Detailed Information on the
Assistance to Refugees Assessment

PRM will work with UNRWA and other donors to develop new measures of refugee education and social services.

As part of the Good Humanitarian Donorship initiative, PRM will work with other donors and humanitarian partners to develop long-term performance measures.

In coordination with USAID/OFDA, PRM will continue to require non-governmental organization partners active in the health sector to report on Crude Mortality Rates (CMR) and Global Acute Malnutrition (GAM) rates in cooperative agreements as appropriate beginning in FY 2008.

PRM's FY 2008 grant with the Centre for Research on the Epidemiology of Disasters (CRED) will require it to establish memorandums of understanding with humanitarian non-governmental organizations in order to increase the quantity and quality of refugee health and nutrition data available to the international humanitarian community.

Measure: Crude Mortality Rate (CMR) - Threshold

Explanation:The crude mortality rate (CMR) is the mortality rate from all causes of death for a population. Criteria developed by UNHCR and Sphere establish regional CMR thresholds for emergency response based on long-term CMR data in these areas. This measure determines the percentage of targeted refugee sites in complex humanitarian emergencies that will not exceed these thresholds. Beginning in FY 2008, a complementary target for stable refugee populations has been added that CMR will not exceed 1.5 deaths per 1,000 per month (0.5/10,000/day) in 90% of targeted sites.

Measure: Global Acute Malnutrition (GAM) Rate - Threshold

Explanation:Nutritional status is a basic indicator for assessing the severity of humanitarian crisis, together with Crude Mortality Rate. In emergencies, weight loss among children 6-59 months is used as a proxy indicator for the general health and well-being of the entire community. GAM is the term used to include all malnourished children whether they have moderate wasting, severe wasting or edema, or some combination of these conditions. GAM is defined as weight-for-height ratios that are less than 2 standard deviations below the mean (Z score of less than -2), or less than 80% median weight-for-height, or the presence of nutritional edema. Targets refer to the percentage of sites where refugee children under five do not suffer from GAM levels of ten percent or higher. In FY 2008, a complementary target is added that in 90% of stable refugee populations in non-emergency settings, less than 5% of children under five suffer from GAM.

Measure: UNRWA - Infant Mortality Rate (IMR)

Explanation:The Infant Mortality Rate (IMR) is reported as number of live newborns dying under one year of age per one thousand live births. IMR is considered a useful indicator of a population's overall health. Inputs to achieving a lower IMR include the provision of maternal and child services, adequate nutrition, and infectious disease control.

Measure: UNRWA - Medical consultations per doctor per day

Explanation:This measure reflects the number of patients seen each day by UNRWA physicians. In order to ensure that each patient receive adequate time, attention, and care, Sphere advises that health care providers in emergency settings have a case load of fifty consultations per day. Inputs to lowering the number of medical consultations per doctor per day include: recruitment of qualified medical personnel, expansion or construction of medical facilities, establishing appointment systems, educating patients to avoid non-essential consultations, and prescribing only essential medications.

Measure: UNRWA - Percentage of Vocational Training Center Graduates Gaining Employment Within 12 Months

Explanation:This indicator measures the extent to which VTC graduates throughout UNRWA's five areas of operation are able to find employment and become self-reliant and productive members of society. As one third of the Palestine refugees are under 16 years of age and fifty percent under 25 years of age, livelihoods are essential to reduce poverty.

Measure: UNRWA - Percentage of Schools Operating on a Double Shift

Explanation:Double shifting reduces the quantity of student-teacher contact time and reduces the quality of education received. Students need sufficient time in the classroom, additional education instruction, and access to extracurricular activities. This is not possible when schools operate on a double-shift as students must leave as soon as their shift is over. Inputs to reducing the percentage of schools operating on a double shift include: recruitment and training of qualified teachers, negotiations with host governments for access to property, and expansion or construction of schools.

Measure: UNRWA - Percentage of assistance deliveries on time and in accordance with specifications

Explanation:DIFOTIS (Delivery In Full On time In Specification) as a performance indicator is an "aggregate," where the supplier passes only if the supplier fulfills all three measures of delivery: (a) in full, (b) on time, and (c) in accordance with specifications. Requiring all three of these criteria met is a necessary expectation because failing to meet any one of these in delivery jeopardizes the efficacy of any given intervention. Identifying suppliers that consistently fail to achieve success according to the targets established by this indicator allows UNRWA to systematically eliminate non-performers and improve service delivery. Suppliers, in turn, understand that they are being measured against a standard and will be held accountable if they consistently fail to achieve that standard.

Is the program purpose clear?

Explanation: The purpose of the Bureau of Population, Refugees, and Migration's assistance program is to sustain life by providing humanitarian support to refugees in sectors such as food, health, water and sanitation, and shelter, as well as to promote quality of life and human dignity through education and livelihoods activities. The program aims to provide assistance according to internationally accepted standards such as the Sphere Minimum Standards in Disaster Response. The United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) best illustrates the refugee assistance program. UNRWA was established by the United Nations General Assembly in 1949. Palestine refugees are persons whose normal place of residence was Palestine between June 1946 and May 1948, who lost both their homes and means of livelihood as a result of the 1948 Arab-Israeli conflict. UNRWA's services are available to all those living in its area of operations who meet this definition, who are registered with the Agency and who need assistance. UNRWA also provides assistance to the descendants of persons who became refugees in 1948. The number of registered Palestine refugees has subsequently grown from 914,000 in 1950 to more than 4.4 million in 2006, and continues to rise due to natural population growth. UNRWA assistance activities include health care, education, relief/social services, and the promotion of livelihoods through micro-credit loans. There are currently 4.4 million Palestine refugees throughout Gaza, West Bank, Jordan, Lebanon, and Syria. In each of these geographic areas, UNRWA provides services to refugees who do not have the financial means to access other services.

Evidence: Migration and Refugee Assistance Act of 1962, as amended; Foreign Assistance Framework Foreign Assistance Hierarchy/Definitions; FY 2008 Congressional Presentation Document (p. 9-10, 21,25, 36, 52-58); Sphere Minimum Standards in Disaster Response, (p. 183, 260-26); UNGA Resolution 302(IV), dated December 8 1949; UNGA Resolution 61/113, dated December 14 2006; The United Nations and Palestinian Refugees, 2007; Policy and Program Review Committee Regional Policy Paper for the Near East 2006 (not including Iraq); Report of the Commissioner General of UNRWA, January - December 2005; Report of the Commissioner General of UNRWA, July 2004 - June 2005; UNRWA Program Budget 2006-2007;

Does the program address a specific and existing problem, interest, or need?

Explanation: Through international and non-governmental (NGO) partners, the PRM assistance program responds to the humanitarian needs of millions of refugees worldwide, including 4.4 million Palestine refugees registered with UNRWA. PRM makes funding decisions on the assistance program in response to annual and emergency appeals by international partners and proposals from NGOs. Both appeals and proposals are based on needs assessments, which link resource requirements to specific assistance activities. A significant body of research has established that refugee populations are at increased risk of malnutrition, disease, and death. For example, a 2005 study by the U.S. Centers for Disease Control and Prevention (CDC) found that refugees in northeastern Chad were at risk of serious illness or death from lack of food, clean water, shelter, and health care. Of refugee children from six months to 5 years of age, almost 40% were malnourished while approximately 60% had diarrhea. According to the World Health Organization (WHO) and the International Committee of the Red Cross (ICRC), Palestine refugees are a vulnerable population that requires assistance to address food insecurity, malnourishment, chronic disease, mental illness/substance abuse, and increasing poverty. Further, Palestine refugees are often denied access to employment opportunities. Without livelihoods, families become trapped in poverty and must rely on international assistance for their basic needs. Near East Consulting reported in January 2007 that 50% of Palestine refugees in the West Bank and Gaza live in extreme poverty. This study determined that the poverty rate was higher for refugees (82%) than non-refugees (75%). The World Food Program (WFP) has also reported that food insecurity in West Bank/Gaza is increasing, both for refugees and the general population.

Evidence: UNGA Resolution 302(IV), dated December 8 1949; UNGA Resolution 61/113, dated December 14 2006; "Framework for Cooperation between UNRWA and the Government of the United States of America for 2007," signed by the parties on December 13 2006; Policy and Program Review Committee Regional Policy Paper for the Near East FY 2007; UNRWA 2005 Annual Health Report; WHO 2005 Progress Report: Health Conditions in the Occupied Palestinian Territory, including East Jerusalem and in the occupied Syrian Golan; ICRC 2006 Report: Declining Government Health Service Provision in the West Bank; Near East Consulting Report 2006; World Food Programme Report for February 2007; UNRWA Prolonged Crisis in the Occupied Palestinian Territory: Recent Socio-economic Impacts 2006; UNRWA, A Socio-Economic Analysis of Special Hardship Case Families in the Five Field of UNRWA Operations; 2006 Report by the Maram Project on the Prevalence of Vitamin A Deficiency Among Children, Aged 12-59 months, in the West Bank and Gaza Strip; UNRWA Emergency and General Fund Appeals for CY 2006-2007; Report of the Commissioner General of UNRWA, January - December 2005; Report of the Commissioner General of UNRWA, July 2004 - June 2005; UNRWA Medium Term Plan 2005-2009; UNRWA Program Budget 2006-2007;

Is the program designed so that it is not redundant or duplicative of any other Federal, state, local or private effort?

Explanation: As the only agency with a Congressional mandate to provide overseas assistance to refugees, PRM leads USG efforts to assist refugees. In some circumstances, other USG agencies provide services that complement, but do not duplicate, PRM's refugee assistance efforts. For example, while PRM's assistance program provides funding to support core assistance programs for Palestine refugees, the Centers for Disease Control and Prevention (CDC) provides technical assistance to multilateral organizations such as UNRWA in order to improve the delivery of health-specific assistance to refugee populations. Similarly, USAID has supported economic development programs that benefit the general population of the West Bank and Gaza, but its assistance programs do not target Palestine refugees. USG bilateral assistance became limited when Hamas won control of the Palestine Authority in February 2006. UNRWA is the only mechanism through which the USG provides assistance to Palestine refugees. UNRWA is unique in terms of its long-standing commitment to one group of refugees and its contributions to the welfare and human development of four generations of Palestine refugees. UNRWA is the only international organization with a mandate to serve this population. There are no similar USG programs which specifically address the needs of Palestine refugees living in Gaza, the West Bank, Jordan, Lebanon, and Syria.

Evidence: Migration and Refugee Assistance Act of 1962, as amended; FY 2008 Congressional Presentation Document (p. 9-10, 21,25, 36, 52-58); UNGA Resolution 302(IV), dated December 8 1949; UNGA Resolution 61/113, dated December 14 2006; "Framework for Cooperation between UNRWA and the Government of the United States of America for 2007," signed by the parties on December 13 2006; The Policy and Program Review Committee Regional Policy Paper for the Near East 2006 (not including Iraq); Report of the Commissioner General of UNRWA, January - December 2005; Report of the Commissioner General of UNRWA, July 2004 - June 2005; The United Nations and Palestinian Refugees, 2007; UNRWA Program Budget 2006-2007;

Is the program design free of major flaws that would limit the program's effectiveness or efficiency?

