Smile Again Africa Development Organization (SAADO) aims at eradication of poverty through life-saving and life-sustaining humanitarian assistance that rehabilitates and fosters resilience. Besides, SAADO is build-up to timely respond to nutrition in emergencies and avoid further deterioration through partnerships and inclusion community. In collaborations, coordination’s and coherence with humanitarian and development actors we are determined to address humanitarian needs of returnees, IDPs, Refugees and Host community in south Sudan and subsequently lay foundation lay foundation for development.

Malnutrition

The effects of chronic malnutrition are devastating and there is limited evidence that it can be reversible. On the other hand, acute malnutrition can be prevented and treated with the right nutrition responses. Aiming for a lasting and efficient undernutrition solution, SAADO adopted a multi-sectoral and integrated approach addressing causal context-specific as well as promotes multi-level response strategies, linking curative, preventive and longer-term structural action Primarily, the causes of undernutrition are complex and the immediate causes are inadequate nutrient intake and diseases which occurs as a prerequisite to underlying factors as attributed by;

• Unhealthy household environment and inadequate health services
• Inadequate maternal intake,
• Poor infant and young child feeding and impaired care practices
• Household food and nutrient insecurity

Goal

Strategic objective 1

Strengthen community- based prevention, management of acute malnutrition and emergency response.

Acute malnutrition is characterized by rapid weight loss and/or nutritional oedema caused by illness and/or inadequate food intake, such as a sudden change in the quality and/or quantity of food or poor infant feeding practices. It often increases during humanitarian crises but occurs during non-emergency situations as well.

In liaison with the UN, Donors, NGOs, south Sudan Ministry of health and community, SAADO intends to effectively manage acute malnutrition and timely respond to emergencies in nutrition using the MIYCN and CMAM approach.

The CMAM approach Comprises of four components; Community outreach and mobilization, Outpatient management of SAM without medical complications, inpatient management of SAM with medical complications and Moderate acute malnutrition (MAM), such a supplementary feeding

SAADO is prepositioned to contribute to prevention, early identification, and treat acute malnutrition for under-five children and pregnant and lactating women.

The community-based management of acute malnutrition method will be inter/intra- linked to other complementary services and programs such as those promoting maternal, infant, and young child nutrition, micronutrient supplementation, water, sanitation, and hygiene (WASH), HIV care and treatment, early childhood development (ECD), and livelihoods, agriculture, and food security. For example, Children attending growth monitoring and promotion services will be screened and referred for acute malnutrition. CMAM personnel will be trained to support recommended infant and young child feeding (IYCF) practices with caregivers at key contact points, and IYCF counsellors will be trained to screen, refer, and follow up children with acute malnutrition. Caretakers of malnourished children be referred to Food security and livelihoods programs aimed at improving the household's livelihood and food security status

Goal

Strategic objective 2

Promote and protect optimal maternal infant and young child nutrition and provide access to micronutrients.

Infants and young children need the right foods at the right time to grow and develop to their full potential. The first 1000 days of life is the period between conception and a child’s 2nd birthday and its unique window of opportunity to support child development and long-term health. This critical period has an enormous short- and long-term impact on the health and wellbeing of unborn babies, infants, and young children, as well as on the pregnant and lactating women. Optimal nutrition during this period lowers morbidity and mortality, reduces the risk of chronic disease, and fosters better development. To improve community knowledge, attitude and practice on optimal maternal MIYCN practices, and health-seeking behavior SAADO intends to;

In liaison with the UN, Donors, NGOs, south Sudan Ministry of health and community, SAADO intends to effectively manage acute malnutrition and timely respond to emergencies in nutrition using the MIYCN and CMAM approach.

1.1 Community inclusion approach throughout the program design, engagement will be at the heart of every intervention. In collaboration with community stakeholders and health care providers SAADO will reach out to the community and create awareness as well as sensitize the community on the importance of optimal feeding behaviour both on individual and group level targeting key messaging focused on the importance of good maternal health and nutrition during pregnancy, early initiation of breastfeeding, exclusive breastfeeding, dietary diversity, complementary feeding, child spacing, hygiene promotion, and sanitation. Community leaders, religious leaders, grandmothers and Fathers will also be involved in the awareness creation process to influence positive feeding behaviour change against taboos and myths that negatively impact feeding practices. Mothers and caregivers of acutely malnourished children will be encouraged to formulate mother to mother support groups and on the other hand Fathers will be supported to establish Men advocates thus continue influencing the community on best practices. Through the partnership with other interrelated programs such as WASH, FSL, Protection, Education and NFI, SAADO will create referral pathways and linkage of the projects at the community level. 1.2 Training and capacity strengthening The most recently launched MIYCN guide book provided a leverage platform for quality knowledge dissemination. In partnership with the Ministry of health, Donors and NGOs, SAADO will strengthen the capacity of health care providers and key community stakeholders on the ideal maternal and infant feeding practices. Training and on the job training approach will be applied to improve the knowledge towards the desired results. 1.3. Establish baby tents and linkages with early childhood development centers in the community The baby-friendly tents aim to protect and support the nutritional needs of both breastfed and non-breastfed infants and young children (0-24 months) by providing a supportive space in which to breastfeed. Priority interventions include breastfeeding protection and support, minimizing the risks of artificial feeding, and enabling appropriate and safe complementary feeding. Mothers will support using the following approach, Individual counselling, group discussions and peer to peer support. Caregivers or mothers enrolled the nutrition programs shall be linked to ECDs, besides attaining formal education children will also benefit from growth monitoring and early identification of malnutrition as well as knowledge will be imparted to caregiver’s early stimulation, on improved hygiene, optimal feeding practices, immunizations and micronutrient supplementation.

