Strengthen and scale-up  Stabilization (inpatient) Center for management of SAM  children with medical complication in priority Newly accessible areas of Borno State (Bama, Gubio, Magumeri and Kala-Balge). This project aims at strengthening and scaling up the inpatient management of SAM children with medical complication in North Eastern Nigeria. More specifically it will strengthen and scale up of lifesaving nutrition services in the selected newly accessible areas of Borno State.

UNICEF has been supporting the State Primary Health Care Development Agency (SPHCDA) to provide integrated live saving nutrition services to the under-5 children and pregnant and lactating women (PLW) in the priority areas of Borno including Bama, Gubio and Kala-Balge, through fixed health facilities and mobile outreach nutrition team to ensure access to quality nutrition services. UNICEF has done program cooperation agreement with INTERSOS for implementation of CMAM and IYCF program in Magumeri LGA. UNICEF has deployed senior LGA nutrition facilitators in those LGAs in collaboration with Deloitte contracting company to provide onsite coaching and supporting supervision to life saving nutrition service providers to ensure quality of nutrition services. UNICEF has also done partnership with local NGOs to deploy nutrition supervisors at ward level mainly to enhance capacity of community nutrition mobilizers (CNMs) to strengthen community mobilization activities for timely detection of SAM children, their admission and follow up in proposed LGAs. 

However, the secondary health care system in Bama, Gubio, Kala-Balge and Magumeri Local Government Areas (LGAs) have been deeply affected by the conflict, and lack of adequate human resources and infrastructure to provide lifesaving nutrition assistance to SAM children with medical complications. This has had serious negative consequences for nutrition services as SAM children with medical complications, who are supposed to be managed in the stabilization center (secondary health care facility), are instead referred to Maiduguri for treatment as there are no stabilization centers in these LGAs. SAM children’s chances of survival are reduced due to lack of regular and reliable referral mechanisms to Maiduguri, or due to insecurity and inaccessibility of the roads. 

In this regard, UNICEF is proposing to liaise with the Hospital Management Board (HMB) and Health and nutrition Partners to establish stabilization centers in proposed LGAs for inpatient management of SAM children with medical complications. UNICEF will provide financial support and technical guidance to partners for the setup of stabilization center and treatment of SAM children with medical complications. 
Inadequate human resources in the selected locations is another challenge for management of SAM children with medical complications. In order to overcome these challenges, UNICEF will support partners to recruit and train additional nutrition providers to augment existing LGA staff and to provide emergency nutrition services. UNICEF will also analyze the data periodically and provide feedback to implementing partners for improvement of program quality and coverage.

Implementing partners will set up stabilization centre as per national standard and adhere to national guidelines during management of SAM children with medical complication. Partners will  ensure that SAM children are referred back to OTP after stabilization of medical complication for further treatment, proper storage and management of nutrition supplies, collection and reporting of routine nutrition program data monthly to UNICEF and Government authorities (SPHCDA).

UNICEF will advocate and coordinate with Government authorities like SPHCDA, HMB, MoH ant others at State level.
Implementing partners will coordinate with Government authorities and other partners at the LGA level 


This project is to support the following aspects enumerated below:
a.	Identification of SAM children with medical complication, and referral for appropriate treatment in  SC
b.	Inpatient management of SAM children with medical complications in SC