Explanation: PRM's refugee assistance program design is free of major flaws that would limit its effectiveness or efficiency, according to independent evaluations. OECD/DAC and OIG reviews of PRM's assistance program have found it to be effective and efficient, and independent studies of UNRWA do not identify major flaws. The program's effectiveness and efficiency is especially remarkable in light of its constraints. Most of PRM's refugee assistance is provided on a multilateral basis. All multilateral contributions are voluntary in nature and given the inability of any one donor government to meet the considerable needs of the global refugee population, burden sharing is a major strength of the multilateral approach. As one of the most significant donors to UNRWA and other international humanitarian organizations, both in terms of engagement and contributions, the USG continually seeks to improve the effectiveness and efficiency with which assistance to refugees is provided. Still, PRM does not have sole control of the direction of multilateral assistance providers nor can it guarantee that all other donors will provide adequate contributions with which to carry out assistance programming effectively. Since UNRWA began its operations in May 1950, further conflict and displacement in the region have significantly increased the number of vulnerable Palestinian in need of assistance. Since 1967 the General Assembly has re-affirmed annually UNRWA's mandate to provide services not only to Palestine refugees but also, within limits, to persons displaced as a result of the June 1967 and subsequent hostilities. UNRWA is not able to register these refugees or include them in the needs assessments that inform its budget, leaving them with limited access to health services, education or formal employment. Since U.S. bilateral assistance to Palestinians became limited when Hamas won control of the Palestine Authority in February 2006, UNRWA is the only mechanism through which the USG provides assistance to Palestine refugees.

Evidence: OECD/DAC 2006 Peer Review of USG Humanitarian Assistance; 2006 Office of the Inspector General Report on PRM (p.1-16) and Responses; UNGA Resolution 302(IV), dated December 8 1949; UNGA Resolution 61/113, dated December 14 2006; UNGA Resolution 2252 (ES-V), July 4 1967; UNGA Resolution 59/118 of 15 December 2004 (A/RES/59/118); Policy and Program Review Committee Regional Policy Paper for the Near East 2006 (not including Iraq); Report of the Commissioner General of UNRWA, January - December 2005; Report of the Commissioner General of UNRWA, July 2004 - June 2005; AdCom Agenda and Preparation Documents (FY 2006 and FY 2007); The United Nations and Palestinian Refugees, 2007; UNRWA's Role and Mandate in Protection of Palestinian Refugees, 2005; UNRWA Program Budget 2006-2007;

Is the program design effectively targeted so that resources will address the program's purpose directly and will reach intended beneficiaries?

Explanation: The assistance program effectively targets resources by funding appeals from international partners that are targeted by region, country, and refugee assistance activity. Data contained within these appeals on health, security, livelihoods and other areas of humanitarian importance inform PRM funding decisions and allow the assistance program to prioritize allocations based on need. The U.S. provides the majority of its funding at the regional and sub-regional levels to allow operational flexibility and facilitate a rapid response in the event of a humanitarian emergency. PRM often coordinates its funding strategies with other bilateral and multilateral donors to minimize gaps and ensure synchronization. PRM's Policy and Program Review Committee (PPRC) and strong monitoring and evaluation requirements ensure that assistance effectively reaches intended beneficiaries and resources are allocated to achieve program objectives. For example, the assistance program targets support to Palestine refugees through a strict refugee registration process and strong oversight. UNRWA registers them and provides education, health care, social services, and micro-credit loans. At the end of 2006, the registered refugee population under UNRWA's mandate totaled 4,448,429, of which 42 percent were in Jordan, 23 percent were in Gaza, 16 percent were in the West Bank, 10 percent were in Syria, and 9 percent were in Lebanon. Over 1.3 million of these registered refugees resided in UNRWA camps. Partly as a result of chronic under-funding, UNRWA is in the process of developing a new strategy to increasingly target services to the neediest refugees to ensure their needs are met. The assistance program contributions to UNRWA support a broad range of health, education, livelihood, and social services; the program occasionally earmarks a small portion of its annual funding for special projects such as refugee camp rehabilitation to ensure USG priorities are rapidly met. UNRWA presently operates 663 schools, 8 vocational training centers, 127 primary health care facilities, 65 women's centers, and 39 community-based rehabilitation centers. During the 2006/7 school year, 484,781 students were enrolled in UNRWA schools. During 2006, there were also 9,222,609 patient visits to UNRWA's 127 primary health care facilities. Relief and social services staff provided hardship assistance, such as food aid, and cash subsidy to over 250,000 special hardship cases. Since 1991, UNRWA has issued 126,474 micro-credit loans worth a total of $131,092,054. Per Foreign Assistance Act Section 301(c), UNRWA has mechanisms in place to ensure that individuals and groups that support terrorism do not benefit from any UNRWA assistance programs. The USG fully funds the Operations Support Officers (OSO) Program to more systematically monitor UNRWA's operations and help ensure its facilities are not being used for political purposes or militant activities. Since 2002, UNRWA's Commissioner General has submitted semi-annual reports to the U.S. Department of State detailing UNRWA's compliance with Section 301(c). This report documents any incursions into or misuse of UNRWA facilities, staff disciplinary issues, and additional measures UNRWA has taken to ensure its compliance with Section 301(c). UNRWA has never violated Section 301(c) and has actively worked to prevent any such violations.

Evidence: UNGA Resolution 302(IV), dated December 8 1949; UNGA Resolution 2252 (ES-V), July 4 1967; UNGA Resolution 61/113, dated December 14 2006; UNGA Resolution 59/118, dated December 15 2004; UNRWA Program Budget 2006-2007; Report of the Commissioner General of UNRWA, January - December 2005; Report of the Commissioner General of UNRWA, July 2004 - June 2005; UNRWA Emergency and Headquarters Appeals for CY 2006 - 2007; UNRWA Email: Contribution Request, dated March 1 2007; Contribution Letters to UNRWA dated February 2007 and July 2006; Letter: Receipt of Contribution from June 18 2006; Email: USA Contribution to UNRWA's Regular Budget dated March 5 2007; Chart of USG contributions to UNRWA; Foreign Assistance Act Section 301(c); Semi-Annual Reports for 2005 and 2006 UNRWA; A Socio-Economic Analysis of Special Hardship Case Families in the Five Field of UNRWA Operations; 2006 UNRWA Outlines for a Programme Strategy: Discussion Paper for the 2007 AdCom; AdCom PowerPoint Presentation for Programme Strategy; Discussion Paper presented at February 2007 AdCom; UNRWA in Figures (as of December 31 2006);

Does the program have a limited number of specific long-term performance measures that focus on outcomes and meaningfully reflect the purpose of the program?

Explanation: The assistance program has two long-term outcome measures that directly support the program purpose of providing essential services to refugees while preserving their dignity and enhancing quality of life. For example, the outcome indicator for health (the infant mortality rate) meaningfully captures long-term progress toward UNRWA's mandate: to sustain the lives of Palestine refugees. The second outcome indicator, the percent of vocational training center graduates that gain employment, recognizes the important relationship between livelihoods and poverty reduction, and meaningfully supports long-term progress to improve the quality of life and human dignity of Palestine refugees. These outcome measures chosen for the assistance program were selected from UNRWA's sizeable set of annual and long-term measures that include input, output, and outcome indicators. Each long-term indicator demonstrates an impact in health or education, to which complementary annual indicators contribute. The two complementary annual and long-term indicators were strategically selected for the Education and Health Departments - UNRWA's largest at 60 percent and 20 percent of the budget, respectively - in order to highlight the need for continued progress in each of these critical areas. Additionally, PRM is working with UNRWA to develop an indicator for abject poverty to better reflect progress in Relief and Social Services Program, which represents 7 percent of the agency's budget. Once fully developed, this measure will be incorporated into PRM's performance measurement tracking. PRM is also working with international humanitarian partners to improve data collection and quality for measuring long-term outcomes of refugee assistance on a global scale. For example, the Bureau supports the UN High Commissioner for Refugees to standardize health surveillance data on infant mortality rates and other indicators across refugee contexts.

Evidence: UNRWA Medium Term Plan 2005-2009; UNRWA Program Budget 2006-2007; "Framework for Cooperation between UNRWA and the Government of the United States of America for 2007," signed by the parties on December 13 2006; European Commission 2006 Report: Development of Results-Based Indicators for UNRWA's Programs funded by the European Commission; "UNRWA in 2005" Report;

Does the program have ambitious targets and timeframes for its long-term measures?

Explanation: The assistance program has ambitious targets to bring the health of Palestine refugees closer to host country standards within 5 years. Working with UNRWA, the assistance program intends to further reduce the Infant Mortality Rate (IMR) from the baseline of 22 deaths/1000 live births in 2003 to 18 deaths/1000 live births/year by CY 2011. As a result of UNRWA's maternal and child health related services, the IMR of the Palestinian refugee population has fallen from 87 deaths/1000 live births/year in 1967 to 22 deaths/1000 live births/year in 2006. While in 2006 Jordan had a lower IMR of 17/deaths/1000 live births/year, the CY 2011 target would exceed current host country standards in other areas of operation such as Syria (29 deaths/1000 live births/year) and Lebanon (24 deaths/1000 live births/year). Recognizing the relationship between livelihoods and poverty reduction, UNRWA seeks to increase the percentage of Vocational Training Center (VTC) graduates who find employment within 12 months of graduation from the CY 2004 baseline of 78% to 90% by CY 2011. In 2006, there were 5,669 VTC students. Continued growth of this program and progress on this measure are important given that approximately fifty percent of Palestine refugees are under 25 years and one third under 16 years of age. Considering that employment restrictions are often placed on Palestine refugees by host governments, the CY 2011 target is ambitious and reflects the extent to which graduates are able to become self-reliant and productive members of society. Given external constraints on operations such as access limitations in Gaza and the West Bank, all UNRWA assistance targets are ambitious and demonstrate a clear commitment to constantly improving services for its beneficiary population. This is reflected by the fact that, in some cases, health indicators for refugee populations meet or exceed those of surrounding communities.

Evidence: FY 2008 PRM Congressional Presentation Document (p. 9-10, 21, 25, 36, 52-58); "Framework for Cooperation between UNRWA and the Government of the United States of America for 2007," signed by the parties on December 13 2006; European Commission 2006 Report: Development of Results-Based Indicators for UNRWA's Programs funded by the European Commission; UNRWA Program Budget 2006-2007; UNRWA Medium Term Plan 2005-2009; Infant Mortality Rate Chart (2006); 2003 UNRWA Annual Health Report (p.61); 2004 UNRWA Annual Health Report (p.61-62); 2005 UNRWA Annual Health Report (p.60-61); Lebanon's Palestinians Right to Work and to Social Security: The Legal Framework and Recent Developments, April 2006; World Bank, West Bank and Gaza Public Expenditure Review, Volume 1, February 2007; OCHA Humanitarian Monitor for the oPt, February 2007; OCHA Implementation on the Agreement on Movement and Access, 21 Feb - 6 March 2007; Cable: Monitoring and Evaluating CRED;

Does the program have a limited number of specific annual performance measures that can demonstrate progress toward achieving the program's long-term goals?

