Improve access to and utilisation of emergency lifesaving Primary health care services and prevent, detect and respond to epidemic prone diseases through 1 PHCU and 1 PHCC in Twic County Save the Children (SCI) is seeking to deliver a six-month emergency lifesaving health project in Twic County, which is one the priority hot spot county where the health situation is critical. The project will be implemented in isolated areas inhabited by internally displaced people (IDPs), and returnees and the host community in Twic County, Warrap State. The objective is to support the implementation of critical, lifesaving primary healthcare services for populations facing greatest needs, compound by armed conflict, displacement, hunger, disease and natural disasters such as floods. The activities will reduce morbidity and mortality among internally displaced children and adults and those from the host community. 

Twic has a population of 249,350 (SS MOH) of which the direct beneficiaries (40,181) include IDPs from the neighbouring Northern Liech and Gogrial, returnees from Sudan and host communities. The activities will complement existing PHC and nutrition services (mobile outreach) currently implemented by SCI in the nearby Abyei County. Trained community health workers (NCHW) will conduct community mobilization, surveillance and referrals of the most ill patients and suspected cases to PHCU/C for management by clinicians.

The funds will strengthen the delivery of PHC in the existing facilities Ajak Kuac PHCC and Pagai Ayoun PHCU . These health facilities are currently in a dilapidated state and will require minor renovations. In the PHCC, the fund will support quality primary health care health service delivery with WASH, Nutrition and FSL linkages to the displaced, returnees and host community. Further, SCI will coordinate nutrition activities with World Vision providing nutrition services in the two health facilities and support referrals of children with SAM to Agok MSF hospital for further care. 

The health services will be delivered through: 
1) Increased access to PHC services by 1 PHCU and 1 PHCC. The PHCC will provide OPD consultations, skilled delivery, ANC, EPI, GBV, CRM BEMoNC and MHPSS services PHCU will provide OPD consultations, EPI, ANC services while PHCU will provide EPI, ANC, OPD consultations, and health education services. 

2) Prevent, detect and respond to epidemic prone diseases (such as Measles, Cholera, Meningitis, Malaria, Rubella, Whooping Cough etc.) among vulnerable groups of population (IDPs, returnees and nomadic host communities). 

SCI will collaborate with UN agencies like WHO, WFP, UNFPA, UNICEF, PSI and other implementing organizations for the integrated response. SCI will pay salaries of staff (clinical officers, nurses amp midwife) in the facilities and within the community (volunteers) as well as training and mentorship of them. The staff will be employed to fill gaps identified in the PHCU/C. The SCI supported by CHVs (men and women) will mobilize the community and conduct health awareness campaigns during integrated outreach. The team will comprise of clinicians, EPI, nutrition and health promoters. They will also identify and refer lt5years children and pregnant/lactating women with malnutrition to the Stabilization Centre in Ajak Kuac PHCC or Agok MSF Hospital depending on geographical access. They will also conduct health awareness-raising activities on EPI, ANC and prevention of endemic diseases. The Home Health Promoters will work closely with health committee to report suspected epidemic outbreaks, which will be investigated, and responded within 48 hours in consultation with WHO. Any maternal and neonatal death reported will be investigated. The health facilities will also be supported with the following: aqua tabs for safe drinking water, handwashing with soap and improved waste management.