Health In Crisis and Catastrophe Populations- Canal /Pigi and Jur River Counties -  South Sudan There is a trend of Persistent crisis that faced the populations in Canal Pigi  and Jur River Counties since 2013. According to the 2019 May Integrated Food Security Phase Classification (IPC) report, in canal pigi, 10,000 people are estimated to have faced Catastrophe (IPC Phase 5) 46,000 people faced Emergency (IPC Phase 4). This is related to the Sept 2018 IPC report placing canal /Pigi in catastrophe (IPC 5).  The HC 2019 estimates that 39,475 people  are in dire humanitarian need. 
Canal, Kaldak, Khorfulus and Alarm lie within SPLA-IO held areas with population that often experiences armed fighting (between rebels amp SPLA, and inter-tribal conflicts), causing routine displacement, life threats and destruction of health service delivery systems (NPA, 2016  Medair, 2019).  
 The Nutrition and Mortality SMART survey (IMC April 2019) report confirms the projected worsening of the Health, nutrition and protection at the current peak of the lean season. 47.1% of morbidity in children under five was due to diarrheal disease.  A GAM rate of 24.3% and SAM rate of 6.7%. Armed conflict amp its adverse effects have and still causing increasing stigmatization, mental illness amp psychosocial distress. Evidence: IOM /South Sudan, 2018.
Jur River County hosts IDPs since 2013(DTM IoM displacement tracking matrix march 2019).  The HC 2019 estimates 59,787 are People in need (PIN). 5,570 IDPs sheltered in Udici Payam and 17,254 in Kuajena (IRNA Gette 2016).  IDPs fled from Baselia and Wau Payams as a result of armed conflict in the region. Proxy nutrition screening (MUAC) records out of 221 children screen, SAM 8% , MAM 15%. In pregnant and lactating mothers, MAM 25% and SAM 5%. Lack of Health service, WASH, food and protection and rape concerns recorded. The PHCU nearby is operational but no essential drugs.   Recent fighting between pastoralist and farmers forced more Populations to settle in Kuajena (DTM IoM displacement tracking matrix march 2019. The cold chain in the facility is not functioning and last immunization campaign was carried out in March 2018. 
There exists high burden of the common illnesses as a result of common occurrences of malaria, diarrheas (both watery and bloody), ARIs, common cold, cough, eye infections and pneumonia and above all Sexual Gender Base Violence and rape. Measles by card (6-59 months) 4.2%, Vitamin A supplementation 28.8% and deworming remain major issues in Canal Pigi and similar concerns noted in Jur River County. The crude death rate (CDR)/cause of local death due to illness stand at 72.2%. Evidence: IMC SMART Survey Nutrition and Health May 2019. WHO recommends that 90% of children aged from 6 to 59 months should be vaccinated against measles, to ensure effective epidemic prevention. HEALTH ACTION AID-HAA Operates 2 mobile team to the hard to reach areas including canal with Kaldak, Khorfulus and Alarm Payams having none (Medair, June 2019)
The proposed intervention will ensure beneficiary communities access (demand and utilize) essential lifesaving health care services in canal pigi and Jur river Counties. 1 mobile team in Canal Pigi and 1 PHCU in Jur River County. This will Increased access amp utilization of Life saving primary health care services to reduce morbidity and mortality, improved access amp utilization of WASH and Protection (including MHPSS) services through integration into essential primary health care service and above all Expanded Management of SGBV survivors (PEP, treatment for STI, wound care, emergency contraceptive pills, prevention care, for tetanus, Hepatitis E and mental health care. Our target beneficiaries are (1) Host Communities: Men 2,798 Women 3,004 Boys 1,643 Girls 1,681 Subtotal 9063 and (2) IDPs Population: Men 4,026, Women 4,324, Boys 2,365 Girls 2,328 Subtotal 13043.  60% of the project will be in Canal Pigi and 40%in Jur river County.  41% are host communities and 59% IDPs guided by DTM IoM displacement tracking matrix  March 2019.