Explanation: The assistance program employs six annual performance measures to track progress on program priorities. Four of these measures highlight program priorities that PRM and other donors have identified for UNRWA, and which are directly related to the achievement of the program's long term goals. One of UNRWA's annual health measures focuses on the number of patients a health care provider consults each day. PRM and other donors have identified improvement of this indicator as a priority because it directly relates to the quality of care received by beneficiaries. The quality of health care provided to pregnant women and infants has a direct bearing on child survival as reflected in health indicators such as the infant mortality rate, which is an annual and long-term indicator of success. In order to reduce the number of provider consultations per day, UNRWA needs to increase the number of qualified medical personnel working in their medical system as well as expand and/or construct new medical facilities. UNRWA can further reduce the burden on its providers by establishing an appointment system, educating patients to avoid non-essential consultations, and prescribing only essential medications. One of the annual education measures focuses on the percentage of primary schools operating on a double-shift. Students need sufficient time in the classroom for quality education instruction and access to extracurricular activities. Double-shifting limits teacher-pupil contact time and reduces the quality of time spent in the classroom. In order to reduce double-shifting, UNRWA will need to train and hire a sufficient number of qualified teachers, as well as expand existing schools and/or construct new schools. School expansion and/or construction requires UNRWA to prioritize negotiations with host governments for access to property. Given external challenges beyond UNRWA's control such as population growth and land availability, it serves as a proxy measure and will be replaced by a new measure - Contact Time Per Child - that is under development by UNRWA and will be introduced in CY 2007. The annual education measure in combination with the other annual measure regarding the percentage of vocational training center graduates that gain meaningful employment together contribute to the long-term goal of supporting refugee livelihoods and self-reliance through education and employment. In addition to the annual measures of assistance to Palestine refugees, Global Acute Malnutrition (GAM) and Crude Mortality Rate (CMR) indicate the severity of humanitarian emergencies around the world and the performance of humanitarian partners in meeting the assistance needs of refugees worldwide. These annual outcome measures reflect the extent to which overall humanitarian efforts through the assistance program are saving lives and alleviating suffering. For this reason, the assistance program has increased its capacity to monitor both CMR and GAM since FY 2003 by developing and expanding the Complex Emergencies Database (CE-DAT), an online compilation of health and nutrition information from humanitarian partners.

Evidence: "Framework for Cooperation between UNRWA and the Government of the United States of America for 2007," signed by the parties on December 13 2006 ; UNRWA Program Budget 2006-2007; UNRWA Medium Term Plan 2005-2009; European Commission 2006 Report: Development of Results-Based Indicators for UNRWA's Programs funded by the European Commission; UNRWA PowerPoint: OD Process - Risk Analysis and Management, 2007; CE-DAT database (http://www.cred.be/cedat/index.htm); CRED Report: Introduction to CMR/GAM; Cable: Monitoring and Evaluating CRED; FY 2008 PRM Congressional Presentation Document (p. 9-10, 21,25, 36, 52-58); Performance and Accountability Report for FY 2006 (p.191-202); Department Performance Plan for FY 2008 (p. 12-38, 44, 48);

Does the program have baselines and ambitious targets for its annual measures?

Explanation: Each of the assistance program's annual measures has baseline figures and ambitious targets. For example, the baseline for the Crude Mortality Rate (CMR) was established in 2005 when the CMR did not exceed the regional emergency threshold of 1.5 deaths per 1,000 persons per month in 98% of refugee sites. In FY 2007, the Crude Mortality Rate is not expected to exceed regional emergency thresholds in 95% of targeted refugee sites, and less than 10% of children are expected to suffer from GAM in 90% of targeted refugee sites. These targets are ambitious given external factors such as limited access to refugee populations in emergencies and unpredictable funding from other donors. Because many refugees are caught in protracted situations, PRM is further refining these indicators in future years by adding sub-targets tailored to non-emergency refugee settings (the current measures focus on emergency refugee situations). In FY 2008, PRM sub-targets are that CMR will not exceed 1.5/1,000/month (0.5/10,000/day) in 92% of targeted non-emergency sites and less than 5% of children under five suffer from GAM in 92% of non-emergency sites. Where results have exceeded targets in previous years, it is important to note the limited availability of data. PRM continues to work with humanitarian partners to improve the availability and quality of data on these measures, for example, by requiring health and nutrition program partners to submit CMR and GAM surveys for inclusion in the Complex Emergencies Database (CE-DAT). Given the unpredictable nature of humanitarian emergencies, it would not be realistic to target 100% of refugee sites below emergency thresholds for CMR and GAM. In emergency settings, Sphere minimum standards establish that the number of consultations per health care provider each day should not exceed 50 to ensure the time, attention, and follow up necessary for optimal care. In CY 2005, UNRWA providers on average saw 110 patients per day (generally in non-emergency settings), far exceeding the Sphere standard. PRM and other donors recognized a clear need for improvement and negotiated annual targets with UNRWA that aim to reduce the number of consultations per provider reach day. While annual targets still do not meet the Sphere standard, they take into account an increasingly difficult context of conflict, border closures, and medical strikes, all of which increase the demand for UNRWA-provided health services. According to CRED, the utilization of UNRWA health services increased 25% in the West Bank and 12% in Gaza from 2005 to 2006. The number of primary schools operating on a double shift directly impacts the ability of teachers to educate and students to learn by greatly reducing the amount of contact time per pupil. In CY 2005, 77% of UNRWA schools operated on a double shift to accommodate an increasing number of students. Annual targets aim to reduce the percentage of double shifting schools to 65%, which is ambitious in light of the challenges UNRWA faces in making annual improvements in performance against this key indicator. External factors will affect progress toward UNRWA's targets for its health and education measures, including the availability of qualified medical personnel, training and hiring of a sufficient number of well-qualified teachers, land availability for construction and/or expansion of existing medical and school facilities, and sufficient funding from donors. Despite these challenges, the program continues to set ambitious targets for improvement.

Evidence: Background on PRM's use of CMR and GAM: FY 2007 Congressional Presentation Document (p. 66-68); FY 2008 PRM Congressional Presentation Document (p. 36, 52-58); CRED Summary: Introduction to CMR/GAM; CRED Summary: Health Indicators for Palestine Refugees; "Framework for Cooperation between UNRWA and the Government of the United States of America for 2007," signed by the parties on December 13 2006; UNRWA Program Budget 2006-2007; UNRWA Medium Term Plan 2005-2009; European Commission 2006 Report: Development of Results-Based Indicators for UNRWA's Programs Daily Activities; Report: UNRWA Convoy Attacked in Gaza;

Do all partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) commit to and work toward the annual and/or long-term goals of the program?

Explanation: The assistance program maintains Annual Framework Agreements with its international partners that clearly state shared priorities as well as indicators and targets required to implement them. Each Framework Agreement represents a policy commitment as well as a tool by which to measure performance annually. Program officers negotiate objectives and indicators in cooperative agreements as well as reporting requirements for each project implemented by non-governmental organization partners. International organization partners in the assistance program follow a similar process of integrating goals and objectives of the assistance program and reporting. For example, UNRWA and its sub-contractors internalize guidelines specified in the agency's biennial budget and respond to recommendations stakeholders make1 by integrating donor concerns into strategic planning documents. In fiscal year 2007, UNRWA committed to regularly tracking a set of annual/long-term indicators and targets that were supported by the two largest donors, the European Commission (EC) and the United States. The United States and UNRWA commit to an annual Framework for Cooperation that incorporates annual and long-term goals and targets. Progress is tracked and reported on a formal basis by UNRWA staff through the UNRWA Commissioner General's Annual Reports, which reports on all performance measures, including those agreed upon in the U.S. - UNRWA Framework for Cooperation. In March 2008, UNRWA will provide PRM with the first formal consolidated report on the indicators included in the PART review. Progress is also monitored and data collected on an ongoing basis through PRM's regional Refugee Coordinator (RefCoord) based in Amman, PRM regional specialists in Washington, and collaborating bilateral and multilateral donors.

Evidence: "Framework for Cooperation between UNRWA and the Government of the United States of America for 2007," signed by the parties on December 13 2006; UNHCR Framework Agreement for 2006; PRM FY 2008 Congressional Presentation Document (p. 35-36, 38, 43-58); PRM General NGO Guidelines and Regional Sample; PRM Cooperative Agreement Sample; PRM Interim and Annual Performance Evaluation Samples; UNGA resolution 61/113 dated December 14, 2006; European Commission 2006 Report: Development of Results-Based Indicators for UNRWA's Programs funded by the European Commission; UNRWA Medium Term Plan 2005-2009; Human Rights Report for Israel and West Bank/Gaza (2006); West Bank and Gaza Daily Situation Report Samples (2007); Cable: Monitoring and Evaluating CRED;

Are independent evaluations of sufficient scope and quality conducted on a regular basis or as needed to support program improvements and evaluate effectiveness and relevance to the problem, interest, or need?

Explanation: The Office of the Inspector General (OIG) carries out an inspection of all PRM programs approximately every ten years. The last inspection took place in 2006, and prior to that, 1995. The OIG inspection covers the performance, management/oversight, and financial controls of the assistance. The OIG inspectors surveyed and interviewed all PRM staff members, and USG and non-USG colleagues who work with PRM. They also reviewed PRM's planning, policy, financial, management, and other relevant documentation. Through this process the OIG evaluated the effectiveness of PRM programs including Assistance to Refugees, closely reviewing the execution of core functions; organizational structure and responsibilities; policy and program direction, strategic planning, and related processes; management and financial controls; use of staff and financial resources; relationships with all relevant actors; and public diplomacy and outreach. Further, a number of studies have been conducted concerning USG and/or international humanitarian assistance infrastructure, of which PRM's assistance program is a part. In FY 2006, the Organization for Economic Cooperation and Development's Development Assistance Committee (OECD/DAC) carried out its periodic (every 4 years) review of USG development assistance and devoted a significant portion to PRM's assistance program. A 2006 Government Accountability Office (GAO) study focused on mortality estimates in Darfur, Sudan, providing an independent evaluation of the quality of a broad range of data sources, including significant attention to PRM's partner the Center for Research on the Epidemiology of Disasters (CRED). All of these independent evaluation documents are publicly available. Regular independent evaluations are conducted on UNRWA's assistance program to Palestinian refugeees. The UNRWA program is examined every two years by the UN Board of Auditors (BOA), the entity mandated by the UN General Assembly to carry out external audits of all UN agencies. The BOA examinations include an audit of UNRWA's system of financial management and a review of UNRWA operations, reporting on the entire scope of UNRWA programming. In addition, different aspects of UNRWA's assistance program have been reviewed by the World Health Organization (WHO); U.S. Centers for Disease Control and Prevention (CDC); the United Nations Educational Scientific and Cultural Organization (UNESCO); the United Kingdom's Department for International Development (DFID), the European Commission (EC), and the University of Geneva's Development Institute (IUED-UCL). These evaluations collectively review all of UNRWA's primary assistance programs, focused predominately on UNRWA's largest programs - education and health. With the implementation of the Organizational Development Plan (ODP), UNRWA's new initiative to implement sweeping reforms in program management and service delivery, PRM and other donors will be collaborating to track established performance measures on a yearly basis. UNRWA's new Monitoring and Evaluation Unit is also in the process of formalizing a schedule of reviews. UNRWA will systematize monitoring and evaluation within the Office of the Director of Operational Support. Managerial reform studies of UNRWA's assistance have also been carried out by Hawes International, the UN Office of Internal Oversight Services, and Booz-Allen. UNRWA HQ staff conduct routine assessments of field programs, accompanied by recommendations for changes and routine follow-up to track implementation of corrective actions. For example, the Health Department HQ staff conduct annual assessments of UNRWA's health clinics, using a standard checklist. Assessors write a field visit report for all assessments, which is reviewed by the Director of Health. The reports include recommendations for changes, requests for action and feedback from the field office or health clinic. The assessors return to the field several months later to review progress.

