Integrated multi-sector response to under nutrition in 5 priority districts of Hodeidah Governorate, Yemen. This project aims at providing an integrated approach against undernutrtion. Hodeidah governorate, and the 5 districts of intervention (Al Suknah, Al Mansuriah, Ad Durayhimi, Ad Mighlaf and Ad Dahi), have been selected as part of the priority areas presented by the Nutrition Cluster, and as the current area of intervention of Première Urgence - Aide Médicale Internationale (PU-AMI), for nutrition, health and food security activities. Indeed, PU-AMI has been implemented food security, nutrition and health activities in Hodeidah for several years and has extensive knowledge of the context and stakeholders.

The approach is to provide services in hard to reach areas, in nutrition, food security and health, to Children Under 5 (CU5) and Pregnant and Lactating Women (PLW) affected by severe acute malnutrition. The beneficiaries for all activities are part of the same catchment population, for a solid integrated approach.

PU-AMI will:

PREVENT MALNUTRITION:
- With a Food for Training Program, PU-AMI will contribute to increase the diet diversity and the nutrition knowledge of the targeted households. These beneficiaries will be selected according to the SAM and MAM cases in the household, using the Community-Based Management of Acute Malnutrition (CMAM) database as one indicator. They will benefit from conditional food distribution for their household after receiving trainings regarding diet diversity, food processing, production of highly nutritious vegetables. These trainings will also encourage beneficiaries to produce highly nutritious and diverse vegetables.
- Community awareness on malnutrition will be reinforced through a network of Community Health Volunteers (CHV), as well as Mobilizers within Mobile Health and nutrition Teams (MHT), who will conduct sensitization sessions among these hard to reach communities.
- In 2 facilities not currently implementing MAM activity, identified by the Nutrition Cluster, PU-AMI will reactivate MAM prevention and treatment by having a Blanket supplementary feeding programmes (BSFP) for children under two (CU2) to prevent malnutrition.

MANAGE AND TREAT SEVERE ACUTE MALNUTRITION:
- PU-AMI will implement Mobile Health and nutrition Teams (MHT), in the level 3 areas, for villages that have no direct access to health and nutrition facilities. The MHT provide nutrition services such as Outpatient Therapeutic Programme (OTP) and Supplementary Feeding Programme (SFP) for CU5 and PLW, as well as treatment of child illnesses, pre and post-natal care, and vaccination. These previous services (Integrated Management of Childhood Illness (IMCI), Antenatal Care (ANC)/ Postnatal Care (PNC), vaccination), if considered as health activities, are however targeting CU5 and PLW, in the response to undernutrition.
- PU-AMI will train and supervise Community Health and nutrition Volunteers (CHV/CHW) to manage screening, referral and follow-up of SAM/MAM cases. This network inside the community, also in hard to reach areas, is crucial for the scale-up of referral and reduction of defaulting.
- In 2 health facilities, the management of MAM will be activated by running a SFP for CU5 and PLW, as it's not currently working in these health facilities.

REINFORCE CAPACITIES OF COMMUNITIES AND AUTHORITIES
- In each MHT, PU-AMI will provide technical supervision and build capacity of the Government Health Office (GHO) staff (midwifes, nurses and vaccinators).
- The CHV will be trained on CMAM and Infant and Young Child Feeding (IYCF), enhancing the communities' knowledge on nutrition prevention and response.
- Government Health Workers, currently working in health facilities of these 5 districts, will be trained on CMAM to build their capacity on undernutrition response.
- In 2 health facilities, in addition to activating SFP for MAM CU5 and PLW, PU-AMI will provide technical and logistical support to the staff and will provide nutrition commodities.

NB: Please refer to the footnotes in each sheet