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        General Assembly
4 August 2003

General Assembly
Official Records
Fifty-eighth Session
Supplement No. 13 (A/58/13)

Report of the Commissioner-General of the United Nations Relief and Works Agency for Palestine Refugees in the Near East


Programme budget 2004-2005

Introduction to the 2004-2005 biennium budget
Education programme
Health programme
Relief and social services programme
Microfinance and microenterprise programme
Operational and technical services
Common services
Staff costs
Project budget


1.1 The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) was established by General Assembly resolution 302 (IV) of 8 December 1949. The mandate of UNRWA has been renewed repeatedly, most recently by the General Assembly in its resolution 56/52 of 10 December 2001, when it was extended until 30 June 2005.

1. 2 UNRWA reports directly to the General Assembly to which the Commissioner-General submits an annual report. A general review of UNRWA programmes and activities is undertaken on an annual basis by the ten-member Advisory Commission, which includes representatives of the Agency’s major donors and host authorities. The Advisory Commission has a working relationship with the Palestine Liberation Organisation.


1.3 The Agency’s goal is to promote the human development of the Palestine refugees and strengthen the self-reliance of the refugee community. The long-term viability of its programmes and sustainability are key themes of its activities. Where feasible, UNRWA incorporates cost sharing and self-support measures into its programmes to ensure the efficient use of resources and to encourage participation by the beneficiary population in the provision of services.

1.4 During the biennium 2004-2005, UNRWA will to continue to provide basic education, health, and relief and social services to more than four million registered Palestine refugees living in Jordan, Lebanon, the Syrian Arab Republic and in the West Bank and the Gaza Strip. It will also continue to offer services under its Microfinance and Microenterprise Programme.

1.5 As in past years, in preparing its 2004-2005 budget, the Agency has been caught in a dilemma of whether to base its budget on the total needs of its clientele population in accordance with its mandate or, in view of the successive funding shortfalls during the last years, to construct a budget that might realistically be funded by the donor community. As a result, the Agency made strategic choices about adequate resourcing of the programme activities it reasonably expects to be funded, and those activities which, while essential, have had to be frozen or eliminated altogether for lack of funds. The 2004-2005 biennium budget, therefore, reflects the Agency’s bare minimum requirements to sustain essential services, with only limited provisions for additional activities it must implement to carry out its mandate.

1.6 The overall objective of UNRWA for the biennium 2004-2005 is to improve the health and education infrastructure and promote socio-economic development within Palestine refugee communities by continuing to provide services and assistance as it has for more than 50 years, waiting a just and durable solution of the Palestine refugee problem. Non-refugees are, from time to time, provided services when the Agency determines them to be in special need or when the General Assembly mandates.

1.7 The Agency also provides emergency assistance to Palestine refugees in situations of acute distress. Following the outbreak of strife in the occupied Palestinian territory (oPt) in September 2000, UNRWA launched a number of emergency appeals and with donor support began promoting emergency assistance to more than 1 million affected refugees, including food aid, employment generation, medical treatment as well as shelter repair and reconstruction. Selective cash and in-kind assistance is offered to families in a state of acute need. Should the current humanitarian crisis in the oPt continue, the Agency will seek further funding through additional emergency appeals to maintain its programme of emergency assistance.

1.8 UNRWA will continue to seek funding for projects including upgrading of school infrastructure, construction and repair of shelters for the most vulnerable families and improvement of environmental health infrastructure in the camps, thus contributing to the improvement of living conditions and socio-economic development of the refugee community.


1.9 The 2004-2005 budget provides the Agency with a renewed opportunity to document the way it intends to allocate its resources to meet its programme, operational and management objectives. Programmatic aspects of the budget have been integrated with the resource narrative by employing a consistent results-based budgeting approach linking clearly defined programme activities to programme objectives and expected accomplishments, with assessment of the latter provided for by key performance indicators. This approach reinforces the usefulness of the budget as a planning, managerial and fundraising tool, while at the same time maintaining the Agency's financial transparency and integrity. Salient features of the budget are detailed below:


1.10 The structure of UNRWA's budget reflects both the recurrent/non-recurrent nature of activities and the means by which they are funded. The budget document indicates how the Agency expects to fund the budget from the different income sources on which it relies. The budget is broadly divided into two parts:

1.11 The regular budget and the project budget together comprise the total budget volume for 2004-2005. The budget text clarifies which programme activities fall under the General Fund, and which fall under the project budget component.


1.12 Residual effect of the emergency situation:

Included in the biennium 2002-2003 budget was $ 8.1 million to meet the additional demand on the Agency’s regular budget resulting from the emergency situation, which had existed since September 2000. This budget item was included on the optimistic view that this crisis would come to an end during the biennium. However, due to the continuation of the conflict in the West Bank and the Gaza Strip, the Agency was compelled to issue separate emergency appeals to meet the emerging requirements in the oPt. Therefore, the 2004-2005 regular budget has not included a provision for the residual effect of the emergency situation in the oPt, because if the emergency situation persists, UNRWA will continue to launch separate emergency appeals commensurate with changing needs and priorities. In the event of progress towards peace, UNRWA will have to cope with the demands of transition from conflict to recovery and development through a special appeal for this purpose similar to the Peace Implementation Programme (PIP), which was launched after the signing of the Oslo accords.

