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									UNITED NATIONS DEVELOPMENT PROGRAMME IN UKRAINE

   Crimea Integration and Development Programme



         Final Report on Credit Proposal
“Community-based Governance, Infrastructure and
         Social Development in Crimea”




                Simferopol, Crimea,
                  October 2004
Table of Contents:

1.    Summary                                                                          1

2.    Objective System as Outlined in Credit Proposal                                  1

3.    Main Results, Achievements and Impact                                            6
      Participatory Local Governance and Community Development                         6
      Community-Based Water Supply                                                     9
      Community-Based Health                                                          11
      Other Community-Based Initiatives                                               12
      Exposure Visit to Switzerland                                                   12

4.    Final Financial Statement                                                       13

5.    Community-Based Governance, Health and Sanitation in Multi-Ethnic
      Settlements in Crimea                                                           13

6.    Annex 1:      Basic Data On Achievements in Local Governance and
                    Community Development                                             14

7.    Annex 2:      List of sub-projects funded by SDC                                16

8.    Annex 3:      Community-Based Operation and Maintenance Management
                    System for Water Supply (Stakeholders, Linkages and Interfaces)   19

9.    Annex 4:      Concept Paper on Implementation of Community-Based Water
                    Supply Projects                                                   21

10.   Annex 5:      Concept Paper on Implementation of Community-Based
                    Preventive Healthcare Projects                                    31

11.   Annex 6:      Final Financial Statement                                         40
UNDP Crimea Integration & Development Programme                                        Final Report SDC


1.      Summary
         The Project “Community-based Governance,
Infrastructure and Social Development in Crimea” was
an integrated part of the overall UNDP Crimea
Integration and Development Programme (CIDP). The
main goal of CIDP is to promote the social, economic
and political integration of the approximately 260,000
Crimean Tatars who returned to the Crimean peninsula
in the South of Ukraine. The SDC-supported project
aimed at promoting the formation of new local
community organizations and the participatory
preparation of community development plans; the
construction of local water supply infrastructure,
including distribution systems and the collection of user fees; the establishment of community health
centers in connection with new concepts of participation in management and cost coverage. The
infrastructure components were foreseen to be concentrated in 5 municipalities with around 4,800
direct beneficiaries. The operational responsibility for the project was with UNDP Ukraine. At the
request of DEZA, consultants from SKAT and STI/SCIH were engaged to provide backstopping and
technical advise in the area of water as well as health. The duration of the project was two years
(originally planned from January 2002 to December 2003). The total budget was US$ 500,000 plus
additional costs for backstopping.

        This report provides in section 2 an overview of the objectives, results, activities and
indicators of achievement as were foreseen in the approved credit proposal. Section 3 presents the
main results, achievements and impact of the project. Detailed quantitative data on project impact are
provided in annexes 1 and 2, whereas concept papers and other technical details are provided in
annexes 3, 4 and 5. Annex 6 presents the final financial report as per the SDC format.



2.      Objective System as Outlined in Credit Proposal
        The following text is copied from the Credit Proposal:

General objective of the project is to foster sustainable human development and promote
peace and stability in Crimea by continuing to improve living conditions in local
communities.

                                          This is to be achieved through two project objectives.

                                          Project Objective 1
                                          To support a bottom-up, participatory decision-
                                          making framework for development that encourages
                                          local community members across Crimea to identify
                                          and prioritize their needs vis-à-vis local development
                                          improvements and establish local strategies to ensure
                                          that such initiatives are sustainable.

        Project funding will be applied to develop a Crimea-wide system in which communities work
        together, in close collaboration with local authorities, to establish sustainable plans for local
        development, especially in the areas of infrastructure and social service improvement. The


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       project will establish an institutional framework
       for the promotion of social mobilization to
       facilitate community-based development across
       Crimea and help link local decision-making to
       higher levels of government. This framework
       will be highlighted by the creation of
       Community Development Centers (CDCs).
       CDCs are to have the primary function of
       assisting CIDP staff in the promotion of social
       mobilization in communities. They will
       facilitate   the     creation of       community
       organizations (COs) and the process of community development planning. They will also
       encourage networking among COs to share ideas on community-based infrastructure and
       social service needs and priorities and, where appropriate, assist in the formation of village
       organizations (VOs) which will establish integrated development plans among different
       communities with similar priorities.

       Furthermore, CDCs are to support networking by facilitating interactions between COs and
       VOs (including women and youth organizations) and the various levels of government in
       Crimea. By encouraging dialogue and partnership between these community-based groups on
       the one hand and local village councils, rayon administrations and rayon councils on the other
       hand, as well as dialogue with higher levels of Government, they will help to mobilize support
       and assistance across Crimea for the implementation of community development plans.

       With project funding, CIDP hopes to have CDCs operating in 12 Regions (Rayons) of Crimea
       by 2003. There are to be approximately 2 trained social mobilization facilitators for each
       CDC. To minimize costs, CDCs will be established in many cases on the basis of existing
       CIDP women and youth centers. Rayon Administrations have agreed to provide office space
       for CDCs free of charge.

       As an incentive for communities to co-operatively mobilize local resources for planned local
       development improvements, a percentage of project funding is to support a Community
       Integration Fund). This fund will be utilized for promoting self-governance activities, as well
       as to match (in the form of seed grant) community projects. The objective of the seed grant is
       to receive additional support from levels of government in Crimea and other partners, this
       Fund will be used to match the value of resources mobilized by a CO toward a local
       improvement activity that benefits the majority of community members, up to US$ 7,000.
       This seed grant will help to motivate local people to actively contribute funding for local
       development and to become full stakeholders in the process.

Result 1.1
A system in which community members work together, in collaboration with local authorities,
to establish plans that address local development needs, such as infrastructure and social
service improvements, in a sustainable way.

                                                   Activities for Result 1.1
                                                   1.1.1 Selection, recruitment and training of
                                                            staff of CDCs by CIDP's Governance
                                                            Component
                                                   1.1.2 Provision of office space by local
                                                            authorities and establishment of CDC
                                                            offices
                                                   1.1.3 Promotion by CDCs of participatory
                                                            decision-making among community

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               members in selected target communities and support for the establishment of COs
               within communities
       1.1.4   Support by CDCs to COs in the identification and prioritization of community
               development needs, such as infrastructure and social service improvements, and the
               development of strategies for their sustainable operation and maintenance in
               community development plans, in collaboration with relevant local authorities
       1.1.5   Provision of small seed grants through a Community Integration Fund that match
               local resource mobilization for community development initiatives across Crimea.
       1.1.6   Support the creation of Functional User Groups for the sustainable management and
               maintenance of social infrastructure and services and the successful introduction of
               user fees.
       1.1.7   Co-ordination by CDCs of local level networking between different COs as well as
               between COs and other community-based groups, often resulting in the creation of
               VOs to establish integrative development plans among different communities with
               similar priorities.
       1.1.8   Co-ordination by CDCs of local level networking, dialogue and partnership between
               Community-based groups and local government structures.

       Indicators of Achievement:
       A high level of participatory decision-making in local communities, the organization of COs,
       the creation of community development plans that prioritize development needs, such as local
       infrastructure and social service improvements, and develop strategies for their sustainable
       operation and maintenance, local resource mobilization for community development
       initiatives, the creation of FUGs to manage the introduction of user fees to cover operation and
       maintenance costs locally, enhanced local level networking in support of community-based
       development and the creation of VOs to establish integrative development plans among
       different communities, active dialogue, collaboration and partnership between community-
       based organizations and local government structures.

Project Objective 2
To provide selected communities with the necessary resources and support to implement and
effectively manage infrastructure or social service improvements, which meet self-
expressed local development needs and priorities.

       The project will direct support and resources to
       communities that have made the greatest progress
       in their community development planning for the
       successful implementation of their development
       plans. Infrastructure and social service
       improvements that meet the self-expressed needs
       and priorities of local communities and are fully
       supported by local authorities will be undertaken
       and support for their sustainable operation and
       management will be provided.

       CIDP's promotion of social mobilization in Crimea began in autumn 2001. Since then, in
       locations across the peninsula, CIDP staff has been actively helping local people establish
       transparent, sustainable community development plans that identify development needs and
       strategies for the implementation of infrastructure and social service improvements. As a
       result of these activities, the communities expressed an overwhelming need for: (i) improved
       water supply and (ii) improved health services. Based on their successful progress, these
       communities will receive financial assistance through the project to realize community-based
       infrastructure and social service improvements prioritized in their own development planning.
       As these communities have identified water supply improvement and the expansion of

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       community-based health care as primary local development needs, the project's budget reflects
       planned funding for 2 water supply and 3 health initiatives. Brief descriptions of the proposed
       projects are presented below as part of the activities to achieve Result 2.1 and Result 2.2.

Result 2.1
Local infrastructure improvements (water supply)
outlined in community development plans.

       Activities for Result 2.1
       2.1.1 Establishment of a local institutional
                mechanism for the sustainable operation
                and maintenance of the planned
                infrastructure improvement and of a cost
                recovery system through user fees, to be
                managed by Functional User Groups with
                full support from local authorities.
       2.1.2 Provision of technical support, including training, to COs and FUGs, for the
                realization of infrastructure improvement plans and to ensure that the costs of
                operating and maintaining the initiatives provided by the project are covered locally.
       2.1.3 Through CDC-facilitated networking, the mobilization of support and assistance from
                the Government of the Autonomous Republic of Crimea and regional authorities for
                the implementation of local infrastructure improvements outlined in community
                development plans.
       2.1.4 Provision of technical assistance in the construction of local infrastructure
                improvements (community-based water supply project in Tenistoye and
                Sevastyanovka)
       2.1.5 Monitoring of local operation and management of infrastructure improvements
                initiated by the project with regular progress reports to project partners.

       Community-based Water Supply Project: The community of Tenistoye and Sevastyanovka
       settlement identified a water supply project as their main priority need and have applied for
       assistance. At present, both settlements have no piped potable water supply systems. The
       proposed water supply projects will serve more than 800 people (FDPs and non- FDPs) living
       in these settlements. Community organizations have been formed (COs), the communities
       have shown their active participation in decision-making processes and a community
       development fund has been established through savings.

                                               The COs have developed a plan for the construction
                                               of a water supply system and determined their local
                                               contribution. This process has fostered social
                                               cohesion, integrating the community members to
                                               solve common problems. The project will improve the
                                               living conditions of the communities by generating
                                               additional income from garden vegetables. For each
                                               local community-based Water Supply Project separate
                                               Project Proposal with the detailed cost breakdown will
                                               be elaborated. The Government of the Autonomous
       Republic of Crimea has agreed to support the project by linking individual households to the
       water mains of the systems. In addition, local communities and authorities will provide labor,
       machinery and other in kind inputs for the completion of the projects.


Result 2.2
Local social service improvements (health care) outlined in community development plans.

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       Activities for Result 2.2
       2.2.1 Establishment of a local institutional
                mechanism for the sustainable operation
                and maintenance of the planned social
                service improvement and of a cost recovery
                system through user fees, to be managed by
                FUGs, with full support from local
                authorities.
       2.2.2 Provision of technical support, including
                training, to COs and FUGs, for the
                realisation of social service improvement plans and to ensure that the costs of
                operating and maintaining the initiatives provided by the project are covered locally.
       2.2.3 Through CDC-facilitated networking, the mobilisation of support and assistance from
                the Government of the Autonomous Republic of Crimea and regional authorities for
                the implementation of local social service improvements outlined in community
                development plans.
       2.2.4 Provision of assistance in the establishment of local social service facility or care
                improvements (community-based health projects in Danilovka, Kurtzi and the town of
                Sudak).
       2.2.5 Monitoring of local operation and management of social service improvements
                initiated by the project with regular progress reports to project partners.

       Community-based Health Projects: The communities of Danilovka and Kurzi and the town of
       Sudak identified community-based health services, as the priority need. These health centers
       are envisioned to provide primary medical services (dispensary, gyneacological and dental
       services), as well as periodical medical check ups. These projects will benefit more than 4,000
       people.

       The allocated fund for health projects will primarily be utilized in the above-mentioned
       settlements. However, basic criteria for the allocation of the fund will be based on (1) active
       participation of communities (cost sharing) and (2) sustainability and cost-recovery through
       introduction of service fees and (3) approval and support from relevant government structures
       for the establishment of the health facilities. This will be determined during the ongoing social
       mobilization and community development processes. For each local community-based Health
       Project separate Project Proposal with the detailed cost breakdown will be elaborated.

