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Mercy Corps Program Summary Award No : AID-OFDA-A- 16- 00053 Start Date : October, 2016 End Date : June 30, 2018 Report Date : October 2016 to June 30, 2018

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I N TEG RATED DRO UG HT RESPONSE IN ETHIO P IAN SO MALI R EGION FOR DROUGHT A F F EC TED POPULATIONS END OF PROJECT REPORT (October, 2016 – June 30, 2018) Reporting Organization Name: Mercy Corps Program Summary Award No : AID-OFDA-A- 16- 00053 Start Date : October, 2016 End Date : June 30, 2018 Report Date : October 2016 to June 30, 2018 Integrated Emergency response for Drought Affected Populations in Ethiopian Somali Region Semi Annual Program Report (November, 2016 to March 2018) OVERVIEW OF THE PROGRAM 1. Program Overview Mercy Corps Ethiopia (MC) and Action Against Hunger Ethiopia (AAH) were working together in a joint effort since October 2016, led by MC, to provide integrated emergency response for drought- affected pastoral communities of sixteen woredas in the Ethiopian Somali Regional State (SRS). The project focused on implementation of Community Management of Acute Malnutrition (CMAM) with particular emphasis on treating acute malnutrition, behavior change on hygiene-promotion and in some districts, sanitation infrastructure. MC was the lead implementer in this project, with AAH as the sub-grantee. The program covered sixteen districts, eleven of which were covered by MC in Jarar, Shabelle, Siti and Fafan Zones, and the other five of which were covered by AAH in Shabelle, Afder, Korahe and Nogob Zones. Districts were selected based on the severity of drought in collaboration with the Regional Health Bureau. The 16 intervention woredas in the SRS include 10 woredas approved for implementation in the initially approved proposal that was started in October 2016, including Jarar Zone, Birkot, Aware, Ararso, Shebelle Zone, East Imi, Denan, Adlade and Gode woredas; Korahe Zone; Marsin woreda, Nogob Zone; Elweyn woreda; Afder Zone, West Imi woredas. Additionally, six woredas were approved in the cost extension period as of October 2017 and include Jarar Zone, Bilibur, Deghamedo and Gunagado woredas; Fafan Zone; Tuliguled and Shabeley woredas; and Siti Zone; Dembel woreda. Operational implementation commenced in December 2016 in ten woredas approved in the first proposal and in the additional six woredas in October 2017. In spite of delays upon start-up of the initial program, as a result of challenges with obtaining government approval, both Mercy Corps and Action against Hunger worked to catch up with the initial implementation plan. Though both partners accomplished many activities to strengthen the existing government system and support the vulnerable communities to save their life and reduce the impact of the drought, the crises continues to threaten the life of the children and mothers. The crisis is exacerbated due to conflict, flooding, disease outbreaks, displacement of people because of tribal conflict, and recently, the political change in the region disrupted the existing systems. Factors including poor livestock productivity and displacement of people from neighboring Oromia region districts create an additional burden, which hampers the efforts of the CMAM nutrition intervention to reduce morbidity and mortality related to malnutrition. In most of the districts, malnutrition has increased gradually, with high SAM and MAM incidence rates, which leads to a shortage of supplies to address the increasing caseload. As a result of all contributing factors, pastoralist communities have lost their livelihoods, in particular, the majority of their livestock and productivity of their livestock significantly decreased and affected the daily diet of children and other family members. As a result of recurrent critical food shortages, the program’s effectiveness was challenged, as sharing of TSFP supplies was observed by families who did not receive general food distribution. Since the beginning of the program, MC and AAH have reached more than the planned target of beneficiaries anticipated for the program, which were estimated based on the trends during the proposal development period. To meet the growing needs of malnourished beneficiaries in the sixteen districts, MC flagged the issue of food shortages to WFP as early as possible and as a result, secured additional supplies from WFP. MC, in collaboration with WFP, implemented blanket supplementary feeding in selected high priority woredas to minimize the effect of malnutrition on under five children and PLW. In spite of all these efforts, beneficiary numbers drastically increased every month and 2 Integrated Emergency response for Drought Affected Populations in Ethiopian Somali Region Semi Annual Program