ABCDEFGHIJKLMNOPQRSTUVWXYZ
1
 RegionResponse Scenario Assumption and DriversBroader Response Strategy (Applied to Response Actions) Response action Programme shift Response modalities Remarks/impact
2
A: The hotspot localities in Darfur, Khartoum and Kordofan States and other States as they situation evolve Scenario 1: Conflict continues with no or very limited access to the nutrition sites (status quo-/complete melt down) in the states or in the hotpot areas with IDPs within and outside the localities • Partners not able to resume routine services
• Stakeholders are able to negotiate tranquility period with warring parties to allow short window of response (cease fire)
• Difficult to deliver and replenish supplies
• Very high GAM prevalence of above 15% to catastrophic levels of acute malnutrition (GAM above 30%)
• Limited farming activities with increased number of food insecurity population falling into IPC -AFI 4 and 5
• Limited farming activities with increased number of food insecurity population falling into IPC -AFI 4 and 5
• Limited or dysfunctional health and WASH services
• Emergency levels of crude and under-five mortality rates associated with malnutrition
• Donors exercise flexibility to fund NGOs and SMOH supported nutrition sites with operational costs and allows for nutrition staff 		• Establish coordination with humanitarian actors (ICRC, MSF and Solidarities) with access comparative advantages to reach those in need with lifesaving interventions
• Develop and use simplified CMAM protocols
• Provision of one- or two-months ration
• Use Rapid Response Mechanisms where appropriate
• Collaborate with ISCG for joint approach to humanitarian responses
• Use Joint delivery and replenishment of supplies with other sectors under the coordination of the logistic sector /OCHA convoys
• Continued advocacy for access with HCT/HC and other stakeholders
• Scale up and combine e-BSFP with GFD
• Scale up and combine e-BSFP with GFD
• Strengthen coordination at national and sub national levels
• Optimizing sector Joint delivery and replenishment of supplies in difficult to reach areas
• Support provision of operational costs for NGOs and SMOH supported nutrition sites
• Integrating nutrition assessments with other multi-sectoral assessments
• Engaging partners to express commitment to implement in their localities. Priority localities explained		.Maternal and Young Child Nutrition (MYCN)Maintained in operational sitesMother to Mother support groups at family/community level estimated # of children in need or targeted that will be missing services ( to be inserted for SAM, SAM with MC and MAM cases
3
Multiple micronutrient supplementation among under-fivessuspended
4
.Treatment of SAM with Medical complication using simplified protocol Maintained in selected hospitals RRM, media announcements Very high GAM prevalence of above 15% to catastrophic levels of acute malnutrition (GAM above 30%)
5
. Treatment of SAM without medical complications using simplified protocol Intermittent (suspended/maintained Static, RRM
6
.Treatment of moderate acute malnutrition among under-fives using simplified protocol Intermittent (suspended/maintained Static, RRM sector prioritizationbefroe and during crisis- discuss.
7
. Treatment of acute malnutrition among PLW using simplified protocol Intermittent (suspended/maintained Static, RRM sector prioritizationbefroe and during crisis- discuss.
8
. Vitamin A supplementation suspended
9
. Early detection of acute malnutrition among under 5 through MUAC mass screenings/ referral and regular at household level) per locality and IDPs Suspended
10
. Early detection of malnutrition among under-fives by Mother MUAC (Household level) and in IDPs maintained with Mothers with MUAC for those with MUAC
11
. Iron folic acid Supplementation for PLW suspended
12
. Deworming among under-five suspended
13
 . Food based prevention of malnutrition (FBPM)suspended
14
. Emergency BSFP for under-fiveIntermittent (suspended/maintained - hLinked with General food Distribution -
15
. Emergency BSFP for PLWMaintained and scaled up Linked with General food Distribution -
16
Procure and distribute supplies
17
Conduct fortnightly/monthly monitoring of evolving nutrition situation and admission trend analysis Maintained
18
Conduct sector coordination meetings at State level and partners mapping Maintained Online
19
Procure and distribute Core supplies timely maintained Convoys
20
Provide allowances/incentives for nutrition workers in the facilities Maintained cash assistance
21
. Conduct nutrition assessments (Implementation of SMART surveys) Rapid SMART
22
23
Scenario 2: Access improves following negotiations between the parties to the conflict that allows partial access and sustaining/resuming nutrition services • Partners have limited access to the facilities and communities
• Stakeholders are able to negotiate tranquility period with warring parties to allow relatively long term (3months) window of response (cease fire)
• Supplies delivery and limited replenishment
• Very high GAM above 15% to catastrophic levels of acute malnutrition (GAM above 30%)
• Emergency levels of crude and under-five mortality rates associated with malnutrition
• Donors exercise flexibility to fund NGOs and SMOH supported nutrition sites with operational costs and allows for nutrition staff		• Develop and use simplified CMAM protocols
• Provision of one month ration for SAM cases admitted in OTPs
• Establish coordination with humanitarian actors (ICRC, MSF and Solidarities) with access comparative advantages to reach those in need with lifesaving interventions
• Use Rapid Response Mechanisms where appropriate
• Collaborate with ISCG for joint approach to humanitarian responses
• Use Joint delivery and replenishment of supplies with other sectors under the coordination of the logistic sector /OCHA convoys
• Continued advocacy for access with HCT/HC and other stakeholders
• Scale up and combine with e-BSFP with GFD
• Scale up and combine e-BSFP with GFD
• Strengthen coordination at national and sub national levels
• Optimizing sector Joint delivery and replenishment of supplies in difficult to reach areas
• Support provision of operational costs for NGOs and SMOH supported nutrition sites
• Integrating nutrition assessments with other multi-sectoral assessments		Maternal and Young Child Nutrition (MYCN)Resume and maintain static, outreach
