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toilet use. Among the Mountainous areas, 70.6% wash their hand before eating, 70.5% aftereating and further 63.8% after using the toilet.Programme coverage: The level of measles vaccination based on immunization card andmother’s recall was in the range of 86-89% in the two survey areas. Approximately 70-73% ofpopulation in the Lowland and Mountain ecological zone had received vitamin A capsule in thepast 6 months prior to the survey. These coverage figures of the current survey are lower thanthe 87% coverage reported in the last Vitamin A supplementation campaign in Lahj governoratewhich was conducted in March 2012. Only 25% of households had salt with adequateiodization.Recommendations:In conclusion, the level nutrition situation in Lahj governorate is categorized as critical in theLowland zone and serious in the Mountainous zone. There is a need for a nutrition response tosalvage the situation and prevent it from further deteriorating. Children are the mostsusceptible to such shocks and such a situation if not rescued will have a detrimental effect ontheir health and lives both in the short and long run. The following recommendations areproposed to compliment the efforts on the ground and to ensure that the nutritionalrequirements of the community are met.• Convene a multi-sectoral meeting at governorate level to develop a joint action planidentifying responsible partners, and setting a time frame to act on therecommendations made for improving the nutrition situation.• Expand and scale-up the current CMAM services to more health facilities to increasecoverage and to reach more malnourished children.• The CMAM service in the existing health facilities must also be strengthened throughcapacity building and as a preparation to enhance the capacity of managing severemalnourished children• Strengthened the community mobilization efforts to improve early case finding andreferral for OTP• Deploy additional mobile health teams to strengthen and compliment the primaryhealth care services delivered at static health facilities• Appropriate targeting and continued distribution of existing food aid• Blanket and targeted supplementary feeding in severely affected areas• Improved coverage of vitamin A supplementation, multiple micronutrient supplementsthat includes iodine and better management of diarrhea and acute respiratoryinfections10