Humanitarian-Development Nexus (HDN) Niger Cecile Basquin - Nutrition Technical Group/Cluster Coordinator GNC annual meeting – Amman - October 2018

Why and what is HD Nexus? 201.5 million people living in 134 countries were in need of international humanitarian assistance in 2017. The complexity, the volume, the cost and length of humanitarian crisis over the past 10 years has grown dramatically. Sources: 2018 Global Humanitarian assistance report from Development Initiatives

Why and what is HD Nexus? These long lasting and complex crisis compromise development efforts, challenge humanitarian and development assistance, with insufficient emergency resources coupled with programming difficulties to pursue development objectives. Long-standing discussion and evolving agenda around better connectivity between humanitarian and development efforts and how to bridge the divide.  The New Way of Working frames the work of development and humanitarian actors, along with national and local counterparts, in support of collective outcomes that reduce risks and vulnerabilities and serve as investments towards achieving the SDGs. 2030 Agenda and the Sustainable Development Goals (SDGs) set out not just to meet needs, but to reduce risk, vulnerability and overall levels of need, providing a reference frame for humanitarian and development actors to contribute to the common vision of a future in which no one is left behind Sources: OCHA IASC EU Picture taken from https://www.unitedinstitutions.org/the-big-picture.html

Objectives of the session To reflect on key considerations around the HD Nexus concept with a nutrition perspective To explore possible enablers toward facilitating the HDN approach in Fragile and Conflict Affected States (FACS) To identify key actions Nutrition stakeholders need to undertake to contribute to advancing the HD Nexus concept To derive more specific actions for Nutrition Clusters to approach HD Nexus in more practical terms

What is HD Nexus from the Nutrition perspective? From a phased LRRD approach to concomitant actions including: Risk-informed, multi-sectoral nutrition-specific and nutrition-sensitive programs Political commitment for Nutrition and better governance Health system Strengthening (HSS) Nutrition-sensitive social protection scheme To address chronic nutrition deprivation / To create a foundation for nutrition resilience In others words, we propose to see HD Nexus has an approach / a means to reach nutrition resilience goal. Good nutrition both a building block for resilience and an outcome of resilience…e.g. well nourished adults can be productive and protect individuals and their households from shocks, can support GDP growth etc. Resilience is the ability of an individual, a household, a community, a country or a region to withstand, adapt to and quickly recover from stresses and shocks, such as sudden or recurrent disasters caused by natural hazards Sources: ENN resilience report, The diagram was created using the definitions of resilience from BMZ, Canadian DFATD, DfID, EU, Irish Aid, OECD, UN (FAO/WFP/IFAD) and USAID

Niger example – contextual background 2018 Humanitarian Needs Overview (HNO) Localized acute humanitarian needs in areas subjected to armed conflict / terrorism versus areas with highest burden of acute malnutrition. Lake Chad BH crisis that affects Diffa region since 2015 is an area where 2.5% of the annual SAM / MAM burden

Niger example – contextual background Malnutrition is a chronic and stagnant problem with all forms of undernutrition above alarming/critical thresholds for over a decade. Burden of acute malnutrition is in Maradi and Zinder regions (bearing over 50% of annual SAM/MAM burden). Seasonal shocks - Predictable peak of admissions Jun – Oct associated with seasonal malaria, agricultural lean season SAM: close to 400,000 total admissions in 2017 ; MAM admissions vary from year to year depending on WFP support capacity Burden in Zinder and Maradi regions (bearing 60% of annual caseload)

Background - Niger context IMAM program integrated to the health system since 2005, scaled-up nation-wide with humanitarian funding. Nutrition-specific interventions (Vit. A; deworming; iron-folate; IMAM, IYCF, MNPs, screening) are delivered in an integrated manner by a fragile health system. Nutrition-specific interventions are almost entirely dependent on external financial support (and mainly from humanitarian donors). Low political commitment, weak government capacities, Declining humanitarian resources, Partners phasing out IMAM programming: funded by humanitarian donors and so development donors do not include AM treatment in their strategies/ budget and government assumes it is upon the responsibility of partners UN agencies and NGO According to national health development plan and verbal report, MoH budget allocated for Nutrition amounts to less than 2 million USD but only a small proportion is actually spent (mainly spent for Nutrition Directorate running costs) In fact, as part of an economic analysis using the Lives Saved Tool, study undertaken by UNICEF, implications of withdrawal of humanitarian funds allocated for acute malnutrition would lead to prevalence of wasting would triple and U5 mortality would go up in the year following the phase out. U5 mortality being one of the few indicators on a long lasting improving trend in Niger.