1.13 Project budget:

Although developmental needs in the Agency’s area of operations have become greater, the project budget has been reduced from $ 116 million in 2002-2003 to $ 93 million in 2004-2005 by application of strict criteria consistent with the best level of anticipated donor funding. Therefore, the project budget neither reflects the real needs nor the totality of projects that are ready to move should funding become available.

1.14 International posts:

An additional provision of $ 1.2 million has been included under the regular budget to cover the cost of four additional posts (one D-1, one P-5, one P-3 and one GS) required to cope with increased needs and challenges, and to rectify a situation where two demanding functions have been amalgamated in one post or assigned to one incumbent on cost containment considerations. The cost of these additional posts was not included in the Secretary-General’s budget submission under Section 26 because of the limitations imposed by Programme Planning and Budget Division (PPBD) on additional staffing proposals.


1.15 A number of scenarios for the work of UNRWA has arisen due to the current situation in the Middle East. Should conflict persist, military operations, security issues, deteriorating economic conditions for the refugees and the restrictions on the flow of goods, services and individuals will continue to affect UNRWA’s work. Should peace talks progress, the Agency may be authorised to begin phasing out certain activities and may be asked to assume new temporary tasks as required by a peace settlement.

1.16 UNRWA operates in a turbulent region buffeted by the Arab-Israeli conflict and its consequences in terms of episodes of violence and a worsening socio-economic situation. Emergency situations, especially in the Gaza Strip and the West Bank, impose heavy operational and financial burdens on the Agency, threatening the sustainability and quality of UNRWA services and necessitating emergency appeals, which may compete with fundraising for the regular budget.

1.17 The current conflict in the Gaza Strip and the West Bank also has disrupted the Agency’s ability to deliver its services, has adversely affected the safety and security of UNRWA staff and has resulted in significant additional expenditure to counteract obstacles imposed by the Israeli authorities.

1.18 Obstacles to UNRWA operations include the imposition of border closures and restrictions on humanitarian access in the West Bank and the Gaza Strip, where some 45% of the Agency's regular budget is spent, and the imposition of charges at Israeli ports for goods destined for the West Bank and the Gaza Strip create additional economic costs for the Agency and hamper its operations.

1.19 UNRWA’s budget, funded entirely by voluntary contributions (cash and in-kind), is subject to uncertainties in the timing and value of funding receipts. This limits the ability of the Agency to plan and implement programmes and project activities.

1.20 Although UNRWA's expenditure is incurred mainly in US dollars, 55% of the income is received in non-US dollar currencies, thus exposing the Agency to the risks of currency fluctuations.

1.21 Support for the Agency and increased co-ordination among the Agency and host authorities, other UN agencies, NGOs and the refugees themselves, contribute to the effective delivery of services by UNRWA.

1.22 Introduction of new courses such as English language and Information Technology into school curricula, change of textbooks and introduction of expensive vaccines into the national immunisation programmes place an additional burden on UNRWA’s scarce resources that must accommodate these unplanned activities. In addition, sudden decrees promulgated by host authorities for increases in the cost of services such as medical care, port charges or the cost of supplies such as fuel and utilities, result in additional unforeseen expenditure.

1.23 Worsening socio-economic conditions and increased rates of unemployment in the Agency’s areas of operation result in larger numbers of school drop outs and increase demand on medical care services, compromising community participation and causing a breakdown in cost-sharing systems.

124 Insufficient project funding for school construction and upgrading of camp infrastructure contributes to overcrowded schoolrooms, poor environmental health conditions and dilapidation of refugee shelters. All call for substantial capital investment.


1.25 The financial results for the fiscal year 2002 (see Table 1) clearly illustrate the funding shortfalls experienced by the Agency in its efforts to implement its mandate of the provision of basic services to Palestinian refugees. The funding gap for the regular budget amounted to $13.4 million and the project budget experienced a shortfall of $33.4 million. The funding gap for the regular budget would have been $28.5 million if the exchange rate gains and the interest income were excluded from the total income. The emergency appeal, which was launched in an effort to alleviate the crisis created as a result of the intifada, was underfunded by $78.8 million. The overall impact of the underfunding for 2002 meant that the Agency was unable to implement crucial activities amounting to $125.6 million.


1.26 Current projections of income and expenditure for 2003, shown in Table 2 below, indicate a funding gap of $ 24.3 million when comparing the net budgeted expenditure of $ 315.1 million with total expected income of $ 290.8 million (based on 2002 total income including exchange rate gains and interest income). Therefore, unless further contributions are forthcoming, the Agency will not be in a position to fully implement its General Assembly approved budget.


1.27 As a direct consequence of the shortfalls in funding for its activities, the Agency has been under severe pressure in terms of cash during the last years. Current forecasts show that the Agency will run out of cash before the end of the year. As indicated in Table 3 below, a shortfall of approximately $19.5 million for the regular budget is expected.


1.28 Lack of funding forced the Agency to introduce lower salary scales in 1999 through a new set of Area Staff Rules (ASR). While this measure allowed the Agency to redeploy a proportion of its income, it created a wide range of problems associated with administering two unequal salary scales (under pre-1999 and 1999 rules) for staff members performing identical work in similar work environments. This measure has affected staff morale and motivation, and led to a significant decrease in compensation competitiveness, resulting in increased delays in recruitment, and a decline in the quality of staff recruited by the Agency.

