#1unicef → for every child A family in Bentiu, Unity State, transports their belongings after severe flooding made road travel impossible O UNICEF South Sudan/2021/Sebastian Rich SOUTH SUDAN Consolidated Emergency Report 2021 March 2022#2Table of contents Abbreviations and acronyms Executive summary Humanitarian context. 3 4 5 Humanitarian results in 2021 7 Nutrition 8 Health 9 Water, sanitation and hygiene (WASH). 10 Child protection, gender-based violence and prevention of sexual exploitation and abuse (PSEA).. Education 12 13 Communication for development (C4D). 15 Results achieved from humanitarian thematic funding.. 16 WASH thematic funding. 16 Child Protection thematic funding 17 Education thematic funding. Assessment, monitoring and evaluation... Financial analysis Future work plan. Expression of thanks Annex 1: Case study... Donor feedback form 17 18 19 22 24 25 28 2#3Abbreviations and acronyms Accountability to Affected People Boma Health Initiative Communication for Development children associated with armed forces and armed groups AAP AoR Area of Responsibility BHI C4D CAAFAG CAP CMAM CNV CPIMS CRC CSO CTFMR ECD EiE ENA EORE FGD FTR FY GBV GPAA HAC ICMN IDP IOM IPC IRRM IYCF KAP LLIN M&E MHPSS MUAC NFIs NGO PoC PSEA PTA R-ARCSS Comprehensive Action Plan to End and Prevent All Grave Violations Against Children community management of acute malnutrition community nutrition volunteer Child Protection Information Management System United Nations Convention on the Rights of the Child civil society organization Country Task Force on Monitoring and Reporting early childhood development education in emergencies education needs assessment explosive ordnance risk education focus group discussion family tracing and reunification fiscal year gender-based violence Greater Pibor Administrative Area Humanitarian Action for Children Integrated Community Mobilization Network internally displaced person International Organization for Migration Integrated Food Security Phase Classification Integrated Rapid Response Mechanism infant and young child feeding Knowledge, Attitude and Practices long-lasting insecticidal net monitoring and evaluation mental health and psychosocial support mid-upper arm circumference non-food items non-governmental organization Protection of Civilian prevention of sexual exploitation and abuse Parent Teacher Association Revitalised Agreement on the Resolution of the Conflict in the Republic of South Sudan Risk Communication and Community Engagement severe acute malnutrition Sustainable Development Goal School Management Committee standard operating procedures surface water treatment technical working group RCCE SAM SDG SMC SOPS SWAT TWG UASC UN UNICEF United Nations Children's Fund UNMISS WASH WFP United Nations Mission in South Sudan water, sanitation and hygiene World Food Programme unaccompanied and separated children United Nations 3#4Executive summary The people of South Sudan entered 2021 having been hit hard the previous year by the triple shock of intensified conflict and sub-national violence, a second consecutive year of major flooding, and the impacts of COVID-19 measures. Around 8.3 million people in South Sudan were estimated to be in need of humanitarian assistance in 2021. These included 8 million South Sudanese women, men, girls and boys and 310,000 refugees and asylum seekers. This is an 800,000 increase in absolute numbers from the 7.5 million people in need in 2020.1 During 2021, recurring floods, droughts and other extreme weather events fueled by climate change, a deepening economic crisis, and sub-national and politically motivated conflicts led to the highest levels of food insecurity and malnutrition since the country attained independence in 2011². The COVID-19 pandemic has severely affected the economy, including due to the sharp decline of international oil prices, resulting in worsening existing vulnerabilities and long-term implications for economic growth and development. South Sudan also relies heavily upon a cross-border supply chain which has been hampered by COVID-19 measures.³ Critical social services, such as primary health care and education, faced significant challenges. The United Nations Children's Fund (UNICEF) Humanitarian Action for Children (HAC) appeal was revised in June 2021 to reflect growing needs (Table 1). The revised HAC noted that food security analysis estimated that the lean season (to July 2021) is the worst ever in terms of severity, with 108,000 at the brink of suffering from famine.4 Table 1: South Sudan HAC revisions 2021 In need of humanitarian assistance To be reached Funding requirements HAC 2021 (December 2020) 7.5 million people, including 4.1 million children 5.1 million people, including 3.7 million children US$197.8 million HAC 2021 Revision 1 (June 2021) 8.3 million people, including 4.5 million children 5.1 million people, including 3.7 million children US$180.1 million The revised HAC reported that an estimated 1.4 million children under 5 years are acutely malnourished, including 313,391 children suffering from severe acute malnutrition (SAM). Over 5 million people needed essential healthcare services; 5.9 million people lacked access to safe water; and 3.4 million children needed education support5. UNICEF was at the forefront of providing a multisectoral response to multiple humanitarian crises in 2021. As of 31 December 2021, UNICEF had received US$65.4 million against the US$180.1 million requested in the revised 2021 HAC appeal. These funds allowed UNICEF to deliver assistance to over 5 million people, including 1.5 million children. UNICEF reached 241,108 children under five (131,249 girls) with SAM treatment, an increase of 20 per cent over 2020. More than one million pregnant women and children received long-lasting insecticidal nets (LLINS) to protect against malaria; more than three times the target of 300,000. A measles mass vaccination campaign reached 483,550 high risk children aged between 6 months and 15 years in the affected eight counties, exceeding the 450,000 target. UNICEF prepositioned and distributed life-saving hygiene, sanitation, water treatment, and water point repair materials reaching 750,633 emergency-affected people. In 2021, 2,736 children (1,344 girls) were registered on the Child Protection Information Management System (CPIMS) and reached with case management services. A total of 898 unaccompanied and separated children (336 girls) were supported with family tracing and reunification (FTR), with 150 children (63 girls) reunited with their families. 1 OCHA, South Sudan Humanitarian Needs Overview 2021, January 2021 https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/south_sudan_2021_hu manitarian_needs_overview_print.pdf 2 UNICEF, Humanitarian Action for Children 2021, 2021 Revision 1 (June 2021) https://reliefweb.int/report/south- sudan/humanitarian-action-children-2021-south-sudan-2021-revision-1-june-2021 3 OCHA, South Sudan Humanitarian Needs Overview 2022 https://reliefweb.int/report/south-sudan/south-sudan- humanitarian-needs-overview-2022-february-2022 4 UNICEF, Humanitarian Action for Children 2021, 2021 Revision 1 (June 2021) 5 lbid 4#5A total of 99,524 individuals (27,338 girls; 22,501 boys; 28,982 women; 20,703 men) were reached through UNICEF's gender-based violence (GBV) prevention and response programme. In 2021, UNICEF reached 92,790 children (43,700 girls) with dedicated mental health and psychosocial support (MHPSS) through child-friendly spaces in communities and schools using a community-based approach, exceeding the target by 16 per cent. Around 5,878 caregivers (3,171 women) participated in psychosocial support and positive parenting sessions - over twice the number of caregivers reached in 2020. In 2021, UNICEF reached almost double the number of children with birth notification compared to the previous year, at 71,229 children (35,699 girls). UNICEF provided essential education in emergencies (EIE) services and supplies to 948,428 children (435,121 girls) in humanitarian situations, allowing them to access and utilize pre-primary, primary, and secondary education services. UNICEF successfully advocated for the reopening of schools after 14 months of closure due to COVID-19 measures, and supported schools to resume functioning. An additional 350,000 children enrolled, compared to when schools first closed in March 2020, bringing the total number of children re-enrolling into schooling to 2.7 million. UNICEF scaled up its risk communication, social mobilization, and community engagement activities in 2021 to address COVID-19 prevention response, the COVAX Facility's vaccines roll out, Polio outbreak response, prevention of malnutrition, flood response and safe reopening of schools. In total, 7,579,988 people were reached with integrated lifesaving messages. In 2022, UNICEF will continue to put the rights of the child at the centre of all interventions through integrated and multisectoral services; strengthening social service delivery systems in high-risk areas; and risk-informed and conflict sensitive programming, to strengthen the capacities of individuals, communities, and local partners from the onset of humanitarian action. Humanitarian context South Sudan remains mired in multiple humanitarian crises including ongoing sub-national conflict, despite the Revitalized Agreement on the Resolution of the Conflict in the Republic of South Sudan (R-ARCSS) signed in September 2018, and the formation of the Revitalized Transnational Government of National Unity (R-TGONU) in 2020. Slow implementation of R-ARCSS has created power vacuums and ambiguity of authority in many areas, contributing to sub-national violence and attacks on humanitarian workers with the number of UNICEF Serious Security Incident Reports increasing from 64 in 2020 to 88 in 2021. Recurring floods, droughts and other extreme weather events fueled by climate change, a deepening economic crisis, and sub-national and politically motivated conflicts in at least 12 counties, have led to extremely high food insecurity, and one of the world's worst humanitarian crises. At the beginning of 2021, more than 7.5 million people, including 4.1 million children, needed multisectoral humanitarian assistance 6. By mid-year the number of people needing support to meet their basic needs had risen to 8.3 million people, including 4.5 million children. Almost 4 million people remain displaced: 1.7 million internally and more than 2.2 million as refugees. Violence against civilians saw a 42 per cent reduction in 2021 compared with the previous year, with 3,414 victims of killing, injury, abduction, and conflict-related sexual violence in 2021 compared to 5,850 in 2020. Most of the victims were men (75 per cent), followed by women (14 per cent) and children (11 per cent). However, 6 UNICEF, Humanitarian Action for Children 2021, December 2020 https://reliefweb.int/sites/reliefweb.int/files/resources/2021-HAC-South-Sudan.pdf UNICEF, Humanitarian Action for Children 2021, 2021 Revision 1 (June 2021) 8 UNHCR, Joint Statement by IGAD, UNHCR and the governments of South Sudan and Sudan on the Solutions Initiative for 7 million forcibly displaced people, 5 October 2021 https://www.unhcr.org/uk/news/press/2021/10/615c418c4/joint- statement-igad-unhcr-governments-south-sudan-sudan-solutions-initiative.html#6conflict-related sexual violence specifically, dipped by only 8 per cent, from 211 in 2020 to 194 to 20219, remaining unacceptably high and likely under-reported. Sub-national conflict accounted for most victims and was particularly high in Warrap, Western Equatoria, Jonglei and Greater Pibor Administrative Area (GPAA). In May 2021, violence surged with at least 230 killed, 120 injured, 178 abducted, and 14 women subject to conflict-related sexual violence 10, and displacing an estimated 20,000 people in GPAA11. Between June and September 2021, at least 440 people were killed, 74 abducted and 64 subjected to conflict-related sexual violence during clashes between warring groups in Tambura County, Western Equatoria State. 