Strategic objective 3

Foster rehabilitation, recovery and build resilience Under nutrition impairs cognitive functions, reduces immunity to disease, increases susceptibility to chronic illness, limits livelihoods opportunity and reduces the ability to engage in the community. Thus undermines resilience and may increase dependence and inhibit recovery. SAADO is determined to efficiently intercept the trend of malnutrition through an integrated and multi-sectoral approach hence address the immediate and underlying causes of malnutrition. Prevention and treatment of acute malnutrition will be linked to Food security and livelihood, Water sanitation and hygiene promotion, shelter and protection and Gender-based violence programming. SAADO is open to inter or intra linkage programming where clear referral pathways will be established.

3.1 Nutrition, Health and Hygiene promotion

Inadequate nutrient intake and Disease/infection create a vicious cycle that exacerbates each other thus leads to death. Integration of health, nutrition and WASH in will provide treatment, prevention, rehabilitation and build resilience. Most of the diseases which result in diarrhoea are spread by pathogens found in human excreta (Feces and urine). The faecal-oral mechanism accounts for most diarrhoea and intestines worm infestation. The effective way to reduce disease transmission is to erect the primary barriers via behaviour change communication. Key hygiene and sanitation messaging will be conveyed routinely in nutrition sites. During nutrition programming, beneficiaries will be sensitized and trained on early identification, treatment and prevention of malnutrition as well as maternal infant and young child nutrition practices. SAADO will adopt the holistic approach will encourage the beneficiaries on health-seeking behaviours such as vaccination, immunizations, de-worming, and growth monitoring and hygiene promotions. Pregnant and lactating women will be encouraged to attend the anti-natal clinics for pregnancy monitoring and folic acid and iron supplementation as well as prevention of mother to child transmission

3.2 Food security and livelihoods

Disease and inadequate nutrient intake impair the physiological and physical functions of an individual. The latter is directly related to inadequate access to or availability of food or from loss of appetite or inability to absorb nutrients as a consequence of disease. The duration of exposure to these factors could either be chronic leading to growth failure or stunting in an individual (i.e., low weight or height in respect to age), an acute state manifested as wasting or thinness (i.e. low weight in respect to height), or both. Acute malnutrition carries with it a higher risk of mortality, the risk increasing with the severity. To curb malnutrition, SAADO aims to take an all-round approach in all our activities to deal with the underlying and long-term causes of hunger and malnutrition. Food security responses aim to meet short term needs and reduce damaging coping strategies to contribute to restoring sustainable food security. An approach that aims to enhance the availability, access, and utilization of nutritionally dense foods and bioavailability

3.3 Promote food and diet diversification

Increased food production and access are crucial to achieving major nutritional improvement. SAADO purposes to build the capacity of the caregivers on food diversification through training and sensitization meetings. Advocacy on breastfeeding and awareness creation of optimal feeding practices and linking families exposed to malnutrition and vice versa to either FSL or nutrition interventions. Food and nutrient sustainability will be achieved through production cultivation of nutrient-rich foods that address macro and micronutrient deficiencies. In conjunction with the FSL technical support, Mother to mother support groups and caregivers of malnourished children will establish a common kitchen garden for learning and will be encouraged to replicate the knowledge at home.

3.4 Protection and Gender-Based Violence

The nutrition programming will focus on GBV risk reduction by implementing prevention and mitigation strategies within the nutrition sector from pre-emergency through recovery stages. The nutrition designs will promote resilience by strengthening community-based systems and enable the at risk of GBV access nutrition care and support and contribute to aid recovery of communities by supporting lasting solutions to GBV. The nutrition programs will be located close to the target population, adhere to the desired frequency of distribution and observe waiting time to reduce the GBV risks to caregivers and children that may be encountered nutrition services. The design will also map out GBV centres and provide inter/Intra GBV referral pathways in situations of Gender-based Violence cases. Also, gender balance will be factored in the recruitment of nutrition staffs.

Education

The relationship between nutrition and learning is undeniably strong. Malnutrition negatively impact on cognitive development, physical development, social and emotional development. Early childhood nutrition, immensely contribute to later learning ability and academic performance. For instance, breastfeeding leads to higher IQ, while iron deficiency correlates with reduced cognition and achievement at school age and undernourished children frequently absent schools as they are prone to illnesses. In partnership with WFP, SAADO has been instrumental in provision of school meal program both in Terekeka and Juba. Besides improving enrollment in school, the program achieved retention in schools too. SAADO is open to further collaborations to see to it that south Sudan HDI index is improved.

• Disability mainstreaming
• HIV/AIDS
• Environment