Quarterly Program Performance Report Integrated Response to Life-Threatening Malnutrition
Organization: Tearfund Date: April 30th 2017 Headquarters Mailing Address: HQ Contact: Programme Funding Advisor for the US Govt. 100 Church Road Telephone: xxxxxxxxxxxxxxxxx Teddington Fax: xxxxxxxxxxxxxx Middlesex Email: xxxxxxxxxxxxxxxxxxxxx TW11 8QE Field Contact: xxxxxxxxxxxxxxxxxxxxxxxxx United Kingdom Mobile: xxxxxxxxxxxxxxxxxxxx Email: xxxxxxxxxxxxxxxxxxxxx
Program Title: Integrated response to life-threatening malnutrition
OFDA Grant Number: AID-OFDA-G-16-00142
Country/Region: Uror and Twic East Counties, Jonglei State, South Sudan
Project period: Sept 1st 2016 - Aug 31st 2017
Time Period Covered by the Report: Jan 1st 2017 - Mar 31st 2017 (Q2)
1. Executive Summary This report provides an overview of completed activities and outcomes for January to March 2017, the second quarter of operation. During the reporting period, as detailed in a number of communications to OFDA the implementation of the project in Motot was disrupted due to insecurity. As a consequence monitoring data for Motot is not currently available and so reporting progress against indicators is not currently possible for all indicators. Notable achievements for this quarter include:
WASH: Uror a) 2 hand pumps were rehabilitated through overhaul of pump parts. b) 320 IYCF counsellors were trained and trainers on safe hygiene (to conduct peer to peer education to other community members in their villages.) c) Hygiene club training was conducted in 4 schools. d) 16 Water Quality tests before rehabilitation works commence. e) 14 water point management committees were supplied with Borehole cleaning tools for use to keep the hygiene of the borehole surrounding clean.
Twic East: f) 30 Patrons and PTA members in 5 schools trained on PHAST. g) 5 meetings conducted with IYCF counsellors on hygiene promotion. h) 5 hygiene school clubs supported with such tools as wheelbarrows, rakes, slashers, handwashing buckets to support their hygiene promotion efforts within and around their schools. i) Cholera awareness campaigns conducted in all the 5 Payams.
NUTRITION: a) Refresher training for 54 people (staff 45 and CHD 9) and 162 IYCF counsellors on Community Management of Acute Malnutrition. b) Provision of Outpatient Therapeutic Program (OTP) services to 960 (486 male and 474 female) severely malnourished children without medical complications and referral of children 10 with severe malnutrition and medical complications to an inpatient facility. c) Provision of Targeted Supplementary Feeding Programed (TSFP) services to 1,390 (664 male and 726 female) children (6-59 months) and 1,907 malnourished PLW. d) Disruption of Nutrition activities in 3 of 14 OFDA supported sites - Padiek, Yuai, Weckol.
Twic East a) 236 community volunteers trained and supported to conduct community screening. b) CMAM and IYCF refreshers sessions conducted for 21 Tearfund and 8 County Health staff. c) Provision of Outpatient Therapeutic Program (OTP) services 233 children (126 male and 107 female) severely malnourished children without medical complications and referral of 3 children with severe malnutrition and medical complications to a stabilization center. d) Provision of Targeted Supplementary Feeding Programme (TSFP) services to 693 (324 male, 369 female) children (6-59 months) and 663 malnourished PLW. e) 38 new mother-to-mother groups formed.
AGRICULTURE AND FOOD SECURITY a) No achievements during this period.
Award Level Beneficiaries for both WASH, Nutrition and FSL
Total Total IDP (WASH, (WASH, Total IDP Total IDP Total IDP Nutrition, Nutrition, FSL FSL WASH WASH Nutrition Nutrition FSL) FSL) Cumulative Target 78,222 11,443 2000 0 49,017 7,352 27,205 4,081 Reporting Period 31,967 4,795 0 0 26,000 3,900 5,967 895 Targeted Reporting Period 14,244 2,790 0 0 10,759 2,062 3,485 728 Reached Cumulative Reached 20,889 3,766 0 0 10,899 2,062 9,990 1,704 (to date)
2. Sector: WASH
Objective 1: To increase access to safe water sources, knowledge on good hygiene practices and sanitary facilities among IDPs and host communities.
