The Mongolian Red Cross Society (MRCS) actively adopted and implemented the COVID-19 National Society Response Plan (NSRP) from March 2020 until the present in order to respond to the global COVID19 pandemic by assisting the Government of Mongolia (GoM) and providing timely assistance to the most vulnerable communities in an effective and efficient manner. Under the following primary operational priorities, the response actions were conducted nationwide across 21 provinces of Mongolia and nine districts of the capital city Ulaanbaatar:
Priority 1 - Health and Water, Sanitation and Hygiene (WASH)
Priority 2 – Addressing the Socio-economic Impacts of COVID-19
Priority 3 – Strengthening National Society
The purpose of this review was to assess the progress and results of the overall COVID-19 response of the MRCS between February 2020 and January 2022 in terms of relevance and appropriateness, efficiency, effectiveness, coverage, and sustainability and connectedness to provide recommendations for further improvement and scale-up of the intervention in similar situation.
In doing so, the review team utilized mixed method approach inclusive of both quantitative and qualitative data collection and analysis methods. The review covered total of 390 people reached and 80 volunteers who took part in the implementation of the MRCS COVID-19 response activities within the quantitative survey. In addition, 23 key informant interviews with government authorities, institutional representatives, and implementation level staff were conducted, five focus group discussions were organized with people who were reached and not reached by the MRCS COVID-19 response and volunteers, and one case study was implemented along with desk review of key documents.
Key findings of the review
The GoM has implemented the COVID-19 response in four main areas including (i) Management and coordination, (ii) Information, communication, surveillance and control, (iii) Assistance and service, and (iv) Resources, supplies and finance. These areas appear to be directly relevant to the three operational priorities outlined by the MRCS. During the peak of the pandemic, over 100,000 people needed medical care which resulted in shortage of human resources in the health facilities at all levels. Accordingly, the major activities carried out by the MRCS, including human resource support and material aid implemented based on the urgent needs of government agencies, have yielded satisfactory results.
The MRCS trained and mobilized 1,440 volunteers to provide support at primary health units and the National Center for Communicable Diseases (NCCD). As a result, a total of 148,200 COVID-19 contacts were identified, 534,250 people were supported through community WASH activities that reduced the risk of COVID-19 transmission, and 118,200 people were vaccinated. In addition, a total of 112 health facilities across Mongolia has been supported with personal protective equipment and WASH supplies.
The MRCS distributed pandemic-related information (COVID-19 risk communication, health, and hygiene promotion messages) to a total of 2.9 million people nationwide through different channels with the support from their volunteers has, this had a significant impact on enhancing public health and disease prevention.
Being one of the key members of the State Emergency Commission, the MRCS was the only humanitarian organization who was able to mobilize and come into contact with those who were infected and affected by COVID-19 in providing support and assistance during the strict lockdown imposed by the government during the peak of pandemic. Over the past two years, the MRCS has generated Swiss Franc (CHF) 2,152,035 by the funding from Red Cross and Red Crescent Movement members and other international and domestic organizations (and individuals) and spent a total of CHF 2,082,182 on the COVID-19 response, of which 51.5% or CHF 1,073,236 have been spent on reducing the socioeconomic adverse impacts of the pandemic.
As a result, 184,380 people who have become vulnerable through income loss due to COVID-19 received food and other in-kind assistance which reduced the risk of malnutrition during the pandemic. 91.9% of households (of 390 survey respondents of the review) that regularly received food assistance from the MRCS stated that support provided by the MRCS has satisfied all of their needs by improving their livelihoods. In addition, four households received long-term employment promotion grants from the MRCS. Two of the households that participated in our survey stated that they were completely satisfied and mentioned how much of an influence the employment promotion grants made on their life.
The review concluded that the MRCS adapted changes and modifications in its operations to better respond to global level health emergency and efficiently mobilized its internal human resources including volunteers. Staff at all levels involved in the COVID-19 response measures had access to timely information, coordination, the process of establishing understanding, management, guidance, decision-making guidelines, and monitoring possibilities thanks to the MRCS’s efficient management structure.
The primary and secondary data that the review team collected for the review suggests that the MRCS has an official process with documentation and guidelines on who, to whom, when, and how to implement the COVID-19 response, and has conducted several essential training and workshops for volunteers and relevant officials to implement them.
