Provision of essential primary health care services for 16,192 IDPs, returnees and host communities in Kajo Keji and Yirol East counties through 1 PHCC, 1 PHCU and 2 mobile teams This project will address the most critical health service needs and gaps in Kajo Keji and Yirol East counties. It will compliment ongoing responses where these are available. The project will address the critical health needs of the community by increasing service coverage through 1 PHCC (Keriwa), 1 PHCU (Romogi) and 2 mobile teams (Korijo in Kajo Keji and Acigor in Yirol East) for vulnerable populations in the two counties who continue to experience the effects of protracted war despite the revitalized peace being signed in Septem 2018. While displacements continue in some parts of the counties, there is reported significant return. The gaps in health service delivery are similar in both Kajo Keji and Yirol East and these include low EPI coverage (below 1% Kajo Keji), high burden of diseases such as malaria (Kajo Keji-33% and Yirol East-22% as of March 2019). RTIs figures for Kajo Keji are reported to be at 26%, diarrhea-10%, UTIs-11% while other cases such as sexual transmitted infections (STIs) intestinal parasites, skin infections and trauma account for the remaining 19% (TRI-SS, EWARS amp IDSR, 2019). Given the current situation, there is a high risk of disease outbreaks including cholera /AWD, Measles, meningitis, Hep.E, Polio and EVD as a result of the poor WASH in facilities especially lack of water. Destroyed health facilities (gt90% damaged), lack of humanitarian support for health, low ANC2 and skilled delivery (lt50%), lack of secondary health care and limited referral facilities and a high risk of HIV transmission with limited ART services also contribute to the gaps. 83% of assessed settlements during a March 2019 REACH survey in Yirol East county were not using latrines. The project objectives and activities are in line with the current health cluster allocation strategy whose main objectives and activities are to 

1. Increase access to essential primary health care services for the vulnerable population in Kajo Keji and Yirol East counties through 1 PHCC, 1 PHCU and 2 mobiles.

Activities to be supported under this objective include
 OPD consultations
 Skilled deliveries
 Malaria case management
 AWD case management
 Health education/promotion

2. Prevent, detect and respond to disease outbreaks
This objective aims at strengthening the existing surveillance system to pick the first case and raise the alert. The following activities are planned under this objective
 Training of health staff on risk communication
 AWD and EVD risk communication and rumor tracking
 Training of staff on disease surveillance and outbreak response
 Training of health staff on IPC
 Emergency measles vaccination

3. Integration of WASH, Nutrition, FSL and protection including MHPSS
 Management of SAM+MC
 Management of SGBV including CMR
 Mental health and psycho-social support
 Training of health staff on integrated response
 Training on IPC (WASH in health facilities)

The project beneficiaries include 16,192 (Kajo Keji: 12,142 and Yirol East 4,050) direct and indirect beneficiaries, 60% (9,688) IDPs and 20% (3,242) returnees and 20% (3,262) people in the host community. 22% (3,577) are men, 25% (4,076) are women, 25% (4,057) are boys and 28% (4,482) are girls. The beneficiary targeting is based on vulnerability with IDPs identified as more affected followed by returnees and host community. Children and women are considered more vulnerable compared to men based on widely used national vulnerability rating criteria.

The methodology is a mixed approach using static (1 PHCC, 1 PHCU) and 2 mobile teams. Referral will be strengthened through the hire of three cars in the two locations 2 for mobile teams and 1 for referral of patients. Existing MoH reporting tools such as IDSR, EWARS, and Quantified Supervisory Checks (QSC), EPI tally sheets and 5Ws will be used for data collection and reporting. The project will use BPHNS, MISP, CMAM and clinical guidelines as national reference materials.