Integrated Response to Life-Threatening Malnutrition in Twic East County of Jonglei State, South Sudan. Project Summary :	The overall objective of this project is to provide lifesaving emergency nutrition services, thereby contributing to reduction of morbidities and mortalities associated with malnutrition amongst under-five children and pregnant and lactating women in Twic East county, Jonglei state.

The proposed project aims to support the County Health Department (CHD) deliver high quality service of Targeted Supplementary Feeding Program (TSFP) across each Payam to prevent unnecessary child mortality during the long hunger gap in drought affected areas and to prevent further deterioration of children and PLW with moderate acute malnutrition. 

Tearfund will conduct screening, admissions and treatment of SAM and MAM cases through 8 OTPs, 8 TSFPs and 2 SCs across Twic East County. The project primarily aims to target 1904 (400 in OTP and 1504 in TSFP) children under five and 1,723 Pregnant and Lactating women (PLW) through the intervention. Tearfund will also rehabilitate 3 OTP/TSFP sites and 1 SC, located in Maar (SC and FC), Wanglei (FC) and Dukchut (FC), reinforcing and ensuring that quality programming can continue. The proposed response also contains an IYCF component mothers will receive counselling on topics including early initiation of breastfeeding and appropriate feeding practices. This will be conducted both on an individual level at the feeding centres, as well as through mother-to-mother support groups that have been formed and are already actively working. While the individual approach ensures that counselling can be more focussed to specific needs, the group approach will encourage the knowledge gained to be disseminated throughout the community. Tearfund will apply an integrated approach through provision of WASH NFIs for households with SAM cases and information on improved hygiene and sanitation practices for mothers.

This is a six months emergency nutrition response which will focus on providing tailored and effective technical and logistics support to the County Health Department (CHD) to address their needs and effectively treat and manage severe and moderate acute malnutrition (SAM and MAM) in children under five years and pregnant and lactating women. It minimizes suffering associated with malnutrition in what is predicted to be a lengthy and severe hunger season. 

This project prioritizes those most vulnerable groups of people, particularly malnourished children under five and pregnant and lactating women in all stages of the project implementation. In addition, the project is designed to integrate gender throughout the implementation. The project aims to achieve outputs including strengthened CMAM programming, increased knowledge and skills on SAM and MAM case management, early detection and management of SAM children at SC/OTP and MAM children at TSFP, to prevent deterioration and ensure children are fully recovered. The project will be supported by a team of staff who are already established and are currently implementing the OTP/TSFP nutrition programme in Twic East, supported by an Advisor with specialist technical knowledge.