Life-saving nutrition intervention in highly affected districts of Kabul Initially, this project aimed at reducing mortality and morbidity related to undernutrition and improving the nutrition status of children under 5 and PLWs in three districts of Kabul province (Sorobi, Mosaee, and Khakejabar) through the delivery of integrated, comprehensive, and quality nutrition and basic primary health care services. However, due to a need to cover a service gap in underserved pocket areas of the province, the project catchment area has been expanded to Qara-Bagh, Shakardara, Bagrami, and Deh Sabz districts. The seven districts total population comprises 94,790 people. The services will be provided through the deployment of three Integrated Mobile Health and Nutrition Teams (IMHNTs). IMHNTs intervention sites will be identified in coordination with the BPHS implementers and the Provincial Public Health Directorate (PPHD) to avoid overlap and duplication of services and ensure fair resource distribution to the local affected population.

The three IMHNTs will provide outpatient services for SAM and MAM cases without medical complications and will support the referral of SAM cases with complications to in-patient care. These activities will be complemented by a community nutrition component consisting of empowering community members on undernutrition prevention and timely case identification and referral through community promoters and the Family MUAC approach. To offer a comprehensive package and obtain a more impactful response, in addition to nutrition services, AAH will provide primary health care services for children under five and women of reproductive age (15-49 years old) as well as Mother, Infant and Young Child Nutrition (MIYCN) awareness and counseling support. AAH will also ensure the provision of winter kits and clothing for acutely undernourished lactating and pregnant women in partnership with the ESNFI cluster.

The sexual and reproductive health services will target girls and women of reproductive age through the provision of basic Sexual and Reproductive Health (SRH) services including contraceptives, antenatal, and postnatal follow-up, as well as referral of at-risk mothers for further support. In addition, SAM children with medical complications, under-five children with common childhood illness and medical complications, and pregnant women detected with complications or at risk of complications will be referred to upper health facilities for further diagnoses and medical support through the cash for health and nutrition support approach. Beneficiaries eligible for cash for health and nutrition service will be selected as per national guidelines and guidance from different technical working groups, as well as AAH Standard of Procedures (SoP) for cash for health/cash for nutrition. SAM children with complications or identified with danger IMNCI consultation and PLWs identified with danger signs during the antenatal care consultations will be benefited from the cash for health/cash for nutrition service.

In addition, AAH will ensure capacity building and technical support to Ataturk, Indra Gandhi, and Maiwand hospital TFUs ran by the government in Kabul urban area to enhance the service quality and ensure that the TFUs meet the increasing demands through formal training, on the job capacity building and regular monitoring of the TFU program services.

AAH has planned to conduct a National Nutrition SMART Survey under AHF 1st standard allocation on separate proposal code AFG-21/3481/SA1/N/INGO/21021. However, the NSS sample size is calculated per region/domain (8 domains) and does not include province-specific results. Therefore, AAH will conduct 1 SMART survey in the province as part of a baseline assessment to have a better understanding of the current nutrition status within the target catchment population, taking into account the current increasing malnutrition trend to safeguard timely informed programmatic decisions.