12 An estimated 835,000 people were affected by severe flooding between May and December 2021, and 80 per cent of those affected were from Jonglei, Unity and Upper Nile states. Many displaced by the 2020 and 2021 floods were unable to return to their homes until early 2022, if at all 13. In 2021, South Sudan faced its highest levels of food insecurity and malnutrition since attaining independence 10 years ago. Food and nutrition insecurity identified in 10 most at-risk counties exacerbated the situation of women and children. In the most food insecure states, more than 50 per cent of the population is facing Crisis Integrated Food Security Phase Classification (IPC) Phase 3 - or worse acute food insecurity 14. In Pibor County, Jonglei State, some indicators surpassed the Famine (IPC Phase 5) thresholds, resulting in an IPC Famine Review 15. Most children treated for SAM came from the Greater Upper Nile Region (46 per cent) and Greater Bahr El Ghazal Region (36 per cent). - Needs are closely interrelated across sectors. For example, acute malnutrition is attributed to persistent high food insecurity, poor quality and diversity of food, low access to water and sanitation, as well as high morbidity due to a weak health system. At any one time, every other child is sick with fever or malaria, and every fourth child with diarrhoea. Limited availability and a lack of access to health services have contributed to an increase in maternal mortality to an estimated 1,150 maternal deaths per 100,000 live births, the highest figure in the world. 16 The under-five mortality rate in South Sudan translates to 1 in 10 children dying before their fifth birthday, and is among the highest under-five mortality rates globally 17. Preventable diseases such as diarrhoea, malaria and pneumonia are responsible for 75 per cent of all child deaths in the country 18. Women and girls are disproportionately affected by the various crises due to factors including ubiquitous GBV and mobility restrictions. Women and girls experience GBV in their homes and while accessing other life-saving services such as fetching water and collecting firewood as well as accessing other humanitarian services. During emergencies including floods and after the closure of schools due to COVID-19, violence against children and reported cases of teenage pregnancies, child marriages and child sexual abuse all increased in South Sudan. Natural and manmade disasters like flood and war exacerbate GBV prevalence and increased vulnerability due to breakdown of traditional protection mechanisms, poverty, and displacement that expose 9 UNMISS, Violence Against Civilians in South Sudan Reduced Significantly in 2021, 17 February 2022 https://unmiss.unmissions.org/violence-against-civilians-south-sudan-reduced-significantly-2021 10 lbid 11 OCHA, South Sudan Humanitarian Snapshot May 2021, 14 Jun 2021 https://www.humanitarianresponse.info/en/operations/south-sudan/infographic/south-sudan-humanitarian-snapshot-may- 2021 12 UNMISS, South Sudan: Hundreds of Killings Among Grave Violations and Abuses Committed Against Civilians in Tambura County in 2021, 1 March 2022 https://unmiss.unmissions.org/south-sudan-hundreds-killings-among-grave- violations-and-abuses-committed-against-civilians-tambura 13 OCHA, South Sudan Humanitarian Needs Overview 2022, February 2022 14 IPC Acute Food Insecurity & Acute Malnutrition Analysis October 2020 - July 2021 Issued: 18 December 2020 https://www.ipcinfo.org/fileadmin/user_upload/ipcinfo/docs/South Sudan_TWG_Key_Messages_Oct_2020-July_2021.pdf 15 2021 Global Report on Food Crises, Regional Focus on The Intergovernmental Authority on Development (IGAD) Member States https://www.fsinplatform.org/sites/default/files/resources/files/Full%20report.pdf 16 South Sudan (1150; uncertainty interval 789 to 1710). World Health Organization. (2019). Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division: executive summary. World Health Organization. https://apps.who.int/iris/handle/10665/327596 and UNICEF data https://data.unicef.org/country/ssd/ 17 Under-Five Mortality Rate South Sudan, 97.86 deaths per 1000 live births, UN Inter-agency Group for Child Mortality Estimation 2020.5 https://childmortality.org/data/South%20Sudan and UNICEF data https://data.unicef.org/country/ssd/ 18 UNICEF, UNICEF Response in South Sudan: Threats to child rights - Overcoming the impact of COVID-19 in a context of chronic vulnerabilities and dire humanitarian needs, May 2020 6#7women to further risks of rape, intimate partner violence, child marriage and physical domestic violence, among others. Untreated mental health conditions are a major contributor to disability in South Sudan 19. Persons with disabilities have been particularly affected by COVID-19 measures, with almost all (97 per cent) experiencing a reduction or loss of income at the start of the pandemic 20. While efforts were made to support distance learning when schools were closed until May 2021, children with disabilities have not benefitted from distance learning due to a lack of materials and equipment21. The number of out of school children has increased to 2.8 million children (2020), 22 and may have been further exacerbated by the pandemic for specific groups of children. For example, girls are at risk of not returning to school due to being subjected to increased rates of child marriage and adolescent pregnancies as a result of school closures. COVID-19 continues to affect the overall implementation context, hindering mobility, face to face contact and supply chains. A total of 15,242 confirmed cases and 135 deaths were reported as of 31 December 202123, though limited testing capacity is hindering an understanding of the true dimension of the outbreak. The pandemic heavily impacted vital access to basic services in early 2021 due to infection prevention and control measures, and has had devastating socioeconomic consequences in South Sudan. However, with a projected growth rate of 1.2 per cent in fiscal year (FY) 2021/22, South Sudan's economy is expected to record a mild economic recovery following an estimated contraction of 5.4 per cent in FY2020/21. Projections of up to 5 per cent growth for FY2022/23 have a high degree of uncertainty due to factors including the uncertain peace process, oil sector developments, climatic shocks, future path of the COVID-19 pandemic, and a weaker global economic context.24 Responding to the needs of children is key to building a prosperous and peaceful South Sudan. However, Government budget allocations and public financial management (PFM) to provide basic care and protection are vastly inadequate. The combined proportion of budget allocations for health, education, and the social and humanitarian pillar rose to 14 per cent in FY2020/21, from 9 per cent in FY2019/20. However, the budget allocation for the social and humanitarian affairs pillar (including social protection) decreased to 1 per cent in FY2020/21, from 2 per cent. An increase in the health budget allocation for FY2021/22 to 10 per cent (from 2 per cent in FY2020/21) is considered an important step. However, budget allocations are still way short of international and national commitments, such as 10-15 per cent for education and 15-20 per cent for health. Humanitarian results in 2021 In 2021, despite significant funding and staffing constraints, UNICEF delivered critical life-saving services to over 5 million people, including 1.5 million children. COVID-19 measures continued to impact UNICEF programming, requiring reprioritization, adjustments to budgets, and new working modalities formalized through revised guidance and standard operating procedures (SOPs), including strengthening remote field monitoring. UNICEF is successfully phasing out the Integrated Rapid Response Mechanism (IRRM) in favour of locally-led emergency preparedness and response. The IRRM was activated exceptionally for the Tambura conflict response in Western Equatoria, which displaced over 90,000 people. The Tambura IRRMS reached 37,265 individuals, including 3,980 children under 5, providing a lifeline to those in otherwise inaccessible areas. Pre- positioning of supplies remains a critical activity due to continued access constraints, particularly during the rainy season. UNICEF continues to integrate programming for peace and sustainability through the humanitarian- development-peacebuilding nexus. Progress was made in promoting better integration between meeting 19 Government of South Sudan, The South Sudan State of Adolescents and Youth Report 2019, 2020 20 Humanity and Inclusion, South Sudan COVID-19 Response Rapid Needs Assessment Report, May 2020 21 Ministry of Finance and Planning, Government of the Republic of South Sudan and UNICEF South Sudan. The Situation of Children and Women in South Sudan 2018-2020. United Nations Children's Fund, Juba. July 2021 22 MOGEI, Preliminary Report: Nationwide Out of School Children Catchment Mapping in South Sudan, May 2020 23 South Sudan: Coronavirus Pandemic Country Profile https://ourworldindata.org/coronavirus/country/south-sudan 24 World Bank, South Sudan Economic Monitor, February 2022 https://openknowledge.worldbank.org/handle/10986/36994 7#8humanitarian water, sanitation and hygiene (WASH) needs and building the resilience of communities. In conflict-affected areas, UNICEF is fostering peace building through learning spaces as zones of peace. UNICEF's long-term country-wide presence in South Sudan has cultivated intensive national and sub-national collaboration with a range of partners from Government and civil society, including clusters and local authorities. Increased engagement with Government in fulfilling child rights treaty obligations included submission of the Initial State Party Report on the Optional Protocol to the United Nations Convention on the Rights of the Child (CRC) on the Involvement of Children in Armed Conflict, and a report on the list of issues on the CRC initial State Party report, as preparation for Government dialogue with the Committee on the Rights of the Child in Geneva in 2022. UNICEF South Sudan continues to leverage its leadership on child rights to influence rights-based action for children and women in the country. UNICEF helps ensure women and children are prioritized through its leadership and membership of multiple national clusters, technical working groups (TWGs) and task forces. These include the inter-agency COVID-19 taskforce; regular participation in the Needs Assessment Working Group and Inter-Cluster Coordination Group to promote evidence-based decision-making; and as co-lead of the United Nations (UN) monitoring and evaluation (M&E) Working Group. UNICEF continued providing leadership to three clusters (education, nutrition, WASH). In child protection, UNICEF leads the Child Protection Area of Responsibility (AOR), and is co-chairing the Unaccompanied