Country Office Humanitarian Situation Report No. 155

UNICEF South Representative (Hamida Lasseko) receiving COVID-19 vaccines at International Airport. The vaccines were facilitated through COVAX. ©UNICEF//Solomon

Reporting Period: 1-31 March 2021

Highlights Situation in Numbers • According to the Integrated Food Security Phase Classification (IPC) analysis released in December 2020, about 7.24 million people (60% 4.4 million of the population) will face Crisis (IPC Phase 3) or worse acute food children in need of insecurity, during the period April to July 2021. humanitarian assistance

• In response to the critical WASH situation in highly food insecure counties, WASH Cluster partners have reached 101,411 people with WASH services. Availability of WASH funding estimated at US$15 8.3 million million by the WASH Cluster remains a critical gap. people in need of

• During the period January to March 2021, a total of 50,865 children humanitarian assistance suffering from severe acute malnutrition (SAM) were treated in (OCHA, HNO, January 2021) inpatient and outpatient therapeutic programs. The performance indicators for SAM treatment were above the acceptable minimum 310,000 SPHERE standards, with a cure rate of 95.8 per cent, a death rate of 0.3 per cent and a defaulter rate of 2.3 per cent. Refugees and asylum seekers • As of 29 March 2021, a cumulative total of 10,119 confirmed COVID- in need of humanitarian 19 cases and 108 deaths had been recorded in South Sudan with a assistance case fatality rate (CFR) of 1.07 percent. South Sudan received (OCHA, HNO, January 2021) 132,000 doses of the AstraZeneca COVID-19 vaccines supported by the COVAX facility. The first shipment will target health care workers 2.24 million and people aged 65 years and older. South Sudanese Refugees in UNICEF’s Response and Funding Status neighbouring countries (UNHCR Regional Portal, South Sudan Situation SAM Admission 19% 30 September 2019) UNICEF Appeal 2021

Funding status 54% Nutrition Measles vaccination 2% US$ 198 million

Health Funding status 17% Funding Status (in US$) People with safe water 20% Funds

WASH Funding status 22% Available,

Children reached with PSS 8% 52M on

Child Funding status 16% Carry- Protecti forward, Children in school 0% Funding $23M

on Funding status 6% gap,146M Educati

Households… 19% on

Social Funding status 2% Protecti Community engagement 28%

C4D Funding status 20%

0% 20% 40% 60% 80% 100%

*Funding available includes funds received in the current year; carry-over from the previous year; and repurposed funds with agreement from donors. 1

Funding Overview and Partnerships In 2021, UNICEF is appealing for US$198 million to provide life-saving services for women, men and children in South Sudan. UNICEF expresses its sincere gratitude to all public and private donors who have continued to support multi- sectoral humanitarian programmes. Without adequate funding, UNICEF and partners will be unable to continue supporting ongoing integrated humanitarian programmes as well as the provision of critical and protective services for women, children and men displaced by conflict and flooding, affected by gender-based violence, facing life-threatening diseases (including COVID-19), and impacted by extreme food and nutrition insecurity in 2021.

