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South Sudan, Koch County and Bentiu Poc, Unity State, Fangak, Jonglei State Time Period Covered by the Report: Final Report: June 1, 2017 – May 31, 2018

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South Sudan, Koch County and Bentiu Poc, Unity State, Fangak, Jonglei State Time Period Covered by the Report: Final Report: June 1, 2017 – May 31, 2018 Made possible by the generous support of the American People NUTRITION A ND F OOD S ECURITY ASS IS TANCE TO CONFLICT -A FFECTED H OUSEHOLDS IN S OUT H S UDAN Country/Region: South Sudan, Koch County and Bentiu PoC, Unity State, Fangak, Jonglei State Time Period Covered by the Report: Final Report: June 1, 2017 – May 31, 2018 Start Date: June 1, 2017 Dollar Amount Requested from USAID/OFDA $2,499,312 Dollar Amount from Other Sources $ 45,395 Total Dollar Amount of Program $2,544,707 Program Goal: TOTAL Total Number of People Affected in the Target Area 143,000 Total Number of People Targeted (Individuals) 89,500 Total Number of internally-displaced persons (IDP) 44,500 Targeted (Individuals) as subset of above - 1 - Final Report 1st June 2017 – 31st May 2018 1. Sector 1: Nutrition Overview of Activities: The Nutrition sector emphasizes Community Management of Acute Malnutrition (CMAM) through screening, referral, treatment and follow-up for malnourished children under five, pregnant and lactating women as well as tracking defaulters to programs by organizing home to home visits by CNVs. A community education component (MIYCN) focuses on behavior change for mothers and care takers on appropriate care giving practices for young children. For the capacity building, many training sessions were organized as well as on to the job trainings. World Relief supported nutrition services in Unity and Jonglei states in South Sudan. • In Koch county unity state, 4 Outpatient therapeutic programs (OTP) and Targeted supplementary Feeding program (TSFP) and 1 stabilization center (SC) in Koch PHCC were operational as of the end of the award period. At other times during the grant, up to 10 OTP/TSFP sites, but some were closed due to inability to access the sites or because the population had evacuated the area. • In Fangak County, Jonglei state World Relief operates 6 OTP/TSFP services during these period • In Bentiu (Rubkona County (PoC). World Relief operates 1OTP/TSFP in sector 2 and 1 OTP in sector 5 of POC. Unexpected challenges: • Throughout June 2017 – May 2018, Insecurity continued to be experienced in Koch resulting to only 4 nutrition sites operational, 4 suspended and 2 remained closed due to no population in the area. • Inadequate logistical support in terms of cars to transport nutrition supplies from the UNICEF and WFP warehouse to the nutrition center. • Delay of nutrition supplies from WFP warehouses to the nutrition centers resulting to no distribution for TSFP in all nutrition sites. • Delay in delivery of OTP supplies by UNICEF. Links to other programs or partners: • Integration of the nutrition activities with FSL e.g. Care takers of discharged children from TSFP been absorbed to FSL programme • FSL members are included in the Mother Support Groups • Integration of Nutrition to WASH ,WASH sector to dig pit latrine in nutrition centers • Integration of nutrition and GBV by conducting GBV awareness in nutrition centers • WRSS participates in various nutrition coordination meetings with SMOH, UNICEF, and WFP including Cluster meetings at the national and state levels and with other nutrition partners on weekly and monthly basis. WRSS also participates in various technical working groups with the nutrition cluster. Indicators Table Indicator OFDA target Final Reporting June 2017 – May 2018 Sub-Sector 1.1: Infant and Young Child Feeding 1.1.1 # and % of infants 0< 6 mo. who are 50% Total: 1,169 exclusively breastfed Bentiu:407 Koch: 311 Fangak: 451 1.1.2 # and % of children 6- <24 mo. 50% Total: 1,343 receiving foods daily in 4 food groups Bentiu: 348 Koch: 513 Fangak: 482 - 2 - Final Report 1st June 2017 – 31st May 2018 1.1.3 # of people receiving behavior change 7,200 Total: 63,377 M: 2,481 F: 60,896 interventions, by sex and age M: 800 F: 6,400 Koch: 7,981 M: 250 F: 7,731 Bentiu: 47,596 M: 1,468 F: 46,128 Fangak: 7,800 M: 763 F: 7,037 Sub-Sector 1.2: Management of Moderate Acute Malnutrition 1.2.1 # of sites managing MAM 15 Total: 17 Koch: 10 Bentiu: 1 Bentiu: 1 Koch: 10 (June to April), 4 (May) Fangak: 4 Fangak: 6 1.2.2 # of people admitted to MAM services, 8,275 Total: 7,383 by sex and age M: 2,851 U5: 4,551 M: 2,175 F: 2,376 F: 5,424 PLW: 2,832 Koch: U5: 459 M: 237 F: 222 PLW: 352 Bentiu: U5: 1,817 M: 841 F: 976 PLW: 1,363 Fangak: U5: 2,275 M: 1,097 F: 1,178 PLW: 1,117 (L: 488 P: 629) 1.2.3 # of health care providers and volunteers 275 Total: 246 (M: 191; F: 55) trained in the prevention and management of M: 140 Koch: 46 (M: 42; F: 4) MAM, by sex F: 135 Bentiu: 74 (M: 59; F: 15) Fangak: 126 (M:90; F: 36) Sub-Sector 1.3: Management of Severe Acute Malnutrition 1.3.1 # of health care providers and volunteers 275 Total: 246 (M: 191; F: 55) trained in the prevention and management of M: 140 Koch: 46 (M: 42; F: 4) SAM, by sex and age F: 135 Bentiu: 74 (M: 59; F: 15) Fangak: 126 (M:90; F: 36) 