and Separated Children (UASC) Working Group and the Country Task Force on Monitoring and Reporting (CTFMR) to collect information on six grave violations committed against children by all parties to the conflict alongside the United Nations Mission in South Sudan (UNMISS). Nutrition UNICEF supported the government of South Sudan to deliver quality promotional and preventative nutrition services to women, girls and boys. UNICEF's leadership of the Nutrition Cluster has increased donor confidence in the nutrition sector and helped to initiate a paradigm shift linking preventive nutrition interventions to treatment of wasting. A total of 4,742,571 children aged 6 to 59 months were supplemented with vitamin A (91.6% of target including 2,494,721 girls), and 4,026,061 children aged 1 to 5 years were treated against worm infestation (86.4% of target including 2,087,989 girls). The campaign reached 77 out of 79 targeted counties in semester 1 and all 80 counties in semester 2. In addition, 2,144,873 caregivers and mothers of children under the age of two years received counselling on appropriate infant and young child feeding (IYCF) practices, almost doubling the target (1,138,303). The capacity of 3,761 health and nutrition workers (25% women) were enhanced on counselling and promotion of good caring and feeding practices. Through collaborative partnerships with over 38 implementing partners and the Ministry of Health, the number of outpatient therapeutic programme (OTP) nutrition sites providing quality care for children with SAM increased from 1,171 in 2020 to 1,213 in 2021. UNICEF contributed to the treatment of 241,108 children (131,249 girls) aged 6-59 months with SAM, increasing the number of children treated by 20 per cent (201,055 children in 2020). The increase is attributed to improved coverage as a result of the expansion of nutrition services in the 10 at-risk food insecurity counties, greater uptake of treatment for children with SAM, and availability of core nutrition supplies throughout the country due to dry season prepositioning. In 2021, the quality of SAM treatment improved year-on-year with nutrition performance indicators well within acceptable Sphere standards, of a 96 per cent cure rate (95% in 2020), 2.0 per cent defaulter rate (3% in 2020) and 0.2 per cent death rate (0.3% in 2020). To improve the quality of community management of acute malnutrition (CMAM) services, UNICEF trained 3,967 health and nutrition workers (871 females) providing nutrition services to improve adherence to the national CMAM protocol and thereby the quality of treatment of children with SAM. Close monitoring, on-the- job mentorship and supportive supervision as part of continuous quality improvement significantly contributed to the improved quality of SAM treatment and to successful adaptations to nutrition programming in the COVID- 19 context. 8#9In the COVID-19 context, UNICEF championed the family mid-upper arm circumference (MUAC) initiative to improve SAM case-finding and referral. The initiative empowered mothers and caregivers of under-fives to assess the nutritional status of their children through distribution of MUAC tapes and training on identification of early signs of malnutrition. This helped to mitigate the safety concerns associated with mass screening. As well as challenges brought about by COVID-19 measures, widespread flooding especially in most parts of Unity, Jonglei and Upper Nile had an impact on nutrition programming. Insecurity due to sub-national conflicts led to displacement of the population and access constraints in some locations. The challenges were largely mitigated through dry season pre-positioning of supplies, conducting outreach nutrition services and establishing new nutrition sites in locations affected by floods. There are key lessons learned around the potential of platforms and mechanisms for integrated service provision. Efforts made by the Government and UNICEF to deliver two rounds of vitamin A supplementation and deworming to young children in 2021, positioned the campaign as an excellent platform to deliver multisectoral promotional and preventative health, WASH and nutrition services to women and children, using the same logistics. Nutrition sites where wasting treatment take place are also an excellent platform to deliver integrated services - as evidenced by successful screening of children for malaria, distribution of 350,000 bed nets, 745,000 bars of soap and 24 million tablets of Aquatab - and offers the possibility for linkages with safety net programmes. The integrated nutrition and food insecurity scale up in 2021, brought innovation in the merging of multiple intersectoral community networks and volunteers to improve reach and build impact of joint work, to reduce the risk of disease, increase access to services and save lives. This model of local integration, as well as enhanced collaboration for preventative actions (e.g. WASH for malnutrition) has enabled greater impact and scale of emergency programmes, increasing UNICEF's ability to reach more children, better, with less. Table 2: Key indicators table for nutrition Indicators Cluster/sector 2021 Target Cluster/sector total results UNICEF 2021 Target UNICEF Total results Number of targeted children 6-59 months with severe acute 241,108 (131,249 242,549 241,108 242,549 malnutrition (SAM) admitted to therapeutic care female) % of exits from therapeutic care by children 6-59 months who have recovered # of pregnant and lactating women with access to infant and young child feeding (IYCF) counselling for appropriate feeding > 75% 96% > 75% 96% 1,138,303 2,144,873 1,138,303 2,144,873 Note: UNICEF, as cluster lead agency, is responsible for information management of cluster partner results and sharing overall results achieved by cluster members collectively. Health In 2021, over 6 million people were at risk of disease outbreaks, including cholera 25. Malaria is endemic in South Sudan and is the leading cause of morbidity and mortality, accounting for 52.6 per cent of all morbidities and 58.2 per cent of all mortalities in 202126. It is a significant risk to pregnant women and can cause malaria-related anaemia in the mother, and contribute to low birth weight. Only 52.4 per cent of households have at least 1 LLIN27. 25 UNICEF, Humanitarian Action for Children 2021, 2021 Revision 1 (June 2021) 26 OCHA, South Sudan Humanitarian Needs Overview 2022, February 2022 27 Government of South Sudan, 2020 National Lot Quality Assurance Sampling (LQAS) Household Survey 9#10In addition, there is a risk of annual measles outbreaks due to low immunization coverage. Only 69 per cent of children aged 12-23 months received measles vaccine before their first birthday 28. In 2021, South Sudan recorded measles outbreaks in eight counties-Tonj East, Magwi, Bor, Kapoeta East, Tonj South, Wau and Pibor. This was against the background of flooding and insecurity, which limited access to basic health care including vaccination services, increasing the risk of vaccine-preventable disease outbreaks. UNICEF continued its efforts to deliver high-quality and community child health services through the scaling-up of Integrated Management of Newborn and Childhood Illness (IMNCI) and the roll out of the Boma Health Initiative (BHI) in 170 bomas (the lowest level of administration each with several villages), through a network of 1,743 Boma Health Workers. The BHI contributed to the reduction in morbidity and mortality through increased access to quality health care interventions and community-based surveillance and allowed UNICEF to reach pregnant women and populations affected by floods or internal displacement with LLINs to protect against malaria. In total, 1,001,507 pregnant women and children received LLINs, more than threefold the target of 300,000. UNICEF supported a measles mass vaccination campaign reaching 483,550 high risk children (246,562 girls) aged between 6 months and 15 years in the affected eight counties, exceeding the 450,000 target. Fixed and outreach-based case detection for malaria and increased support for measles vaccination programmes including stockpiling measles vaccines through dry stock prepositioning supported exceeding the planned targets. The worsening of the humanitarian situation in 2021 due to multiple shocks led to intense mobilization of health funding, and integration of responses with nutrition in humanitarian settlements. Huge investments in capacity development and the use of integrated health service delivery channels such as community health structures were key to improving the reach of emergency response interventions. This provided continued access to hard- to-reach settlements and mitigated the effects of the limited access occasioned by flooding and insecurity. Table 3: Key indicators table for health Indicators Cluster/sector 2021 Target Cluster/sector total results UNICEF 2021 Target UNICEF Total results N/A 450,000 483,550 N/A N/A 300,000 1,001,507 Children aged 6 months to 15 years N/A vaccinated against measles Children and pregnant women provided with insecticide-treated nets in malaria endemic areas Water, sanitation and hygiene (WASH) UNICEF continued to lead WASH emergency coordination as the WASH Cluster lead agency and co-manager of WASH core pipeline supplies for emergency humanitarian preparedness and response. SOPs for the WASH core pipeline were developed to support non-governmental organization (NGO) partners in clarifying processes. Pre-positioning of supplies remains a critical activity due to continued access constraints, particularly during the rainy season. There were no breakages in the pipeline during 2021. In 2021, UNICEF prepositioned and distributed life-saving hygiene, sanitation, water treatment, and water point repair materials reaching 750,633 emergency-affected people. UNICEF reached 77,199 individuals with access to safe sanitation (25% of the target) through provision of temporary emergency latrines for displaced populations and through continued desludging and maintenance services for communal latrines in the former Protection of Civilians (POC) sites, which have been re-designated into conventional internally displaced persons (IDP) camps under Government administration. 