Activity Progress/Achievement
Sub sector 1: Water supply infrastructure
Borehole rehabilitation 2 hand pumps were rehabilitated in Karam of Motot Payam in Duok village and Chuek village. Pump parts were changed i.e. 18 connecting rods, 18 Riser pipes and 1 cylinder each. Activity was disrupted by the insecurity that started in February, 2017. Changing these pump parts improved the quality of the water since the old parts were coloring and contaminating the water.
Water quality testing at 16 Water Quality Tests were conducted prior to rehabilitation of boreholes. Test results were water points, pre- test negative for fecal coliform contamination. More tests are to be conducted on the hand pumps after the rehabilitations are complete.
Water management 20 Water Management Committees were formed and 140 Members were trained to manage committee members the 20 boreholes targeted for rehabilitation. This activity was completed in Q1. formed and trained
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Training of Hand pump Training had commenced on the 15th of February, 2017 when fighting broke out in Yuai and the mechanics. training has therefore been stopped until further notice.
Water safety plans After training, the WMCs developed Water Safety Plans for the 20 Boreholes and 2 Water developed by Water user Yards. This activity was completed. These are to be followed-up to ensure that risks to committee members contamination of the borehole water are reduced. This activity was completed in Q1.
Water management Also in Q2 Water Management Committees in 14 of the 22 targeted boreholes were supported committee members with Borehole cleaning tools in February. Tools comprised of a rake, a traditional hoe called equipped with borehole Maloda, a Spade, a Panga, heavy duty gloves and a metallic bucket. These were prepositioned cleaning tools. from our Motot Office and taken to the different water points and distributed to the water management committees.
Sub sector 2: Hygiene promotion
Training of IYCF In Uror, 320 IYCF counsellors were trained by the 5 IYCF facilitators who had been trained in counsellors and extension Q1. 186 IYCF counsellors were trained in January, 2017 and then 134 IYCF counsellors were workers on PHAST trained in February, 2017. All participants were female. These IYCF counsellors, following their approach training, are to hold sessions with community members sensitizing them on good hygiene practices.
TE- 5 meetings held with the new IYCF Counsellors in Panyagor, Lith, Pawel, Wanglei and Dukchut feeding centers. A total of 50 IYCF Counsellors attended these meetings. These meetings were aimed at stressing the basic hygiene messages that the IYCF counsellors would share in their mother support groups meetings. Training is scheduled for quarter 3.
Support and Facilitation of In Uror in the month of February 2017, 4 schools Hygiene clubs were supported with cartons School-based Hygiene of soap for the hygiene promotion activities. This support was given to ensure that the Clubs at 15 schools children practice good hygiene.
TE- Hand washing soap, hand washing buckets, wheelbarrows, hoes, latrine brooms, jerry cans, slashers, and hygiene promotion booklets provided to 5 school hygiene clubs.
WASH Campaign / In Uror, within the first two months of this quarter, no campaign events were conducted. Mobilizing Events- These had been scheduled to take place in Q3. However, 4 drama groups, one in each of hygiene campaigns, water Modit, Karam, Yuai and Wickol were trained in Q2 on how to create dramas with hygiene day, toilet day promotion messages in preparation for the WASH campaigns.
TE- Tearfund supported cholera awareness campaigns were conducted in all the 5 payams of the county. These were in response to the recent outbreak of cholera in the Bor, Duk and the Islands of Jonglei and Zhiam Zhiam along the river Nile. 500 Households were supported with hand washing soap to promote handwashing and chlorine tablets to support water treatment. 2 mother-to-mother support groups have been engaged in preparing plays/skits for presentation during community gatherings and campaign events. They will be encouraged to present such during feeding days to help disseminate hygiene messages.
