Emergency assistance to crisis-affected communities of Central African Republic - phase III By joining the consortium led by The Mentor Initiative and funded by FCDO, Action Against Hunger aims to address some of the needs mentioned above through its assistance to the ADH. Action Against Hunger will strive to reduce mortality and morbidity in the communities of the Alindao-Mingala Health District through the improvement of secondary health care and water, hygiene and sanitation conditions at the ADH Health and Nutrition:
-	Action Against Hunger will support the implementation of under-5 children and maternal outpatient consultations as well as hospitalisations for under-5 children, maternity, emergency obstetrical and neonatal care. Action Against Hunger will provide essential drugs, medical and equipment supply, laboratory reagents, data management tools 
-	A hygienic delivery kit will be provided to each pregnant woman giving birth at the ADH.
-	In addition to the payment of bonuses to hospital staff and the operating costs of the structure, Action Against Hunger will provide the ADH with additional personnel, including a doctor, a midwife and a pharmacy manager, in order to improve the quality of care. 

-	Action Against Hunger currently supports the management of Severe Acute Malnutrition (SAM) cases with medical complications through a USAID/BHA funded project that will end on 31st July 2022. Action Against Hunger plans, under FCDO funding, to improve the quality of care of the ADH TFU by strengthening the capacity of health-care personnel on the management of SAM cases with medical complications (TB, HIV, vital emergencies, vital signs) through a 1 day training of 25 health workers, which will be reinforced by the weekly supervision and coaching of the Action Against Hunger staff working at the ADH.

-	In order to improve the quality of care in the paediatric and maternity wards of the ADH, Action Against Hunger will provide training for health care providers on various topics, including blood transfusion, quality and safety and complementary emergency obstetric and neonatal care (SONUC). Moreover, Action Against Hunger will also organise within the hospital, a performance evaluation of the paediatric and maternity services with all the staff every six months. Finally, quarterly formative supervisions will be organised in order to identify needs, to allow for the capacity building of the health-care personnel as well as to ensure the implementation of the previous quarterly review recommendations. 

-	Action Against Hunger will also support the referral of children and pregnant/lactating women from peripheral health facilities to the ADH by : 
1. Covering the cost of transport, either by ambulance or through the reimbursement of transport costs (i.e. with moto-taxis) for the health facilities not covered by Mentor Initiative ;
2. Providing a food ration to hospitalised patients and their caregivers during their stay at the ADH. 

-	Finally, Action Against Hunger will ensure the supply of equipment to the ADH (solar lamps, office supplies, hygiene and maintenance materials) as well as the operation and maintenance of the generators. Action Against Hunger will also carry out small repairs (electrical repairs, plumbing, rehabilitations, etc.) as required.

Water, Sanitation and Health (WASH):
-	Action Against Hunger will provide, with other funds, an emergency water supply from a safe drinking water supply. Thus, thanks to the ADH borehole, Action Against Hunger will ensure a permanent filling of the 20m3 bladder. This operation will be facilitated by equipping the borehole with a submersible pump that will run on a generator regularly supplied with fuel. The pump attendants dedicated to this activity will chlorinate the water before making it available to patients, their caregivers and the health-care personnel. This chlorination will comply with the national and cluster standards for water disinfection with a Residual Free Chlorine (RFC) between 0.2 and 1mg per litre.

-	Action Against Hunger will be in charge of training health care staff, in collaboration with the health district, on IPC standards. These health workers trained on hygiene techniques will then become hygiene focal points in charge of informing their colleagues on any new prevention protocols. 

-	Action Against Hunger will provide the ADH with PPE and IPC kits as well as setup a system for their rational use and management. The Action Against Hunger teams on site and working at the ADH will monitor the use of hygiene materials and equipment (ensuring that there is no waste, the rational use of cleaning products, etc.).

-	For sanitation, Action Against Hunger will carry out quarterly draining of latrines using a membrane pump and disinfecting products while ensuring acceptable conditions of use for these latrines. Hygienists will be in charge of cleaning the latrines and will be equipped with PPE at each stage. A rented skip-truck loaded with a 5m3 bladder will transport the sludge from the latrines to the final dumping site identified by Action Against Hunger in collaboration with the local health authorities Health and Nutrition / 
Targets of the activities: 42,000 residents of Alindao and Mingala will benefit from a functional hospital with improved secondary health care. An estimate of 18,501 persons (7,899 men and 10,602 women) will benefit from direct secondary health care. The staff of Alindao’s district hospital will benefit from training and reinforced capacities in health and nutrition

Water, Sanitation and Health (WASH)/
Targets of the activities: 18,501 patients from the Alindao Hospital will benefit from access to safe drinking water. The staff of Alindao’s district hospital will benefit from training and reinforced capacities in water, sanitation and hygiene.