In the early months of 2008, Kenya experienced worst skirmishes which were as a result of the post election violence. This led to more than 1,000 lives lost and mass internal displacement of more than 300,000 persons.The affected populations had in general lived in areas with low levels of malnutrition (KDHS 2003 report indicates global acute malnutrition of 4%).  However, trends of rapid MUAC (Mid Upper Arm Circumference) screening that were conducted since the beginning of the crisis in April 2008 show that the nutritional situation of the host, returnees and resettled populations rose with reports highlighting poor water and sanitation conditions in the transition camps and household food insecurity with limited access to adequate food, quality and quantity wise. It is clear that the case load of acutely malnourished individuals is now higher compared to pre-crisis levels and is most likely going to deteriorate further given the presence of aggravating factors such as HIV/AIDS.  As a result, the capacity to manage malnutrition was overstretched against the growing burden of malnutrition.

Even though initiatives had been taken to build MoH capacity in diagnosing and managing malnutrition and HIV/AIDS, much more efforts were needed to reach the expected standards and coverage, especially in the most affected areas of Kisumu district and its environ. It was therefore proposed that a) K-MET conduct continuous technical support, mentoring and monitoring in the slum areas of the district ) intensive training events, followed-up by close monitoring  and implementation of out patient therapeutic program for severely malnourished children under five years  be implemented in the post election affected areas of Kisumu East district.

Population density in West Kolwa and central Kolwa location combined is 125,000 households with a total population of more than 240,680; of which 36,264 are CU5 and 117,451 are women of reproductive age (WRA). Besides that K MET Clinic has initiated the OTP which is a nutrition component that deals mainly with severely malnourished children of ages {6months to 59months} as well as moderately malnourished child. Having achieved the community entry into Central kolwa, the community has begun to own the project and is positive to initiate the activities that are entailed in the program at Ragumo Health Centre.

Overall Objective
To reduce morbidity and mortality in children aged 6 to 59 months in the informal urban settlements of Kisumu East District.

Specific Objectives:

• To strengthen technical and organizational capacity of K-MET and Ragumo in the implementation of the MoH nutrition essential package.
• To strengthen combined services for nutrition prevention and treatment of HIV and TB services.
• To improve infant and young child feeding practices
•   To improve household and caregiver nutrition

OTP and Primary health care services
The OTP has scaled up its operation to Ragumo Health centre. The nutrition assistants are due to be recruited. Continuous OTP project at K-MET clinic was delivered to the communities living in West and Central Kolwa locations. The communities benefited from free nutrition rehabilitation services which ranged from giving free drugs and high energy high protein, mineral, and vitamin fortified therapeutic nutrition supplement (plumpy nuts).  A total of twenty (20) OTP clients were identified and attended to.

Breastfeeding clubs
Recruitment of breastfeeding mothers is still ongoing at the facility level. However, mobilization at the community level has commenced in Ragumo area. 20 mothers have so far been recruited, and formalization of the club was done as the mothers themselves have recruited their officials.

Reporting tools
Data collection and reporting tools for OTP was adopted from the Ministry of Health, which includes nutrition data requirements. However, to help streamline K-MET-specific program needs and activities, which include nutrition activities, a total of 50 I.E. C materials with nutrition messages were adopted from MoH and distributed to the Community. They included posters, brochures and fliers.