GNC Scoping Mission to Assess Nutrition Needs, Response and - - PowerPoint PPT Presentation

Ukraine, 3-14 February 2015

GNC Scoping Mission to Assess Nutrition Needs, Response and Coordination

Objectives of Mission

• To review nutrition coordination structure
• To identify and map capacity of partners
• To map nutrition interventions
• To assess nutrition information needs and the possibilities

for conducting nutritional assessment

• To identify programmatic and geographic areas of need and

key NiE interventions

• Identify core advocacy concerns related to NiE interventions

Methodology

• Documents review (assessment reports, regional

reports, surveys, situation reports, press releases, media articles)

• One-on-one consultations with 27 individuals
• Additional review of documents shared by key

informants

• SRP workshop, two operational planning

meetings, two FS&N Cluster meetings, two Health Cluster meetings and a WASH Cluster meeting attended

Nutrition Situation Pre-Crisis

• GAM prevalence 1.3% (2000)
• Anaemia prevalence pre-crisis 22.2%

(2004); no information on other MND but expected to be common

• IYCF practices sub-optimal, ex. Exclusive

BF 19.7% (2012), wide use of BMS

• No info on other population groups

Infant feeding patterns by age, Ukraine, 2012

Im Importance of f Protecting In Infant and Young Chil ild Feeding in in Emergencies

• Breastfed children healthier than non-breastfed children in

all contexts – even non-emergency

• In emergencies disease & death rates for < 5s significantly

higher due to: ↑ communicable diseases, ↑ undernutrition, lack of appropriate health care

• Difficult unsanitary conditions + risk of water borne disease
• BF confers critical protection from infection and death

especially in emergencies when lack of safe water & poor sanitation

• Artificial feeding even riskier in in emergencies 

significantly endanger infant & young children’s health and lives

Im Importance of f Protectin ing In Infant and Young Chil ild Feedin ing in in Emergencies

• Even when safe water guaranteed, infant formula use has high risks:
• deprives infants of disease prevention/fighting action of breast-

milk

• retards development of the immune system
• renders babies more susceptible to colonisation by pathogens
• BMS should only be provided to targeted infants who have been

assessed by a qualified health/nutrition worker

• Additional resources, training and support for caregivers to minimise

the risks of artificial feeding

• Once started, provision of BMS must continue as long as infant

requires

• Spill over risks of BMS programmes high, so interventions to support

non-breastfed infants should always include component to protect BF

WHO/UNICEF recommendatio ion on IY IYCF

• infants should initiate exclusive breastfeeding within
• ne hour of birth
• and continue exclusively breastfeeding for the first six

months of life.

• After this time, infants should continue breastfeeding

until they are two years of age or beyond while also receiving age-appropriate, nutritious and hygienic complementary foods.

• Introduction of complementary foods at 6 months
• f age
• Semi-solid, nutritious foods providing not only

required energy, but also vitamins, minerals and high quality (animal) protein

• Thick porridges, soft fruits and vegetables, minced

meat/chicken/eggs

• Gradual transition to family foods around 1 year of

age

WHO/UNICEF recommendatio ion on IY IYCF

Mission Findings – Nutritional status

No info on acute malnutrition

• Expected to increase, due to aggravation factors

(deterioration of food security, WASH and health situation, care practices, access to basic services)

• Reports that children are unhealthy, pale, not

active, however no confirmed reports of acute malnutrition

No info on MNDs

• Expected to increase due to very limited access to

fruits, vegetables, fish and meat

Mission Findings – IYCF-E

• Lack of info on current IYCF practices
• Non-existent capacity of partners and gvt in NiE, incl.

IYCF

• “Baby baskets” contradict WHO/UNICEF

recommendations

• Widespread BMS distributions
• Reports that mothers stop BF because of the stress,

strong believes that mothers do not have enough milk to BF

• Sub-optimal complementary feeding
• Early introduction of CF
• Very limited access to MN-rich food
• Limited access to protein-rich food
• Focus on industrial CF
• High demand for BMS and CF

Mission Findings – other factors Risks of increased morbidity, malnutrition amplified by current conditions:

• deteriorated water quality and supply
• decreased sanitation and hygiene
• lack of safe and appropriate complementary foods
• lack of available food, especially MN and protein-

rich

• decreased access to health services
• low exclusive BF rates
• lack of skilled support for appropriate IYCF

Mission Findings – Response and Coordination

• Nutrition was part of the FS and Nutrition Cluster
• No coordination/IM capacity for nutrition
• One NGO distributes BMS and one NGO

distributes CF&BMS

• Some potential partners on the ground identified

(local NGOs, INGOs, UN agencies, gvt)

• Non-existent capacity of partners and gvt in NiE
• No nutrition assessments conducted, Save was

planning IYCF assessment

• SRP was revised during the mission

Recommendations – Response

• Technical capacity in nutrition of CLA and

leading partners should be enhanced

• Build capacity of partners in NiE
• Conduct IYCF assessment, discuss need for
• ther assessments
• Develop and agree upon cluster strategy, focus
• n quick wins
• Focus on children, PLW and older people
• Implementation in partnership with other

clusters/sectors and gvt

• Orient hum. community on NiE
• IYCF statement and communication campaign

Recommendations – Coordination

• Create Nutrition Sub-group under Health cluster
• Bring everyone “on the same page”
• UNICEF start recruitment of NCC and deploy

RRT

• Build sub-national presence
• Advocate to INGOs with NiE expertise to

implement nutrition programming