. Background and Humanitarian needs
Despite improvements in the overall humanitarian situation significant needs persist in parts of Somalia. An estimated 2.6 million people remain internally displaced, either in rural areas or in informal settlements surrounding urban areas. Results from the 2018 Post-Deyr (October-December) seasonal Food Security and Nutrition Assessment indicate that 4.9 million Somalis, an increase from 4.6 million half a year ago, face acute food insecurity and will require humanitarian assistance and protection through mid-2019. Among these are 1.5 million people whose conditions are expected to deteriorate from Stressed (IPC Phase 2) to Crisis (IPC Phase 3) or worse between February and June due to the impact of below-average 2018 Deyr seasonal rainfall (October to December) compounded by the lingering effects of destitution and displacement from the 2016/2017 drought.1 In addition, 903,100 children under the age of five years will likely face acute malnutrition in 2019, including 138,200 who are likely to be severely malnourished.
Modest improvements in the nutrition status among some rural populations (and internally displaced persons (IDP) (Addun pastoral and Galkaacyo IDPs in the north east, Burau IDPs in the north east and Dhusamareeb and Kismayo IDPs in south central) have been recorded since Deyr 2017 due to improvements in food security, reduction in disease outbreaks and sustained humanitarian assistance. Although the national prevalence of Global Acute Malnutrition (GAM) has remained Serious (10-14%) over the past three seasons, the 2018 post Deyr season nutrition results indicate that the level of acute malnutrition is Critical (GAM 15-29%) in six out of 34 populations surveyed4 due to food insecurity, high morbidity, low immunization and Vitamin-A supplementation, and poor care practices. Notably, morbidity was high (> 20%) in more than half of the groups assessed including these six. Of specific concern are groups whose nutrition status has deteriorated from Serious to Critical in the past year (since 2017 Deyr) and projected to remain so until April (see map 2 in the annex). These include groups in parts of the East Golis Livelihood Zones, Guban Pastoral and NIP livelihoods in Bari, Sanaag and Sool. Worryingly, these groups also face deterioration in food security to Crisis levels through June if no assistance is provided and are among hotspots that urgently require nutrition and health interventions particularly targeting children under the age of five and pregnant and lactating women. Others are Baidoa, Mogadishu and Qardho IDPs, Beletweyne district in the Southern Agropastoral, Ceel Barde district in Bakool, and the Sorghum high Potential Agropastoral zones of Bay and Shabelle regions.
However, SOYDA have been providing integrated package of nutrition, Food Security, Education, WASH, protection, and health intervention in both Mogadishu IDPs as well as the Afgooye corridor district.
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 Lower Shabelle and Banadir 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. SOYDA enrolled 200 IDP children and provided teaching/learning materials and emergency teaching incentives.
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 quarter of Jan-March 2019, they include:
 With help of FMoH, UNICEF, SOYDA facilitated Mini-Measles Vaccination Campaign in Afgooye Corridor and 10 districts of Mogadishu, Mogadishu for targeting more than 118,000 children, the campaign reached a cumulative coverage of 94% for the 5 days.
 SOYDA Launched commemoration of International Day of Zero Tolerance for Female Genital Mutilation (FGM), 6 February 2019 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.
 A total of 42,561 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.
 Through the facility and outreach program sites SOYDA was able to reach a total of 9,232 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 quarterly coverage under five children thus indicating greater progress to the set indicators within the program.
 A total of 35,508 of under five children and 14,936 PLW and deliveries were provided TSFP and MCHN service in Benadir and Lower Shabelle region.
 SOYDA continuously conducting routing immunization in all the project target sites for health and nutrition however, in this reporting quarter, 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 6,433 children. This has since improved the quality of the target beneficiaries in all the program areas.
 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 quarter a total 585 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 7,831 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 mothers with improved maternal health care services in both facilities and outreach sites program.
 On the same reporting period a total of 643 women of reproductive age have received T1-T5. The community health workers are continuously conducting community sensitization and education in the project areas.
 Through this reporting quarter a total of 1974 <5 children received penta 1-3 in both the mobile outreach project sites as well as the facility base program sites, this has since provided the target beneficiaries enhance access to feasible emergency integrated nutrition and primary health care services.  1,436 Children and PLW were provided acute malnutrition treatment and also provided IYCF and NHHP counseling during this reporting period.  165 Hygiene kit distributions were done to the discharged CTC patients.  Provided 267 solar lanterns to improve safety for women and girls in IDP communities and provide opportunity for school children to study after work. Lanterns reduce the risk of fire and the negative impacts of burning kerosen indoors.  On GBV responses, 376 cases were provided STI treatment, basic emotional support and psychosocial support.  SOYDA Conducted Community Training and Awareness on Gender Based Violence for GBV Prevention and response for 80 participants in Mogadishu and Afgooye corridor IDPs.  298 dignity kits were provided to GBV risk and survivors in Mogadishu IDPs.  SOYDA conducted Case management and Referral pathway -meetings and referral costs and community service 13-15 March 2019, for 80 community participants.  SOYDA conducted WASH Committee training, 7th – 11th March 2019