Health facilities in crises affected areas in Northern and Central Mozambique are under pressure due to increased demand for services and lack of resources and capacity to cope with the increased catchment population due to displacement. Especially in the areas receiving people displaced due to insecurity in Cabo Delgado, districts’ health services have limited capacity and logistical resources to fully integrate newly displaced and resettled communities into their regular outreach services schedule. In addition, the COVID19 pandemic has put additional risks to public health, especially for migrants and internally displaced people as they are on the move and sometimes face additional issues to access services.Key programmatic interventions include: 

• Providing continuous support to district health services to implement mobile outreach services to highly affected and hard-to-reach communities, including logistics support (such as fuel, vehicles/boats and medical supplies) and technical assistance in the districts affected by natural disasters and conflicts;
• Continuous strengthening of the continuum of care, especially for HIV and tuberculosis services in displacement affected communities, through community-based outreach to both identify and reintegrate patients into care and treatment. In addition, IOM will conduct active screenings and household contact tracing to prevent new infections, timely identify new cases and enrollment into adequate treatment regimens;
• Ensuring health services are coordinating with and linked to referral pathways for specialized protection services, including GBV, to ensure patients get timely access to necessary services;
• Prepositioning of essential medicines, medical supplies, medical equipment, personal protective equipment and infection prevention and control supplies to ensure uninterrupted supply in the event of an emergency; 
• Facilitating the deployment of rapid response teams at key points of entry to enhance surveillance at points of entry through screening and referral in the event of a public health emergency; 
• Providing maternal health care and newborn care including safe deliveries, emergency obstetric, and sexual and reproductive health services; 
• Providing health education at the health facilities and during mobile and outreach sessions;
• Supporting COVID-19 preparedness and response in displacement settings;
• Coordination and capacity building of government and humanitarian partners to mainstream prevention and management of HIV in an emergency context.

IOM will continue assisting people living in insecurity-affected communities with the provision of MHPSS, particularly in communities affected by stressful events and multiple displacements. Key programmatic interventions include:

• Ensuring the provision of and access to high-quality MHPSS services including through capacity building, prepositioning of supplies, provision of transport, strengthening referral pathways;
• Proactively identifying risks and barriers related to accessing MHPSS services, and mitigating these risks;
• Direct community-based MHPSS services through the deployment of integrated MHPSS/Protection mobile teams (teams consist of trained psychologists and aim to be gender-balanced);
• Identification and referral of cases in need of specialized MHPSS, health and protection services;
• Capacity building on community-based MHPSS in emergencies and psychological first aid (PFA) to partner organizations and government counterparts;
• Implementation of culturally appropriate MHPSS activities to strengthen community members' capacity to identify the main factors of personal and collective uneasiness and stress;
• Strengthening MHPSS services for Children: Based on its global expertise and local capacities in providing MHPSS to the IDP and host community population, IOM will strengthen its community-based MHPSS interventions by complimenting the community interventions with MHPSS activities focusing on children, including building children’s capacities through informal education and build the capacities of child and health services to improve the access of children to such services through targeted trainings, on-the-job coaching and coordination efforts.

All MHPSS activities will be in line with the IOM Manual on Community-Based Mental Health and Psychosocial Support in Emergencies and Displacement and coordinated with partners.

IOM will continue working to promote access to protection services for IDPs and host communities, including in relocation sites. Through its integrated approach targeting priority displacement sites and areas receiving new arrivals, the multi-sector approach will include protection, medical and MHPSS support to respond to the needs of affected households and the most vulnerable individuals. Key programmatic interventions include:

• Strengthening gender-based violence (GBV) and protection referrals through capacity building and coordination with other protection actors;
• Capacity building of government social workers; protection partners and IOM staff on how to respond to a disclosure of a protection incident, especially GBV, and how to safely and ethically refer victims to available services;
• Deployment of protection focal points in the sites and providing support to partners on gender-based violence (GBV), trafficking in persons (TiP), child protection, and protection from sexual exploitation and abuse (PSEA) awareness and referral;
• Supporting the Reference Groups on Child Protection and Combating TiP in affected districts by strengthening their capacities to assist victims of violence, including children;
• Provision of protection services based on identified needs, especially in areas where government response is limited. This could include direct assistance and counselling to the most vulnerable IDPs, including people with disabilities, and survivors of GBV or trafficking;
• Conducting safety audits.