1.3.2 # of sites established/rehabilitated for OTP/TSFP: 10 Total: 19 inpatient and outpatient care SC: 2 Koch: SC: 1 OTP/TSFP: 10 (June to April), 4 (May) Bentiu: OTP: 2 Fangak: OTP/TSFP: 6 1.3.3 # of people treated for SAM, by sex and 2,627 Total: 4,975 M: 2,409 F: 2,566 age M: 1,280 F: 1,347 Koch: 2,318 M: 1,113 F: 1,205 Bentiu: 1,957 M: 965, F: 992 Fangak: 700 M: 331 F:369 - 3 - Final Report 1st June 2017 – 31st May 2018 1.3.4 Rates of admission, default, death, cure, Cure rate >75% Koch relapse, nonresponse-transfer, and length of Defaulter rate <15% Cure – 98.8% stay Death rate <10% Defaulter – 0.0% Non- response rate <15% Death rate – 0.0% Non respondent – 1.2% Medical transfer – 0.0% Bentiu Cured: 94.3% Defaulter: 1.6% Death : 0.0% Non respondent : 1.7% Medical transfer: 0.7% Fangak Cured – 90.8% Defaulter – 9.0% Death – 0.0% Non respondent – 0.2% Medical transfer – 0.1% • Indicators 1.1.1 and 1.1.2: There was no KAP survey conducted under this grant; therefore, WRSS is unable to report on the percentages for these indicators. A KAP survey is being conducted under the new award which will be used to inform future programming. • Indicators 1.2.1 and 1.3.2: In Koch County Unity State, 4 Outpatient therapeutic programs (OTP) and Targeted supplementary Feeding program (TSFP) and 1 stabilization center (SC) in Koch PHCC were operational as of the end of the award period. At other times during the grant, up to 10 OTP/TSFP sites, but some were closed due to inability to access the sites or because the population had evacuated the area. • Indicators 1.2.2 and 1.3.3: The number of cases admitted for treatment to MAM were lower than the projected target, while the number of cases admitted for SAM were higher than the target, which is indicative of the increasing food insecurity in the region. 2. Sector 2: Health Overview of Activities: The Health sector supported a primary healthcare in Sector two of the Bentiu PoC. The PHCC offers basic integrated primary health care services including reproductive and child health, disease surveillance and prevention package. Health activities include; antenatal care, deliveries, postnatal care; curative consultations for common conditions (Malaria, diarrhea, and acute respiratory infections (ARI)); routine EPI immunizations (with gift- in-kind from UNICEF); Key maternal and child health messages were disseminated by Home Health Promoters in the community as well at the health facilities. HHPs have been active in referrals from the community to the facilities thus the increase in maternal and child health service utilization. Additionally, WRSS procured essential medicines and supplies for sector 2 health facility and some formal and on to the job trainings were organized under OFDA grant. Unexpected challenges: • Shortage of essential drugs particularly Malaria RDT testing kits. This is addressed through collaboration with partners in Bentiu POC. Request to core pipe line partners (UNICEF & WHO) to supply us drugs/RDT testing kits with subsequent stock replenishment from WR Juba main store to avoid stock outs. - 4 - Final Report 1st June 2017 – 31st May 2018 Links to other programs or partners: • Health, Nutrition and ECD (Education) sectors managed to work in collaborative managers including referral of children in the OTP/TSFP with medical conditions for treatment, integrated health education messages, tracing both EPI and nutrition defaulters and their referrals to the respective health and nutrition sections. • Coordinated with health cluster Juba and Bentiu as well as SMOH, UNICEF, UNFPA, WHO, IRC, IOM and MSF to enhanced coordinated efforts during the implement phase of this project. Indicators Indicator OFDA target Final Reporting June 2017 – May 2018 Sub-sector 2.1 Health Systems and Clinical Support 2.1.1 # of health care facilities supported and/or 1 PHCC 1 PHCC rehabilitated by type 2.1.2 # of health care providers trained by type, by sex Staff: 50 Total: 32 M: 25, F: 25 Clinical Officers: 5 Midwives: 3 Volunteers: 225 Nurses: 3 M: 115, F: 110 HHPs: 9 Clerk: 3 Vaccinators: 5 Laboratory Technicians: 2 Health Officer: 2 2.1.3 # and % of health facilities submitting weekly 1, (100%) 1 (100%) surveillance reports 2.1.4# of consultation by sex* and age per quarter <5:5600 <5 Total: 12,222 (M: 5,989; F: 6,233) 5+: 12,500 5+ Total: 42,631 (M:20,889; F: 21,742) Sub-Sector 2.2: Communicable Diseases 2.2.1 Incidence and prevalence of high morbidity rates by N/A Diarrhoea: 5% (2,973/54,853) type (e.g., diarrhea, ARI, measles, and other), by sex* ARI: 66% (36,201/54,853) and age Measles: 0% Malaria: 21% (11,602/54,853) 2.2.2 # and % of cases diagnosed and treated per <5: 22,400 <5 Total: 12,222 (22% of all standardized case management protocols such as IMCI, consultations) disaggregated by sex* and age (M: 5,989; F: 6,233) 2.2.3 Case fatality rates for diarrhea, ARI, measles, and 0 0 (No death case was registered in the other, by sex* and age clinic during this grant period) Sub-Sector 2.3: Reproductive Health 2.3.1 # and % of pregnant women who have attended at 600, 60% 61.3% (2,430/3,967) least two comprehensive antenatal clinics (ANC) 2.3.2 # and % of women and newborns that received 300, 30% 99.9% (704/705).
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