SOMALI NUTRITION STRATEGY 2011 – 2013 - ReliefWeb

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x Table of Contents Foreword iii Preface vi Acknowledgements vii Acronyms ix Executive Summary 1 1. Background 3 1.1 Nutrition situation 3 1.2 Determinants of malnutrition 4 1.3 Nutrition interventions 5 2. Justification, Scope and Guiding Principles 8 2.1 Justification 8 2.2 Scope 8 2.3 Guiding principles 8 3. Goals, outcomes, outputs 10 4. Implementation 13 4.1 Opportunities 13 4.2 Partnerships 14 4.3 Zonal differences 15 4.4 Formative research 16 4.5 Technical support 16 4.6 Behaviour Change Communication 16 5. Monitoring 17 Annexes Annex 1. Logical framework - Results based matrix 19 Annex 2. Situational analysis 42 Annex 3. Justification of outcomes and key approaches adopted in this strategy 60 Annex 4. Proven effective interventions identified by Lancet series on Maternal and Child Undernutrition 65 Annex 5. Copenhagen Consensus 2008 66 Annex 6. How malnutrition affects achievement of MDGS 67 Key References 68 List of Figures Figure 1. Seasonal trends in national median rates of acute malnutrition 2001-2009 3 Figure 2. Annual national median stunting rates 2001-2009 4 Figure 3. Median rates of wasting, stunting and underweight by Zone 2001-2008 4 Figure 4. Prevalence of anaemia and vitamin A deficiency amongst women and children 2009 4 Figure 5. Prevalence of some key determinants of malnutrition in Somalia 2009 5 Figure 6. Trends in wasting, stunting and underweight by livelihood group, 2001-2008 44 Figure 7. Malnutrition rates by zone 2009, according to National Micronutrient and Anthropometric Nutrition Survey, Somalia 2009 45 Figure 8. UNICEF Conceptual model of causes of malnutrition 47 Figure 9. Breast feeding initiation 49 Figure 10. Age Specific fertility rates by urban-rural residence, Somalia 2006 50 Figure 11. Immunisation coverage among children under five years, 2009 51 Map Map 1. Map of current nutrition situation and interventions as of 18th March 2010 7 List of Tables Table 1. SWOT analysis of current nutrition interventions in Somalia 56 Table 2. Existing programmes presenting opportunities for the integration and strengthening of nutrition activities 57
Executive Summary Malnutrition in Somalia is a huge public health problem, negatively affecting growth, development and survival of the population. Situational analysis shows a long term nutrition crisis characterised by persistently high rates of acute and chronic malnutrition throughout the country with some variation by zone and livelihood system. This situation reflects nearly two decades of armed conflict and insecurity, with breakdown in social and public services coupled with recurrent droughts and flooding seriously affecting food security and livelihoods. In response to the alarming rates of acute malnutrition, nutrition programming coordinated by the Nutrition Cluster, has been primarily focussed on the immediate needs of saving lives through the management of acute malnutrition, based on seasonal assessments of food security and nutrition surveillance data primarily by FSNAU. 1 However, surveillance data shows that even in years of improved food production and relative stability, rates of acute and chronic malnutrition remain high in certain regions indicating other underlying causes play a significant role. Evidence shows that sub-optimal infant, young child and maternal feeding and care practices, low dietary diversity, poor hygiene, water and sanitation, high morbidity coupled with inadequate access to health care are key determinants of the problem. To address these multi-factorial and overlapping causes, a holistic package of interventions with multi-sector collaboration is required. This strategy has been developed via a consultative approach between UN agencies, local and international NGOs and the national and regional health authorities to provide an agreed upon framework for action to meet this need for a shift to a more holistic approach. The results-based strategy provides a detailed action plan to guide prioritisation of interventions in face of limited resources, project implementation and resource mobilisation. Based on the situational analysis, review of best practices and proven effective interventions feasible in the challenging context of Somalia, the following goal and outcomes for the strategy have been established. Overall of the strategy is: To contribute to improved survival and development of Somali people through enhanced nutritional status. This will be accomplished through the achievement of the following outcomes: Outcome 1: Improved access to and utilisation of quality services for the management of malnutrition in women and children Outcome 2: Sustained availability of timely and quality nutrition information and operational research into effective responses to the causes of undernutrition Outcome 3: Increased appropriate knowledge, attitudes and practices regarding infant, young child and maternal nutrition Outcome 4: Improved availability and coverage of micronutrients and de-worming interventions to the population Outcome 5: Improved mainstreaming of nutrition as a key component of health and other relevant sectors Outcome 6: Improved capacity and means in country to deliver essential nutrition services The outcomes will be achieved by conducting defined activities that will produce key outputs. Implementation of the strategy will be guided by the overarching principle of improving partnerships between all stakeholders <strong>–</strong> local and national authorities, donors, UN agencies, local and international NGOS, local community and the private sector <strong>–</strong> and increased collaboration
Page 1 and 2: SOMALI NUTRITION STRATEGY 2011 - 20
Page 3 and 4: Foreword Good nutrition is one of t
Page 6 and 7: vi Preface This Somali Nutrition St
Page 8 and 9: viii Dr. Ahmed Mohamed Jama MoH/L T
Page 12 and 13: 2 between sectors. While the main e
Page 14 and 15: 4 Preliminary results of the meta-a
Page 16 and 17: 6 Furthermore WFP is providing food
Page 18 and 19: 22. JUSTIFICATION, SCOPE & GUIDING
Page 20 and 21: 3 GOAL, OUTCOMES & OUTPUTS The goal
Page 22 and 23: 12 Outcome 6: Improved capacity and
Page 24 and 25: 14 4.2 Partnerships Implementation
Page 26 and 27: 16 In Somaliland and to a lesser ex
Page 28 and 29: 18 ANNEXES
Page 30 and 31: 20 1.3 Food based interventions for
Page 32 and 33: 22 (including lipid-based nutrient
Page 34 and 35: 24 Outputs: 2.1 Quality nutritional
Page 36 and 37: 26 Outcome 3 Project description In
Page 38 and 39: 28 traders/importers of breast milk
Page 40 and 41: 30 Outcome 4 Project description In
Page 42 and 43: 32 conducted for a specific target
Page 44 and 45: 34 reducing missed opportunities 4.
Page 46 and 47: 36 5.2 Nutrition is integrated into
Page 48 and 49: 38 5.2.2 Establish a mechanism for
Page 50 and 51: 40 implement quality nutrition prog
Page 52 and 53: ANNEX 2 NUTRITION SITUATION ANALYSI
Page 54 and 55: 44 As highlighted by the Post Gu 20
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50 Furthermore, adequate complement
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52 Only just over half of household
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54 4.4 Management of moderate acute
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56 Table 1: SWOT Analysis of curren
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58 WHO/UNICEF Strengthening GAVI He
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60 In this section, internationally
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62 The advantages of LNS pertinent
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64 Outcome 5 Nutrition is mainstrea
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66 Annex 5 Copenhagen Consensus 200
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68 Key References Bhutta ZA, Ahmed
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