Emergency Nutrition Response in Ethiopian Somali Region: Jarar Zone, Dig and Yo'ale Woredas; Shabelle Zone, Abakorow and Ber'anno Woredas Mercy Corps (MC) proposes to support the most vulnerable populations affected by drought in Yo’ale and Dig woredas of Jarar Zone and Ber’ano and Abakorow woredas of Shebelle Zone in Somali Region. The overall objective of the project is to contribute to the reduction of morbidity and mortality related to acute malnutrition -in the target woredas.

The six- month project will target severely and moderately acute malnourished children below five years (U5) and pregnant and lactating women (PLW) using the Community Based Management of Acute Malnutrition (CMAM) approach including Mobile Health Nutrition Teams in each of the woredas. A WASH component promoting five critical handwashing times has been included to prevent communicable disease break vector cycles associated with acute watery diarrhea (AWD) a phenomenon which is affecting most woredas of Somali region.

MC aims to  reach 12,281 beneficiaries ( U5 and PLW) by implementing the full CMAM continuum of care which includes community mobilization, Outpatient Therapeutic Program (OTP), Stabilization Center (SC), and Targeted Supplementary Feeding Program (TSFP) to address severe and moderate acute malnutrition (MAM) for U5 and MAM for PLW.  The TSFP program will rely on the TSFP commodity availability pipeline from WFP  which currently provides for P1 woredas only.  Every admitted beneficiary will receive counseling on Maternal Infant and Young Child Nutrition (MIYCN) and personal and household level hygiene.

The intervention comprises  three  components:  
SCs will support delivery of inpatient care treatment for children suffering from SAM with medical complications (an estimated 10% of SAM cases). Children referred to the SCs will receive intensive medical care 24 hours a day until stabilized – this includes management of complications, treatment for underlying infection, and the provision of therapeutic food. Once stabilized, children will be discharged to the OTP nearest to their home. All children less than 6 months of age with signs of visible wasting or edema will be treated in the SC.  
OTPs will deliver comprehensive outpatient care for children with uncomplicated SAM.  Children will be assessed and if their  MUAC is lt11cm or if they have oedema of both feet and passing appetite test they will be admitted in OTP. Upon entry, children will undergo a routine health assessment, treatment for underlying infections and receive a one-week supply of Ready to Use Therapeutic Food (RUTF). Weekly thereafter, for static clinics, patients will return for a medical assessment and additional one week supply of RUTF. Other medicines and micronutrients like de-worming drugs, vitamin A capsules, folic acid and antibiotics, will appropriately be given as per the Emergency Nutrition Response guidelines. Upon discharge, children will be referred to a TSFP program for 3 months to prevent recurrence of malnutrition. The project team and two Health Extension Workers (HEWs) will form the Mobile Health and Nutrition Team which will address the hard to reach areas and provide weekly support and supervision and on the job capacity building for all static OTPS and SCs.  TSFP: will be attached to each of the OTP sites to treat MAM U5 and PLW with children less than 6 months old. Patients will be screened and admitted when their Mid Upper Arm Circumference (MUAC) is between 11 to 12.0 cm (U5) and less than 23 cm for PLW. The MAM admitted beneficiaries wwould be monitored on a monthly basis. Enhanced Outreach Services (EOS) and MC’s active case finding, according to national guidelines, will be used to identify and admit beneficiaries. MC will get TSFP supplies from WFP supply chain for MAM beneficiaries. 
Mobile Health Nutrition Teams (MHNT): One MHNT will be deployed per woreda to provide emergency health and nutrition services to areas which currently do not have functioning health facilities.  The MHNTs will be aligned with Regional Health Bureau criteria.