Global Overview of the IYCF-E Humanitarian Response

Why focus on Infant and Young Child Feeding (IYCF)? Extremely Vulnerable to Illness Malnutrition Death Increased risk Chronic diseases Lower productivity Long term Consequences PREVENTABLE SAY: The first two years of life is a period of rapid growth and body demands are high. Which is why when those needs are not met, children get malnourished, meaning their body lacks nutrients and energy. Children may become extremely thin or wasted (mouse click), have water-retention or edema (mouse click), become short for age or stunted (mouse click), (Both the girls are 3 and half years of age but we can clearly see that one of the girls is shorter than the other girl) or have micronutrient deficiencies such as anemia (mouse click), which is deficiency of a micronutrient called iron. Children under two are also vulnerable to illnesses and death. But it doesn’t end there (mouse click), children suffer long term consequences (mouse click). Children who fail to catch up on their growth suffer illness and death later in life. And if they gain weight, for example, in later years, it increases their likelihood of chronic diseases such as heart disease. Children who do not attain their full growth, also have lower productivity as adults and therefore have lower wages. In emergencies the risk of dying increase up to 70 times. DO: (mouse click) The good news is that all this: illnesses, malnutrition and deaths can be prevented! Therefore, it is so important that IYCF is not overlooked. Prevention is better than cure. So, what can we do to protect and promote appropriate IYCF? FANTA, 2008 Mayaclinic, 2014 FANTA, 2008 Rae Galloway, 2006 Source: Programming guide for IYCF by UNICEF, 2011 Source: Guiding principles for IYCF during emergencies, WHO , 2004.

And more…. much more….

IYCF-E: The World Health Assembly on May,2018 (WHA 71.9)

IYCF-E OPG: Meetings the needs of all children (Breastfeeding and non Breastfeeding) 1. Endorse or develop policies 2. Train staff 3. Co-ordinate operations 4. Assess and monitor 5. Protect, promote and support optimal IYCF with integrated multi-sector interventions Breastfeeding Not Breastfeeding Complementary Feeding 6. Minimise the risks of artificial feeding (safeguarding all infants and young children) IYCF-E Operational Guidance,2017

IYCF-E: What are the humanitarian standards? Sphere 2011

IYCF-E: What are humanitarian standards? Sphere 2011

WHO. Global Nutrition Policy Review, 2016-2017 Draft Report

Components of protocols for infant feeding in emergencies in 38 countries WHO. Global Nutrition Policy Review, 2016-2017 Draft Report

UNICEF, From the first hour of life, 2018

IYCF-E OPG in the Humanitarian Response: A review of HRPs/RRPs/JRPs in June 2018 The objective (s): To understand how Infant and Young Child Feeding in Emergencies is integrated/reflected in the Humanitarian Response Plans To identify the type of indicators, activities that are recommended/endorsed in the Humanitarian Response Plans; and To assess whether IYCF-E is a costed component of the Humanitarian Response Plans 2/15/2019

IYCF-E OPG in the Humanitarian Response: A review of HRPs/RRPs/JRPs in June 2018 The methods used: Identification of standard information to be reviewed Design of a review matrix HRP/JRP/RRP review against the standard information (source: Relief Web and/or Humanitarian Response Page) Matrix filled for each of the indicators information by HRP Processing of the data (frequency count mainly) standard information Summary and analysis Qualitative information from the field (Save the Children responses from 4 priority responses)

IYCF-E OPG in the Humanitarian Response: A review of HRPs/RRPs/JRPs in June 2018 Total No. of live HRPs/JRPs reviewed Total No. of RRP reviewed Total of JRPs for special appeals reviewed Priorities Countries Regional Responses Other appeals 21* 4 1 13 3 Note: the review did not include the Syria HRP. As this is not available online. There are a total of 25 live HRPs/ JRPs at the time of analysis

IYCF-E objectives in the humanitarian response Ten (71%) of the 14 have an objective that is related to IYCF/IYCF-E. (a bar graph will be inserted) The objectives are generally focusing on strengthening access to preventative nutrition services and provision of IYCF and other preventive interventions.

IYCF-E Indicators in the Humanitarian Response Ten (71%) of the 14 have indicators that are relevant/related to IYCF/IYCF-E. A diverse menu of indicators is reflected Only 1 uses one of the 13 IYCF-E key performance monitoring indicators from the NC Indicator Registry

IYCF-E activities in the Humanitarian Response Twelve (86%) of the 14 have activities relevant/related to IYCF/IYCF-E. Activities range from - counselling, promotion, training, and education sessions. No activities referring to the NBF infants. Very limited complementary feeding activities.

IYCF-E Integration and Financial Allocations Four (4) of the 14 HRPs/JRPs describe specific IYCF-E integrated within other sectors Two (2) provides a cost estimate/requirement for the IYCF-E related activities.

IYCF-E what are the strengths from the field (Save the Children) The IYCF-E TWG group under the nutrition sector coordination helps to promote and standardize IYCF services in the whole response Integration with CMAM, Health, MHPSS and CP teams Health and community structures as delivery platform for IYCF-E Continuous capacity building opportunities The IYCF-E external and remote support with tools and guidance

IYCF-E what are the challenges from the field (Save the Children) Lack or limited policies and guidance on - Code violations, management of collected donated BMS, weak monitoring system and enforcement National policy and capacity gaps in the management of the non breast fed infants Challenge in getting strategies and guidelines agreed and approved from the stakeholders Lack of strong leadership in relation to IYCF-E Limited attention, resources to implement sustained IYCF-E programmes

IYCF-E Food for thoughts : IYCF-E is reflected in the Humanitarian Response but… There are major gaps in IYCF-E leadership, preparedness, policies and capacities at the country level The key IYCF-E indicators are generally not used The activities not targeting complementary feeding and the management of the non breastfed infants IYCF-E programming is not integrated within other sectors There is a need to cost the IYCF-E component of the plans

So…what can we do to raise the profile of IYCF-E in preparedness and response What actions and initiatives would help governments and NGOs/INGOs uptake on IYCF- E capacity building, preparedness and response? What can/should be done to increase the capacity(national/international) to design and deliver effective and quality IYCF-E programmes What is needed by the national nutrition clusters to raise IYCF-E , higher in the response agenda?

Group work What are the barriers (national & global) to putting policy into practice? Non-breastfed infants Complementary feeding Monitoring & evaluation of impact of interventions Planning & costing What do we need to do about it?