South Sudan: RMF UNICEF Malnutrition Treatment and Prevention Program Jonglei State

Project Goals:
 
The overall goal of this project is to reduce the GAM rate to acceptable level of less than 15% in each of the payams assigned to RMF. This will be in line with standards set by South Sudan National Nutrition Program.

Project Objectives:
 

• To provide lifesaving nutrition services for acutely malnourished children (boys and girls) less than 5 years of age
• To prevent malnutrition in early childhood through promotion of improved infant and young child feeding, care giving and care seeking practices at the facility, community and family level.
• To prevent and treat micronutrient deficiency disorders in children through provision of multiple micronutrient supplementation, Vitamin A and deworming campaigns in the assigned areas.
• To strengthen the capacity of the County Health Department (CHD) and provide appropriate resources for the initiation and integration of nutrition services into existing Primary Health Care as well as linking nutrition interventions in the health system in the targeted counties

Summary of RMF-sponsored activities carried out during the reporting period under each project objective:
 
Implemented activities in line with RMF sponsored activities and project objectives include:
 

• Facilitated and established one additional OTP during the reporting quarter making it a total of six OTPs run by RMF, all providing adequate CMAM and IYCF services.
• Procured all the necessary equipments for establishing an OTP in Pagak payam, an area in Duke County but annexed to Kuach-deng payam of Ayod County.
• Chartered UNHAS operated helicopters which delivered nutrition supplies and OTP equipments, foodstuffs and the trained nutrition staffs to Pagak payam.
• Recruited an experienced nutrition manager and a nutrition coordinator to oversee the nutrition program.
• Continued to replenish our nutrition supplies in all our sites of operation through chartering UNHAS operated helicopters and some commercial airline companies.
• Conducted on job training on CMAM and IYCF for all our nutrition staffs in all the sites so as to continue providing quality services.
• Continued support of high WIFI internet services in Juba office to enable smooth coordination.
• Procured and delivered five water purifying equipments for our field base to enable our nutrition team have clean, safe drinking water.
• Procured and delivered portable solar lighting system to all our TFP sites, the power system is adequate to light and charge the Thuraya phones.
• Procured two additional communication devices (Thuraya phones), one for Pagak OTP and another for Juba office; this is to enhance proper coordination since internet and telephone services provided in the major towns (security stable locations) are not available in all our intervention areas which are designated as hard to reach places and also majorly affected by the ongoing conflict which erupted in mid-December 2013.
• Continued to procure and deliver essential foodstuffs to all our TFP sites for our nutrition team.
• Continued facilitation of our team to participate in all coordination activities.

Results and/or accomplishments achieved during this reporting period:
 