       Indicators of Achievement
       A strong capacity within communities to plan the sustainable operations and maintenance of
       local infrastructure and social service improvements, effective cost recovery in communities
                                                   through a well designed system of users fees,
                                                   strong support and assistance from regional
                                                   authorities and the Government of the
                                                   Autonomous Republic of Crimea for community-
                                                   based development planning, infrastructure and
                                                   social service improvements in communities that
                                                   meet the self-expressed needs and priorities of
                                                   community members, the sustainable operation
                                                   and management of local infrastructure and
                                                   effective monitoring of project-sponsored
                                                   initiatives, highlighted by the publication of
                                                   annual and end-of-project reports.
3.     Main Results, Achievements and Impact


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        The cost-sharing agreement between SDC and UNDP for the implementation of the project
was signed by both parties on 9 August 2002 and the transfer of the first installment was initiated on
29 August 2002. The project was technically completed on 30 September 2004, following an approved
extension of the project duration with three months. During the 25 months of actual implementation (1
September 2002 until 30 September 2004) the following has been accomplished:


        Under the first objective, i.e. “to support a bottom-up, participatory decision-making
framework for development” the following results and outcomes were achieved (see Annex 1 for
detailed data)1:


Participatory Local Governance and Community Development:

         Integration and Development Centers (IDCs)
were established in ten regions (rayons) of Crimea under
the respective Regional State Administrations (see map
below). The regional authorities provided office space in
or near the buildings of the Regional State
Administrations, whereas UNDP/CIDP selected and
trained teams of two staff for each IDC in order to lead
the process of community mobilization and dialogue
between citizens and local authorities. Each IDC team is
ethnically and gender balanced in order to promote
sensitivity for and facilitate access to all constituencies
                                              (i.e. FDPs and non-FDPs, men and women).

                                                         In the original credit proposal, the term
                                                 Community Development Center (CDC) was used, but
                                                 during the course of implementation it emerged that
                                                 stakeholders were more comfortable with the more
                                                 generic “Integration and Development Centers”, which
                                                 implies that in addition to promoting community
                                                 development, the Centers would have local governance



and multi-ethnic integration as part of their
mandate as well.

         In the credit proposal it was expected
that 12 IDCs would have been established by
the end of 2003, whereas the actual amount is
ten. In the course of implementation it was felt
that adding another two Centers would stretch
the projects administrative and logistic
resources too much. However, in the coming
years, the number of Centers will be expanded
if and when the opportunity arises. As the



1
 The activities leading to the results under the first project objective have been partly financed by SDC and
partly by CIDA/Canada and Matra/Netherlands as part of the overall CIDP strategy, whereas those under the
second project objective have been exclusively carried out with SDC support.

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community-based initiatives that were financed under this project are located in regions in which IDCs
have actually been established, the less than hoped for amount of Centers has not in any way affected
the outcomes of the SDC-funded project.

         In terms of sustainability of the IDCs, in most regions they have already been fully
integrated into the overall structure and day-to-day proceedings of the Regional State
Administrations. For all practical purposes, they are seen as part of the Regional State
Administrations rather than part of UNDP. While UNDP continues to cover the salaries and travel
expenses of the IDC staff, this is mainly because supervision and training of the IDCs by CIDP
specialists is still ongoing. However, it is clear that the Regional State Administrations, while perhaps
not all in a position to actually employ the IDC staff, are at least in a position to take over the
functions of the IDCs as officials of the Regional State Administrations have been working closely
with the IDC staff. The full institutionalization of the IDCs will be undertaken in the next two years.

        At the end of September 2004, IDCs in partnership with the Regional Administrations had
been able to mobilize close to 47,000 residents of 155 rural settlements (about 25% of the total) in 87
Village Councils (about half of the total) in the 10 target regions. The residents had formed 319 self-
governing community organizations with the aim to jointly identify and address priority needs.
Approximately 47% of the members are FDPs, mainly ethnic Crimean Tatars, and 53% are ethnic
Russians and Ukrainians. The community organizations represent over 15,000 households and on
average 85% of households in each settlement.




         The Community Organizations were trained to establish transparent internal management
and decision-making procedures laid down in written statutes, and to prepare development plans for
their settlements through consensus-based identification and prioritization of needs. In addition, each
CO established community saving funds, which have “cemented” people’s commitment to their
community organization and jointly achieving their goals and which provides a framework for
solidarity support to members in need, as well as a basis for expanding into income-generating
activities through micro-lending schemes. As of September 2004, more than 121,000 hryvnya (i.e.
US$ 22,500) had been saved in this way.

         The community organizations have already initiated 136 self-help initiatives, ranging from
establishing or upgrading drinking and irrigation water supply systems, basic health services, roads
and gas supply to pre-school facilities, sports/playgrounds and community centers, benefiting almost

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42,000 people directly. These initiatives represent a total investment of almost US$ 1.5 million of
which 27% was contributed by the beneficiary communities (mostly in-kind, such as labor), 17% by
local authorities and private sector and 56% by UNDP/CIDP through a Community Integration &
Development Fund established for this purpose under which Community Organizations can receive
seed-grants for self-help initiatives up to a maximum of US$ 30,000.

         SDC funded community self-help initiatives will be discussed in more detail below under the
results for the second objective, but it can be mentioned here that out of the 136 self-help initiatives
implemented by community organizations, 34 (or 25%) have been co-funded by SDC (see also Annex
2), benefiting more than 16,000 people. Towards these projects, 42% has been contributed by COs and
local authorities and 58% by SDC through UNDP.

        With the exception of a few more costly and
technically complex projects, all initiatives have been
implemented by the Community Organizations. The
sense of ownership of the outputs of the projects that this
has produced also resulted in a strong motivation to ensure
the future sustainable operation and maintenance of the
outputs. Moreover, the confidence inspired by the
successful implementation of these projects has
encouraged community organizations to undertake many
smaller initiatives entirely through their own efforts.

        Mechanisms for dialogue and decision-making
involving communities and local authorities (i.e. appointed administrations as well as elected
representative councils) have been established, such as bi-monthly Regional Forums for Integration
and Development hosted by the Regional State Administrations and facilitated by the IDCs, which
enhance collaboration and partnership between communities and authorities and promote
understanding and respect for each other’s capacities and constraints.

        The inclusiveness, transparency and highly participatory and non-discriminatory character of
Community Organizations and the capacity of these to identify and address needs that are common to,
and priorities of, all its members, regardless of ethnicity, gender and age, has greatly enhanced
mutual understanding and social cohesion in these communities, thereby reducing conflict
potential.

         Similarly, the increased respect of community members for each other and confidence in their
own capacity to make improvements in their lives, in combination with the realization that local
authorities are willing and able to respond to their needs within the limitations of their capacity and
budgets, has made people feel less marginalized and excluded and that they are becoming active
stakeholders in society, which further reduces the potential for conflicts in the future.

        Local authorities have started recognizing the effectiveness of community-based
development and are allocating increasing amounts of funding in their annual budgets to support
community-based initiatives, as well as actively encouraging other settlements to form self-help
organizations. Through increased networking among themselves to compare and discuss their
experience with community-based development, local authorities are starting to increase their capacity
to assess their own shortcomings and to lobby for the interests of their constituencies at higher levels
of authority.

         The process of forming Community Organizations and encouraging these to undertake self-
help initiatives in collaboration and partnership with local authorities has reached a “critical mass” in
that communities and local authorities are starting to take the lead in promoting the expansion of the
process to other villages and areas. In this sense, the process has become self-perpetuating.
Moreover, the first Regional Associations of Community Organizations are now being established.

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       Under the second project objective, i.e. “to provide selected communities with the
necessary resources and support to implement and effectively manage infrastructure or social
service improvements“, the following results and outcomes can be highlighted (see Annex 2 for
detailed data):


Community-Based Water Supply:

         Two pilot projects for sustainable
community-based water supply, as foreseen under
the project in the villages of Sevastyanovka and
Tenistoye in Bakhchisarayskii Region, were
successfully implemented. In both villages, the
construction of water reservoirs, water mains and the
connection to the existing pumping stations were
carried out by competent and experienced local
construction firms selected through a transparent
competitive tender bidding process. In the village of
Sevastyanovka, seed-grants were provided to the four
local Community Organizations for the construction
and connection of the water distribution system from the water mains to the individual houses. In both
villages, users installed water meters at their own expense.

                                                             As a result, the 810 inhabitants of the
                                                    two settlements have received regular clean
                                                    water supply for the first time since the
                                                    settlement of FDPs in the area. This firstly has a
                                                    positive impact on sanitary and hygienic
                                                    conditions in the villages where previously
                                                    people mainly depended on unsafe water from
                                                    local rivers. Secondly, the increased availability
                                                    of water enables the residents to irrigate their
                                                    kitchen gardens on which most of them depend
                                                    for their sustenance and income. Therefore, the
                                                    projects have an important social (health) as
                                                    well as economic (income) impact on the
communities.

         In    Sevastyanovka,      ethnic    Russians,
Ukrainians and Crimean Tatars live side by side and
the close involvement of the community members in
the implementation of the project has resulted in a
notable increase of mutual respect and social
cohesion within the community, as well as a new
optimism that living conditions in the village can be
improved through joint efforts of residents and local
authorities. In Tenistoye, Crimean Tatars and
Russians/Ukrainians live in separate parts of the
village, but the completion of the water system in the
Crimean Tatar part of the village has greatly reduced




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pressure on the existing system in the Russian/Ukrainian part, whose residents will now be able to
benefit from excess water from the new system. In both villages, this has helped to turn around the
perception that the FDPs were a “burden” for the village, rather than an asset.
         In both settlements, community-based management systems for sustainable water supply
have been established that are cutting-edge and advancing best practices at the international
level and truly revolutionary within the context of the former Soviet-Union. Whereas the
installations are on the books of the local Village Councils (an elected self-governing body that
represents the lowest level of public administration), the management of the systems and rights of
exploitation has been awarded to a private enterprise, specifically established in each village for this
purpose by a local resident who has been selected by the local Community Organizations through a
transparent application, interview and selection process.

        The private enterprise in each village is formally registered, has written statutes detailing its
functions and has agreements with both the local Village Councils and the local Community
Organizations. In addition, it has agreements with each individual household for the provision and
payment of water. The water tariff has been established transparently by calculating the real cost of
providing water, including the full operation and maintenance costs of the system, and discussed with
and agreed upon by the local residents. Please see Annex 3 for a schematic presentation.

         Traditionally, local water systems are managed by a public communal service utility
established for the entire area under jurisdiction of the Village Council. Lack of public funding,
opaque pricing and poor management have in most instances resulted in a vicious circle of poor
services, widespread non-payment, large debts and even bankruptcy of the communal service utilities.
The system piloted in Tenistoye and Sevastyanovka under the project, by maximizing the involvement
of users in all stages of planning, design, implementation and management of the water supply
systems, is providing a sustainable alternative that motivates users to share responsibility for
maintaining the system and to pay for services provided.

        The Regional State Administration and Council of Bakhchisarayskii Region have been closely
involved in the process of establishing the above-mentioned community-based management systems
and are now encouraging other Village Councils and communities in the region to establish similar
mechanisms. At the same time, Chairpersons of several Village Councils and Community
Organizations, including from other regions of Crimea, have traveled to Sevastyanovka and Tenistoye
to study the management arrangements of the local water system. In addition, the First Deputy
Minister of Economy of Crimea visited the two settlements, as well as a host of other key policy- and
decision-makers, including the Deputy Speaker of the Crimean Parliament, and expressed strong
interest in the further development of such community-based management systems and their
applicability to other parts of Crimea.

        The community-based operation and management of water supply system has increased the
sense of ownership of the beneficiaries as well as strengthened partnership between local authorities
and community organizations. The readiness of people to pay for the water used in accordance with
the readings of the water meters has provided a strong incentive for people to economize on the use of
water. The per capita consumption of water in Sevastyanovka and Tenistoye is well below the
standard norm that is applied by the Government and state water authorities.

        Following the successful implementation of the water supply projects in Sevastyanovka and
Tenistoye, similar projects were started up in the settlements of Bryanskoye, Samokhvalovo,
Kholmovka and Zavetnoye in Bakhchisaraiskii Region, and Malochnoye in Krasnogvardeiskii Region.
These projects benefited some 2,725 people. In addition, training on community-based management
of water systems was provided.

       A key role in achieving the above-mentioned results has been played by an Engineering and
Environmental Management Specialist of Skat Consulting, who undertook four technical backstopping
and monitoring missions on behalf of SDC and has been able to successfully transfer international

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experience in the area of sustainable community-based water supply management to relevant CIDP
staff and adapt and apply this experience to the local context. More detailed information about the
above-mentioned water supply projects and the community-based management systems can be found
in his mission reports, as well as recommendations about future steps. Also, a coherent community-
based water supply concept has been developed and documented (see Annex 4).


