Ukraine, 3-14 February 2015 GNC Scoping Mission to Assess Nutrition Needs, Response and Coordination

Objectives of Mission To review nutrition coordination structure To identify and map capacity of partners To map nutrition interventions To assess nutrition information needs and the possibilities for conducting nutritional assessment To identify programmatic and geographic areas of need and key NiE interventions Identify core advocacy concerns related to NiE interventions

Methodology Documents review (assessment reports, regional reports, surveys, situation reports, press releases, media articles) One-on-one consultations with 27 individuals Additional review of documents shared by key informants SRP workshop, two operational planning meetings, two FS&N Cluster meetings, two Health Cluster meetings and a WASH Cluster meeting attended

Nutrition Situation Pre-Crisis GAM prevalence 1.3% (2000) Anaemia prevalence pre-crisis 22.2% (2004); no information on other MND but expected to be common IYCF practices sub-optimal, ex. Exclusive BF 19.7% (2012), wide use of BMS No info on other population groups

Infant feeding patterns by age, Ukraine, 2012

Mission Findings – Nutritional status No info on acute malnutrition Expected to increase, due to aggravation factors (deterioration of food security, WASH and health situation, care practices, access to basic services) Reports that children are unhealthy, pale, not active MSF screening in HCs found 0 AM children No info on MNDs Expected to increase due to very limited access to fruits, vegetables, fish and meat

Mission Findings – IYCF-E Lack of info on current IYCF practices Non-existent capacity of partners and gvt in NiE, incl. IYCF “Baby baskets” contradict WHO/UNICEF recommendations Widespread BMS distributions Reports that mothers stop BF because of the stress, strong believes that mothers do not have enough milk to BF Sub-optimal complementary feeding Early introduction of CF Very limited access to MN-rich food Limited access to protein-rich food Focus on industrial CF High demand for BMS and CF

Mission Findings – other factors Risks of increased morbidity, malnutrition amplified by current conditions: - deteriorated water quality and supply - decreased sanitation and hygiene - lack of safe and appropriate complementary foods - lack of available food, especially MN and protein- rich -decreased access to health services - low exclusive BF rates - lack of skilled support for appropriate IYCF

Mission Findings – Response and Coordination Nutrition was part of the FS and Nutrition Cluster No coordination/IM capacity for nutrition One NGO distributes BMS and one NGO distributes CF&BMS Some potential partners on the ground identified (local NGOs, INGOs, UN agencies, gvt) Non-existent capacity of partners and gvt in NiE No nutrition assessments conducted, Save was planning IYCF assessment SRP was revised during the mission

Recommendations – Response Technical capacity of CLA and partners should be enhanced Build capacity of partners in NiE Conduct IYCF assessment, discuss need for other assessments Develop and agree upon cluster strategy, focus on quick wins Focus on children, PLW and older people Implementation through other clusters and gvt Orient hum. community on NiE IYCF statement and communication campaign

Recommendations – Coordination Create Nutrition Sub-group under Health cluster Bring everyone “on the same page” WHO/UNICEF discuss roles and responsibilities Start recruitment of NCC and deploy RRT Build sub-national presence Advocate to INGOs with NiE expertise to implement nutrition programming

Discussion Commitments to increase technical NiE capacity in Ukraine (UNICEF, WFP, NGOs) Commitment of agencies operational in Ukraine to consider/implement NiE interventions What should be the “BF vs BMS” strategy considering Low exclusive BF pre-crisis Population dependence on BMS pre-crisis Low non-breastfed infants rate pre-crisis (about 10%)