Sustaining and Expanding Lifesaving Emergency Nutrition Services Scaled up to Reach Underserved Payams in Nyirol  Fangak Counties South Sudan The emergency this project will address is life threatening acute malnutrition of children under 5. Children suffering from SAM are nine times more likely to die than their healthy peers. The project will be implemented in Nyirol and Fangak Counties rated as IPC 4 Emergency and IPC 3! Crisis where some households likely to deteriorate to IPC 5 Catastrophic by September (IPC SS Apr 2018, FEWS Net, pg 4). The estimated a total of IDPs in Nyirol is 49,335 IDPs and 28,200 in Fangak. These counties have been rated as Severity of Need Level 4 and Level 5 respectively (South Sudan HNO 2017, UNOCHA pg 10). 

Nutrition Cluster data shows the U5 GAM rate of 25.7% (3.2% SAM, 22.5% MAM) in Nyirol and 15.8% (2.9% SAM, 12.9% MAM)in Fangak. The caseloads are: Nyirol, SAM – 2,679, MAM – 18,839 and Fangak, SAM – 3,011, MAM – 13,394 (Nutrition Cluster HNO Case Load 2018, Oct 2017). 

The lack of access to lifesaving nutrition services for the most vulnerable U5 children of unserved IDP populations is the critical humanitarian gap this project will fill. It will save lives of U5 children suffering SAM and MAM in payams not being served. The payams targeted are Chuil, Pultruk, and Pading in Nyirol and Manajang, Pulita, Mareang and the boma of Pakan in Fangak. The gap this project will fill is to reach any new IDPs displaced by conflict and seasonal floods through outreach and mobile units, and to reach unserved bomas (in Pading and Yawkuach, Pathiel of Chuil payam in Nyirol and Tangnyang, Pulken, Kamel, Palei of Manajang Payam, Rupkota, Kurdeng of Pulita Payam and Pakan in Phom payam in Fangak). Areas targeted comprise an estimated 55% of the total population of targeted counties, and about 52% of the IDP population. This project will reach 2,220 U5 children with SAM and 5,170 U5 children with MAM interventions. Planned coverage of these life-saving nutrition interventions are 80% of caseloads for U5 SAM and 62% for U5 MAM in targeted areas. 

CMA’s PCA with UNICEF and FLA with WFP will support complementary objectives specifically: (1) increasing access to MIYCN program preventing under-nutrition among the most vulnerable and at risk, reaching at least 60% of PLW in need in high burden areas (2) enhancing nutrition situation monitoring, analysis and utilization of early warning information for timely coordinated response decision making and (3) increasing access to integrated Nutrition and Health services, and through high effort to collaborate and coordinate with local humanitarian actors, integrate to increase access to WASH, FSL, Education and Protection activities where GAM is ≥ 15%.  

To achieve these objectives, the project will provide human resources so that each boma has at least 2 community nutrition workers, on-the-job training, and support to facilitate robust outreach through mobile units in each county to reach areas where large IDP populations who are without access to any nutrition services. The project will conduct screening (including screening of U5 children for malaria) and provide treatment services both from the static sites and through mobile services. To ensure women and children have unimpeded access to nutrition services, communities will be organized to protect vulnerable women and children so they can consistently access nutrition services. The nutrition services of this project will be fully integrated with CMA’s health services sharing human, facilities and transportation resources. The project will make use of combination of responses linking static with mobile services to serve hard-to-reach locations where IDPs are concentrated.

Presently, CMA has extended the PCA with UNICEF and FLA with WFP through December 2018. With support from SSHF, CMA will scale-up and expand the reach of current activities to serve IDP and host populations in payams of Chuil and Pading in Nyirol, and Manajang, Pulita, Mareang payams and the unserved boma of Pakan in Fangak