Community-Based Health:

         By the end of September 2004, fourteen pilot
Community-based health facilities had been
established     in     multi-ethnic      settlements     in
Bakhchisaraiskii, Krasnogvardeiskii, Pervomaiskii and
Belogorskii Regions, benefiting an estimated 11,082
people. These initiatives were entirely implemented by
local Community Organizations through their own
resources, those of local authorities and seed grants from
CIDP. Although in the original proposal the construction
of three larger rural clinics was foreseen, it was
recommended by the technical backstopping and monitoring consultant of the Swiss Tropical
Institute/SCIH engaged by SDC to focus on small basic primary health care facilities instead. Not only
was it considered that these would better match actual requirements in the rural settlements, but also
that these could be run in more sustainable manner than larger facilities.

                                                              For the operation and maintenance of
                                                     the community-based health facilities, the local
                                                     Village Councils have typically provided
                                                     premises or made land available and agreed to
                                                     cover the salary of the health workers from their
                                                     budgets, as well as the cost of basic utilities, such
                                                     as electricity, fuel for heating in winter, etc. The
                                                     Community Organizations took charge of
                                                     repairing the building or procuring a pre-
                                                     fabricated container and the procurement of basic
                                                     equipment and supplies. Community Health
                                                     Funds have been established, based on monthly
                                                     contributions of all residents, from which basic
                                                     maintenance and repairs of the facility and
equipment can be undertaken, as well as preventive health initiatives in the community. Although the
facilities mainly provide first-line diagnosis, medical assistance and referral services to larger clinics
and hospitals free of charge, a few more specialized services are provided against a small fee. Average
seed grants per facility have been just above US$5,000.

         Linked to the establishment of the community-based health facilities, Community
Organizations have started developing and implementing plans for promoting preventive health
initiatives. Spearheaded by the medical workers of the health facility, these include campaigns for
garbage collection and improved garbage disposal, training on hygiene and sanitation, awareness
raising on the dangers of smoking, drinking and narcotics, promotion of safe sex, organization of
fitness and aerobic classes, etcetera.

        For this purpose CIDP’s IDC staff and some local health personnel received training on
promoting preventive health initiatives in late 2003, which already translated into concrete results by
early 2004. During Summer 2004, a Ukrainian NGO specialized in preventive health undertook
systematic training of health workers and community members in the settlements so far covered by


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CIDP, as well as of medical personnel and authorities in the two pilot regions of Bakhchisaraiskii and
Krasnogvardeiskii and later also in Pervomaiskii and Belogorskii Regions.

         While still in its infancy, the successful introduction of such preventive health initiatives is
very encouraging, especially in view of the fact that health care in this part of the world has always
been almost exclusively focused on the curative aspect of treating diseases, rather than on preventing
these in the first place. The village nurses, being part of the communities they are serving, are well
placed to undertake such very low cost initiatives, as they generally have the trust and respect of the
other villages.

        As with the water supply projects, the health initiatives have played an important role in
promoting mutual understanding and social cohesion within the multi-ethnic target communities,
as well as promoting dialogue, confidence and partnerships between citizens and local authorities. It
has encouraged communities to plan and undertake other self-help initiatives to improve living
conditions in their settlements. Health administrations and regional authorities are in principle very
supportive of the participative CIDP approach towards primary and preventive health care.

         Also, as in the case of the water supply projects, a key role in achieving the above-mentioned
results has been played by the consultant of the Swiss Tropical Institute/SCIH, who undertook four
technical backstopping and monitoring missions on behalf of SDC and has been able to successfully
transfer international experience in the area of sustainable community-based primary and preventive
health care to relevant CIDP staff and adapt and apply this experience to the local context. More
detailed information about the above-mentioned health initiatives can be found in his mission reports,
as well as recommendations about future steps. Also, a coherent community health development
concept has been developed and documented (see Annex 5).


Other Community-Based Initiatives:

         In addition to the water supply and health projects, a total of eight other community self-help
initiatives were supported with SDC funding. These include four sports/playgrounds for youth and
other community members, 1 community women and youth development center, 2 gravel roads and
one culvert. These projects benefited 1,766 people.


Exposure Visit to Switzerland:

        In June 2004, an exposure visit of one week to
Switzerland took place, involving representatives of the
ARC       Council     of   Ministers,   Regional     State
Administrations, Regional Councils, Village Councils and
Community Organizations. The visit, which was hosted
and co-sponsored by SDC, was highly successful in terms
of exposing the participants to practices of direct grass-
roots democracy, community-based management of public
services, decentralization in a multi-ethnic context, and
local self-organization of farmers and other producers in
marketing and related associations.

         One main outcome was that the visit clearly showed to the participants that the strategy
applied by CIDP is not just theory, but based on highly successful practices around the world. Upon
return, the group prepared plans for how to apply some of the principles observed in Switzerland to the
Crimean context. Through regular contact with the participants, CIDP staff is observing that the
participants during public meetings and other events continue to refer frequently to examples and
practices observed in Switzerland.

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4.      Final Financial Statement
         Annex 6 provides the final financial report for the Credit Proposal as per the standard SDC
format. As can be seen, all funds made available by SDC have been disbursed, as well as the final US$
20,000 that, according to the Cost-Sharing Agreement, would be transferred by SDC to UNDP after
receipt and acceptance of final operational and financial reports.




5.      Community-Based Governance, Health and Sanitation in Multi-
        Ethnic Settlements in Crimea
        In May 2004 UNDP submitted a new Credit Proposal to SDC in order to build upon the
results and achievements mentioned in the previous sections. The proposal, which is called
“Community-Based Governance, Health and Sanitation in Multi-Ethnic Settlements in Crimea” seeks
to promote and institutionalise sustainable community-based health and sanitation in Crimea by
supporting, through seed grants and training, community self-help initiatives in primary health care,
preventive health initiatives, safe water supply and other relevant initiatives, and encourage the
adoption of a relevant legal/policy framework and implementation guidelines at regional and
Republican levels.

        In tandem, it will promote and institutionalise a decentralized, participatory community-
based governance framework in Crimea through the establishment of a network of Regional Funds
for Integration & Development managed by Regional Associations of Community Organizations in
close collaboration with local authorities and other stakeholders, and the adoption of a relevant
legal/policy framework and implementation guidelines at regional and Republican levels.

        The proposed duration of the new project will be two years. The Credit Proposal has already
been approved and SDC and UNDP are currently finalizing all arrangements to start implementation
during the fourth quarter of 2004.




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              Annex 1: Basic Data On Achievements in Local Governance
              and Community Development

   Table-1:            UNDP/CIDP Coverage through Local Governance and Community
                       Development Activities

       S.N Name of Regions          Total № Village        № of V.C               № of        № of settlements
                                      Councils in        participating in    settlements in   covered by CIDP
                                         region               CIDP             the region
       1     Bakhchisaraiskii              14                   12                  81               26
       2     Belogorskii                   17                   10                  81               18
       3     Krasnogvardeiskii             20                    9                  84               23
       4     Pervomaiskii                  17                   13                  44               23
       5     Simferopolskii                22                    7                 109               12
       6     Sakskii                       24                   12                  81               19
       7     Sudak                         7                     5                  13                6
       8     Leninskii                     27                    6                  68                7
       9     Sovetskii                     12                    5                  38                7
       10    Kirovskii                     13                    8                  42               14
             Total                        173                   87                 641              155

   Notes:
   The administrative units of Autonomous Republic of Crimea are categorized into (i) Raiyons
   (regions), (ii) Cities/Municipalities of republican significance, (iii) Towns/sub-municipalities of
   regional (Raiyon) significance, and (iv) Village Councils.
   Total Regions (Raiyons)                  = 14
   Total Cities/municipalities              = 11
   Total Towns/sub-municipalities           =5
   Total Village Councils                   = 243


   Table-2:            Community Investment in Self-Help Initiatives

                             Community                           CO Investments (UAH)
                      № of
        Name of Region       Savings2 as                                     Social &      Total
S.N                    CO                              Social Economic                                    Remarks
                            of Sept. 2004                                   communal      Amount
                     formed                             help Activities
                                                                             services     (UAH)
                               (UAH)
 1  Bakhchisaraiskii    39         17,869               3,216      1,804        389,345   394,365
 2     Belogorskii      39         10,979               2,650        970         76,022    79,642
                                                                                                  Social mobilization
 3 Krasnogvardeiskii    47         22,164              18,920      4,531        828,251   851,702 process commenced
 4    Pervomaiskii      46         27,172               4,520      2,430        329,822   336,772 by the end of 2001
 5       Sakskii        46         10,744               3,230      1,450        250,712   255,392
 6   Simferopolskii     19          8,416               1,630        820         19,266    21,716
 7       Sudak          10          6,557                 100          0         17,471    17,571
 8      Kirovskii       31         11,953                   0          0         76,084    76,084 Social mobilization
 9      Leninskii       20          2,409                   0          0         68,645    68,645 process commenced
10      Sovetskii       22          2,859                   0          0        172,946   172,946 by the end of 2003
          Total        319       121,122               34,266     12,005      2,228,564 2,274,835

   2
       Saving fund is mainly used for social help and micro-scale economic activities.

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      UNDP Crimea Integration & Development Programme                                 Final Report SDC




      Table-3:       Households and Population Participating in Self-Governing Community
                     Organizations

#      Regions              Total H/H     № of H/H        Members of community organizations      Of
                            in CIDP       participating                                           which
                            target        in CO           Women     Men      Children     Total   FDPs
                            settlements                                      below 16
                                                                                yrs
1      Bakhchisaraiskii           2806           1630       1956     1849          1136    4941     2071
2      Belogorskii                2059           1792       2671     2454          1078    6203     2534
3      Krasnogvardeiskii          2912           2753       4299     4250          1759   10308     4181
4      Pervomaiskii               2552           2456       2363     2157          1183    5703     3940
5      Sakskii                    1934           1700       2143     2058          1051    5252     2602
6      Simferopolskii             1197           1012       1732     1416           648    3796     2095
7      Sudak                       511            431        652      592           360    1604      687
8      Kirovskii                  1515           1541       2029      903           408    3340      753
9      Leninskii                   933            692        846      759           776    2381      702
10     Sovetskii                  1235           1105       1316     1263           623    3202     2367
       Total                     17654          15112      20007    17701          9022   46730    21932


      Table-4:       Number of Community-based Projects Implemented in Partnership with
                     CO, Private Sector, Local and Republican Authorities

           Regions   Community                 Total          Cost-sharing contribution (UAH)
S.N                            Beneficiaries
                      Projects                Amount UNDP           CO        VC        PS    UKS
 1 Bakhchisaraiskii      22       5,433      1,161,035 670,540 410,814 79,681              0       0
 2 Belogorskii           13       4,206        501,428 309,013 132,386 60,029              0       0
 3 Krasnogvardeiskii     31      16,990      2,147,380 932,161 416,392 147,627             0 651,200
 4 Pervomaiskii          28       7,285      1,689,504 1,060,570 411,723 125,721 91,490            0
 5 Sakskii               19       2,195        914,607 543,995 348,388 22,224              0       0
 6 Simferopolskii         4       1,767        144,737    93,230    19,203 32,304          0       0
 7 Sudak                  5       1,260        187,650 100,907      62,780 11,963 12,000           0
 8 Kirovskii              3       1,614        217,408 122,173      76,084 19,151          0       0
 9 Leninskii              4        396         257,107 118,277      68,645 70,185          0       0
10 Sovetskii              7        835         528,176 348,732 172,946         6,498       0       0
     Total (UAH)        136      41,981      7,749,032 4,299,598 2,119,361 575,383 103,490 651,200
      Total (US$)                            1,453,852 806,679 397,629 107,952 19,417 122,176

      Notes: CO – Community Organization; VC – Village Council; PS – Private Sector (local); UKS –
      Capital Construction Department of Reskomnats (Republican Committee for Nationalities and FDPs)




