P a g e | 1 2016 AFGHANISTAN COMMON HUMANITARIAN FUND Second Standard Allocation Strategy 2016 ------------------------------------------------------------------------------------------------------------------------- The Allocation Strategy The Afghanistan Common Humanitarian Fund (CHF) was established in January 2014 under the leadership of the Humanitarian Coordinator (HC). The objective of the CHF is to promote needs based assistance in accordance with humanitarian principles, to respond to the most urgent needs, and strengthen coordination and leadership of the HC. The CHF enables a strategic response to address gaps in delivering priority actions in the 2016 Humanitarian Response Plan (HRP). The priorities identified for funding under the envelopes of this Allocation Strategy have been identified following an inter cluster led Mid-Year Review of the HRP. The review exercise assessed progress in the first six months of the year compared to targets and priorities set by each sector; identified contextual changes impacting humanitarian needs; and considered newly available data pointing to additional or exacerbated humanitarian needs that have emerged or developed over the past six months. This comprehensive joint analysis informed a prioritization exercise through which the most urgent humanitarian needs and response gaps were determined. The criteria for prioritisation took into account where most lives could be saved; geographical areas most severely affected; which activities are time critical or critically enabling and which activities maximise cost efficiencies and value for money. This strategy paper therefore reflects a robust analysis of where and how to allocate critical resources where they are most needed over the coming months. The total amount of funding available for this allocation is c. $23 million. The funding will be allocated to address the following priorities: 1. Provide critical treatment for children under five and pregnant and lactating women with acute malnutrition - particularly targeted to underserved conflict IDPs and refugees; 2. Ensure emergency first aid and trauma capability to treat an increasing number of conflict casualties; 3. Address urgent protection concerns, basic service and assistance gaps, and reduce ERW casualties among people recently displaced by conflict; 4. Identify and address neglected shelter gaps and food insecurity threats among families who lost their homes and livelihoods in past natural disaster events and remain extremely vulnerable; 5. Strengthen humanitarian coordination and enhance the quality of data gathering and needs analysis to inform future response programme design at a strategic level; 6. Maintenance of an Emergency Reserve of $5 million, to enable flexible response to new, unforeseen humanitarian emergencies. To be activated by the HC as and when need arises. Coordination Saves Lives The mission of the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) is to mobilize and coordinate effective and principled humanitarian action in partnership with national and international actors. http://afg.humanitarianresponse.info/ P a g e | 2 Allocation envelopes Envelope One: Emergency support to address a worsening malnutrition crisis Acute Malnutrition remains a widespread problem in 2016 HRP SO4: Treatment and Afghanistan. Since the publication of the 2013 National prevention of acute malnutrition Nutrition Survey (NNS) the scale of the malnutrition crisis in has received increased attention however evidence from Bridge critical gaps in Basic Package of Health Services (BPHS) treatment of acute malnutrition 2016 province level SMART surveys indicate that the and prevent further deterioration of nutritional nutrition situation remains serious and in some cases is status. deteriorating. The recalculation of caseloads based on 2016 Relevant Cluster Objectives: SMART assessments in Ghazni, Panjsher, Badghis and Herat Nutrition Objective 1: The incidence of Acute indicate an increased burden from 238,529 to 369,680 acute Malnutrition is reduced through Integrated malnourished children (an additional 131,000) in these four Management of Acute Malnutrition among boys, provinces alone. girls, pregnant and lactating women. Nutrition Objective 2: Enhance the prevention of Severe acute malnutrition (SAM) is a life threatening Acute Malnutrition through promotion of Infant and young child feeding (IYCF) and micronutrient condition requiring urgent treatment. The median under-five supplementation. case-fatality rate for severe acute malnutrition typically Nutrition Objective 3: Quality community and ranges from 30% to 50%. Integrated Management of Acute facility based nutrition information is made available for programme monitoring and timely Malnutrition (IMAM) programmes which can substantially response. reduce the fatality rate have low coverage and frequent high WASH Cluster Objective 1: Ensure timely access to defaulting in Afghanistan. Outpatient SAM interventions are a sufficient quantity of safe drinking water, use of only reaching an estimated 38% of those that need adequate and gender sensitive sanitation facilities and appropriate hygiene practices. treatment. Across the board critical barriers remain with regards to ensuring children with unmet needs have access Allocation: $8.0 million to treatment of acute malnutrition. There are many contributing factors but key amongst these is the limited access to community level delivery of services, especially nutrition education, counselling, and treatment follow-up, and overall weak capacity at all levels of health care. Four coverage assessments carried out so far in 2016 (Laghman, Wardak, Ghazni and Herat) all indicated coverage well below recommended sphere standards in terms of the proportion of SAM children accessing treatment. These findings align with 16 other coverage assessments conducted in 2015. The lack of complimentary Moderate Acute Malnutrition (MAM) services in Herat province has been identified as one of the main barriers to the treatment of malnutrition and a significant contributing factor to high numbers of SAM cases in the province as children receive no care in the early stages of malnutrition - only when they deteriorate to a severe state. Those children that deteriorate to the most severe and complicated state of malnutrition require referral to in patient Therapeutic Feeding Units (TFU). Lack of access to, and poor condition of existing TFU facilities Coordination Saves Lives The mission of the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) is to mobilize and coordinate effective and principled humanitarian action in partnership with national and international actors. http://afg.humanitarianresponse.info/ P a g e | 3 however is a major challenge. TFUs in District Hospitals, particularly in the cluster targeted provinces urgently need to be assessed and rehabilitated to include adequate facilities for preparation of therapeutic foods, improve the water, sanitation and hygiene conditions of the sites, and ensure adequate provision of F-75/F-100 milk preparation kits. Conflict and insecurity compound the problems of poor service coverage. The spread of the conflict has not only interrupted and limited access to health facilities but caused massive displacement of families who experience prolonged periods of uncertainty and substandard living often in circumstances which exacerbate the risks for their children becoming undernourished. A Rapid Nutrition Assessment (RNA) undertake in the Kabul Informal Settlements (KIS) where more than 45,000 IDPS are estimated to live (20% children) found combined GAM and SAM prevalence of 21.9% and 5.9% respectively indicating an urgent need to ensure access to treatment programmes for over 2,000 children. Similar circumstances of deprived living conditions and limited coverage of health and nutrition services, has likely contributed to an increase in malnutrition detected among refugee children in the Gulan camp in Khost province. The RNA conducted there in May indicates emergency levels of acute malnutrition (wasting) with GAM and SAM prevalence of 17.3% and 4.6 % respectively and a significant deterioration in stunting (indication of chronic malnutrition) since last year, increasing from 37% to almost 50%. The surveys have further revealed significantly poor nutritional status of both pregnant and lactating women however the cluster receives extremely inadequate funding to provide critical nutrition support for this target group – essential to tackle the intergenerational cycle of malnutrition. In Afghanistan, this cycle is accentuated by high rates of pregnancy among adolescent girls who themselves often suffer stunted growth due to poor nutrition. As such they are therefore highly likely to have low-birth-weight babies, significantly contributing to infant mortality and severe short- and long-term adverse health consequences and markedly increasing the chance of childhood malnutrition and irreversible cumulative growth and development deficits. A major constraint in addressing malnutrition is the availability of recent assessment data to help target the most critical needs. Since 2013 the cluster has gradually been updating the findings of the NNS. During the 1st half of 2016 the nutrition Cluster through ACF and partners have managed to assess and provide updated evidence for 7 provinces and through additional CHF funding in the first 2016 will continue to assess another 8 priority provinces through multi-sectorial