To  provide and improve access to nutrition services for children under 5 and PLW affected by malnutrition due to the protracted crisis in Ayod County. COSV’s Implementation of nutrition activities is integrated with health in three (Jiech, Pagil, Menime) out of the seven health facilities in Ayod County. The activities core component is the community participation and outreach activities. 

COSV has been running Primary Health Care Programs in South Sudan since the 90s, and since 2006 has established its presence in the Ayod Payam. From 2006 up to 2012 COSV only supported the County Health Department and the Ministry of Health in the provision of primary health care services in the Ayod Payam, upgrading the existing Ayod PHCU into a PHCC++ that provides the following services:
	Screen and treat moderate and acute malnutrition among under 5 Children and PLWs.
	Carry out integrated health and nutrition outreaches  in the neighboring Payams
	Maintain and expand the immunization level between under 1yr (U1) and pregnant women.
	Treat all the most  prevalent and potentially epidemic diseases by maintaining an efficient surveillance and report system, treating all the patients and preventing disease spread.
	Provide antenatal, delivery and post-natal care,
	Detect and diagnose through laboratory tests the most common diseases that affect the area,
However, post 2014, the community and IDPs from Southern Ayod flee to the Northern County side. And all settling as IDPs in Jiech, Mogok, Pagil and Canal areas health facilities in Ayod, Kuachdeng and Pajiek areas being abandoned and destroyed. The large movements of population and IDP's took place affected the health situation in the area. Because, the primary health care services were unprepared to deal with the new influx.  The destruction lead to the incapacity of the health infrastructure, and settlement of IDP’s in areas perceived as safe havens with no peripheral units coupled with the fact that most health workers scattered. 
Ayod county current nutrition and health care services are predominantly manned by people of  lower cadre (untrained semiliterate, NA CNVs, CHW) accounting for about 45% and lack necessary technical skills for implementation of CMAM. The county remains under served in terms of basic Nutrition and health services involving, nutrition and Immunization. Nutrition supplies are irregular, and most often supplies are supplemented with UNICEF, or through MOH, Logistic remain a major challenge. 
With CHF funds, other supplies of nutritional materials and logistic activities could be supported, especially to reach the hard to reach locations. Strengthening surveillance is essential in early warning so as to minimize the impact of outbreaks and lastly, foster continued training of nutrition staff, will improve their capacity to respond to nutrition education for Pregnant and Lactating Women/ IYCF-E, Coordination, rapid assessments, surveys, health and disease assessment linkage with nutrition, food security and livelihoods assessment and Surveillance and early warning. This will also enhance the quality of care, and reporting. Through CHF SA1 funds, COSV will continue supporting such responses and outreach strategies to reach the remote communities and more regularly supervise practices in already established peripheral OTP amp TSFP sites and scale up to more forecasted sites in 2016