1 Emergency Nutrition Response in Whole of Syria MAP 13 th – 15 th October, 2015 GNC Annual Meeting, Nairobi, Kenya

Country Context 2 Pre-crisis (Nutrition Indicators)Current Situation GAM prevalence U5 was 9.3% (7 % MAM & 2.3 % SAM) GAM prevalence U5 of 7.2% (2.3% SAM and 4.9%MAM) Stunting level of children U5 was 23 % Stunting U5 22.3% IYCF indicators: 43 % Exclusive Breastfeeding 63% EBF 46% initiating breastfeeding within the first hour of birth Nd 37% providing timely introduction of complementary food Nd Micronutrient deficiencies: 29.2% anemia and 12.9% iodine deficiency Nd

Nutrition sector Coordination Structure WoS Nut sector (UNICEF &ACF) Jordan (H&N WG) (WHO/UNICEF) Gaziantep Nut Cluster (UNICEF/GOAL) Damascus Nutrition Sector (UNICEF/MoH) Four Sub-National Coordination

Overview of Needs Assessments and Analysis Nutrition Cluster used the findings from the below surveys to develop Severity Ranking Scale in order to inform strategic priorities of response:  2009 Syrian Family Health Survey.  , a series of Rapid Nutrition Assessments conducted from Damascus, among IDPs in 13 of the 14 governorates. 3 SMART surveys, 1 KAP study and 1 Anemia Survey conducted from Cross border through Turkey (IDP and Host communities in 3 governorates) + 1 SMART survey conducted through cross border from Jordan.  Monthly 4Ws data  Findings of other sectors such as Food Security, Health and WASH are also used to identify needs. →Conducting assessments inside Syria is one of the main challenges due to security, capacity and sensitivity. 4

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Syria SRP: 2015 Strategic Nutrition Priorities 1.Promote preventive nutrition services for vulnerable groups (IYFC, micronutrient & optimal maternal nutrition) 2.Strengthen the systematic identification, referral & treatment of acutely malnourished cases (use of standard guidelines & treatment products) 3.Promote nutrition situation analysis using standard tools + screening for children & women 4.Promote response and practices enhancing nutrition well- being of Syrians through multi-sectoral analysis, integrated response, coordination & capacity strengthening

Gaps in Resource Mobilization  Highlight key gaps (max 6 bullet points):  Human Resources:  Capacity of partners to implement NiE interventions and to scale-up  Insufficient capacity of cluster leads in coordination of NiE interventions  Restrictions on the work of INGOs inside Syria  Supplies:  Gap in procurement of MAM supplies and supplies for in-patient SAM treatment  Access restrictions to deliver supplies to partners and beneficiaries  High influx of uncontrolled BMS  Financial:  Only 18% ($8.5 M) of the total sectoral needs ($ 48 M) for WoS is funded 7

Challenge at WoS level 1.Limited level of data details available (dependent on hub); no recent national data is available for situation analysis 2.There is no sector-wide nutrition strategy and CMAM operational Guideline adapted to the Syrian context 3.Despite advocacy, partners facing challenges of capacity, visa, authorization to operate in the 3 hubs (due to host government procedures) – hampering capacity building activities 4.Unique programme environment hence different approaches in Jordan, Syria, S/Turkey, Lebanon & Iraq  capacity, coordination with government vs policies, etc 5.Dealing with multiple governing structures; e.g. SSG, UNCT, ISCCG, etc & derive the complementarity to enhance program outcome 10

 Breastfeeding is being undermined by a proliferation of myths/misconceptions about breastfeeding.  Widespread donations and untargeted distributions of breastmilk substitutes (BMS) and other milk products,  Lack of skilled support for breastfeeding mothers  Negative influence of private sector on IYCF-E  Lack of appropriate support for children with no possibility to breastfeed.  Lack of complementary foods; concern about the poor micronutrient content of food and restrictions on CF.  Patchy health services with little IYCF/IYCF-E capacity  Poor/strained WASH facilities impacting on ‘safe’ infant feeding outcomes. 11 Specifically on IYCF-E