1.29 In an effort to reduce the disparity created by the two ASRs, the Agency ensures that each time a salary increase is granted to area (local) staff, a larger proportion of the award is allotted to those staff employed under the less advantageous 1999 ASR. Currently 31% of the Agency’s area staff are employed under the 1999 ASR.

1.30 The impact of this strategy is demonstrated by the fact that in 2001 the disparity between the two salary scales was in the region of 20-40%. In 2003 this disparity was ameliorated to the extent that the new ASR salary scales are lower than the pre-1999 ASR scales by 9-38%.

1.31 The Agency's continued inability to build up a provision for termination indemnities means that it will be severely constrained financially when operations eventually wind down. The Agency however, cannot afford to reduce staff as a deficit-reduction measure not only because the current level of staffing is below acceptable standards but also because of the short-term financial implications of paying termination indemnities.

1.32 Table 4 below provides illustrations of the impact of chronic underfunding on the Agency's programmes.



1.33 UNRWA’s clientele population, and consequently the overall demand on the Agency’s services, are expected to grow by 3.5% annually. At the same time the annual weighted average rate of inflation in the Agency’s area of operations is calculated at 4%. The combined effect of these two factors warrants a budget growth of 7.5% annually.

1.34 Table 9 below shows that the regular budget estimates for the biennium 2004-2005 reflect an overall nominal growth of 5.5% (i.e. 2.75% per annum) over the 2002-2003 regular budget appropriations. Therefore, in real terms, this budget has a negative growth of 4.75% per annum (7.50% - 2.75%) with the concomitant negative impact on the Agency’s ability to implement its programmes and provide services to the refugees. The 2002-2003 regular budget demonstrated an annual negative growth of 3%.

1.35 The 4.75% negative real annual budgetary growth, a result of donor support not being commensurate with the actual needs of a growing refugee population, is impacting adversely on the Agency's clientele. The negative budget growth of 6% in the biennium 2002-2003, followed by further shrinkage in real terms in the 2004-2005 biennium budget of 9.5%, results in a combined contraction in real terms of 15.5% over the four years.

1.36 With the 2004-2005 regular budget, Agency programmes - already struggling to maintain standards in the face of persistent budget deficits – are at risk of a further decline in the quality of education, health, relief, and social services. Overcrowding and double shifting in Agency schools, excessive workloads at Agency clinics, a reduction in essential food assistance for the poorest refugee families, and loss of skilled area staff owing to non-competitive salaries, are some of the clear signs that chronic funding shortfalls are undermining the foundation of UNRWA's services. A vivid illustration of this is the drop in the Agency’s expenditure per refugee, from approximately $ 200 in the 1970s to $ 73 in 2002.

1.37 The proposed regular budget for the biennium 2004-2005 reflects at best the bare minimum funding requirements to sustain essential services at the current level and to cater for additional funding requirements. These additional funding requirements result from integration of new programmes introduced by the host authorities such as Information Technology courses in the General Education Programme, as well as the accommodation of additional requirements resulting from natural growth into the regular budget. Because of this negative budgetary growth, the Agency will, in reality, be striving to maintain its core programme activities at a lower level of resources than would have been justified under a needs-based budget, should the Agency receive full funding of its actual requirements.


(In Thousands of United States Dollars)


1.38 UNRWA is funded through a variety of sources. The ability of the Agency to provide its regular services to a clientele population that grows at approximately 3.5% per annum is entirely dependent on sufficient voluntary funding being made available to it annually. The Agency is also dependent on additional funding being made available to it to carry out its project budget and emergency operations. Figures 2 and 3 show the expected sources of funding for each year of the Agency's total budget volume for the years 2004 and 2005 respectively, including both the regular and project budgets.

1.39 As UNRWA does not have a system of assessed contributions, its budget is funded almost entirely by voluntary cash and in-kind contributions from governments, inter-governmental and non-governmental bodies.

1.40 Voluntary contributions are expected to cover about 93.9% of total budget volume for 2004-2005, of which 78.1% are cash contributions to the GF, 10.8% cash contributions to projects, and about 5.0% are in-kind contributions.

1.41 The funding of 105 international posts out of the United Nations regular budget accounts for about 4.3% each year of total budget volume. The remaining 1.8% of expected income is from the following sources:


1.42 Figure 4 shows the 2004-2005 regular budget broken down into categories of expenditure. Staff costs account for 71.3% of the regular budget, of which 65.9% represents the cost of area staff and 5.4% represents the cost of international staff. Supplies account for 11.9%, 44.1% of which are donated to the Agency in kind, and services account for 5.5%. All other categories account for less than 5% each. Table 9 shows the resource growth in each category of expenditure. This is explained below:

1.43 International Staff: all costs associated with international staff. Resource growth of $ 8.7 million (29.6%) over 2002-2003 appropriations is attributed to increase in budget standard costs for the international staffing table and establishment of an additional P5 post funded by WHO and the proposed establishment of additional posts (one D-1, one P-5, one P-3 and one GS).

