Pillar 1: Increased access and provision of comprehensive (preventive and curative) nutrition services for vulnerable children under 5 and PLWs in Akkar, North and Mount Lebanon (El Metn). 6 Primary Healthcare facilities will be targeted in: TRIPOLI: Makkarem Health Center, El Mina (Treatment); AKKAR: Al Ataa al Jazil, El Bireh (Treatment); Qabiit Health Center, Qabiit (Screening); EL METN: Armenian General Charitable Medical Center, Sad el Bouchriyeh (Treatment); Caritas Health Center, Sin el Fil (Treatment); Wadih El Hajj Medical Center, Baskinta  (Treatment) This Project is designed to provide life-saving nutrition services in poor neighborhoods with high density of Host Communities, Syrian Refugees, PRS/PRL amp Migrants in vulnerable situation through both community and facility-based interventions including:
1. Infant and young child feeding (IYCF) practices optimization, micronutrient supplementation distribution, and reporting of blanket distribution of Infant formula
2. Screening, referral, and treatment of malnutrition (SAM without complications and MAM) among children under 5 and PLWs

The project will be implemented by Mercy-USA in the North, Akkar and Mount Lebanon (El Metn). The project will target 18.000 people (Host communities, Syrian Refugees, PRS/PRL and migrants) disaggregated as follows:
- 5,914 Pregnant and Lactating Women (PLWs)
- 12,086 Children under 5 (5,844 girls - 6,243 boys)

1 outreach team (1 IYCF counselor and 1 Community Health Worker) will be based out of each PHCs to provide visual MUAC screening, referrals, distribution of Multiple Micronutrient Powders (MNPs) and IYCF services for PLWs and children under 5. These outreach teams will work in parallel and direct coordination with the selected health facilities in the targeted areas.

The PHC Staff will screen, identify, and refer cases of malnutrition among pregnant and lactating women (PLWs) and Children under 5 (CU5) if needed for treatment as well as provide IYCF through:
- IYCF sessions
- Counseling PLWs and caregivers of children under 24 months of age and providing messages on IYCF recommended practices to mothers who have malnourished children
- Promoting timely initiation of breastfeeding, exclusive breastfeeding and introduction of safe, age appropriate and nutrition diversified complementary food (including related hygiene messaging)
- Provision of Skilled Infant and Young Child Feeding (IYCF) counselling and support to for breastfed and non-breastfed children under 6 months of age
- Distributing micronutrients and nutrition supplies for the PLWs and children 
- Reporting breast milk substitute distribution

This project will empower mothers and HH members through training them to screen their own children for malnutrition by teaching them how to use color-coded Mid-Upper Arm Circumference (MUAC) tapes. In addition, this service will be provided in the treatment of PHCs to mothers with malnourished children in order for them to keep on track the nutritional status of their children after discharge from the treatment program.

Throughout this project and in order to ensure utilization of nutrition services for nutritionally vulnerable children and caregivers, and alleviate the financial burden on vulnerable communities, suspected and confirmed malnourished cases referred to the PHCs will benefit from financial support towards the consultation fee, and will receive cash support for the cost of transportation.

This response will adopt the safety recommendations in the COVID-19 context.