Inter-Agency Working Group on Reproductive Health in Crises SPRINT, sharing good practices: Lebanon MISP training Nada Aghar Naja, UNFPA

Presentation objective Share the Lebanon experience in rolling out the MISP training in terms of challenges and lessons learned

Minimum Initial Service Package (MISP) in RH in times of crises The training is part of the SPRINT Initiative that aims to increase SRH services and information for persons living in crisis and post-crisis situations. The overall goal of the training is to increase the coordination skills of SRH Upon completion of this training, participants (coordinators/managers) should be able to: 1. Advocate for SRH in crises 2. Apply core concepts and techniques provided in the MISP 3. Apply coordination skills for the implementation of the MISP 4. Produce an action plan to integrate SRH into national emergency preparedness plans

Context of the MISP training 2009 Regional TOT workshop attended from national stakeholders (MoPH, IMC, UNHCR, UNRWA, LFPA, LRC) Inclusion of the MISP activity within the 2011 MoPH AWP supported by UNFPA Launched the training in the North, early 2012

Context of the MISP training April 2011: Security events in Syria ==) displacement of Syrians across the Lebanese - Syrian borders Lebanese-Syrian borders are still not demarcated residents in both Syria and Lebanon around the borders in the North are known to inter marry and have family ties Nbr of registered and assisted till March: UNHCR: 11,000; others not registered because for security reasons. March 2012: more than 500 (4,000 persons) Syrian families crossed the Bekaa border. No demarcation line too

MISP training for the North area UNFPA CO initiative to launch the training Coordination was done with the core group of TOT LSOG interest to take it in charge Participants selection: From SDC MOSA), and PHC (MOPH/NGOs) and a referral hospital in Akkar. Have a large volume of SRH work and beneficiaries Availability of specialized health care providers and social workers Background and current work: Social science, nurses, midwives, socio-medical supervision and medical doctors.

LESSONS LEARNED: Facilitating factors Good selection of the TOT core group members Benefit gained from the TOT regional training A well established system of communication and information sharing (TOT, UNFPA, UNHCR) Advocacy for rolling out the ECHO training lead by UNFPA with support from TOT 1) committed, multidisciplinary (RH including HIV/AIDS; GBV), field knowledge, represent a variety of UN agencies, NGOs and government Benefit from the regional TOT 3) Lead to including the training activity in the UNFPA supported AWP of MOPH, all this lead to representation of the MoPH DG and the Qada doctor of Akkar in the opening, Implementing partner: LSOG , Participation of doctors in workshop’s opening session where MISP on RH in crisis situations was presented (to gain support and advocacy

LESSONS LEARNED: CHALLENGES Absence of a National Preparedness Plan to respond to crises ====) Absence of a lead governmental response including advocacy and awareness raising addressed to humanitarian partners, decision makers and donors. (not yet felt a priority, lack of vision (this will affect referral, credibility among the national stakeholders trained, inclusion of their PoA within the national one, establishment of a functional coordination mechanism, etc.) A need for advocacy and awareness raising addressed to : Humanitarian partners, decision makers and donors.

LESSONS LEARNED There is a need for such a training though it might be considered very basic to service providers: remarkable improve in knowledge from 24% to 80% correct answers, especially questions related to when preparation for MISP to take place, what are the priority activities MM and sexual violence management are concepts to be highlighted during the MISP training as they were perceived very important topics to address Need for a refresher or further coordination after the training in order to keep momentum high among participants Equip the referral hospital with the supplies/commodities needed for EO services and NN care in crisis and after crisis situations covered in this training.

LESSONS LEARNED MOPH to reconsider the provision of RH commodities and drugs to SDC (as they stopped supplying them since 2009) for the MISP to be realistically implemented.