1.44 Area Staff: all costs associated with area staff, including hiring of staff on temporary assistance or other contractual basis. The resource growth of $ 29.4 million (6.7%) over 2002-2003 appropriations is attributable to the following reasons:

1.45 Services: services bought by the Agency in the course of its operations, including hospital services, port services, customs clearance, hired transport, mail/phone services, travel, staff training, etc. The resource growth of $ 3.8 million (10.9%) over 2002-2003 appropriations is attributable to the following:
1.46 Operational Reserves: provisions to meet expenditure at the Field level which could not have been foreseen at the time of budget preparation. These are considered part of the direct programme costs. The resource growth of $ 0.1 million (12.9%) is due to an increase in education reserves.

1.47 Supplies: supplies purchased by the Agency and received in kind, including food ration commodities, medical supplies, textbooks, fuel, spare parts and office supplies. The resource growth of $ 1.3 million (1.5%) over 2002-2003 allocations is due to the following:

(iv) Increase of $ 0.7 million in transport supplies due to increase in fuel prices.

1.48 Equipment and Minor Construction: all equipment including computer hardware and software, furniture, and vehicles, as well as minor construction works. The resource growth of $ 4.4 million (48.6%) over 2002-2003 appropriations is attributable to the following:

1.49 Premises: rent, maintenance, electricity and water for premises. The resource growth of $ 0.2 million (1.6%) over 2002-2003 appropriations is due to the following:
1.50 Grants and Subsidies: direct payments to beneficiaries as part of programme activities, including patients subsidies, support to community centres, food support cash grants, etc. The increase in resources budget of just below $ 4.1 million (17.3%) over 2002-2003 appropriation is attributable to the following:
1.51 Other requirements: Agency-wide requirements not yet attributable to Fields or Programmes as follows:



(In Thousands of United States Dollars)

1.52 Figure 6 shows the 2004-2005 regular budget by Field of operation. Direct allocations for Field operations account for 89.2% of the regular budget. Taking into account the allocation of the requirements for working capital and salary increases to Fields, the percentage rises to 92.6%. Headquarters costs represent 7.4% of expenditure. The distribution of expenditure across Fields does not reflect any substantive difference in services, but rather variations in the clientele population, US dollar exchange rates, and costs within the areas of operation as well as differing levels of service provision by host authorities.



(In Thousands of United States Dollars)

1.53 Figure 8 shows the 2004-2005 regular budget by programme activity. Direct allocations to the Education Programme account for 53.8% of the regular budget, followed by the Health Programme (17.8%)and the Relief and Social Services (RSS) Programme (9.8%). The remaining portion represents support costs and items budgeted centrally, including working capital and area staff salary increase requirements.

1.54 Table 11 provides information on resource growth in the Agency’s regular programmes for the biennium 2004-2005 over budget appropriations of the biennium 2002-2003. The resource growth shown in this table is summarised below. Reference should also be made to paragraphs 1.42 to 1.51 above.

1.55 Education Programme: The growth of $ 31.8 million in the Education Programme (9.1%) over 2002-2003 appropriations is due to additional teaching staff requirements, additional textbooks, new computer labs, replacement of dilapidated school furniture and the proposed establishment of an additional P-3 post. Reference should be made to Table 12 and paragraph 1.72 for more details about the Agency’s Education Programme.

1.56 Health Programme: The resource growth in the Health Programme of $ 7.2 million (6.1%) over 2002-2003 appropriations is attributed to additional health staff requirements, increase in hospitalisation costs and patient subsidies budget and increased medical supplies requirements. Reference should be made to Table 13 and paragraph 1.99 for more details about the Agency’s Health Programme.

1.57 Relief and Social Services Programme: The resource growth in the Relief and Social Services Programme of $ 1.3 million (1.9%) over 2002-2003 appropriations is due to an increase in cash subsidies for special hardship cases, and staff costs in respect of additional social workers. Reference should be made to Table 14 and paragraph 1.120 for more details about the Agency’s Relief and Social Services Programme.

1.58 Operational and Technical Services: The resource growth of $ 5.9 million in Operational and Technical Services (14.9%) over 2002-2003 appropriations is attributable to staff costs, increasing the capacity of the SWAN both in equipment and services and increases in fuel prices, all of which affect Programme and Field operations. Reference should be made to Table 15 and paragraph 1.142 for more details about the Agency’s Operational and Technical Services.

1.59 Common Services: The resource growth of $ 5.9 million in Common Services (10.3%) over 2002-2003 appropriations is attributed mainly to the increase in the standard budget cost of international staff and the proposed establishment of additional posts (one D-1, one P-5 and one GS). Reference should be made to Table 16 and paragraph 1.147 for more details about the Agency’s Common Services.



