download - World Vision's Nutrition Centre of Expertise

Nutrition Situation• As of 28 October 2011, 450,000 children inSomalia are acutely malnourished of whom190,000 suffer from severe acute malnutrition(SAM) (Source: UN Office for the Coordinationof Humanitarian Affairs - OCHA). Ongoinginterventions supported by WV includeoperationalising outpatient therapeuticprogrammes (OTP) and stabilisation centers (SC)and targeted and blanket supplementary feedingprogrammes.Total Number of People affected• The UN estimates 13 million people across EastAfrica are currently affected by the drought. Fourmillion of these people are in Somalia where750,000 are at risk of death before the end of theyear.World Vision’s ResponseWV is responding across four countries to mitigatethe effects of the drought and famine:• Between 20-27 October, WV provided foodassistance to 82,495 people in Kenya, 28,513people in Ethiopia and 13,386 people in Tanzania.• Between February and November 2011, WVEthiopia’s CMAM OTP programme admittedand treated 6,812 children with SAM in theircommunities, with a recovery rate of 97%.• Between February and November 2011, WVSomalia’s CMAM OTP programme admittedand treated 2,254 children with SAM in theircommunities, with a recovery rate of 83%.• Somalia: water, sanitation and hygiene (WASH),non-food items (NFIs), child protection, shelter,health and nutrition, disaster risk reduction (DRR),livelihoods• Kenya: WASH, food distributions, supplementaryfeeding programme (SFP), outpatient therapeuticprogramme (OTP) stabilization centers (SC),blanket supplementary feeding programme, health• Ethiopia: WASH, livelihoods, food distributions, fuelefficient stoves, solar torches, education, health,therapeutic and supplementary feeding• Tanzania: food distributions, WASH, targetedsupplementary feeding, health, livelihoodsA Beneficiary’sExperienceKume Mohammed, a three year old girl from Ethiopia,is one of many children affected by the current droughtacross East Africa. Kume’s mother Bosie Kasim toldWV that she did not have enough food for her smallfamily, and that Kume, her second daughter, has beenmost affected by the food shortage. She was severelymalnourished with swollen feet, hands and face whenBosie took her to the WV Ethiopia supported villagehealth post where she was diagnosed with severe acutemalnutrition (SAM). Kume was treated with de-wormingtreatment, iron supplements, vitamins and antibiotics, andher mother was given sachets of ready to use therapeuticfoods (RUTF) to administer at home. A WV Ethiopiatrained community health worker visits Kume and hermother regularly to monitor her progress and is pleasedwith her recovery from SAM. WV’s support in training,essential drugs and therapeutic food has helped thehealth post where Kume was rehabilitated, along withother health posts in Shashemene ADP operational areas,to respond to the needs of malnourished children inpartnership with the district.Kume Mohammed (3) and Bosie Kasim, Kenya3

CMAM Africa UpdateCMAM Africa Update: Summary of FunctionalIndicators and Influencing Factors as of 28 Oct 2011Submitted by Cyprian Ouma – Africa CMAM Technical AdvisorCountryS. SudanKenyaEthiopiaSomaliaZimbabweNigerEDRCWDRCZambiaMauritaniaSierraLeoneProjectareas /ADP’scoveredProjectstatus(O=ongoing)FoodsecuritysituationTonj Sth,Tonj Nth,GogrialWestUp to endof 2011Very Poor- receivingfood aid9 21 1 6 17 2 9 2 5 2Up to endof 2011Very poor– nationaldisasterOPoor –need foodaidClosed insome parts.PuntlandopenedVery poor– receivingfood aidGwandaphasedout.RushingaandLupanestillongoingPoor –receivingfood aidin someareas buteconomystabilising0In responseto SahelfaminePoor –receivingfood aidFundraisingfor MasisiandRwangubaPoor –receivingfood aidmainly dueto conflictOPoor –receivingfood aidmainly dueto conflictPhased out.Waitingfor fundsto dointegrationandcapacitybuildingPoor –receivingfood aidODataNotReceivedPoorODataNotReceivedPoorGeneralsecurityPoor -cattlerustlingand clanviolencePoor -cattlerustlingGenerallygoodVery poor Good ModeratePoor -sporadicrebelattacksGoodGenerallygoodGoodGoodAccess