28 2021 Routine immunization administrative data from the Ministry of Health 10 10#11A total of 623,995 people in humanitarian situations were reached with life-saving access to safe water (76% of the target). UNICEF's emergency response included different approaches and interventions to deliver clean and safe water supply services through rehabilitation of existing water facilities, drilling of new boreholes and installation of handpumps and solarized systems, water trucking in the Juba internally displaced person (IDP) camps, and support in the operation and maintenance of water yards, and surface water treatment (SWAT) systems. This achievement excludes the households reached with safe water from the provision of household water treatment chemicals through the WASH core pipeline. As part of ensuring continuity of water supply during the COVID-19 pandemic, water treatment chemicals were provided to ensure safe water to an estimated 400,000 people connected to the South Sudan Urban Water Corporation water network in Juba, Wau, and Bor. UNICEF continued supplying water to the urban areas of Malakal and parts of Jonglei and Upper Nile State through emergency SWAT systems. Hygiene promotion activities were accelerated aimed at combating the spread of COVID-19 as well as preventing outbreaks of WASH-related diseases. In total, 473,312 people were reached with key messages. The extensive flooding caused disruption and damage to WASH facilities in addition to displacement. With the impacts of climate change causing large scale annual flooding events, UNICEF established anticipatory agreements with NGO partners to rapidly respond to flood displacement needs. UNICEF was able to much more rapidly deploy the more durable solutions for repair of water points, installation of emergency water facilities, and support to communities for emergency sanitation facilities. In response to the food insecurity and malnutrition crisis in South Sudan, UNICEF supported WASH facilities in nutrition treatment centres, targeting the 10 priority counties in Northern Bar Ghazal, Warrup, Jonglei, and GPAA where malnutrition rates were highest. Activities included construction or rehabilitation of latrines, repair of water points, installation of handwashing facilities, and construction of new water points in health facilities and communities with high levels of global acute malnutrition (GAM); and provision of hygiene non-food items (NFIs) and household water treatment chemicals to caretakers and mothers of malnourished children. UNICEF also supported WASH in schools as part of efforts to return children back to school after the impacts of COVID-19. UNICEF, as a member of the WASH Cluster former PoC transition working group, is working with partners to provide more sustainable services as part of the transition to IDP camps. This includes shared latrines rather than communal latrines, water through the centralized network in Juba, and handover of hygiene facilities to community members. Solid waste management and sewerage desludging continued, as part of sanitation services supported by UNICEF in the IDP sites of Juba and Bentiu for 50,000 individuals in the early part of 2021 until services were discontinued. UNICEF began a partnership with the World Food Programme (WFP) to incorporate electronic restricted vouchers for water delivery utilizing its SCOPE beneficiary and transfer management platform and International Organization for Migration (IOM) biometric registration in the Juba IDP camps. Water trucking continued in the Juba IDP sites as the kiosk construction and trainings for kiosk attendants commenced to operationalize the water voucher system from the centralized network in 2022. UNICEF is actively innovating for climate change adaptation, and in emergency contexts piloted elevated latrines - constructed with the participation of households - as a flood adaptation measure. This includes using local materials for the construction of the substructures and raised superstructures to avoid collapse and flooding during the rainy season. Similarly, UNICEF piloted elevated handpumps through humanitarian programmes in food insecure counties with regular flooding incidences. This is now being disseminated as climate adaptation good practice for the WASH Cluster's 2022 strategy. UNICEF will continue to pilot this infrastructure with different partners to define a best fit model that has high levels of community acceptance. 11#12Table 4: Key indicators table for WASH Indicators # of target population provided with access to safe water as per agreed standards (7.5-15 litres of water per person per day) # of target population provided with access to appropriate sanitation facilities Cluster/sector 2021 Target Cluster/sector UNICEF UNICEF total results 2021 Target Total results 3,000,000 2,243,386 817,000 623,99529 3,000,000 319,667 303,500 77,199 Note: UNICEF, as cluster lead agency, is responsible for information management of cluster partner results and sharing overall results achieved by cluster members collectively. Child protection, gender-based violence and prevention of sexual exploitation and abuse (PSEA) During 2021 child protection services were more accessible to children and caregivers than in 2020, due to the lifting of many COVID-19 restrictions. Nevertheless, UNICEF continued to roll out the COVID-19 adapted guidelines and remote case management to provide services on MHPSS, FTR, case management, GBV, children associated with armed forces and armed groups (CAAFAG), and justice for children. Remote case management and follow ups, and door-to-door awareness raising have continued as part of COVID-19 preventive measures. In 2021, 2,736 children (1,344 girls) were registered on the Child Protection Information Management System (CPIMS) and reached with case management services. A total of 898 UASC (336 girls) were supported with FTR, with 150 children (63 girls) reunited with their families. A total of 99,524 individuals (27,338 girls; 22,501 boys; 28,982 women; 20,703 men) were reached through UNICEF's GBV prevention and response programme. GBV risk mitigation work was strengthened in 2021 through close coordination with the Health and Nutrition Clusters. UNICEF also supported a GBV multisectoral safety audit to ensure that women's and girls' safety is ensured in accessing all sectoral services. Under the leadership of the Child Protection AoR chaired by UNICEF, the Minimum Standards for Child Protection in Humanitarian Action were presented and a roll out plan for 2022 agreed. This will support enhanced capacity to deliver quality and effective life-saving child protection interventions in line with international standards. Only 6.5 per cent of at-risk children in South Sudan have access to MHPSS and other child protection services 30. The multisectoral integration of MHPSS has shown a real impact with an increased number of reached beneficiaries with low-cost implications. In 2021, UNICEF reached 92,790 children (43,700 girls) with dedicated MHPSS through child-friendly spaces in communities and schools using a community-based approach, exceeding the target by 16 per cent. Around 5,878 caregivers (3,171 women) participated in psychosocial support and positive parenting sessions - over twice the number of caregivers reached in 2020. A total of 4,242 adolescents (2,072 girls) and 452 young adults (309 women) in five states were reached through the Adolescent Kit, a package of multidimensional tools for MHPSS, training and life skills development for conflict-affected adolescents. In the context of COVID-19, UNICEF reached 35,884 individuals (6,964 girls; 7,233 boys; 14,215 women; 7,472 men) with MHPSS awareness-raising activities. Six posters with key MHPSS messages for children in schools were developed and 47 Ministry of General Education and Instruction (MOGEI) trainers (2 women) were trained on MHPSS with a view to rolling out the training to teachers at state level in 2022. 29 This result for UNICEF does not include the individuals who accessed safe water through household water treatment chemicals through the WASH core pipeline, included in the WASH Cluster results. 30 UNICEF, Humanitarian Action for Children 2021, 2021 Revision 1 (June 2021) https://reliefweb.int/report/south- sudan/humanitarian-action-children-2021-south-sudan-2021-revision-1-june-2021 12#13Thanks to UNICEF, 71,229 children (35,699 girls) were reached with birth notification in 2021, almost double the number in 2020. An assessment was undertaken of the digital birth notification system and its potential interoperability with a comprehensive Civil Registration and Vital Statistics system. In partnership with the United Nations Mine Action Service (UNMAS), 64,208 individuals (20,587 girls; 21,730 boys; 11,376 women; 10,515 men) living in high-risk mine areas were reached with key lifesaving explosive ordnance risk education (EORE). A total of 2,940 community liaison leaders (1,423 women) were trained on EORE to disseminate messages to their communities. Implementation of the security arrangements for R-ARCSS continued. The Joint Defence Board commenced the screening of armed forces and groups in preparation for establishing the unified armed forces. This provided an opportunity to identify CAFAAG, allowing for 12 boys to be released in 2021. A total of 514 former CAFAAG (127 girls) continued to benefit from UNICEF-supported reintegration programmes. UNICEF has continued to strengthen Government capacities to deliver child friendly justice services. A total of 112 Government staff (40 women) such as judges, prosecutors, social workers, and prison and police officers, received multidisciplinary training to strengthen awareness of child rights and the coordination and collaboration on children in conflict with the law. Nine Government, civil society organization (CSO) and academic facilitators were trained to cascade the trainings at the sub-national level using a new facilitators guide and participant handbook. UNICEF supported the provision of case management services including MHPSS, FTR and referrals for 561 children and youth (191 girls) in conflict with the law. UNICEF continued it engagement with 10 national NGOs to scale up the localization strategy through intensive support with focused trainings, coaching and mentoring in both institutional development and child protection programming and service delivery. Table 5: Key indicators table for child protection, GBV and PSEA Indicators # of children reached with psychosocial support (PSS) Cluster/sector 2021 Target Cluster/sector total results UNICEF UNICEF 2021 Total Target results 92,790 N/A N/A 80,000 (43,700 female) 100,000 99,524 # of people reached by gender- based violence (GBV) prevention and response services ✗ Education In 2021, UNICEF provided education support to the development and humanitarian response in the context of multiple challenges to delivering quality education to all children. On the humanitarian front, UNICEF provided essential EiE services and supplies to 948,428 children (435,121 girls) in humanitarian situations, allowing them to access and utilize pre-primary, primary, and secondary education services. UNICEF constructed and rehabilitated 21 schools and 42 classrooms to provide conducive learning spaces; provided WASH facilities; and constructed 20 climate-resilient kitchens and food stores to support school feeding in collaboration with WFP, which assure longevity of infrastructure particularly for areas regularly affected by seasonal flooding. UNICEF procured and distributed essential education supplies including 43,961 dignity kits for adolescent girls, 2,101 recreation kits to support the development of social and life skills, 3,237 student kits and 2,542 teacher kits to supplement the new curriculum materials, and 954 early childhood development (ECD) kits for preschool children and their caregivers. UNICEF successfully advocated for the reopening of schools that had been closed due to the COVID-19 pandemic. With the successful reopening of schools in May 2021 after 14 months of closure, UNICEF supported schools to resume functioning by disinfecting learning premises, providing infection prevention and control 13#14supplies to facilitate school communities to adhere to COVID-19 SOPs, and providing incentives to 34,881 teachers to resume teaching and keep schools functional. In total, 2.7 million school children re-enrolled into schooling, from 2.35 million in March 2020 when schools closed. The significant enrolment of 350,000 out-of-school children could be attributed to the intense mobilization conducted by UNICEF's Communication for Development (C4D) team, the inspiration from radio