Lifesaving Integrated Nutrition Response to Prevent Maternal and Child Morbidity and Mortality in Priority Districts of Ghor Province The proposed action’s objective is to contribute to reducing child and women morbidity and mortality related to malnutrition by the establishment of Mobile Health Teams (MHTs), support to a Sub-Health Center (SHC) and the establishment of Infant and Young Child Feeding (IYCF) corners in Ghor Province. 

Ghor province is already affected by cycles of heavy armed conflict and natural disaster like drought and heavy rain causing flash floods. The province has very high needs in terms of nutrition, as highlighted in the different IPC reports. Especially the IPC report released in November 2020 identified Ghor as one of the main provinces affected by acute malnutrition. The emergence of the COVID-19 outbreak is also disastrous considering the fragile health system in this province. Finally the winter is a critical period in the province due to its high latitude, low temperature, heavy snow and roads blocked, isolating the province from the rest of the country.

The proposed intervention consists of two axes: 

- The provision of nutrition management services to children under 5 (CU5) and pregnant and lactating women (PLW) suffering from Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM). Management services are key to prevent the mortality of the most malnourished children suffering from SAM are in average nine times more likely to die than their healthy peers.
MAM CU5 and PLW will be admitted into the Supplementary Feeding Programme (SFP), whereas SAM CU5 will be admitted in Outpatient Therapeutic Programme (OTP). AAH will offer the ambulatory SFP and OTP services through two modalities: two MHTs will be deployed to Chaghcharan and Dawlatyar districts, reaching an average of 10 villages each and AAH will hire a Nutrition nurse and a Screener in a BPHS implementer-run SHC in Chaghcharan where a gap in nutrition services has been identified. 

- The provision of IYCF counselling and good care practices sensitization to tackle misconceptions about breastfeeding and enable the healthy development of the infants in their first years. AAH will sensitize on IYCF and good care practices through different modalities: at the MHT by AAH midwife and nurse, through Family Health Action Groups (FHAG) and AAH Community Promoters in the villages targeted by the MHTs (Chaghcharan and Dawlatyar districts), at the SHC by the Nutrition Nurse in Chaghcharan, and at four IYCF and Breastfeeding corners established in Basic Health Centers (BHCs) in Shahrak, Doleena, Pasaband and Lal districts. 

AAH will establish FHAG in the communities targeted by the MHTs. Close coordination will be maintained with these FHAG, AAH Community Promoters and SHC Community Health Workers (CHW) to ensure smooth referrals of detected or suspected MAM and SAM cases to AAH nutrition programs in the targeted locations.

To increase the chances of recovery of admitted SAM and MAM CU5 and PLW, AAH-run MHTs will also offer basic health services particularly targeting these groups: Sexual and Reproductive Health (SRH) consisting of antenatal and postnatal care and family planning services, and Integrated Management of Childhood Illness (IMCI). 

As people with disability (PWD) are also an important part of the community, AAH will ensure that the teams will reach those PWD in the communities and provide them with equal services (based on needs) in the mobile site, in SHC and IYCF Corners supported by AAH. 

AAH is supporting actively the good coordination of humanitarian activities in Afghanistan, especially for the Nutrition Sector through the allocation of a senior staff, with long nutrition experience in different contexts with AAH, for the position of Co-Lead of the Nutrition Cluster. This position will be covered partially by this grant, and AAH is taking the responsibility to cover the remaining months with other sources of funding.