Nutrition Sub-cluster: Potential Priorities and Strategies

Considerations Vulnerable groups and potential problems Assessment needs to confirm or refute How to gather this information Potential interventions of choice Feasibility and relevance Modes of delivery

Distinct population groups NGCAs (Luhansk, Donetsk) – resident and displaced GCAs (Luhansk, Donetsk) – resident and displaced IDPs in Zaporizhia, Kharkiv, Dnipropetrovsk oblast

Potentially vulnerable groups/problems Children <2 (IYCF – BF, complementary feeding) Children 6-59 mo (MN deficiencies, wasting???) Pregnant women (MN deficiencies, wasting???) Lactating women (MN deficiencies, wasting???) Elderly (MN deficiencies, wasting)

Assessment children <2 Children <2 (IYCF) in-depth assessment planned by Save with support from UNICEF and CDC (April-June) – FG, KII, HH survey – only GCA and NGCA of Donetsk obl – Need to extend to other oblast (Luhansk and DKZ)

Assessment children 6-59 mo Opportunistic MUAC screening by mobile clinics and primary health facilities – MSF, potentially others (who support these facilities) Potentially include MUAC in HH IYCF survey by Save Note: at this point we do not have any evidence and do not expect elevated wasting (except in elderly)

Assessment pregnant women Availability of pre-natal services for residents in conflict zone and NGCA (FG, KII) Availability of prenatal services for IDPs (FG, KII, potentially small ad hoc surveys) Availability and use of folate pills Regular Hb screening, prevalence of anemia (polyclinic data) Use of iron pills for anemic Wasting??? (MUAC screening)

Assessment lactating women Wasting??? (MUAC screening) Hb screening, prevalence of anemia (polyclinic data – much less likely to get) Note – MN deficiencies are less likely in any group during Spring/Summer/Fall Lack of animal products in diet may put at risk for some deficiencies (Iron, Zinc, B12)

Assessment elderly Wasting??? (MUAC screening) MN deficiencies – Hb, clinical signs (clinic visits data)

Assessment summary IYCF assessment – Expand to Luhansk and DKZ – Include MUAC for children and vulnerable adults? Data from pre-natal clinics, FG – Current access and coverage, folate coverage – Anemia prevalence in pregnant women  Fe suppl Data from clinics on elderly, children, others? – discuss other potential assessment options

Interventions children <2 Age-appropriate supplementation baskets – <6 mo: diapers or foods for the mother for BF; formula for non-BF  BF ASSESSMENT NEEDED!! – 6-24 mo – baby foods (incl. meat puree), cereals for porridge (cream of wheat, oats, buckwheat, etc.) – mo – no baby foods, perhaps porridge cereals Formula to non-BF infants of HIV+ mothers Access to individual BF/CF counseling (hotline) IYCF education/support (leaflets, media ads, group and individual sessions) Strengthen IYCF counseling in Roddoms, Polyclinics

Interventions PLW Improve: – Access to prenatal care – Availability of folate pills – HB screening and iron supplementation

Elderly Improving access to social support networks Improving access to health care, screening for nutrition-related problems Extra food or extra voucher support Fortified food supplements (licensing may be an issue)???