distance learning, and the improved security situation allowing displaced communities to resettle and demand quality education services. Children in humanitarian situations face challenges in registering and sitting for the national examinations that enable them to transition to higher levels. Some children in areas previously controlled by the opposition did not get the chance to sit their examinations and were forced to repeat Primary 8 or Senior 4 for several years. Others were denied the chance to attempt examinations because their locations were cut off and the National Examinations Council had no capacity to airlift and deliver examination materials and invigilators to those locations. In 2021, UNICEF enabled 67,247 Primary 8 candidates (29,414 girls) to sit their national examination through support including transportation of examination materials and government examiners to different locations across the country, and transportation of candidates from IDP camps to examination centres. To enhance the delivery of the curriculum, UNICEF trained 3,245 teachers (617 women) on basic EiE principles and conflict sensitive learner centred pedagogies. Cumulatively 12,035 teachers (3,254 women) have been trained on EIE and learner centered pedagogy since 2019. A competency-based school inspection framework will lead to 700 school inspectors being trained to reinforce teacher accountability and professional support. Further, 1,283 School Management Committee (SMC) and Parent Teacher Association (PTA) bodies were functionalized and 14,113 SMC/PTA members (5,360 women) received training to enhance parental and community engagement for quality education services. The school closures due to COVID-19 provided any opportunity to explore new partnerships with media houses and mobile network operators to support distance learning through radio programmes in the country. It also revealed the gaps in interventions for children with disabilities and children in vulnerable households. The distance learning programme inadvertently excluded children with disabilities and children in areas that did not receive South Sudan Broadcasting Corporation (SSBC) or Radio Miraya signals. The pre-primary television learning programme which targeted urban children excluded thousands of children in urban areas who had no access to televisions, and rural children were not catered for in the intervention design. This requires a sharpened approach to reach the most vulnerable children with education, including increased advocacy for disadvantaged children. There is a need to capitalize on UNICEF's supported radio programmes and make distance learning a credible pathway for learning through investments in children's access to digital technologies. Table 6: Key indicators table for education Indicators # of children accessing quality formal or non-formal early learning, pre-primary, primary or secondary education # of teachers trained on education- in-emergencies basic pedagogy and centred methodologies Cluster/sector 2021 Target Cluster/sector total results UNICEF 2021 Target UNICEF Total results 93,27131 797,024 292,879 (117,705 female) 770,000 (34,264 female) 4,355 2,583 4,000 472 Note: UNICEF, as cluster lead agency, is responsible for information management of cluster partner results and sharing overall results achieved by cluster members collectively. 31 In 2021 UNICEF supported more then 948,428 children (435,121 girls) with pool funding (Global Partnership for Education; KfW Development Bank; thematic funding; European Union; and African Development Bank). But this figure (93,271) represents results from specific emergency funding only. In 2021 it was discovered that many partners did not report under the 5Ws tool (Who is Where doing What, When and for Whom), managed by the cluster team, hence the seemingly low result. 14#15Communication for development (C4D) UNICEF continued with its pivotal role in supporting the Ministry of Health, other line ministries and partners including UN agencies, international and national NGOs, CSOs, faith-based organizations (FBOs) and the private sector, in promoting positive behavioural practices towards mitigating and preventing diseases and other emergencies across the country. A participatory approach and partner engagement in planning for C4D proved crucial for buy-in, ownership and strategic support. As a co-lead of the Risk Communication and Community Engagement (RCCE) TWG, UNICEF scaled up its risk communication, social mobilization, and community engagement activities in 2021 to address COVID-19 prevention response, the COVAX Facility vaccine roll out, Polio outbreak response, prevention of malnutrition in six food insecure areas, flood response and safe reopening of schools. - UNICEF supported partners with its evidence-based communication and community engagement programming reaching a total of 7,579,988 people with integrated lifesaving messages - including on COVID-19 with a focus on promoting demand for services and creating an enabling environment to address social norms. Messages and engagement helped to build the capacity of caregivers and parents to protect themselves and their children in light of communicable diseases. UNICEF together with National and State Ministries of Health, County Health Departments (CHDs) and partners supported implementation of phased COVID-19 vaccine roll out with RCCE and social mobilization across the country. A national communication strategy for COVID-19 vaccines, communication materials and aids, and training modules were developed in collaboration with the RCCE TWG and national COVID-19 Vaccination TWG. Different community engagement strategies and communication platforms reached over 7.5 million individuals (in line with the target) with COVID-19 vaccine promotion messages, including 15,195 (5,471 women; 9,724 men) community/religious leaders. Community gate keepers are catalysts in creating an enabling environment for positive change in social norms and included a South Sudan Council of Churches network with teachers and women pastors. Interpersonal and group communication were delivered through 1,801 (424 women; 1,377 men) trained Integrated Community Mobilization Network (ICMN) mobilizers reaching 540,300 households with lifesaving messages. Further, 30 radio stations broadcast a weekly cycle of jingles and talk-shows in over 10 languages reaching 40 per cent of the population, educating and creating demand for COVID-19 vaccination. The use of the ICMN has grown exponentially and was key to engaging the community. These structures act as innovators for the community, overcoming the impact of COVID-19 restrictions and the digital gap. The campaign used gender-responsive approaches to address the challenge of low female uptake of COVID- 19 vaccines through evidence generation and actionable recommendations such as providing women easy access to the vaccines, dissemination of testimonies from influential women promoting vaccines, broadcast of recorded voices from women role models, and dissemination of gender-specific key messages. This resulted in increased female uptake from 25 per cent in Phase I of the campaign, to 40 per cent in Phase III (December 2021). Knowledge, Attitude and Practices (KAP) studies revealed that 87 per cent of respondents expressed willingness to receive COVID-19 vaccines. To better understand the concerns and fears around COVID-19 vaccine acceptance among health workers, an Internet of Good Things (IoGT) (UNICEF's light internet-based platform with a set of free, mobile-ready resources and applications) survey was conducted among 612 health workers. In continuation of the response to the 2020 Polio outbreak, with 55 cases of circulating vaccine-derived poliovirus type 2 (CVDPV2) in 27 counties, two rounds of monovalent oral polio vaccine type 2 (mOPV2) were implemented, vaccinating 1,489,826 and 1,218,546 under-five children respectively. A mop-up round was held, vaccinating a total of 2,717,133 children nationwide (98% of the target). The campaigns were supported with nationwide communication, social mobilization and community engagement interventions reaching 92.4 per cent social mobilization coverage as per the Post Campaign Evaluation (PCE). As part of monthly regular ICMN interventions, 2,000 routine immunization interaction sessions were conducted reaching 226,947 households. Through household visits, the ICMN mobilizers traced a total of 10,400 defaulter children aged under one years, who were subsequently followed up to complete their immunization schedules. 15#16As part of Accountability to Affected People (AAP), 29, 124 calls were received through the UNICEF-supported 2222 hotline. This facilitated information sharing, tracking of rumours around COVID-19 and other health issues and providing psychosocial support to callers. About 32 per cent of callers sought information related to health including COVID-19 and routine immunization. A total of 341 focus group discussions (FGDs) (761 females; 1012 males) were conducted across all states, allowing women to openly discuss barriers to women accessing health services. In 2021, UNICEF continued to sustain its engagement on the "Faith for Positive Change for Children" initiative in collaboration CSOs and FBOs such as Episcopal Church for South Sudan (ECSS), The Rescue Initiative of South Sudan, Care International, United Network for Health, Eye Media and others. Other important partners include mobile operators such as Zain and MTN, the Ministry of Health, Health Link, and South Sudan Council of Churches which supported hotlines 6666 and 2222. These engagements and collaborations helped UNICEF to reach the unreached across the country during multiple disease outbreak scenarios. Table 7: Key indicators table for C4D Indicators Communication platforms or networks supported by UNICEF meet quality standards for children and adolescent engagement and participation across development priorities Communication and community engagement coordination Cluster/sector 2021 Target Cluster/sector total results UNICEF 2021 UNICEF Target Total results N/A N/A Level 4 Level 4 N/A N/A Level 4 Level 4 mechanism meets standards for AAP during humanitarian crises Number of households reached with key life-saving messages 450,000 540,300 7.5 million 7,579,988 Number of people who participate in COVID-19 engagement actions [COVID SitRep] Results achieved from humanitarian thematic funding In 2021, thematic funding allowed UNICEF and partners to support emergency programming in the WASH, Child Protection, Nutrition and Education sectors. Of these, the Education and Child Protection sectors are critically underfunded. Extensive communications were undertaken during 2021 covering all areas of global and thematic funding, including numerous UNICEF website articles and social media posts which directly credited the respective donors. WASH thematic funding Global thematic funding and thematic funding from Germany allowed UNICEF to be a more predictable and dependable partner to other UN agencies but also to other partners. For example, through funds to operate and manage a WASH core pipeline warehouse in Aweil through an NGO partner, Centre for Emergency and Development Services. Similarly, UNICEF operated a WASH core pipeline warehouse in Bentiu that provided WASH items to WASH Cluster partners responding to displacements caused by flooding. Through German thematic funds UNICEF also operated dewatering pumps in Bentiu Town to divert flood water while the dykes to protect the city from submersion were constructed. The funding also allowed UNICEF to provide integrated services, for example, by supporting a state level WASH Cluster Coordinator for Northern Bar Ghazal which was a priority food insecurity response county in 2021. 