Provision of comprehensive (preventive and curative) nutrition and health services for vulnerable children under 5 and PLWs in Akkar and North Lebanon, and conducting a SMART survey at national level (8 Governorates + the Camps). 

8 Health facilities be targeted in 19 localities as follows: 
1- (Saint paul comprehensive services) -, Akkar district 
2- (Prince Medical Center) Akkar district 
3- (Bashir and Amira Al Khoury Merhi Medical Center) Bcharre district, 
4- (Meziara charity dispensary) - Zgharta district,
5- (Tannourine PHC Center) - El Batroun district, 
6- (Deir amar municipality dispensary) - El Minieh-Dennie district
7- (Al Rahma Health Center - Qalamoun) - Tripoli subdistrict
8- ( Alazm wassadeh zahriyeh dispensary), Tripoli subdistrict This Project is designed to provide life-saving nutrition services in poor neighborhoods with high density of Lebanese and Migrants in vulnerable situation through both community and facility-based interventions including:
1.Infant and young child feeding (IYCF) practices optimization, micronutrient supplementation distribution, and reporting of blanket distribution of Infant formula
2. Screening, referral, and treatment of malnutrition (SAM without complications and MAM) among children under 5 and PLW 

Moreover, an assessment of the nutritional status of children aged 6-59 months in order to generate information for an improved response by conducting a SMART survey. The SMART survey will be conducted at national level across all 8 Lebanese Governorates + the camps. The overall objective of the survey is to conduct a nutrition assessment representative at the national and governorate level to determine the nutrition status of children under 5 years of age, maternal nutrition status for pregnant and lactating women as well as critical IYCF practices. The survey results will be used to derive recommendations needed to inform the nutrition sector response in the country.

The project will be implemented by Mercy-USA in cooperation with the sub-IP BASMEH amp ZEITOONEH in the North and Akkar Governorates. The project will target 41,237 people (Host communities, Syrian Refugees, PRS/PRL and migrants) disaggregated as follows:
- 15,956 Pregnant and Lactating Women (PLWs)
- 25,281 Children under 5 (13,002 girls - 12,279 boys)

19 localities will be targeted through the support which will be provided to 8 Non-supported Primary Healthcare Centers(PHCs) in high populated areas in the targeted Cadasters (List of pre-selected PHCs is attached to the proposal).The targeted PHCs were identified according to:
1-The list of non-supported PHCs shared in the allocation paper
2-The need assessments conducted by Mercy-USA 
Note: The selected PHCs could be changed based on MoPH guidance, and based on the evolving situation needs in terms of humanitarian assistance.

6 outreach staff (3 IYCF counselors and 3 Community Health Workers) will be based out of each PHCs to provide visual screening, referrals and IYCF services for PLW and children under 5. These outreach teams will work in parallel and direct coordination with the selected health facilities in the targeted areas. 

Staff will assess the nutritional status of children under 5 and distribute nutritional supplies to them as needed. Additionally, IYCF services will be provided through:
- IYCF sessions
- Counseling PLWs and caregivers of children under 24 months of age and providing messages on IYCF recommended practices to mothers who have malnourished children
- Promoting timely initiation of breastfeeding, exclusive breastfeeding and introduction of safe, age appropriate and nutrition diversified complementary food (including related hygiene messaging)
- Provision of Skilled Infant and Young Child Feeding (IYCF) counselling and support to for breastfed and non-breastfed children under 6 months of age
- Distributing micronutrients and nutrition supplies for the PLWs and children 
- Reporting breast milk substitute distribution to the cluster  

A pre and rapid coordination combined with referrals will be put in place whenever the team identifies any sign of abuse or violence among children under 5 and or mothers. All cases of violence against women and children will be referred to the pre-identified health facility and signaled to the relevant sector.

This response will adopt the safety recommendations in the COVID-19 context.

This project will empower mothers and HH members through training them to screen their own children for malnutrition by teaching them how to use color-coded Mid-Upper Arm Circumference (MUAC) tapes.