Envelope for Priority 2: Scaling up access to lifesaving nutrition services focused on treatments of severe and moderate acute malnutrition of children under 5 years and moderate acute malnutrition of pregnant and lactating women, for populations experiencing acute malnutrition severity levels 4 and 5 in the payams of Manajang, Paguir, Phom and Mareang of Fangak County, Jonglei State, South Sudan The disaster gripping Fangak County South Sudan is driven by the economic crisis, persistent intercommunal conflict and 3 consecutive years of flooding. The inter-sectoral severity of need is Level 5 (Catastrophic) for Fangak (SSD HNO 2022, pg. 8). The January 2022 IPC report indicates that Fangak is classified in IPC AMN Phase 4 (Critical) (pg. 6). The targeted payams of this project exhibit WSC 5 (Catastrophic) (SSD HNO 2022, pg. 66). The SSD HNO 2022 (pg. 65) shows gender-based violence (GBV) is ranked severity of need Level 4 (Extreme). Fangak is among the five worst affected counties and a Priority 1 concern for SSHF. 

To address this crisis, the key activities are treating SAM and MAM of children 6-59 months and treating MAM Pregnant and Lactating Women (PLW). The project will also provide MIYCN counseling for PLW/caregivers for children 0-23 months. Given the high level of GBV risk, this cross-cutting sector is a priority concern and embedded in all humanitarian programming in Fangak County. The project plans treat 1,260 children suffering SAM and 3,800 with MAM as well as 1,800 PLW with MAM. An estimated 5,082 PLW and caregivers will be reached with MIYCN counselling.

The critical GBV outputs will be safety audits completed covering nutrition facilities. To strengthen the sustainability of nutrition outcomes, the project will collaborate with all sectors namely health for treating malaria of under 5 patients and providing Clinical Management of Rape (CMR) services, and with the FSL partner to support the establishment of  demonstration kitchen gardens and WASH support for WASH kits for U5 children and WASH infrastructure to provide safe water and latrines at nutrition facilities. In addition, a budget has been planned to enhance CMA’s capacity to reach out to co-located humanitarian partners to link with this project’s nutrition activities to achieve a more integrated program. This includes enhanced capacity to collaborate and coordinate with other humanitarian partners and participate fully in the county-based coordination forums of government and NGOs.

Operating from 4 OTP/SC nutrition facilities, the project will provide a 16-member field team of Nutrition Nurses, CMAM Supervisors, Nutrition Assistants, and Community Nutrition Mobilizers/MIYCN Counsellors to deliver static and mobile outreach services. In Mareang payam, the project will deliver static services from two OTP units Kuertet and Kuerdeng and also support the establishment of the new SC at Kuerdeng OTP site and support mobile outreach to Leet from Kuerdeng. In Phom payam, the project will support a new static unit at Wuntur near Pakan PHCC – OTP. In Paguir payam, the project will support a static OTP center at Pulita near Keew PHCC – OTP/SC and from the Juaibor PHCC – OTP/SC location in Manajang payam, the project will support mobile outreach to the sites of Pajang and Jiath. The 3 remote locations targeted with mobile outreach will deliver services to IDPs in hard-to-reach locations and provide capacity to respond to emergencies. These personnel will be mobilized with a vehicle, a boat and canoes as maybe required in a flooding emergency.

In order to mitigate the threat of floods, several measures have been put in place. For instance, CMA will liaise with strategic partners and local leaders for a multisectoral support to facilitate advance access and transportation of key nutrition inputs i.e. from core pipelines to avoid stockouts and also construction of dykes to protect the nutrition structures. Scaling up of the outreach activities will be prioritized by enhancing the capacity of the mobile team to reach the high number of displaced persons in the occupied higher grounds. CMA will also mobilize community-based protection mechanisms to ensure vulnerable persons have access to needed services. CMA has also prepositioned a speed boat in Juaibor in Fangak to facilitate access for supplies and other inputs through the waterways.