topopulationPoor dueto rainsModerateGoodPoordue toinsecurityGood Good Poor GoodGoodexceptduringrainsGoodGoodTotalnumber ofsitesOTP=31SFP=31OTP=66SFP= 83OTP=61SFP=N/AOTP=39SFP=33OTP=20SFP=20OTP=33SFP=52OTP=17SFP=0OTP=37SFP=0OTP=16SFP=16OTP=22SFP=305NumberadmittedsinceprogrammesetupOTP=618SFP=7686OTP=2909 OTP=2304 OTP=633 OTP=385OTP=4127SFP=7622OTP=2808OTP=3484SFP=16688OTP=587SFP=969OTP=NADUNumbertrained inCMAMCV=98MOH=10WV=44CV=112MOH=36WV=82CV=560MOH=173WV=14CV=592MOH=11WV=37CV=210MOH=23WV=4CV=1329MOH=282WV=16CV=333MOH=14WV=6CV=89MOH=53WV=11CV=1208MOH=36WV=12DUDURecovered 85% >80% 93% 81.3% 70% 85 90% OTP 84% 67%Deaths inprogramme

Research and Global ParticipationGlobalNutritionClusterMeeting,New York,3 to 5October,2011The Inter-Agency Standing Committee (IASC) Global Nutrition Cluster (GNC) held itssixth face-to-face meeting in New York, USA between 3 and 5 October 2011, which wasattended by 41 persons from NGOs, UN agencies, universities and technical and researchgroups. Mesfin Teklu attended the meeting on behalf of World Vision International.The meeting was opened by Louis George Arsenault (Deputy Director, EmergencyOperations, UNICEF) who provided members with an update on the key outcomes anddecisions resulting from the an internal UNICEF review of its cluster lead functions. Keyoutcomes included a decision to relocate a number of clusters, including the GNC, fromthe UNICEF Programme Division in New York to the Emergency Operation in Geneva, asof January 1, 2012. This move will ensure that all UNICEF led cluster coordination teamsare closer to decision-making and other mechanisms within the IASC, as well as providebetter support to the cluster countries and improve service delivery.A key theme of the meeting was defining the relationship between the GNC and otherclusters, as well as the relationship between the GNC and specific technical initiativesrelevant to emergency nutrition. During this meeting, representatives from the FoodSecurity Cluster (gFSC) and the Health Cluster were invited in order to draw outlinkages between those clusters and the GNC, in addition to sharing progress made todatein the respective clusters. In order to highlight practical ways in which coordinationcan be improved, the Nutrition Cluster response as well as intercluster and interagencycoordination around the Horn of Africa response was also an important focus of themeeting.One of the key objectives of the meeting was to present Nutrition Cluster achievementsas well as gaps since the last GNC meeting in March 2011, and then using this informationand other emerging priorities from the discussion to develop the working group workplans for the next 24 months. In order to highlight areas for incorporation of relevantsupport and engagement of partners into the GNC work plan, the meeting also providedan overview of a number of key technical initiatives in emergency nutrition.Please visit the Global Nutrition Cluster website for the full meeting report: http://oneresponse.info/GlobalClusters/Nutrition/Pages/Global%20Cluster%20Meetings.aspxWV Emergency Nutrition StaffMEETAntony PeterYears with WV: I worked with WV Lankaand WVI for nearly five years following theAsia Tsunami before moving to work for otherNGOs and the UN. I recently started back withWV in August 2011.Current position: Emergency NutritionAssociateCurrent work location: I am based inCanada however can be deployed anywhere inthe world.Main work responsibilities/activities: Iwork 50% with the WV Global Rapid Response Team (GRRT) during which I am available fordeployment to major emergencies to provide support to National Offices in the midst of aresponse, and 50% with WV Canada supporting their ongoing nutrition programming.What you may not know about me: My passion for humanitarian work started duringmy school days when I was an internally displaced person (IDP) in my own country (SriLanka) and then a refugee for many years. These experiences motivated me to complete myMasters in Food and Nutrition and become a humanitarian worker.When you’re not working what do you enjoy doing?Spending time with my family who include my wife and two boys aged 5 years and 19 months.The NextENUIf you have anysuggestions, stories orreports which you thinkwould be helpful for ENUreaders, please email tokaitrin.both@worldvision.com.au by Tuesday,January 10, 2012. Ourtheme topic for Oct-Dec11 issue will focus onManagement of ModerateAcute Malnutrition(MAM).6

