Emergency nutrition and health service provision and strengthening technical capacity for effective nutritional need analysis and program designing in Yemen In September 2016, the Ministry of Health officially announced the interruption of operational/running costs of health facilities, which, compounded with major delays in payment of government salaries, shortage of electricity and medical supplies has left the health system close to collapse. Preliminary results of health facility assessment conducted mid 2016 indicate as much as 50% of the facilities are either non or partially functioning (YHB Issue 12). The combination of high levels of food insecurity, massive displacements, loss of income generating opportunities, and failure of the health system has prompted a severe and large scale deterioration of the nutritional status of the population, with an estimated 1.5 million children U5 today suffering from severe acute malnutrition (Nutrition Cluster). The health system is today heavily dependent on external support to continue functioning and delivering life-saving services, amongst which nutritional treatment. 

For the last years, ACF has been supporting and gap filling MoPHP in selected districts of Al Hodeidah Governorate for provision of nutrition and primary health care services. According to the SMART survey conducted by MoPHP/UNICEF in March 2016 in the lowland areas of Hodeidah (which ACF targets) Global Acute Malnutrition was 21.7% (95% C.I. 18.1 - 25.9), and Severe Acute Malnutrition 3.3% (95% C.I. 2.0 - 5.6) well above emergency thresholds. Acknowledging this emergency situation, and reduced capacity of MoPHP to provide adequate response ACF proposes to scale up its nutrition and health response in Al Garahy district, and to Al Tuhayat district - recently identified by Clusters as priority and requiring substantial support for nutrition service delivery. The proposed response consists in the deployment of 2 mobile teams for treatment of SAM and child common illnesses, and opening of one Stabilization Center.

While nutrition has come to be consistently prioritized as humanitarian intervention for Yemen in 2016 unavailability of updated and quality data has remained a major impediment to resource mobilization, response planning and effective/at-scale nutrition service delivery. Lack of in-country capacity to conduct nutrition surveys has left a critical gap in humanitarian needs analysis, which severely undermines ongoing response in terms of prioritization of geographical areas and interventions for scaling up nutrition interventions. In situations of emergency such as Yemen, experts recommend that nutrition surveys be conducted at least every 6 months (1 year in more stable contexts) to ensure timely response and scale up where required. Yet, as of 2016, only 5 Governorates were meant to be covered by nutrition surveys (implemented by MoPHP/UNICEF), and for others, the latest available data dates back to 2012 (Ibb) or 2014 (Lahj). When surveys are conducted, issues remain around the (i) protocol used, (ii) quality of data, and (iii) timeliness of information sharing (out of the 4 SMARTs conducted in 2016, only one report was validated by the AWG and released so far). 

To address this major shortfall, the Nutrition Cluster and Assessment Working Group have identified the need to engage nutrition partners to provide technical support and capacity building support to existing MoPHP survey teams to deliver quality nutrition information for strategic needs estimation and response planning. As leading partner to the Nutrition luster and AWG ACF proposes to provide technical and operational support to MoPHP to conduct nutrition surveys (SMARTs) in 3 priority governorates of Yemen in 2017. This technical support will be provided under the leadership and in close collaboration with the Nutrition Cluster and AWG.