24
Multiple Micronutrient Supplementation among under-fives Suspended
25
.Treatment of SAM with Medical complication using simplified protocol Resume and maintain static, outreach
26
. Treatment of SAM without medical complications using simplified protocol Resume and maintain static, outreach
27
.Treatment of moderate acute malnutrition among under-fives using simplified protocol Resume and maintain static, outreach
28
. Treatment of acute malnutrition among PLW using simplified protocol Resume and maintain static, mobile team, outreach
29
. Vitamin A supplementation suspended
30
. Early detection of malnutrition among under 5 through MUAC mass screenings/ referral and regular at household level) in the localities and IDPs Resume and maintain static, mobile teams, outreach
31
. Early detection of acute malnutrition among under-fives by Mother MUAC (Household level)suspended
32
. Iron folic acid Supplementation for PLW
33
. Deworming among under-five suspended
34
 . Food based prevention of malnutrition (FBPM) for under-twossuspended -replaced with e-BSFPLinked with General food Distribution -
35
 . Food based prevention of malnutrition (FBPM) for PLWs suspended -replaced with e-BSFPLinked with General food Distribution -
36
. Emergency BSFP for under-five in host and in IDPs Maintain Linked with General food Distribution -
37
. Emergency BSFP for PLW in host and in IDPs Maintain Linked with General food Distribution -
38
Conduct fortnightly/monthly monitoring of evolving nutrition situation and admission trend analysis Maintained
39
Conduct sector coordination meetings at State level and partners mapping Maintained Online
40
Procure and distribute Core supplies timely maintained Convoys
41
Provide allowances /incentives for nutrition workers in the facilities Maintained cash assistance
42
43
. Implementation of SMART surveys
44
45
Scenario 3: Parties to the conflict sign an agreement that ensures access to all facilities and communities, bringing the conflict to an end.• Partners have access to the nutrition facilities and communities
• Supplies are delivered and replenished timely
• Very high GAM of above 15% to catastrophic levels of acute malnutrition (GAM above 30%) (may take three months after the conflict to improve)
• Humanitarian assistance allowed to flow
• Access to health and WASH services improves
• Donors exercise flexibility to fund NGOs and SMOH supported nutrition sites with operational costs and allows for nutrition staff		• Scale up preventive and protective minimum package interventions
• Strengthen referral for SAM and support transport costs for SAM with MC
• Mass screening (find and treat) campaign
• Partners capacity building
• Cash assistance for poorest families and vulnerable groups
• Optimizing sector Joint delivery and replenishment of supplies in difficult to reach areas
• Support provision of operational costs for NGOs and SMOH supported nutrition sites for at least 6months after signing agreement
• Engaging partners to express commitment to implement in their localities. Priority localities explained		Maternal and Young Child Nutrition (MYCN)Resume and scale up Static, mobile teams, out reach, campaign, media
46
Multiple Micronutrient Supplementation among under-fives Maintained and scaled up
47
.Treatment of SAM with Medical complication Resume and scale up Static, mobile teams, out reach, campaign, media
48
. Treatment of SAM without medical complications Resume and scale up Static, mobile teams, out reach, campaign, media
49
.Treatment of moderate acute malnutrition among under-fives Resume and scale up Static, mobile teams, out reach, campaign, media
50
. Treatment of acute malnutrition among PLWResume and scale up Static, mobile teams, out reach, campaign, media
51
. Vitamin A supplementation Resume and scale up Static, mobile teams, out reach, campaign, media
52
. Early detection of acute malnutrition among under 5 through MUAC mass screenings/ referral and regular at household level) per locality and IDPs Resume and scale up Static, mobile teams, out reach, campaign, media
53
. Early detection of malnutrition among under-fives by Mother MUAC (Household level)Resume and scale up Static, mobile teams, out reach, campaign, media
54
. Iron folic acid Supplementation for PLW Resume and scale up Static, mobile teams, out reach, campaign, media
55
. Deworming among under-five Resume and scale up Static, mobile teams, out reach, campaign, media
56
 . Food based prevention of malnutrition (FBPM)Resume and scale up Static, mobile teams, out reach, campaign, media
57
. Emergency BSFP for under-five in newly displaced populations Resume and targetStatic, mobile teams, out reach, campaign, media
58
Non-Food prevention of malnutrition Resumed and scaled up Static, mobile teams, out reach, campaign, media
59
Procure and distribute Core supplies timely maintained Convoys
60
. Emergency BSFP for under-five in newly displaced populations Resume and targetStatic, mobile teams, out reach, campaign, media
61
Provide allowances/incentives for nutrition workers in the facilities Maintained cash assistance
62
. Implementation of SMART surveys / needs assessments/ food security surveys integrating nutritionSMART surveys
63
64
B: The rest of the localities in Darfur and Khartoum States (outside the hotspot areas) Scenario 1: Conflict continues with limited/partial access to the nutrition sites and IDP communities within and outside the district (status quo)• Partners have partial access to the facilities and communities
• Stakeholders are able to negotiate tranquility period with warring parties to allow passage of supplies from stores in the locality towns to facilities
• Limited Supplies delivery and limited replenishment
• Very high GAM above 15% to catastrophic levels of acute malnutrition (GAM above 30%)
• Limited farming activities with increased number of food insecurity population falling into IPC -AFI 4 and 5
• Limited or dysfunctional health and WASH services as health care providers have fled or became IDPs
• Emergency levels of crude and under-five mortality rates associated with malnutrition
• Donors exercise flexibility to fund NGOs and SMOH supported nutrition sites with operational costs and allows for nutrition staff 		• Advocating for full access clarifying why we are doing the intervention
• Pre-positioning stocks/supplies for a longer period.