• During the reporting quarter (July- September) a total of 2,326 children under 5 were screened for signs of severe acute malnutrition (SAM) and a total of 553 SAM children were enrolled in our feeding program as per national guidelines.
• A total of 387 and 470 children received deworming tablets (Albendazole) and Vitamin A supplementation, respectively, in our TFP sites as per national protocols.
• Procured all the essential OTP equipments and delivered them to Pagak through chartered UNHAS operated helicopters.
• The amended PCA document now covers Ayod and Boma Counties, and the estimated SAM caseload is revised to 4,283 from the previous 7,214.
• During the amendment of the PCA, UNICEF agreed to pay all RMF technical staff in USD which is a big boost toward staff retention as the South Sudanese currency continues to depreciate against the USD.
• Strengthened the nutrition technical team through promotion of our nutrition coordinator to a position of a nutrition program manager and recruited a new well experienced nutrition coordinator. The duo oversees the implementation of the whole nutrition program in accordance with national policy guidelines.
• Interviewed and recruited local staffs from our areas of operation to support the trained CMAM nurses taken from Juba.
• The locally recruited nutrition staffs were trained on basic CMAM and IYCF protocols and guidelines during establishment of TFP centers and routine M&E visits by the nutrition technical team so as to provide standardized and quality nutrition services.
• Continued replenishment of nutrition supplies in all our OTP and SC sites through chartered commercial and UNHAS operated aircrafts.
• Coordinated RMF nutrition activities with UNICEF, UN agencies, nutrition cluster and other nutrition partners both at the national and state levels.
• Our nutrition field based teams are able to have clean, safe drinking water through use of provided water purifying equipments.
• Continued provision of essential foodstuffs to all our TFP sites since all our areas of intervention are hard to reach and getting basic foodstuffs there is not possible.
• Our nutrition field based teams are able to charge their Thuraya phones by use of provided portable solar lighting system.
• The RMF Juba based staff, visiting nutrition staffs from the various field locations and JTH staffs are benefiting from the high-speed WIFI internet services installed in RMF office.
• RMF accountant and the team leader participated in HACT (Harmonized Approach to Cash Transfer) training conducted by UNICEF hence the team is now able to request and liquidate project cash according to UNICEF guidelines.
• Procured and provided two additional Thuraya phones, one for Pagak OTP and another for Juba office enabling smooth communication and timely weekly progress reports as required by UNICEF.
• RMF Juba coordination office continued to have reliable source of power due to back-up by the installed solar system in the previous quarter making day to day running of activities easier.
• Monthly payment of Thuraya subscription fares to enable effective communication without interruptions.
• Prepared and submitted TSFP proposal for Ayod County to WFP.

Number served/number of direct project beneficiaries:

• Direct project beneficiaries are approximately 140,517 people living in the Payams assigned to RMF projected based on the 2008 South Sudan Population and Housing Census.
• The project is aimed at treatment and provision of multi-micronutrients to about 4,283 Severe Acute Malnourished (SAM) Children and provision of IYCF messages to 19,632 mothers/ caretakers in the two Counties.

Number of indirect project beneficiaries (geographic coverage):

• Indirectly targeting the whole population of the two Counties estimated to be 340,661projected from the 2008 South Sudan Population and Housing Census.
• The population of 1,622,242 in Jonglei State and Greater Pibor also benefits from the project indirectly as there is frequent movement of the people across the Counties.
• The nutrition service centers also receive beneficiaries from the neighboring Counties and Internally Displaced Persons from various areas of Jonglei State and other States in South Sudan.

Project Photos

(L) RMF nutrition nurse taking the weight of a child during screening; (C) during assessment of a child for signs of severe malnutrition; (R) Severely acute malnourished child enrolled in feeding program in RMF OTP

(L) Severely acute malnourished child enrolled in feeding program in RMF OTP; (C) Malnourished child on feeding program in RMF OTP; (R) Malnourished children on feeding program in RMF OTP

(L) Examination for mid upper arm circumference (MUAC); (C) Mothers with their children awaiting to collect nutrition supplies; (R) RMF nutrition nurse distributes nutrition supplies for children on feeding program

(L) A severely malnourished child on feeding program in RMF Boma OTP; (C) Procured water purifiers delivered in RMF Juba office awaiting transportation to the field locations; (R) Water purifier, Juba team are trained on how to assemble and use the equipment

(L) Procured portable small solar lighting system for field base; (C) Small solar system with its accessories; (R) Nutritional guidelines printed by RMF for all our TFP sites

(L) Samples of OTP register printed by RMF; (C) Delivering IYCF materials collected from UNICEF; (R) IYCF materials awaiting transportation to the TFP sites

(L, C) Basic materials procured for the OTP sites; (R) Plumpy’Nuts and other materials to be taken to Pagak OTP

(L) Nutrition and other supplies to be taken to Juba airport, to be flown to Pagak with UNHAS operated helicopter; (C, R) Essential foodstuffs to be taken to various TFP sites

(L, C) Nutrition supplies to be taken to various OTP/SC sites to replenish our stock level; (R) RMF nutrition nurse Kojoiki Afisha preparing to purchase some basic items before leaving for Mogok