Evidence: 2006 Office of the Inspector General Report on PRM (p. 31-36,42,58); OECD/DAC Peer Review of USG Humanitarian Assistance (2006); Report of the United Nations Board of Auditors, Financial Report and Audited Financial Statements for the biennium ended 31 December 2005 (biennial UNRWA audit); WHO Report on Water/Sanitation Including Sewerage in Jenin Camp; UNESCO General Evaluation of the Agency's Technical and Vocational Education and Training Program; UNRWA-UNESCO Education Program Data Sheet (CY 2005 - 2006); UNRWA-UNESCO Quality Assurance Framework for UNRWA Schools (CY 2005 and 2006); UNRWA-UNESCO Collaboration Documentation (CY 2005 - 2006); UK DFID Study on Student Attitudes UNRWA Note on Oversight Functions in UNRWA, dated May 4; 2006 UK DFID Evaluation of UNRWA's Academic Achievement Testing in Arabic, English, Math and Science; European Commission Evaluation of UNRWA Administrative Reforms European Commission Review of the Special Hardship Case Program (2005); GAO Report on "Department of State and the United Nations Relief and Works Agency (UNRWA) Actions to Implement Section 301(c) of the Foreign Assistance Act of 1961," presented to Congress on November 17, 2003; UNRWA Health Program: Report of a WHO technical assessment mission, 2005; DFID Multidonor Review October 2005;

Are Budget requests explicitly tied to accomplishment of the annual and long-term performance goals, and are the resource needs presented in a complete and transparent manner in the program's budget?

Explanation: Resource needs for the assistance to refugees program are presented under the USG Foreign Assistance Framework's Humanitarian Assistance objective. This framework ties budget requests explicitly to annual performance goals related to saving lives and reducing suffering, using CMR and GAM as outcome indicators. Budget requests to support UNRWA are included in the Humanitarian Assistance objective, under Program Element 1.2: Assistance and Recovery. The Framework also identifies the indirect "Program Support" costs required for each Program Area; these are PRM's administrative costs (staff, supplies, travel, etc.) required to execute the program. PRM's resource needs for the assistance to refugees program are also presented in the Congressional Presentation Document (CPD), which explicitly ties the performance goals and indicators (detailed in the 2007 & 2008 Bureau Performance Plan contained in the CPD) to budget requests for the Migration & Refugee Assistance account and the President's Emergency Refugee & Migration Assistance fund. PRM contributions to UNRWA are linked to the annual U.S.-UNRWA Framework Agreement, which establishes performance goals and indicators, as well as policy priorities. UNRWA's budget requests conform to the annual and long-term performance goals it outlines in General Fund and Emergency Appeal solicitations. In its biennium budget reports, UNRWA breaks down its resource needs along functional and geographic lines, and clearly identifies the goals, objectives, and program outputs it seeks to achieve through it budget. It identifies funding allocations to be made in each of its five fields of operations and specifies amounts to be spent on recurrent administrative operating costs, its core programs as well as on infrastructure and "special projects." Its budget construction reflects a results-based budgeting approach and is based on the beneficiary population that UNRWA serves and not the overall refugee population (as not all refugees utilize UNRWA's services). PRM contributes to UNRWA's General Fund, and designates a small percentage for special projects of particular concern to the USG. UNRWA's 2006-2007 biennium budget reflects donor recommendations - including by PRM - that the agency adopt a needs-based budget rather than a resource-based budget, and incorporates elements of UNRWA's Medium Term Plan (MTP) to bring UNRWA's programs up to host government and international standards. With the Organizational Development Plan (ODP), UNRWA is currently revising its budget construction to more closely link its new strategic planning framework with the budget, which will also improve the targeting of its interventions. The 2008-2009 budget will be "transitional" as the ODP and Program Strategy are still in the process of implementation. By the 2010-2011 budget UNRWA expects to fully harmonize the budget with the new program strategy.

Evidence: PRM Congressional Presentation Documents for FY 2007 (p. 32, 49, 59-70); PRM Congressional Presentation Document for FY 2008 (p. 25, 36, 52-58); Foreign Assistance Framework; Foreign Assistance Framework Hierarchy and Definitions; Foreign Assistance Framework Summary/PRM budget by Elements; Foreign Assistance Framework Indicators (p. 31-33); Action Memo: PRM Spending Plan for FY 2007; UNRWA Program Budget 2006-2007; UNRWA Commissioner-General's Annual Report, dated September 26 2005; UNRWA Medium Term Plan 2005-2009 UNRWA Report: 12 years of Credit to Microenterprise Report;

Has the program taken meaningful steps to correct its strategic planning deficiencies?

Explanation: Working with the Department's Director of Foreign Assistance (F) and Resource Management (RM) staff, PRM has corrected strategic planning deficiencies, as recommended by the 2006 Office of the Inspector General's (OIG) report. The Bureau has extensive strategic planning structures and processes in place. The PRM Policy and Program Review Committee (PPRC) provides a systematic process for establishing bureau policies and allocating resources for assistance programming. Every funding allocation for the assistance program is discussed and any concerns are addressed in the context of the Bureau's strategic assistance priorities. Per the OIG recommendation, PRM has streamlined this process. Bureau staff meet regularly with F and RM staff to discuss strategic planning issues, and the Department's processes for formulating the Bureau Strategic Plan and other strategic planning documents have changed to address OIG-identified deficiencies. PRM program officers have worked extensively with UNRWA to improve its performance measurement and strategic planning functions and the agency has shown steady progress. At the June 2004 Stakeholders' Conference in Geneva, PRM and other donors expressed concern over UNRWA's performance management and strategic planning capacity. With the support of UNRWA's Working Group on Stakeholder Relations, the UK Department for International Development (DFID) funded a comprehensive study of UNRWA's operations. This review provided recommendations on how UNRWA could streamline its operations, decentralize, and provide more decision-making autonomy to the five field directors. Through this process, UNRWA determined that more comprehensive changes were needed in order to strengthen program management and delivery, and consequently the Commissioner General initiated the Organizational Development Plan (ODP) in late 2005. In May 2006, UNRWA launched the three-year, $30 million ODP to implement sweeping reforms in service delivery and program management in response to the deficiencies previously identified in various reviews, including the DFID study. The ODP is centered on overhauling the agency's organizational structure to focus on strategic thinking, policy planning, accountability, and results-based management. The initiative includes updating internal processes, introducing program cycle management capacity, and improving UNRWA's human resource management and procurement systems. Concurrent to implementation of the OPD, UNRWA is also reviewing its program strategy to address changes in its operational environment. The program strategy is based on a commitment to improve program management, explore different ways of delivering services, and continue to focus on increasing overall development among Palestine refugees. UNRWA's strategic planning reforms are solidly underway, and UNRWA has shown a clear record of improvement and responsiveness to donor concerns. The engagement of PRM program officers, RefCoords, and leadership helps to ensure that UNRWA continues to improve the effectiveness of its assistance programming, and follows through on commitments to improve strategic planning.

Evidence: 2006 Office of the Inspector General Report on PRM (p. 13-15) and PRM responses; UNRWA Medium Term Plan 2005-2009; UNRWA Organizational Development Plan Powerpoint Presentation: Update on Organizational Development Plan; Interview Notes: PRM Consultations with UNRWA HQ Staff; Geneva 2004 Conference Report (leading up to the MTP and ODP); Working Group on Stakeholder Relations - Issues and Options for Consideration (2005); UNRWA Paper: Outlines for a Programme Strategy, 2007; UNRWA PowerPoint: Program Strategy Discussion Paper, 2007; UNRWA Paper: ODP Framework for Planning and Reporting, 2007; UNRWA Paper: ODP Initiative Workplan, 2007; UNRWA Paper: Table of Outcomes and Indicators: Discussion Document, 2007; UNRWA PowerPoint: OD Process - Risk Analysis and Management, 2007; DFID Multidonor Review October 2005 UNRWA Note on Oversight Functions in UNRWA, dated May 4 2006;

Does the agency regularly collect timely and credible performance information, including information from key program partners, and use it to manage the program and improve performance?

Explanation: Through quarterly and annual reporting from international organizations and non-governmental partners, PRM establishes baselines, negotiates targets, and monitors progress to improve assistance program performance. When a partner performs poorly, consultations take place as to why targets were not met and corrective actions are specified to improve performance. Performance history is taken into consideration in funding decisions. PRM uses framework agreements with international partners and cooperative agreements with NGO partners to implement the assistance program. These agreements determine when, how often, and on which activities partners will report performance information on the assistance program. For instance, PRM requires that appropriate IO and NGO partners provide CMR and GAM related data to CRED for inclusion in the database. In addition to reporting on the select indicators agreed to in the framework agreement between the U.S. and UNRWA, UNRWA regularly collects data on all of its program indicators, and reports performance in the Commissioner General's Annual Report for review and feedback from the United States and other donors. Based on USG and other donor feedback, UNRWA has agreed to collect data and report on a set of key indicators identified by the EC in 2006, with annual reviews conducted jointly by donors beginning in the fall of 2007. UNRWA reports progress on agency-wide initiatives to the AdCom, which meets three times per year, and the annual Hosts and Donors Meeting. Through its participation in AdCom Sub-Committees, PRM provides feedback on overall agency initiatives and specific performance issues. PRM determines how it will earmark contributions to UNRWA based on program performance and information provided by the Agency. For example, PRM continues to fund the Operation Support Officer (OSO) program on an annual basis as UNRWA provides semi-annual reports showing the program's effectiveness in meeting shared UNRWA/USG goals. In FY06, UNRWA responded to changed conditions in Lebanon by implementing a four-year initiative to improve conditions in refugee camps in Lebanon; PRM saw the importance of this initiative, earmarked $2.56 million for this project in FY06 and plans to earmark a similar amount in FY07. The UN Office of Internal Oversight has ranked UNRWA number one out of 25 UN agencies in compliance with the Integrated Monitoring and Document Information System (IMDIS). IMDIS is used by the Office of the Internal Oversight Services (Monitoring, Evaluation and Consulting Division) to monitor performance in UN Agencies based on the indicators and targets set within the UN regular budget. The results indicate that UNRWA has institutionalized the monitoring and management of performance data, and is consistently reporting on this data. As part of the ODP process, UNRWA is currently systematizing the monitoring and evaluation function in order to create a new M&E framework while adjusting existing reporting mechanisms based on field priorities. UNRWA is also developing an operational handbook, including the M&E section and UNRWA's first evaluation plan for 2007 and the 2008-2009 biennium.

