Emergency Nutrition response in Four  woredas, of Erer and Nogob Zones, Somali Regional State Southern and eastern Ethiopia continue to battle the impact of the Indian Ocean Dipole-induced drought, exacerbated by disease outbreaks, large scale loss of livelihood assets and displacement. The humanitarian situation countrywide has been further compounded by below average spring rains – the third consecutive poor/failed rains in the southern drought belt. To date, the number of people requiring humanitarian food assistance in Ethiopia stands at 8.5 Million. The national ‘hotspot’ classification updated in early July show slight increase in the number of priority woredas (districts) from 454 to 461, nearly half of which (228 woredas) are now classified as ‘priority one’ (very severe). As of June, the worst affected households are facing Emergency (IPC Phase 4) food insecurity outcomes. The drought has resulted in significant livestock losses, greatly reduced access to food, and has driven large-scale displacement. Of the 461 current hotspots, nearly half (228) are considered top priority. In Somali region, out of the total 93 woredas, 83 woredas (90%) are classified as Hotspot 1 indicating highest severity needs for life-saving support. 1.7% of the population are affected by SAM, the most severely affected areas are Dollo, Korahe, Afder, Erer/Nogob and Jarar Zones. The nutritional situation has also been deteriorating rapidly with a caseload of over 376,000 children suffering from SAM - 97,000 of whom are in the Somali region. Some 3.6 million pregnant and breastfeeding women and children under age 5 are projected to develop moderate acute malnutrition (MAM) and 376,000 children under age 5 severe acute malnutrition (SAM) in 2017. The GU assessment conducted in Somali region in June 2017 reports that Malnutrition caseloads are increasing as the drought intensified in nine out of eleven zones in the region. Admission rates in the region show 36,578 SAM cases in the last six months, higher SAM cases from all therapeutic feeding centers compared to 12,610 cases in the period November 2015 to April 2016. Save the Children rapid assessment and other field reports indicate high levels of increasing acute malnutrition trend, absence and weak health care services, poor technical capacity of staff working in the woredas and shortage of routines drugs. Field reports indicate that many health facilities in Nogob amp Erer zone are not functional at all times and they are unable to provide the basic health care services expected from the level of the care. The assessment also found that there is no a regular screening (CHD) in most of the woredas, poor nutrition reporting systems and no clear referral linkages for malnourished cases. This is compounded by lack of standard CMAM AND IYCF-E implementation, monitoring, and supervision guidelines and tools. Given the protracted dry spell, and projected rupture of relief and TSFP pipelines, serious concerns exist that malnutrition rates will deteriorate further in the months ahead unless full food, and nutrition response is secured across the region until the situation improves. Based on the identified gaps in the GU assessment and key recommendations set forth on the Mid-Year Humanitarian Requirement Document, Save the Children propose to implement emergency nutrition response project in Garbo, Hararey, Horashagah amp Wangay woredas (which are identified as hot spot priority number 1) of Nogob amp Erer zones. The project will support the Management of SAM at Stabilization Centers (SC)/ Outpatient Therapeutic Program (OTP) Management of MAM at TSFP: In priority one woredas of Garbo, Horashagah, Hararey and Wangay, SC’s will support TSFP targeting lt 5 years children’s, Pregnant and Lactating Women (PLW) and OTP discharged children with moderate acute malnutrition through supporting EOS screening and provision of super cereals. Save the Children will sign tri-partite agreement with WFP for the provision of targeted supplementary foods including OTP discharge rations in all priority o