1 Good Practices and Lessons Learned: Nutrition in Emergencies in the Philippines Assistant Secretary of Health Maria-Bernardita T. Flores, CESO II Executive Director IV, National Nutrition Council Chair of the National Nutrition Cluster

Disaster Disruptions Reduced/ destroyed production Lack/limited food resources Massive population migration Increase of communicable diseases Malnutrition/ death Production Distribution Accessibility Consumption Biological Utilization Nutritional Status Adaptations Changed habits Different crops Price increase subsistence Economize Barter Migration of certain groups Changed resource distribution within the household Traditional care Stunting Food Chain N U T R T I O N in E M E R E G E N C Y

Nutrition assessment IYCF protection, support and promotion Management of acute malnutrition Micronutrient supplementation Other food and non-food interventions Components of Nutrition in Emergencies 3 Management systems... Planning... service delivery... coordination... monitoring and evaluation

4 Source: materials/349/ PHILIPPINES.pdfhttp://

5 Source: PHILIPPINES.pdfhttp:// PHILIPPINES.pdf

6 Source: ecentre.net/resources/workshop/ materials/349/ PHILIPPINES.pdfhttp:// ecentre.net/resources/workshop/ materials/349/ PHILIPPINES.pdf

07/22/09

Organizational Structure in the DOH 8

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Bohol Earthquake Zamboanga Siege 2013

Durian Ketsana 2009 Washi 2011 Bopha 2012

12 Having an overall policy on nutrition in emergencies and related guidelines

NNC Governing Board Resolution No. 1 S Adopting the National Policy on Nutrition Management in Emergencies and Disasters 1. Scope, e.g. who should apply the guidelines 2. Objectives of the policy guide 3. Policy statements underlying the provisions of the guidelines 4. Implementing mechanisms  Coordination & networking  Planning  Capacity building  Planning  Capacity building  Organizational support  Social mobilization  Advocacy  Logistics management  Surveillance, monitoring and evaluation  Service delivery 5. Institutional management that lays out the roles of various stakeholders 13

Minimum Service Package on Nutrition 14 Pre- disaste r Alert phase Pre-emptive evacuation Day 1 Day 2-3 Day 3 onwards Set-up system, capacity building, advocacy Update resource inventory, mapping of partners Activation of partners and teams Deploy assessment team Rapid nutrition assessment, Implement nutrition interventions, information management, referrals, cluster coordination and exit strategy development

Ongoing finalization of guidelines 15  Finalization of the policy and guidelines on the community-based management of acute malnutrition

16 Adoption of the cluster approach and organization of thematic working groups

Government Organizations 1. DOH – Health Emergency Management Bureau 8. DSWD – Disaster Response Assistance and Management Bureau 2. DOH - DPCB (Family Health Office) 9. DSWD – Council for the Welfare of Children 3. DOH – National Nutrition Council 10. Department of the Interior and Local Government 4. DOH – Health Facility Development Bureau 11. Department of Trade and Industry 5. DOH – Health Promotion and Communication Service 12. Department of Education 6. Food and Drug Administration 13. Commission on Higher Education 7. DOST – Food and Nutrition Research Institute National Nutrition Cluster Members 17

National Nutrition Cluster Members UN Agencies and International NGOs 1. United Nations Children’s Fund 8. Medecins Sans Frontieres 2. World Health Organization9. Child Fund 3. World Food Programme10. Merlin 4. Save the Children11. Helen Keller International 5. Plan International12. World Vision 6. Action Against Hunger (ACF)13. Arugaan 7. Philippine Red Cross 18

National Nutrition Cluster National Level Regional Nutrition Cluster Regional Level Local Nutrition Cluster Provincial/City Municipal/ Barangay Level Nutrition Cluster 19

Cluster working groups National Nutrition Cluster Chair: National Nutrition Council (Assistant Secretary of Health Maria-Bernardita T. Flores) Community-based Management of Acute Malnutrition Chair: DOH (Dr. Rosalie Paje) Infant and Young Child Feeding in Emergencies Chair: DOH (Dr. Anthony Calibo) Assessment and Monitoring Chair: NNC-NSD (Ms. Hygeia Ceres Catalina Gawe) Advocacy and Communications Chair: NNC-NIED (Ms. Jovita Raval) Strategic Core Group Members: Chairs of the TWGs, UNICEF, NNC 20

21 Setting up of mechanisms for communication

Mechanisms for communication 22  Regular meetings  Nutrition Cluster Yahoo Group  Advisories for the public and for responders via social media and SMS

23 Having a system for generating, analyzing and disseminating data for informed action

 Cluster partner reporting and mapping  Routine  Through Information Management Officers in severe disasters SMART (Standardized Monitoring and Assessment of Relief and Transitions) surveys Data generation and dissemination 24

25 Vigilance on potential issues related to infant formula donations

Vigilance to issues on milk donations 26  Release of Cluster statement on infant formula in disasters  Preparation of position paper in anticipation of an issuance that would allow infant formula donations  Mobilization of alternative sources of breastmilk—milk banks, wet nurses

27 Linkage with other clusters

Positive results 28  Guidelines on camp management provide for spaces for mothers with infants and young children  Content of family food pack changed  Replacement of instant noodles with multi-nutrient growth mix  Addition of canned vegetables

Continuing Actions  Review and updating of the National Disaster Response Plan for Earthquakes and Tsunamis  Formulation of the Nutrition Cluster Strategic Plan for  Continuing organization of local nutrition clusters 29

 Capacity building on Nutrition in Emergencies at the local level  Strengthening the link of the Nutrition Cluster with the other sub-clusters of the Health Cluster and the other response clusters  Strengthening of information management Continuing Actions 30

Needs for research and innovation 31  Indigenous food formulations for  Improved family food packs  Blanket feeding  Management of acute malnutrition  Tools and approaches for participatory planning, monitoring and evaluation

In summary 32 1.Policy and guidelines formulation 2.Cluster approach and thematic working groups 3.Mechanisms for communication 4.Information management 5.Protection of breastfeeding 6.Linkage with other response clusters

33 Preparedness is key - Good nutrition programs, pre-disaster

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