Evidence: 2007 Framework for Cooperation between UNRWA and the Government of the United States of America; Report of the Commissioner General of UNRWA, January - December 2005; Report of the Commissioner General of UNRWA, July 2004 - June 2005; UNRWA Medium Term Plan 2005-2009, May 2005; UNRWA Organizational Development Plan (ODP); IMDIS report for 2006/Email Summarizing UNRWA Performance; Monitoring and Evaluation Trip Report Sample: Talbieh Camp (2006); Emergency Multilateral Assistance Team Trip Report, dated May 21 2004; CE-DAT Reports on CMR/GAM for FY 2004 -2006; Cable: Monitoring and Evaluating CRED 301(c) Semi-Annual Reports for 2005 and 2006; FY 2006 PPRC: UNRWA Special Projects; Daily Activities Report: (SBU) AdCom welcomes agency initiatives, dated June 20 2006; Daily Activities Report: (U) Establishment of UNRWA AdCom Sub-Committees, dated October 5 2006; Daily Activities Report: (U) US-UNRWA Framework for Cooperation, dated November 15 2006;

Are Federal managers and program partners (including grantees, sub-grantees, contractors, cost-sharing partners, and other government partners) held accountable for cost, schedule and performance results?

Explanation: PRM program officers with direct responsibility for the assistance program are evaluated annually on their efforts to advance USG priorities; awards and advancements are based on efforts to accomplish these objectives. Continuing employment is contingent on performance of program duties, and performance is considered as employees compete for ongoing assignments and advancements. PRM program managers and regional refugee coordinators are held accountable for a grantee's results. If partner performance is not acceptable, program funding may be withheld or funds may be earmarked to encourage results. PRM has greatly increased the capacity of program officers and RefCoords to monitor and evaluate protection and assistance programs. Monitoring and evaluation is a core PRM competency and is incorporated into the job elements of all program officers; staff are expected to continually develop and refine this skill through ongoing training. All staff, including RefCoords, complete a one week intensive course on monitoring and evaluation. PRM also holds biweekly training sessions on monitoring and evaluating assistance-related activities such as shelter, livelihoods, water/sanitation, etc. These sessions teach program officers how to negotiate indicators, interpret budgets, and assess performance. The framework agreement between U.S. - UNRWA establishes policy and program priorities, in addition to key indicators. PRM program officers in Washington and the regional RefCoord in Amman work actively and in tandem with UNRWA on managerial reform, costs savings, and performance measures, ensuring that UNRWA is held accountable and makes necessary adjustments to improve performance. PRM has multiple ways to address any area where we have concerns about UNRWA operations or where UNRWA is not achieving performance standards. PRM can address these issues on a bilateral basis with UNRWA's Commissioner General or on a multilateral basis through the Advisory Commission. PRM can also decide not to earmark funds for a particular project if there are performance issues or to require the establishment of a Project Advisory Committee (PAC) to provide oversight to a specific USG-funded project. For example, PRM required that UNRWA establish a PAC, consisting of the USG, the Government of Lebanon, and UNRWA, to provide oversight to a Lebanon camp project funded by PRM in FY06. Currently, UNRWA uses the UN performance evaluation and review system to conduct staff evaluations, but they are not well-linked to the performance of UNRWA's mandate or improvement of services. As part of the ODP, UNRWA will put into place a new management accountability framework by mid-2007, which will indicate who is accountable for what activities and results at each point in the process. This will be accompanied by a competency framework, which will include job descriptions and the competencies that are expected for each position. The accountability framework, competency framework, and revised performance management mechanism are due to be completed by the end of 2008.

Evidence: UNRWA Organizational Development Plan (ODP); PRM Monitoring and Evaluation Weeklong Course Schedule; PRM Monitoring and Evaluation Brownbag Schedules for 2006 and 2007; PRM Monitoring and Evaluation Tools; Sample Program Officer Appraisal Report Form; Sample RefCoord Instruction Cable: Meeting with UNRWA Operations Support Officers, dated January 30 2003; UNRWA Personnel Code of Conduct Documentation; UNRWA Personnel Appraisal Documentation; The United Nations and Palestine Refugees (2007);

Are funds (Federal and partners') obligated in a timely manner, spent for the intended purpose and accurately reported?

Explanation: PRM funds are obligated and expended for the assistance program by partners in a timely manner. Using the Abacus database, PRM tracks the efficiency of its program management, seeking to minimize the average number of days between receipt of an appeal or proposal and funding execution. PRM has in place processes to ensure that each payment for contributions to IOs and grants and cooperative agreements to NGOs is made in accordance with the federal regulations governing grants and cooperative agreements and internal PRM procedures. PRM contributions to IOs are provided early in the calendar year to ensure that partners have sufficient funds to start the year and can plan appropriately for further fundraising. (The USG fiscal year starts earlier than that of many other donors.) All funds are obligated at the time the contribution action is made. PRM's Comptroller issues payments on the obligations as the agencies require funding. PRM's Comptroller reviews all payment requests submitted by partners to ensure that funds are requested only in amounts required to meet immediate cash needs PRM seldom pays out the full amount as a lump sum, unless it is justified to meet an emergency situation. For example, PRM's contribution to UNRWA's General Fund is usually given in January or February, and the Comptroller makes payments to UNRWA throughout the year as UNRWA requires funding. PRM makes subsequent contributions for UNRWA's Emergency Appeals throughout the year to meet needs as they arise. The UNRWA Commissioner-General presents an annual report to the United Nations General Assembly (UNGA) providing a detailed account of how the U.S. grant and other contributions were dispersed and spent. UNRWA recognizes that it likely will not receive all of the funding needed to support its needs-based budget. It ranks its program priorities and ensures that program activities commence only once funding has been allotted. The budget preparation exercise first involves attaching monetary values to the UNRWA's strategic aims within the realistic confines of the its capacity. Field Offices calculate the cost of operationalizing the program strategies within the overall framework of enhancing human development and according to the needs and priorities of their respective refugee populations. Field Offices estimate the financial resources required for UNRWA to provide services that meet relevant international standards and that generally meet the standard of services provided by host countries to their nationals. The main drivers of financial requirements are refugee numbers, progress against quality standards, increases in the costs of service delivery, the scale of humanitarian and emergency relief, and the costs of planned maintenance and development projects. After the financial requirements have been established, the UNRWA compares that estimate with the levels of funding it expects to receive. Recent experience has shown that UNRWA's requirements exceed the level of funding available. In response, UNRWA first determines whether further savings may be achieved by the imposition of new, or further, austerity measures and, then, if necessary prioritize its services. The recent development of UNRWA's programme strategy allows UNRWA to prioritize in accordance with the context of its overall goals and mission. As far as possible, every effort it made to protect the integrity of UNRWA's basic services (primary education, comprehensive primary health, vocational training, relief). Those activities/sub-programs/expenditures that will only be undertaken in the event UNRWA receives more funding than estimated, are included in the "Justification Reserve" in its regular budget. If more funds are forthcoming than have been estimated, the additional funds are allocated to activities/sub-programmes/expenditures in the Justified Reserve by reference to UNRWA's program strategy.

Evidence: 2006 OIG Report on PRM Contribution Letters; State Department A-123 Appendix A Implementation (Cotton & Company Review) - Obligations p.7-10, Payments 10-14; 2006 and 2007 UNRWA Contribution Receipts; E-mail: PRM Comptroller - Details of Payments to UNRWA FY 2006, FY 2007 dated 24 April 2007; 2006 UNRWA Contribution Request, email dated March 1, 2007; UNRWA Financial Regulations, dated August 28, 2005; UNRWA Letter to the AdCom, dated April 6, 2006; UNRWA Program Budget 2006-2007; UNRWA Note on Oversight Functions in UNRWA, dated May 4, 2006; Interview Notes: PRM Consultations with UNRWA HQ Staff;

Does the program have procedures (e.g. competitive sourcing/cost comparisons, IT improvements, appropriate incentives) to measure and achieve efficiencies and cost effectiveness in program execution?

Explanation: PRM uses a database system (Abacus) to track programs by awardee, region/country, sector, keyword, strategic goal, funding amount, award status, and other criteria. The system allows PRM to efficiently search, sort, and report on basic program information. PRM is 100% compliant with grants.gov, which ensures competitive sourcing. UNRWA achieves considerable cost savings by providing assistance almost entirely through locally employed staff, many of whom are refugees themselves, while only 1 percent of staff are international and/or contractors. UNRWA also reduces costs through improved logistics and procurement. The UNRWA efficiency measure seeks to ensure that a high percentage of deliveries arrive on time and in accordance with pre-determined specifications, with the understanding that UNRWA will discontinue use of suppliers that fail to achieve targeted standards. UNRWA reports annually on the procurement delivery data for the five fields of operation, and provides a weighted average of the five to track UNRWA's overall procurement efficiency. PRM officers regularly meet with UNRWA staff throughout the year to review their performance. In an effort to improve performance tracking, UNRWA requested to adjust the efficiency measure, which initially only tracked delivery of goods to UNRWA from the supplier. The measure is more ambitious as it now takes into account the entire supply chain to its various fields of operation. This enables UNRWA to identify delays in the supply-chain and make adjustments accordingly to ensure goods are readily available for beneficiaries. UNRWA's procurement department will be replacing its current IT procurement system in 2007, which will provide more accurate and consistent procurement data, as well as streamline the purchasing process and the management of inventory. Strengthening information and communication technology (ICT) management and service delivery is a main component of UNRWA's ODP. The UN Secretariat recently reviewed UNRWA's ICT capacity and governance, and developed a three-year plan for strengthening ICT, including acquiring better technology.

Evidence: UNRWA Organizational Development Plan (ODP); ODP Framework for Planning and Reporting: Information Note, 2007; ODP Initiative Workplan, Annex 1 (Initiative 4B & D, p. 19 - 24), 2007; CD-ROM: UNRWA Finance Manual and Financial Regulations; AdCom Summary Note from February 27-28, 2007 Regular Session; Abacus Report Samples; UNRWA Efficiency Measure Reporting; Interview Notes: PRM Consultations with UNRWA HQ Staff;

Does the program collaborate and coordinate effectively with related programs?

