Integrated Nutrition and WASH Response for Acutely Malnourished Children 6-59 months, Pregnant and Lactating Mothers in targeted Districts of Maarib, Saada and Hodeida Governorates in Yemen Global Acute Malnutrition (GAM) Rates are reported to be above critical emergency threshold (gt15%) in the targeted locations. In response, this is a multi-sector (Nutrition/WASH) live-saving project designed to support Ministry of Public Health amp Population (MoPH) implement an integrated Community Based Management of Acute Malnutrition (CMAM) program  in Harib, Marib City amp Marib districts in Maarib Gov, Alhujjaylah district in Hodeida and Hydan District in Saada Gov in 59 targeted HFs. WASH interventions will ensure that CMAM beneficiaries have access to safe water, appropriate latrines amp hand-washing facilities, hygiene promotion key messages amp appropriate waste management in all the 59 HFs (nutrition distribution centers). The project will also address the causes of under-nutrition e.g. poor Infant and Young Child (IYCF), poor hygiene  Practices, poor micro-nutrient supplementation amp low deworming coverage.
In the 3 targeted districts of Maarib where a total of 40 temporary HFs have been closed, IRY will recruit 3 Mobiles Teams (MTs) one in each district comprising of 1 Team Leader, 1 Nurse amp 1 Midwife who will offer CMAM interventions, hygiene promotion amp other key primary health services by visiting the sites once per month. 2 Community Health Volunteers (CHVs) will be recruited amp trained in each site to support the MTs.  In Hydan, this project will address the existing gaps in 15 HFs (9 are newly opened) by supporting MoPH to implement CMAM interventions as well as provision of other key primary health care services. In Al Hujayllah, the funds will seek to address the existing gaps in 4 HFs in the on-going CMAM interventions under WFP funded project more-so in supporting MoPHP in reaching the uncovered malnourished cases in level 2 and 3 villages through mobile teams approach.
Key WASH interventions will comprise of rehabilitation of 59 water systems, construction of 59 hand-washing points, provision of 118 cleaning kits amp 118 solid waste bins to all HFs, provision of 12,253 Jerry-cans to HHs with CMAM beneficiaries, distribution of 2,241 hygiene kits to HHs with SAM cases, water quality analysis amp treatment, establishment amp training of 59 water management committees (WMCs)  and promotion of hygiene practices. Priority will be given to HHs with malnourished cases to implement hardware activities through CFW program. 
Key nutrition interventions will be recruitment of 1 HW per HF (to roll out the lacking CMAM components) amp 2 CHVs, CMAM and IYCF trainings for HWs amp CHVs, transportation of nutrition supplies, provision of furniture to new HFs, provision of routine medicines, provision of preventative services (micro-nutrient supplementation, deworming, Iron/Folate supplementation to PLW as well as promotion of hygiene practices). Both the MTs (in Maarib) amp recruited HWs will be responsible for providing all CMAM services for children 6-59 months with SAM amp MAM at HFs amp at community levels i.e. nutrition screening, admission into TSFP amp OTP, immunization, Vitamin A supplementation, Fe/Fo supplementation to PLWs, deworming, Zinc supplementation for diarrhea cases, hygiene promotion amp other key primary health services. In Al Hujayllah where we have 25% unmet need , high defaulters rates amp absenteeism the HWs will be facilitated to conduct monthly outreaches in hard-to-reach areas-level 2 amp 3 villages.To strengthen community sensitization on malnutrition, active amp passive screening, referral systems amp defaulter tracing mechanisms, the project will recruit 2 CHVs at level 2amp 3 villages who will also disseminate key IYCF/Hygiene key messages during health promotion sessions.