1.60 Education is the Agency's largest programme, measured both in terms of its relative share of the Agency's budget and staff. The programme provides general education, teacher education, and technical vocational education and training for Palestine refugee children and youth, in accordance with their needs, identity and cultural heritage. It does so within the framework of the prescribed curricula of the host authorities and in conformity with the standards of the United Nations Educational, Scientific and Cultural Organization (UNESCO). The General Education sub-programme, currently employing 15,735 teaching staff, provides general education (elementary and preparatory education in all its areas of operation and secondary education in Lebanon) for 500,973 eligible refugee children in 656 UNRWA schools. As a result of natural growth among the Palestine refugee communities the school population is expected to grow by 3.5% to some 518,321 by the end of the biennium 2004-2005 (i.e. 2005/2006 school year). The Technical and Vocational Education and Training sub-programme currently provides 5,101 vocational and technical/semi-professional training places in eight training centres (two in Jordan, three in the West Bank and one each in Lebanon, the Syrian Arab Republic and the Gaza Strip). The Teacher Education sub-programme is designed to meet the requirement of the Government of Jordan and the Palestinian Authority that teachers in the basic education cycle possess four-year first-level university degrees. The pre-service teacher training in this sub-programme leads to a four-year university degree. Through its fourth sub-programme, Placement and Career Guidance, the Agency helps Palestine refugees who graduate from its training centres and other institutions to secure suitable jobs, whether locally or in neighbouring countries. Counselling and career guidance are also provided for Palestine refugee students to help them in selecting an appropriate vocation. The Agency will continue its efforts to improve the quality of teaching, training and staff development, and will continue to rely on UNESCO for technical expertise and support.


1.61 To provide general education for Palestine refugee children and youth at the elementary and preparatory levels, as well as at the secondary level, on a limited basis, in Lebanon only.

1.62 To provide university-level pre-service teacher education for young Palestine refugees as well as in-service teacher education for UNRWA teachers to enable them to improve the quality of education in UNRWA schools.

1.63 To provide vocational and technical education and training for young Palestine refugees enabling them to become productive citizens and contribute to the well being of their communities.

1.64 To provide job placement assistance for the graduates of the Agency's vocational training centres and enhancing career guidance and counselling services for the Agency's preparatory and secondary school students as well as vocational and technical graduates.


1.65 The structure of the Education Programme is as follows:


1.66 Providing basic education to 515,722 pupils in the elementary and preparatory cycles.

1.67 Providing secondary education in Lebanon Field only to 2,600 students.

1.68 Providing vocational and technical education to 5,169 trainees at eight vocational training centres.

1.69 Providing pre-service teacher education to 1,200 students in the three education science faculties in the Jordan and West Bank Fields and in the teacher training section in Lebanon.

1.70 Providing in-service teacher training to 800 teaching and supervisory staff.

1.71 Providing placement services to the graduates of training centres programmes, as well as vocational guidance to the students in both UNRWA’s and host authorities' secondary schools to facilitate the recruitment of trainees to the training centres.



1.72 Table 12 above indicates a resource growth in the Education Programme of $ 31.8 million (9.1%) over 2002-2003 appropriation. This is attributable to:



1.73 The Agency's second largest programme is health. The foundation of UNRWA health care is its network of 122 primary health-care facilities. Programme activities are focused on comprehensive primary health care, comprising essential medical care services, child health care, expanded maternal health and family planning and control of communicable and non-communicable diseases supported by assistance towards secondary care. The programme also provides environmental health services in camps and food aid to vulnerable groups. UNRWA is committed to the achievement of World Health Organisation strategies and targets for the eradication of vaccine-preventable diseases including poliomyelitis, neo-natal tetanus and measles as well as control of tuberculosis and prevention of HIV/AIDS. Ongoing programmes to rehabilitate and upgrade health infrastructure at the primary level and to improve environmental health conditions in refugee camps will continue to receive high priority. Sewage disposal, management of storm-water run-off, provision of safe drinking water, collection and disposal of refuse and control of rodents and insects will continue to be provided to some 1.3 million registered refugees living in camps. Cost-efficiency measures such as cost sharing in hospitalisation expenses, which were implemented to make optimal use of the limited financial and human resources, will be maintained.


1.74 To preserve the sustainable investment achieved in primary health care and upgrade the capacity of the health care system by rehabilitation of physical facilities and expansion of the available provision of diagnostic and treatment facilities including laboratory and dental services.

1.75 To improve the health status of the Palestine refugees by reduction of morbidity and mortality from preventable and chronic diseases, by promoting the use of modern contraceptive, surveillance of communicable/noncommunicable disease, oral health and healthy life practices, and by ensuring access of refugee patients to the medical care facilities, including essential hospital services, regular monitoring of children and women of reproductive age.

1.76 To maintain environmental health conditions in refugee camps compatible with the levels set by local municipalities and acceptable international standards set by the World Health Organisation by implementing developmental projects to improve camp infrastructure of water, sewerage and drainage and solid waste disposal facilities.

1.77 To improve the nutritional status of groups at risk, by providing nutritional aid to vulnerable population groups through in-kind contributions and to prevent micro-nutrient deficiencies by implementing affordable intervention strategies such as food fortification and iron supplementation.

1.78 To enhance the process of institutional capacity building and carry out a series of management reforms to maximise system performance, improve service quality and increase efficiency and cost-effectiveness.

1.79 To harmonize health policies and service standards with those of the host authorities to make optimal use of the scarce resources and avoid duplication, overlap and incompatible priorities.

1.80 To prevent breakdowns in service delivery, quality and sustainability under emergency situations by developing plans, as may be required, to improve preparedness and response.


