Increasing equitable access to integrated preventative and lifesaving nutrition services for crisis affected populations in Nyirol County. The emergency this project will address is life threatening acute malnutrition of children under 5 in Nyirol County. Nyirol is among the 15 worst affected counties with 105,927 people in need (PIN) at a Severity of Need Level 4 (Humanitarian Needs Overview (HNO) 2020 South Sudan, pg 26). The South Sudan Acute Food Insecurity amp Acute Malnutrition (AFI amp AMN) Brief January 2020 shows Nyirol is classified in Critical (Integrated Phase Classification (IPC) Phase 4) for malnutrition during February to August 2020 (pg 8). Nutrition Cluster (NC) data shows the GAM rate for children under 5 is 25.5% with SAM rate at 5.4% (NC PowerPoint, Meeting of 24 Jan 20). Based on this evidence, the estimated population of children under 5 years in need of nutrition support in Nyirol is 4,931 SAM, and 18,355 MAM. Presently, CMA has a Project Cooperation Agreement (PCA) with UNICEF and a Field Level Agreement (FLA) with WFP. With SSHF SA1 support, CMA will target unserved locations identified through a thorough gap analysis completed by the nutrition subnational cluster for Jonglei State (Jonglei Sub-cluster Meeting 17 Feb 2020). The gap locations identified are Jondoru 2, Limkuon, Wumbil, Guer, Wenyal, Borduot, Pokbor and Keath. This project will serve all these locations except Pokbor. 

The lack of access to lifesaving nutrition services for the most vulnerable U5 children of unserved internally displaced population (IDP) and host populations is the critical humanitarian gap this project will fill. New static outpatient therapeutic program (OTP) facilities will be established at Limkuon PHCU Nyambor Payam and Wenyal PHCU Pading Payam respectively. In addition, due to high patient intake 2 OTP facilities with capacity to provide stabilization center services will be established at Pading PHCU and Waat PHCC to serve large IDP and host populations. The Waat OTP will serve Waat and 2 outreach locations of Borduot and Wunbil, the Pading OTP will serve 2 outreach locations of Guer and Keath and Limkuon OTP will serve Jondoru 2. Areas targeted comprise an estimated total population of 66,690, 36% of the total Nyirol population.

This project will reach 890 under 5 children with SAM interventions and 2,318 under 5 children with MAM interventions. NC SA1 2020 caseload targets for Nyirol are - under 5 SAM 761 and under 5 MAM 1,896 (2020 SSHF SA1 Cluster Targets, Mar 2020). 

The complementary assistance from UNICEF and WFP will enable the project to support: (1) increased access to maternal, infant and young child nutrition (MIYCN) program for at risk pregnant amp lactating women (PLW) and caregivers including capacity building on MIYCN guidelines and coronavirus (COVID)-19 prevention (2) a strengthened integrated response with CMA’s health services, and through collaboration with Water, Sanitation amp Hygiene (WASH) and Food Security amp Livelihoods (FSL) partner Oxfam, and Protection partner Save the Children International (SCI) and (3) enhanced screening to monitor the nutrition situation and issue timely early warning amp coordinated response.

To achieve project objectives, the project will provide human resources to ensure OTP and targeted supplementary feeding program (TSFP) treatment services are delivered in respect of the Community based Management of Acute Malnutrition (CMAM) protocols including training on COVID-19 prevention, and the MIYCN protocols including training on COVID-19 prevention. The project will ensure that each location has at least 1 Community Nutrition Mobilizer (CNM) and 1 MIYCN Counselor. The project will make use of a combination of responses linking static with mobile services to serve hard-to-reach locations where IDPs lack nutrition services. Nutrition services of this project will be fully integrated with CMA’s health services sharing human, facilities and transportation resources, and where ever feasible collaborate with on-ground humanitarian actors Oxfam in WASH and FSL and SCI in Protection.