The proposed action will scale up emergency humanitarian assistance that prevents loss of life from the combined effects of armed conflict and natural disasters in Somalia. The actions aim to increase availability, access and utilisation of essential health, nutrition, WASH, and Food Security needs reaching 198,264 most vulnerable internally displaced people (IDPs), returnees and host community households in Somalia, through Integrated Area Based Programming. Specifically, the action will contribute to reduced morbidity and mortality through the provision of life-saving, integrated Health, Nutrition and WASH services and multi-purpose cash assistance to the most vulnerable and conflict-affected populations in Afmadow, Jamaame, and Bardhere Districts of Jubaland State in Somalia. The proposed action will result in [1] Enhanced access to responsive preventative and curative health care services. [2] Improved nutrition status for at-risk under five children, pregnant and lactating women. [3] Improved access to public health-strengthening WASH products and services for at-risk health facilities. [4] Access to timely, gender-responsive Multipurpose Cash Assistance (MPCA), for vulnerable households to meet urgent essential needs enhanced. [5] Life-saving emergency crisis contingency capacities in displacement and conflict-affected communities strengthened. World Vision Germany, together with implementing partners World Vision Somalia, Oxfam Somalia, Oxfam Novib, ZAMZAM Foundation, and WASDA, will collaborate with the Ministry of Health at the State and Federal Levels, the Somalia Disaster Management Agency, the State Ministry of Humanitarian and Disaster Management, and other humanitarianand development agencies in delivering life-saving assistance. World Vision in partnership with Oxfam, WASDA and Zamzam commissioned a joint needs assessment in preparation to respond to the ECHO HIP 2024 call for proposals. Assessment data was collected in December-January 2024, and further updated and validated in July 2024. The assessment covered IPD and non IDP settlements from 3 prioritydistricts (Afmadhow, Baardhere, and Jamaame, selected based on IPC ranking, with at least IPC4 considered. The selected districts also fall within the regions affected by persistent and protracted humanitarian crises as a result of extended periods of widespread insecurity fomented by armed factions and clan conflict. This assessment was conducted with the following specific objectives: · Toidentify the priority needs of theaffected communities in relation to health and nutrition, water sanitation and hygiene, food security and livelihoods and protection, among others. · To identify possible risks (e.g., environmental risks, etc.) associated with the communities by addressing the needs or risks associated with not providing the needs during this crisis. · To assess the existing opportunities, capacity among the communities and functioning of the local market in the targeted locations Proposed WASH services combine facility-based WASH services and provision NFIs to targeted caregivers discharged from nutrition treatment programs as an extension of continuity of care to reduce exposure to WASH-related diseases causing co-morbidity among children. The action will provide in-kind assistance to minimize the risk of limited product supply in local markets and to ensure that targeted household access required NFI at the point of discharge along with appropriate hygiene and sanitation education. Proposed health activities are primarily facility-based health services directly provided to patients through medical consultations, treatment services, health facilitycapacity strengthening (Electronic record management systems, medical drugs replenishment, capacity building of Ministry of Health Human Resources <(>&<)> Supervisory capacity), community outreach services, and disease outbreak response, all not feasible through direct cash assistance (out of pocket health access support). The nature of the proposed health activities (e.g.,setting up alert systems, conducting referrals, raising community awareness, etc.) directly addresses gaps in emergency health needs. The action will not be providing direct cash to assist with out-of-pocket financial resources to access health servicesasthere are very limited health services providers (including privately owned) in the targeted locations. However, facility level targeting and referral for MPCA (linking with Result 4) will enable targeted women, men and caregivers (for children with MAM<(>&<)>SAM) access financial resources multi-sectoral needs including covering transport costs to access some referral secondary and tertiary health instructions. Health facility targeted will among other criteria, priorities individuals with special needs,(chronic illness, disability, elderly) with higher health related expenses. Given the nature of the needs under the nutrition sector, the main focus is on capacity building of health workers, and the management of acute malnutrition among others, making MPCAnot the most appropriate approach alone. However, MPCA will be provided as a component of the overall intervention, which will complement the nutrition sector services and MPCA beneficiary selection will specifically integrate nutrition-sensitive criteria. Integrating MPCA into the nutrition sector as a complementary component of a broader intervention strategy can enhance support for families dealing with malnutrition. By focusing on capacitybuilding of the staff and providing necessary resources fortransport, this approach aims to improve the health outcomes of acutely malnourished children while also supporting their caregivers. This will help address immediate needs while fostering long-term improvements in nutrition and health within the community.Emergency Transport Assistance will Provide MPCA to families with severely malnourished children with complications who require urgent care. This support will cover transportation costs to the nearest stabilization centre. This will also insure thatcaregivers get support to ensure that mothers or primary caregivers can dedicate time to care for their severely malnourished child without the burden of worrying about other children at home. The action aims to support a total of 1,010 households acrossthreedistricts through three cycles of cash transfers. Oxfam will reach 400 households in the five mostfood-insecure villages of Afmadow district, while its partner, WAZDA, will target 360 households in Bardhere district. ZAMZAM, the local partner of WorldVision International (WVI) in Jamaame, will assist 250 households. Each household in the Lower Juba region (specifically Jamaame and Afmadow) will receive an unconditional mobile cash transfer of USD 90, while households in the Gedo region (Bardhere)willreceive USD 110, in alignment with the Somalia Cash Working Group (SCWG) Minimum Expenditure Basket (MEB) recommendations from September 2022.