Explanation: PRM coordinates closely with partner agencies, including other State Department bureaus, the NSC, USAID, HHS, and DOD, so that USG funds best support refugees' assistance needs. PRM collaboration with USAID's Bureau of Democracy, Conflict, and Humanitarian Assistance (DCHA) is particularly important, and includes the development of funding guidelines, joint proposal reviews, the State-USAID Joint Strategic Plan, and shared training opportunities. PRM and DCHA regularly coordinate contributions to international organizations and participate in each other's reviews of NGO proposals. PRM has the USG lead on responding to refugees crises; in complex humanitarian emergencies with varying affected populations, PRM and DCHA closely coordinate funding actions to ensure no duplication or overlap. During the summer 2006 Lebanon crisis, PRM and DCHA ccoordinated the USG's emergency response to meet the assistance needs of refugees and internally displaced persons (IDPs). PRM provided contributions to its primary IO partners providing assistance to IDPs and conflict victims in Lebanon (UNRWA, UNHCR, IOM, and ICRC), and neighboring countries hosting refugees (UNHCR and UNRWA). DCHA funded its primary IO partners assisting IDPs and conflict victims in Lebanon (UNICEF, OCHA, WFP) as well as NGOs providing assistance in Lebanon. PRM also has formalized letters of agreement with the CDC's International Emergency and Refugee Health Branch (IERHB) and USAID's Office of Foreign Disaster Assistance (OFDA), affirming increased collaboration in areas such as joint M&E trips, proposal reviews, training sessions, and regular exchange of information, technical expertise, and staff. PRM improves coordination with donor governments by participating in the Good Humanitarian Donorship initiative, and by promoting multi-donor missions and information sharing. PRM collaborates with other donors and host governments to harmonize performance indicators and targets for refugee assistance. In 2007, collaboration on Palestine refugee assistance will include an annual joint donor review of UNRWA's performance indicators spearheaded by the European Community. PRM works closely with donor and host governments to coordinate recommendations made to UNRWA both during Advisory Commission sessions and on important issues between regular sessions. UNRWA collaborates with a number of bilateral, multilateral, and non-governmental partners. A recent example highlights UNRWA's meaningful collaboration with other organizations in management and resource allocation. In March 2007, sewage from a waste water treatment plant flooded a village in northern Gaza, displacing over 2000 people, primarily Palestine refugees. Over ten humanitarian organizations collaborated in responding through the establishment of temporary shelters and distribution of humanitarian assistance; UNRWA was appointed lead agency to ensure coordination between all organizations. During the 2006 Lebanon crisis, UNRWA provided critical support to other UN agencies and partners by supplying emergency relief items from its Lebanon warehouses. UNRWA also consults regularly with each of the hosts governments. UNRWA coordinated closely with the Government of Lebanon on the development of its rehabilitation plan for camps in Lebanon. The GOL strongly supports this plan, and incorporated it into broader appeals for recovery efforts. UNRWA has also worked closely with the Government of the Syria Arab Republic (SARG) on the Neirab Rehabilitation Project, to improve living conditions and livelihood opportunities for 18,000 Palestinian refugees. The SARG donated land and made a financial contribution to the project funds enabling interested refugees to relocate to a less crowded camp.

Evidence: PRM-DCHA Funding Guidelines; FY 2007-2012 Joint Strategic Plan; USAID website documenting joint USG Assistance to Lebanon in 2006 (http://www.usaid.gov/locations/asia_near_east/middle_east/); Sample Situation Report: USG Assistance to Lebanon (12/30/06); PRM-CDC/IERHB Letter of Agreement; PRM-USAID/OFDA Letter of Agreement; Joint Donor Mission Trip Report Sample (DRC); Framework for Cooperation between UNRWA and the Government of the United States of America for 2007; Good Humanitarian Donorship: Principles and Good Practice of Humanitarian Response; Cable: Good Humanitarian Donorship - Report from Ottawa Meeting (2004); Good Humanitarian Donorship Public Website: www.goodhumanitariandonorship.org; Message from the EC regarding the 'Annual Joint Review of UNRWA; The United Nations and Palestinian Refugees (2007); Beit Lahiya Situation Report (2007); Beit Lahiya Emergency Response proposal (2007); UNRWA Camp Improvement Initiative for Palestine Refugees in Lebanon, dated June 2006; UNRWA Memorandum of Understanding Samples; UNRWA Lebanon Flash Appeal 2006; No-Meeting PPRC: UNRWA FY2006 Special Projects, dated July 21 2006; Neirab Project Implementation Plan, Phase One, 2004; Neirab Rehabilitation Project: Phase Two, The Development of Neirab Camp, 2007; Cable: (U) Lebanese PM Fouad Siniora Briefs Security Council on Lebanese National Dialogue, dated 27 April 2006; Cable: (U) GOL Proposes New Program for Palestinian Refugees, dated May 10 2006; Daily Activities Report: (U) Lebanese Ministers Vow to Improve Palestinian Camp Conditions, dated March 27 2006; Daily Activities Report: "Lebanese Officials Visit Ail al-Hilweh," Daily Star, dated July 1 2006; Media Notice: U.S. Lauds Lebanon Camp Improvement Initiative, dated June 28 2006;

Does the program use strong financial management practices?

Explanation: The 2006 OIG inspection of PRM state that PRM "provides effective financial oversight over contributions to IOs and the preparation and execution of grants and cooperative agreements??. PRM's program officers and refugee coordinators are in continous contact with IOs to ensure that the funds are being spent as the organization agreed and that performance indicators are being met??. The bureau manages the post-award portion of its federal assistance for NGOs well." A Cotton and Company review of PRM in FY 2006 assessed the effectiveness of internal controls for each accounting application/accounting event and detailed the significant controls that PRM has to ensure that obligations and expenditures are valid, accurate, complete, and verified. The FY 2006 Department of State financial statement noted that in a review of three of its largest Federal Financial Assistance Programs (including Refugee Assistance Programs) there were no improper payments. To ensure that the assistance program maintains the highest level of internal control, PRM requires all assistance program partners to share annual audit reports and report on their efforts to address any critical recommendations. PRM's Comptroller reviews all audit reports of PRM-funded organizations for any unallowable costs or internal control issues, proactively issues letters conveying expectations of corrective actions, and monitors reporting to determine if such actions were taken. With regard to PRM's assistance to Palestine refugees, UNRWA is under scrutiny of internal and external auditors. The UN Board of Auditors (BOA) carries out external audits of UN agencies biennially, reviewing financial statements, accounting principles, and agency transactions. The BOA also examines administration and operational effectiveness. The BOA issued an unqualified audit opinion for UNRWA's 2004-2005 financial statements, indicating the auditors have no reservations regarding the accuracy and fairness of UNRWA's financial records. The BOA found no material internal financial control weaknesses, highlighted UNRWA's effective system of internal controls, and remarked that UNRWA has directives to guide the daily running of the Agency and ensure adherence to internal controls. The BOA found that UNRWA has a transparent system of fund accounting, which "provides a full identification of income and expenditure by purpose and the complete separation of the assets and liabilities of each fund." The Audit and Inspection Committee (AIC) addresses internal oversight issues at an agency-wide level. It is comprised of high-level UNRWA officials and external members: the European Union Anti-Fraud Director, Auditor General of the African Development Bank, and the World Bank Auditor General. UNRWA's Department of Internal Oversight Services (DIOS) conducts audits, investigations, and inspections of UNRWA. DIOS and the AIC develop an annual audit plan based on risk assessment. UNRWA conducted 59 internal audits from 2004-2005, and conducts ad hoc audits when an issue is identified. DIOS tracks completion dates, progress on and completion of recommendations, meets with managers if programs are not acting on recommendations, and provides an annual report to the Commissioner General on oversight progress and audit implementation. The U.S. funded OSOs conduct random, unannounced inspections of UNRWA facilities in the West Bank and Gaza to ensure USG funding does not support terrorist groups. UNRWA's Financial Regulations mandate that the AdCom be closely involved in financial planning, policy and budgetary control. Two Advisory Commission Sub-Committees provide input on planning, implementation, and evaluation of programming. The USG helped establish and chaired UNRWA's Sub-Committee on Finance and Administration, ensuring that accountability is reflected in UNRWA's budget mechanisms

Evidence: 2006 OIG Report on PRM with Bureau Responses - including M&E (p. 31-32, 58); Department of State FY 2006 Financial Statement (p. 66): http://www.state.gov/s/d/rm/rls/perfrpt/2006/; State Department A-123 Appendix A Implementation (Cotton & Company Review) - Obligations p.7-10, Payments 10-14; CD-ROM: UNRWA Finance Manual and Financial Regulations; UNGA Resolution 74(I) of 1946, Appointment of External Auditors UNRWA Financial Regulations, dated August 28 2005; Report of the Board of Auditors, Financial Report and Audited Financial Statements for the biennium ended December 31 2005 (on Financial Controls page 6/paragraph 34; on Fund Accounting page 8/paragraph 42); UNRWA Programme Budget for CY 2006-2007; Report to the Senate Subcommittee Letter from UNRWA to AdCom, April 2006; 301(c) Reports from UNRWA for 2005 and 2006; AdCom Rules of Procedure, dated June 19 2006; Kick-off Meeting of Sub-Committee on Finance and Administration, dated October 5 2006; AdCom December 2006 Regular Session Summary Note Recommendations adopted by AdCom from the Sub-Committees, dated January 17 2007; Recommendations adopted by AdCom from the Sub-Committees, dated February 28 2007; UNRWA Fraud Awareness Initiative: Strengthening Organizational Integrity UNRWA Note on Oversight Functions in UNRWA, dated May 4 2006; Report of the Working Group on the Financing of UNRWA, dated November 2004; UNRWA AdCom Sub-Committee on Finance and Administration Revised Work Plan, dated October 22 2006; E-mail from PRM Comptroller with payment schedule for FY06 and FY07 (UNRWA Contribution); Email: Results of Today's AdCom Sub-Committee Organizational Meeting, dated October 5 2006; Interview Notes: PRM Consultations with UNRWA HQ Staff;

Has the program taken meaningful steps to address its management deficiencies?