Training of School hygiene In Uror in the month of February 2017, Hygiene club training was conducted in 4 schools. 1 in clubs Wickol, 1 in Karam and 2 in Modit. Some of the schools that had been targeted for school hygiene clubs were not in operation at the time hence no facilitation was done for them. 48 members were trained, 24 Males and 24 Females.
TE-30 School hygiene club Patrons and PTA members were trained on PHAST Approach during the quarter.
Reporting Reporting Project Achieved Indicators Baseline period Period Explanation Target Cum. target Achieved
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Sub-Sector 1 : Water supply infrastructure
1 # people directly Activities in Subsector 1 were benefitting from the scheduled to be completed in water supply the months of February and infrastructure March, 2017 but the work 0 26000 26000 6287 6287 program could not continue after February 5th due to the tense security situation. Therefore targets were not met
2 # test results with 0 16 water point samples were faecal coliforms per taken and tests were 100ml sample conducted. 4 further tests that had been scheduled to be 0 20 0 0 0 conducted were planned in the last week of February however this could not happen since the security situation became tense.
3 # water points Hand pump rehabilitation was developed, repaired planned to be completed in the or rehabilitated 0 20 20 2 2 current quarter. However, due to insecurity the work could not continue
4 # water points actively utilizing the 0 20 20 20 20 water safety plan
Sub-Sector 2 : Hygiene promotion
1 # people receiving 216 HHs visited by WASH direct hygiene Extension workers, 336 women promotion(excluding reached during hygiene mass media education on feeding days, campaigns and 1260 mothers reached by IYCF without double- Counsellors during mother to 0 30,350 7,588 4,478 4,478 counting) mother support groups meetings, 1500 pupils reached by school hygiene clubs and 30 patrons and PTA members in the 5 schools in Ajuong and Pakeer Payams (TE)
2 # village water user committee active at 0 20 20 20 20 least 3 months after training
3 # water points that The distribution of the are clean and Borehole cleaning tools to protected from water management contamination committees had just been done 0 20 0 0 0 in the month of February, 2017. A verification exercise to ascertain the use of the borehole cleaning tools had not 4
yet been conducted.
4 Percentage of Progress to be measured Uror Uror Uror respondents who during endline KAP survey 32.6% 32.6% 32.6% know 3 of 5 critical 60% 0 Twic Twic East Twic East times to wash hands, East 8% 8% 8% disaggregated by sex.
Female (Uror) 32.7% 60% 0 32.7% 32.7%
Male (Uror) 31.4% 60% 0 31.4% 31.4%
Female (TE) 7.8% 7.8 % 7.8%
Male (TE) 8.4% 8.4% 8.4%
5 Percentage of Uror Progress to be measured Uror Uror households who store 61.1% during endline KAP survey 61.1% 61.1% their drinking water Twic 80% 0 Twic East Twic East safely in clean East 56% 56% containers. 56%
3. Sector: Nutrition
Objective: To increase access to life-critical services for the treatment of severe and moderate acute malnutrition.
Activity Progress/Achievement
Sub sector 1: Management of MAM
Screening and referral Uror - 686 children aged between 6-59 months of age (362 male and 324 female) were (common for both screened for malnutrition. Of these, 77.7% (n=533) were normal, 18.4% (n=126) were MAM and SAM) moderately malnourished while 3.9% (n=27) were severely malnourished. Screening was done by MUAC.
TE- 6244 children (male 3,097 and 3,147 female) aged between 6-59 months have been screened85% (n=5,320) were normal, 12% (n=772) were moderately malnourished and 2% (n=152) were found to be severely malnourished. Screening was done both at the community and at the centers.
Vitamin A After October 2016 UNICEF, the cluster lead, changed the protocol for issuing routine supplementation medications. Going forward Vitamin A will be provided by UNICEF through Ministry of Health (common for both (MoH) with support from Tearfund. The National Immunization Day’s (NID’s) are scheduled to MAM and SAM) be done after every six months and Tearfund hope to provide support through mobilizations and use of the feeding center facilities.
