Health and Nutrition

Health and Nutrition

Caritas Marsabit is implementing Nawiri program, a five-year research, humanitarian and resilience program that works in collaboration with Marsabit and Isiolo communities, county governments (CG), the private sector and other partners, to sustainably reduce persistent acute malnutrition (PAM) in vulnerable communities in the arid and semi-arid lands (ASAL). The program has achieved several successes and learned valuable lessons in FY22 through the implementation of core, layered activity interventions. These accomplishments are centered around key pillars of consortium work, which include different sectors such as Health and Nutrition, Livelihoods, Water, Sanitation, and Hygiene (WASH), Gender, Youth, and Social Dynamics (GYSD), and Social and Behavior Change (SBC), as well as integrated initiatives. The following summarizes the achievements and lessons learned in these areas.

Through the Nawiri program, Caritas Marsabit has contributed to increased access to health and nutrition services through integrated outreach. The integrated outreach has improved health and nutrition service access for vulnerable communities by facilitating 54 integrated outreach clinics in Marsabit, targeting those most affected by the drought who have migrated further for water and pasture. As a result, some highly vulnerable households have accessed health services, including ante-natal care and childhood immunizations. In total, 57413 children under the age of five and 10880 pregnant and lactating women were screened for malnutrition, with 2347 severe acute malnutrition and 22263 moderate acute malnutrition admissions. A total of 4803 people received treatment for minor illnesses, 10612 received Vitamin A supplementation, 4014 received Iron and Folic Acid supplementation, and 8008 were dewormed through integrated outreaches

During FY22, 195 newly employed and existing health care workers and community health volunteers in Marsabit were trained on Integrated Management of Acute Malnutrition, maternal, infant, and youth child feeding nutrition, Family Mid Upper Arm Circumference, social and behavior change facilitation, and the Baby Friendly Community Initiative, including some as Training of Trainers. Increased knowledge and skills have led to four facilities now offering IMAM services through enhanced capacity. IMAM Surge seeks to build resilient and shock-responsive health systems and communities. Nawiri currently supports 36 health facilities in Marsabit to implement, strengthen, and monitor caseload surges monthly, through the IMAM Surge dashboard, to prioritize action. FY22 has seen improved IMAM Surge monitoring, e.g., during periods of false “normals,” mass screenings have been triggered, and community health volunteers have been supported to intensify active case finding across hotspot Community Units.

Trained community health volunteers reached 3,083 households through Family Mid Upper Arm Circumference rollout in Nawiri hotspot Community Units. Family Mid Upper Arm Circumference is critical for the prevention and early identification of acute malnutrition. Caregivers have shared positive experiences of it, including it catalyzing self-referrals.

In addition to health and nutrition, the Nawiri Project has also focused on other sectors such as livelihoods, water, sanitation, and hygiene, gender, youth, and social dynamics, and social behavior change.  The following summarizes the achievements and lessons learned in these areas.

 During FY22, Nawiri collaborated with Marsabit county Departments of Agriculture, Livestock and Fisheries, to support 7,502 pastoralists from Marsabit county. Interventions focused on appropriate technologies, livestock production and management, animal health and livestock marketing strategies. Nawiri sensitized pastoralists on livestock off-take and collaborated with other partners who were providing livestock feeds to the vulnerable communities. However, FY22 targets were not met due to the worsening drought that fueled migration, significant livestock loss, and insecurity in parts of the County.

In the value chain activities, 3,117 pastoralists were engaged in value chain activities through linkages with certified Private Veterinary Service Providers (PVSPs). The pastoralists were linked to 14 PVSPs including Sidai Africa, which actively engaged PVSPs to provide services and products to pastoralists in last mile locations. These links should help the communities sustainably source critical animal health and production advisory services. 122 Community Disease Reporters from North Horr and Laisamis sub-counties and Golbo Ward were recruited and trained by the Department of Veterinary Services. They will undertake disease surveillance and reporting using existing tools.

Nawiri supported the set-up of 268 Savings and Internal Lending Communities (SILC) groups in Marsabit (5,015 members), with KES 5,712,660 in savings and KES 1,534,215 as outstanding loans. However, SILC group formation was relatively low due to the severe persistent drought that has depleted assets and increased migration, forcing SILC group members to travel long distances for water and pasture. Finally, in response to the severe impacts of the worsening drought, including amplified water scarcity and significant loss of livestock and livelihoods through FY22, Nawiri scaled up consumption smoothing and unconditional cash transfers (CT) in highly vulnerable, last-mile communities. The project reached 3,300 HHs in 11 wards in Marsabit by December 2022. Moving forward, responsive emergency and livelihoods support will continue to strengthen vulnerable community health, nutrition, and longer-term resilience.