16#17Sub-national conflict in Tambura County, Western Equatoria resulting in displacement of 90,000 people fleeing the area. Global thematic funding allowed UNICEF to respond to time-critical needs by instating a partnership with International Aid Services to provide hygiene NFIs and messaging to 27,000 IDPs; sanitation and handwashing facilities in three of the IDP camps; and water supply for 14,500 IDPs. As part of the transition to the restricted voucher modality for provision of water to the 30,000 residents in the Juba IDP camps through the centralized network, UNICEF entered a partnership with Nile Sustainable Development Organization to construct water kiosks in the IDP camps and commence community engagement to identify the locations for the kiosks, identify kiosk attendants, and inform the community how to use the electronic voucher system to receive water. This partnership and two months of water trucking to this population was financed with global thematic funding and initiated the sustainable WASH service delivery transition, that was subsequently financed by the Government of Germany and the South Sudan Humanitarian Fund in the former Juba PoCs. Through global thematic funding UNICEF procured 9,000 buckets to provide 54,000 emergency affected persons (one per household) with water storage and collection containers. This contributed to the overall pre- positioning for the WASH core pipeline, for the immediate life-saving response to various crises including COVID-19 prevention. Child Protection thematic funding Thematic funding allowed UNICEF and partners to respond equitably to children affected by crisis by delivering life-saving child protection interventions, reaching 256,522 individuals (91,625 girls; 93,321 boys; 40,358 women; 31,218 men) with critical services including case management, family FTR, MHPSS, support to CAAFAG, prevention of and response to GBV, EORE and the Monitoring and Reporting Mechanism on Grave Violations against Children in Situations of Armed Conflict (MRM). Thematic funds were also used to provide leadership and critical technical support to the Child Protection AoR. UNICEF is also co-chairing the UASC Working Group and the CTFMR alongside UNMISS. Thematic funding was instrumental in allowing UNICEF to strengthen the capacity of community-based child protection networks and increase awareness on child protection, reaching 37,321 people (18,795 girls; 15,603 boys; 1,544 women; 1,379 men) with awareness raising messages on children's rights. Thematic funding contributed to support UNICEF efforts to strengthen GBV prevention and social norms transformation through the Communities Care Programme which promotes gender equitable social norms to prevent GBV and support survivors. The programme continued to be scaled up in 2021 in partnership with the United Nations Population Fund (UNFPA) and GBV organizations, to address child marriage, adolescent pregnancies, and sexual violence. Capacity building trainings were conducted for community leaders, and formal and informal service providers on GBV response. Community members including adolescents, were trained to lead community discussion groups as allies in harmful social norms transformation. The programme engaged 709 people (75 girls; 42 boys; 354 women; 238 men) in 15-week community engagement courses to reach 25,505 people (7,228 girls; 6,376 boys; 7,223 women; 4,678 men) with community actions on subjects such as such as ending child marriage, and promoting women's participation in peace building Global thematic funding allowed UNICEF to support the CTFMR in its capacity development efforts, supporting 29 capacity building sessions for 790 members of armed forces (111 women), including Government security forces (570), Sudan People's Liberation Army in Opposition (SPLA-IO) (202), and South Sudan Opposition Alliance (SSOA) (18). Further, 3,236 members of the security forces (773 women) benefited from 179 child protection awareness-raising sessions. Education thematic funding In 2021, humanitarian thematic funding supported access to quality education for 27,981 children (11,193 girls) from IDP settings and host communities in conflict- and flood-affected areas in Upper Nile, Unity, Western Equatoria, Eastern Equatoria, Jonglei and Warrap States. UNICEF also used this funding to construct and rehabilitate 21 temporary learning spaces with handwashing facilities. 17#18UNICEF was also able to train 2,092 PTA members (837 women) on school governance and management skills, including implementation of school development plans. Using the thematic funds, UNICEF provided 585 teachers with education kits, and also provided children with 176 ECD kits, 350 recreational kits, 4,396 dignity kits, and 917 student kits. Assessment, monitoring and evaluation Evidence generation UNICEF South Sudan led global knowledge management efforts on scaling nutrition in complex emergencies through publication of a UNICEF field note and two peer reviewed articles to share experience and lessons learned on scaling up care for children with SAM through integrated community-based management of severe wasting programmes. In addition, in 2021, the Food Security and Nutrition Monitoring system (FSMNS) expanded for the first time to include other sectors such as education, child protection and shelter modules. South Sudan was one of the pilot countries for a new global inter-agency WASH Severity Classification exercise, to help define priority emergency needs and target areas for sustainable development services. Considering the continued declines in humanitarian funding against the considerable needs in the country, evidence-based prioritization of resources will be critical in future years. To support social service workforce strengthening to prevent and address violence against children a Social Service Workforce mapping and assessment was initiated to inform the strategy to enhance Government capacity to provide more sustainable child protection preventive and responsive services with more and better skilled social workers. UNICEF provided leadership in the education cluster and supported the nationwide education needs assessment (ENA) across 442 schools to provide an in-depth understanding of the current education situation in South Sudan. The ENA offered a situational analysis of the functioning of South Sudan's education system, particularly given the impact of over seven years of conflict and displacement, as well as the COVID-19 pandemic and subsequent interruption of education in South Sudan. The findings from the 2021 ENA underscored that most of the education challenges that have been highlighted in previous assessments persist and have been exacerbated by COVID-19 school closures. Many of the challenges noted by county education officials, headteachers, learners, and community members revolve around lack of finances for both the supply and demand side of education (such as families not being able to afford fees for their children to attend schools, or teachers not receiving regular and sufficient salaries). Economic barriers to education may make alternative options (such as cattle rearing for boys and marriage/pregnancy for girls) more attractive to families who are looking to mitigate their economic challenges, which keep children from returning to schooling. Other issues highlighted by various stakeholder groups, include poor infrastructure in schools, including lack of washrooms for girls, lack of food, inaccessibility for children with disabilities, and the ever-growing need for trained teachers. It is worth noting that the advocacy for school grants attests to the increased capacity of PTAs to plan, prioritize and allocate resources for improvements in education service delivery. In 2021 UNICEF co-chaired the UN Country Team (UNCT) M&E Working Group and contributed to the Sustainable Development Goal (SDG) Data Landscaping Exercise which was completed in May 2021. The exercise aimed to map the country's data landscape to identify what is available, gaps, weaknesses and opportunities; and identify priority areas for potential investment to improve the availability of data for planning and monitoring the SDGs. A new Situation Analysis of Children and Women in South Sudan 2018-2021 was launched in July 2021 to support development of the new country programme. The report highlights the patterns of deprivation that children face in South Sudan, particularly those children most at risk of being left behind. Multiple stakeholders were engaged in development of the Situation Analysis including children, Government, UN partners, civil society and media. 18#19In 2021 the office completed the L3 Emergency (part-2) evaluation and case study on WASH Protracted Crises. Five KAP studies, targeted FGDs and community feedback mechanisms were spearheaded which provided real-time evidence that informed socio-behavioural communication programme planning and implementation, particularly for COVID-19 vaccines roll out, safe reopening of schools and other diseases outbreak responses. Programme monitoring Due to learning from 2020 where field visits were a challenge due to COVID-19 travel restrictions, more emphasis was placed on strengthening field monitoring in 2021 through i) revision of field monitoring SOPs on the introduction of remote monitoring; ii) rolling out a costed field monitoring plan; and iii) quarterly field monitoring plans with expenditure tracking. Monitoring and Reporting of Grave Violations against Children through the MRM UNICEF continued to co-chair the CTFMR alongside UNMISS. The Comprehensive Action Plan to End and Prevent All Grave Violations Against Children (CAP) was extended to August 2022. With UNICEF support a high-Level Committee on CAP implementation at the ministerial and technical level has been established nationally and 10 technical committees at the state level. In 2021 the CTFMR verified 196 grave violations affecting 183 children (148 boys, 35 girls), some as young as one year old. This represents a 19 per cent increase in the number of violations compared to 165 grave violations against 154 children verified in 2020. Overall, there has been a significant drop in the number of verified grave violations against children since R-ARCSS (803 grave violations in 2018). Case management data Online national case management was significantly enhanced when the data of 18 NGOs were migrated from the offline CPIMS to the online CPIMS+, bringing the number of CPIMS+ users from five to 23. UNICEF supported training on CPIMS+ for 207 case workers, data clerks and supervisors (94 women). UNICEF Headquarters and Save the Children, which hosts the CPIMS+ database in South Sudan, continued to provide technical support in 2021 to the new users. Financial analysis The flexibility provided by thematic humanitarian funds in 2021 was greatly appreciated by UNICEF South Sudan. The unearmarked funds were especially useful in allowing UNICEF to use the resources to meet the most urgent needs. Thematic funding was critical to treating children affected by acute malnutrition and in providing access to safe, clean water. In addition, flexible funding allowed