• Rapid response mechanism (RRM)"
• Advocacy for conflicting parties to allow us to access the communities
• Advocacy through OCHA/humanitarian platforms/donors to local authorities and conflicts parties to allow access for humanitarian aid.)
• Use of community structures to offer basic nutrition services like IYCF messaging
• Use of local regimen (locally available food items to tackle malnutrition)
• Provision one month or two rations for SAM cases
• Establish coordination with humanitarian actors (ICRC, MSF and Solidarities) with access comparative advantages to reach those in need with lifesaving interventions
• Use Rapid Response Mechanisms where appropriate
• Air drop of Food and Nutrition supplies
• Advocating FAO to intervene to improve the food security situation"
• Collaborate with ISCG for joint approach to humanitarian responses
• Use joint delivery and replenishment of supplies with other sectors under the coordination of the logistic sector /OCHA convoys
• Continued advocacy for access with HCT/HC and other stakeholders
• Scale up combined e-BSFP with GFD
• Scale up combined e-BSFP with GFD
• Strengthen coordination at national and sub national levels
• Optimizing sector Joint delivery and replenishment of supplies in difficult to reach areas
• Support provision of operational costs for NGOs and SMOH supported nutrition sites
• Engaging partners to express commitment to implement in their localities. Priority localities explained 		Maternal and Young Child Nutrition (MYCN) (e.g., Basic IYCF)Maintained Static, RRM
65
Multiple Micronutrient Supplementation among under-fives Suspended
66
MUAC Screening (mother)
Support and advoacate preparation of local regiments (locally available food items to tackle malnutrition)
1- Remotely administered/operated
2- Maintained		1- Mobile
2- Local Community Health Care Workers/providers
3- Volunteers
4- Community Midwives, Community Nutrition volunteers
67
.Treatment of SAM with Medical complication Maintained in operational Hospitals
68
. Treatment of SAM without medical complications Maintained Static, RRM
69
.Treatment of moderate acute malnutrition among under-fives Suspended
70
. Treatment of acute malnutrition among PLWSuspended
71
. Vitamin A supplementation Suspended
72
1- Multi-sectoral assessment
2- MUAC Screening		Maintained
73
. Early detection of malnutrition among under 5 through MUAC mass screenings/ referral and regular at household level) per locality and IDPs maintainedStatic, mobile
74
. Early detection of acute malnutrition among under-fives by Mother MUAC (Household level)maintained
75
. Iron folic acid Supplementation for PLW Maintained Static, mobile
76
. Deworming among under-five Suspended
77
 . Food based prevention of malnutrition (FBPM)Suspended
78
. Emergency BSFP for under-five in host communities and IDPs Maintained and scaled up General Food Distribution
79
. Emergency BSFP for PLW in host and IDPs Maintained and scaled up General Food Distribution
80
Conduct fortnightly/monthly monitoring of evolving nutrition situation and admission trend analysis Maintained
81
Conduct sector coordination meetings at State level and partners mapping Maintained Online
82
Procure and distribute Core supplies timely maintained Convoys
83
Provide allowances/incentives for nutrition workers in the facilities Maintained Cash assistance
84
. Implementation of SMART surveys Rapid SMART
85
86
Scenerio2: Conflict continues with no or very limited access to the nutrition sites (status quo-/complete melt down) in the rest of the localities in all the states with IDPs within and outside the localities See Scenario 1 for hotpot localities above) See Scenario 1 for 16 hotpot localities above) See Scenario 1 for hotpot localities above) See Scenario 1 for hotpot localities above) See Scenario 1 for 16 hotpot localities above)
87
88
Scenario 3: Parties to the conflict sign an agreement that ensures access to all facilities and communities, bringing the conflict to an end. See Scenario 3 hotspot localities above See Scenario 3 hotspot localities above See Scenario 3 hotspot localities above See Scenario 3 hotspot localities above See Scenario 3 hotspot localities above
89
90
91
92
93
94
95
96
97
98
99
100