TE: These are normally being provided at the health facilities by the MoH.
Deworming (common This was not carried out during the period as Deworming is now also being done by UNICEF for both MAM and through MoH with support from Tearfund during NID’s since October 2016. SAM) TE: These are normally being provided at the health facilities by the MoH and will be done during National Immunization Days supported by UNICEF through MoH.
MAM (Children) Uror: 210 children (114 male and 96 female) aged between 6-59 months were admitted for admissions and MAM services. 159 were discharged. Of those discharged, 73.6% (n=117) were cured, 0% died,
5 discharges 18.2% (n=29) defaulted, 7.5% (n=12) were non responders while 0.6% (n=1) were referrals to OTP. The sphere standards for cure and default were not met due to a high default rate because there were no MAM supplies for the month of February. These are usually provided on a monthly basis by WFP however there were challenges with their pipeline. When the supply chain was reestablished, many of the beneficiaries did not come back on time despite efforts encouraging them to return
TE: 693 (324 male, 369 female) children were admitted into TSFP. 910 children were discharged. 85% (n=778) were cured, 0% died, 7% (n=64) defaulted, 2.9% (n=26) non responders and 3% (n=28) referred to OTP.
PLW admissions and Uror: 367 pregnant and lactating women were admitted for TSFP – PLW services. 243 were discharges discharged from the program. 82.3% (n=200) were discharged as cured, 0% died while 17.7% (n=43) as defaulters. The sphere standard for default was not met. This was attributed to then ongoing food distribution in Waat. People (mainly women) moved to Waat for receive food rations (general food distribution). This led to increased absenteeism and thus defaulting.
Twic East: 663 PLW admitted into TSFP. 914 were discharged with 86% (n=787) cured, 0% deaths and 10% (n=91) defaulters. All standards were met.
Sub sector 2: Management of SAM
SAM admissions and Uror: 199 children aged between 6-59 months were admitted for OTP services. 91 children discharge were discharged. Of these, 91.2% (n=83) were cured, 0% died, 7.7% (n=7) defaulted, 0% non- response while 1.1 % (n=1) were referred for inpatient care (Stabilisation Centre). All the sphere standards were met.
Twic East: 233 children (126 male and 107 female) were admitted into OTP. 280 children were discharged over this period. Of these; 88% (n=245) were cured, none died, 5% (n=13) defaulted, 4% (n=12) were non responders. 1% (n=3) were referred for inpatient care.
Severe malnutrition Uror: 1.1% (n=1) were referred to Stabilization Centre supported by MSF-Holland in Nyiror with medical County. Tearfund gave them money to support transport and living expenses. complication Twic East: 1% of children discharged (n=3) were referred to a stabilization center for treatment of complications.
Sub sector 3: IYCF
Identification of Uror: 161 new support groups were set up during the period, making the number of functional counsellors and set up support groups 492. 51 new counsellors were trained making the total number of active of support groups counsellors 112. The support groups are therefore supported the 112 IYCF counsellors and 5 IYCF facilitators. The support groups conduct at least 2 group sessions per month to discuss and share experiences while referring to counselling cards. IYCF counsellors attended 2 monthly meetings aimed at learning from each other and to report on the progress of their activities.
TE: 50 new IYCF counsellors have been trained in Panyagor, Lith, Pawel, Wanglei and Dukchut. 38 new groups were formed over the reporting period. The mother to mother support groups continue to meet every 2 weeks with the support of the IYCF counsellors.
IYCF sessions and Uror: 1,740 sessions were conducted. 1,019 individuals attended the sessions. The total people attending number of session attended and people attending was low. This was due to the insecurity that meetings began on 5th of February.
Twic East: 380 IYCF Mother support group sessions have been held to date attended by 1,231 individuals.
