1 Emergency Nutrition Response in Nepal 13 th – 15 th October, 2015 GNC Annual Meeting, Nairobi, Kenya 14 Priority Earthquake affected districts

Nepal Country Context 2 Pre-crisis (Nutrition Indicators)Current Situation Wasting was 11% (DHS 2011)MUAC screening GAM prevalence between 5-7%?? Stunting was 41% (DHS 2011) Exclusive breastfeeding rates in boys and girls aged between 0 to 5 months of age: 70% DHS 2011 Anemia prevalence (<2 years: 70%, <5 years: 43%) DHS 2011 Access to food/healthcare was a major problem but the female community health volunteers (FCHVs) despite challenges continued the community support group activities

Nutrition sector Coordination Structure Government is leading the Cluster (MOHP) Double hatting National NCC, 2 surge NCCs for 12 weeks National dedicated IMO, 1 surge IMO for 12 weeks 28 partners Two subnational/regional level hubs; ToR of SAG validated and pending approval CMAM, IYCF and IM working groups 3

Overview of Needs Assessments and Analysis Assessment and Analysis: IRA/MIRA and other nutrition assessment wasn’t conducted immediate after EQ emergencies However, quick field based information was collected from different partners and government officials Secondary data analysis of DHS (2011) - ecological region based data was used as proxy information for planning Strategic Planning: The target number of affected population was set based on the HMIS target population of MoHP Nepal and coverage estimate was made districtwide Priorities for interventions identified based on the nutrition cluster operating guideline, contingency plan etc. PDNA and district level review recommendations are the basis for nutrition recovery planning 4

Strategic Nutrition Priorities Objective: “to ensure timely and effective nutrition response in Earthquake affected 14 priority districts to minimize mortality and morbidity of Earthquake affected population and increase in malnutrition focusing to children under five, pregnant and lactating women has been prevented”.. Key Cluster Interventions (six building blocks) Promotion, protection and support for breast feeding Promotion of complementary feeding Supplementary Feeding Programme (SFP) for prevention and management of moderate acute malnutrition Therapeutic Feeding Programme (TFP) for the management of Severe Acute Malnutrition (SAM) Micronutrient for children and women (Vitamin A and MNP for children age 6-59 months, Deworming to children age months, IFA for pregnant and postnatal mother

Gaps in Resource Mobilization  Highlight key gaps (max 6 bullet points):  Human Resources;  No full time dedicated NCC at national level and at regional/hub level.  NiE technical “thematic” gaps among all partners. Geographically the NC partners are present in all 14 affected districts but gaps exist in the coverage of the six building blocks  Financial: For flash appeal 11 Million USD was required and 9.8 Million USD is funded (89.5%). Flash Appeal expired in September 2015  Supplies were available but some gaps in distribution 6

Nutrition Cluster Target Vs. Achievement SNIntervention AreaCluster Target Achievements (#) Achievements (%) 1 Counselling the mother of 0–23 months old children on breastfeeding 168,000152, Counselling the mother of 6–23 months old children on complementary feeding 126,000137, Children age 6-59 months screened for identification of their nutrition status 397,211373, Children age 6-59 months with severe acute malnutrition who were identified through screening 2,5001, Children age months with SAM who are admitted to therapeutic care 2,5001, Blanket supplementary feeding programme to the children age 6-23 months 43,25632, Children age 6-59 month who received multiple micronutrient powders to improve their diets and prevent nutritional deficiencies 323,775326, Children age 6-59 months who received vitamin A capsules 362,000354,56298

Challenges in achieving strategic priorities Limited capacity with MoHP for nutrition cluster coordination for appropriate emergency nutrition preparedness and response Limited capacity for Nutrition cluster information management Lack of access to the services due to difficult geography in many districts Early identification and management 100% SAM cases in the OTP sue to capacity of community volunteers Supplementary feeding programme for the management of moderate acute malnutrition 8