Ensuring access to life saving nutrition services through the establishment of IMAM services in Kabul city (southern and western zones) This proposal is designed to address the 1st allocation from CHF 2017 with regards to: Establishment of IMAM program in Kabul city, west and South part. This project aims to scale up and strengthen IMAM program in Kabul where there is no management of acute malnutrition except in 6 hospitals with Therapeutics Feeding Unit, with inpatient but no outpatient. Kabul population is 3,329,885 including 632 680 U5 children with risk of deterioration of nutritional status. In addition to the city population under HFs coverage, conflict displacement is increasing, with more than 137,000 people displaced in Afghanistan since the beginning of 2016, representing a 16% increase compared to the same period last year. A recent Rapid Nutrition Assessment conducted in the KIS indicated emergency levels burden of malnutrition under 5 children is: GAM 21.9%, SAM 5.9%.
Nutrition national survey (NNS) done in 2013  shows the following results at national level: GAM 9.5%, SAM 5.5% and MAM 4% (standing at 6.5% at Kabul level)
The Nutrition Cluster estimates 45,000 children aged 0-59 months will be in need of severe acute malnutrition (SAM) treatment, 85,000 children aged 6-59 months will be in need of moderate acute malnutrition (MAM) treatment and 62,500 pregnant and lactating women will be in need of malnutrition treatment in 2017 (NNS 2013). In addition, about 24% of returnees from Pakistan are settling in Kabul further increasing number of people in need of acute malnutrition treatment.
ACF will focus on implementing the activities and strengthening the capacities of the health facilities through both facility based intervention (by reinforcing the health and nutrition service delivery points with nutrition) and community based intervention (through volunteers’ female screeners’ approach, who will also roll out MUAC by mothers approach and promoters men who will work with the Mullah and community leaders). This project will integrate management of acute malnutrition with raising level of awareness in communities.
ACF recognizes the high importance of implementing IMAM program in each health facility of the country. This is implemented partly in few provinces but not in Kabul province. ACF has experience in strengthening health structure with IMAM program, with ongoing program in Ghor province and past experience in Balkh province. To cover the emergency gap in IMAM management, ACF is covering 48 KIS in Kabul with the mobiles clinics. The link will be done with the mobiles activities and the scaling up of IMAM program and at the end of the mobile clinic some children will be referred to the HFs with IMAM activities.
ACF intends to support the 26 health structures in the West and South parts another NGO will be selected by CHF to implement IMAM program in the East and North of the province. All the geographic areas will be covered to give children and PLW access to under acute malnutrition treatment. 
An assessment will be conducted to assess the different needs of HFs to scale up the activities ACF will support them in the procurement requests for supplies to PND (UNICEF CHF call), calculation of the need for WFP (LFA between ACF and WFP) and managing the activities. With the experience on IMAM implementation, ACF will support the HF through the different steps of the scale up and strengthen the HF staff capacities through training and on the job mentoring. It will be very important to have a strong support and a program implementation of quality. It will have an impact on the quality of the care and on the development and good perception of program in the area. It will also have an impact on the access or on the barrier of the program in the city. The approach for the community management is different in the city compare to a rural area. The structure of CHW, FHGD and shura are almost non-existent. ACF will approach the community through radio messages and female volunteers going door to door doing screening and training mothers on MUAC.