Situation Overview & Humanitarian Needs Women and children in South Sudan continue to be faced with multiple risks which include extreme food and nutrition insecurity, residual impact of floods, localized conflict, an ongoing economic crisis and disease outbreaks including COVID-19. In response to the multiple shocks and hazards, South Sudan launched the Humanitarian Response Plan (HRP) for 2021 during the reporting month. The HRP will target 6.6 million people across all the country’s 78 counties. According to the IPC analysis released in December 2020, about 7.24 million people (60% of the population) will face Crisis (IPC Phase 3) or worse acute food insecurity during the lean season (April to July). This number includes 2.5 million people who are projected to face Emergency (IPC Phase 4) acute food insecurity and 31,000 people who are likely to face Catastrophe (IPC Phase 5) acute food insecurity in Akobo county in , Aweil South county in Northern Bahr el Ghazal State, and Tonj North county in State. The nutrition situation is critical, with 57 (72%) of the counties being projected to be IPC Acute Malnutrition (AMN) Phase 3 and above during the same period (April to July 2021). A total of 38 counties are projected to be in IPC AMN Phase 4, and 19 counties in IPC AMN Phase 3. An estimated 1.4 million children and 480,000 pregnant or lactating women will be acutely malnourished and in need of treatment. During the reporting month, nutrition SMART surveys were conducted in two priority counties of Pibor Administrative area in Jonglei state and Tonj North county of Warrap state. The findings from this survey revealed a Global Acute Malnutrition (GAM ) prevalence of 21.6 in Pibor and 18.4 in Tonj North indicating a critical nutrition situation, above the WHO emergency threshold of 15%. The Crude Mortality Rate (CMR) in Pibor and Tonj North was 0.77 and 0.87 per 10,000 population per day respectively which is below the WHO threshold of <1 death per 10,000 population per day. There is a limited coverage of safe water supply in the highly food insecure counties which increases the risk of morbidity and mortality from diarrhoeal diseases. The food and nutrition insecurity response is encompassing an integrated multi-sectoral approach to achieve maximum impact of interventions. Food Security and Livelihoods (FSL), Health, Nutrition and Water, Sanitation and Hygiene (WASH) clusters have developed a common integrated plan which focuses on prioritized counties.

Some parts of the country will have a very short window to conduct road transport, and humanitarian actors including UNICEF have worked to pre-position as much as possible, to avoid incurring expensive air freight costs later. This is especially the case in Pibor, and other parts of Jonglei state. Crime continues at a high level. Torching of commercial vehicles and abductions with demands for ransom and killing of foreign drivers has been reported in Greater Equatorias. This led to the suspension of logistical vehicles by Uganda and Kenya which has an impact on the availability of commodities. In Greater Pibor Administrative Area (GPAA), age set fighting triggered insecurity in the area along the Bor to Pibor road, the fighting subsided towards the end of the month. In State, armed robberies and shooting were reported, mostly in Cueibet county.

Summary Analysis of Programme Response Health UNICEF continues to work closely with the Government of South Sudan and NGO partners in supporting integrated primary health care services in all the 25 counties of Jonglei and states targeting an estimated 1.8 million people. The support includes the distribution of essential drugs and medical equipment to 1911 health facilities and support for emergency preparedness and response to the Ministry of Health (Both at a national and sub-national level). As part of the COVID-19 response significant quantities of oral rehydration salts (ORS) and paracetamol were dispatched to eight states to scale up home based care services in the country. UNICEF Health, C4D and Supply teams continued to support the national COVID-19 deployment and vaccination plan (NDVP). As part of the multi-sectoral response to COVID-19, the country received 132,000 doses of the AstraZeneca vaccine through the COVAX Facility. The initial phase of the vaccination campaign targeting 4,400 health workers commenced during the first week of April. A total of 929 health workers and 1,160 members of other target groups had been vaccinated by the 15th of April.

During the period January to March 2021, UNICEF through partners provided curative consultations to 482,208 individuals (196,705 males and 285,503 females) through static health facilities, community outreach activities and the Boma Health Initiative (BHI). This includes a total of 150,465 people ( 68,199 males and 82,266 females) reached in March. A total of 76,445 of these individuals reached with the curative consultations were under the age of five, while

1 After almost a year of discussion with local authorities, it has been impossible to handover two health facilities from MSF to Livewell (PEHSP-Implementing Partner). These two health facilities were removed from the PEHSP List. 2

74,020 were aged five years and above. Most children and adults received consultations for malaria (34 per cent) followed by pneumonia (14 per cent) and diarrhoea (11 per cent). UNICEF through implementing partners, supported the vaccination of 12,409 children aged 6 months – 59 months through a measles follow-up campaign in Luakpiny/Nasir county in Upper Nile State. Similarly, a maternal and neonatal tetanus elimination (MNTE) vaccination campaign for girls and women of reproductive age was implemented in Jonglei and Upper Nile states reaching 82,270 girls and women.

