PROVISION OF LIFE SAVING HEALTH INTERVENTIONS INCLUDING AWD/CHOLERA CASE MANAGEMENT IN  AFGOYE DISTRICT Physicians Across Continents (PAC) has been managing emergency lifesaving projects in Juba land, South West and Banadir Regions for the last 10 years. The current context, of limited access to health care, poor access by response actors due to insecurity and high malnutrition rates, requires a tailored approach targeted at reducing the case fatality rate of the outbreak, limiting the spread and reducing transmission.

 In view of the prevailing drought and to reach the 21,000 at-risk population ,PAC in the proposed emergency program aims at reducing cases of mortality and morbidity especially among 6,930 boys, 5,670 girls, 3,780 men and 4,620 women in the targeted communities of the Afgoye District in Lowe Shebelle. 

This project will be integrated to existing nutrition programme run by PAC in Afgoye district. it will provide support to 3 static health facilities (1 in Hawo tako, 1 in Dolawe and 1 in Mareerey), 2 mobile outreach ( Afgoye Town and Baalgur )  and 1 Cholera Treatment Center  which will be located in Afgoye hospital as the main CTC of Afgoye district. The 2 mobile teams will ensure strengthened reporting and referral of persons suspected of AWD to main CTC.

The main proposed project scope of intervention will be as follows:

1. Outpatient preventative and curative consultation services will include treatment of the common illnesses - malaria, Acute Watery Diarrhoea (AWD), measles, Respiratory Tract infections (RTI), eye infections, skin diseases, chronic conditions, as well as routine immunization services for women and children. The referral mechanism between the health center and secondary level care facilities will be strengthened.

2. Provision of ante-natal care (ANC) and post-natal care (PNC) services and skilled birth attendance.  During ANC visits pregnant women will be screened and treated of any infections, provided with at least 2 doses of tetanus toxoid vaccination iron, Folate/Folic Acid, insecticide treated bed nets and Intermittent Preventive Treatment in pregnancy (IPTp). Screening will focus on identifying and treating common pregnancy related disorders and undernutrition cases. Delivery at the health facility with a skilled birth attendant will be continually promoted, and the project will support basic emergency obstetric care services (BemOC) for neonates and delivering mothers. The project will provide women with Postnatal Care (PNC) such as neonatal care and hygiene promotion services, including early initiation of breast feeding, exclusive breastfeeding for the first six months of the infant, family planning and post abortion care services.

3. Community mobilisers and community health workers will conduct awareness sessions in the community to promote positive health seeking behaviors in prevention of AWD,as well feedback mechanisms for measures of improvement and monitoring.

4. Increase access to sexual and reproductive health services including clinical management of rape and reporting mechanisms.

5. Strengthening of existing disease surveillance systems whereby records will be reported on a weekly basis to the WHO Early Warning and Response Network (EWaRN), and partners will respond to disease outbreaks in their target areas as/when they occur.

6. Work closely with WASH, CCM and Gender Cluster in ensuring that the drought affected people are getting highest attainable standards of care.