Emergency Response to reduce morbidity and mortality associated with critical rates of Global Acute Malnutrition amongst under-five children in IDP populations  of Helmand Province In line with the Humanitarian Response Plan 2016, and the 2nd allocation strategic priorities, ACF proposes to launch an intervention targeting the most vulnerable households of Mukhtar IDP Camp, Lashkar Gah, Helmand province. While the ongoing conflict in the province has recently brought thousands of families in the provincial capital fleeing the violence, this settlement, populated by IDPs since the last 15 years, displays alarming levels of poverty compounded by high rates of malnutrition, exposure to critically bad health conditions and a dire lack of sanitation infrastructures. Part and parcel of the provincial capital, and hosting more than 25,000 people, this settlement has scarcely benefitted from public spending on infrastructure and services to the population. Its density, exposure to new influx of population due to ongoing conflicts, and the lack of awareness in terms of health, nutrition, sanitation and care practices make up for an extreme vulnerability of most of its inhabitants.

The proposed intervention builds on an integrated WASH and Nutrition approach aimed at effectively tackling the main causes of child deaths in the area, i.e. diarrheal diseases and acute malnutrition. The overall objective and approach envisioned both fits in ACF general mission strategy and agreed framework for intervention which are geared towards reducing excess morbidity and mortality amongst children under-five, and support integrated programming. The focus on WASH and Nutrition, in addition to aligning with national humanitarian priorities (see above), corresponds to ACF fields of expertise: in Afghanistan as worldwide, ACF is recognized for its technical know-how and field experience in successfully implementing Nutrition and WASH humanitarian projects. In country, ACF is one of the leading members of the WASH and Nutrition Cluster.

The proposed approach was selected after thorough assessment of needs, and on the ground capacity of humanitarian actors to respond. While the scope of needs appear close to or exceeding international emergency thresholds (i.e. for prevalence of Global Acute Malnutrition) there is currently no organization present in Helmand with the capacity to provide appropriate response, whether for lack of relevant technical expertise, or financial resources. To account for the severity of the situation, ACF opted for a two pronged approached of direct implementation/substitution to actors in charge of delivering WASH (i.e. the government) and Nutrition (the local NGO responsible for implementing the basic package of health services) services however building on the (scarce) existing local capacity.   
In the sector of Nutrition, ACF will refer all MAM cases to WFP’s local partner for MAM services in Helmand Province (ACTD). ACF proposes to complement the resources of ACTD, the NGO responsible for implementing the basic package of health services in the area to (i) increase the quality of SAM treatment, and (ii) expand the coverage/outreach of these services.

The proposed WASH activities in this project are considered to be the most appropriate and linked to nutrition hence contributing strongly to the overall nutrition objective of this project as well as the strategic objectives of the nutrition cluster and the humanitarian response plan 2016.
ACF intends to support 4 sub-villages within Mukhtar IDP settlement with integrated health, nutrition and WASH interventions. In these settlements ACF will establish 1 mobile team to provide health and nutrition services, provide support to the CHC covering the settlement with nutrition and health training to the staff and regular monitoring and supervision to strengthen service delivery, , provision of Bio sand filters to 1000 vulnerable families, provision of community sensitization sessions and provision of 2000 hygiene and menstrual kits to women in the targeted communities. 
The project duration is expected to be 12 months starting from October 2016.