Management of Severe Acute Malnutrition with complications among Boys and Girls aged below 5 years in Borno, Adamawa and Yobe States, Nigeria. In Nigeria, the North-east and the Lake Chad region are facing one of the most severe humanitarian crises in the world today, with Borno State being one of the most affected state. The crisis has largely been triggered by a regionalized armed conflict that has caused massive loss of life and liberty across northeastern Nigeria. Civilians continue to bear the brunt of a conflict that has led to widespread forced displacement, violations of international humanitarian and human rights laws, severe protection concerns and a food and nutrition crisis of massive proportions. Even in its tenth year, the crisis remains one of the most severe in the world. In the three worst‐affected states of Borno, Adamawa and Yobe,1.9 million people are internally displaced and human rights violations continue to be reported daily. According to Nigeria 2019-2021 Humanitarian Response Strategy (January 2020 - December 2020 ), 7.7 million people are in need of life saving assistance in 2020 whilst 5.8 million people are targeted for life-saving assistance.

Despite the fact that the Nutrition situation in Yobe and Borno states has improved slightly in the last two years, results from nutrition surveillance conducted in May 2019 still show high levels of malnutrition. In Borno, the Global Acute Malnutrition (GAM) prevalence was 11.2% and SAM prevalence was 1.2%. In Yobe and Adamawa States, the GAM and SAM prevalence were 13.0%, 1.4% and 6.1% and 0.6% respectively. According to WHO, children with Severe Acute Malnutrition (SAM) are 4-11 times more at risk of mortality than their healthy counterparts the risk is further exacerbated with the presence of medical complications.

The purpose of this proposal is to support the continuation of treatment of Severe Acute Malnutrition (SAM) with medical complications among boys and girls aged below 5 years in three northeastern BAY States with particular focus on Askira/Uba, Chibok, Gubio, Hawul, Kaga, Konduga and Magumeri LGAs of Borno State. UNICEF undertakes procurement and distribution of Therapeutic Milks (TM) for 100% for the collective nutrition response requirement in northeast Nigeria. This project aims to procure 50% of the Nutrition Sector Stabilization Centre supplies needs for 2020. The supplies will be prioritized for the seven targeted LGAs highlighted in the NHF 2nd Reserve Allocation for 2019 while extra available supplies will be distributed to all other SCs in the BAY states. The current TM procured by UNICEF with internal and bilateral donor funding is projected to last until end of the 2019, with a pipeline break envisaged at the beginning of 2020.

UNICEF is uniquely placed to implement this project, as the Cluster Lead Agency (CLA) for the nutrition response and co-chair for the Nutrition sector with State Primary Health Care Development Agency (SPHCDA) in Borno. UNICEF, through this action will continue to support SPHCDA in the delivery of treatment of Severe Acute Malnutrition with medical complications  among  boys and girls aged below 5 years in the priority areas. Treatment of SAM with medical complications among children aged below 5 years is part of the agreed basic integrated nutrition package that encompasses micronutrient supplementation to children aged 6-24 months for prevention of micro-nutrient deficiencies, Zinc supplementation among children aged below 5 years with diarrhea, Vitamin A supplementation among children aged 6-59 months to boost immunity against common childhood illnesses and deworming for children aged 6-59 months for prevention of iron deficiency anemia. These interventions are implemented alongside promotion of optimum Infant and Young Child Feeding practice (IYCF) aimed at promoting maternal nutrition as well as child feeding and care practices. The services are provided through reconstructed health facilities and, where required, by mobile nutrition teams to ensure optimum and ease of access to quality nutrition services at scale