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     Annex 2:             List of sub-projects funded by SDC
                                                                                                   Total Cost-sharing contribution (USD)
                                                                             Implementing
 #                                Projects                                                        Budget                   CO & local Beneficiaries
                                                                              organization                SDC/UNDP
                                                                                                   USD                     authorities
 I Bakhchisaraiskii Region
   Construction of water main, service reservoir and borehole well for
 1                                                                               PMK-2                12,401      11,512            889         315
   drinking water supply system in Tenistoye settlement
   Construction of water main and service reservoir for drinking water
 2                                                                              PMK-238               19,835      17,610           2,224
   supply system in Sevastyanovka settlement
   Construction of distribution system for drinking water supply system
 3                                                                             CO "Dalira"             8,258       4,790           3,468
   of Sevastyanovka settlement
   Construction of distribution system for drinking water supply system
 4                                                                             CO "Mriya"              9,207       5,235           3,971        495
   of Sevastyanovka settlement
   Construction of distribution system for drinking water supply system
 5                                                                            CO "Mechta"              8,347       5,000           3,347
   of Sevastyanovka settlement
     Construction of distribution system for drinking water supply system
 6                                                                           CO "Nadezhda"             8,818       5,493           3,325
     of Sevastyanovka settlement
 7 Community Sport Complex in Tenistoye                                       CO "Bereket"             1,390       1,127            263          97
   Youth Initiative for Integration and Development in Viktorovka
 8                                                                          CO "Yani Yashlav"          1,670       1,039            631         334
   settlement
   Community center for women and youth development in Kholmovka
 9                                                                           CO “Zalan koi”            2,603         970           1,633        256
   Settlement
                                                                              CO “Yanimale
10 Community road in Perulok Sadoviy of Krasniy Mak Settlement                                         9,106       3,699           5,407        128
                                                                                Karalez”
11 Children and Youth Development Initiative in Zavetnoye Settlement           CO “Alma”               1,801         832            969         130
   Reconstruction of Community water supply system in Shkolnaya and
12                                                                             CO "Gidro"              3,988       1,959           2,028         75
   Moskovskaya streets of Kholmovka settlement
13 Community Healthcare Center in Zavetnoye Settlement                        CO Zelyenoye             2,995       2,506            489         619
14 Community Healthcare Center in Samokhavalovo Settlement                    CO Istochnik             5,101       3,894           1,207        547

15 Community Gravel Road in Malovidnoe Settlement                              CO Edishel              8,009       5,138           2,871        224



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16 Reconstruction of culvert in Samokhvalovo Settlement                     CO Druzhba Narodov           2,021      804     1,217    464
   Children and Youth Development Initiative in Bogatoye Ushchelye
17                                                                              CO Kokluz                2,526     1,499    1,027    133
   Settlement
   Community water supply system in Pervomaiskaya and Novaya
18                                                                               CO Alma                16,510     7,541    8,969
   Streets of Zavetnoye Settlement
   Community water supply system in Zarechnaya Streets of Zavetnoye
19                                                                              CO Vesna                13,258     6,233    7,024    619
   Settlement
     Community water supply system in Zelyonaya Street of Zavetnoye
20                                                                             CO Zelyonaya             22,761    16,059    6,702
     Settlement
     Construction of a crossing structure and water main for water supply
21                                                                             CO Istochnik             29,184    25,304    3,880
     system in Samokhvalovo Settlement
     Community water supply system in Zhirzhinskaya and Zhelezno-
22                                                                          CO Druzhba Narodov          23,019    10,190   12,829    547
     Dorozhnaya Streets of Samokhvalovo Settlement
     Community water supply system in Komsomolskaya Street of
23                                                                            CO Kara-Deniz             25,578    10,887   14,691
     Samokhvalovo Settlement
24 Community water supply system in Bryanskoye Settlement                     CO Klubnichka             11,681     5,605    6,076
                                                                                                                                     920
     Construction of water main, service reservoir and borehole well for
25                                                                               PMK-86                 27,697    24,545    3,152
     drinking water supply system in Bryanskoye Settlement
25                                Sub-total:                                                           277,763   179,472   98,291   5,903
II   Belogorskii Region
 1 Community Healthcare center in Karasevka settlement                           CO Istok                6,817     3,301    3,517    228
 1                            Sub-total:                                                                 6,817     3,301    3,517    228
III Krasnogvardeiskii Region
 1 Community Healthcare Center in Mendelievo settlement                       CO Mendelievo              3,242     2,313     929     196
 2 Community Healthcare Center in Nekrasovo settlement                         CO Nadezhda               5,669     4,211    1,458   1004
 3 Community Healthcare Center in Molochnoye settlement                         CO Center                7,224     4,638    2,586    564
 4 Community Healthcare Center in Timoshenko Settlement                      CO Vozrozhdenie             7,292     5,680    1,612    550
 5 Community Healthcare Center in Tsvetkovo Settlement                         CO Tsvetkovo              7,454     4,784    2,669    221
 6 Community water supply system in Malochnoye settlement                      CO Kievskaya             22,058    11,139   10,919    564


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 7 Community Healthcare Center in Amurskoye Settlement                        CO Birlik               12,350     6,617     5,733    2,622
 8 Community Healthcare Center in Novo-Alekseevka Settlement            CO Novo-Alekseeavka-2         12,059     8,955     3,104     614
 9 Ambulatory/Healthcare Center in Rovnoye Settlement                     CO Sovetskaya Str           20,147     7,865    12,281    1,972
10 Community Healthcare Center in Zernovoye Settlement                        CO Savluk                9,362     4,792     4,570    1,433
10                               Sub-total:                                                          106,857    60,995    45,862    9,740
IV Pervomaiskii Region
 1 Community Healthcare Center in Rovnoye Settlement                       CO Adzhi-Atman              8,748     5,570     3,178     175
 2 Community Healthcare Center in Susanino Settlement                      CO Nadezhda-3               8,027     5,168     2,859     337
 2                               Sub-total:                                                           16,774    10,738     6,036     512
V Trainings
     Training on preventive health care for Community Mobilization        Christian Children's
 1                                                                                                     2,673     2,673        0       24
     Assistants working in 10 regions                                             Fund
                                                                           Trainers from city
     Training for community-based Enterprises for operation and
 2                                                                          water utility and            534      534         0       18
     management of water systems
                                                                         sanitation department
     Training on promotion of community-based preventive health in 20    Christian Children's
 3                                                                                                    25,173    25,173        0      320
     settlements of 5 regions and 10 doctors                                     Fund
3                                Sub-total:                                                           28,380    28,380         0      362
41                                 Total:                                                            436,592   282,886   153,706   16,745



Notes:

PMK 2, PMK 86 and PMK 238 are specialized construction companies that were selected through competitive tender bidding

CO: Community Organization




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 Annex 3: Community-Based Operation and Maintenance
 Management System for Water Supply (Stakeholders, Linkages
 and Interfaces)




                                                                                                                                                                                                        GorVodoKanal
Village Council Level                                                                                                         Reporting
                                                           Village Council




                                                                                                                                                                                                        Reporting
                                                                (Head)




                                                                                                                                       Agreement (in absence of CK)
                                        Represent COs




                                                                        Partnership Agreement
                                                                                                Reporting
                                                                                                                                                                                  KK



Settlement/                             VC
                                                                                                                 FG




                                                                                                                                                                                                   Fees + Technical Services
Neighbourhood Level                Representatives




                                                                                                                                                                                       Agreement
                                                                        CO                      1 – n




                                                                                                                    Technical Monitoring
                                                             Feedback




                                                                                                            Technical & Financial Report                                          CBE
                                                                                                                           Sub-Contract




VC    Village Council
FG    Functional Group                                        Consumers
                                                        - Households;                                                  Service Contract
CBE   Community-Based Enterprise
                                                        - Commercial Enterprise;                                          Tariff Payment
KK    Kommune-Khoz                                      - Institutions
CO    Community Organization




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Annex 4:


   UNITED NATIONS DEVELOPMENT PROGRAMME IN UKRAINE
                         AND
    SWISS AGENCY FOR DEVELOPMENT AND COOPERATION



     CRIMEA INTEGRATION AND DEVELOPMENT
                 PROGRAMME




                              CONCEPT PAPER

     ON IMPLEMENTATION OF COMMUNITY-BASED
             WATER SUPPLY PROJECTS
                within the framework of the
       SDC-funded Community-based Governance,
 Infrastructure and Social Development in Crimea Project




                                    FEBRUARY 2003

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               CONCEPT PAPER ON IMPLEMENTATION OF
             COMMUNITY-BASED WATER SUPPLY PROJECTS

1.       INTRODUCTION

        In 1995, at the request of the Government of Ukraine, UNDP launched the Crimea Integration
and Development Programme (CIDP) in order to support and facilitate the peaceful integration of
formerly deported people (FDPs) into Crimean and Ukrainian society.

        During the first two phases of CIDP (1996-98 and 1998-Mid 2001), a number of FDP
communities in four regions were provided with basic infrastructure and social services, such as
drinking water supply, schools and health clinics. The involvement of the Swiss Agency for
Development and Co-operation (SDC) in CIDP began in 1996 with support to the construction of a
water supply system in the Simferopol suburb of Kamenka. In 1999, SDC extended its support to
include community-based preventive healthcare in Bakhchisaray and Belogorsk regions and supported
the construction of a water supply system in the 7th micro-rayon of Bakhchisaray town.

         With regards to the water supply projects, these were community priorities that were
recommended by the relevant Regional Administrations and carried out by UNDP/CIDP in partnership
with the Republican Committee for Nationalities and Formerly Deported People Issues (Reskomnats).
Implementing Partners (Contractors) were selected through competitive tender bidding for the
construction works, whereas the relevant Regional Administrations facilitated all issues related to
legal requirements, permits, etc., at local level. The completed water supply systems were handed over
to the relevant local water management authorities for operation and maintenance.

         Although these projects were successfully implemented, both UNDP/CIDP and SDC realized
that community (user) participation in the identification, planning and implementation of the projects
had been weak and that operation and maintenance were largely left to the relevant water management
authorities, which suffer from serious organizational and budgetary constraints. Users did not feel
responsibility for and ownership of the new water supply systems and had therefore little incentive to
pay for water consumed and to make efficient use of the water available. As a result, the new water
supply systems became an additional burden for the already overstretched and weak capacity of the
existing water management authorities. Hence, the sustainability of the water supply projects was in
doubt.

        Based on these and other lessons learned in the first two phases, and following extensive
consultations with SDC and other partners, UNDP/CIDP has developed a more people-centered
approach, which focuses on broad participation and involvement of users/beneficiaries of social and
communal infrastructure in all stages of project conception, planning, implementation and operation &
maintenance. This document presents a conceptual framework for the realization of water supply and
other basic infrastructure projects within the framework of the SDC-funded Community-based
Governance, Infrastructure and Social Development in Crimea Project.


2.       CONCEPTUAL FRAMEWORK

       In its third phase, which started in mid-2001, CIDP is focusing on supporting integration and
development in Crimea by:

        Promoting peace and stability through the establishment of a human security monitoring
         system for policy development and recommending appropriate measures
        Increasing tolerance and social cohesion through education, culture and mass media


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       Supporting community development and good governance through promoting community
        self-help initiatives and decentralized participatory planning and decision-making processes
       Reducing poverty through the creation of income and employment opportunities and an
        enabling environment for small and medium enterprise development
       Improving living conditions through the provision of basic social and communal infrastructure
        and services

        Currently working in seven regions of Crimea, the Programme plans to expand its activities to
14 regions in the coming two years.

         In this context, equitable and sustainable development is a prerequisite for maintaining peace
and stability in the region. Such development is possible only if all members of a community,
regardless of sex, age and ethnic background, have equal opportunity to participate in the decision-
making processes that affect their lives and the well being of the community. This approach, which is
essentially one of promoting good governance, forms the basis of the UNDP/CIDP strategy in the third
phase of the Programme. This is key not only to successfully addressing social and communal
infrastructure priorities of target communities, but also to empowering people to undertake a wide
range of other community self-help initiatives, relying on their own resources, and to enter into a
dialogue and partnership with local authorities to address issues of mutual concern in a participatory,
responsive and transparent manner.

