Emergency Nutrition response in 9 Woredas of Sitti, Fafan  Jarar Zones, Somali Regional State Save the Children is proposing an emergency nutrition response project targeting Erer, Shinile, Bike, Gablalu, Harshin, Babile, Koran, Gashamo amp Daror woredas of Sitti, Fafan amp Jarar zone, (all are hotspot priority one woredas). The project is an extension to an EHF funded project in Fafan and OFDA funded project in Sitti zone. Despite the interventions in the areas, the reports still show that the numbers for Sever Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM) cases are still high prompting the need for further intervention. The project will have a duration of nine months with a total budget of US $ 1,250,000 (eight months of direct implementation and one month for finalizing activities and reporting). 
Management of SAM at Stabilization Centers (SC)/ Outpatient Therapeutic Program (OTP): According to the recent Ethiopian Democratic Health Survey (EDHS), the prevalence of global acute malnutrition (22.7%) in Somali Region is the highest of all regions of Ethiopia and much higher than the national average of 9.9%. This has contributed to high rates of acute malnutrition and increases in admissions of children with SAM at OTP and SC. Regional Therapeutic Supplementary Food Programme (TSFP) admissions trend at regional level has increased in all seven zones affected by drought (higher than monthly estimated caseload) with 18% increment compared to the same period last year (16,223 vs 13,268). Some 84,610 acutely malnourished under five children (which 7,403 were in SAM condition) and pregnant and lactating women were (which 7,403 were in SAM condition), identified in a biannual nutrition screening conducted in October 2016. SC SAM admission trend in Erer, Shinile, Harshinamp Babile woredas also show an increasing trend where a total of 1096 cases admitted in the last 6 month. Save the Children will support government health posts and health centers to manage SAM cases through OTP and will refer SAM cases with medical complications to the stabilization center. Children admitted in OTP will attend weekly follow-ups, and treated with Ready to Use Therapeutic Food (RUTF). Annex 1 tables 1 and 2 show selection criteria. 
Management of moderate acute malnutrition (MAM) at TSFP: In priority one woredas (Erer, Shinile, Bike, Gablalu,  Harshin, Babile, Koran, Gashamo amp Daror woredas of Sitti, Fafan amp Jarar zone). 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 the provision of super cereals. Save the Children will sign tri-pirate agreement or FLA with World Food Programme (WFP) for the provision of targeted supplementary foods including OTP discharge rations in all priority one woredas. 
Infant and Young Child Feeding in Emergencies (IYCF-E): Despite the reduction of under-five morbidity and mortality in Ethiopia over recent years, the rate of initiation  of breastfeeding and exclusive breastfeeding has shown less improvement. According to 2016 EDHS, the percentage of exclusively breastfed children has slightly increased from 52% in 2011 to 58% in 2016. Increasing exclusive breastfeeding practices at this time is seen as key in avoiding malnutrition and life-saving, particularly during such emergency time. Mother to mother support groups established at health facilities can be an effective entry point for this. SC will recruit IYCF officers, train midwives to provide skilled and individual support for mothers having trouble with breastfeeding, and facilitate mother-to-mother support group’s establishment at OTP sites.