Nutrition Cluster Meeting, 27 June 2014 UNICEF Integrated Rapid Response Mechanism (IRRM) Updates, Achievements and Ways Forward

UNICEF, WFP and FAO working together in the field in a collaborative manner to : assess needs Provide multisectoral responses. Outline of Integrated Rapid Response Mechanism (IRRM) Food distribution education Logistics HealthNutrition Child protection WASH

Key IRRM activities - Nutrition Children 6-59 months: MUAC screening SAM treatment MNP Vitamin A Deworming PLW: MUAC screening MNT IYCF Key messaging Supervision: SC OTP (re)-Establishment of nutrition services: Identification of gaps and potential partners Initiation of services Ensure continuation of services Ensure supplies Capacity building: Anthropometry/screening Treatment Management Reporting IYCF

IRRM-Nutrition process during GFD The implementation process: Mobilization Head count/ Registration Distribution (Food, NFI, Wash,) Nutrition, Health Follow-up Nutrition intervention: Screening MN supplementation Deworming IYCF messaging

IRRM Nutrition process Scenario 1: With partners Scenario 2: Direct implementation (no partners) WFP GFD schedule Information gathering on area/situation Plan of Action in coordination with Cluster UNICEF: Coordination of activities and supplies Supervision of services and support capacity building Partner: Planning and execution of activities Follow-up activities Direct implementation with community volunteers Initiation of a minimum package of nutrition services. Identification of key gaps in services Identification of partners for follow-up activity

Humanitarian level:  Increased coverage towards the targets of CRP 2014  Golden opportunity: multisectoral actions in a minimum amount of time  Strengthened intersectoral and inter-organizational cooperation Cluster level:  Opportunity for revitalization of field presence for (previous) partners  Creating new opportunities for partnerships  Creating opportunities to increase quality of services (capacity building, supplies, supervision)  Collecting additional nutrition information (surveillance, gaps etc) 6 Benefits of the IRRM Nutrition response

Achievements of IRRM Nutrition activities so far Target 24 RRM-Nutrition missions 68,500 children 6-59 months screened 5,000 SAM children referred for treatment 68,500 children aged 6-59 months supplemented with vitamin A and deworming treatment 29,000 PLW screened for acute malnutrition 29,000 PLW accessing IYCF-E messages and micronutrients tablets. Achievement (21 st June) 13 IRRM-Nutrition missions 30,254 children 6-59 months screened 2,586 (8.5%) SAM children & 6,100 MAM (20.7%) children detected 858 SAM children not already enrolled, referred for treatment 17,367 children 6-59 months supplemented with vitamin A and 14,066 children reached with deworming treatment 5,370 PLW screened. 913 (16.8%) are found malnourished Expansion of OTP activities by partners

Achievements – IRRM Nutrition (as 21 st June) 13 missions conducted so far Locations covered with MUAC screening: Akobo, Mayendit, Kodok, Pagak, Lankien, Haat, Pochalla, Old Fangak, Walgak, Jeich, Leer 30,254 children 6-59 months screened 5,370 PLW screened Main findings: Proxy SAM : 8.5% Proxy MAM: 20.2% PLW MUAC <18.5cm: 16.8%

Results of MUAC screening (11 IRRM sites)

Contributions of RRM towards Nutrition Surveillance MUAC <11.5cm 10.8% >11.5cm - < 12.5cm 24.5% MUAC <11.5cm 3.7% >11.5cm - < 12.5cm 9.1% MUAC <11.5cm 4.0% >11.5cm - < 12.5cm 8.0% MUAC <11.5cm 4.5% >11.5cm - < 12.5cm 13.5% MUAC <11.5cm 1.9% >11.5cm - < 12.5cm 27.3% MUAC <11.5cm 28.8% >11.5cm - < 12.5cm 22.6% MUAC <11.5cm 4.1% >11.5cm - < 12.5cm 6.6% MUAC <11.5cm 0.4% >11.5cm - < 12.5cm 6.4% MUAC <11.5cm 1.0% >11.5cm - < 12.5cm 21.0% MUAC <11.5cm 9.6% >11.5cm - < 12.5cm 12.1% MUAC <11.5cm 18.6% >11.5cm - < 12.5cm 30.4% MUAC <11.5cm 10.1% >11.5cm - < 12.5cm 29.9%

Nutrition partners involved so far NGOs Partners involved in RRM up to date : Save the Children International IMC Nile Hope UNIDO Hold the Child MSF- Holland MSF-Spain GOAL Care COSV

IRRM Jeich, Ayod county 3-10 June A total of 2,297 children 6 – 59 months were screened for malnutrition (MUAC). Of this 84 (3.7%) were found with SAM and referred to the PHCC. 208 children had MAM (9.1%) A total of 359 pregnant and lactating women were screened using MUAC. 1 found to be 18 - < 21 2,049 children 6-59 months received Vitamin A supplementation 1,349 children 12 – 59 months received deworming tablets Monitoring of the OTP was done and corrective measures taken through coaching of OTP staff on appropriate practices Agreements reached with COSV and CHD on immediate response to be provided to children with complications Follow-up is on-going with partner on facilitating start-up of SC services in Jeich

IRRM Leer county June IRRM organized outside GFD due to needs signaled by partners on the ground:  UNICEF providing mass vaccination campaigns ( 12,942 ch) micronutrient supplementations (4,080 ch), deworming (3,508 ch) and MUAC mass screening (4.467 ch & 2,876 PLW)  MUAC screening: SAM 10.1%, MAM 29.9%  UNICEF facilitating access for MAM treatment activities (UNIDO)  1,107 PLW reached with one-to-one IYCF key messages  UNICEF facilitating support for supplies ensuring treatment by partners without stock out (+++caseloads in nutrition centers)  UNICEF liaising with Nile Hope to plan for a scale up health facility activities with nutrition service components as well as Mother Support Groups (IYCF)  Joint follow-up visit with health scheduled for end July

Ongoing IRRM 2 IRRM currently ongoing: Koch, Unity State (partner: World Relief) Nhialdiu, Unity State (direct implementation)

Gaps in the Response Selected sites not always aligned with most at nutritionally at risk counties Number of missions Service continuity beyond the mission (number & composition of teams )

What is needed to scale up?  Coverage of areas beyond GFD  Prioritization of areas with identified nutritional needs  Refining of strategy for scenario 2: direct implementation (areas with no partners)  Increased number if IRRM nutrition teams  Technical field teams with health profiles for areas with direct implementation ( no partners )  Need to enlarge IRRM focus to ensure coverage SAM & MAM services => improved dialogue with WFP / partners => expanded SAM protocol where no MAM services?

Scale-up Options MOBILE TEAMS to complement existing resources Increased number of RRM missions in areas of greatest nutritional needs Review of mobile team composition Increased number of mobile teams