         The methodology developed by UNDP/CIDP takes into account the specific social, economic,
historical and cultural context of Crimea, from which the following four characteristics can be
highlighted:

       The majority of FDPs of Crimean Tatar ethnic background, upon return to Crimea, were
        forced to settle in relatively isolated rural settlements that often lack the most basic conditions,
        such as water supply, roads, health facilities, schools, and even electricity. Moreover, high
        unemployment and lack of access to land and an initially hostile attitude from the side of the
        authorities have reinforced a sense of exclusion from participating as full-fledged citizens in
        society among FDPs that was already strongly developed during the decades of exile in
        Central Asia and other parts of the former Soviet Union.
       At the same time, this sense of exclusion, which reinforced the need to preserve their identity
        as a people and a nation, has facilitated a degree of self-reliance and self-organization, which
        has been unparalleled in the former Soviet Union, where such initiatives were not tolerated.
        Only an outcast nation desperate to preserve their identity and to return to their motherland,
        such as the Crimean Tatars, could to a certain degree defy the standard Soviet mould, be it
        sometimes at a huge cost.
       The desire to return to Crimea, combined with the realization that ethnic Crimean Tatars
        constitute only 12% of the population of Crimea and the need to survive as a nation has
        resulted in a rather pragmatic approach of the Crimean Tatar leadership in trying to avoid
        violent conflicts. While the approach vis-a-vis the authorities had been very activist, utmost
        care has been employed in preventing conflicts from taking on ethnic dimensions, which could
        have resulted in widespread ethnic conflict of which there are already many examples in the
        former Soviet Union and the Balkans.
       The collapse of the Soviet Union has been a traumatic experience for the vast majority of the
        population. People saw their savings and security vanish almost overnight and adjusting to the
        new realities of post-Soviet independent Ukraine has been difficult. Although it provided an
        opportunity for Crimean Tatars to return to their homeland, many of them gave up good
        standards of living in Central Asia to start from scratch in Crimea. At the same time, the other
        people living in Crimea, many of them retired, or descendants of retired, army personnel,
        party officials and other representatives of the power structures and of ethnic Russian descent,
        saw their former privileged positions turn to one of hardship and feeling abandoned in being
        separated from Russia. Therefore, an exclusive focus of the Programme on FDPs would
        ignore the plight of other people in Crimea as well as other potential causes of conflict.
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         Therefore, in order to ensure a participatory development approach that builds upon existing
traditions of activism, self-reliance and self-organization of FDPs in seeking to diminish the sense of
exclusion from mainstream society, while taking into account the needs of non-FDPs as well, a
methodological tool is being employed by UNDP/CIDP that is often referred to in literature as “social
mobilization”. Through “social mobilization”, inhabitants of individual settlements are encouraged to
organize themselves into self-governing community organizations (COs). These COs are informal
institutional set-ups at the neighborhood or settlement level in order to facilitate addressing
community problems on the basis of democratic governance norms and principles of transparency and
accountability.

         The purpose of the self-help community organization is therefore to harness people’s
capacity to take initiative and solve their problems, while at the same time strengthening
community cohesion and mutual tolerance and become part of wider civil society. In order to
ensure that the CO fulfills its purpose successfully, there are a number of principles that apply to its
internal organization and proceedings and for which training is being provided by CIDP staff from
Simferopol and from the local Integration and Development Centers:

        Encourage the vast majority of residents (at least 80%) to become member of the CO and that
         there is an equitable representation of women, youth and different ethnic groups.
        Establish simple and transparent rules and procedures for the mandate and functioning of the
         CO and that the management of the CO is democratically elected and accountable to all
         members.
        Encourage members to pool resources and establish a community saving fund of which the
         CO can assume full ownership and responsibility.
        Encourage members to identify and prioritize common needs through open discussion and
         debate and based on consensus and to identify which of those priority needs can be addressed
         by the members of the CO themselves, i.e. without intervention from external agencies.
        Encourage members to establish Functional Groups to undertake feasibility studies of selected
         priorities, taking into account the need to maximize benefits and participation of all members,
         regardless of sex, age and ethnicity, the need to operate, maintain and sustain the project
         beyond its technical completion, as well as the project’s cost-effectiveness, identification of
         locally available resources for its realization and the need for resource mobilization from
         external partners.
        Ensure recognition of the CO by local authorities and encourage dialogue and partnerships
         between COs and local authorities (in particular the elected Village Councils), as well as
         between COs from different settlements.
        Encourage implementation of community-based self-help initiatives to take place within the
         framework of consensus and agreement among all the internal (CO members) and external
         (local authorities, public service providers, private sector entities) stakeholders involved.

        Although CIDP is in principle able to provide assistance to all settlements and village councils
that express interest in participating in the Programme, in line with CIDP's mandate priority is being
given to areas with a high proportion of FDPs. The following section will describe in detail how the
successful establishment and functioning of community organizations and functional groups facilitates
the participatory, transparent and sustainable provision of social and communal infrastructure and
services, such as community water supply systems.


3.       COMMUNITY-BASED INFRASTRUCTURE PROJECTS

         Community-based infrastructure projects follow in principle the same project cycle as
traditional projects, but community members, i.e. the beneficiaries or users, actively participate in the
process of project identification, design, implementation and exploitation/operation & maintenance, as
described below:

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3.1     Identifying and Prioritizing Community Needs
         Once a self-help community organization is formed in the village/settlement, the elected
chairperson and active members of the CO organize public meetings of all members to discuss and
identify common interests, problems and needs. Those needs on which there is a consensus that they
constitute priorities for the entire community are confirmed in another public meeting where at least
80% of CO members are present. The decisions taken are recorded in minutes.

        Based on the priority needs identified and confirmed in the public meetings, a community
development plan is prepared, which includes all identified social, economic and infrastructure
projects. The CO then presents this community development plan to the local Village Council in order
to be incorporated into the Village Council and regional development plans. This allows the Village
Council to plan in advance for any contribution and support it may be able to provide to the
implementation of the community development plan. This practice therefore strengthens the self-
governing role of COs and Village Councils and enhances the bottom-up and decentralized planning
process in government in general.

         The CO also presents preliminary project proposals to UNDP/CIDP, requesting to study the
project and provide technical and financial assistance towards its implementation.

3.2     Project Formulation, Planning and Design
        CIDP specialists, together with the CO, subsequently study the feasibility of the project.
Whereas the detailed technical design of water supply projects require specialized technical
knowledge, it is equally important to ensure that the project meets the needs and requirements of its
future users and that these users are fully involved in the initial formulation, planning and design of
the project. For this purpose, the CO established a Functional Group (FG) consisting of 3-5
community members who have know-how and experience on the particular subject. The FG is usually
chaired by a local engineer/technician, if available, or any other qualified person nominated by the CO
members in a public meeting.

         To the extent possible, the FG assumes full responsibility for planning and designing the water
supply project. It prepares the preliminary layout plan indicating potential water sources, alignment of
water main, location of proposed reservoir, proposed water distribution lines of the intended water
supply project, etc. In addition, the FG collects demographic data, information on public and private
establishments located in the project area and livestock in order to calculate the water requirement of
the community. The FG also prepares a tentative cost estimate for the project based on the
approximate scale of the water supply system and reservoir size.

         In general, large-scale and/or new water supply projects (such as the SDC-funded projects in
Tenistoye and Sevastyanovka) require a specialized technical input for technical design and
preparation of cost estimates. In this case UNDP/CIDP or Reskomnats engage professional designers
for the preparation the project. However, the FG remains fully involved in the design process, for
example in determining the size and location of the service reservoir, calculating the estimated water
requirement for the community, the selection of material used for piping (polyethylene or cast iron or
steel pipe), design of the water grid, etc. Important technical recommendations are presented by The
FG and the CIDP engineer to a meeting of active CO members or in public CO meetings.

        In the case of small-scale or reconstruction/repair projects, the FG usually prepares the entire
project with the assistance of the CIDP engineer.

         In both cases, the final design of the project is discussed in public meetings, during which
community contributions to the realization of the project are being determined. Such contributions
often take the form of in-kind labor, which translated in monetary terms can be a significant part of the
total cost of the project. Also, issues related to connecting individual houses (usually the responsibility
of the individuals), the installation of water meters, operation & maintenance of the system and the
level of charges for water use are being discussed and determined at this stage.

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         Subsequently, the CO presents the approved project proposal to the Regional Forum for
Integration and Development (RFID), which is chaired by the Regional State Administration and
facilitated by the local CIDP Integration & Development Center and in which all Village Councils and
Community Organizations, local NGOs and other stakeholders in the concerned Region participate.
The Forum provides an opportunity to for the CO to obtain viewpoints and inputs from other entities
in the Region and to have the project included in the regional development plan.

        In case the project cost is below USD 10,000, the RFID members can subsequently
recommend the project for funding through the UNDP/CIDP-managed “Community Integration and
Development Fund”. This is a micro-capital grant fund in which SDC also participates. Larger-scale
projects can be reviewed by UNDP/CIDP based on the availability of specifically earmarked funding
for the activity, as is the case with the SDC-funded water supply projects in Tenistoye and
Sevastyanovka.

3.3     Project Implementation and Monitoring
         Once approved, UNDP/CIDP signs a contract with the CO for the implementation of the
project, determining in detail the scope of works, cost-sharing contributions from UNDP/CIDP, the
CO and local authorities, milestones for progress payments and completion, and activities to be
undertaken for ensuring sustainable exploitation, operation and maintenance of the system. For
construction works on new and large-scale water supply projects involving building water mains and
reservoirs and drilling boreholes, specialized contractors are selected through a process of open
competitive bidding by UNDP/CIDP in the presence of the CO, whereas the CO itself actively
participates in the construction of the water distribution system, individual house connections and the
installation of water meters. Local authorities (Village Council and Regional State Administration)
usually provide a small amount from their limited budgets, in-kind support such as equipment, and,
most importantly, administrative support in order to ensure that all legal requirements are met and
permits are obtained for construction and future user-based exploitation of the system.

During implementation, CIDP staff, including the CIDP Engineer, the CIDP Community Development
Specialist and the local ICD staff, regularly monitors progress. This monitoring does not only cover
works performed by the contractor, in which the CO also participates, but also covers the contributions
and activities of the CO itself and the local authorities. Progress payments are issued based on
certification by the relevant CIDP staff that all activities related to a particular stage of the project, as
determined in the contracts, have been completed.

3.4     Project Commissioning and Handover
         Two types of tests are conducted before handing over the completed project for exploitation,
operation and maintenance. These include leakage tests of pipelines and service reservoir, as well as
testing the water quality at source, service reservoir and house tap. After completion of testing, the
contractor receives final payment and the project is commissioned and handed over to the concerned
water management agencies. There are two organizations responsible for exploitation, operation and
maintenance of drinking water supply systems in Ukraine. An urban water authority (GorVodaKanal)
for urban water supply systems and a Communal Enterprise (KomunKhoz) for rural drinking water
supply system.

        Both organizations are highly inefficient not very capable in ensuring the proper upkeep of the
water supply systems under their responsibility. Water tariffs are centrally determined without taking
into account the actual cost of operating and maintaining the concerned water supply system, thereby
not providing any incentives for cost-effectiveness. Weak accountability and lack of transparency and
involvement of users in the management of the systems, results in users not feeling responsible for the
upkeep of the water system. As a result, collection of water user fees is inadequate to meet operating
and maintenance cost, resulting in frequent breakdowns and cut-offs. In turn, the users, complaining
about poor service, are even less prepared to pay for the water resulting in a downward spiral of
increasing dysfunction typical of so many social and communal services following the collapse of the


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Soviet Union. As it is, local authorities simply lack the budgetary resources to permanently subsidize
such services and bail out poor public service providers.

         However, there is plenty of room in the law for devising exploitation, operation and
maintenance systems that involve users to the maximum. UNDP/CIDP is working with COs, Village
Councils and the local water management authorities on establishing options that are most effective
and appropriate for the specific water supply system and its users. These options are described in
detail in the next section.


4.        SUSTAINABILITY OF THE PROJECTS

        The sustainable exploitation, operation and maintenance of technically completed projects are
preconditions for UNDP/CIDP financial and technical support to water supply systems and other
social and communal infrastructure projects. Therefore, the design of realistic sustainability
mechanisms is included from the inception period of the water supply projects and discussed with all
stakeholders, including the CO, KomunKhoz or GorVodaKanal, the local Village Council and the
Regional Administration. Based on past experience, UNDP/CIDP has recognized the following
elements as key to ensure the sustainability of the project.

4.1       Institutional Arrangements
        GorVodaKanal and KomunKhoz are presently the only institutions engaged in the operation
and maintenance of the water supply systems in urban and rural areas respectively. The quality of
water supply services especially in the rural areas is very poor for the reasons explained in section 3.4.
In this context, UNDP/CIDP has developed two alternative models of institutional arrangement for
sustainable management of the water supply systems.

      4.1.1 Establishment of Private/Cooperative Enterprise of CO
               In the case of new and relatively small and simple water supply systems, the CO may
      decide to establish a private enterprise for the exploitation and O&M of the system. In this case,
      the CO selects a CO member who has experience and technical know-how and asks him/her to
      register a private enterprise for communal services. The private enterprise subsequently signs
      contracts with individual households for the provision of water services and payment by the user.