UNICEF to respond to COVID-19 and its related challenges, including remote learning opportunities for children during school closures, and to support school reopening. Thematic funds were also used to deliver critical child protection services to extremely vulnerable children, women, and their communities to minimize protection risks, particularly by ensuring continued provision of quality technical expertise. Table 8: 2021 Funding Status against the appeal by sector (in USD) Sector Requirements Funds Available Against Appeal as of 31 December 2021* Funds Received in 2021 % Funding Gap Carry-Over Health 6,006,000 1,083,141 1,154,547 63% Nutrition 60,000,000 35,884,189 5,365,032 31% WASH 35,388,764 20,490,161 9,330,016 16% Education 46,839,920 2,023,019 2,801,318 90% Child Protection 23,720,800 4,895,090 3,443,705 65% 19#20Social Protection Communication for Development Total 4,117,000 4,000,000 180,072,484 979,833 65,355,433 102,659 98% 807,311 55% 23,004,588 51% *Funds available includes funds received (gross) against current appeal and carry-forward from previous year. Table 9: Funding available (received + carry over) by donor and funding type (in USD) Donor Name/Type of funding Programme Budget Allotment reference Overall Amount* I. Humanitarian funds received in 2021 a) Thematic Humanitarian Funds See details in Table 10 SM/18/9910 2,889,137 b) Non-Thematic Humanitarian Funds USAID/Food for Peace SM/21/0028 25,000,000 The United Kingdom SM/16/0378 8,498,584 Canada SM/21/0188 3,164,557 Germany SM/21/0004 2,983,294 German Federal Foreign Office SM/22/0009 2,972,652 Japan SM/21/0109 2,000,000 European Commission / ECHO SM/21/0493 1,789,976 German Federal Foreign Office SM/21/0493 1,189,061 Canada SM/21/0817 1,179,245 Norway SM/21/0179 583,908 Spanish Committee for UNICEF SM/21/0260 121,065 Total Non-Thematic Humanitarian Funds 49,482,342 c) Pooled Funding (i) CERF Grants (ii) Other Pooled funds - including Common Humanitarian Fund (CHF), Humanitarian Response Funds, Emergency Response Funds, UN Trust Fund for Human Security, Country-based Pooled Funds etc. CERF CERF SM/21/0596 SM/21/0214 CERF SM/21/0926 United Nations Multi Partner Trust Fund SM/21/0638 United Nations Multi Partner Trust Fund SM/21/0855 4,941,758 4,500,001 1,199,688 1,436,296 747,297 d) Other types of humanitarian funds In-kind assistance (French National Committee) KM/21/0031 575,400 Total humanitarian funds received in 2021 II. Carry-over of humanitarian funds available in 2021 54,450,659 e) Carry over Thematic Humanitarian Funds Thematic Humanitarian Funds SM/18/9910 1,990,154 Thematic Humanitarian Funds SM/20/9910 Total carry-over Thematic Humanitarian Funds 89,026 2,079,180 20#21f) Carry-over of non-Thematic Humanitarian Funds Global Partnership for Education - HAC Coronavirus SC/20/0356 5,219,147 European Commission / ECHO SIDA -Sweden UNOCHA The United Kingdom UNOPS - New York - HAC Coronavirus SM/19/0269 4,353,936 SM/20/0847 3,252,485 SM/20/0767 2,561,074 SM/16/0378 1,772,138 SC/20/0739 660,311 USA (State) AF SM/18/0410 638,922 Germany SM/21/00/04 568,054 GAVI The Vaccine Alliance - HAC Coronavirus SC/20/0764 305,807 China SM/20/0732 240,439 USA CDC SM/20/0677 225,886 German Committee for UNICEF SM/20/0038 214,034 Spanish Committee for UNICEF SM/20/0712 217,354 Republic of Korea SM/20/0828 185,185 USA (USAID) OFDA SM/20/0138 180,747 Japan SM/20/0354 103,103 United States Fund for UNICEF SM/20/0192 84,217 USA CDC SM/20/0719 66,078 USA (USAID) OFDA SM/20/0296 47,087 UNOCHA SM/20/0103 19,589 USA (USAID) OFDA SM/20/0018 5,811 Global Partnership for Education SC/20/0189 4,004 Total carry-over non-Thematic Humanitarian Funds 20,925,408 Total carry-over humanitarian funds 23,004,588 III. Other sources EPF (not reimbursed) GE/20/0021 Total other resources 144,806 144,806 *Global Thematic Humanitarian Funding contributions are pooled and then allocated to country and regional offices by EMOPS. A detailed list of grants will be available in the 2020 Humanitarian Action Global Annual Results Report. **Programmable amounts of donor contributions, excluding recovery cost. Table 10: Thematic Humanitarian Contributions Received in 2021 Thematic Humanitarian Contributions Received in 2021 (in USD): Donor Grant Number32 Programma ble Amount (in USD) Total Contribution Amount (in USD) Global Thematic German Committee for UNICEF German Committee for UNICEF SM189910 SM1899100157 1,180,989 812,884 1,250,000 855,667 SM1899100064 581,395 611,995 Norwegian Committee for UNICEF SM1899100491 162,849 171,420 Luxembourg Committee for UNICEF Danish Committee for UNICEF SM1899101010 75,069 79,020 SM1899100043 35,979 37,873 32 International Aid Transparency Initiative (IATI) requires all grants to be listed in reporting. http://iatistandard.org/ 21#22Spanish Committee for UNICEF United States Fund for UNICEF Total SM1899100944 SM1899100183 23,439 24,673 16,533 2,889,137 17,403 3,048,051 Future work plan Through integrated and multisectoral services, UNICEF will put the rights of the child at the centre of all interventions. Strengthening social service delivery systems in high-risk areas will improve accountability to and results for children, by building resilience and sustaining gains. Risk-informed programming will strengthen the capacities of individuals, communities, and local partners from the onset of humanitarian action. UNICEF's programmes will be informed by a conflict sensitive approach, with a strong focus on social cohesion, embedded in an analysis of socio-political-ethnic dynamics as the main drivers of violence. UNICEF established agreements with NGO partners in advance of the rainy season, to rapidly respond to flood displacement response needs. Further innovative thinking and analysis will be taken forward in 2022 to improve how UNICEF works in flooded contexts and work towards local level resilience building, disaster risk reduction and adaptable mobile light responses. UNICEF will continue to strengthen leadership and coordination through its leadership of the nutrition, education and WASH clusters and the child protection AoR to contribute to strategic humanitarian action linked to development. Nutrition As laid out in the UNICEF conceptual framework on nutrition, the underlying causes of malnutrition reflect a variety of interconnected socioeconomic risks and vulnerabilities. To address this, UNICEF will implement a systems approach to nutrition that is multisectoral in nature and aligns with food security, health, WASH, risk communication and social protection sectors among others. In 2021, UNICEF supported a network of 7,404 (2,947 female) community nutrition volunteers (CNVs) (an increase of 1,000 from 2020) on a cost sharing basis with WFP to promote optimal maternal, infant and young child nutrition (MIYCN) at household level. Similar efforts will increase the number of CNVs by a further 1,000 in 2022 to scale up availability and access to preventive nutrition services. 2022 Programme Targets - Nutrition 33 • • • 241,500 children aged 6 to 59 months with severe acute malnutrition admitted for treatment 1,234,257 primary caregivers of children aged 0 to 23 months receiving infant and young child feeding counselling 2,940,435 children aged 6 to 59 months receiving vitamin A supplementation. Health A draft Health Sector Stabilization and Recovery Plan (2020-2022) is being validated which includes recommendations for a limited number of key cross cutting interventions in critical elements of the health system (human resources, infrastructure, information systems etc.) with a catalytic potential. 2022 Programme Targets - Health • 97,067 children aged 6 to 59 months vaccinated against measles • 311,000 pregnant women and children provided with insecticide-treated nets in malaria-endemic areas. WASH UNICEF will continue to respond to emergency WASH triggers in 2022 through anticipatory financing and actions for more predictable emergency needs such as floods. UNICEF will continue to manage the warehouses and teams for the WASH core pipeline. 33 All programme targets from UNICEF, Humanitarian Action for Children 2022, December 2021 https://www.unicef.org/southsudan/media/9126/file/2022-HAC-South-Sudan.pdf 22 22#23In 2022 UNICEF will commence the transition to the voucher water provision programme in the Juba IDP camps as part of the transition to more durable and sustainable solutions in those locations. As a good practice identified in 2021, UNICEF will scale up the installation of climate/flood resilient facilities to provide more long- lasting water and sanitation services and to reduce the need for annual repairs of water points and latrine facilities. UNICEF is also commencing on multiple programmes for installing water points in schools and nutrition/health sites to build more resilient communities. Through cluster leadership at the national and state levels UNICEF intends to continue the WASH severity classification exercise to prioritize humanitarian needs and transition some areas toward sector coordination - transitioning humanitarian planning to development planning where appropriate. UNICEF and the WASH Cluster strategic advisory group with validation of the broader cluster formalized a co- coordination role with UNICEF double-hatting staff members at the state level to improve and streamline coordination moving forward. UNICEF and the Ministry of Water Resources and Irrigation will co-lead new WASH TWGS at national and state level to coordinate sector partners. Development of a strong local supply chain to enable the flow of spare parts for sustainable operations and maintenance of improved water sources will be very important to the WASH sector. In 2022, UNICEF will therefore explore opportunities for the development of supply chains for the local market including the use of voucher systems. 2022 Programme Targets - WASH • . 700,000 people accessing a sufficient quantity of safe water for drinking and domestic needs 223,000 people use safe and appropriate sanitation facilities. Child Protection UNICEF Child Protection programme will continue prioritizing life-saving child protection interventions to support extremely vulnerable, conflict-affected girls, boys and women and focusing on child protection system building during humanitarian action; targeting community resilience and promotion of long-term durable solution for children and women. Prevention, mitigation and response to sexual and gender-based violence will be strengthened. UNICEF will enhance collaboration with humanitarian agencies, key stakeholders, national and international NGOs and the Government. 2022 Programme Targets - Child Protection, GBVIE and PSEA • 80,000 children and parents/caregivers accessing MHPSS • • 100,000 women, girls and boys accessing GBV risk mitigation, prevention and/or response interventions 500,000 people who have access to a safe and accessible channel to report sexual exploitation and abuse by aid workers . 4,000 children who have received individual case management. Education Access to education will be improved by strengthening the quality of community-based learning opportunities. In 2022, UNICEF will target the most disadvantaged children in South Sudan with the education services being delivered in selected locations in the 10 states. Support to strengthen the Alternative Education System (AES), include plans for the translation of P2 and P3 textbooks to national languages, to be undertaken in 2022. 