Envelope 1: Provide integrated lifesaving / preventive nutrition, water, sanitation and hygiene interventions for children and women in need, in 95 high-priority districts from 15 governorates in Yemen The conflict in Yemen has taken a devastating toll, particularly on the most vulnerable members of society: children. It is estimated that 2.1 million children under 5 -including 385,000 children suffering severe acute malnutrition (SAM) - and 1.1 million pregnant or lactating women (PLW) currently require life-saving nutrition services to treat acute malnutrition. These numbers are based on the findings of the Emergency Food Security and Nutrition Assessment (EFSNA) 2016 and SMART Surveys undertaken in the later part of 2016 and during 2017. Levels of acute malnutrition in the country are likely to increase as a result of the continuing economic crisis, growing food insecurity, ongoing conflict, decreasing access to safe water and sanitation, declining availability of health services (further aggravated by non-payment of salaries to health workers for the past year) and because of the massive outbreak of cholera/acute watery diarrhea (AWD). Since March 2015, a large number of fixed health facilities have stopped delivering services at a time when fuel shortages and expensive transportation also challenges access to services, especially in rural and suburban areas. Weak coverage of moderate acute malnutrition (MAM) services is one of the causes of the increasing number of SAM cases.
Providing urgent lifesaving interventions for severely acute malnourished children is a priority for the Yemen Humanitarian Country Team (YHCT). The Humanitarian Response Plan (HRP) 2017 sector target is to treat 323,000 severe acute malnutrition cases. This project will contribute considerably towards this objective, in line with the YHRP 2017 objective: Deliver quality, life-saving interventions for acutely malnourished girls and boys and pregnant or lactating women.
The Nutrition Cluster Community Management of Acute Malnutrition (CMAM) Scale up Plan outlines the collective effort to address lifesaving nutrition programmes including active case finding (screening and referral of children U5 and PLWs), treatment of moderate and severe acute malnutrition, micronutrient supplementation, and Infant and Young Child Feeding (IYCF) counselling.
The proposed project will focus on addressing the growing risk of famine in Yemen, targeting the most vulnerable individuals living in 95 Priority 1 districts, as per the Nutrition and Food Security cluster joint prioritization - based on Global Acute Malnutrition (GAM) rate (more than 15%) - and percentage of Food Insecure Population (more than 20%), according to the current IPC classification and EFSNA/ SMART survey data.
In targeted districts, 30,000 malnourished children under 5 will benefit from nutrition and water, sanitation and hygiene (WASH) integrated services provided at health facilities and via mobile teams. Identified children will receive the essential nutrition supplies needed for their treatment in addition to consumable hygienic kits - received twice during the treatment course. WASH supplies will supplement nutrition interventions while contributing to the improvement of the hygienic conditions at household level. This is particularly relevant considering that diarrhea - and other water-borne diseases - caused by poor sanitation, lack of hygiene, and unsafe drinking water, are among the leading causes of child death, and inhibit nutrient absorption leading to starvation even if sufficient nutrition is consumed. Furthermore, malnutrition also reduces a child’s resistance to subsequent infections. 
The proposed project will have a duration of 12 months and is part of integrated lifesaving interventions in Yemen. The procured supplies will be used by all implementing partners, through government or NGO partners.