IOM’s WASH interventions aim at improving access to sufficient and safe WASH services for insecurity-affected populations, as well as improving hygiene practices in displacement sites and host communities in northern Mozambique. All distribution and hygiene promotion activities will be implemented following national guidelines on COVID-19 preventive measures, such as physical distancing. Key interventions include:

• Construction and/or rehabilitation of gender-segregated latrines and other WASH facilities. This activity will be informed by safety audits and community consultations, especially women and girls and persons with disabilities, to ensure any barriers and risks related to accessing these facilities are identified and mitigated (e.g. location, distance, layout, etc.);
• Construction and/or rehabilitation of water system networks;
• Strengthening of WASH at health facilities in collaboration with the WASH team;
• WASH facilities are maintained to ensure their sustainability through IOM’s support to the gender-balanced community-based WASH committees in displacement sites;
• Integrate protection mainstreaming in its WASH interventions in displacement sites to minimize risk and prevent protection concerns;
• Involve IDP committees in the planning and construction of WASH facilities and to maximize the safety, privacy and dignity of women, boys and girls;
• Health and hygiene promotion activities are also conducted in displacement sites, at household and community level including referral of cases to health facilities. This is particularly important against the backdrop of the ongoing COVID-19 pandemic as well as to prevent waterborne diseases;
• Distribution of hygiene kits (inclusive of menstrual hygiene management items).

Displaced populations and their host communities are in urgent need of emergency shelter support, including essential household items to secure safe, dignified, and healthy living conditions that provide at least basic protection from further adversities. Key interventions for this sector include:

• Responding to the immediate live-saving shelter/NFI needs of crisis-affected populations through a strategy that is conducive to early recovery and resilience to future shocks, using a preemptive and responsive approach to tailor the response to beneficiary needs, including the most vulnerable. Due to the dynamic context of operations, IOM will combine mobile and static teams to promote flexibility to respond immediately to rising needs and reach hard-to-reach areas;
• Through the continuous operationalisation and management of the shelter/NFI pipeline immediate life-saving emergency shelter and NFIs kits will be distributed to the most vulnerable in temporary sites and host communities based on needs assessments. Priority will be given in providing NFIs that have durable lifespans and could support the recovery of IDPs in the medium term;
• Provision of emergency shelters to families in host communities or relocation sites to achieve minimum standards on a timely basis;
• For those in situations of protracted displacement and the host community, IOM will maximise the effectiveness of the response by using cash-based interventions (CBI) or livelihood strategies where markets are available and functioning;
• Direct shelter construction or reconstruction, including materials, technical and labour support, will be provided for the most vulnerable households living in areas with disfunction or with inexistant markets, or high exposure to insecurity or natural hazards.

Although the need for essential life-saving assistance remains widespread, IOM recognizes the urgent need for recovery and stabilization interventions. Community stabilization seeks to support governments, states and communities undergoing significant socioeconomic and political changes during and following a crisis, in order to (re)establish stability and security, prevent further forced migration, restore trust among community members, vulnerable populations and local authorities and lay the foundations for durable solutions, lasting peace and sustainable development. Key interventions in this area include:

• Promoting positive coping mechanisms by providing MHPSS support to re-establish family and community support structures disrupted by the conflict. This creates an enabling environment for conflict-affected populations to sustain the emotional well-being of the community when facing obstacles and other challenges in transitioning from humanitarian aid to recovery efforts;
• Providing technical and logistical support to local CSOs to promote peace dialogues and to promote local recovery and restore social cohesion; 
• Enhancing coordination and complementarity between humanitarian, stabilisation and development partners, through a people-centred approach spanning across the humanitarian-development-peace nexus.

