Provision of Life Saving Health Services in Keich Kuon, Greater Nasir County n line with the Health Cluster’s Strategic Objectives and priorities, Relief International (RI) proposed intervention aims to improve access to essential health care services in Keich Kuon in Greater Nasir County. RI will deploy a mobile team targeting communities with limited access to health facilities. RI currently maintains strong relationships with community leaders and has coordinated with partner agency UNKEA and will undertake a community-based approach to provide complimentary services to scale up ability to respond to leading causes of morbidity and mortality and to manage severe acute malnutrition (SAM) with medical complications. In addition, the proposed intervention will improve ability to detect and respond to epidemic prone diseases through the initiation of community based surveillance system and strengthening of referral pathways.

Through current OFDA and UNICEF funding, RI will support the primary health care center (PHCC) in Keich Kuon to provide comprehensive primary health care services and in-patient therapeutic care for children with severe acute malnutrition with medical complications. RI’s proposed SSHF-funded “provision of life-saving health services in Keich Kon” will compliment RI’s existing programming to increase access to essential health and nutrition services at Keich Kuon PHCC through complementing static service delivery with mobile teams and outreach activities targeting hard-to-reach populations. The mobile team will provide: curative care to both children and adults, reproductive health services (ante-natal and post-natal care, family planning, and referrals for deliveries), immunization, and screening for malnutrition.

To scale up ability to address primary causes of mortality and morbidity, RI will adapt the Ministry of Health’s (MoH’s) Boma Health Initiative (BHI) as a vehicle to provide increased access to essential health services at the community level. RI’s BHI supported by SSHF Round Two funding will also improve health seeking behaviors as well as initiate community-based-surveillance (active and passive) for priority conditions. 

Taking into account the emergency context of that area, it will not be feasible to roll-out the BHI to scale. RI will thus focus on selected components of the BHI which are appropriate for the operating environment and pilot this tailored approach. Lessons of a small-scale BHI to meet emergency operating needs will be used to further refine the program before scaling it up.
 
Community health workers (CHWs) and home health promoters (HHPs) will be recruited from each boma and trained on health promotion, integrated community case management of childhood illnesses (ICCM), reproductive health, and surveillance. As community health workers have a higher level of education and will be working full-time, they will receive more comprehensive training to enable them to supervise home health promoters in each boma. 

Community cadres off CHWs and HHPs will also support with obtaining and tracking vital statistics (including registration of births and deaths) in their communities. Cadres will also collect data on tracking population movement in case of displacement. With strong linkages to the health facility and the mobile team, CHWs and HHPs can effectively trace defaulters from the expanded programme on immunization (EPI) and nutrition programs and track pregnant women for ante-natal, delivery, and post-natal care at Keich Kuon healthcare facility.

Regular monitoring missions, including joint monitoring missions, will be conducted by senior staff to monitor and track progress and achievements in all locations, and coordinate any course corrections as necessary. RI will also consult community members and leaders throughout the project process to ensure accountability to affected populations.