Integrated Nutrition, Health, WASH Response in Sana'a The proposed intervention will contribute to the objectives outlined for the Nutrition, Health, and WASH sectors in the Strategic Response Plan. The key focus of this project is an integrated approach to address immediate causes of malnutrition by ensuring adequate access to food, nutrition, health, and WASH for the most vulnerable. A four-pronged approach will be adopted, involving - 1. direct delivery of essential services by Relief International (RI) through fixed health facilities (HFs) 2. supporting the selected fixed HFs with essential rehabilitation 3. supporting RI’s mobile medical teams (MMTs) by providing treatment of common illnesses and chronic conditions to the population above 5 years of age and 4. implementing, through a local partner, a community based outreach component of the project. Please note that in this proposal, “HF” means both fixed HFs and MMTs. 

RI is proposing to implement this intervention in 2 districts of Sana’a governorate (Safa’n and Manakhah) as prioritized by the first standard allocation YHPF 2017 strategy paper. The intervention would consist of the delivery of essential Nutrition, Health, and WASH services through 16 HFs (13 fixed HFs and 3 MMTs). The project would be implemented in close coordination and collaboration with the local health authorities involving the authorities in key decisions related to the project. This collaboration includes the geographic selection (within the proposed districts) of the area for the deployment of the MMTs, the needs identification process at the selected fixed HFs, and the monitoring of the project activities. The selection of the districts has already been approved by the GHO (please refer to Annex II). However, the geographic selection (within the proposed districts) of the area for the deployment of the MMTs will be determined by Sana’a GHO according to the Movement Plan created by them immediately prior to the outset of the project.

Outreach Services are different from RI’s proposed MMTs. Using MMTs rather than Outreach Services has been discussed between RI and the Health Cluster. It was agreed that RI could propose to include MMTs rather than Outreach Services as long as we gave strong justification for this. While Outreach Services use the same staff in the fixed HF to conduct outreach 2 days/week, RI’s proposed MMT staff will be different staff members from the staff in the fixed HFs. RI’s proposed MMTs will remain in the 2nd and 3rd tier zones and only serve beneficiaries in those zones, 6 days/week. 

RI’s justification for MMTs, is that the MMTs are already funded by UNICEF and WFP to deliver primary healthcare and nutrition services for CU5 and PLW. With funding from OCHA, RI is proposing to add a doctor a pharmacist and medicines to each of the 3 MMTs to treat people over 5 years old, thereby covering a gap in services. We believe this is strong justification for using MMTs rather than the preferred Outreach Services. It is a highly cost-effective way to deliver services to people over the age of 5 because the MMT expenses (driver, vehicle, fuel, etc.) are already covered. 

Lastly, community-based, integrated Nutrition, Health, and WASH promotion of the project will be implemented through a partnership with a local NGO (LNGO) by establishing a network of community health volunteers (CHVs) in the intervention districts. They will mobilize the communities and develop linkages between the targeted communities and RI’s interventions. 

RI is in the process of selecting the LNGO as a partner for this project. Shortlisted LNGO's are as follows:
Al-Atta Institution for Social Development and Charity
International Youth Council – Yemen (IYCY)
Life Maker Meeting Place Organization (LMMPO)
Responsiveness for Relief and Development (RRD)
Coalition of Humanitarian Relief (CHR)
Building for Development (BFD)