the conflict? Plenary discussion (15 mins) 57

OUR APPROACH AS CONFLICT SENSITIVE PROMOTERS Step 1: Understand the context of our programs through a conflict/context analysis Step 2: Understand the different stakeholders in our context Step 3: Understand the potential impacts of our programs on the conflict / contexts Step 4: Act on this understanding to avoid negative impacts and increase positive impacts 58

3MDG AEI&CS 1 Leadership on Accountability, Equity and Inclusion Organisations demonstrate their commitments to program quality, which includes accountability, equity and inclusion. 1 2 Staff Capacity and Support Organisations support their staff to improve program quality. 2

3MDG AEI&CS Information Sharing and Transparency 3 Organisations publicly communicate their mandates, projects, and what stakeholders can expect from them. 3 Participation 4 Organisations involve the people it aims to assist in all phases of their projects. 4

3MDG AEI&CS 5 Feedback and Response Mechanisms Organisations put formal feedback and response mechanisms in place to gather and act on feedback. 5 Monitoring, Evaluation and Learning 6 Organisations learn from experience to continually improve their performance. 6

3MDG AEI&CS Conflict Sensitivity 7 Organisations ensure that their activities do not make conflicts worse and where possible that they improve possibilities for peace. 7 Working with Partners and Other Stakeholders 8 Organisations collaborate with partners and other stakeholders to ensure coordinated and efficient interventions. 8

3MDG AEI&CS What is an AEI&CS Assessment? AEI&CS? The process of assessing an organisation's AEI&CS-related policies, systems and practices against the 3MDG AEI&CS set of standards. An AEI&CS Assessment helps your organisation to evaluate how well it is doing in terms of AEI&CS, and to identify good practices and areas for improvement. It is done once a year; and is mandatory for all 3MDG s Implementing Partners. AEI&CS 3MDG AEI&CS 3MDG

3MDG AEI&CS How do you do an AEI&CS Assessment? AEI&CS? You have only one tool to fill: the AEI&CS Assessment Tool The AEI&CS Assessment Tool is an Excel document that includes 3MDG s 8 AEI&CS standards Each standard has indicators to help us measure how well we are achieving the standard When conducting the assessment, a score is given to each indicator, depending on the performance of the organisation on this indicator. Excel document 3MDG AEI&CS

3MDG AEI&CS

3MDG AEI&CS (SMT) (Field Staff) (Communities) (Partners)

3MDG AEI&CS Once you have heard the opinions of these four groups of people, you can honestly give your organisation a score for each indicator under each standard. Doing so will allow to identify good practice and strengths as well as areas for improvement.

3MDG AEI&CS With this information you will be able to develop an improvement plan to improve on AEI&CS. AEI&CS This will help you to become better and have a bigger impact in the lives of people.

3MDG AEI&CS Puzzle Game

3MDG AEI&CS The AEI&CS Assessment Process has to be conducted once a year: 2014: IPs lead the AEI&CS assessment with the support from HAP 2015: HAP and/or an external party will lead AEI&CS assessments with the active participation of IPs 2016: IPs lead the AEI&CS assessment with the support from HAP AEI&CS 2014: HAP 2015: HAP 3MDG AEI&CS 2016: HAP

Role Play

The Good Enough Guide

Focus Group Focus Group Foucs Group

( )

Scoring Indicators on the AEI&CS Assessment Tool The AEI&CS Assessment is led by an AEI&CS Assessment Team Leader. This person has the ultimate management responsibility of conducting the AEI&CS assessment. AEI&CS

Scoring Indicators on the AEI&CS Assessment Tool The AEI&CS Assessment Team Leader is supported by an AEI&CS Coordination Group. This group composed of 3 people, of which the AEI&CS Assessment Team Leader, plans and coordinate the AEI&CS Assessment. AEI& CS

3MDG AEI&CS (SMT) (Field Staff) (Communities) (Partners)

Scoring Indicators on the AEI&CS Assessment Tool It is not necessary for the AEI&CS Assessment Group Leader or the AEI&CS Coordination Group to conduct all the interviews or FGDs. They can delegate as they see fit. If they choose to delegate, they must however give very clear instructions on how to conduct the interviews or FGDs and ensure to get quality notes from the FGDs and interviews conducted.

Scoring Indicators on the AEI&CS Assessment Tool Once all the interviews and FGDs have been conducted, the AEI&CS Coordination Group needs to collect and review all the notes from the interviews and FGDs. It is only after having reviewed all the notes that the AEI&CS Assessment Team Leader can begin scoring the indicators on the AEI&CS Assessment Tool.

