Programme Document
PD Ref. No.:___________________
To be issued by UNICEF
Section 1. Programme & CSO overview
1.1 Programme UNICEF Office UNICEF Timor-Leste
submission
Programme Title Conducting mobile birth registration and establishing local
reference
coordination mechanisms to improve birth registration
system in Timor-Leste
PD submission date
1.2 Organization Organization Name
information
Acronym
Name of CSO Authorized
Officer
Title of Authorized Officer
Email of Authorized Officer
Phone of Authorized Officer
Name of Progr. Focal Point
Title
Email
Telephone
1.3 Programme Planned duration1 Start date:
information End date:
Geographical coverage State/ province, etc.
Population focus Number of beneficiaries / groups
1.4 Programme From CSO Currency, Value
budget
From UNICEF Currency, Value
Total Currency, Value
Section 2. Programme description
2.1 Rationale/ This section outlines the problem statement, the context and the rationale for the Programme:
justification • Overview of the existing problem, using data (disaggregated) from existing reports; who is
affected and what are the barriers/bottlenecks to outcomes for children?
(3 to 5 • How the problem is linked to national priorities and policies;
paragraphs; max • The relevance of the Programme in addressing problem identified.
400 words
(appx))
2.2 Programme The table below defines the programme results framework (results and their link to outputs
document defined in the UNICEF country programme and/or humanitarian response plan; specific
Expected results indicators, baselines, targets and MOV for each programme document output). (No narrative
required) (Enclosed Excel workbook can be used to replace this section 2.2)
1 The planned start date cannot be earlier than the date of signature from both CSO and UNICEF authorized officers.
1
Means of
Result statement Performance indicator/s Baseline Target
Location Verification2
Output 3.2 Increased - Percentage (%) of children Country 60.4% 80%
equitable access to and under five whose births are
utilization f child protection registered
systems that prevent and
respond to violence, abuse,
exploitation and neglect in
programme municipalities
(UNICEF Country
programme)
Programme document List each indicator in a separate
Output 1 line
Service or product resulting
from the programme
Programme document
Output 2
Programme document
Output 3
2.3 Gender, This section briefly mentions the practical measures taken in the programme to address
Equity and gender, equity and sustainability considerations. (1 to 3 paragraphs; max 250 words (appx))
Sustainability
2.4 Partner’s This section briefly outlines the partner specific contribution to the programme (monetary or
contribution in-kind) (1 paragraph; max 100 words (appx))
2.5 Other This section outlines other partners who have a role in programme implementation, including
partners involved other organisation providing technical and financial support for the programme. This section
would also specify whether UNICEF has approved any aspect of the programme document
to be sub-contracted to another entity. (1 paragraph; max 100 words (appx))
2.6 Other List any other critical aspects of programme delivery specific to the programme document.
considerations For example, in humanitarian response content related to how the partner will meet the IASC
Commitments to Affected Population.3 (1 to 3 paragraphs; max 250 words (appx))
2.7 Additional Additional documentation can be mentioned here for reference. (1 paragraph; max 100 words
documentation (appx))
2 The specific sources from which the status of each of the performance indicators can be ascertained. If any data source
is a survey or a study which the implementing partner is planning to conduct for this programme, this should be planned
and budgeted for in section 3 below (programme work plan and budget).
3 Since 2011, together with other members of the IASC, UNICEF formally endorsed commitments to affected population in
five areas: 1) Leadership and Governance; 2) Transparency; 3) Feedback and complaints; 4) Participation; and 5) Design,
monitoring and evaluation.