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Reporti Reporting Indicators Project ng Achieved Baseline Period Explanation Target period Cum. Achieved target
1) Sub Sector 1: Management of MAM
1 # of Sites managing MAM 13 13 13 13 13
2 # of people admitted to MAM services by sex and 0 12,981 3,245 1,933 5,152 age
Female Total 0 8,219 2,055 1,495 3,986
293 Female 0-11 mo 0 824 206 91
Female 1-4 Years 0 3,752 938 374 951
Female 5-14 Years 0 0 0 0 0
Female 15- 49 Years 0 3,643 911 1,030 2,742
Female 50- 60 Years 0 0 0 0 0
Female 60+ 0 0 0 0 0
Male Total 0 4,762 1,190 438 1,139
Male 0-11 mo 0 857 214 90 272
Male 1-4 Years 0 3,905 976 348 867
Male 5-14 Years 0 0 0 0 0
Male 15- 49 Years 0 0 0 0 0
Male 50- 60 Years 0 0 0 0 0
Male 60+ 0 0 0 0 0
3 Number of health care providers and volunteers trained 0 100 41 101 186 in the prevention of MAM, by sex
Female Total 0 49 20 101 165
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0 51 21 0 21 Male Total
4 Admission rate 100% 100% 25% 59.5% 61.5%
Cure rate 94.3% >75% >75% 79.3% 75%
<15% <15% Default rate 5.5% 12.6% 19.05%
Death rate 0% <3% <3% 0% 0.05%
Non Response 0 <10% <10% 5.75% 2.85%
80 Length of stay (days) 64 >60 >60 79
Walking distance 1.03 1.5 <2 <2 1.03 (hours)
Coverage >50 >50 >50 >50% >50%
Transfer rate 0.2 >5% >5% 1.8% 2.6%
2) Sub Sector 2: Management of SAM
1 Number of health care providers and . volunteers trained 0 100 41 101 186 in the prevention of SAM, by sex and age
Female Total 0 49 20 101 165
Female 15-49 Years 0 49 20 101 165
Female 50- 60 Years 0 0 0 0 0
Female 60+ 0 0 0 0 0
Male Total 0 51 21 0 21
Male 15-49 Years 0 51 21 0 21
Male 50-60 Years 0 0 0 0 0
Male 60+ 0 0 0 0 0
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2 Number of sites (4) 12 12 12(Uror-4,TE- 12 The 4 in the baseline established/rehabili 8) section are the tated for inpatient centers that Tearfund and outpatient care has been running SAM admissions and have been supported by the previous action. In Uror, Yuai FC does not offer treatment for SAM as this is carried out by MSF. An outreach site in Weckol has been providing OTP services that help to improve coverage of nutrition services in Yuai/Weckol Payam. However, Nutrition activities in 2 of 13 OFDA supported sites were disrupted in Feb,
3 Number of people admitted for SAM by 0 3,238 810 458 1,280 sex and age
Female Total 0 1,587 397 218 642
Female 0-11 mo 0 190 48 52 162
Female 1-4 Years 0 1397 349 166 480
Female 5-14 Years 0 0 0 0 0
Female 15- 49 Years 0 0 0 0 0
Female 50- 60 Years 0 0 0 0 0
Female 60+ 0 0 0 0 0
Male Total 0 1,651 413 240 638
Male 0-11 mo 0 198 50 57 160
Male 1-4 Years 0 1,453 363 183 478
Male 5-14 Years 0 0 0 0 0
Male 15- 49 Years 0 0 0 0 0
Male 50- 60 Years 0 0 0 0 0
0 Male 60+ 0 0 0 0 0
4 Admission rate 100% 100% 25% 65.75% 70.65%
Default rate 7.8% <15% <15% 6.35% 6.55%
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Death rate 0% <10% <10% 0% 0.15%
Cure rate 85.3% >75% >75% 89.6% 85.9%
Non response 5.2% <10% <10% 2% 4.4%
Transfer rate 1.7% <5% <5% 1.05% 1.3%
Length of stay 64.1 <60 <60 61 67
Sub Sector 3: Infant and Young Child Feeding and Behavior Change (IYCF)
1 Number & 3252 Reported upon at end 3252 4222 Percentage of Uror 2186 of the project after an Uror 2186 Uror: 2282/ infants 0-<6 mo. /43.1% endline assessment. /43.1% 45% who are exclusively 0 0
breastfed. TE- TE- TE 1586/32.7 1586/32.7% 1940/40% %
2 Number and 829 829 Reported upon at end 1234 Percentage of of the project after an
children 6-<24 mo. Uror – Uror – endline assessment. Uror receiving foods daily 477/3.8% 0 0 477/3.8% 628/5% in 4 food groups
