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9. Model Action Plan Format
District Name: Prepared by:
Approved bydate:
Required TCMPTICMO
IMCIC District Council
Variable Village council
Ward Relevant sectors at national level
Background
Issue assessment
Issues identified:
• •
• • .
Priority issues selected:
• . •
•
Geographic Scope attach map Issue Analysis and Action Planning
Monitoring Budget
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Issue analysis Form 1
Issue 1:
Main causes Consequences
Solutions to do
Objective to achieve desired
end-situation Results to
achieve what
Issue 2:
Main causes Consequences
Solutions to do
Objective to achieve desired
end-situation Results to
achieve what
One form 1 for each priority issue
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Describing goals, results and Activities Form 2
Intervention logic Objectively verifiable
indicators ovi Means of
verification mov Assumptions and
preconditions
Objectives
Results:
Activities: Inputs:
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Putting the solutions into action Form 3
Activity: Sub-Activities
By when Responsible
personagency Cost
Source of funding
Activity: Sub-Activity
By when Responsible
personagency Cost
Source of funding
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Monitoring the activities: Form 4. Monitoring plan
Objectively verifiable
indicators ovi
Means of verification
mov How verified
Who Collects
Analyses How
OftenWhen Data
Stored where?
Additional inputs
required
Summary Budget
Summarise all costs. Provide a column for each source
Stakeholder Participation and certifying the Process
The signed minutes of all important stakeholder meetings
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ANNEX 1 FORMAT FOR PRELIMINARY ISSUE ASSESSMENT REPORT
Name: “district name Preliminary Issue Assessment Report”
The report should be divided in the following sections:
1. General Section:
1.1 Location: physical location, boundaries 1.2 Map of the district, indicating wards, villages, roads, rivers, etc.
1.3 Physical features: surface, km coastline 1.4 Microclimateweather: temperatures, rainfall
1.5 Geology and Soils 1.6 Administrative structure: Divisions, Wards, Villages: list the coastal Divisions, Wards
and Villages 1.7 Demographic patterns: population size, sex and age distribution, density, birth rate; list
population total and structure of coastal villages – combine this in one table with the list of coastal Wards and Villages. Is there anything particular to say about sex or age
distribution in coastal villages? 1.8 District capacity: staffing of the district
2. State of infrastructures:
Kategori