               The advantage of this system is that it is simple and transparent: users personally know
      and trust the elected CO member who will take charge of the exploitation of the system. Also, the
      price that users will pay for the service is directly linked with the cost of providing that service
      and can be checked by community members at any moment. Therefore, there will be an incentive
      to be as cost-effective as possible and minimize overhead costs. Most of the time, people pay less
      for their water under such private management, as there is no need to maintain a bureaucratic and
      technical apparatus that comes with more centralized systems of water management.

               On the other hand there are also some disadvantages: in case of a major breakdown of the
      system it may be difficult for the community to raise the money required for repair. In that case,
      there is no obligation from the part of the Village Council of the local KomunKhoz to provide
      assistance. In fact, they may legally not even be able to, even if they have the resources available.
      Therefore, it is important that ownership of the water system itself is formally transferred to the
      local Village Council, who in turn will hand over the system for day-to-day O&M to the private
      CO enterprise. For a successful O&M, a tripartite agreement between Village Council, CO and
      private enterprise will be signed with clear responsibilities of each partner. The private company
      will responsible for quality services and accountable to CO and Village Council.

             An alternative to establishing a private enterprise for O&M is for the CO to register a
      cooperative (user association) for the provision of water services of which each household
      becomes a member. In this case, the CO will sign an agreement with the Village Council for O&M
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   of the system. The CO appoints experienced and technically qualified CO members to carry out
   day-to-day O&M for the cooperative. The salary and O&M cost will be covered by the water tariff
   approved in the public meetings of the CO. In this case, the cooperative will sign the contract with
   each individual household.

           In both cases, a tripartite agreement will be signed to ensure full participation of users in
   decision-making processes and ensure transparency and accountability of the water management
   board to the CO and Village Council. The general institutional arrangement mechanism and
   linkages of stakeholders is presented in Fig.-1 below.


                  Figure-1: Institutional Arrangement and linkage of stakeholders

                        Community                   (A)          Village
                        Organization                             Council

                                  (A)                     (A)                  ($)

                                                                  (TS)
                                        Cooperative/Private                Technical
                        (E)
                                            Company             ($)        Support Center

                                                     (W)
                                           ($)

                                             Household


            Legend
             E- elect, $- money, W- water, A-Agreement, TS- technical support



           Which of the two alternatives, private enterprise or water management cooperative, COs
   would like to pursue can be discussed and established by them in public meetings.

   4.1.2 Improve management system of KomunKhoz
            Another option is to improve the existing management system of KomunKhoz to ensure
   quality of service, transparency, accountability and full participation of users. In this case, a
   special agreement will be made between KomunKhoz, the local Village Council and the CO in
   which responsibilities of each side are clearly defined. A water management board will be formed
   under the Chairpersonship of the Head of the local Village Council. Other board members will be
   representatives from respectively the CO, KomunKhoz and the Village Council in charge of
   public services. For the day-to-day O&M of the water system, KomunKhoz will be requested to
   appoint at least one member recommended by the CO. This will ensure confidence by the users in
   the capacity of KomunKhoz to run the system transparently and cost-effectively. The water tariff
   will be set in accordance with the expected O&M costs in a transparent way, meaning that it will
   be widely discussed with all concerned parties before it is established. The CO will assist
   KomunKhoz in collecting the water fees as per consumption of each household. The CO will
   encourage its members to install water meters and will control mishandling of valves and misuse
   of scare drinking water.

            This option is more appropriate where reconstruction/repair is undertaken to improve
   existing water supply services that are already under KomunKhoz responsibility. Training on
   efficient and effective water management will be conducted for the KomunKhoz and FG and local
   authorities to enhance capacity of the existing institutions.

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              Whereas both options have their advantages and disadvantages, in both cases the risk that
      the new or repaired water supply system cannot be properly maintained increases with the
      complexity of the system. Therefore, support to the establishment of large-scale, complex and
      expensive systems in rural areas should generally be avoided. This equally applies to other rural
      social and communal infrastructure and services, such as schools, health facilities, etc.

4.2       Financial arrangements
         All the existing KomunKhoz are financially autonomous. This means that O&M is being
carried out with the revenue collected from the water users. At present, water fees are charged to
consumers in a lump sum amount per head for domestic use and per m2 for irrigation of the kitchen
garden. The reason for this crude mechanism is that many users do not have water meters installed. As
a result, there are no incentives for individual users to be frugal with the use of water, as the fees are
not related to the actual amount consumed. Apart from being environmentally unsustainable, this
system is generally seen as unfair and has created misunderstandings and mistrust of KomunKhoz.
Consequently, many people do not pay for water. Therefore, installation of water meters by users is a
prerequisite for a fair and regular collection of water fees.

         UNDP/CIDP requests the FG to calculate the water cost during the formulation of the project.
These costs should reflect at least production cost (electricity consumption for pumping), operation
cost (salaries, chlorination and cleaning the reservoir etc) and maintenance cost (regular minor repairs
such as replacement of pumps and valves etc). On the basis of these cost calculations, a water tariff is
established and discussed with the CO members as to whether they are willing to pay for recovery of
the above-mentioned costs. The cost of house connection and installation of water meters is included
as part of the cost-sharing contribution of the CO to the project and laid down in the implementation
agreement with UNDP/CIDP.

         Whereas operation and periodic maintenance can be covered from the collected water fees, it
is as yet unrealistic to expect users to cover the cost of capital investment in the systems. Also, in case
of major breakdowns or natural disasters, external support (from government) will most likely be
needed to restore the water system.

4.3       Operation and Maintenance
        Responsibility for O&M very much depends on what type of institutional arrangement has
agreed upon. UNDP/CIDP encourages the COs to adopt the option of establishing private enterprises
or cooperatives. This ensures active participation of users and develops ownership of the CO of “their”
water supply system. The second option of making arrangements through KomunKhoz is more
feasible in the case of upgrading existing water supply systems. However, in both cases, individual
house owners are responsible for maintenance of the connecting pipeline from the distribution system
to the house, while the private enterprise/cooperative or KomunKhoz is responsible for O&M of the
water supply system itself. The CO and local authorities will monitor and facilitate the O&M process.

4.4       Partnership Arrangements
        The community-based water supply projects are being implemented by COs in partnership
with local authorities (Village Council and Regional Administration). It is therefore important to
continue the partnership concept in operation and maintenance. Village Councils, KomunKhoz and
COs are identified as the main partners for O&M to ensure sustainability of the project.

4.5       Environmental Management
         There is a strong link between sustainable development and environmental management. Any
activity that may potentially produce a negative impact on the environment is automatically excluded
from UNDP/CIDP support. Moreover, UNDP/CIDP actively encourages communities to use water
economically and efficiently in order to avoid the excess use of scare ground water. For this purpose,
the Programme encourages the CO to install water meters and introduce additional penalty systems in
case of waste and abuse. The Programme also suggests community members to build septic tanks to
avoid pollution of ground and surface water.
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5.      CONCLUSIONS AND FUTURE PERSPECTIVES

         The Programme plans to cover 14 Regions of Crimea by the end of 2004. The condition of
social and communal infrastructure and services in many rural areas is very poor. Moreover, water
supply systems, health centers and schools do not exist in most new settlements where the majority of
the inhabitants are FDPs. Recognizing the need to improve living conditions through the provision of
social and communal infrastructure and services in those areas, UNDP/CIDP has given high priority to
promote sustainable community-based water supply projects in rural areas where more than 75% of
FDPs are living. The construction of water supply systems not only meets basic drinking water
requirements but also gives an opportunity to earn additional income by growing vegetables in the
household farms. The present Concept Paper has outlined that in the Crimean context it is very much
feasible to provide such infrastructure and services in a sustainable and cost-effective way, while at the
same time contributing to strengthening local good governance and empowering people to take charge
of their future.




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Annex 5:

   UNITED NATIONS DEVELOPMENT PROGRAMME IN UKRAINE
                         AND
    SWISS AGENCY FOR DEVELOPMENT AND COOPERATION



     CRIMEA INTEGRATION AND DEVELOPMENT
                 PROGRAMME




                              CONCEPT PAPER

     ON IMPLEMENTATION OF COMMUNITY-BASED
         PREVENTIVE HEALTHCARE PROJECTS
               Within the framework of the
       SDC-funded Community-based Governance,
 Infrastructure and Social Development in Crimea Project




                                    FEBRUARY 2003

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          CONCEPT PAPER ON IMPLEMENTATION OF
     COMMUNITY-BASED PREVENTIVE HEALTHCARE PROJECTS

1.      INTRODUCTION

        In 1995, at the request of the Government of Ukraine, UNDP launched the Crimea Integration
and Development Programme (CIDP) in order to support and facilitate the peaceful integration of
formerly deported people (FDPs) into Crimean and Ukrainian society.

        During the first two phases of CIDP (1996-98 and 1998-Mid 2001), a number of FDP
communities in four regions were provided with basic infrastructure and social services, such as
drinking water supply, health clinics and home-based schools. The involvement of the Swiss Agency
for Development and Co-operation (SDC) in CIDP began in 1996 with support to the construction of a
water supply system in the Simferopol suburb of Kamenka. In 1999, SDC extended its support to
include community-based preventive healthcare in Bakhchisaray and Belogorsk regions and supported
the construction of a water supply system in the 7th micro-rayon of Bakhchisaray town.

        With regards to the community-based healthcare projects, these were mostly implemented
through the local NGO “Health” of Bakhchisaray region. During CIDP Phase-II, the maternity
department of the regional hospital of Belogorsk region was equipped with gynecological equipment;
a minibus and gastro-duodenoscope were provided to the regional hospital of Bakhchisaray region. In
addition, two health clinics and three health posts were established in the Bakhchisaray region. For
the successful implementation of these projects, the relevant Regional Administrations facilitated all
issues related to legal requirements, permits, etc., at local level. The completed health clinics and
health posts were handed over to the NGO “Health” for management.

         Although these projects were overall quite successfully implemented, both UNDP/CIDP and
SDC realized that for some of the project components community (user) participation in the
identification, planning and implementation of the projects had been weak and that operation and
maintenance were largely left to the medical staff, which is working on voluntary basis. Users did not
develop responsibility for and ownership of these projects and had therefore little incentive to pay for
services. As a result, there is some doubt about the sustainability of at least one of the project
components, that is the comparatively large facility in Viktorovka.

        SDC consultants evaluated these projects and a number of recommendations were
implemented for further improvement. Based on lessons learned in phase-II and following extensive
consultations with SDC and other partners, UNDP/CIDP has developed a more people-centered
approach, not only in the health sector, which focuses on broad participation and involvement of
users/beneficiaries of social and communal services in all stages of project conception, planning,
implementation and operation & maintenance.

       At the same time, it has been recommended to emphasize the importance of preventive, rather
than just curative, health care in the target settlements. This document presents a conceptual
framework for the realization of community-based preventive healthcare projects within the
framework of the SDC-funded Community-based Governance, Infrastructure and Social Development
in Crimea Project.


2.      CONCEPTUAL FRAMEWORK

       In its third phase, which started in mid-2001, CIDP is focusing on supporting integration and
development in Crimea by:


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       Promoting peace and stability through the establishment of a human security monitoring
        system for policy development and recommending appropriate measures
       Increasing tolerance and social cohesion through education, culture and mass media
       Supporting community development and good governance through promoting community
        self-help initiatives and decentralized participatory planning and decision-making processes
       Reducing poverty through the creation of income and employment opportunities and an
        enabling environment for small and medium enterprise development
       Improving living conditions through the provision of basic social and communal infrastructure
        and services

        Currently working in seven regions of Crimea, the Programme plans to expand its activities to
14 regions in the coming two years.

         In this context, equitable and sustainable development is a prerequisite for maintaining peace
and stability in the region. Such development is possible only if all members of a community,
regardless of sex, age and ethnic background, have equal opportunity to participate in the decision-
making processes that affect their lives and the well being of the community. This approach, which is
essentially one of promoting good governance, forms the basis of the UNDP/CIDP strategy in the third
phase of the Programme. This is key not only to successfully addressing social service priorities of
target communities, but also to empowering people to undertake a wide range of other community
self-help initiatives, relying on their own resources, and to enter into a dialogue and partnership with
local authorities to address issues of mutual concern in a participatory, responsive and transparent
manner.

