1. © 2005, CARE USA. All rights reserved. IYCF Support in Emergencies Mother-to-Mother Support Groups in the Dadaab Refugee Camps TOPS FSN Network Regional Knowledge Sharing Meeting Washington, DC: November 2012 Mary Lung’aho for CARE, UNHCR and Partners

2. © 2005, CARE USA. All rights reserved. Partners in IYCF Support in Dadaab UNHCR UNICEF CARE GTZ IRC NCCK IMC ACF SAVE UK MSF KRCS

3. © 2005, CARE USA. All rights reserved. Emergency Contexts: Population on Move

4. © 2005, CARE USA. All rights reserved. Emergency Contexts: Congested Settings

5. © 2005, CARE USA. All rights reserved. Emergency Contexts: Disrupted Families

6. © 2005, CARE USA. All rights reserved. Emergency Contexts: Defensible Living Space

7. © 2005, CARE USA. All rights reserved. Emergency Contexts: Organized Camps

8. © 2005, CARE USA. All rights reserved. Dadaab Refugee Camps

9. © 2005, CARE USA. All rights reserved. Creating a System of IYCF Support

10. © 2005, CARE USA. All rights reserved. MtMSG Objectives  Share experiences  Ask questions and exchange information  Examine values and attitudes, discover patterns of behavior  Encourage women and communities to identify and solve their own problems  Make better decisions about feeding and care of their children  Provide SUPPORT for each other  Build self-confidence

11. © 2005, CARE USA. All rights reserved. Camp-level Support Structure

12. © 2005, CARE USA. All rights reserved. Capacity-Building: Knowledge & Skills Training materials for Community Workers in Dadaab based on competencies outlined in:  WHO counselling courses  IFE Core Group Modules 1 & 2: for health and nutrition workers in emergency situations, including: Assessment of infant feeding Practical help with breastfeeding

13. © 2005, CARE USA. All rights reserved. 13 Experiential Learning Cycle: Skills Supervised field practice and feedback Discuss skill Demonstrate Practise in classroom

14. © 2005, CARE USA. All rights reserved. Capacity-Building: IYCF Support Activities With: Field Practice Supportive supervision/mentoring Referral Routine programme monitoring Periodic refresher training Exchange visits Quarterly meetings: share experiences, discuss ‘cases’ (‘peer’ mentoring)

15. © 2005, CARE USA. All rights reserved. Field Practice

16. © 2005, CARE USA. All rights reserved. Counselling Cards that can be used in MtMSG

17. © 2005, CARE USA. All rights reserved. Impact ??? Much of the impact is often assumed Impact evaluation usually not possible: often no population level baseline or endline in emergencies Thus: heavy reliance on monitoring data But: lack of agreement on routine monitoring indicators Q: Possible to adapt or build upon indicator categories suggested for development programming?

18. © 2005, CARE USA. All rights reserved. IYCF Routine Programme Monitoring Q1: How much did we do? Implementation of activities:  # Training events  # / % MtMSG facilitators trained  # / % MtMSGs active  # / % MtMSG facilitators mentored  # Communications activities (videos, drama, IEC materials)  Monitoring records (pictorial)

19. © 2005, CARE USA. All rights reserved. Activities: MtMSG Facilitator Training

20. © 2005, CARE USA. All rights reserved. Activities: MtMSG Meetings

21. © 2005, CARE USA. All rights reserved. Activities: Video Presentations (Messaging )

22. © 2005, CARE USA. All rights reserved. Activities: Pictorial ‘record-keeping’/monitoring

23. © 2005, CARE USA. All rights reserved. IYCF Routine Programme Monitoring Q2: How well did we do it? Coverage: geographic/spatial coverage (MtMSGs per camp, health post, block) Coverage: participation of target population (in MtMSGs) Quality: % MtMSG facilitators who meet quality benchmarks Quality: caregiver knowledge and attitudes Quality: client satisfaction

24. © 2005, CARE USA. All rights reserved. Coverage: Camps Blocks showing MtMSGs

25. © 2005, CARE USA. All rights reserved. Quality: Supportive Supervision/Mentoring

26. © 2005, CARE USA. All rights reserved. IYCF Programme Results Q3 (RESULTS - survey): Is anyone better off? IYCF Practices (WHO indicators) Health & nutritional status

27. © 2005, CARE USA. All rights reserved. Exclusive Breastfeeding & Population Growth

28. © 2005, CARE USA. All rights reserved. Results: Exclusive Breastfeeding

29. © 2005, CARE USA. All rights reserved. Global Acute Malnutrition (GAM)

30. © 2005, CARE USA. All rights reserved. Issues: Incentives

31. © 2005, CARE USA. All rights reserved. Men’s Involvement

32. © 2005, CARE USA. All rights reserved. Creating Excitement

33. © 2005, CARE USA. All rights reserved. Charismatic Leadership

34. © 2005, CARE USA. All rights reserved. THANK YOU!