81. The structure of the Health Programme is as follows:



1.82 Providing approximately 8.0 million out-patient medical consultations per annum to refugee patients through UNRWA’s network of 122 primary health care facilities in Jordan, Lebanon, the Syrian Arab Republic, the Gaza Strip and the West Bank.

1.83 Providing approximately 600,000 dental consultations/treatments per annum through UNRWA’s network of 80 stationed dental units and 8 mobile dental teams as well as regular screening of pregnant women and school children to detect dental and periodontal diseases.

1.84 Providing expanded maternal health services including ante-natal, pre-natal, post-natal care and iron supplementation to approximately 90,000 women per annum through UNRWA’s network of primary health care facilities.

1.85 Providing family planning services to approximately 100,000 women of reproductive age per annum including counselling services and provision of modern contraceptive methods.

1.86 Implementing within a multisectoral approach of targeted health education and promotion activities are core elements of the programme. Current initiatives are aimed at promoting healthy lifestyles among population groups at risk, as well as educating youth on prevention of HIV/AIDS and other sexually transmitted diseases, and prevention of tobacco use.

1.87 Providing regular immunisation for all registered infants under the age of 12 months; two rounds of mass immunisation campaign against poliomyelitis and measles each year; participation in the national programmes of the host authorities for control of tuberculosis and HIV/AIDS.

1.88 Providing close medical supervision and monitoring to more than 220,000 children below 3 years of age per year, including immunisation against vaccine-preventable diseases and treatment of anaemia among children 6-24 months of age.

1.89 Maintaining a system of active surveillance of communicable diseases, including vaccine-preventable diseases and providing special care to approximately 120,000 patients suffering from non-communicable diseases such as diabetes mellitus and hypertension.

1.90 Providing preventive care to approximately 500,000 school children enrolled in UNRWA schools including thorough medical examination of new entrants, management of morbidity conditions, booster immunisations and de-worming of all school children.

1.91 Providing referral services to Agency contracted hospitals and assistance towards hospitalisation costs to approximately 56,000 patients per annum.

1.92 Providing environmental health services to over 1.3 million Palestine refugees residing in 58 refugee camps in the five fields of operations in close collaboration with local municipalities of the host authorities to minimise risks to human health and prevent environmental degradation by maintaining optimal sanitary conditions and improving basic environmental health facilities in refugee camps.

1.93 Maintaining a system of active surveillance of the nutritional status of vulnerable groups through maternal and child health service as well as through periodic nutritional surveys, as well as providing food aid to pregnant women, nursing mothers and tuberculosis patients in the form of dry rations to meet the special nutritional needs of those vulnerable groups and prevent nutritional deficiencies.

1.94 Enhancing community participation and cost-sharing through co-payment towards secondary care, tertiary care, prosthetic devices, specialised medical investigations and non-programmed life-saving medicines as well as through self-help projects for pavement of pathways and connection of refugee shelters to internal sewerage systems in refugee camps.

1.95 Implementing programmes for development of human resources for health and enhancing the process of institutional capacity building through in-service and on-the-job-training of the various categories of health personnel to enhance their skills and capabilities and streamline service standards consistent with approved health policies, strategies, technical guidelines and defined procedures.

1.96 Carrying out periodic evaluations of the various programme components to assess performance and measure outputs/outcomes.

1.97 Maintaining close partnership with the World Health Organization (WHO), which assumes technical supervision of the Health Programme under the terms of an agreement signed between UNRWA and WHO in 1950 including meeting the cost of international and area professional staff assigned to Headquarters as well as technical guidance and consultant services. Also maintaining close collaboration with other UN organisations including UNICEF and UNAIDS.

1.98 Maintaining close collaborative links with the Ministries of Health of the host authorities with respect to surveillance of communicable diseases, participation in national immunisation campaigns, provision of vaccines as in-kind contributions to UNRWA, integration of environmental health projects into regional planning schemes, sharing of technical expertise and information, and joint participation on an ad hoc basis in health-related projects and training.



1.99 Table 13 indicates a resource growth in the Health Programme of $ 7.2 million (6.1%) over the 2002-2003 appropriation. This increase is attributable to the following:



1.100 The Agency also provides a range of relief and social services. These services will continue to be provided to eligible refugees, whether they live in camps, towns, villages or remote areas, and include food support, shelter rehabilitation, and selective cash assistance, which are delivered to special hardship cases, that is, refugee families that are unable to meet their basic needs. As at the end of December 2002, a total of 228,912 persons (57,531 families) were benefiting from the cyclical assistance under the Special Hardship programme. The number of special hardship cases is expected to grow by an average 3.5% per annum during the biennium 2004-2005. The Relief and Social Services programme also provides income-generation and community development services that promote self-reliance among less advantaged members of the refugee community, in particular women, youth and the physically and mentally disabled. Eligibility for services is determined by the Registration sub-programme. In emergency situations, assistance will be extended to affected communities (refugees and non-refugees) as a temporary measure and as donor support allows.


1.101 To ease the immediate plight of the poorest eligible refugee families through basic subsistence support at the current food/cash subsidy levels of $ l00 - $ 110 per person per annum.

1.102 To provide housing to families who have lost their shelters (due to military action in the West Bank and the Gaza Strip) or who live in sub-standard housing as a result of chronic poverty.

