Integrated emergency health and Nutrition response in Somali Region - East Imi in Shebele Zone, Tuliguled and Goljano in Fafan Zone and Ararsso woreda in Jarar Zone Mercy Corps (MC) proposes to respond to lifesaving health and nutrition needs of the community in five woredas where the health and nutrition situation is very critical and the communities in those woredas are highly vulnerable. Both host communities and internally displaced persons (IDP) have been affected by droughts, floods, infectious diseases and the COVID-19 pandemic, which may completely disrupt nutrition and health systems and lead to more crises. The overall objective of the project is to reduce the morbidity and mortality associated with undernutrition and increased illnesses of communities who do not have access to primary health care services and basic nutrition services. Most importantly, efforts will include prevention of COVID-19 through awareness raising of the community and strengthening community level surveillance, coordination at woreda and Zonal level, and supporting logistics for COVID response. Selection of woredas for the project considered the severity of the situation and are among the top priority list based on cluster priorities. In addition, the acute malnutrition caseload and infectious disease burden are significantly high, the capacity of local government actors is limited to manage the current burden and inadequate preparedness and capacity to prevent COVID-19, particularly for IDP sites and people living in remote areas. 

The project will provide management of moderate and severe acute malnutrition and will reach 25,089 participants (CU5 and PLW) through full Community based Management of Acute Malnutrition (CMAM) in all proposed woreda health facilities and outreach sites and provide essential mobile health services for displaced people and communities in hard to reach kebeles of Tuliguled, Goljano and East Imi woredas who cannot access basic health services from existing health facilities. All acute malnutrition cases will be admitted either in outpatient therapeutic programs (OTP), targeted supplementary feeding programs (TSFP), or in stabilization centers for management of medical complications, and counseling on Infant and Young Child feeding in emergency and hygiene promotion. The Mobile Health Teams (MHNT) that will be deployed for Tuliguled, Goljano and East Imi woredas will cover 6 outreach sites in each woreda to serve the displaced peoples affected by recurrent drought, disease outbreak, and floods particularly in East Imi. Social behavioral change communications (SBCC) focusing on COVID-19, improving community surveillance, supporting coordination and logistics at the woreda level.

The intervention comprises the following outcomes:
Nutrition: Implemented in Goljano and Ararso 
Outcome 1: Improving capacity for management AM at facility level 
Outcome 2: Improved services accessibility for IDPs and hard-to-reach areas through MHNT
Outcome 3: SBCC with focus on Infant and Young Child feeding (IYCF-E), prevention of acute malnutrition and hygiene promotion

Health: Implemented in Tuliguled, Goljano and East Imi 
Outcome 1: Diagnosis, consultation and treatment of common diseases with a focus on child illnesses using IMNCI to treat common causes of child mortality 
Outcome 2. Improved maternal health including ANC,PNC, FP  and skilled staff assisted delivery
Outcome 3. SBCC with particular focus on COVID-19 prevention and prevention of other communicable disease
All pregnant mothers who have no/insufficient access to maternal health services at the facility level will get ANC, PNC, FP and safe delivery services

Outcome 2. Improved child health services including immunization and growth monitoring 
All children under five will get immunization services to prevent vaccine preventable diseases starting from birth up to 9 months, until they complete all vaccines, including measles. Vitamin supplementation and de-worming will continue every six months for children who did not receive Vitamin A and de-worming in the last 6 months