Somali Young Doctors Association (SOYDA). Monthly Progressive Narrative Report. February 2021. 1. Background and Humanitarian needs Somalia continued to face multiple threats, including the COVID-19 pand emic, Desert Locusts and poor rains from the Deyr season. In the north of the country, the situation was further aggravated by unprecedented rainfall and strong-winds from Cyclone Gati in November, which caused flash floods resulting in crop, livestock and property losses, particularly in Iskushuban district of Bari region. Approximately 120,000 people were affected, including the displacement of around 42,100 people. Food insecurity is expected to worsen in 2021 across Somalia, driven by the effects of localized floods, below-average rainfall and a worsening Desert Locust infestation. In the absence of humanitarian assistance, over 2.7 million people are expected to face crisis or emergency levels of food insecurity by mid-2021, according to the findings of the 2020 post-Deyr seasonal food security and nutrition assessment. An additional 2.9 million people are expected to be under food stress, bringing the total number of people facing acute food insecurity to 5.6 million. Approximately 840,000 children under the age of 5 are likely to be acutely malnourished, including nearly 143,000 who are likely to be severely malnourished. While large-scale humanitarian food assistance and government support since July 2020 is likely to have mitigated the magnitude and severity of food insecurity, the situation is expected to deteriorate towards mid-year among poor rural, urban and displaced populations. The situation will likely be exacerbated by erratic weather patterns which are expected to continue in 2021, including La Niña in the first quarter of the year, with drought conditions forecast due to a harsh Jilaal dry season (January-March 2021) and possible delayed or poor Gu rains (April-June 2021). Already, pre-drought conditions have been recorded in Somaliland, Jubaland, Galmudug and Puntland, characterized by widely depleted berkeds and shallow wells, loss of livestock, as well as extensive critical loss of pasture. In addition, the Desert Locust infestation is expected to remain serious until at least March 2021, particularly as control measures are a challenge in the south due to limited ground and aerial access. The desert locust infestation continues to spread in the southern parts of Somalia. In Banadir region, locusts were spotted hovering in parts of Dayniile and Kahda. Local farmers have reported that locusts have destroyed pastures, trees and gardens that had just began to grow. In Jubaland State, the situation is worsening, with more than 20 villages and pastoral areas surrounding Dhobley and Afmadow district affected. In South West State, swarms of locusts have been reported in Lower Shabelle and in the Bay region. An estimated 200 hectares of farmland have been destroyed in Afgooye-Marka. In Puntland, immature and mature swarms of desert locusts are present in many areas where breeding is ongoing due to favorable weather conditions following recent rains. It is projected that the hatched swarms will start hovering around areas with vegetation in search of food, depending on the direction of the wind. In Hirshabelle State, a huge presence of newly hatched locusts has been spotted in Hiiraan and Middle Shabelle regions. However, SOYDA have been providing integrated package of nutrition, Food Security, Education, Civic Education, Youth empowerment, WASH, protection, and health intervention in Benadir, Southwest and Jubbaland State of Somalia. SOYDA shall however, continue its program implementation to enable reduce the vulnerability as well as provide improved lifesaving Health, Nutrition, WASH, Food Security, Protection and Education services i. Program effectiveness. The overall program management was assured by strong capacities in planning, implementation and monitoring through a very qualified and well- organized team and leaderships in Southwest State and Benadir region. It worked through integration of health programs in which SOYDA was also in partnership with SHF, DFID, WFP and UNICEF Somalia. The program produced important immediate results that show high prospects for larger impacts. Within its limited scope, the program reached vulnerable households as well as enabling equitable access to essential health and nutrition services. During the program implementation, the community members expressed their satisfaction, and it was clear their relationship was very good. The community nutrition education improved health and nutrition seeking behaviour of the communities, through the effective community health workers engagement on daily screening and referral as well as the traditional birth attendance who have visited the homes time to time in order to ensure the pregnant mothers deliver safely at SOYDA facilities. Through the community health workers, the project was able to reach the community members and provided the services to their doorstep, this has led to decreased in AWD/cholera related disease reported high before the initiation of the project. i. Program activity achievement. The following were some of achievement recorded in this Month of Feb 2021, they include: • SOYDA Launched commemoration of International Day of Zero Tolerance for Female Genital Mutilation (FGM), 6 February 2021 through community awareness engagements in Our Project Areas. Our awareness campaign started all our health facilities in Benadir and Lower Shabelle Region which aims to raise community awareness and mobilize people everywhere to bring about change through targeting Community leaders, Youth Symposium and Women entities to discuss the effects of FGM by Providing families and communities with information about the harm FGM causes – and the benefits to be gained by ending it. We encouraged families and communities taking action themselves and refusing to permit their girls to endure the violation of FGM. Marking the annual International Day of Zero Tolerance for Female Genital Mutilation (FGM) in the context of COVID-19 is a timely reminder of the health sector’s vital role ending this violation of girls’ and women’s health and human rights. From offering preventive services at the primary care level to ensuring the highest quality care possible for women and girls who have already undergone FGM, healthcare providers are powerful agents for change and service in their communities. FGM is an extreme form of discrimination against women, reflecting deep-rooted gender inequality. Evidence shows that COVID-19 is worsening existing gender and social inequalities. WHO strongly affirms that women’s choices and rights to sexual and reproductive health care should be respected, regardless of COVID-19 or their COVID-19 status. To promote the abandonment of FGM, coordinated and systematic efforts are needed, and they must engage whole communities and focus on human rights and gender equality. They must also address the sexual and reproductive health needs of women and girls who suffer from its consequence ▪ A total of 14,565 number of crisis affected women, children and Men in emergency was reached with improved life-saving primary health care services, However, integration of nutrition, WASH, protection and health have helped the community members have better lifesaving nutrition and health services with easy access to the facilities and mobile sites. ▪ SOYDA conducted internally displaced persons IDPs community awareness sessions through informing about COVID-19 risks, prevention, and seeking behavioral change of COVID-19 and good hygiene practice. We also provided face masks and hand sanitizers of the high vulnerability of older people and people with underlying health conditions to COVID-19. ▪ IEC materials on Covid-19 awareness and protection disseminated throughout our sites ▪ Through the facility and outreach program sites SOYDA was able to reach a total of 3,174 children under five boys and girls for vitamin A supplementation to enable enhance the vulnerable children nutrition status. This has since be able the program to reach more than 81% of the monthly coverage under five children thus indicating greater progress to the set indicators within the program. ▪ A total of 3,803 of under five children and 1,859 PLW were provided TSFP and MCHN service in Lower Shabelle region. ▪ SOYDA continuously conducting routing immunization in all the project target sites for health and nutrition however, in this reporting monthly. it was able to reach Routine measles immunization in both the facility base as well as outreach mobile services hence the program has been able to reach a total of 2,432 children. ▪ Skilled delivery is the core of primary health care services thus the project was able to record success in both facilities and at home visit for the traditional birth attendance hence encourage facility delivery and passed knowledge and information to the mothers in the target areas for safe motherhoods hence this reporting monthly a total 256 safe deliveries were conducted in SOYDA health and Nutrition facilities. This improvement was also attributed closer coordination between the program outreach team as well as community traditional birth attendants in the project areas. ▪ The project was able to attend to a total of 1,244 pregnant and lactating mother’s antenatal care (ANC 1st visit) in this reporting period and has since completed all the 4 comprehensive ANC visit. The program has recorded success in all reaching the vulnerable