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Integrated Drought Response in the Ethiopian Somali Region Funded by USAID/Office of Foreign Disaster Assistance (OFDA)

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Integrated Drought Response in the Ethiopian Somali Region Funded by USAID/Office of Foreign Disaster Assistance (OFDA) Quarterly Progress Report January 2017 – March 2017 Integrated Drought Response in the Ethiopian Somali Region Funded by USAID/Office of Foreign Disaster Assistance (OFDA) 1. Project Summary USAID/OFDA Grant No.: AID-OFDA-A- 16- 00053 Country/Region: Ethiopia Type of Disaster/Hazard: Drought 2. Program Overview Mercy Corps Ethiopia (MC) and Action Contre Le Faim Ethiopia (ACF) are working together in a concerted effort to provide integrated emergency response for drought-affected pastoral communities of ten woredas in the Ethiopian Somali Regional State (SRS). The project focuses on implementation of Community Management of Acute Malnutrition (CMAM) with particular emphasis on treating acute malnutrition, hygiene-promotional behavior change and in some woredas, sanitation infrastructure. MC is the lead implementer in this program, with ACF as the sub-grantee. The project covers ten districts, five of which are covered by MC in Jarar and Shabelle Zones, and the other five of which are covered by ACF in Shabelle, Afder, Korahe and Nogob Zones. Woredas were selected based on the severity of drought in collaboration with the RHB. The ten intervention woredas in the SRS are: Jarar Zone, Birkot, Aware and Ararso woredas; Shebelle Zone, East Imi, Denan, Adlade and Gode woredas; Korahe Zone, Marsin woreda; Nogob Zone, Elweyn woreda and Afder Zone, West Imi woredas. Actual implementation has commenced as of December 2016. In spite of delays upon start-up, the team has worked to catch up with the initial implementation plan. Two major challenges faced during this quarter were the worsening drought situation and outbreak of Acute Watery Diarrhea (AWD), which hampers the efforts of the CMAM nutrition intervention to reduce morbidity and mortality related to malnutrition. Pastoralist communities have lost the majority of their livestock and the milk productivity of the remaining livestock has decreased, affecting the daily diet for children. As a result of continuing critical food shortage, the program effectiveness is challenged as sharing of TSFP supplies is observed by families who do not receive blanket supplementary food support. The target population is children under five (U5) and pregnant and lactating mothers (PLW) who are moderately or severely acutely malnourished in the aforementioned woredas. Like many other regions and communities in Ethiopia, SRS faces ongoing challenges of deteriorated natural resources and the inability to grow sufficient and sufficiently diverse, food. As a result, acute malnutrition threatens the livelihoods and stabilities of local communities. Approximately 85% of the inhabitants of SRS are pastoralists or agro-pastoralists; therefore, the well- being for much of the population depends on the ability to make efficient use of scarce natural resources to support livestock herds. Frequent drought challenges the ability of pastoral communities to support themselves with their current livelihoods, and also contributes to a decrease in livestock productivity due to shortages of feed and water. Program Goal The program goal is to contribute to the reduction of mortality, morbidity and suffering associated with moderate and severe acute malnutrition in under 5 children, pregnant and lactating women living in the target woredas of ESRS. Objectives • Objective 1: Reduce mortality and morbidity associated with moderate and severe malnutrition of under 5 children and pregnant and lactating women living in the targeted areas. • Objective 2: Reduce mortality and morbidity associated with poor sanitation and water quality, amongst moderate and severe malnutrition of under 5 children and pregnant and lactating women living in the targeted areas. These objectives are further delineated as follows: • Improve awareness of the community through health education so they can practice appropriate maternal, infant and young child feeding and recommended hygiene practices. • Improve the capacity of health care providers so they can manage acute malnutrion independently at facility level. • Strengthen the government health system by providing technical and logistical support. • Improve health facility sanitation infrastructure through construction of new Ventilated Improved Pit Latrines (VIPL) and rehabilitating the existing facilities to be functional. • Provide timely distribution of Corn Soya Blend Plus (CSB++) for U5 and PLW with Moderate Acute Malnutrition (MAM) to minimize the number of severe acute malnutrition cases. • Distribute water treatment chemicals to prevent water born disease. Planned Activities The activities listed below were those planned for the