TE- TE- TE 606/5% 352/2.9% 352/2.9%
3 Number of people receiving behavior change 0 10,886 2,722 1,437 5,309 interventions, by sex and age.
Female Total 0 10,559 2,640 1,422 5,294
Female 15-49 Years 0 10,559 2,640 1,422 5,294
Female 50-60 Years 0 0 0 0 0
Female 60+ 0 0 0 0 0
Male Total 0 327 82 15 15
Male 15 – 49 Years 0 327 82 15 15
Male 50-60 Years 0 0 0 0 0
Male 60+ 0 0 0 0 0
4 Percentage of Reported upon at end mothers practicing of the project after an Uror - 67.7% Uror 85% continued 0 0 72% endline assessment. TE - 79.2% TE 85% breastfeeding rate at 2 years
5 Percentage of Reported upon at end Uror - 89.8% Uror 95% mothers initiating 0 0 90% of the project after an TE - 96.5 TE 98% breastfeeding endline assessment.
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within an hour after delivery.
6 Percentage of Reported upon at end children introduced of the project after an Uror -35.3% Uror 40% to semi solid or soft 0 0 28% endline assessment. TE - 20% TE 30% food at the appropriate time.
7 Percentage of Reported upon at end Uror - 52.9% Uror 55% children fed at least 0 0 52% of the project after an TE -52.9% TE 55% 3 times a day. endline assessment.
4. Sector: Agriculture and Food Security
Objective: To improve the food security of households with malnourished children through agricultural support to help them breaking the cycle of malnutrition
Activity Progress/Achievement
Sub sector 1: Improving Agricultural production/Food security
Selection and forming of Due to insecurity, no progress was made on this activity in this quarter 10 farmers groups
Provision of farming tools Due to insecurity, no progress was made on this activity in this quarter to all groups
Provision of seeds to all Due to insecurity, no progress was made on this activity in this quarter groups
Agriculture training for all A meeting with the Agriculture Officers of Bieh State (based in Waat) was conducted, and they will groups support the identification of resource people who have rich local experience for training.
Promotion of sharing of Sharing sessions did not going ahead as planned due to the ongoing disruption of activities in the experience in targeted project area. villages
Reporting Reporting Total Project Indicators Baseline period Period Achievements Explanation Target target Achieved - Uror
Sub-Sector 1 : Improving Agricultural production/Food security
1 Number of people benefiting from seed systems/agricultural input 0 2,000 0 0 0 activities, disaggregated by sex.
Female 0 1200 0 0 0
Male 0 800 0 0 0
2 Percentage of beneficiaries reporting an increase in area 0 100% 0 0 0 planted in 2017 compared to 2016
3 % of beneficiaries demonstrating 0 80% 0 0 0 .
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improved agricultural practice
4 Number and percentage of people 0 200 0 0 0 trained in pest control practices, 0% 30% 0% 0% 0% disaggregated by sex.
0 180 0 0 0 Female 0% 90% 0% 0% 0%
0 20/ 0 0 0 Male 0% 10% 0% 0% 0%
5. Challenges and Constraints:
In Uror there have been no general food distributions and continued limited access to health services. Beneficiaries have therefore relied heavily on treatment of malnutrition, without sufficient support to tackle the underlying causes. This also puts stress on families and can damage the recovery of OTP and TSFP patients.