The process of finding durable solutions to displacement is critical beyond the initial emergency response, spanning through mitigation of displacement risks and addressing the root cause of displacement, in alignment with the IASC durable solutions principles. In 2016, IOM adopted the Progressive Resolution of Displacement Situations (PRDS) Framework which aims to guide IOM and inform its partners to frame and navigate the complexity of forced migration dynamics and support efforts to progressively resolve displacement situations. In line with the PRDS Framework, IOM will continue to promote an inclusive, resilience-based approach in Mozambique and embrace mobility strategies that support progression towards resolving displacement, while ensuring safety nets are in place to avoid potentially harmful mobility strategies. Under this objective, IOM will support IDPs living in resettlement sites in the central area and northern Mozambique and affected communities through preventive and recovery measures using a holistic approach. Key programmatic interventions include: 

• Enhancing access to durable solutions, including access to income-generating (sustainable livelihoods and employment) activities for displaced people;
• Ensuring IDPs have an adequate standard of living (access to adequate food, water, durable housing, health services and education);
• Empowering IDPs to build and maintain safe community structures, including houses, for longer-term resilience and safety of assets, food stocks and drinking water;
• Improving individuals' (family members/craftsmen) knowledge and understanding of safe construction practices, including DRR elements;
• Awareness-raising, promote agency, coping and self-reliance abilities and supporting local governance capacity building for long term resilient communities;
• Supporting activities for understanding and resolving the causes of displacement, including research, strategy and policy development.

The current health and social system capacities remain overstretched. IOM’s intervention will aim to strengthen the capacity of the public health authorities to deliver services in areas affected by insecurity and with a high concentration of IDPs. IOM will continue supporting provincial and district health services to implement mobile outreach services to highly affected and hard-to-reach communities, with logistics support and technical assistance. Key programmatic activities include:

• Technical support to strengthen disease outbreak and public health emergency preparedness and response capacity, including support to the development and implementation of local preparedness and response plans, for detection, prevention and management of outbreaks;
• Technical and logistical support to local health services to increase their capacity to provide continuous and quality outreach services to affected communities and hard-to-reach communities;
• Capacity building of community-based health actors to identify priority concerns and barriers to access, capacity building on community (event) based surveillance and strengthen the demand and use of preventative and curative health services;
• Restoring the continuum of care, especially for human immunodeficiency virus (HIV) and tuberculosis (TB) patients, through community-based outreach activities with awareness-raising, intense case finding as well the identification and reintegration of lost-to-follow-up patients into care and treatment;
• Specific sexual and reproductive health and rights interventions targeting women, adolescents and young people to address the specific vulnerabilities of this group, including GBV risks and care;
• Strengthening the links between health and non-health emergency response actors, to improve the national capacity to respond and prepare for outbreaks, notably currently COVID-19, and to better coordinate simultaneous responses with other sectors.

Insecurity, displacement and natural disasters cause significant psychological and social suffering to affected populations, particularly in the medium to long-term. As aligned with the multisector integrated approach towards more durable solutions, IOM will continue assisting people living in displacement sites and affected communities through individual and community-based support based on IOM's global expertise and local capacities. This will be done through an integrated MHPSS approach, and include protective and preventive measures that seek to encourage social cohesion and conflict resolution within affected communities.Key programmatic interventions will be tailored depending on the context and include: 

• Stabilization activities, psychosocial resilience and supporting protective networks as key factors in promoting dialogue with communities and preventing violence in insecurity affected areas;
• Providing sustainable continuity of care with regards to MHPSS services in sites and host communities;
• Strengthening community actors and networks, including social integration activities to address identity changes and marginalisation in Sofala and Manica Provinces;
• Rebuilding relations of trust between displaced populations in resettlement sites and surrounding communities.
• Community-based organisation capacitated to provide MHPSS support and livelihood opportunities to the most vulnerable groups of the displaced populations;
• Improving access to MHPSS services for Children, by strengthening community-based MHPSS interventions focusing on children, and build the capacities of child and health services to improve the access of children to such services through targeted trainings, on-the-job coaching and coordination efforts.