Nutrition UNICEF is providing preventive and curative nutrition services to children and women in South Sudan in partnership with nutrition sector implementing partners. A total of 50,865 children suffering from severe acute malnutrition (SAM) were treated in inpatient and outpatient therapeutic programs during the first 3 months of the year. The achievement translates to 21 percent of the annual target and 16 percent of the people in need (burden). The highest admissions were recorded in Jonglei state (21.9 percent) followed by state (14.9 percent) and Northern Bahr el Ghazal state (11.6 percent). The performance indicators for SAM treatment were above the acceptable minimum Sphere standards, with a cure rate of 95.8 percent, a death rate of 0.3 percent and a defaulter rate of 2.3 percent. During the same period, infant and young child feeding counselling services reached a total of 457,464 pregnant women and caregivers of children 0-23 months.

A standalone Vitamin A and deworming campaign was implemented in 61 out of 79 counties during the reporting month. A total of 1,847,978 children (53.6 percent girls and 43.4 percent boys) received Vitamin A supplements and 1,535,326 children received deworming tablets. The campaign is ongoing in the remaining 18 Counties. In response to the ongoing food and nutrition insecurity situation, UNICEF scaled up its response in 10 most food insecure counties. There are more than 150 functional static nutrition sites and 50 outreach sites being supported by 12 Implementing partners in the 10 counties. During the period January to March 2021, a total of 9,632 children with SAM were admitted in the program , the highest admissions were recorded in Akobo (26% ) and Pibor (25%). During the same period, a total of 69,996 pregnant and lactating women received infant and young child feeding counselling services in the high-risk counties.

Child Protection UNICEF and partners reached 3,867 children (1,851 boys and 2,016 girls) with psychosocial support activities in child- friendly spaces in , , , Jonglei, Lakes, Unity and Upper Nile States, raising the total to 9,659 children reached since January 2021. A total of 29 children (17 boys and 12 girls) were newly identified, registered and documented as unaccompanied and separated children (UASC) in Upper Nile, Unity, Jonglei and Lakes states during the reporting period. A total of 192 children (96 boys and 96 girls) were registered and received case management services according to the vulnerability criteria, in Jonglei, Lakes, Unity, Upper Nile, and Warrap States. During the reporting month a total of 2,836 individuals (963 girls, 873 boys, 520 women and 480 men) were reached with explosive ordnance risk education (EORE) key messages in the communities in Lakes, Central and Western Equatoria states, this includes 120 community liaison leaders (59 women and 61 men) who were trained on key EORE messages and 30 teachers (14 women and 16 men) who were oriented on key EORE messages in schools. The Child Protection sector continues to support the implementation of COVID-19 prevention programmes. To date a total of 30,736 individuals (5,253 girls, 5,684 boys, 12,993 women and 6,806 men) were reached with psychosocial support services in Eastern Equatoria, Unity, Jonglei and Northern Bahr El Ghazal states. The UNICEF supported Child protection programme reached 8,478 people (3,422 boys , 5,016 girls, 14 women and 26 men) with messages on children's rights and the Child Act of 2008. In addition, 299 people (16 boys and 2 girls 183 women and 98 men) had access to at least one justice service consistent with the best interest of the child and youths in Northern Bahr El Ghazal and Unity states. During the reporting period, UNICEF and implementing partners reached 6,241 people (1,772 girls, 1,045 boys, 2,383 women and 1,041 men) with gender-based violence (GBV) prevention, response, and risk mitigation messages. A total of 872 women and 611 girls received case management, psychosocial support, and skills-building courses in Women and Girls’ Friendly Spaces (WGFS), and referrals for other specialised and non-specialised services. A total of 90 community leaders (70 men and 20 women) were trained on GBV risk mitigation, prevention, and response to strengthen community-based protection mechanisms. A total of 25 girls and 55 women were enrolled in skills-building programmes and will receive a start-up kit to start income generating activities at the end of the training. Under the Communities Care Programme (CCP), a total of 8 community action groups were formed and engaged in social norms transformation discussions and action courses to support positive changes in beliefs and perceptions about gender- based violence within their communities.