HD Nexus in Niger – what are possible enablers? NWoW and Nexus concepts are relevant for Niger but what does it mean in practical terms? What would be the possible facilitating factors? Policies, governance Financing Programmes Scheme sources: https://www.care.org/sites/default/files/documents/care_hub_detailed_paper_doing_nexus_differently_final_sep_2018.pdf

HD Nexus in Niger – progress and challenges Policy framework President’s initiative (3N) on Food Security and Nutrition including resilience strategy Resilience building programs focus on food security et rural development Multi-sectoral Nutrition Security policy and its budgeted plan of action Nutrition security policy not implemented (not funded) Relatively low political commitments for Nutrition The potential of multi-sectoral nutrition-sensitive interventions not fully understood

HD Nexus in Niger – progress and challenges Coordination High level HD Nexus coordination mechanism and roadmap are being defined Not yet trickle down to any measures /actions Multiple actors and initiatives, limited true multi-sectoral approaches, some efforts toward convergence Fragmented coordination / Different coordination bodies struggling to break silos; even among 3N, SUN and NTG

HD Nexus in Niger – progress and challenges Financing Pooled funding mechanisms Development agencies embrace more and more the NWoW and HDN and include shock-responsive / resilience building programs in their strategies Room for more concerted funding strategies among donors Barely no domestic financial contribution for Nutrition-specific interventions Mention World Bank and AFD « descending » on Diffa region /Lake Chad basin with multi-million USD projects without much concertation coordination with humnitarian actors present there since 2015 Source of the scheme: Financing the Humanitarian-Development-Peace Nexus , UNDP fact sheet

HD Nexus in Niger – progress and challenges Programmes Preparedness and resilience CMAM surge approach Community-based approaches such as Mother-MUAC Limited capacities to cope with seasonal shocks / to prevent predictable peak of acute malnutrition Weak EWEA and EPR planning capacities Sources: the New Framework for CMAM Design ENN P. Hailey adapted by ACF (Emergency Nutrition handbook) and CONCERN (CMAM-Surge)

HD Nexus in Niger – progress and challenges Programmes HSS et decentralization of care Agencies and NGOs accelerate transition from hand-on support to services delivery to system strengthening and technical support. Bottleneck analysis (health facility diagnosis) iCCM + Nutrition Huge and persistent gaps in all HS building blocks HSS goals down to infrastructure rehabilitation and purchasing equipment such as cars, ambulances, motorcycles, IT materials, solar equipment, vaccines, drugs, mosquito nets, etc. Source: 2008 USAID From Humanitarian and Post-conflict Assistance to Health System Strengthening in Fragile States: Clarifying the Transition and the Role of NGOs

HD Nexus in Niger – more questions arise How do you transition humanitarian programming when foundations to transition to are weak? How to foster / trigger political will for Nutrition in a fragile state like Niger that translate into increasing national budget for Nutrition? How do you build government capacity in coordination – navigate the difference between technical assistance and capacity building versus substitution of government role? What are the opportunities for HDN approach at sub- national levels (in a context of decentralisation)? What are the risks to the population of driving transition in the face of a fragile government system that lacks capacity?

HD Nexus in FACS – how to move forward? What are the facilitating factors / enablers of HDN in FACS? Policy framework / governance Financing arrangements Programmes – especially those that strengthen integration into existing systems, that lead to nutrition resilience; that maximize nutrition impact What needs to change or to be done in practical terms?  Group work session Come back to session objectives, while mentionning the groupe work in the afternoon to collectively identify key practical actions we need to undertake in order to move the HDN forward