Explanation: The 2006 OIG report on PRM recommended that the Bureau increase efforts to strengthen its monitoring and evaluation (M&E) systems. PRM senior managers participated in an off-site exercise in May 2006 to identify management priorities, including strengthening the Bureau's monitoring and evaluation efforts. PRM has implemented several steps and procedures to address these recommendations. PRM organizes an annual week long M&E training course for all incoming officers. In addition, PRM recruits regional and sectoral experts to conduct biweekly M&E training sessions for bureau staff and USG inter-agency partners. These sessions allow officers to develop skills needed to carry out the M&E and oversight of assistance programs. PRM is also developing a certification process by which its staff would complete an intensive series of trainings and have their M&E proficiency documented. Plans are underway to hold a RefCoord conference to tailor their M&E training to regional contexts. In 2008, PRM plans to finance its first ever impact evaluation to assess the long-term effectiveness of assistance programming with a specific refugee population. In addition to its own management practices, PRM closely monitors those of its international organization partners providing assistance, including UNRWA. UNRWA consistently responds to PRM and other donor input and recommendations to address and improve management deficiencies. PRM closely monitors UNRWA's implementation of the BOA recommendations formally through participation in the AdCom and its Subcommittee on Finance and Administration, and on a less formal basis through its Refcoord posted in Amman. Implementation of BOA audit recommendations is also a high priority for UNRWA. UNRWA has either completed or started implementation on all but three of the BOA's 17 critical recommendations for 2004-05. PRM has led the effort to transform the UNRWA AdCom into an effective oversight body, which helps formulate UNRWA's annual work plan and set performance goals and measures. PRM also led the establishment of two AdCom sub-committees on finance and programming to give donors more direct input into UNRWA's financial and program planning and activities. In 2006, the Subcommittee made specific recommendations on how UNRWA could strengthen implementation of the BOA recommendations by clearly specifying which recommendations will be given the highest priority and providing greater details about financial resources needed for implementation. In 2005 the UK's Department for International Development (DFID) carried out an analysis of UNRWA management structures, hiring, and other personnel practices, decision making, and programs. This review found that UNRWA made significant improvements in financial management, but that UNRWA's IT system was outdated and should be replaced. UNRWA has incorporated this recommendation into the ODP process and is actively seeking contributions to fund this initiative.

Evidence: PRM Monitoring and Evaluation Reference book; PRM Monitoring and Evaluation Weeklong Course Schedule PRM Expanded Monitoring and Evaluation Brownbag Schedule for FY 2006 and FY 2007; OIG Report on PRM (pp. 31-32, 58) with Bureau Responses; FY 2007 PPRC: Monitoring and Evaluation; UNRWA Organizational Development Plan; European Commission 2006 Report: Development of Results-Based Indicators for UNRWA's Programs funded by the European Commission; 2007 Framework for Cooperation between UNRWA and the Government of the United States of America for 2007; Kick-off Meeting of Sub-Committee on Finance and Administration, dated October 5 2006; AdCom December 2006 Regular Session Summary Note Recommendations adopted by AdCom from the Sub-Committees, dated January 17 2007; Recommendations adopted by AdCom from the Sub-Committees, dated February 28 2007; Report of the Board of Auditors, Financial Report and Audited Financial Statements for the biennium ended December 31 2005; Report of the Board of Auditors, Financial Report and Audited Financial Statements for the biennium ended December 31 2003; Letter to Refcoord: UNRWA Reporting on Procurement and Logistics Reform dated March 14, 2006; UNRWA Note on Oversight Functions in UNRWA, dated May 4 2006; Interview Notes: PRM Consultations with UNRWA HQ Staff; DFID Multidonor Review October 2005;

Does the program have oversight practices that provide sufficient knowledge of grantee activities?

Explanation: Assistance program partners report formally on indicators and targets contained within frameworks agreements and cooperative agreements at semi-annual intervals during the program. PRM program officers are in daily contact with partners who informally report on program progress. RefCoords verify partners' formal and informal reports during monitoring trips. Sectoral reports are produced annually by international partners. Program officers take part in monitoring and evaluation trips to assess program progress, make recommendations, and ensure that funding provided is used in a manner that is efficient and technically sound. Monitoring trips take place at any time, especially when it is suspected that assistance is being provided to a refugee population below internationally accepted standards. PRM's Comptroller rigorously examines budget requests to ensure that they are in full compliance with U.S. laws and regulations, and also visits program partners' offices to monitor their financial practices. PRM requires that partners with relevant health programs report CMR and GAM both directly to PRM and to CRED for inclusion in the CE-DAT database. If a partner is not meeting targets, consultations take place to determine causes and a corrective course of action. Partners' performance is reflected in PRM's strategic planning documents which include the Bureau Performance Plan, the Department Performance Plan, the Performance Accountability Report, the Program Assessment Rating Tool, and the Congressional Presentation Document. The USG is a member of UNRWA's AdCom as well as the Finance and Program sub-committees, and participates in semi-annual meetings and activity reviews. The UNRWA Commissioner-General also provides an annual report to the AdCom, which includes a compilation of reporting from UNRWA's program departments. PRM program officers and RefCoord maintain regular contact with UNRWA on the progress of assistance activities. UNRWA field programs in its areas of operation are monitored by PRM's RefCoord in Amman. These trips always involve an assessment of project oversight and accountability. In order to address any shortcomings, results are provided to UNRWA staff at HQ and in the field, as well as PRM Washington. Periodic internal and external evaluations of UNRWA further enhance the Bureau's oversight capabilities. PRM maintains contact with other donors to discuss progress, concerns, and opportunities for harmonization.

Evidence: 2007 Framework for Cooperation between UNRWA and the Government of the United States of America for 2007; Report of the Commissioner General of UNRWA, January - December 2005; Report of the Commissioner General of UNRWA, July 2004 - June 2005; 301(c) Semi-Annual Reports for 2005 and 2006; AdCom December 2006 Regular Session Summary Note; AdCom February 2007 Regular Session Summary Note; Recommendations adopted by AdCom from the Sub-Committees, dated January 17 2007; Recommendations adopted by AdCom from the Sub-Committees, dated February 28 2007; UNRWA Note on Oversight Functions in UNRWA, dated May 4 2006; UNRWA Health Department Annual Report, 2005 Monitoring and Evaluation Trip Report Samples; Cable: (U) Jalazoun Refugee Camp: Women Using USG Funded Exercise Center, dated September 19 2006; Email: Results of Today's AdCom Financial Management and Admin SubCmte. Meeting, dated October 30 2006; Congressional Presentation Document for FY 2008

Does the program collect grantee performance data on an annual basis and make it available to the public in a transparent and meaningful manner?

Explanation: PRM tracks, collects, and makes the performance results of the assistance program available to the public through the Department's Performance and Accountability Report, the Bureau Performance Plan, and the Congressional Presentation Document. Performance indicators on PRM's partners are also available via numerous fact sheets and other documents on PRM's websites. Where performance data is specific to a particular grantee, such as UNRWA, this information is included in PRM's publicly available reports. UNRWA's efficiency measure has been included in PRM's Congressional Presentation Document since 2004 (the President's FY06 budget request). CE-DAT is a public website and data repository through which anyone with an internet connection can analyze the health status of selected refugee and conflict affected populations. Performance data on UNRWA is provided formally to donors annually in the Commissioner General's Annual Report. UNRWA also provides annual performance data to PRM on the indicators contained in the framework agreement. Results are also discussed through USG statements at UNRWA governing bodies. UNRWA makes available extensive information and assistance related information on its website including budgets, strategic plans, annual reports, sectoral reports, and relevant UNGA resolutions. PRM views its annual cooperative framework with UNRWA as a reporting tool by which its performance for the year will be evaluated.

Evidence: Congressional Presentation Document for FY 2007 (p. 52-58); Performance Accountability Report for FY 2006 (p.191-202); PRM Public Website (http://www.state.gov/g/prm/); CE-DAT Database (www.cred.be/cedat); UNRWA Public Website (http://www.un.org/unrwa/english.html); PRM PART Summaries 2007; Framework for Cooperation between UNRWA and the Government of the United States of America for 2007; USG Assistance to UNRWA, Fact Sheet, dated April 10 2006; USG Contribution to UNRWA's 2006 Emergency Appeal for West Bank and Gaza, Fact Sheet, dated July 17 2006; Report of the Commissioner General of UNRWA, January - December 2005 Report of the Commissioner General of UNRWA, July 2004 - June 2005; Report of the Board of Auditors, Financial Report and Audited Financial Statements for the biennium ended December 31 2003; Report of the Board of Auditors, Financial Report and Audited Financial Statements for the biennium ended December 31 2005; UNRWA Emergency and General Fund Appeals for CY 2006-2007; USG Contribution to UNRWA's 2006 Emergency Appeal fgor West Bank and Gaza, Fact Sheet dated July 17, 2006;

Has the program demonstrated adequate progress in achieving its long-term performance goals?

Explanation: While the assistance program has not met all of its short-term performance targets for outcome measures, the program has demonstrated progress toward meeting its performance goals over the long term. With regard to health, the long-term goal is to decrease the Infant Mortality Rate (IMR) from a baseline of 22 deaths/1,000 live births/year in 2003, to 18 deaths/1,000 live births/year in 2011. UNRWA has made progress toward this goal, decreasing the IMR from 32 deaths/1,000 live births/year in 1997 to 22 deaths/1,000 live births/year, the program's target level in 2006. Over the longer term, dramatic improvements have been achieved in this key performance measure as evidenced by the 1967 rate of 98 deaths/1,000 live births/year. This progress is due to ambitious expansion of its vaccination program and strict follow-up with mothers and children. UNRWA requires monthly check-ups for the first year of life, a standard above that of other countries throughout the region. Despite spending far below WHO recommendations for health care expenditures (UNRWA: $16/patient/year as compared to the WHO: $40/patient/year), UNRWA continues a level of service that maintains its beneficiaries' health standards and achieves the target IMR. The WHO attributes steady improvement in most health indicators for the Palestine refugee population to both UNRWA provided health services and to the dedication and commitment of the Agency's staff. The long-term outcome target for education is to increase the Percentage of Vocational Training Center (VTC) graduates who find employment within 2 months of graduation from a baseline of 78% in 2004 to 90% in 2011. In 2006, UNRWA achieved 78%, 2% below the benchmark target of 80%. While UNRWA did not achieve the short term target for education, the longer term progress indicates progress is being achieved. UNRWA provides one career guidance officer in each field of operation, and arranges interviews and provides career guidance. However, employment rates for the VTC graduates are largely dependent upon socioeconomic factors within each field of operation, and the availability of and access to employment, which may limit the ability of graduates to find jobs, despite their education and qualifications. For example, Palestinian refugees in Lebanon are prohibited from occupying professional jobs and most manual, clerical and administrative positions. There are still administrative impediments such as barriers to obtaining a work permit, and high fees. Employment opportunities are also limited in the West Bank and Gaza, and the Government of Israel (GOI) has significantly limited Palestinians' ability to travel into Israel for employment.

Evidence: European Commission 2006 Report: Development of Results-Based Indicators for UNRWA's Programs funded by the European Commission; Report of the Commissioner General of UNRWA, January - December 2005; Report of the Commissioner General of UNRWA, July 2004 - June 2005; 2003 UNRWA Annual Health Report (p.61); 2004 UNRWA Annual Health Report (p.61-62); 2005 UNRWA Annual Health Report (p.60-61); UNRWA/UNESCO Education Program Data Sheet for CY 2005 - 2006; UNRWA/UNESCO Quality Assurance Framework for UNRWA Schools in CY 2005 - 2006; UNRWA's Epidemiological Reports, 2006; WHO 2005 Technical Assessment Mission: UNRWA Health Program;

Does the program (including program partners) achieve its annual performance goals?

