Emergency nutrition and health services for conflict-affected populations in 14 sites of Birao sub-prefecture, Vakaga, CAR IMC will implement emergency integrated and targeted primary health and nutrition services in the Vakaga prefecture. Programming will be implemented across 14 sites (11 of which are outpatient therapeutic programs (OTPs) and three of which are both OTPs and stabilization centers (SCs)) and will provide targeted health and nutrition community outreach and support to health facilities for service delivery and capacity building. These sites include Birao, Ouandja, Delembe, Boromata, Vodomassa, Bamara, Koumbal, Takamala, Aiffa, Tiringoulou, Gordil, Sikikédé, N’Diffa and Mele. Among these sites, there are three SCs located in Sikikédé, Tiringoulou, and Birao Hospital.


IMC will continue existing activities funded by the Humanitarian Fund (HF). These activities include support to and management of SCs and OTPs which provide therapeutic treatment for severe acute malnutrition (SAM) cases with and without medical complications respectively ongoing infant and young child feeding (IYCF) promotion and counselling to encourage healthy feeding practices, as well as integrated outreach in communities to promote important health and nutrition messages. IMC will also provide treatment for moderate acute malnutrition (MAM) as part of this program's routine activities, depending if WFP is able to provide the required inputs. A network of community health workers (CHWs) will provide counselling as well as defaulter tracing and active case-finding to improve the scope and reach of the program. The project targets 835 SAM cases and 1200 MAM cases.

At 10 of the 14 targeted health facilities, IMC provides health facility support as part of a Bêkou-funded project. Hence, IMC proposes to also provide direct health support for the four other health facilities in the form of pharmaceutical supplies and other equipment, staff supervision and trainings, and incentive payments. This program will contribute to reducing morbidity and mortality by providing nutrition and health services through static and outreach approaches, which would otherwise be non-existent in the region. These approaches will balance the urgent need to improve health outcomes with longer-term capacity building that will strengthen the local health.

Surveys conducted by IMC have shown that a majority of women received advice about IYCF and know about good practices, but that they often do not implement them. In order to address this, IMC will also increase the frequency of culinary demonstration based on local foods available locally to most of household and cooperate with Triangle in order to integrate the families identified as the most vulnerable in their household garden program. 
In preparation for the lean season,  IMC  will operate  to promote  health and nutrition preventative activities  to strengthen the nutritional  status of children ( mosquito net distribution, catch up  immunization  campaign  and vitamin A supplementation. In addition, IMC will explore the opportunity to implement blanket supplementary feeding for children aged 6-23 months during this period. 
IMC  will advocate  for extra funding to conduct  a study on  the barriers to the implementation of IYCF practices that have an impact on the nutritional status of children. 

Regarding the support costs of the project, IMC designates a percentage of support costs to each grant in accordance with the level of support required for the grants successful implementation. IMC in CAR currently allocates at least 20% of support costs to each of the other donor programs. Although the extremely challenging operational environment in Vakaga demands a higher degree of involvement from the support structure per dollar than other project areas, due to the smaller scope of this project, IMC was able to reduce those support costs to 10%. However, in order to ensure the support needed to achieve the objectives laid out in this proposal, it is not possible to further decrease this amount.