Aweil West is one of the 5 counties in the former Northern Bar El Ghazal (NBeG) that borders Aweil North, Aweil East, Aweil South, Aweil Center and Raga Counties all around it. The County is projected to have a population of 296,950 with a 19% population being children below 5 years. The area is considered to be rural wherein each household has an average size of 6 people . Community members depend on farm produce, market purchase and relief food periodically brought in as General Food Distribution (GFD) for their household livelihood. The household food insecurity dwindled due various reasons such as: the below average food production in the previous rainy season, the near collapse of markets in 2016 that increased food prices and the floods in 2017 that destroyed some of the farm produce in the agricultural zones.
Nutrition therapeutic services are offered through the support of 2 partners (American Refugee Committee (ARC) and Concern Worldwide (CWW)) in Aweil West County with sites totaling to 42. Concern Worldwide has 25 of these sites (19 Primary Health Care Units (PHCUs) and 6 Primary Health care Centers (PHCCs)) all based in the already established health facility points in the County; spread within the 9 Payams. These sites offer integrated health and nutrition services with an emphasis on nutrition treatment.
The most recent SQUEAC assessment was conducted between February and March of 2015 that saw the beginning of the lean season with gradually increasing food prices . The process realized point coverage of 39.8% (CI 29.0-51.9) as a result of many program barriers that had negative effect on coverage at the time. Since then, the program engaged in activities as guided by the recommendations that were directed towards counteracting the effect of those barriers (Annex 5). The 2017 SQUEAC assessment, on the other hand, was conducted within the post-harvest period of December 2017 when the prevalence of severe acute malnutrition was estimated as 1.9% and classified as low. It utilized the 3 stages of the methodology between December 2nd and 9th with a team of 14 enumerators as well as the assistance of CNVs and HHPs from health facilities that served the sampled villages. A coverage estimate of 78.9% was attained where the variation would be attributed to the difference in the timeline of the assessment from the previous coverage (2015), and the notable changes in the actions points identified herein as boosters.
In conclusion, the increase in human resource capacity to implement the CWW program seemed to enhance community awareness of the malnutrition program that contributed to the positivity surrounding the OTP, leading to increased referrals. As a result, majority of the children reached the OTP timely for treatment that further enhanced good outcome with more referrals. This positive cycle highly contributed to minimizing the barriers and their supposed effect on the coverage. Action points were recommended to reinforce the progress made towards program coverage, with targeted activities to reduce the effect of the respective barriers. They included formulation of OTP beneficiary support groups with income generating agenda, Intensified OJT that emphasize on all admission and discharge criteria, support of CNVs and HHPs with mobility and protective working gear (such as gumboots to facilitate movement in the rainy seasons) in addition to support to PHCUs and PHCCs to engage in some of their integrated outreach activities in the “far” catchment villages.