Lifesaving Emergency Nutrition Services Scaled up to Reach Unserved Payams in Fangak County in South Sudan The project will be implemented in Fangak County rated as Severity of Need Level 5, for nutrition (SS HNO 2017, UNOCHA pg 23) and IPC 3 Crisis (IPC SS February 2017, FEWS Net, pg 3). Estimates for Fangak show a total of 76,200 IDPs. Based on a GAM rate of 17.2% (3.4% SAM, 13.8% MAM), the county caseloads were estimated as follows: U5 SAM – 2,034, U5 MAM – 8,254 and PLW MAM – 3,095 (Nutrition Cluster HNO Case Load 2017). CMA’s experience from Fangak during the final quarter of 2016 showed SAM and MAM admissions rose by 62% even in the post-harvest season (CMA Report to UNICEF and WFP). Screening of 1,157 U5 children conducted in Manajang and Paguer payams during February 2017 showed a proxy GAM rate of 38.2% (12.1% SAM, 26.2% MAM). This data could indicate that the original Nutrition Cluster estimated caseload is low.

The critical humanitarian gap that needs to be filled is the lack of access to lifesaving nutrition services for the most vulnerable U5 children and PLW of unserved IDP populations. The overall objective of this project is to save lives of U5 children and PLW suffering SAM and MAM in payams not being served. The payams targeted are Barbuoi, Manajang, Mareang, Paguer and New Fangak. Areas targeted comprise an estimated 58% of the total population of Fangak County, and 61% of the IDP population.

Project objective 1 is to deliver quality lifesaving management of acute malnutrition for the most vulnerable and at risk. This project will reach 616 U5 children with SAM interventions, 2,523 U5 children with MAM interventions and 1,312 PLW with MAM interventions. Planned coverage of these life-saving nutrition interventions are 75% of caseloads for U5 SAM and MAM and 60% of PLW caseload in targeted areas. 

Project objective 2 will increase access to integrated programs preventing under nutrition for the most vulnerable and at risk children. Project objective 3 will ensure enhanced needs analysis of nutrition situation and enhanced monitoring and coordination of emergency nutrition response. And project objective 4 will increase access to safe and integrated nutrition, FSL, health and WASH responses in payams with critical levels of acute malnutrition. Under these objectives, the main activities will include linking beneficiaries with BSFP delivered by NPA, increasing coverage of Vitamin A supplementation and deworming of children, delivery if IYCF interventions, sharing monthly nutrition reports with collaborating humanitarian actors, and increasing coordination/integration of nutrition programming with health, FSL and WASH programming.

To achieve these objectives, the project will provide human resources (cost-shared with the UNICEF/WFP), in-service training for nutrition and health workers, and support to facilitate a robust nutrition outreach approach to reach areas where large IDP populations have settled but who are without access to any nutrition program. The project will conduct screening (including screening of U5 children for malaria and providing iron folate for PLW) and provide treatment services both from the static sites and through mobile outreach services. To achieve gender equality in opportunity to access nutrition services, communities will be organized to protect vulnerable women and children so they can consistently access nutrition services. The nutrition services of this project will be fully integrated with CMA’s health services in the same locations sharing human, facilities and transportation resources. 

Presently CMA has a PCA with UNICEF and FLA with WFP. UNICEF assistance focuses on SAM of U5 children while WFP provides supplies for MAM of U5 children and PLW.  UNICEF assistance also covers activities to prevent undernutrition. With support from CHF, CMA will scale-up and expand the reach of current activities to reach unserved IDP and host community populations that urgently need SAM and MAM services.