Scoop situation - Field Exchange - Emergency Nutrition Network

Joint Statement on micronutrientdeficiencies in emergenciesA Joint Statement has been issued by WHO,WFP and UNICEF on preventing and controllingmicronutrient deficiencies in populationsaffected by an emergency. It focuses on pregnantand lactating women and children aged6 to 59 months, as the groups most vulnerableto micronutrient deficiencies and their consequences.For a pregnant woman these includea greater risk of dying during childbirth, or ofgiving birth to an underweight or mentallyimpaired baby. For a lactating mother, hermicronutrient status determines the healthand development of her breastfed infant,especially during the first 6 months of life. Fora young child, micronutrient deficienciesincrease the risk of dying due to infectiousdisease and contribute to impaired physicaland mental development.Micronutrient deficiencies can easily developduring an emergency or be made worse ifthey are already present. So the micronutrientneeds of people affected by a disaster must beadequately met. One way of achieving this isthe regular provision of adequate amounts offoods fortified with micronutrients as part offood rations during emergencies.Fortified foods include corn soya blend,biscuits, vegetable oil enriched with vitaminA, and iodised salt.However, foods fortified with micronutrientsmay not fully meet the needs of certain nutritionallyvulnerable sub-groups. Two dailymultiple micronutrient formula have beendeveloped by UNICEF and WHO to meet therecommended nutrient intake (RNI) of pregnantand lactating women and children aged6-59 months in emergencies (see table 1).Pregnant and lactating women should begiven their supplement (1 RNI/day) whetherthey receive fortified rations or not. Dosagesand schedule for administration of the children’ssupplement are included for situationswhere there is or there is not provision of fortifiedrations. Recommendations are madeTable 1regarding continuation of iron and folic acidsupplementation in pregnant and lactatingwomen, and vitamin A supplementation toyoung children and mothers post-partum.Breastfeeding and appropriate complementaryfeeding should be promoted actively.The Joint Statement recommends that multiplemicronutrient supplements should begiven until the emergency is over and accessto nutrient rich foods is restored. At this timethe micronutrient status of the populationshould be assessed to decide whether furtherinterventions to prevent and control micronutrientdeficiencies are needed.The delivery of supplements should be monitoredto assess coverage, existing micronutrientprogrammes should continue as before theemergency, and the health of target groupsmonitored for deficiencies as well as excessiveconsumption. The continued need for supplementsand fortified foods should be assessedperiodically during and after the emergency.As the crisis wanes, the general distribution ofsupplement is likely to be reduced and thenincreasingly targeted to specific groups.The Joint Statement is available at:www.who.int/nutrition/publications/WHO_WFP_UNICEFstatement.pdfComposition of multiple micronutrient supplements for pregnant women,lactating women, and children from 6 to 59 months of agePregnant/lactating womenVitamin A µg 800.0 400.0Vitamin D µg 5.0 5.0Vitamin E mg 15.0 5.0Vitamin C mg 55.0 30.0Thiamine (vitamin B1) mg 1.4 0.5Riboflavin (vitamin B2) mg 1.4 0.5Niacin (vitamin B3) mg 18.0 6.0Vitamin B6 mg 1.9 0.5Vitamin B12 µg 2.6 0.9Folic acid µg 600.0 150.0Iron mg 27.0 10.0Zinc mg 10.0 4.1Copper mg 1.15 0.56Selenium µg 30.0 17.01WHO, WFP, UNICEF Joint Statement. Preventing andcontrolling micronutrient deficiencies in populations affectedby an emergency. Multiple vitamin and mineral supplementsfor pregnant and lactating women, and for children aged 6to 59 months. WHO, 20072Both supplements contain iron (27mg/day for pregnant/lactatingwomen and 10mg/day for children 6-59months). Risks and consequent recommendations regardingiron and folic acid supplementation in highly malariousregions are given in a WHO statement, Iron supplementationof young children in regions where malaria transmission isintense and infectious disease highly prevalent. (undated).Available at http://www.who.int/child-adolescent-health/New_Publications/CHILD_HEALTH/WHO_statement_iron.pdfThis WHO Statement is reflected in the recommendation ofthe Operational Guidance on Infant and Young Child Feedingin Emergencies, v2.1, February 2007, Section 5.1.2, a positionreached by consensus at the UNSCN meeting in Rome,2007. Available at http://www.ennonline.net/ife (Eds)Children (6–59 months)ReportingSkills andProfessionalWritingHandbookNewsTo help develop writing and reporting skills,a self-study programme has been developed,designed for development professionals butalso relevant to those working in the emergencysector.The Handbook covers the entire reportingprocess from setting objectives, through datagathering and analysis tools, to planning,drafting, editing and designing a report. Itcontains examples, practical exercises, and anextended case study to fully apply all thetools presented.Two example modules (Data GatheringMethods and Writing Clarity) are available todownload fromhttp://www.reportingskills.org/resources.htmThe whole Handbook comprises eight stepsto ‘effective reports’:1: Professional Writing and the WritingProcess2: Setting Objectives & Data GatheringMethods (entire module available fordownload)3: Analysing & Interpreting Information4: Planning the Report5: Writing Skills – Clarity (entire moduleavailable for download)6: Writing Skills – Organisation7: Putting it all Together8: Finishing Off the ReportA moderated web forum, where users canpost ideas and reach the author withcomments, questions and feedback, supportsthe Handbook.The Handbook is only available as an electronicdownload and can be bought anddownloaded fromhttp://www.reportingskills.org(single user edition costs £30GBP).There are special licenses for organisations(10 users) and the Project Office Edition (50-user licence) also includes a Training Pack –Trainer Guide, Participant Notes,Supplementary Materials and over 250 slides.The Reporting Skills and Professional WritingHandbook: a self-study programme fordevelopment professionals, © Neil Kendrick2007. Published by Education, Language andDevelopment Training Programmes (UKCharity no. 1083385)Iodine µg 250.0 90.018