Report (November, 2016 to March 2018) supply shortages were a bottleneck to address all the needy community. Like many other regions and communities in Ethiopia, SRS faced ongoing challenges of deteriorated natural resources, the inability to grow sufficient and diversified food. As a result, acute malnutrition threatens the livelihoods and stability of local communities. Program Goal Reduce mortality, morbidity and suffering associated with moderate and severe acute malnutrition of children and pregnant and lactating women living in the target Woredas of ESRS through an integrated response of strengthening Community Management of Acute Malnutrition (CMAM), provision of water, sanitation and hygiene (WASH) services for poor households that are affected by El Nino phenomena. Objectives Objective 1: Reduce mortality and morbidity and associated with moderate and severe malnutrition of under 5 children and pregnant and lactating women living in the targeted areas. Objective 2: Reduce of 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 Planned Activities The activities listed below were planned with the following target figures: Community mobilization improved infant and young child feeding: o Distribute IEC/BCC materials for all health facilities, schools and beneficiaries to use them as teaching aids to change the behavior of the community. o Provide education to mothers to practice exclusive breast-feeding and maternal, infant and young child feeding practices to 15,666 mothers. Management of MAM cases: o Screen and admit 64,121 beneficiaries into Targeted Supplementary Feeding (TSFP), including OTP discharged Beneficiaries. Management of Severe Acute Malnutrition (SAM) cases: o Establish or rehabilitate 158 OTP and 20 SC sites. o Establish 96 sites for mobile health and nutrition teams. o Treat 5,134 children in inpatient and outpatient therapeutic programs. Hygiene promotion services: o Provide hygiene promotion to 99,299 people. o Provide soap for hygiene promotion to 64,121 nutrition beneficiaries. 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 64,121 people. Sanitation infrastructure: o Construct 21 VIPLs for health facilities. o Establish 45 hand-washing points for health facilities. Capacity building for improved CMAM and WASH services: 3 Integrated Emergency response for Drought Affected Populations in Ethiopian Somali Region Semi Annual Program Report (November, 2016 to March 2018) o Provide training to 419 health care providers on SAM management and WASH services. o Train 1,970 community volunteers on community mobilization. o Train 419 health workers care providers on MIYCN. SECTOR 1: Nutrition As planned, MC provided full Component of CMAM including Community mobilization, Targeted supplementary feeding program for MAM Beneficiaries, Outpatient and Inpatient Therapeutic program for SAM beneficiaries with and without medical complications 1.1 Infant and Young Child Feeding (Planned target for the whole project life = 99,299) MC teams in each district conducted routine nutrition education and nutrition campaigns using different entertainment methods to teach people to change their nutrition practices and behavior. Health education and awareness creation were the center of MC and its partner’s, AAH’s, area of focus at all service delivery points, including food distribution days, Outpatient Therapeutic Program (OTP) days and any occasions of community gathering. Awareness creation campaigns were conducted in all districts, at 64 selected kebeles. The campaigns focused on promotion of nutrition, hygiene promotion, particularly on Maternal, Infant and Young Child Nutrition (MIYCN), Acute Watery Diarrhea (AWD) prevention through promoting the five key handwashing times. Different messages have been delivered during these campaigns through circus, dramas and local public entertainment methods including messages on exclusive breast-feeding for the child’s first six months and proper complementary feeding after six months. In total, 29,925 (M= 13,471 and F= 16,454) beneficiaries have been educated through these campaigns at 64 selected kebeles. IEC/BCC materials including IYCF counseling cards, mother action cards, breast feeding posters, WASH reminder cards, leaflets for water treatment chemical instruction, were produced and used to educate people. The Mobile Health and Nutrition Teams (MHNT) also provided routine health education with particular emphasis on maternal and child nutrition covering the first 1000 days of the children’s life. Through routine health education in sixteen districts, the project reached 246,221 (M= 48,472 and F=197,749) beneficiaries. The awareness of the community has been changed significantly. Previously, when their children became
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