Treatment of MAM children age 6-59 months and pregnant  lactating women Acute malnutrition is a significant public health problem in Afghanistan. Ongoing conflict, low access to basic services, and the impact of natural disasters and displacement have exacerbated the existing vulnerabilities of communities and resulted to very high rates of acute malnutrition. Based on recent nutrition surveys, two-third of the provinces of the country are currently above the emergency level threshold of acute malnutrition based on WHO classification of wasting rates for children under the age of five (global acute malnutrition - GAM ≥10 per cent with aggravating factors). Currently WFP is supporting targeted supplementary feeding/OPD-MAM for treatment of moderate acute malnourished children and PLWG in all 22 HRP prioritized provinces. However, due to insufficient resources, a lot of malnourished children and PLWG are left with no treatment support. The funding from AHF 3rd reserve allocation will enable WFP to increase the OPD-MAM (TSFP) coverage in the 12 HRP priority provinces with the lowest coverage (Badakhshan, Ghazni, Ghor, Kandahar, Khost, Paktiak, Pakya, Parwan, Wardak, Badghis, Herat, Takhar) and reach more MAM children and PLWG.

WFP’s Targeted Supplementary Feeding Programmes (TSFPs) – or Outpatient Department  of  Moderate Acute Malnutrition (OPD-MAM) is an integral component of the Integrated Management of Acute Malnutrition (IMAM). The TSFPs (OPD-MAM) are integrated with UNICEF’s supported Outpatient and Inpatient Therapeutic Feeding Programmes (OPD-SAM, IPD-SAM), whenever and wherever possible, with linkages from the community to health facilities, ensuring that acute malnourished children and PLWG can be identified early and treated in their homes using specialized nutritious foods. WFP’s TSFPs (OPD-MAM) maximize the impact of IMAM by treating children with moderate acute malnutrition (MAM) before they become severely malnourished and malnourished pregnant amp lactating women thereby significantly reducing the burden on SAM treatment and health system in general. 

TSFP is implemented in partnership with national and international NGO Cooperating Partners who are delivering the Basic Package of Health Service. This proposal specifically focusing on the procurement of specialized nutritious foods (SNFs) for treatment of moderate acute malnourished children and PLWG (Pregnant and Lactating Women amp Girls) in the prioritized provinces. With the US$ 2,238,786 from AHF 3rd reserve allocation WFP will procure 202.5 mt RUSF and 959.6 mt Supercereal, this quantity can cover the treatment requirement of 22,500 MAM children and 25,600 malnourished pregnant and lactating women in the above-mentioned priority provinces.

WFP is currently facing a complete stockout of supercereal required to treat acute malnutrition among PLWG (Pregnant and Lactating Women amp Girls) but has 600MT of RUSF in stock sufficient to meet a 7week requirement for MAM treatment among children 6-59 months leaving a gap of 5 weeks till end of December. WFP will therefore allocate a larger proportion for the current funding to procure supercereal to address the current gap up to end of December,  while a smaller proportion will be allocated to procure RUSF to top up on the existing stocks to address the gap up to end of December 2019.

As soon as the funding proposal is approved, WFP will take advantage of its Global Commodity Management facility for advance financing and express commodity procurement to ensure reduced lead time to get the commodities into the country.
Additionally, in the event of unanticipated delays in deliveries, WFP may consider prioritizing the existing stocks in locations with the highest burden of malnutrition within the prioritized provinces in order to avoid interruption of service delivery where it is most needed.
WFP will continue to look out for other sources of funding to address the needs to avoid interruption of the MAM treatment services in the prioritized locations and other malnutrition hot spots