Another key finding of the review was that volunteer mobilization was significantly effective averaging 8.90 score points out of maximum 10 score points as rated by 80 surveyed volunteers. As part of the COVID-19 response, the MRCS has organized various types of online and in-person training, workshop, and experience sharing sessions covering 4,307 volunteers and staff (in overlapped number) to strengthen their preparedness, institutional readiness to disaster and crisis, and financial stability skills.
The number of partner organizations that have coordinated with the MRCS had increased by 16 from 54 to 70 during the period of 2021 and 2022 as part of the COVID-19 response. All 23 representatives of stakeholders who have been interviewed during the review highlighted that the MRCS response activities were highly effective and achieved its initial plans.
Key lessons learned and recommendations derived from the review
It is crucial to keep up the excellent practice of supporting doctors, bridging the human resource shortages in healthcare organizations, and emphasizing volunteer involvement in this area of pandemic response. Focus should be placed on attaining age and gender parity, raising the value of involvement, developing rewards for diligence, and establishing a system that can be sustained over the long term for the recruitment and retention of volunteers. Government officials have particularly emphasized and recognized the surveillance work carried out by the volunteers as one of the best practices that was taken as part of the response measures.
Distribution of information about the pandemic (the COVID-19 risk communication, health, and hygiene promotion messages to the public) through the media and volunteer mobilization by the MRCS had a significant influence on enhancing public health and disease prevention. It is imperative to continue constant awareness raising and advocacy work on public health using the same information methods that have proven to be successful in reaching the general public.
During the review, it was observed that current number and composition of staffing at the MRCS on all levels lacked to fully respond to similar global emergencies that cover mass population in the future.
Mobilization of volunteers was proven to be effective in addressing this challenge. However, policies and initiatives must be planned and put into action to address the funds required to increase the workforce and human resources. To maintain the sustainability of current trained and experienced workforce and volunteers, in depth assessment could be carried out to remove overlaps in roles and responsibilities and decrease workload per staff along with suitable incentivization measures.
One of the core challenges faced by the MRCS staff and volunteers during their COVID-19 response activities was logistical issues. Specifically, the lack of standard warehouses to store all food items and shortage in transportation to deliver assistances to the target communities was significantly critical. In some cases, MRCS staff at mid-branch levels had to use their personal vehicles to transport and deliver food parcels to households as well as local facilities like school halls and khoroo buildings which were utilized as warehouses to address and overcome this difficulty. Due to this difficulty and a lack of finances, the MRCS hired various unconventional spaces and even operated its main office as a warehouse. Transportation issue was addressed through contracting with companies that provide transportation services, such as taxicab companies and automobile rental agencies.This was another wise move. Establishing logistics department in line with the logistics assessment and needs could be essential in addressing further similar challenges in the future.
It was discovered during the review that monitoring-evaluation and accountability system was not properly in place within the MRCS. Since the MRCS collaborates with numerous organizations both national and internationally, systems to notify, report, review, and improve the effectiveness of operations should be put in place and implemented at all levels of the National Society – General Secretariat, mid and primary-level branches. In addition, community feedback and response mechanism need to be established within the MRCS to enhance accountability towards the public.
An integrated cloud database with details on the target group's geographic, socioeconomic, and demographic information should be created and utilized to ensure those in need of assistance are identified and reached accordingly. The database will make it possible to swiftly locate those who require help and support as well as to keep track of whether supplies have been given to the right persons. This should be followed with needs assessment, pre and post distribution surveys to increase accuracy of coverage in the future.
Planning for a long-lasting crisis like a pandemic involves several stages, during which time the requirements and context of the populace change in accordance with the circumstances. The actions taken by the MRCS up until the end of 2021 were intended to alleviate immediate sufferings brought on by several lockdowns, job losses, and other negative implications on livelihood and household economy.
Being the first humanitarian responder, the MRCS timely engaged in this crucial and important area of action to stop malnutrition from affecting the most vulnerable through humanitarian aid. In response to the significant socio-economic effects of COVID 19, the MRCS is expanding and scaling-up its current assistance for food security and livelihoods and adapting new programs to deal with the pandemic's effects as stated in their National Society Response Plan on 2022.