Scoring Indicators on the AEI&CS Assessment Tool The scoring scale is as follows: 0: Not at all 1: Some, but quite weak 2: Yes, but room for improvement 3: Strong, but with minor weaknesses 4: Fully in place You can only choose one of these 5 options. You cannot choose 2.5 for example.

Scoring Indicators on the AEI&CS Assessment Tool In order to decide which score to give to each indicator, you need to review the answers of all 4 groups. Once you have done that, you can decide which score to give to that indicator.

Scoring Indicators on the AEI&CS Assessment Tool You also need to explain why you are giving yourself this score. This is what is called Reasons / Evidence for Score. This must be done for every indicator.

Scoring Indicators on the AEI&CS Assessment Tool All indicators related to policies or procedures (1.1, 2.1, 3.1, 4.1, 5.1, 5.2, 6.1, 7.1, 8.10) are just about having a written policy or procedure; it is not about if the policy or procedure is well understood by staff If you do not have a policy on a specific topic, you should score 0.

Scoring Indicators on the AEI&CS Assessment Tool For example, indicator is 2.1 is: The organisation has a recruitment policy or equivalent guidance that is fair, transparent and non-discriminatory. If your organisation does not have a recruitment policy, you should indicate 0.

Scoring Indicators on the AEI&CS Assessment Tool Example, continued Indicator 2.2 is: «The recruitment policy or equivalent guidance pays specific attention to: Gender equity; Ethnic and religious diversity» If you do not have a recruitment policy, then you should score 0 to that indicator as well.

Scoring Indicators on the AEI&CS Assessment Tool Another example: SMT: «We have clear guidelines on information sharing with communities». SMT :

Scoring Indicators on the AEI&CS Assessment Tool Field staff: «I have not been told by my supervisors which information exactly I should share with communities but I make sure to share a lot of information about the project with communities». Field staff:

Scoring Indicators on the AEI&CS Assessment Tool Example, continued Communities: We have some information about the project, but we would like to have more information. Also we would like to learn more about the organisation itself. Communities:

Scoring Indicators on the AEI&CS Assessment Tool Partners: We have discussed briefly with the organisation about which information we should share with the communities, but I am not sure what is our role exactly in sharing this information. Partners:

Scoring Indicators on the AEI&CS Assessment Tool Which score should be given for the indicator 3.2 : «Information on the following topics is provided on a regular basis and in timely manner to beneficiaries and communities»?

Scoring Indicators on the AEI&CS Assessment Tool Another example: SMT: «When employees are hired, we make sure they read and understand the staff code of conduct well. They have to sign a form that confirms they understand it». SMT :

Scoring Indicators on the AEI&CS Assessment Tool Field staff: Staff code of conduct? I am not sure what it is exactly but I remember signing a lot of papers when I was hired. Field staff:

Scoring Indicators on the AEI&CS Assessment Tool Which score should be given for the indicator 2.6 : «The organisation has a process to ensure that staff understand the code of conduct well»

Scoring Indicators on the AEI&CS Assessment Tool Once the AEI&CS Assessment Team Leader has completed the AEI&CS Assessment Tool, the AEI&CS Coordinating Group must review it using the records of the interviews and the focus group discussions and reach consensus on the scores given to the indicators.

Scoring Indicators on the AEI&CS Assessment Tool Scoring is not an exact science; it is all based on your judgment. An important point to always keep in mind while scoring is the outcome, or what is really happening in the field/office.

Scoring Indicators on the AEI&CS Assessment Tool The results of the FGDs with communities will then be really important. It is really important to be really honest in scoring the indicators; the goal is to improve and learn. No organisation has ever had a score of 100%!

Scoring Indicators on the AEI&CS Assessment Tool A fictive example of a completed AEI&CS assessment will be shared with all IPs soon. This will give you a good idea of what a completed AEI&CS Assessment Tool should look like. AEI and CS

Scoring Indicators on the AEI&CS Assessment Tool All IPs must finish their AEI&CS assessment for November 15 and share it by email to their organisation HAP focal point. CS HAP AEI &

Scoring Indicators on the AEI&CS Assessment Tool We remain available to support you during this process; please feel free to contact us anytime.

Scoring Indicators on the AEI&CS Assessment Tool Questions?

Thank you! Thank you for your great participation!