Health Response to the Outbreak of Acute Watery Diarrhoea in Blue Nile, Sinnar, Gezira, Kassala, and Khartoum  states The ongoing outbreak of Acute Watery Diarrhea (AWD) has started since the third week of August 2016. Up to date, more than 4,400 clinically confirmed cases were reported from five states (Blue Nile, Sinnar, Geizera, Kassala and Khartoum) in addition to 20 Suspected AWD cases recently reported from 2 localities in South Kordufan. The total deaths is estimated at 109 deaths bringing the case fatality ratio into more than 2% (almost double the acceptable value). Since beginning of the outbreak, emergency committees- with UNICEF and WHO as key members- have been activated at federal level and in all affected states to provide guidance on outbreak’s planning, response, in addition to monitoring and evaluation. Response plans have been developed to meet the urgent needs of the affected states and to ensure timely containing of the situation. These response plans focus on: Supporting and expanding the surveillance system, Capacity development of the care providers, availing adequate quantities of the essential medicines and health supplies, providing safe drinking water and proper sanitation in the affected areas, in addition to intensifying health and hygiene messages to cover all affected communities. The suggested start date of expenditures will be the 1st of October 2016. This is due to the lengthy negotiations of SHF reserve funds and UNICEF anticipated the response in the field in the targeted states.

This project is designed to support the State Ministry of Health (SMoH) in five of the  affected states to effectively and timely contain the ongoing outbreak. The overall objective is to participate in reducing the excess mortality and morbidity among the population at risk through availing essential medicines and health supplies needed for proper case management (Diarrheal Diseases Kits, Oral Re-hydration Salts and Zinc supplement), training of health care providers at PHC level on the Oral Rehydration Treatment (ORT corners / centers) for AWD out patient cases and referral of severe cases to CTCs (supported by WHO), in addition to improving the early detection and referral of case and carrying out massive health promotion campaigns to raise the community’s awareness about the disease (sources, means of transmission, symptoms and preventive measures) and encourage people to seek timely medical care. The project targets a total of 8,000 out patient treatment of mild moderate AWD and diarrhea cases as well as about 1.5 million households in 26 localities in the target states. It aims to support case management of approximately 8,000 out patients mild to moderate cases of diarrhoea and reach 8,962,973 population in the affected localities with health promotion messages. The total requested fund is estimated at 320,257 USD to cover supplies’ procurement (8 diarrheal diseases kits, 640 cartons of ORS and 350 packs of Zinc supplement), training of 350 primary health care providers to manage out patients through the 15 ORT corners and 350 Community health volunteers to conduct awareness raising campaigns in the affected communities. This project will be paired up with the water and sanitation (WASH) project to optimize the impact on the AWD outbreak control. The key partners of the project will be the SMoH at the target states who are currently leading the response activities at state level. UNICEF sub-offices in Kassala and Blue Nile as well as the Country office in Khartoum will closely monitor the implementation at the field level through supervisory visits and periodic reports reflecting a specific set of indicators. Progress reports will be prepared at the field level and shared with the senior management on monthly basis to facilitate decision making and corrective actions taking. To avoid any overlap and duplication and make maximum use of the available resources, UNICEF will ensure that the proposed activities are complementing the interventions that WHO are carrying out at state level.