1. Tech RRT Webinar: Tech RRT deployment to Yemen

2. Today’s webinar Introduction and objectives Tech RRT overview
Background to the Yemen deployments
Presentations from the advisers:
CMAM
IYCF-E
Overall Lessons Learned
Open discussion

3. Introduction Webinar Objectives:
Foster discussion on the situation in country
Share information about the Tech RRT deployments
Improve follow up of work from the deployments
Facilitator: Andi Kendle, Program Manager
Presenters:
Simon Karanja, CMAM Advisor
Anne Marie Kueter, IYCF-E Advisor (on loan from Save the Children)

4. What is the Tech RRT?
Technical rapid response mechanism to support collective work for nutrition in emergencies
Consortium
Funding
In close collaboration with
Objectives: To improve overall emergency nutrition response
by deploying technical advisers
by providing technical remote support

5. Yemen deployments details
Deployments initially discussed with NCC in October 2016
Development of TORs with the Nutrition Cluster partners
Requested support for all 4 technical areas:
CMAM Adviser:
29 January – 9 March (5.6 weeks)
Hosted by International Medical Corps
IYCF-E Adviser:
14 February – 11 April (8 weeks, 2 with support from Save the Children)
Hosted by Save the Children
Assessment Adviser:
Currently deployed: 30 April – 31 May (4 weeks)
Hosted by Action Against Hunger
SBC Adviser:
Visa rejected

6. Yemen - Background
2 year conflict with a blockade imposed by the coalition
Caused a humanitarian disaster - 70% of the population in need of aid
Ongoing hostilities in the western coast are now jeopardising the operation of the key Al Hudaydah port.
Potential serious consequences for food imports and delivery of urgent life-saving assistance
Over 2 million individuals have been displaced across 21 governorates
17 million people (~60% of the total Yemeni population) are food insecure and require urgent humanitarian assistance to save lives and protect livelihoods.
6.8 million people - IPC Phase 4 ‘emergency’
10.2 million people - IPC Phase 3 ‘crisis’

7. Yemen Conflict Map

8. Yemen Projected Food Insecurity Situation overview (March-July 2017)

9. TECHNICAL SUPPORT AND CAPACITY BUILDING FOR Community Management of Acute Malnutrition (CMAM) in Yemen

11. CMAM Context Nearly 2.2 million children acutely malnourished
462,000 children under 5 suffering Severe Acute Malnutrition (SAM)
Out of 22 governorates of Yemen
4 with GAM ≥15% (above the WHO Critical threshold) - Abyan, Taiz, Al Hodaidah, and Hadramout
7 with GAM % (serious levels)
8 with GAM 5-9.9% (at poor levels)

12. CMAM Coordination Structure
90% of CMAM program operated by the MoPHP
Cluster coordination at central and governorates level
25 active nutrition cluster partners:
10 INGOs
11 National NGOs
4 UN & Government
MoPHP CMAM strategy available led by CMAM focal person
CMAM program:
1,951 TSFP sites supported by WFP for MAM management
2,929 OTP sites supported by UNICEF for SAM management
42 TFCs supported by WHO and UNICEF for inpatient SAM

13. Deployment Achievements
Purpose
To strengthen the implementation of CMAM programs through the provision of technical support and capacity building
Achievements
Facilitated the revision/update of the Interim National CMAM guidelines, including:
Review of reporting and monitoring tools
Mainstreaming of IYCF into the CMAM guidelines:
integrated IYCF in all chapters
a specific IYCF section to make proper referral to IYCF resources
Consultation Review Workshop
Led a joint monitoring visit to SC & OTP in Sanaa urban
Contributed to drafting the Nutrition Cluster CMAM Scale-up plan and strategy

14. National CMAM Guidelines Review Workshop

15. Follow up actions
MoPHP to finalize and endorses the revised National CMAM guidelines
Support MoPHP to revise and to roll out training of the revised National CMAM guidelines.
Support WHO & Al Sabreen to establish the hospital’s TFC as a centre of excellence