1.103 To assist families with small-scale emergency needs during a family-specific economic or humanitarian crisis through selective cash assistance.

1.104 To promote and facilitate community-based action that provides rehabilitation services or creates new social, cultural, economic or educational opportunities for vulnerable individuals and families.

1.105 To promote the institutional capacity of community-based organisations so refugees can more effectively formulate and implement social services for vulnerable groups in their own respective communities.

1.106 To increase the number of credit opportunities for individuals and groups in line with the specific mandate of RSSP and as stipulated by the 2003 policy.

1.107 To promote continued progress on the long-term goals of the three project-funded priorities, namely to preserve electronically the historical records of the registered refugees; to reach a higher level of technical accuracy, dependability and validity for the Agency’s computerised refugee registration system through total redesign; and to alleviate sub-standard housing conditions in Neirab Camp.

1.108 To maximise use of limited resources through increased operational efficiencies ; inter-Agency and inter-departmental cooperation; ongoing consultation with host authorities; programmatic, funding and professional collaboration with local and international NGOs and through various cost sharing and self-help mechanisms.

1.109 To maintain updated registration records on the more than 4 million refugees through monthly updates (births, marriages, deaths) and amendment of family registration and ration cards.

1.110 To improve the skills and professional knowledge of RSSP staff through the creation of systematic, in-house continuing education opportunities. Special priority will be given to the orientation and on-going training of the social workers, who comprise 41.2% of RSSP staff.


1.111 The structure of the Relief and Social Services Programme is as follows:


1.112 Providing quarterly food rations and cash subsidies to at least 230,000 impoverished refugees (57,500 families) enrolled each year in the Special Hardship Assistance programme.

1.113 Monitoring the implementation of the Special Hardship Assistance programme through regular home visits by 260 social workers and on-going supervision of senior field management.

1.114 Increasing the self-reliance of refugees through such measures as the further development of the self-help approach to housing, teaching higher level management skills to committee members managing refugee-administered community development programmes, and improving the use and impact of credit operations. Self-reliance will be encouraged through making a wide range of opportunities available and easily accessible at more than 134 facilities inside the refugee camps.

1.115 Utilising selective cash assistance programme to aid families finding themselves in a sudden emergency or crisis situation, with no cushion of support. Providing one-time grants directed at meeting basic humanitarian needs, such as replacement of essential household goods lost to fire or flood to heating fuel or equipment, emergency medical bills, critical immediate financial needs due to the unexpected and sudden death of a head of family, or school clothes for children.

1.116 Implementing emergency measures in any of the five areas of operation as necessary including mass food distribution; post-injury assistance to the newly disabled; shelter reconstruction, repair or adaptation of premises (access for disabled), counselling/referral services; or emergency cash assistance (for temporary housing of homeless families, kitchen or other household equipment, basic survival needs, prosthetic devices, medicine).

1.117 Implementing the Department’s strategic plan. Improving the monitoring and evaluation activities of field and HQ operations, implementing the new gender and updated disability policies and instituting new courses designed for social workers and senior field managers.

1.118 Completing a social policy with an accompanying set of technical instructions ensuring that the more than four million refugees eligible for UNRWA services are registered in its computerised records. The Department seeks to maximise client satisfaction and efficiencies in this regard through the utilisation of up-to-date information technology.

1.119 Promoting the programme and project priorities that need extra-budgetary funding including the Neirab Rehabilitation Project, the on-going shelter rehabilitation programme, major emergency responses, the Palestine Refugee Records Project and most of the human resource development activities.



1.120 Table 14 indicates a resource growth in the Relief and Social services Programme of

1.121 $ 1.3 million (1.9%) over the 2002-2003 appropriation. This increase is attributable to:



1.121 The Agency's Microfinance and Microenterprise Programme (MMP) supports the development of the microenterprise and small-scale business sector within the refugee community by providing working capital and capital investment products. The programme, which runs large-scale credit operations in the West Bank and the Gaza Strip, initiated expansion into Jordan and the Syrian Arab Republic in 2002. The programme provides its credit products on a commercial, self-sustaining and market-oriented microfinance basis. These products strengthen business activity, create jobs, generate income for participants and help to alleviate poverty. Small and microenterprise training is provided in the Gaza Strip, contributing to employment generation and the economic development of the area. The mainstreaming of women in credit is also a significant element of the development mission of the programme. In addition to helping women to become economically self-reliant, loans to women help informal enterprise owners to develop formal enterprises and create a culture where women’s economic activity is socially valued. UNRWA promotes credit for women through its Solidarity Group Lending programme, which provides credit solely to women-owned microenterprises.


1.122 To provide sustainable credit in a cost-effective manner, by concentrating financial services in poorer urban areas which are centres of commercial and industrial activity with a highly localised density of Palestine refugees.

1.123 To pursue programme development and expansion through adhering to international standards of efficiency and outreach in a way that provides cost-effective services to clients in a sustainable manner. The programme strives to maintain the best practices of the microfinance industry by adhering to the standards established for the industry by such institutions as the Consultative Group to Assist the Poorest, the United States Agency for International Development, the Microfinance Network, Calmeadow Foundation and Accion International.

1.124 To meet the emerging standards for business training and Business Development Services (BDS), where all the direct costs of training from participation fees are covered and overhead and administrative costs are met from donor contributions.