Uror Conflict broke in Uror in February. As a result, all existing stores (feeding centers and Tearfund office) were looted. The program activities have now been halted until the situation improves. Tearfund were also forced to relocate staff in February due to the ongoing insecurity. An emergency assessment of Uror following the fighting was completed in March 2017. As a consequence of this insecurity the planned activities for March were not able to be completed and all supplies prepositioned at sites across Uror have been lost. Communities have been affected and large scale displacement of the population has been reported in April. A full incident report has been provided to OFDA during the period of project disruption and can be provided upon request.
Twic East The Ministry of Health is not externally funded as the World Bank stopped its funding for the Ministry of Health last year. Most of the health facilities have reduced their operations with staff now working as volunteers as they have no salaries. John Dau Foundation (a national NGO) and KONDA (a community based organization) are supporting the running of some of the facilities. If this funding challenge continues, health services are likely to stop and this will adversely affect beneficiaries. With poor or no medical services, there is likelihood of increased disease prevalence. Possible impact to the beneficiaries may include more increased numbers of SAM cases, more malnourished children with medical complications and high numbers of non-responders. Tearfund will liaise with UNICEF to ensure that additional supplies are provided if need be so that project is not disrupted.
The agency running the Stabilization Centre to which Tearfund refers its beneficiaries has had funding challenges and have not been able to fully operate the center as expected. Some of the children referred here end up back in Tearfund OTP centers because of the lack of support. UNICEF has been consulting with Tearfund on the possibility of running the center in collaboration with the ministry of health.
6. Lessons learnt: In order to integrate the WASH and Nutrition programming better, Tearfund has started to train community volunteers on both hygiene and Nutrition messaging. This has worked well to help further beneficiary understanding of the underlying causes of malnutrition and it is hoped, will support the prevention strategy of the Action, increasing the effectiveness and efficiency of the project.
Conflict dynamics have had an effect on assumptions made on the security and access situation in Uror County. As the situation continues to develop, Tearfund will closely monitor and assess the risk to our project and staff. In the interests of managing this risk, Tearfund are undertaking a contingency planning process to plan for ongoing insecurity in the region. This will include scenario mapping, the identification of key scenario triggers and planning of actions and contingency plans. As other actors on the ground are continuing to deliver assistance to IDPs via mobile response, Tearfund are also exploring how this approach would ensure a measure of flexibility to our response as needed. Tearfund will ensure that senior staff are present in the area at regular intervals and continue to build relationships with the authorities in Uror as the situation allows
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7. Budget: As at end of March, 44% of the budget was utilized. Uror operations were disrupted in February hence this reduced spending.
8. Other Pertinent Information:
Collaboration - In Twic East the program has worked closely with the Ministry of Health County Health Department to deliver nutrition services through the existing health centers. Over the reporting period, Tearfund has worked with other health partners in Twic East – the John Dau Foundation, a national NGO and Kongor Development Authority, a Community Based Organization who are running some of the health facilities within the county.
Coordination - Tearfund has attended all relevant coordination meetings at various levels to ensure there is no duplication and that implementation is harmonized in the target area and in line with national standards. The WASH and Nutrition teams have attended coordination meetings at Bor, Yuai and Waat. For coordination of Nutrition activities, Tearfund are also coordinating with MSF Holland in Lankien, where severely malnourished children with complications are referred. We have also continued attending national WASH, FSL and nutrition cluster meetings and sending our monthly cluster reports. We have continued hosting and attending partner meetings in Uror and Twic East counties. Our bases in Motot and Yuai have also continued to provide support to other visiting partners coming into Uror.
In Twic East, Tearfund is an active member of the newly established WASH cluster at the county. The agencies were able to coordinate through this to organize and conduct cholera awareness campaigns across the county following an outbreak in the neighboring Duk County. Visiting partners and donors have been supported and hosted at the Tearfund base in Twic East.
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