Somalia: Changes to Nutrition Cluster governance and partnership to reflect learning and operational realities GNC Annual meeting October 2015

Overview Somali context Governance – Limitations from – Restructuring 2015 Service delivery partnerships – Challenges – Rationalisation 1.0 (2013) – Rationalisation 2.0 (2015) Learning Nutrition coordination moving forward

Context ‘Somalia’- 3 autonomous regions 2006 Nutrition Cluster activated (IASC) 2011/12 famine- huge scale-up of treatment of SAM – Slight improvement in nutrition situation – Remaining gaps at policy level- SUN, nutrition policy and health strategic plan 2015 – serious deterioration in situation – GAM >15%, est 203,000 children with acute malnutrition

Nutrition service delivery rapid scale up of IMAM services

Implications of rapid expansion of nutrition service delivery Locations for service delivery based on accessibility, not part of strategic planning process Geographic coverage not optimal (50% in 2014) Duplication and overlap of services Limited integration of health and nutrition services, SAM/MAM services Concentration of partners and multiple layers of partnership

Rationalisation 1.0 (2013) Why? – improvement and decreased funding – Nutrition services disproportionate to need Aim? – To identify partners/area based on comparative advantage – To develop district level service plans for nutrition Process (limited consultation –only at higher level) – What services are needed? – Who can fill? Defined Criteria for partner selection – in absence of principles/rationle

Challenges to Rationalisation 1.0 Other programmes started mid 1.0 (BPHS, GHNP) Overlap in partnership inevitable due to limited capacities- referral challenges Clan linkages to service delivery remained Non-existence of sites (GPS) Lack of strategy on how to integrate health and nutrition services and develop service plans Lack of consensus on partner selection in some areas Lack of agreement among agencies on a partners ‘risk’

Limitations to governance Lack of NC leadership – 10 month absence of NCC – Weak government engagement Dormant SAG and Working Groups NC meetings shifted from NBO to Mogadishu to support Somali government – limited partners based in Mogadishu – limited decision making power – Insecurity prevented attendance by international staff No NC coordination at regional level – CLA represented NC – Shift from cluster to programme perspective, unofficial ‘transition’ in absence of IASC de-activation

Governance restructuring process Early 2015 with new NCC NCC and CLA agreement to – Clarify roles and responsibilities – Identify and formalise strategic and technical working groups with an aim to eventually shift leadership to gov over time Consultative workshop to endorse strategic documents – Roadmap for Nutrition Cluster – NC Strategic Operating framework – Work plan SOPs and WG TORs developed

New governance structure 141 active partners (80% local NGOs) by 2015 Co-led by the NGO/Federal Ministry of Health Current staff (CCT) – Nutrition Cluster Coordinator (NCC)- NBO – Nutrition cluster coordination assistance - Mogadishu – Nutrition Cluster Coordinator co-chair (NGO)- NBO – Information Management Officer (IMO)- NBO – Data entry clerk – NBO 11 Sub-national coordination mechanism chaired and co- chaired by volunteers

Rationalization 2.0 (2015) Similar process except unique concept/model of applying singly primary partner per district, defined principles, inclusive consultation at all level for six months and well defined steps (3S) GHNP partner given priority in district Ideally: 1 partner for all services/ district Primary, secondary and tertiary partners Independent geotagging of sites Matching capacity to case load expected in assigning partners

New way of working Inclusive- key cluster functions taken on by partners SAG -highest decision making body WGs chaired by partners Human resources- 2 additional staff (change in position and contract) Cascading meeting schedule (different levels of autonomy and issues) – Regional  Mogadishu  Nairobi

Results from changes Credibility of NC and SAG Consistency in efforts Respect by partners of NC structure Engaged partners Less resistance on initiatives Transparency Decreased work load on agencies Could be sustained if gap in NCC

Learning Honest discussions around problems have resulted in effective solutions Tremendous partners support and buy-in Expansion of SAG to include 3 local NGOs increased NC credibility, partner engagement, inclusiveness Increased credibility of NC has resulted in better working relationships among partners Incorporating AAP has shifted focus from partner interest to affected population Partners chairing WG distributes work load and rotation allows for wider participation

Somali nutrition coordination moving forward NC advocating and supporting SUN SAG to be more proactive at country level to engage partners More decentralized coordination mechanism and decision making process Universal geotagging/mapping exercise Evidence based advocacy supported by research – NCA Capacity development and IKM Innovation – mNutrition, RapidPro AAP – client feedback mechanism, MoU outlining accountability FW b/n members and cluster