2
Section 3. Programme work plan and budget
The table below defines the programme implementation work plan (the specific activities to be undertaken towards achievement of each of the programme outputs;
the schedule of implementation; and the planned budget, including the CSO and UNICEF’s contributions to the programme). (Enclosed Excel workbook can be used
to replace this section 3)
Timeframe (quarters/year(s) Total (CSO+ UNICEF contribution
Result CSO
Result/activity UNICEF)
Level Q1 Q2 Q3 Q4 Year2 contribution Cash1 Supply
[currency]
Progr. E.g. Community-based management of SAM introduced in 200 villages in 10 districts
Output 1:
Performance indicator(s),
400,000 10,000 190,000 200,000
- # children receiving RUFT/in patient
- # children receiving RUFT/ community
- recovery rate
Act.1.1 Organise training of 500 health workers in community nutrition in 100,000
x x 100,000
10 districts
Act. 1.2 Undertake community outreach activities & referral in 200 villages x x x 50,000
x 50,000
in 10 districts
Act. 1.3 Provide nutrition equipment & supplies in 50 health centres x x 200,000 200,000
Act. 1.4 Programme management and technical supervision x x x x 50,000 10,000 40,000
Progr. Output statement
Sub-total Sub-total Sub-total Sub-total
Output 2:
output 2 output 2 output 2 output 2
Performance indicator(s):
Act 2.1 Activity statement2
Progr. Output statement
Sub-total Sub-total Sub-total Sub-total
Output 3:
output 3 output 3 output 3 output 3
Performance indicator(s):
Act 3.1 Activity statement
1 The budget is prepared in the currency of implementation. Most generally, this correspond to the local currency in the country.
2 Costs budgeted as part of the programme output budgeting include the following:
• Cash for programme activities;
• Cost of supplies that directly assist beneficiaries or beneficiaries institutions, including related costs for warehousing, transport and assembling;
• Technical assistance and costs of technical staff to directly support beneficiaries / beneficiary institutions;
• Cost of surveys and other data collection activities in relation to beneficiaries or measurement or programme expected results;
• Communication activities to directly support programme planned results.
3
Timeframe (quarters/year(s) Total (CSO+ UNICEF contribution
Result CSO
Result/activity UNICEF)
Level Q1 Q2 Q3 Q4 Year2 contribution Cash1 Supply
[currency]
Act 3.2
Sub-total for the outputs
Progr. Effective and efficient programme management Sub-total Sub-total Sub-total Sub-total
Output 4 output 4 output 4 output 4 output 4
Act 4.1 Standard activity: In-country management & support staff3 pro-
rated to their contribution to the programme (representation,
planning, coordination, logistics, admin, finance)
Act 4.2 Standard activity: Operational costs pro-rated to their contribution
to the programme (office space, equipment, office supplies,
maintenance)
4.3 Standard activity: Planning, monitoring, evaluation and
communication4, pro-rated to their contribution to the programme
(venue, travels…)
Sub-total for programme costs
HQ support costs5 (7% of the cash component)
Total programme document budget
* UNICEF specifies whether subsequent year funding in the programme budget is indicative for planning purposes only. UNICEF Offices can add additional columns
for multi-year planning.
3 Costs of technical assistance/staff directly related to the achievement of planned results are budgeted as part of programme output budgeting, see footnote 2.
4 Costs of M&E and communication activities directly related to the achievement of planned results are budgeted as part of the programme output budgeting see footnote 2.
5 Payable to international CSO with their headquarters outside of the programme of implementation. Amount is an estimate. Amount paid is a standard 7% on actual expenditures subject
to calculation exclusions as per UNICEF Guidance on Budgeting and Financial Management for CSO partners.
4
Section 4. Descriptions of work plan
Please provide details of the
programme work plan.
The scope, content,
locations, timeframe and
processes for
implementation of the
programme should be
addressed. Suggestions not
included in the concept note
are welcomed.
Section 5. Partnership management plan (To be completed with UNICEF as part of finalization of the programme
document)
4.1 HACT programmatic visit Dates planned:
4.2 Final partnership review Date planned:
4.3 Cash transfer
modality(ies)
4.4 Observations/ Risk
management measures/
Capacity building activities (if
any)
Section 6. Other requirements
5.1 Additional Specify any reporting requirements in addition to the FACE form and attached standard
reporting programme progress/final report
required
5.2 Applicable Specify any technical specifications or guidance this is applicable to the programme
technical implementation
specifications or
guidance
5.3 Procurement For supplies procured by UNICEF: specify lead times and other key considerations.
and logistics Outline significant components of the programme planned to be procured by the CSO
considerations, if (supplies/services).
applicable
5.4 Other
Section 7. Signatures and date
_______________________________________ ________________________________________
CSO Authorised Officer name, signature and date UNICEF Authorised Officer, signature and date
