Malnutrition and Cholera Response through Health interventions in Hajjah governorate The conflict in Yemen and resulting humanitarian crisis have a severe impact on the health status of the population due to a lack of access to income and food, the aggravating effects of poor WASH services and unsafe behaviors on malnutrition and morbidity, and much of the population having difficulty accessing health and nutrition services. Only 50% of the health system is functional (HNO 2018) and due to public budget deficit, health staff have not been paid. UNOCHA reports that 9.3 million people are in acute need of health care. The provision of medical supplies for routine programming and outbreak response is a main constraint. This lack of access to quality services must be urgently addressed to stem the cumulative deteriorating effect on people’s lives. 

With the overall goal of contributing to reduction in health and nutrition related morbidity and mortality among vulnerable conflict affected communities in the target areas in Hajjah governorate, ZOA Int. Yemen seeks to implement a health program as proposed in this document. The health coordination mechanism identified Wadrah and Hajjah rural districts as a level 5 health cluster priority districts, with significant gaps in services (including emergency GAM rates and recent outbreaks or fatalities due to preventable diseases). 

Consultation with clusters, INGO’s and the ministry of health, and review of secondary and primary data identified significant gaps in essential health and nutrition service provision in Hajjah. ZOA conducted a health, nutrition, food security and WASH needs assessment in the selected area of the governorate earlier this year. Collected data shows that only 2 of 6 Health Units were functioning, 2 clinics had structures but were not operational due to a lack of supplies, medicines and staff. None of the clinics had MAM, IMCI, ANC/PNC services. No staff had received salaries in the 3 months prior. None of the clinics had access to safe water or a fixed cold chain in place. 30% of people interviewed reported that there had been 1 or more U5 deaths in the month prior to the assessment, caused by diarrhoea, malnutrition and diphtheria. Recall morbidity data (14 days) of the SMART Survey of Hajjah Governorate shows that 54.7% and 61.3% of assessed children in lowlands and highland respectivelyhad illnesses caused by more than one disease. Main needs identified by the communities were water followed by health care.

Considering the above, ZOA has started a health and nutrition response in July 2018 to provide increased access to essential and qualitative services for vulnerable communities in Hajjah Rural and Wadrah Districts. In this proposal, ZOA proposes to continue the delivery of life-saving health services at 3 health facilities, currently funded until the end of this year. This main objective of the proposed project aligns with YHF’s overall objective as well as overall priorities under envelope 1 of the 1st standard allocation 2018.

ZOA has worked in Yemen since 2012, has established a presence in Hajjah through ongoing assistance projects, and has a national and expatriate staff team on the ground. The proposed project will involve collaboration with the existing health system. For health and nutrition, ZOA specifically partners with the staff of local MoPHP health facilities and community health volunteers. ZOA will strengthen the capacity of local clinic and community staff who are already linked to MOH, and will ensure that quality services reach the underserved and hard to reach areas. ZOA is an active member of the cluster and to avoid duplication, ZOA maintains good coordination and collaboration with other INGOs in Yemen.

ZOA Int. Yemen upholds strong values of accountability to affected populations. From the design stage until the exit phase of the project, ZOA will work in a transparent and accountable manner (to both beneficiaries and the donor) using monitoring tools and feedback mechanisms to ensure appropriate servi