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Education During the reporting period, UNICEF, in collaboration with the Ministry of General Education and Instruction (MoGEI) distributed 1,152 solar powered radio sets to 3,960 vulnerable learners (927 girls and 3,033 boys) in Lakes and Eastern Equatoria states. The initiative is part of UNICEF’s support to the Ministry’s radio distance learning programme. During the month of March, UNICEF supported 3,307 candidates (937 females and 2,370 males) to complete their Secondary School Leaving Certificate examinations in Northern Bahr el Ghazal and Central Equatoria states. In addition, UNICEF provided face masks, hand sanitizers to pupils and teachers in Buluk A and B Primary Schools, and Juba Girls Secondary School examination centres in Central Equatoria. Through the support of Education Cluster Partners, the national exams for the Senior 4 Grade were conducted by the National Examination Council (NEC). Over 34,000 pupils including 1,058 former Juba Protection of Civilian (PoC) site secondary school students were registered to sit for the exams across the country. The Education Cluster partners supported the field transportation of examination scripts in hard to reach areas and played an instrumental role of bridging communication gaps between the students, teachers and the NEC and provided food assistance to students who were writing exams in hard to reach areas.

WASH During the reporting month, the WASH programme provided critical life-saving support to vulnerable and at-risk populations through the provision of access to safe water, basic sanitation and hygiene services to individuals in former PoC sites, host communities and internally displaced persons (IDPs) in collective sites. As a result, a total of 164,512 individuals have so far been provided with access to safe drinking water through the rehabilitation of non-functional waterpoints in communities, schools and health care facilities. UNICEF also continued to provide support for the operation and maintenance of water yards, surface water treatment (SWAT) systems and urban water systems. UNICEF continued to support the construction of the water supply system for urban and peri-urban communities in Juba. The project is now at a commissioning stage and will serve an estimated population of 70,000 people living in the city and an additional 33,000 vulnerable people living in the former PoC sites which have now been designated as IDP camps. UNICEF is currently trucking water to the IDP sites in Juba and constructing water kiosks as part of a voucher program focusing on the provision of safe water. Investigations and feasibility assessments are ongoing for the upgrade of the Bor town water supply system. This project is expected to benefit up to 250,000 people.

Through UNICEF support, a total of 19,119 individuals have gained access to basic sanitation facilities through the construction and rehabilitation of latrines in communities, schools, and health facilities. In relatively stable communities in Northern Bahr el Ghazal and Eastern Equatoria, community led total sanitation (CLTS) is being implemented as a sustainable approach to promote sanitation and increase the coverage. A cumulative total of 58 villages have so far been triggered in both locations. A total of 12,321 people have been reached with key hygiene promotion messages. As part of the inter-agency WASH programme, an assortment of WASH non-food items (NFIs) from the core pipeline were distributed to a total of 17,414 individuals during the reporting month.

Cash-based Programming UNICEF continued to support programme sectors and partners to operationalize and mainstream humanitarian cash programmes in South Sudan. In the month of March, UNICEF reached 493 vulnerable households and a total of 1,871 people (883 females and 988 males) through an unconditional cash support project in . The objective of the project is to supplement the basic food needs of vulnerable communities (mostly returnees and internally displaced). The households for the unconditional cash support project were identified and registered by UNICEF through a collaborative effort with local partners and community leaders. The continued depreciation of the South Sudanese pound (SSP) against the U.S. dollar, and the difference between the market value of the SSP compared with the official Central Bank rate is a formidable challenge. Preparatory work to initiate the WASH voucher pilot programme targeting the former Juba PoC sites continued during the reporting month. A total of 9,125 households were registered on the SCOPE platform in the former Juba PoC sites 1 and 3 . These households are earmarked to be provided with access to safe water through a voucher modality, in collaboration with WFP. UNICEF is in the process of establishing Long term agreements (LTAs) with mobile money operators.

