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1 Baseline Report Emergency Response in the Greater Upper Nile

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1 Baseline Report Emergency Response in the Greater Upper Nile Baseline Report Emergency Response in the Greater Upper Nile Region in South Sudan: Agriculture and Food Security, Health, Nutrition, and WASH Program Support Methods and Data Sources To supplement the baseline data gathered from existing health and nutrition sites, from compiling and analyzing clinical registers and reports submitted to the Ministry of Health and other stakeholders, an end- of-project KAP survey conducted in February, 2019 provided additional data for the health and nutrition sectors. Also, a baseline survey on targeted beneficiaries in Koch and Fangak for AFS and WASH in April, 2019 also measured prevailing conditions, provided data and is informing targets for the project. Baseline data for AFS and WASH activities in Fangak and Koch Counties was collected using existing WRSS project staff conducting meetings with authorities, focus group discussions with community members, private home visits with a select number of randomly chosen beneficiaries and through stakeholders meeting with other partners working in these areas which helped in mapping out operational areas. Locations and Timing Data is gathered from locations covered in the project in Bentiu PoC, Koch County, and Fangak County. Baseline data for health and nutrition activities is gathered from existing health facilities and/or nutrition sites as well as the reporting done in the former project period. Data for AFS and WASH activities has been collected in initial months of the project in areas where activities will be implemented. Data was collected from Boaw, Gany, Jaak, Kuachlual, Ngony, Norbor, and Pakur payams in Koch County and Kuemduok, Kuernyang, and Tiep payams in Fangak County. Limitations and Mitigating Measures The biggest potential limitation for project monitoring is access to certain project areas in Fangak and Koch Counties. WRSS uses a boat to access remote locations in Fangak, but access remains fickle with rising and lowering water levels at different times of year. There are also challenges in working with the in-Opposition authorities in Fangak County who have demanded direct payment of taxes for things including staff salaries, landing fees, and fees for conducting trainings and workshops. With the support of the US Embassy and OFDA staff, some of the challenges have been overcome, most notably the readmission of relocatable staff required to provide adequate supervision and monitoring of all project activities, and WRSS continues to negotiate with all partners. In Koch County, different areas are governed by government and In-Opposition (IO) authorities and territory changes hands from time-to-time. Certain areas are made inaccessible by authorities, especially the IO, when fighting occurs or when local populations vacate an area. WASH and activities proposed for Koch County do not depend on the establishment of static locations but are designed to be delivered in communities using the Koch town base as a hub. 1 Findings Note: The baseline data is based on a six-month period, while the targets have been projected with consideration to the twelve-month award period. Sub-Sector Indicator Baseline Target Remark Outcome Indicator: % of 6-23 months old children who 20% 45% This target has been decreased after Nutrition receive a minimum acceptable diet analyzing the baseline data. The (MAD) decreased percentage is more realistic due to the actual food items available in target communities. Data collected in Feb 2019, OFDA 2018-19, Endline Survey. 1.1 Infant and Young Child 1.1.1 Proportion of infants 0-5 months 67% 70% Feeding in emergencies of age who are fed exclusively with breast milk 1.1 Infant and Young Child 1.1.2 Proportion of children 6-23 39% 45% Feeding in emergencies months of age who receive foods from 4 or more food groups 1.1 Infant and Young Child 1.1.3 # of people receiving behavior 34,824 70,000 Feeding in emergencies change interventions to improve infant (M: 4,626; (M: 10,000; and young child feeding practices F: 30,198) F: 60,000) 1.2 Management of Acute 1.2.1 # of health care staff trained in the 0 30 Malnutrition (MAM) prevention and management of acute (M: 20; F: 10) malnutrition 1.2 Management of Acute 1.2.2 # of supported sites managing 8 8 Malnutrition (MAM) acute malnutrition 1.2 Management of Acute 1.2.3 # of people admitted, rates of 4,713 9,000 Malnutrition (MAM) recovery, default, death, relapse, and (M: 1,352; (M: 4,320; average length of stay for people F: 3,361) F: 4,680) admitted to MAM sites Cure Rate: 97% Cure Rate: >90% Defaulter: 2% Defaulter: <15% Death: 0% Death: <3% Non-Cure: 