         The methodology developed by UNDP/CIDP takes into account the specific social, economic,
historical and cultural context of Crimea, from which the following four characteristics can be
highlighted:

       The majority of FDPs of Crimean Tatar ethnic background, upon return to Crimea, were
        forced to settle in relatively isolated rural settlements that often lack the most basic conditions,
        such as water supply, roads, health facilities, schools, and even electricity. Moreover, high
        unemployment and lack of access to land and an initially hostile attitude from the side of the
        authorities have reinforced a sense of exclusion from participating as full-fledged citizens in
        society among FDPs that was already strongly developed during the decades of exile in
        Central Asia and other parts of the former Soviet Union.
       At the same time, this sense of exclusion, which reinforced the need to preserve their identity
        as a people and a nation, has facilitated a degree of self-reliance and self-organization, which
        has been unparalleled in the former Soviet Union, where such initiatives were not tolerated.
        Only an outcast nation desperate to preserve their identity and to return to their motherland,
        such as the Crimean Tatars, could to a certain degree defy the standard Soviet mould, be it
        sometimes at a huge cost.
       The desire to return to Crimea, combined with the realization that ethnic Crimean Tatars
        constitute only 12% of the population of Crimea and the need to survive as a nation has
        resulted in a rather pragmatic approach of the Crimean Tatar leadership in trying to avoid
        violent conflicts. While the approach vis-a-vis the authorities had been very activist, utmost
        care has been employed in preventing conflicts from taking on ethnic dimensions, which could
        have resulted in widespread ethnic conflict of which there are already many examples in the
        former Soviet Union and the Balkans.
       The collapse of the Soviet Union has been a traumatic experience for the vast majority of the
        population. People saw their savings and security vanish almost overnight and adjusting to the
        new realities of post-Soviet independent Ukraine has been difficult. Although it provided an
        opportunity for Crimean Tatars to return to their homeland, many of them gave up good
        standards of living in Central Asia to start from scratch in Crimea. At the same time, the other
        people living in Crimea, many of them retired, or descendants of retired, army personnel,
        party officials and other representatives of the power structures and of ethnic Russian descent,
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         saw their former privileged positions turn to one of hardship and feeling abandoned in being
         separated from Russia. Therefore, an exclusive focus of the Programme on FDPs would
         ignore the plight of other people in Crimea as well as other potential causes of conflict.

         Therefore, in order to ensure a participatory development approach that builds upon existing
traditions of activism, self-reliance and self-organization of FDPs in seeking to diminish the sense of
exclusion from mainstream society, while taking into account the needs of non-FDPs as well, a
methodological tool is being employed by UNDP/CIDP that is often referred to in literature as “social
mobilization”. Through “social mobilization”, inhabitants of individual settlements are encouraged to
organize themselves into self-governing community organizations (COs). These COs are informal
institutional set-ups at the neighborhood or settlement level in order to facilitate addressing
community problems on the basis of democratic governance norms and principles of transparency and
accountability.

         The purpose of the self-help community organization is therefore to harness people’s
capacity to take initiative and solve their problems, while at the same time strengthening
community cohesion and mutual tolerance and become part of wider civil society. In order to
ensure that the CO fulfills its purpose successfully, there are a number of principles that apply to its
internal organization and proceedings and for which training is being provided by CIDP staff:

        Encourage the vast majority of residents (at least 80%) to become member of the CO and that
         there is an equitable representation of women, youth and different ethnic groups.
        Establish simple and transparent rules and procedures for the mandate and functioning of the
         CO and that the management of the CO is democratically elected and accountable to all
         members.
        Encourage members to pool resources and establish a community saving fund of which the
         CO can assume full ownership and responsibility.
        Encourage members to identify and prioritize common needs through open discussion and
         debate and based on consensus and to identify which of those priority needs can be addressed
         by the members of the CO themselves, i.e. without intervention from external agencies.
        Encourage members to establish Functional Groups (FG) to undertake feasibility studies of
         selected priorities, taking into account the need to maximize benefits and participation of all
         members, regardless of sex, age and ethnicity, the need to operate, maintain and sustain the
         project beyond its technical completion, as well as the project’s cost-effectiveness,
         identification of locally available resources for its realization and the need for resource
         mobilization from external partners.
        Ensure recognition of the CO by local authorities and encourage dialogue and partnerships
         between COs and local authorities (in particular the elected Village Councils), as well as
         between COs from different settlements.
        Encourage implementation of community-based self-help initiatives to take place within the
         framework of consensus and agreement among all the internal (CO members) and external
         (local authorities, public service providers, private sector entities) stakeholders involved.

         Although CIDP is in principle prepared to provide assistance to all settlements and village
councils that express interest in participating in the Programme, in line with CIDP's mandate priority
is being given to areas with a high proportion of FDPs. The following section will describe in detail
how the successful establishment and functioning of community organizations and functional groups
facilitates the participatory, transparent and sustainable provision of community-based preventive
healthcare.


3.       COMMUNITY-BASED HEALTHCARE PROJECTS

       There are multiple health problems in the settlements that need to be addressed. The most
obvious one is the difficult access to curative health care, such as first-line medical treatment of minor
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UNDP Crimea Integration & Development Programme                                         Final Report SDC


ailments and referral to more specialized medical services. However, there are also numerous health
problems that are linked to a lack of public awareness on the need to improve personal hygiene, local
sanitary conditions, prevention of transmissible diseases, including STDs, responsible use of
medicaments, family planning, safe use of contraceptives, promotion of healthy life styles, dangers of
tobacco, alcohol and drugs abuse, etc.

        Whereas the purpose of curative health services is well understood by users, the purpose of
preventive health services much less so. Therefore, in prioritizing healthcare, there is a need to raise
awareness among the members of the Community Organization that a health facility that only provides
medicine and treatment is of limited use in improving the living conditions and health of people.

        It is therefore fundamental that the community members, i.e. the beneficiaries/users, actively
participate in the process of project identification, design, implementation and operation &
maintenance, as described below.

3.1     Identifying and Prioritizing Community Needs
         Once a self-help community organization is formed in the village/settlement, the elected
chairperson and active members of the CO organize public meetings of all members to discuss and
identify common interests, problems and needs. Those needs on which there is a consensus that they
constitute priorities for the entire community are confirmed in another public meeting where at least
80% of CO members are present. The decisions taken are recorded in minutes.

        Based on the priority needs identified and confirmed in the public meetings, a community
development plan is prepared, which includes all identified social, economic and infrastructure
projects. The CO then presents this community development plan to the local Village Council in order
to be incorporated into the Village Council and regional development plans. This allows the Village
Council to plan in advance for any contribution and support it may be able to provide to the
implementation of the community development plan. This practice therefore strengthens the self-
governing role of COs and Village Councils and enhances the bottom-up and decentralized planning
process in government in general.

         The CO also presents preliminary project proposals to UNDP/CIDP, requesting to study the
project and provide technical and financial assistance towards its implementation.

3.2     Project Formulation, Planning and Design
         CIDP specialists, together with the CO, subsequently study the feasibility of the project. The
CO is encouraged to form a Functional Group (FG) consisting of 3-5 community members for the
detailed design and planning the project. The FG is usually chaired by a local doctor/nurse, if available
in the community, or any other qualified person nominated by the CO members in the public meeting.

         To the extent possible, the FG assumes full responsibility for designing and planning the
healthcare project. It collects demographic and health data. On this basis, the FG makes a choice.
Possible options could be small-scale health insurance funds, for example to ensure timely referral in
case of an emergency, small community pharmacies to ensure access to basic and essential drugs with
a revolving fund, or the organization of local awareness campaigns on issues relevant to health and
sanitation. It could of course also be the creation of or support to a health post.

         If the latter option is chosen, the FG also studies possible location options for the health post
in the project area. The FG also prepares the preliminary plan for services to be provided through the
healthcare center, including preventive services, and calculates a tentative cost estimate for the
establishment of the center. At the same time, the FG prepares a detailed plan of sustainable
management, operation and maintenance of the health center. This includes proposals on who will
staff and run the clinic and how salary is going to be paid, how medical supplies and drugs will be
provided, how and how much community members will need to pay for health services in order to


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UNDP Crimea Integration & Development Programme                                           Final Report SDC


cover operation and maintenance expenditures, etc. During the formulation process, the FG regularly
consults with other community members in public meetings.

        The final design of the project is discussed in public meetings, during which community
contributions to the realization of the project are being determined. Such contributions often take the
form of in-kind labor, which translated in monetary terms can be a significant part of the total cost of
the project. Also, issues related to the sustainable management, operation and maintenance, including
payment for services, are being discussed and determined at this stage. This will have to include
preliminary discussions with the local Village Council and the Regional Health Administration.

         Subsequently, the CO presents the approved project proposal to the Regional Forum for
Integration and Development (RFID), which is chaired by the Regional State Administration and
facilitated by the local CIDP Integration & Development Center and in which all Village Councils and
Community Organizations, local NGOs and other stakeholders in the concerned Region participate.
The Forum provides an opportunity to for the CO to obtain viewpoints and inputs from other entities
in the Region and to have the project included in the regional development plan. It is also an
opportunity to ensure full commitment from the part of the local Village Council and Regional Health
Administration to recognize the planned health center as part of the overall health structure in the
region and to make provisions for covering the salary of the medical staff.

        In case the project cost is below USD 10,000, the RFID members can subsequently
recommend the project for funding through the UNDP/CIDP-managed “Community Integration and
Development Fund”. This is a micro-capital grant fund in which SDC also participates. Larger-scale
projects can be reviewed by UNDP/CIDP based on the availability of specifically earmarked funding
for the activity. However, practical experience has shown that larger health facilities in rural
settlements, such as in Viktorovka in Bakhchisaray Region, are extremely difficult to make
sustainable. Therefore, the Programme will give priority to small ambulatory posts that are easy to
maintain with available local resources.

3.3     Project Implementation and Monitoring
         Once approved, UNDP/CIDP signs a contract with the CO for the implementation of the
project, determining in detail the scope of works, cost-sharing contributions from UNDP/CIDP, the
CO and local authorities, milestones for progress payments and completion, and activities to be
undertaken for ensuring sustainable management, operation and maintenance of the center. For
procurement and construction works, the CO will select providers and contractors through local
competitive bidding, whereas the CO itself actively participates in providing for example labor. Local
authorities (Village Council and Regional State Administration) usually provide a small amount from
their limited budgets, in-kind support such as equipment, and, most importantly, administrative
support in order to ensure that all legal requirements are met and permits are obtained for construction
and future user-based management of the center.

        During implementation, CIDP staff, including the CIDP Engineer, the CIDP Community
Development Specialist and the local ICD staff, regularly monitors progress. This monitoring does not
only cover works performed by providers and contractors, in which the CO also participates, but also
covers the contributions and activities of the CO itself and the local authorities. Progress payments are
issued based on certification by the relevant CIDP staff that all activities related to a particular stage of
the project, as determined in the contracts, have been completed.

3.4     Project Commissioning and Handover
        The local health department inspects the completed structure and inventory in order to assess
whether it meets sanitary norms and standards required for healthcare activities. The health post
building will be transferred to the local Village Council. In order to ensure successful management,
operation and maintenance of the healthcare center, an advisory committee will be created under the
chairmanship of the head of the local Village Council in which the CO and the manager of the health
center are represented.

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4.      SUSTAINABILITY OF THE PROJECTS

        The sustainable exploitation, operation and maintenance of technically completed projects are
preconditions for UNDP/CIDP financial and technical support to preventive health care and other
social projects. Therefore, the design of realistic sustainability mechanisms is included from the
inception period of the health projects and discussed with all stakeholders, including the CO, the local
Village Council, the Regional Administration and the local Health Department. Based on past
experience, UNDP/CIDP has recognized the following elements as key to ensure the sustainability of
the project.

4.1     Institutional Arrangements
        All formal health services in the region fall under the overall responsibility of the Health
Department of the Regional Administration. This department is usually located in the Central Rayon
Hospital, which in turn depends on the Ministry of Health. However, in spite of this hierarchical
structure, basic health facilities at the village level are no longer financed from the regional or
republican budgets. This responsibility has been transferred to the local self-governing Village
Councils. However, this kind of institutional arrangement has created serious problems for many
existing health posts in the rural areas as the Village Councils have practically no budgets beyond
covering salaries and operations of the Village Councils and institutions under their responsibility.
Therefore, indiscriminately establishing new health posts in villages and transferring the responsibility
for operation and maintenance to the Village Council is not sustainable under the present conditions in
Ukraine.

        Recognizing this fact, UNDP/CIDP has decided to support only those healthcare projects
where there is substantial community participation and contribution and where any allocation of
budget required from the Village Council is guaranteed in advance. In contrast with for example water
supply systems, where people are quite willing to pay for a service they are using every single day, it
is more challenging to convince people to maintain a service they may only need every now and then,
such as health services.