Tools, Guidelines and RecommendationsDo you knowabout the keyupdates to theWorld Visionpolicy governingthe procurementand use of milkproducts in fieldprogrammes?UPDATED!To ensure effective infant feeding practices and avoidance of harm to children, WorldVision (WV) has set an internal policy regarding the procurement and use of milk and milkderived products in both emergency and non-emergency contexts. The 2007 version ofWV’s Milk Policy was recently updated to include the recommendations in the World HealthOrganization’s 2010 Guidelines on HIV and Infant Feeding.The policy emphasises that WV protects, promotes and supports breastfeeding and safeand appropriate infant and young child feeding practices and upholds the provisions of theInternational Code of Marketing of Breast Milk Substitutes. It also includes clear guidelinesregarding the distribution of breast milk substitutes. WV will not accept unsolicited donationsof breast milk substitute and milk products. WV will not accept donations of liquid or semiliquidmilk, including evaporated, condensed and Ultra High Temperature milk, and will notaccept or supply bottles and teats (nipples). WV will accept, source and distribute driedmilk products only if they can be used under strict control in hygienic conditions either foron-the-spot consumption in a strictly supervised environment, such as therapeutic feedingprogrammes and wet supplementary feeding programmes or pre-mixed centrally with cerealflour, sugar and oil to produce a dry take-away premix for cooking at household level. Driedmilk should not be distributed as a single commodity or in general food rations.In an HIV specific context, World Vision supportsthe WHO 2010 guidelines on HIV and Infant Feeding.WVMilkPolicySubmitted by Magalie Nelson,WVI Emergency NutritionTechnical Specialist, NCOEWhere HIV status of mother is positive:The country infant feeding strategy should be followed, based on WHO Guidelines (eitherbreastfeeding plus anti-retroviral (ARV) prophylaxis or totally avoid breastfeeding). The secondoption (totally avoid breastfeeding) is only recommended when all of the following criteria aremet:• access to safe water and sanitation and• sufficient infant formula milk is provided to support normal growth and development and• infant formula can be prepared cleanly and frequently enough to be safe and• for the first six months, infant is exclusively formula fed and• family is supportive of this practice and• access to health care that offers comprehensive child health services.If conditions needed to safely formula feed are not met and mothers are HIV positive, thentheir infants should be breastfed (whether or not the mothers are accessing ARVs) forgreatest chances of survival.Note:In the majority of countries in which WV works, these criteria cannot be met bymost families and therefore exclusive breastfeeding for the first six months of life andcontinued breastfeeding with appropriate complementary feeding until environmental,economic and social circumstances are safe for and supportive of replacement feedingis strongly recommended.When HIV status of mother is unknown or known to be HIV-negative:WV encourages and supports the mother to exclusively breastfeed her infant for the first sixmonths of life, and continue breastfeeding for two years or beyond, with timely and correctuse of adequate and appropriate complementary foods starting at six months of age.Global Health & WASHNutrition Centre of ExpertiseThe complete policy is available on wvcentral: https://www.wvcentral.org/cop/hnh/Documents/WVMilkPolicy2011.pdfFor questions or contributions to the WV ENU,please contact the WV Nutrition Centre of Expertisenutrition_coe@wvi.orgNCOE is hosted by WVCanada.7