Malnutrition and cholera response through nutrition interventions in Hajjah governorate Yemen’s conflict and resulting humanitarian crisis have a severe impact on the health status of the population due to a lack of access to income, the aggravating effects of poor WASH services and unsafe behaviors on malnutrition and morbidity, and much of the population having difficulty accessing health and nutrition services. 

To contribute to reducing health and nutrition related morbidity and mortality among vulnerable conflict affected communities in Hajjah governorate, ZOA Int. Yemen seeks to implement a nutrition program. The health coordination mechanism identified Wadrah as a level 5 health cluster priority district, with significant gaps in services. Nutrition and food security concerns are high. 

Consultation with clusters, INGO’s and the MoH, and review of secondary and primary data identified significant gaps in essential health and nutrition service provision in Hajjah. ZOA conducted a health, nutrition, food security and WASH needs assessment in the selected area of the governorate earlier this year, using health facility assessment, community member interviews and focus group discussions. Collected data shows that 95% at community level (Zone 2 and 3) reported not having access to services that manage acute malnutrition. No community level SAM and MAM outreach or follow-up services were available. More general, data showed an urgent need for both health care and nutrition support, with only 2 out of 6 Health Units functioning and children reported to have died by preventable illnesses in the month prior. SMART Survey data of Hajjah Governorate shows a 14.9% GAM rate in lowland and 8.9% in highland areas, with SAM of 2.3% and 0.8% respectively. With the exacerbating factors of cyclical cholera and ongoing conflict, these rates constitute a nutrition emergency.

ZOA has started an emergency nutrition response in July 2018 to provide increased access to essential and qualitative nutrition services for vulnerable communities in Hajjah and Wadrah Districts, Hajjah Governorate. 

In this proposal, ZOA proposed to continue the delivery of these life-saving services, which are currently funded until the end of 2018. This main objective of the proposed project aligns with YHF’s overall objective as well as overall priorities under envelope 1 of the 1st standard allocation 2018. The activities will consist of treatment of SAM in children 0-59 months, MAM in children 6-59 months, and acute malnutrition in PLW. ZOA will also provide health education for mothers/caregivers of infants children aged 0-23 months and do screening of children aged 6-59 months and referral of acute malnutrition to the treatment programs. The nutrition program targets 398 PLW, 2766 girls and 2711 boys and will be implemented at the following health units in Hajjah: Alkanan Kafla Alkaisi in Hajjah District, Ghareb Al Mohmer and Al Kahetenah in Wadrah district. 

ZOA has worked in Yemen since 2012 and has established a presence in Hajjah through ongoing assistance projects. For health and nutrition, ZOA specifically partners with the staff and volunteers of local MoPHP health facilities. The link between ZOA’s nutrition and health activities allows for community outreach, active case finding and referrals of malnourished children through the network of community health volunteers. ZOA will strengthen the capacity of local clinic and community staff who are already linked to MOH, and will ensure that quality services reach the underserved and hard to reach areas. ZOA is an active member of the cluster and  maintains good coordination and collaboration with other INGOs.
ZOA Int. Yemen upholds strong values of accountability to affected populations. From the design stage until the exit phase of the project, ZOA will work in a transparent and accountable manner (to both beneficiaries and the donor) using monitoring tools and feedback mechanisms to ensure appropriate service delivery and protection of beneficiaries.