Communication for Development (C4D) A total of 952,995 people (470,334 males and 482,661 females) from 178,016 households were engaged in integrated messaging for positive behaviours and social change since the beginning of the year. During the reporting month, UNICEF distributed information education and communication (IEC) materials which include posters, banners and flyers, and conducted radio talk shows on COVID-19 and the second round of the polio immunization campaign which reached 2,433,576 (99% coverage) of the target. The integrated community mobilizers network (ICMN) which has been recognized as a global best practice was an influential mechanism in achieving 99% coverage of the circulating vaccine 4 derived polio virus type 2 (cVDPV2) vaccination campaign. During the reporting period UNICEF provided technical support to community mobilizers deployed at Gavi supported health facilities spread across the country. The support focused on defaulter tracing and counselling of vaccine-hesitant caregivers. A total of 929 defaulter children (who missed the vaccine) were traced, (811 in and 118 in ).

The community mobilizers conducted 56,656 meetings with community influential groups and reached approximately 154,306 families at households, marketplaces, health facilities, and waterpoints through raising awareness on positive health and hygiene seeking behaviours. The mobilizers also conducted meetings focusing on the importance of routine immunization and polio vaccination in all the ten states. UNICEF continues to lead national advocacy efforts for the re-opening of schools provisionally planned for 3 May 2021. The schools are re-opening amidst a second wave of COVID-19 cases, in that regard risk communication and community engagement (RCCE) interventions have been scaled up to mitigate the risk. Over 2,000 calls were received at the UNICEF supported COVID-19 hotline (6666). A total of 90% of the calls were inquiring about the COVID-19 situation , where to get tested, and when the COVAX Facility supported vaccine would be available in South Sudan. During the reporting period, the C4D section completed the data collection exercise for the 3rd round of the Community Rapid Assessment (CRA) focusing on community perception and understanding of COVID-19 signs and symptoms as well as the acceptance and hesitancy of the COVID-19 vaccine. The C4D section in collaboration with the Ministry of Health (MoH) and partners continued with the preparation for the implementation of the COVAX vaccination roll out in Juba targeting over 4,000 healthcare and frontline workers. Plans are underway to conduct a health worker COVAX vaccine survey to understand the knowledge, attitudes, and perceptions of the health workforce and social mobilizers, who will be among the first 3 percent of the population that will receive the COVID-19 vaccine.

Humanitarian Leadership, Coordination and Strategy UNICEF is co-leading three Clusters and one Area of Responsibility (AoR) out of a total of ten clusters and three AoRs currently active in the country. UNICEF at a national level co-leads the Child Protection AoR and the Education Cluster with Save the Children, the Nutrition Cluster with Concern, Action Against Hunger (ACF) and the World Food Program (WFP) and the WASH Cluster with the Norwegian Refugee Council (NRC). UNICEF participates in the inter-agency protection of sexual exploitation and abuse (PSEA) task force under the Special Representative of the Secretary General (SRSG)/Resident Coordinator (RC)/Humanitarian Coordinator (HC), advocating for protection of children against sexual exploitation and abuse (SEA).

Human Interest Stories and External Media Hamida Lasseko was welcomed as the new UNICEF South Sudan Representative during the reporting month. As part of COVID-19 risk mitigation measures an important milestone was reached during the month, namely the arrival of the first batch of COVID-19 vaccines . The vaccines were facilitated through the COVAX initiative where UNICEF is a proud partner. UNICEF also facilitated the transportation of the vaccines and the syringes. Ahead of the World Water day commemoration in March, UNICEF focused on the critical water, sanitation and hygiene situation in South Sudan including in schools. A webinar for National committees focusing on WASH in Schools (WiNS) was held during the reporting month. A web feature was published including new human interest stories on the importance of water, latrines, menstrual hygiene and hygiene clubs in schools. UNICEF continued to highlight the difficult humanitarian situation in South Sudan including preparations for the upcoming flood season. UNICEF continued to advocate for schools to re- open while covering the execution of the final exams highlighting the importance of giving every a child a chance to reach this stage in their education.