IOM Mozambique’s Peacebuilding and Disarmament, Demobilization and Reintegration programme aims both to prevent and resolve tension and insecurity. It does so by addressing these as drivers of displacement and by supporting sustainable peace and reintegration. These programmatic responses focus on understanding the root causes and addressing the social, economic, resource or political dynamics that drive insecurity and tension. Key interventions include:

• Engaging communities in culturally appropriate activities that promote well-being and reconciliation;
• Conducting social cohesion messaging campaigns through culturally relevant media;
• Implementing small-scale infrastructure projects prioritized by communities to incentivise peace and social cohesion in communities;
• Supporting civil society to facilitate dialogues for peace in communities.

IOM Mozambique’s work on DRR will contribute to the government’s efforts to implement the Sendai Framework for Disaster Risk Reduction 2015-2030. IOM’s DRR programmes will integrate mobility-based strategies in efforts to reduce disaster risk and strengthen resilience. Paying particular attention to at-risk communities, migrants, including displaced populations, and other vulnerable mobile groups, this programming aims to prevent or reduce displacement through support for prevention and mitigation, risk governance and information, as well as strengthen resilience through “build back better” measures in recovery and reconstruction. It will further include further key interventions:

• Community-based disaster risk reduction (CBDRR): IOM intends to strengthen the functions and capacities of the local committees for disaster risk reduction and management in the sites and affected communities by natural disasters, as well as supporting the disaster risk management structures at the national, provincial and district levels. This also includes: (i) capacity-building of disaster risk management committees; (ii) basic community-based disaster mitigation measures in priority locations; (iii) multi-hazard identification and mapping of risks; and (v) revision of disaster risk reduction and management (DRRM) plans and contingency planning, including simulation exercises, when/as required;
• Rolling out the Words into Action Disaster Displacement Guidelines in Mozambique, which offers practical guidance to help government authorities integrate disaster displacement and other related forms of human mobility into regional, national, sub-national and local DRR strategies in accordance with Target (E) of the Sendai Framework, to revise or develop DRR strategies by 2020.  

IOM aims to support the government and humanitarian partners to provide an effective operational response to ongoing and sudden-onset emergencies in Mozambique. Through the Inter-Agency Standing Committee (IASC), IOM supports collaborative responses conducted in close cooperation with the UN system and other organizations and with due respect for individual mandates and expertise. Its participation in the United Nations Consolidated Appeals Process, its lead role under the cluster approach in camp coordination and camp management in natural hazards, and the fact that it is a key partner in emergency shelter, logistics, health, protection and early recovery ensure that its activities are well coordinated. IOM ensures a strong preparedness element through its intervention, ensuring systems, capacities - including rapid response capacities - are in place to respond to disasters and new crises as well as to mitigate their inputs. This is done in coordination with partners thorough the clusters led by IOM as well through its operational capacities for its programmes. Key interventions include:

