Provision of lifesaving therapeutic supply (RUTF) for children aged 6-59 months with Severe Acute Malnutrition (SAM) in the high priority areas The overall objective of this intervention is to contribute to the reduction of under-nutrition related morbidity and mortality amongst children aged under-five.

Afghanistan’s nutrition situation continues to be alarming. Ongoing conflict, low access to basic services, and impact of natural disasters have exacerbated the existing vulnerabilities of communities, contributing towards high rates of acute malnutrition. More than two thirds of the country (25 out of 34 provinces) with high prevalence of acute malnutrition are classified at emergency level [Draft HNO/ HRP 2020].

The Afghanistan’s nutrition cluster has identified 70 districts within 10 provinces (including IDP sites) with pre-existing emergency level of acute malnutrition and low level of programme coverage, that would need continued provision of nutrition services.

UNICEF, the sole provider of Ready-To-Use-Therapeutic-Food (RUTF) in the country, forecasted, earlier in 2019, a shortage of RUTF for the year, which led to the interruption of the scaling up of Severe Acute Malnutrition (SAM) treatment services at the national level, including in the Humanitarian Response Plan (HRP) priority areas. To maintain the current scale of services in the target areas with an acceptable level of treatment coverage, UNICEF is seeking the support of Afghanistan Humanitarian Fund (AHF) 4th Reserve Allocation to complement the support from the last allocation (3rd Reserve Allocation) to procure the lifesaving therapeutic supplies (RUTF) to secure SAM treatment services to children in priority areas.

UNICEF will procure the RUTF through its Supply Division. Supplies will be stored at national and regional UNICEF warehouses. Based on agreement between UNICEF and the Public Nutrition Directorate (PND) of Ministry of Public Health (MoPH), PND is responsible to receive, review and forward the supply requests to UNICEF on a quarterly basis and similarly, UNICEF is accountable to review the requests and process the distribution of requested supplies for implementing partners (IPs) from central and zonal warehouses to the provincial level in a timely manner. The AHF project implementing partners are: Aga Khan Foundation (AKF), Agency for Assistance and Development of Afghanistan (AADA), Coordination of Humanitarian Assistance (CHA), Bu Ali Rehabilitation amp Aid Network (BARAN), Organization for Health Promotion and Management (OHPM), Health and Humanitarian Assistance Committee (HEWAD), Medical Management and Research Course for Afghans (MMRCA) and Directorate of Public Health (DoPH) of Parwan.

UNICEF will use other funding sources to provide therapeutic milks (F-75 amp F-100) and ReSoMaL to complement the lifesaving treatment services addressing the needs of children with SAM with medical complications in 70 target districts in the 10 target provinces.

Outpatient and inpatient treatment of SAM are integral components of the Integrated Management of Acute Malnutrition (IMAM) approach, that will be delivered by the Basic Package of Health Services/ Essential Package of Hospital Services (BPHS/ EPHS) and humanitarian implementing partners through fixed health facilities and mobile teams.

Furthermore, SAM treatment will be provided simultaneously with the treatment of Moderate Acute Malnutrition (MAM) supported by World Food Programme (WFP), where applicable.