Explanation: The program achieved performance goals in two of the six annual measures. The program achieved annual targets for the two overarching measures of annual performance. For instance, CMR has not exceeded emergency thresholds in 95% of targeted refugee sites and GAM has not exceeded emergency thresholds in 90% of targeted refugee sites. PRM support to assistance partners has been instrumental in reducing the CMR and GAM rates among Sudanese refugees living in Chad. In June 2004, refugees were dying at a rate of 2/10,000/day - a serious humanitarian emergency. PRM partners were able to ramp up their assistance programming and bring the CMR rate to below 1/10,000/day in FY 2005. In harsh and insecure environments such as Eastern Chad, assistance programming has saved lives and alleviated human suffering. While the assistance program for UNRWA did not achieve the performance targets for the four annual measures, progress has been made progress in several areas. For instance, UNRWA has reduced the average number of daily medical consultations per doctor, bringing the overall UNRWA average across the five fields down from 110 in 2005 to 95 in 2006. While this falls short of reaching the annual target of 90, progress has been achieved through the hiring of 30 additional doctors in Gaza in 2006 from UNRWA's job creation program (funded through UNRWA's Emergency Appeal). As a result of hiring additional doctors, Gaza's daily medical consultation rate dropped from 137 in 2005 (the worst of the five fields) to 95 in 2006, demonstrating the impact hiring additional medical personnel has on lowering the number of consultation and improving medical care. In 2006, UNRWA maintained the number of schools operating on a double-shift at 77%, slightly below the 2006 target of 75%. Inputs for this measure include recruitment and training of qualified teachers, negotiations with host governments for access to property, and expansion of schools. According to the Education Department, 480 schools were operating on a double-shift system in 2006. To reduce the percentage to 70%, UNRWA will need to build 25 new schools, in combination with other inputs. The construction costs are roughly $50 million. Given chronic under-funding of UNRWA's programs, to maintain existing services UNRWA cannot spend any funding on building new schools. Despite this challenge, UNRWA continues to use this measure because it is clearly related to long-term goals and critical to providing a quality education.

Evidence: OECD/DAC Peer Review on USG Humanitarian Assistance (2006); CRED Report: Introduction to CMR/GAM; CMR/GAM reports for 2004-2006; Cable: Monitoring and Evaluating CRED; CDC Report on the Darfur Emergency in 2004; NGO Sample Reporting; PRM Summary of Major Activities for FY 2006; European Commission 2006 Report: Development of Results-Based Indicators for UNRWA's Programs funded by the European Commission; Report of the Commissioner General of UNRWA, January - December 2005; Report of the Commissioner General of UNRWA, July 2004 - June 2005; UNRWA's Annual Report of the Department of Health, 2005; UNRWA/UNESCO Program Data Sheet for CY 2005 - 2006; UNRWA/UNESCO Quality Assurance Framework for UNRWA Schools in CY 2005-2006; UNRWA's Epidemiological Reports, 2006;

Does the program demonstrate improved efficiencies or cost effectiveness in achieving program goals each year?

Explanation: Although the program did not meet its annual targets in FY2005 or FY2006, progress is being made to increase the efficiency of the UNRWA through improved deliveries of assistance. In FY 2006, for example, the adoption of UNRWA's efficiency measure for deliveries in full on time in specification (DIFOTIS) have underscored a number of areas in which the agency was able to improve its logistical capacity, reduce cost, and raise expectations for sub-contractor performance. This measure tracks efficiency of the procurement system, a core function of UNRWA as the primary provider of goods and services central to the welfare of Palestine refugees. UNRWA's procurement department requested the adjustment of the indicator to measure the delivery of goods directly to each of the five fields of operation, extending supply chain tracking. This change initially resulted in UNRWA's performance declining slightly from targets, but is a more accurate representation of performance and service to the beneficiaries. It also indicates UNRWA's commitment to tracking performance data with the goal of improving performance. Institutional adoption of this indicator allowed UNRWA to improve DIFOTIS from a level of 42% in CY 2001 to 80% in CY 2006, with steady improvements every year, despite ongoing security and logistical challenges. In 2006, UNRWA had a target of 82% for this indicator, and achieved 80% (a weighted average of the five fields of operation, which ranged from 75% to 87%). Performance improved in Gaza from 68% in 2005 to 75% in 2006 due to an increase in local purchases of goods. Restrictions placed by the Government of Israel (GOI) on imports into Gaza and frequent closures of all entry points to Gaza necessitated UNRWA's shift to purchase more goods locally to ensure the beneficiary needs are met. From 2005 to 2006, performance declined in the West Bank (from 84% to 77%) due to Israeli security requirements, ongoing closures for movements between West Bank cities and strikes undertaken by Palestinian citizens. Despite the conflict in Lebanon in 2006, performance in Lebanon remained virtually the same (at 86%). Jordan and Syria remain at or above target levels, both showing improvements from 2005 to 2006 (Jordan: from 78% to 82%; Syria: from 85% to 87%). Overall, the average for this indicator is slightly below the target primarily due to constraints on access and movement in the West Bank and Gaza. Despite these challenges, UNRWA has consistently improved its performance against this indicator, taking creative steps such as switching to local purchasing to ensure that the goods arrive in a timely manner to meet beneficiaries' needs. UNRWA continues to strive for improvements, and is on track to reach its ambitious target of 90% in 2009. UNRWA also provided extensive training to local procurement staff to build their capacity by developing an understanding of codes of conduct and procurement processes, and supporting training resulting in certifications in procurement and contracts in line with Western standards. These actions promote best-practices and ensure a basic local capacity to continue and expand such practices, promoting increased efficiency and effectiveness. Overall, PRM's obligations totaled nearly $995 million, with only $22.6 million (2.3%) devoted to administration, demonstrating that PRM maintains highly cost-effective operations.

Evidence: PRM FY 2006 Summary of Major Activities; Efficiency Measure Reporting from UNRWA; 2006 Human Rights Report for Israel and West Bank/Gaza; OCHA Humanitarian Monitor for the oPt, February 2007; OCHA Implementation on the Agreement on Movement and Access, Feb 21 - March 6 2007; Daily Situation Reports, examples from 2007;

Does the performance of this program compare favorably to other programs, including government, private, etc., with similar purpose and goals?

Explanation: PRM is mandated to administer and monitor USG contributions to organizations to assist refugees, and therefore is the only USG agency that funds partner organizations for refugee assistance activities. While other countries and private organizations support refugee programs, PRM is the only entity that assists refugees overseas to advance USG policy goals. PRM and USAID target distinct populations and generally fund separate programs; there are no documented comparisons of performance. During complex humanitarian emergencies where both PRM and USAID/DCHA are involved, the bureaus follow established guidelines on the division of funding responsibilities, which support cooperation and coordination among the UN agencies, other IOs and NGOs. It is rare that an IO or NGO would receive funding from both PRM and USAID in a given emergency. More frequently, discussions focus on gaps in response. PRM is the sole source of USG contributions to UNRWA. UNRWA is the only international organization with a mandate to assist Palestine refugees displaced by the 1948 Arab-Israeli War and currently residing in Jordan, Syrian, Lebanon, the West Bank, and Gaza. While other international organizations and NGOs may operate in some of these locations, UNRWA is the only provider of extensive education, health care, social services, and large-scale emergency relief services for this beneficiary population. While UNHCR protects and assists Palestinian refugees in other locations, its activities focus on legal protection issues and basic assistance, and do not include the extensive range of services provided by UNRWA. No other agencies provide the level and scope of services that UNRWA provides to this population.

Evidence: Migration and Refugee Assistance Act of 1962, as amended; PRM-DCHA Funding Guidelines; UNGA Resolution 302(IV), dated December 8 1949; The United Nations and Palestinian Refugees, 2007;

Do independent evaluations of sufficient scope and quality indicate that the program is effective and achieving results?

Explanation: Independent evaluations from 1995, 2002, and 2006 show PRM and its partners are achieving positive results. The 2006 OIG report found that PRM "receives high marks for both the effectiveness of its programs and the efficiency with which it manages its contributions, grants, and cooperative agreements." The 2006 OECD/DAC Peer Review of the USG found that PRM leads innovative efforts to improve the use of evidence in humanitarian decision making. A 2006 GAO review of Darfur death estimates found that a group of experts had the highest confidence in mortality estimates by PRM's partner, CRED. Independent evaluations of UNRWA note its effectiveness and efficiency particularly in light of external factors, and document that it is achieving results in each major program area: health, education and relief and social services. The 2006 EC report on UNRWA results-based indicators cited that UNRWA's Health Program achievements in maintaining vaccination rates (above 99% in all areas of operation) and percentage of infants delivered by trained personnel are so high that major improvements could not be expected. Additionally, UNRWA's infant mortality rates are often better than those of the host countries, and the agency aims to further reduce them in upcoming years. The UN IMDIS review of UNRWA's indicator tracking stated that UNRWA's maternal and child health services have contributed to a lower IMR. It also indicated that UNRWA has increased the percentage of pregnant women registering for antenatal care, a key factor in maternal and child health. UNRWA also increased the percentage of camp shelters connected to underground sewage systems, a key environmental factor impacting health status. A 2005 WHO evaluation also determined that the steady improvement in most health indicators could be attributed to UNRWA's health programs and to the dedication and commitment of the agency's staff. On education, the EC report indicates that literacy rates among Palestine refugees are higher than for Arab states as a whole, and generally higher than host countries. UNRWA also achieved gender equality in all of its schools by the 1980s. The IMDIS review indicated the pupil pass rate exceeded 95%. A 2006 multisectoral evaluation of UNRWA carried out jointly by the University of Geneva and the Catholic University of Louvain notes that the agency has been a pioneer in providing free education to its beneficiary population. A 2003 UNESCO evaluation of UNRWA's Technical and Vocational Training program found it to be achieving "a high degree of success" with an employment rate of 75% within one year of graduation, and noted that this employment rate is favorably comparable to developed countries. An EC report on Special Hardship Cases (SHC) found that UNRWA's procurement service is extremely effective as a result of highly efficient systems and competent staff. The SHC Program was determined to be effective in keeping beneficiaries food secure, though continued efforts will be needed to combat chronic malnutrition and high levels of anemia among pregnant women and small children.

Evidence: 2006 OIG Report on PRM (with Bureau Responses); 2006 GAO Report on Darfur Death Estimates ((http://www.gao.gov/new.items/d0724.pdf); WHO Report on Water/Sanitation and Sewerage in Jenin Camp; UNESCO General Evaluation of the Agency's Technical and Vocational Education and Training Program; UK DFID Study of Student Attitudes; GAO Report on "Department of State and the UNRWA Actions to Implement Section 301(c) of the Foreign Assistance Act of 1961," presented to Congress on November 17, 2003; European Commission 2006 Report: Development of Results-Based Indicators for UNRWA's Programs; WHO Report on a Technical Assessment Mission of UNRWA Health Programs; Synthesis Report: University of Geneva and the Institute of Development Studies at the Catholic University of Louvain (2006); CRED Report: Introduction to CMR/GAM; Cable: Monitoring and Evaluating CRED;