• Ensuring preparedness and response with emergency relief items stockpiling as part of the continuous management of the common pipeline mechanisms which will be reinforced by the Online Tracking System for Common Pipeline Requests. The stockpiling and prepositioning will take place in line with the country's contingency plan and based on operational needs, and IOM will rely on its warehouses in the northern as well as the central area of operations (Cabo Delgado and Sofala Provinces); 
• Prepositioning of items enables the rapid response to sudden-onset emergencies in 2021, to assist affected populations uprooted by natural hazards or by insecurity, including in host communities and in hotspot areas of displacement. Prepositioning to replenish has become increasingly critical after as tropical storm Chalane and tropical cyclone Eloise early 2021 depleted existing stocks;
• Supporting INGC in the development of a Disaster Displacement Management Strategy, taking into account lessons learned from cyclones Idai and Kenneth;
• Building on the longstanding partnership, IOM will continue to conduct relevant capacity building of INGC staff which will focus on emergency preparedness and response;
• Supporting the government in updating district level contingency plans using the lens of displacement management. The plans will include the location of hazardous areas identified by the communities, the resources needed, the DRRM simulation, early warnings and anticipatory actions and pre-emptive evacuation plans.
• Ensuring robust CCCM preparedness measures and systems through mitigation work in sites, community-based disaster risk-reduction, early warnings and sensitization, including contingency planning and simulation exercises.

IOM works in close collaboration with the National Migration Service (SENAMI) on interventions at the points of entry (PoEs), with SENAMI being the coordinating entity of relevant government actors at the borders. Key interventions will include:

• Building the capacity of relevant government entities at PoEs on humanitarian border management;
• Supporting the development and implementation of Public Health Emergency Preparedness and Response plans, as well as Standard Operating Procedures for the coordination and operations at PoEs during public health and other crises;
• Upgrading infrastructure and capacities of key PoEs to manage significant cross-border movements as a result of a disaster or crisis in Mozambique or neighbouring countries;
• Contributing to the formation/adaptation of existing, evidence-informed, policies and programmes to ensure safe, regular and orderly migration through a better understanding of migrant smuggling and trafficking dynamics, including the evolving routes, stakeholders, modes of exploitations, and migrants’ vulnerabilities in light of the rapidly changing border situation due to crises.
• Supporting the Ministry of Health to implement the International Health Regulation (IHR, 2005) standards, to prevent, detect and manage public health threats;
• Conducting on-the-ground research in crises affected areas with high irregular and mixed migration movements.

The Displacement Tracking Matrix (DTM) remains the main provider of data to support humanitarian response planning as well as data on preparedness, resilience and recovery needs. Information on the conditions and needs of affected communities, displacement sites (resettlement, reception and displacement hotspots and/or relocation sites) and host communities remains of key-importance to identify priorities for the different sectoral responses. IOM Mozambique will continue to implement the DTM countrywide, targeting different types of displacement. Products will be adapted to provide relevant and up-to-date information for different scenarios and geographic coverage. DTM information packages will include Monthly Baseline reports, Flash reports (Emergency Tracking Tool - ETT) in case of sudden and significant displacement, as well as thematic reports and analysis (including sex- and age-disaggregated data) on specific topics of interest to IOM and its partners to inform evidence-based planning and programming. Key programmatic interventions include: 

• Mobility tracking tools in locations with rapid mobility flows: DTM will deploy emergency tracking tools (ETT) to capture locations and rapid population movements, and mobility tracking tools (MTT) to produce baseline reports on internal displacement movements, disaster risks, population needs and vulnerabilities, and sectoral gaps inside and outside site settings; 
• IOM will continue to routinely collect DTM data in the form of Multisector Need Assessments in areas affected by displacement and make the findings accessible to humanitarian partners and local authorities to inform humanitarian planning. It will also expand where needed in terms of information collected and geographic areas covered according to the needs;
• Thematic surveys will be implemented to provide a deeper understanding of what the intentions/perceptions of affected populations are and to describe a communities’ socio-economic characteristics. DTM surveys are based on representative sampling methods. Thematic surveys include can include village assessments (VA) and return intention surveys (RIS) as well as very specific topics such as child protection risks;
• Issuance of rapid need assessments and flash reports in the case of sudden onset emergencies;
• Flow monitoring at POE's for disease outbreak preparedness and response (Ebola and COVID19) as well as for new cross-border movements if occuring.