Nutrition Cluster Meeting, 27 June 2014

1. UNICEF Integrated Rapid Response Mechanism (IRRM) Updates, Achievements and Ways Forward Nutrition Cluster Meeting, 27 June 2014

2. Outline of Integrated Rapid Response Mechanism (IRRM) UNICEF, WFP and FAO working together in the field in a collaborative manner to : • assess needs • Provide multisectoral responses.

3. Key IRRM activities - Nutrition Children 6-59 months: • MUAC screening • SAM treatment • MNP • Vitamin A • Deworming PLW: • MUAC screening • MNT • IYCF Key messaging Supervision: • SC • OTP (re)-Establishment of nutrition services: • Identification of gaps and potential partners • Initiation of services • Ensure continuation of services • Ensure supplies Capacity building: • Anthropometry/screening • Treatment • Management • Reporting • IYCF

4. IRRM-Nutrition process during GFD The implementation process: Nutrition intervention: Screening MN supplementation Deworming IYCF messaging

5. IRRM Nutrition process WFP GFD schedule Information gathering on area/situation Plan of Action in coordination with Cluster Scenario 1: With partners Scenario 2: Direct implementation (no partners) • UNICEF: • Coordination of activities and supplies • Supervision of services and support capacity building • Partner: • Planning and execution of activities • Follow-up activities • Direct implementation with community volunteers • Initiation of a minimum package of nutrition services. • Identification of key gaps in services • Identification of partners for follow-up activity

6. Benefits of the IRRM Nutrition response Humanitarian level: Cluster level: Opportunity for revitalization of field presence for (previous) partners Creating new opportunities for partnerships Creating opportunities to increase quality of services (capacity building, supplies, supervision) Collecting additional nutrition information (surveillance, gaps etc) • Increased coverage towards the targets of CRP 2014 • Golden opportunity: multisectoral actions in a minimum amount of time • Strengthened intersectoral and inter-organizational cooperation

7. Achievements of IRRM Nutrition activities so far Target Achievement (21st June) 13 IRRM-Nutrition missions 30,254 children 6-59 months screened 2,586 (8.5%) SAM children & 6,100 MAM (20.7%) children detected 858SAM children not already enrolled, referred for treatment 17,367children 6-59 months supplemented with vitamin A and 14,066 children reached with deworming treatment 5,370 PLW screened. 913(16.8%) are found malnourished Expansion of OTP activities by partners • 24 RRM-Nutrition missions • 68,500 children 6-59 months screened • 5,000 SAM children referred for treatment • 68,500 children aged 6-59 months supplemented with vitamin A and deworming treatment • 29,000 PLW screened for acute malnutrition • 29,000 PLW accessing IYCF-E messages and micronutrients tablets.

8. Achievements – IRRM Nutrition (as 21stJune) 13 missions conducted so far Locations covered with MUAC screening: Akobo, Mayendit, Kodok, Pagak, Lankien, Haat, Pochalla, Old Fangak, Walgak, Jeich, Leer 30,254 children 6-59 months screened 5,370 PLWscreened Main findings: Proxy SAM : 8.5% Proxy MAM: 20.2% PLW MUAC <18.5cm: 16.8%

9. Results of MUAC screening (11 IRRM sites)

10. Contributions of RRM towards Nutrition Surveillance MUAC <11.5cm 4.5% >11.5cm - < 12.5cm 13.5% MUAC <11.5cm 4.1% >11.5cm - < 12.5cm 6.6% MUAC <11.5cm 1.9% >11.5cm - < 12.5cm 27.3% MUAC <11.5cm 1.0% >11.5cm - < 12.5cm 21.0% MUAC <11.5cm 10.1% >11.5cm - < 12.5cm 29.9% MUAC <11.5cm 3.7% >11.5cm - < 12.5cm 9.1% MUAC <11.5cm 9.6% >11.5cm - < 12.5cm 12.1% MUAC <11.5cm 4.0% >11.5cm - < 12.5cm 8.0% MUAC <11.5cm 18.6% >11.5cm - < 12.5cm 30.4% MUAC <11.5cm 10.8% >11.5cm - < 12.5cm 24.5% MUAC <11.5cm 28.8% >11.5cm - < 12.5cm 22.6% MUAC <11.5cm 0.4% >11.5cm - < 12.5cm 6.4%

11. Nutrition partners involved so far • NGOs Partners involved in RRM up to date :

12. IRRM Jeich , Ayodcounty 3-10 June • A total of 2,297 children 6 – 59 months were screened for malnutrition (MUAC). Of this 84 (3.7%) were found with SAM and referred to the PHCC. 208 children had MAM (9.1%) • A total of 359 pregnant and lactating women were screened using MUAC. 1 found to be <18 cm (0.3%) and 47 (13%) were >18 - < 21 • 2,049 children 6-59 months received Vitamin A supplementation • 1,349 children 12 – 59 months received deworming tablets • Monitoring of the OTP was done and corrective measures taken through coaching of OTP staff on appropriate practices • Agreements reached with COSV and CHD on immediate response to be provided to children with complications • Follow-up is on-going with partner on facilitating start-up of SC services in Jeich

13. IRRM Leer county 11-18 June IRRM organized outside GFD due to needs signaled by partners on the ground: • UNICEF providing mass vaccination campaigns ( 12,942 ch) micronutrient supplementations (4,080ch), deworming (3,508ch) and MUAC mass screening (4.467ch & 2,876 PLW) • MUAC screening: SAM 10.1% , MAM 29.9% • UNICEF facilitating access for MAM treatment activities (UNIDO) • 1,107 PLW reached with one-to-one IYCF key messages • UNICEF facilitating support for supplies ensuring treatment by partners without stock out (+++caseloads in nutrition centers) • UNICEF liaising with Nile Hope to plan for a scale up health facility activities with nutrition service components as well as Mother Support Groups (IYCF) • Joint follow-up visit with health scheduled for end July

14. Ongoing IRRM 2IRRM currently ongoing: • Koch , Unity State (partner: World Relief) • Nhialdiu, Unity State (direct implementation)

15. Gaps in the Response • Selected sites not always aligned with most at nutritionally at risk counties • Number of missions • Service continuity beyond the mission (number & composition of teams)

16. What is needed to scale up? • Coverage of areas beyond GFD • Prioritization of areas with identified nutritional needs • Refining of strategy for scenario 2: direct implementation (areas with no partners) • Increased number if IRRM nutrition teams • Technical field teams with health profiles for areas with direct implementation ( no partners ) • Need to enlarge IRRM focus to ensure coverage SAM & MAM services => improved dialogue with WFP / partners => expanded SAM protocol where no MAM services?

17. Scale-up Options