Next SitRep: 20 April 2020

UNICEF South Sudan Crisis: www.unicef.org/southsudan UNICEF South Sudan Facebook: www.facebook.com/unicefsouthsudan UNICEF South Sudan Appeal: http://www.unicef.org/appeals/south_sudan

Who to contact for Hamida Lasseko Yves Willemot further information : Representative Chief of Communications UNICEF South Sudan UNICEF South Sudan Email:[email protected] Email: [email protected]

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Annex A

Summary of Programme Results

PROGRAMME RESULTS INDICATORS 2021

UNICEF and IPs Response Cluster/Sector Response

Change Change Sector Total 2021 Total since last 2021 Total since last

Needs Target results report Target results report Indicator | Disaggregation ▲▼ ▲▼

Nutrition # children aged 6 to 59 Girls 27,715 9,885 27,715 9,885 months with severe acute 272,978 272,978 malnutrition admitted for Boys 23,150 8,296 23,150 8,296 treatment

Girls 990,333 990,333 990,333 990,333 # of children reached with 2,971,481 2,971,481 vitamin A supplementation Boys 857,645 857,645 857,645 857,645

# of caregivers of children aged 0 to 23 months who received counselling on Female 1,133,149 457,464 174,563 1,133,149 457,464 174,563 maternal, infant and young child nutrition

Health # of children aged 6 months Girls 6,329 6,329 to 15 years vaccinated 540,000

against measles Boys 6,080 6,080 # of pregnant women and children provided with 340,000 147,788 8,440 insecticide-treated nets in malaria-endemic areas WASH

Girls 782,167 # of people accessing a

sufficient quantity of safe Boys 799,351 817,000 164,512 28,834 149,051 39,614 water for drinking, cooking Women 726,230 and personal hygiene Men 692,251

Girls 782,167

# of people accessing safe Boys 799,351 and appropriate sanitation 303,500 19,119 827 56,541 56,541

facilities Women 726,230 Men 692,251 Child Protection # children and caregivers Girls 4,818 2,016 accessing Boys 4,841 1,851 127,000 250,000 52,957 17,554 mental health and Women psychosocial support Men # of children and women Girls 4,052 1,772 accessing gender-based Boys 3,403 1,045 violence risk mitigation, 100,000 Women 4,926 2,383 prevention or response interventions Men 2,507 1,041 Education

# accessing quality formal or Girls Host 770,000 797,024 3,029 3,029 nonformal early learning, pre-

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primary, primary or secondary Girls IDP education Boys Host

Boys IDP

Female # of teachers trained on education in emergencies, 2,500 4,355 40 40 basic pedagogy and learner Male centered methodologies

Social Protection HHs 30,000 5,786 2,385 Female 90,000 18,373 5,637 # of households reached through the cash transfer Male 60,000 13,704 4,258 programme Girls 27,000 NA Boys 18,000 NA Communication for

Development

# of people accessing Female 1,320,000 317,919 132,059 mechanisms to voice their needs/concerns/ feedback, Male 1,080,000 366,078 109,418 including on Ebola

Annex B

Funding Status* Funds available Funding gap Resources Funds available Humanitarian Sector Requirements available from resources $ % 2020 (Carry- received in 2021 over) Health 6,776,000 6,776,000 - 1,154,547 1,154,547 83 Nutrition 60,000,000 60,000,000 27,000,000 5,365,032 32,365,032 46 WASH 45,587,800 45,587,800 824,678 9,330,016 10,154,694 78 Education 52,032,200 52,032,200 100,000 2,801,317 2,901,317 94 Child Protection 25,292,600 25,292,600 666,826 3,443,705 4,110,531 84 Social Protection 4,117,000 4,117,000 - 102,659 102,659 98 Community 4,000,000 80 engagement 4,000,000 - 807,311 807,311 Total 197,805,600 28,591,504 23,004,588 51,596,092 146,209,508 74%

* The Fund Received are gross (including global recovery) whilst the Carry Forward are programmable at CO level (figures are provisional).

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