1.125 The structure of the Microfinance and Microenterprise Programme is as follows:


1.126 Disbursing 41,995 loans valued at $37.44 million in the West Bank, the Gaza Strip, Jordan and the Syrian Arab Republic over the 2004-2005 biennium.

1.127 Opening in Jordan and the Syrian Arab Republic a minimum of three new branch offices. Completing extension of the branch office network in the West Bank to Ramallah, Bethlehem, Qalqilya and Jerusalem.

1.128 Regionalising the programme together with a new central office/headquarters.

1.129 Designing and implementing a new loan management information system that is fully integrated with UNRWA's finance management system and/or its own accounts package.

1.130 Developing an in-house training capacity to ensure the quality control of products and the corporate understanding of credit methodologies and job functions.

1.131 Maintaining the human resources capacity and developing the human capital so that it passes through the current period of austerity without reducing its capacity or the professionalism of its services.

1.132 Introducing a staff incentive scheme to help recover the pre-crisis high levels of programme productivity and efficiency in the West Bank and the Gaza Strip. Increasing the growth and cost-recovery rates of the programme in Jordan and the Syrian Arab Republic.



1.133 The mission of the Operational Technical Services Department (OTSD) is to sustain customers’ service through creating synergy in the functions of the Agency’s information systems, procurement, logistics and construction and engineering services, and to direct these services to achieve best value for money thereby contributing to UNRWA’s mandate in providing humanitarian assistance to Palestine refugees.


1.134 To enhance the quality, communication efficiency, reliability, timeliness, and cost-effectiveness of the operational and technical services in the areas of procurement, logistics, information and communications technology (ICT), construction, and engineering.


1.135 The structure of the Operational Technical Services is as follows:


1.136 Procuring goods, IT services, engineering and construction services. Preparing designs, technical instructions and procedures for user departments in a cost effective, timely and transparent manner in accordance with specifications, user requirements and within budget. Working in synergy to provide integrated and optimal solutions and services to fulfill the user needs.

1.137 Managing the Agency's inventory for a range of goods, including basic commodities, stationery, equipment, computer hardware and software, medical supplies as well as an extensive variety of general supplies. The Department also manages the vehicle fleet throughout the Agency, including procurement of vehicles and spare parts, maintaining the inventory of spare parts and running workshops for vehicle maintenance. Providing logistical services for transport of staff and goods within and among the fields. Running distribution centres for basic food commodities.

1.138 Introducing, maintaining and modernising Information Technology in UNRWA. Deploying systems and telecommunications infrastructure. Formulating and updating hardware, software and telecommunications standards and related instructions of acquisition, distribution, maintenance and support.

1.139 Implementing a training plan for all Divisions based on actual needs of staff re-skilling and development.

1.140 Reviewing and updating specifications in co-ordination with user departments to ensure fitness for purpose and value for money.

1.141 Enhancing computer utilisation and automation of office routines.



1.142 Table 15 shows a resource growth of $ 5.9 million in Operational and Technical Services (14.9%) over the 2002-2003 appropriation. This growth is attributable to the following:



1.143 Common Services provide the appropriate supervision and support required by the Agency and its Programmes.

1.144 Common Services comprises: Commissioner-General’s Office, Legal Services, Audit and Inspection, External Relations, Public Information, Policy Analysis, New York and Geneva Liaison Offices, Administration and Human Resources, and Financial Services.


1.145 To provide leadership and strategic policy guidance to the Agency's Field and Programme managers, to render legal counsel to the Commissioner General’s office and the Agency's Fields, and to strengthen the cost effective management and administration of UNRWA's human and financial resources.

1.146 To provide leadership and strategic policy and legal guidance in relations with the Agency's external stakeholders, and to increase the support of those stakeholders for the Agency's operations.



1.147 Table 16 shows a resource growth of $ 5.9 million in Common Services (10.3%) over the 2002-2003 appropriation. This growth is attributable to:


1.148 Through Resolution 3331 B (XXIX) of 17 December 1974, the General Assembly decided that the expenses relating to the emoluments of international staff in the service of UNRWA, which would otherwise have been charged to voluntary contributions, should be provided for under the UN’s regular budget with effect from 1 January 1975 for the duration of the Agency’s mandate.


1.149 Project funding has accounted for a considerable share of the Agency's income and expenditure in recent years. Projects form an integral part of programme activities and are the means by which virtually all of the Agency's capital costs (for example, school construction and upgrading of health centres), as well as the costs related to environmental health improvements and shelter rehabilitation are funded.

1.150 The project budget represents the Agency's best estimate at the time of budget preparation of its immediate project funding requirements for the 2004-2005 biennium, based on the best anticipated level of donor funding. During the biennium, the Agency will present donors with proposals of projects contained in the project budget.

1.151 Table 19 shows a breakdown of the project budget by programme and Figure 10 shows how this budget is split between the Fields. The project budget amounts to $ 45.9 million for the year 2004 and $ 47.1 million for the year 2005. These amounts represent 11.6% of total budget volume for the biennium. With the exception of MMP, a self-funded project for which recurrent costs amount to $ 3.1 million annually, the project budget represents unfunded activities.


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