Infant and Young Infant and Young Child Feeding in Child Feeding in - - PowerPoint PPT Presentation

Infant and Young Infant and Young Child Feeding in Child Feeding in Dadaab: Dadaab: Improving practices Improving practices

in a protracted crisis in a protracted crisis

Mary Lung Mary Lung’ ’aho, CARE aho, CARE

• n behalf of
• n behalf of

Interagency Dadaab IYCF Team Interagency Dadaab IYCF Team UNHCR, CARE & Partners UNHCR, CARE & Partners October 14, 2009 October 14, 2009

IYCF Support in Dadaab: an Interagency Effort IYCF Support in Dadaab: an Interagency Effort

Dadaab IYCF Team Members Dadaab IYCF Team Members

• UNHCR*

UNHCR*

• CARE*

CARE*

• GTZ*

GTZ*

• NCCK

NCCK

• IRC*

IRC*

• ACF

ACF

• MSF

MSF‐ ‐Swiss* Swiss* * = current * = current

Objectives Objectives

• Integrate support for

Integrate support for appropriate IYCF into appropriate IYCF into multi multi‐ ‐sectoral sectoral programming programming

• Strengthen capacity of

Strengthen capacity of staff/workers and staff/workers and partners to support partners to support IYCF in emergency IYCF in emergency contexts contexts

Protracted Emergency Protracted Emergency Dadaab Refugee Camps in Kenya Dadaab Refugee Camps in Kenya

Dadaab Camps Dadaab Camps

Strengthening the System Strengthening the System

What are the key elements? What are the key elements?

• Orientation for all staff

Rapid assessment of new arrivals Capacity‐building for staff & volunteers IYCF support in on‐going programming Behavior change communications Monitoring

Health Post Health Post Dadaab IYCF Team UNHCR—CARE—GTZ—NCCK AAH—Save UK Hagadera Hospital Ifo Hospital Dagahaley Hospital Health Post IYCF Coordinating Team: IYCF Health Post Team IYCF Community Workers

Health Post Staff

• ANC consultant
• Under five consultant
• HIS staff
• EPI staff
• SFP and OTP staff

UNHCR Nutritionist CARE IYCF Supervisor GTZ Nutrition Coordinator NCCK Community Workers

• CHWs- Community Health Workers
• TBAs- Traditional Birth Attendants
• CDWs- Community Dev Workers
• RHMs- Repro. Health Motivators
• CPWs- Children Protection Workers

Community Volunteers-IYCF Counselors Mother-to-Mother Support Groups Secondary Targets

• Men’s support groups
• School clubs
• Youth groups
• etc.

IYCF Officer.

• Maternity staff
• Pediatric staff
• Under five

consultant

• HIS staff
• SC staff
• PMTCT
• etc.

• IFE: Why it Matters

IFE: Why it Matters

• Key policy guidance:

Key policy guidance: IFE Core Group: IFE Core Group: Ops Guidance Ops Guidance

• Challenges in

Challenges in implementation implementation

• Role and

Role and responsibilities of all responsibilities of all sectors sectors

• CME for medical staff

CME for medical staff

Orientation for all staff Orientation for all staff

Ensure staff have Ensure staff have basic knowledge basic knowledge

Rapid Assessment for New Arrivals Rapid Assessment for New Arrivals

• Identify acute

Identify acute feeding and care feeding and care problems needing problems needing immediate immediate attention attention

• Provide critical

Provide critical information information

• Link to support

Link to support systems systems

Orientation & Capacity Orientation & Capacity‐ ‐Building Materials Building Materials

• Orientation: interagency

Orientation: interagency Ops Guidance & IFE Ops Guidance & IFE Core Group Mod 1 Core Group Mod 1

• WHO/UNICEF BF

WHO/UNICEF BF Counselling Counselling course (40 hr)

course (40 hr)

• IYCF Community

IYCF Community‐ ‐Focused Focused and C and C‐ ‐F Plus (incorporates F Plus (incorporates ENA content) Approaches ENA content) Approaches

• Mother

Mother‐ ‐to to‐ ‐Mother Mother Support Group: Facilitator Support Group: Facilitator Training Training

• Integration of IYCF Support

Integration of IYCF Support into CTC/CMAM into CTC/CMAM

Capacity Capacity‐ ‐Building Building

IYCF Community IYCF Community‐ ‐Focused Approach Focused Approach Integration of IYCF Support into CTC/CMAM Integration of IYCF Support into CTC/CMAM

Capacity Capacity‐ ‐Building: Breastfeeding Counselling Building: Breastfeeding Counselling

WHO/UNICEF 40 WHO/UNICEF 40‐ ‐hour course hour course

Community Community‐ ‐Focused Training Focused Training

Strengthening Assessment Strengthening Assessment & Counselling Skills & Counselling Skills

Staff & Workers: Hands Staff & Workers: Hands‐ ‐on Practice

• n Practice

Peer Support: MtMSG Peer Support: MtMSG

Camp Blocks showing Mother Support Group Locations Camp Blocks showing Mother Support Group Locations

BCC Activities BCC Activities Transporting a video between health posts Transporting a video between health posts

IEC Materials IEC Materials

IYCF Support Activities IYCF Support Activities

IYCF Counsellors: staff, CHW incentive workers and

mother volunteers (234 CHWs, 214 trained‐to‐date as IYCF Counsellors; 32 Trainers)

Identified Contact Points (facility and community) to

visit and counsel pregnant and lactating women

IYCF counselling cards and other job aids for

community workers

Mother support groups spread throughout the blocks:

currently 658 functioning groups (610 with trained facilitators)

Activities to engage community ‐‐ including men;

involve religious leaders

Instructional videos and action‐oriented educational

talks in health posts

Feedback to community

Tracking our Progress Tracking our Progress Has it made a difference? Has it made a difference?

Monitoring of programme activities Age‐disaggregation in UNHCR HIS Annual nutrition survey

Measures child nutritional status Provides coverage data Tracks IYCF practices at population level using globally‐agreed indicators

Step‐by‐Step GUIDE to Collecting and

Analyzing IYCF Data, with Tools

Annual nutrition surveys Annual nutrition surveys

0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 2005 2006 2007 2008 2009

Exclusive BF Dadaab 2005‐2009

Percent EBF Dag Hag Ifo

Projected EBF Rate from Baseline IYCF Program Start Influx of New Refugees

African Countries: EBF 0 African Countries: EBF 0‐ ‐<6 Months <6 Months

UNICEF State of the World UNICEF State of the World’ ’s Children 2009 s Children 2009

& &

EBF 0 EBF 0‐ ‐<6 Months in Dadaab: 2005 & 2009 <6 Months in Dadaab: 2005 & 2009

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Exclusive Breastfeeding 0 <6 months

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0% 40.0% 45.0% 50.0% 2005 2006 2007 2008 2009

Global Acute Malnutrition Dadaab 2005‐2009

Percent GAM Dag Hag Ifo

Ongoing Challenges Ongoing Challenges

Continued population influx: 134,000 to

289,307 …

Limited diet options

Quality: limited food commodity diversity Quantity: continued pressure from influx Concerns for maternal nutrition & care

Post‐training mentoring of workers &

volunteers

Ongoing staff turnover Others …

This year: transition to UNHCR coordination

The Dadaab experience suggests The Dadaab experience suggests that IYCF practices can be protected, that IYCF practices can be protected, and even improved, in some and even improved, in some emergency contexts. emergency contexts.

Thank You! Thank You!