1% Non-Cure: <10% Avg. Length of Avg. Length of Stay: 5 weeks Stay: 5 weeks 1.2 Management of Acute 1.2.4 # of people screened for 60,590 120,000 2 Malnutrition (MAM) malnutrition by community outreach (M: 18,133; (M: 36,000; workers F: 42,457) F: 84,000) Sub-Sector Indicator Baseline Target Outcome Indicator: Health Overall case fatality rate 2% <3% 2.1 Health Systems and 2.1.1 # of health facilities supported 1 PHCC 1 PHCC Clinical Support 2 PHCUs 3 PHCUs 2.1 Health Systems and 2.1.2 % of total weekly surveillance 90% 100% Clinical Support reports submitted on time by health facilities 2.1 Health Systems and 2.1.3 # of outpatient consultations 43,399 96,000 Clinical Support (M: 20,733; (M: 45,200; F: 22,666) F: 50,800) 2.1 Health Systems and 2.1.4 # of health facilities rehabilitated 2 PHCUS 4 (1 PHCC & 3 Clinical Support PHCUs) 2.1 Health Systems and 2.1.5 # of health care staff trained 21 45 Clinical Support (M: 16; F: 5) (M: 30; F: 15) 2.2 Communicable Diseases 2.2.1 # of communicable disease 22,135 48,960 consultations (M: 10,979; (M: 24,284; F: 11,156) F: 24,676) 2.2 Communicable Diseases 2.2.2 Case fatality rates for 0% <3% This indicator is difficult to track at the communicable diseases PHCC/U level, because severe cases or cases with complications are referred for higher level care. 2.3 Reproductive Health 2.3.1 # and % of pregnant women who 2,213 (55%) 3,320 (80%) have attended at least two comprehensive antenatal clinics 2.3 Reproductive Health 2.3.2 # and % of women and newborns 728 (65%) 1,008 (90%) that received postnatal care within three days after delivery 2.3 Reproductive Health 2.3.3 # and % of births assisted by a 672 (60%) 896 (80%) skilled attendant at birth 2.3 Reproductive Health 2.3.4 # of cases of sexual violence 36 45 treated 2.3 Reproductive Health 2.3.5 # and % of pregnant women in 0 100 (80%) their third trimester who received a clean delivery kit 2.4 Pharmaceutical Supplies 2.4.1 Number of people trained in 10 20 and other Medical medical commodity supply chain 3 Commodities management 2.4 Pharmaceutical Supplies 2.4.2 Number of health facilities out of 2 0 and other Medical stock of any medical commodity tracer Commodities products, for longer than one week, 7 consecutive days 2.5 Non-Communicable 2.5.1 Number of consultations for non- Not available 9,600 Diseases, Injury, and Mental communicable diseases (Currently non- (M: 4,762; Health communicable F: 4,838) diseases are not tracked in the DHIS and EWARS) 2.5 Non-Communicable 2.5.2 Number of consultations for 1,404 5,760 Diseases, Injury, and Mental trauma-related injuries (M: 730; (M: 2,857; Health F: 674) F: 2,903) Sub-Sector Indicator Baseline Target Outcome Indicator: WASH % of population with adequate hygiene 50% 70% Target has been increased slightly after practices analyzing the baseline data. 38% handwashing with water and soap at, at least 3 critical times for handwashing; 63% handwashing with some elements (ash, herb…) at least 3 critical times for hand washing. Average, 50.4%. Baseline data collected in April, 2019. 3.1 Hygiene Promotion 3.1.1 Number of people receiving 5,000 22,500 direct hygiene promotion (excluding mass media campaigns and without double-counting) 3.1 Hygiene Promotion 65% 75% Target has been decreased after analyzing the baseline data. The 3.1.2 Percent of people targeted by the baseline was lower than anticipated, hygiene promotion program who know and the lower target is more realistic at least three (3) of the five (5) critical given the current conditions in Koch times to wash hands and Fangak. Koch = 62.6% 4 Fangak = 68.1% Average= 65.4% Baseline data collected in April, 2019. 3.1 Hygiene Promotion 3.1.3 Percent of households targeted by 14% 60% the hygiene promotion program with soap and water at a designated handwashing location 3.2 WASH NFIs 3.2.1 Total number of people receiving 0 8,000 WASH NFIs assistance through all (New activity) modalities (without double-counting) 3.2 WASH NFIs 0% 60% Target has been decreased slightly as (New activity) this is a new activity. Experience with 3.2.2 Percent of households reporting receiving NFIs from the WASH satisfaction with the contents of the Cluster shows that generally fewer WASH NFIs received through direct items are provided in one area due to distribution (i.e. kits) or vouchers competing priorities across the country. 3.2 WASH NFIs 0% 70% Target has been decreased slightly as 3.2.3 Percent of households reporting (New activity) this is a new activity. Experience with satisfaction with the quality of WASH receiving NFIs from the WASH NFIs received through direct Cluster shows that items can differ distribution (i.e. kits), vouchers, or cash among distributions due to competing priorities across the country.
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