second quarter; target figures are those listed for the life of the project. • Community mobilization improved infant and young child feeding: o Provide seven types of Behavior Change Communication (BCC) materials: Maternal, Infant and Young Child Nutrition (MIYCN) counseling cards, mother action cards, critical handwashing time action cards, point of use water treatment chemicals (POUWTC) action cards, Water and Sanitation Hygiene (WASH) and MIYCN posters. o Provide education to mothers to practice exclusive breast feeding and maternal, infant and young child feeding practices to 8,635 mothers • Management of MAM cases o Screen and admit 34,986 beneficiaries into Targeted Supplementary Feeding (TSFP), Outpatient Therapeutic Feeding (OTP) and Stabilization Center (SC) services • Management of Severe Acute Malnutrition (SAM) cases o Establish or rehabilitate 83 OTP and 12 SC sites o Establish 95 sites for mobile health and nutrition teams o Treat 2832 children in inpatient and outpatient therapeutic programs • Hygiene promotion services o Provide hygiene to 54,971 people o Provide soap for hygiene promotion to 34,986 people o Conduct 50 hygiene promotion campaigns o Provide Non-Food Items (NFIs), including water treatment chemicals, jerricans and buckets for point of use water treatment chemicals (POUWTC) to 34,986 people • Sanitation infrastructure o Construct 21 VIPLs o Establish 45 hand-washing points for health facilities • Capacity building for improved CMAM and WASH services o Provide training to 234 health care providers on SAM management and WASH services o Train 1,050 community volunteers on community mobilization 3. Program Performance Activities Implemented The program’s overall goal is to contribute to reduction of morbidity and mortality among U5 children and PLWs by strengthening the CMAM system with technical and logistics support, and providing some components of WASH to minimize the spread of disease that arises from poor sanitation and hygiene. In spite of delayed start during the first quarter, MC and its partner, ACF, continued program implementation in the second quarter with full capacity and achieved substantial progress in nearly all planned activities. The team supported the Regional Health Bureau to strengthen the health system to provid CMAM services at health facilities by providing materials and equipment, capacity building training for government staff and logistics support for woreda health offices. Training was provided for Health Extension Workers (HEWs) in all woredas; however, training could not be scheduled for health workers as these staff were all extremely busy with AWD case management and did not have time for the standard five-day SAM management training. The team also provided mobile health and nutrition services for beneficiaries living in remote areas without access to health facilities. MC has also procured all of the required materials and supplies for the program based on the capacity assessment. Since the end of the first quarter, MC has received 567.22MT of CSB++ from CRS in three rounds, of which 472.57MT were distributed in the second quarter for target beneficiaries based on the national Targeted Supplementary Feeding Program (TSFP) criteria. In the second quarter, 31,587 beneficiaries were reached, of which 9,508 were cured and discharged from the program. As the overall project target is 34,986 beneficiaries, the number of beneficiaries reached by the second quarter is already 90% which indicates the severity of the drought. Of the first round of beneficiaries receiving the food in January, 12,936 beneficiaries were admitted into the program; of these, 9,508 were cured after three rounds while the remaining 3,428 will continue into the fourth round. This relatively high number of beneficiaries continuing into the fourth round may be a result of sharing of food amongst other family members, as the severity of the drought limits the food availability for the entire family. Table 1, Summary of supplementary feeding Per Woreda Woredas Admission Discharge Total end five children Preg. and Transferred in Total Cured Defaulted Total of the admitted Lactating from OTP for Admissi discharge month discharge ration on Ararso 1516 1226 43 2785 967 0 967 1818 Aware 1200 979 21 2200 915 0 915 1285 Birkot 1779 1056 0 2835 387 0 387 2448 Denan 965 1855 23 2843 267 0 267 2576 East Imi 1755 1611 58 3424 1379 0 1379 2045 Gode 2221 2473 0 4694 1608 0 1608 3086 Adadle 1701 3619 0 5320 2310 0 2310 3010 Elwyene 614 659 0 1273 0 0 0 1273 West Imi 1431 3295 0 4726 1593 0 1593 3133 Marsin 400 1087 0 1487 82 0 82 1405 Total 13582 17860 145 31587 9508 0 9508 22079 Pictures of Beneficiaries during distribution at FDPs Health education and awareness creation were components of all service delivery, including food distribution days, Outpatient Therapeutic Program (OTP) days and any occasions for community gathering. The Mobile Health
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