        Whatever system of charging for health services is agreed upon by the community (micro-
insurance or pay-as-you-go), it is unlikely that the CO will be able to guarantee payment of the salary
of the health staff right from the beginning. As one cannot expect medical staff to provide a dedicated
and professional service if they are not able to count on receiving regular payment of salary, such
payment should for the time being still be guaranteed by the local authorities. Therefore, unless the
local Village Council commits itself to cover the salary of the medical staff of the health center,
providing support for the establishment of such a center is not advisable. However, the community
might explore possibilities to offer additional monetary or non-monetary incentives for the staff. It
also means that any plans for health centers that employ more than one or two staff should be
considered as unrealistic.

        However, other costs of operating and maintaining the health post, i.e. medical supplies and
drugs, electricity, water, waste disposal, heating, maintenance and repair of building and equipment,
should be covered by the community members. If the health center is sufficiently small and focuses on
basic preventive and curative health care only, this should be perfectly feasible if a clear and
transparent system for paying for medical services is established (see section 4.3).

        The degree to which users are willing to pay for basic health services depends to a large extent
on the degree of ownership the community members feel for the health center. Therefore, participation
of the CO in all stages of project conception, preparation, implementation and management of the
health service is essential for people to consider it “our” clinic. Important in this respect is also that the
medical staff employed in the center is well-known and trusted by all the community members, not
only from a social and medical qualification point of view, but also in terms of charging fair prices for
services provided.


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        In order to involve the CO in the management of the clinic and enhance ownership and
sustainability, UNDP/CIDP proposes to establish “community healthcare advisory committees”,
consisting of representatives of the CO, health post management, Village Council and Regional Health
Department. The function of the advisory committee is to monitor the performance of the health post
and provide support for efficient and effective services.

         At the same time, the advisory board serves to “connect” the health center with other medical
services and initiatives (through the participation of the Regional Health Department). For the quality
of the service, it is important that the staff has access to “best practice” medical information,
preventive healthcare initiatives, etc., and that they become part of an information dissemination
network. In fact, the role of such small community health centers in preventive health care and public
health awareness outreach is essential. In this respect, UNDP/CIDP will ensure that health centers
supported under the Programme are connected with and can participate in relevant ongoing and
planned health initiatives of Government, local NGOs and international organizations, including
training opportunities.

         Once a substantial number of community-based health centers have been successfully
established under the Programme, UNDP/CIDP plans to organize a series of trainings and workshops
for the health staff of these centers on a wide range of public and preventive health care topics,
including rational drug prescription, involving also medical staff of the nearest referral facilities.

4.2     Financial Arrangements
        Prior to receiving funding from UNDP/CIDP, the CO should calculate the minimum budget
required for O&M of the community-based health posts and propose a system for charging for health
services that will cover those expenditures. One possibility is to introduce a fee for consultations,
prescriptions, treatments and home-visits by the medical staff, which people pay when they make use
of the service. Another possibility is to establish a community “health fund”, also called “micro-
insurance scheme”, whereby people can deposit small fixed monthly contributions into a fund, from
which O&M costs of the center are being paid, in turn for which the community members will not be
charged for any services by the center.

         In both cases, it is important that the fees are transparently established and agreed upon by
everybody. In the case of establishing a “health fund”, it is important that the vast majority of the CO
members participate and not just those in poor health in order not to put the burden of maintaining the
center disproportionately on those who are in the poorest health condition. Another disadvantage of a
“health fund” is that it will allow people to call upon the services of the center for even the smallest
issues, as the cost for using the medical services often or rarely would be the same. Under a pay-as-
you-go scheme, people will think twice before calling on the services of the center for treatment. On
the other hand, under a pay-as-you-go-scheme preventive health information, awareness and services
should be provided free of charge.

        An advantage of the “health fund” system above the pay-as-you-go system is that you can
make fairly accurate estimations of the income of the center, based on the contributions of the
community members. However, it should be clearly defined what will be done with any savings in the
“health fund” at the end of the year. It could be used for improvements to the center, it could be
carried over to next year, allowing people to decrease their contributions, or it could be returned to the
people. Whichever system is used, transparency and simplicity is all-important for its success.

         It is important that the fees are not used to cover the salaries of the medical personnel, but that
they are paid from an independent source. Otherwise, there will be an incentive for the medical staff to
provide more treatments and make people come more frequently to the center than would be necessary
from a strictly medical point of view. As said before, given the fact that covering salary expenses may
well exceed the possibility of the CO members and that regular payment of salary is an essential
precondition for expecting quality services and dedication from the medical staff, it is recommended
that these salaries will be covered from the budget of the Village Council. This will also be tangible

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UNDP Crimea Integration & Development Programme                                          Final Report SDC


evidence of formal recognition of the health center as part of the health system of the area, as the
Village Council will become an active stakeholder in the center.

        On the other hand, systems that try to provide additional income to medical staff from the sale
of drugs should be discouraged, as it would provide an incentive for over-prescription. Only in case
the center receives donations of drugs and medical supplies for free, which is very rare and then only
in very small quantities for the most basic items can the medical staff supply these to the patients.
Otherwise, efforts should be made to strictly separate prescription and sale of drugs to patients. If there
is no pharmacy in the village or easily accessible for patients, it could be a possibility to ask a local
shop owner or other CO member to open up a small branch in the village of a pharmacy in the nearest
town. The medical staff of the health center can recommend a minimum required stock of essential
drugs, but the management and sale of these drugs should be left to the shop owner, who could sell the
drugs to patients based on a prescription by the health center. Attention should be paid that only
essential drugs, in accordance with relevant standards and guidelines of the World Health
Organization, are made available at the health centers.

         Alternatively, COs could decide to collect funds to buy a stock of essential drugs and supplies.
These drugs could then in principle be supplied free of charge to patients by the medical staff of the
clinic, but it could still result in over-usage of drugs. Besides, asking people to invest in drugs that
they might not ever use many may perceive as unfair.

        In short, there are various options for how to make community-based health centers
sustainable that will need to be discussed in public meetings of the CO members before deciding on a
final course of action. However, it is essential that the strategy for running the center in a sustainable
manner is clear to all before work is starting on the establishment of the center.

4.3     Partnership Arrangements
         The community-based healthcare projects are being implemented by COs in partnership with
local authorities (Village Council and Regional Administration). It is therefore important to continue
the partnership concept in operation and maintenance. Village Councils, health department of the
regional administration and COs are identified as the main partners for O&M to ensure sustainability
of the project.

4.4     Environmental Management
         There is a strong link between sustainable development and environmental management. Any
activity that may potentially produce a negative impact on the environment is automatically excluded
from UNDP/CIDP support. Moreover, sanitation and hygiene have a direct impact on people’s health.
Therefore, in the training programmes that will be organized for the medical staff of the health centers,
sanitary and environmental management will be one of the subjects. This will allow the medical staff
to conduct awareness campaigns on waste management (not in the least on how to treat medical
waste), wastewater use and other sanitary measures and to keep an eye on local sanitary and
environmental conditions in general.


5.      CONCLUSION AND FUTURE PERSPECTIVES

         The Programme plans to cover 14 Regions of Crimea by the end of 2004. The condition of
social and communal infrastructure and services in many rural areas is very poor. Moreover, water
supply systems, health centers and schools do not exist in most new settlements where the majority of
the inhabitants are FDPs. Recognizing the need to improve living conditions through the provision of
social and communal infrastructure and services in those areas, UNDP/CIDP has given high priority to
promote sustainable community-based health care in rural areas where more than 75% of FDPs are
living. The present Concept Paper has outlined that in the Crimean context it is feasible to provide
such services in a sustainable and cost-effective way, while at the same time contributing to
strengthening local good governance and empowering people to take charge of their future.
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UNDP Crimea Integration & Development Programme                                   Final Report SDC



        The Programme also plans to establish a network of community-based healthcare centers to
share the best practices and lessons learned in working in partnership with communities for health
services. This can then serve as a model for decentralized community-based health management in the
rest of Crimea and beyond. The health centers will also be linked up with local NGOs, International
Organizations and government agencies working in the health sector so that the centers will have
access to relevant resources and training opportunities in the future.




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    UNDP Crimea Integration & Development Programme                                         Final Report SDC



Annex 6:
Project Name:                                                        Community-based Governance, Infrastructure and Social Development in Crimea
Grantee:                                                             UNDP Crimea Integration and Development Programme
SDC Grant Total:                                                     USD 500,000
Project Period:                                                      31 July 2002 - 30 September 2004

                                                     FINANCIAL REPORT ON SDC CONTRIBUTION
                                                                   (2002-2004)

Currency: USD

III. BUDGET COMPARED TO ACTUAL REPORT

                                                                                                        Reported Period
                                                                       Expenses of                                                                    Cumulative
Budget category                                      Total budget                       Planned        Actual     Actual exp.,        Variance*                      Balance
                                                                     previous periods                                                                  expenses
                                                                                        expenses      expenses        UAH               (adv)
                                                         A3                B3              C3            D3            E3            F3 =C3-D3        G3=B3+D3      H3=A3-G3
1. Technical Personnel                                   30,000.00          1,000.00      39,034.10     39,034.10                -                -     40,034.10    (10,034.10)
2. Act. 1.1.1 CDC Staffing                               40,000.00         15,967.00       7,400.24      7,400.24                -                -     23,367.24      16,632.76
3. Act. 1.1.2 CDC Office Equipment                       18,000.00         11,461.00       6,814.00      6,814.00                -                -     18,275.00       (275.00)
4. Act. 1.1.3 CO Training                                12,000.00                 -                                             -                -             -      12,000.00
5. Act. 1.1.4 CO Technical Support                        5,000.00          1,654.00       2,885.73      2,885.73                -                -      4,539.73         460.27
6. Act. 1.1.5 CO Seed-Grants                             95,000.00         20,591.00      74,409.00     74,409.00                -                -     95,000.00              -
7. Act.1.1.6 Training Functional Groups                   4,000.00                 -                            -                                 -             -       4,000.00
8. Act. 1.1.7/1.1.8 CO/VC/RSA Networking                  5,000.00                 -              -             -                -                -             -       5,000.00
9. Act. 2.1.1/2.1.2 Water Supply O+M Training            10,000.00                 -              -             -                -                              -      10,000.00
10. Act. 2.1.3 Mobilization Govt support for Water        2,000.00                 -              -             -                -                -             -       2,000.00
11. Act. 2.1.4 Construction Water Supply Systems        142,000.00        136,898.00      24,544.66     24,544.66                -                -    161,442.66    (19,442.66)
12. Act. 2.1.5 Monitoring/Reporting Water                 2,000.00                 -       4,426.34      4,426.34                -                -      4,426.34     (2,426.34)
13. Act. 2.2.1/2.2.2 Health O+M Training                 10,000.00          3,004.00      25,173.00     25,173.00                -                -     28,177.00    (18,177.00)

    __________________________________________________________________________________________
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     UNDP Crimea Integration & Development Programme                                              Final Report SDC


14. Act. 2.2.3 Mobilization Govt support for Health            2,000.00                -                -               -               -      -            -       2,000.00
15. Act. 2.2.4 Support to Health Initiatives                  96,000.00        11,773.00        80,521.00       80,521.00               -      -    92,294.00       3,706.00
16. Act. 2.2.5 Monitoring/Reporting Health                     2,000.00         5,868.00         2,766.41        2,766.41               -      -     8,634.41     (6,634.41)
17. Service and Miscellaneous                                 25,000.00        10,410.80        13,398.72       13,398.72               -      -    23,809.52       1,190.48
TOTAL SDC                                                    500,000.00       218,626.80       281,373.20      281,373.20               -      -   500,000.00          (0.00)

* Any variance exceeding 10% should be explained additionally

IV. SDC FINANCING - DETAILS


Received from SDC (cumulative) including:                                                                                                          480,000.00
-installment 1                                                             29/08/2002                                                              300,000.00
-installment 2                                                             19/06/2003                                                              100,000.00
-installment 3                                                             27/05/2004                                                              80,000.00
Cumulative expenses charged to SDC                                                                                                                              500,000.00

Balance SDC                                                                                                                                                     (20,000.00)

This report is a complete and accurate financial representation of the activities supported by the Third Party Cost-Sharing Agreement
of 31 July 2002 for implementation of the above mentioned project. / Цей звіт є повним та правдивим відображенням
фінансового стану, пов'язаного з реалізацією вищезазначеного проекту, відповідно до Угоди….




International Programme Coordinator UNDP/CIDP
                                                                                 signature                     name                         date




Project Accountant
                                                                                 signature                     name                         date



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