Geneva – WASH Advisors meeting March 2017 Nutrition and WASH - Geneva – WASH Advisors meeting March 2017

Outline Understanding Nutrition Nutrition Emergencies and WASH interventions WASH and nutrition impact

Malnutrition Root causes – UNICEF model

Nutrition and Infection Cycle

Malnutrition

Wasting – two types

Malnutrition – Acronym Jungle MUAC – Mid Upper Arm circumference SAM – Server Acute Malnutrition MAM – Moderate Acute Malnutrition GAM – Global Acute Malnutrition GFD – Global Food Distribution SFP – Supplementary Feeding Program OTP – Outpatient therapeutic Feeding SC – Stabilisation Center RUTF – Ready to use Therapeutic food (plumpy nut) SAM MAM GAM

Unprecedented food security needs in 2017 70 million people in 45 countries

Four countries are predicted to reach Famine status in 2017 Nigeria, South Sudan, Yemen, Somalia Famine is more than just a title or a label, it has a particular set of criteria and thresholds that are met before being classified. The last declared Famine was in Somalia in 2010, 250000 people were estimated to have died. Current estimates indicate 2017 will be of a similar of greater magnitude in terms of food security indicators. Famine is preventable with early action.

IPC classification for Area Based analysis

WASH in Drought Response Human AND Animal water supply Quantity is more important than quality Community and health facilities People on the move Sanitation is still an issue Floods often follow droughts

WASH Response Options Rehabilitation What about sustainability? Trucking How long? Is Cash an alternative? Household Water Treatment Our ERUs and RDRT can handle this

WASH in Development The Sustainable Development Goals (SDGs) encourage more cross-sector work within and between organisations, but many organisations face policy, funding, evidence and attitudinal barriers towards integration. Therefore, in order to get serious about achieving the SDGs and solving the complex health problems facing children under two around the world, a focused coalition addressing issues of integration during the first 1,000 days is essential.

Global Burden of Stunting

First 1000 days

E Coli numbers ingested by an active one year old baby per unit weight Ngure FM et al. AJTMH, 2013 1 gram of soil from a laundry= 69 E. coli counts 1 gram of water = 2 E. coli counts 1 gram of chicken faeces =10 million E. coli counts

Intestinal inflammatory response to constant fecal- oral contamination

Integrated programming for improved outcomes

Lots of new initiatives and guidelines 1000 days http://thousanddays.org/ Babywash coalition http://babywashcoalition.org/ ACF – Wash and Nutrition guideline http://www.actioncontrelafaim.org/sites/default/files/publications/fichiers/manuel_wash_nutrition_online.pdf IFRC – Nutrition Matter http://www.ifrc.org/Global/Publications/Health/Nutrition-matters.pdf Can Water, sanitation and hygiene help eliminate stunting. Current evidence. Cumming and Cairncross https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084825/

References IFRC Drought in the Horn of Africa – Preventing the next disaster http://www.ifrc.org/PageFiles/90410/1203800-Drought%20in%20the%20Horn%20of%20Africa-Preventing%20the%20next%20disaster-EN-LR.pdf IFRC – Don’t blame it on the rain. http://www.ifrc.org/en/news-and-media/opinions-and-positions/opinion-pieces/2011/dont-blame-it-on-the-rain/ HPN Good Practice Review Food Security http://odihpn.org/resources/emergency-food-security-interventions/ FEWS net http://www.fews.net/global/alert/january-25-2017 HPN Emergency Food Security Interventions http://files.ennonline.net/attachments/882/hpn-emergency-food-security-interventions.pdf Technical Manual Version 2.0 IPC http://www.ipcinfo.org/fileadmin/user_upload/ipcinfo/docs/IPC-Manual-2-Interactive.pdf

Thank you © International Federation of Red Cross and Red Crescent Societies, Geneva, 2014. Add any information to copyrighted materials here. Any part of this presentation may be cited, copied, translated into other languages or adapted to meet local needs without prior permission from the International Federation of Red Cross and Red Crescent Societies, provided that the source is clearly stated. Requests for commercial reproduction should be directed to the IFRC Secretariat at secretariat@ifrc.org All photos used in this presentation are copyright of the IFRC unless otherwise indicated. This presentation was written and developed by Amanda McClelland and produced in Feb 2017. This presentation and relevant resources are available on FedNet at fednet.ifrc.org