16. Challenges
The full scale-up for both SAM/MAM challenging due to insecurity, and limitations in resources (40% affected children can’t reach the SAM services, even more for MAM)
Less than half (45%) of health facilities are fully functional.
Inadequate integration of CMAM services. Not all OTP sites provide MAM treatment.
Poor coverage of TFCs; 42 TFCs versus the need of >350 TFCs. Poor quality of care.
Continued interruptions of the MAM treatment supplies for children under 5 and PLW

17. Recommendations
Support to the MoPHP/GHO to scale-up nutrition services in remote areas and strengthen their training, supervision and monitoring.
Support the cluster/WHO to accelerate the scale-up of inpatient management (TFCs)
Support the National/local NGOs/CBOs to expand their reach to increase in their support for CMAM scale up.
Strengthen the nutrition information management system at the MoPHP/GHO/district level

18. Technical support on Infant and Young Child Feeding in Emergency (IYCF-E) in yemen

19. IYCF Context
Low rates of Exclusive Breastfeeding – only 10% according to DHS 2013
Culture of bottle feeding – 44% according to DHS 2013
Lack of enforcement of National Breastfeeding Legislation
Lack of a national IYCF Strategy
Limited implementation of quality IYCF programmes
No implementation of IYCF-E programmes
During this slide I will explain a little bit about what type of IYCF activities are currently being carried out.
Al Sabeen Hospital,Sana’a, Save the Children
Al Sabeen Hospital,Sana’a, Save the Children

20. Purpose of the deployment
Support the development of a national IYCF Strategy in collaboration with the MoH and other key stakeholders and strengthen the delivery of the IYCF-E response through support to nutrition cluster partners.
Key Objectives
Development of a national IYCF Strategy
Development of an IYCF-E Response Plan
Set up of BMS reporting mechanism for code violations
Development/re-launch of IYCF joint statement

21. Key Results
Development of final draft National IYCF Strategy
Development of IYCF-E Response Plan for Nutrition Cluster
Integration of IYCF into revised CMAM Guidelines
Strengthening of the IYCF TWG
Set-up of a reporting mechanism for Code Violations
Revision and release of IYCF Joint Statement
Capacity building (IYCF-E Orientation; IYCF and CP; IYCF and Media/Comms)
IYCF Strategy Workshop, Sana’a 9th April 2017

22. Follow up actions
Set-up a steering committee to support the implementation of the IYCF Strategy
Enforcement of BMS Regulations
Capacity building of Health Facility staff on BMS Regulations and reporting of Code Violations
Establish BMS program for infants and children with no option to breast feed
Capacity building of MoH and partner staff on IYCF-E (scheduled for July 2017)

23. Challenges
Language barrier (especially with MoH staff) / documentation of some key documents in Arabic
Difficult to receive feedback from partners via (remote support previously reported to be challenging)
Use of infant formula embedded within society and aggressive marketing of infant formula by manufacturers
Lack of quality and up-to-date data on IYCF

24. Recommendations Advocate for resources for IYCF-E activities
Advocate for more partners to work on IYCF and IYCF-E and to scale-up the implementation of quality IYCF and IYCF-E programmes
Follow-up support visit from IYCF-E TRRT focusing on support to implementation (scheduled for July 2017)
IYCF-E orientations within and outside of the cluster
Work with AWG to strengthen IYCF data collection through assessments

25. Overall lessons learned from the deployments

26. Overall lessons learned from the deployments
Timeframe for development of strategies and guidelines
What is the role of the Tech RRT?
Ambitious TORs
Focusing support to be realistic
Follow-up required to deployment activities must be considered from the start of the deployment
Role of remote support after departure of the Tech RRT

27. Let’s discuss – any questions? Thank you!

28. Questions to stimulate discussion
How can we provide continued support to the MoH?