2022 Programme Targets - Education • 917,942 children accessing formal or non-formal education, including early learning • 7,546 teachers received training on EiE and child-centered teaching . 580,156 children supported with distance/home-based learning. Social Protection UNICEF will continue to implement recommendations from the 2019 national social protection mapping, with the roll out the national social protection M&E framework and development of a national MIS for Social Protection. A stakeholder workshop in 2022 will develop a national roadmap to harmonize humanitarian 23#24databases in South Sudan, the most significant of which are those of the World Bank, WFP, and the UK Foreign, Commonwealth & Development Office (FCDO). 2022 Programme Targets - Social protection and cash transfers C4D • 11,974 households reached with UNICEF funded multipurpose humanitarian cash transfers. UNICEF will continue with its pivotal role in promoting positive behavioural practices towards mitigating and preventing diseases and other emergencies across the country. UNICEF will be accountable to affected populations and will ensure equitable representation of women and girls in all community feedback and complaint mechanisms and will target the most vulnerable people, including internally displaced persons, survivors of GBV, children with disabilities as well as young people and adolescents. 2022 Programme Targets - C4D, RCCE and AAP . • 3,825,503 people reached through messaging on prevention and access to services 304,745 people with access to established accountability mechanisms. Expression of thanks UNICEF's work is funded entirely through the voluntary support of millions of people around the world and our partners in government, civil society, and the private sector. Voluntary contributions enable UNICEF to deliver on its mandate to protect children's rights, to help meet their basic needs, and to expand their opportunities to reach their full potential. On behalf of the children and women throughout South Sudan who have been reached with your assistance, UNICEF South Sudan would like to express its sincere appreciation to its resource partners around the world for their continued and critical support. We take this opportunity to thank all our partners for their commitment and trust in UNICEF. UNICEF South Sudan's humanitarian interventions in 2021 would not have been possible without the continued generous support from resource partners both from the public and private sector. Results achieved in 2021 for children and women in South Sudan were possible thanks to donors' support and more specifically to thematic flexible funding that allowed UNICEF South Sudan to respond more effectively and efficiently to the needs of all children and women across the country. It is thus critical that donors continue providing flexible funding in the future. 24 224#25Annex 1: Case study UNICEF-supported nutrition stabilization centre in hard-hit Jonglei State saves the life of a 2-year-old boy Top Level Results With resources made available through global thematic funds, UNICEF procured therapeutic milk for the treatment of children affected by severe wasting and underlying medical complications, and recruited and trained nutrition nurses to support 24-hour treatment at the inpatient nutrition stabilization centre in Keew Payam, Fangak County, Jonglei State. This support helped save the life of a 23-month-old severely malnourished little boy called Gatdet (not his real name) who was successfully treated for two weeks at the Centre and was then discharged to an OTP to continue his treatment until full recovery. Gatdet spent a longer time in the stabilization centre than is usually required because on admission he was severely dehydrated and had recurrent diarrheal episodes and loss of appetite. Nevertheless, the staff managed to stabilize the child, and the mother of Gatdet was so happy to see her child regaining strength and return to normal health status: "I thank you for saving the life of my child and to UNICEF for the support provided through Christian Mission Aid," said Gatdet's mother. "I could not believe my child was going to recover from this sickness. In addition to treatment provided to my child, I also benefitted from education on how to feed and take care of my children such as on early initiation of breast-feeding, exclusive breastfeeding and complementary feeding. I also now understand why it is important to play with my kids and I can make toys from materials we have in the community" she added. "I will live as an example to encourage other mothers not to believe in traditional healers or food taboos. I ask all of you to continue with the good service in our community." Gatdet's mother concluded. Gatdet playing with ECD toys. Gatdet during an appetite test. Background Jonglei is one of the top six areas in South Sudan, in dire need of humanitarian assistance, including malnutrition treatment services. Food insecurity, limited access to health care services and safe drinking water, and are some of the major issues underlying malnutrition. Access constraints due to poor road connections are also an obstacle to effective service provision in the area. Most health facilities are non-functional and communities rely 25#26only on food aid. Fangak County is particularly badly affected: In August 2021, reporting of severe hunger was found to be especially high at 100% of assessed settlements in the county 34. Progress and Results On 19 August 2021, a 23-month-old severely malnourished infant boy named Gatdet appeared in Keew primary health care centre managed by Christian Mission Aid. Gatdet was immediately transferred to the UNICEF- supported Keew nutrition stabilization centre in Fangak County, for admission. On arrival, the mother and sick child were welcomed by the stabilization centre nurse and provided with orientation on the admission process. Gatdet was very weak, and so was immediately given an oral sugar water solution. Gatdet's mother indicated that he had a fever, loss of weight, loss of appetite, diarrhoea and a cough that had lasted more than two weeks. Gatdet's anthropometric measurements were taken, and the Weight-for-Height Z- Score indicated severe acute malnutrition (SAM) at <-3SD. Vital signs were also taken, as well as a Malaria Rapid Diagnostic test; Gatdet was found to be positive for malaria. With resources made available through global thematic funds, UNICEF procures therapeutic milk for treatment of children affected by severe wasting and underlying medical complications, and recruits and trains nutrition nurses to support 24-hour treatment at the stabilization centre. This support allowed Gatdet to regain his health and his strength and contributed to saving his life. Criticality and Value Added Addressing malnutrition is a core element of UNICEF South Sudan's programming priorities. The biggest burden of food insecurity is on children whose bodies cannot endure hunger, as they become wasted, emaciated and severely malnourished. Children suffering from wasting have weakened immunity, are susceptible to long term developmental delays, and face an increased risk of death, particularly when wasting is severe. These children require urgent feeding, treatment and care to survive 35. The UNICEF programme allows for immediate identification and effective treatment of severely malnourished children and any medical complications, increasing their chance of survival and treatment outcomes, and reducing the mortality rate. Challenges and Lesson Learned Initially Gatdet's mother was reluctant to get him admitted into the stabilization centre as there was no one to take care of her other children, but she was convinced by the staff in the hospital. Due to severe flooding in Keew village and the entire Fangak County, it was very challenging to sustain the services and deliver the expected results. To protect the stabilization centre, staff made a dyke around the facility to avoid it being submerged and the situation was not easy to manage. Once stabilized, Gatdet could not be referred to secondary care in a Médecins Sans Frontières-supported centre in old Fangak because of severe flooding, which cut off Keew stabilization centre. The only means to get to Old Fangak was through use of a hired canoe, so the wasted Gatdet would spend more than 5 hours in water on a daily basis. Therefore, the facility staff retained Gatdet in the stabilization centre for the duration of his care. Moving Forward UNICEF seeks further support to continue providing urgent treatment for children 0-59 months with severe wasting, in the context of increased investments into robust and resilient community-based management of severe wasting programmes in protracted conflict environments, informed by global guidelines and protocols. Improved access to preventive services is also vital to allow caregivers to give their children the best start in life, such as through education and awareness raising on infant and young child feeding practices including 34 REACH, Humanitarian Situation Monitoring, Jonglei State South Sudan April - August 2021 https://www.impact- repository.org/document/reach/366d535e/REACH_SSD_Situation_Overview_Jonglei_April_August_2021_final.pdf 35 UNICEF/WHO/World Bank, Levels and trends in child malnutrition UNICEF/WHO/World Bank Group Joint Child Malnutrition Estimates Key findings of the 2019 edition https://www.who.int/nutgrowthdb/jme-2019-key-findings.pdf 26#27early initiation of breastfeeding within one hour of birth, exclusive breastfeeding and complementary feeding. In addition, ECD interventions such as psycho-social stimulation, age-appropriate play and responsive feeding will be further integrated into the community-based management of acute malnutrition programme across the country to reduce recovery time and support cognitive development36. 36 Renzaho, A.M.N.; Dachi, G.; Tesfaselassie, K.; Abebe, K.T.; Kassim, I.; Alam, Q.; Shaban, N.S.; Shiweredo, T.; Vinathan, H.; Jaiswal, C.; et al. Assessing the Impact of Integrated Community-Based Management of Severe Wasting Programs in Conflict-Stricken South Sudan: A Multi-Dimensional Approach to Scalability of Nutrition Emergency Response Programs. Int. J. Environ. Res. Public Health 2021, 18, 9113. https://doi.org/10.3390/ijerph18179113 and UNICEF, Scaling up care for children with severe acute malnutrition in South Sudan: Lessons learned from expanding quality services in a complex emergency context, New York: UNICEF; 2020 27#28Donor feedback form Project title: Consolidated Emergency Report (CER) 2021 UNICEF is working to improve the quality of our reports and would highly appreciate your feedback. Kindly answer the questions below for the above-mentioned report. Thank you! Please return the completed form back to UNICEF by email to: Name: Jennifer Schulz, Donor Relations Manager Email: [email protected] *** SCORING: 5 indicates "highest level of satisfaction" while 0 indicates "complete dissatisfaction" 1. To what extent did the narrative content of the report conform to your reporting expectations? 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Please provide us with your suggestions on how this report could be improved to meet your expectations. 6. Are there any other comments that you would like to share with us? Thank you for filling this form! 28#29For further information, please contact: UNICEF South Sudan Totto Chan Compound Juba Republic of South Sudan United Nations Children's Fund (UNICEF) March 2022 unicef→