Sustaining and Expanding Lifesaving Emergency Nutrition Services Scaled up to Reach Under served Payams in Nyirol County South Sudan The emergency this project will address is life threatening acute malnutrition of children under 5. Children suffering from SAM are nine times more likely to die than their healthy peers. The project will be implemented in Nyirol County rated as IPC 4 Emergency for the February-May period of 2018, with some households likely to deteriorate to IPC 5 Catastrophic during this period (IPC SS Oct 2017, FEWS Net, pg 7). Estimates for Nyirol from October 2017 showed 49,335 IDPs (Populations in Need, Health Cluster Oct 2017). Recent conflict in Waat has added as many as 16,000 new IDPs. 

Nutrition Cluster data shows the U5 GAM rate of 25.7% (3.2% SAM, 22.5% MAM). The county caseloads have been estimated as follows: SAM – 2,679, MAM – 18,839 (Nutrition Cluster HNO Case Load 2018, Oct 2017). CMA’s experience from Nyirol during the final quarter of 2017 showed a proxy GAM rate of 24.2% (8.0% SAM, 16.2% MAM) during the post-harvest season (CMA Report to UNICEF and WFP-2017).

The critical humanitarian gap that needs to be filled is the lack of access to lifesaving nutrition services for the most vulnerable U5 children of unserved IDP populations. The overall objective of this project is to save lives of U5 children suffering SAM and MAM in payams not being served. The payams targeted are Chuil, Pultruk, the unserved population in Pagor of Thol payam and the newly displaced population in Keew near Waat. Areas targeted comprise an estimated 40% of the total population of Nyirol County, and about 56% of the IDP population. 

Overall project objective is to deliver quality lifesaving management of acute malnutrition for the most vulnerable and at risk. This project will reach 846 U5 children with SAM and 3,820 U5 children with MAM interventions. Planned coverage of these life-saving nutrition interventions are 80% of caseloads for U5 SAM and 62% for U5 MAM in targeted areas. 

CMA’s PCA with UNICEF will complement SSHF funding to support project objectives 2, 3 and 4, specifically: (1) increasing access to MIYCN program preventing under-nutrition among the most vulnerable and at risk, reaching at least 60% of PLW in need in high burden areas (2) enhancing nutrition situation monitoring, analysis and utilization of early warning information for timely coordinated response decision making and (3) increasing access to integrated Nutrition and Health services, and access to WASH, FSL, Education and Protection activities in counties with critical levels of global acute malnutrition (GAM ≥22%) and/or in IPC 4.

To achieve these objectives, the project will provide human resources so that each boma has at least 2 community nutrition workers, in-service training for nutrition and health workers, and support to facilitate a robust nutrition outreach and mobile approaches to reach areas where large IDP populations have settled but who are without access to any nutrition services. The project will conduct screening (including screening of U5 children for malaria) and provide treatment services both from the static sites and through 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. The project will make use of combination of responses such as rapid responses and linking static with mobile services to serve inaccessible or hard-to-reach locations where IDPs are concentrated.

Presently, CMA has extended the PCA with UNICEF and FLA with WFP through December 2018. With support from SSHF, CMA will scale-up and expand the reach of current activities to reach unserved IDP populations in Keew, Yawkuach, Diini and Pagor that urgently need services