United Nations System
Standing Committee on Nutrition

Report of the Sub-Committee on Nutrition at its Twenty-Fifth Session

II. Work in Progress: Summary of Discussion and Conclusions

C. Reports of decisions taken in Working Groups

C.6 Nutrition of Refugees and Displaced People -- Summary Report of the Working Group

47. The Working Group appreciated and acknowledged the participation of some 20 NGOs at the meeting, several attending for the first time.

48. As a point of information it was reported that revised Guidelines for Estimating Food and Nutritional Needs in Emergencies, by WFP and UNHCR, have been published and distributed to SCN members. The study on the Acceptability and Use of Cereal-Based Foods in Refugee Camps (use of cereals and blended foods carried out in three refugee sites), was presented. As a follow-up, WFP will explore with UNHCR, MI and other partners, plans to hold a meeting to discuss levels of micronutrient fortification in blended foods.

49. A panel discussion on "How Food Aid Works", with invited speakers from ICRC, WFP, USAID and CIDA, reflected on issues related to the appeal process, food aid procurement and nutrition. The objective of this discussion was to improve understanding of how the procurement process can best work for nutrition improvement. Full cost-recovery, retrospective ration provision and tying of donations to domestic production were identified as practices with potentially important impact on nutrition. The Group agreed that the SCN's Refugee Nutrition Information System (RNIS) should broaden its scope to cover non-food as well as food responses to emergencies.

50. It was proposed by WFP and UNHCR to change the name of this Working Group to "Nutrition in Emergencies" to signal a broader scope for discussion.

Full Report of the Meeting of the Working Group on the Nutrition of Refugees and Displaced People*

Sunday 29 March 1998, Oslo, Norway

Chaired by Rita Bhatia, UNHCR and Anne Callanan, WFP
Rapporteur: Judith Appleton, OXFAM-GB

* During the course of the SCN 25th Session it was decided to rename the Working Group as the SCN Working Group on Nutrition in Emergencies in order to signal a broader scope for discussion

I. Participants

Among the participants of ACC/SCN’s 25th session who attended were NGO, bilateral and UN agency members, some members of the AGN and members of the Working Group.

II. Agenda:

The two agenda items for 29/03/98 addressed concerns voiced at previous meetings of the Working Group.

The meeting noted that since the last meeting of the Working Group in Dublin on 21/02/97, revised WFP/UNHCR Guidelines for estimating food and nutritional needs in emergencies were issued in December 1997, and a revised MOU between the two agencies was signed in March 1997. Copies can be requested from UNHCR or WFP.

Agenda item 1: Acceptability and Use of Cereal-Based Foods in Refugee Camps

The study investigated the use and acceptability of fortified blended foods across different age groups, and the feasibility of cereal fortification at the local level in three refugee situations (Ethiopia, Nepal and Tanzania). The study was conducted by OXFAM-GB and funded jointly by UNHCR and MI. The results were presented by the researcher Cathy Mears and co-author Helen Young.

The idea of conducting a study of this type arose during UNHCR’s ’Workshop on Improving Nutrition of Refugees and Displaced Populations in Africa. The focus of the study was expanded to include an investigation into fortification of food aid, in particular cereal fortification at the local level, with the Micronutrient Initiative (MI) interest in the subject. This was a direct result of a CIDA-commissioned paper on the subject.

The nutritional situation and nutritional content of the rations at each of three sites studied were included to give background and context. Summaries of preferences at each site between items provided in the ration, and among ration and non-ration food items were described. Differences in preferences were found to be related to differences in age of consumer, salability of items, familiarity of food type, cooking time required, cooking methods and type of meal or beverage. The study also conducted a preliminary assessment of the opportunities for fortification of cereals at different levels (i.e. regional, national, household and camp-level mills).

The presentation stressed the broad pragmatism found among users of fortified foods in accepting them and devising and adapting recipes and cooking methods for their consumption.

Findings:

Regional-level fortification of cereals would require adequate milling capacity relatively close to the population, a medium- to long-term commitment to this by donors, and considerable technical and management expertise.
Camp-level fortification of cereals would be most appropriate where the staple grain being distributed was highly acceptable and consumed in milled form.
Household-level fortification of cereals (at pounding/grinding) did not appear to be feasible. However, a fortification powder (premix) could be added to household meals during cooking.
The evidence suggested that selection of foods/a food for fortification should be context-specific. The range of factors recommended for investigation into appropriate vehicles for micronutrient provision in each situation include local familiarity, the perceived status of the food item, understanding of its food value, its resale value, and local cultural values placed on that food type.
No evidence emerged of rejection on cultural grounds of any of the blended foods investigated. The acceptability of blended foods was linked strongly with familiarity, but unfamiliarity did not indicate low acceptability. On the whole, blended foods were highly acceptable. However, the report highlights some technical and operational issues of quality control and timely supply of local products.

Further action:

UNHCR will ensure every agency and member of the Working Group receives a copy of the OXFAM report. Further copies can be purchased from OXFAM.
WFP will initiate a meeting with key partners to discuss levels of micronutrient fortification in blended foods.

Agenda item 2: How emergency aid works - panel discussion

Jeremy Shoham introduced a number of concerns among NGOs and organizations implementing food aid distributions in the areas of:

international and nation food aid policies;
food and cash resources;
donor and multilateral policies on the distribution of food;
politics of trade affecting food aid.

As a basis for discussing these, representatives from five food aid agencies and donors were invited to describe their procedures for assessing emergency requests and procuring and transporting food. Below are points from their presentations salient to Working Group discussions.

Torbin Due and Trudy Bower presented the food aid mobilization process of WFP. 70% of the pledges to WFP are allocated as emergency food aid.

The presenters outlined how the organization mobilizes pledges around its annual forecast and supplements these through quarterly updates, notices of pipeline breaks, and special appeals. WFP’s resource mobilization staff then described the needs assessment process. This includes collaboration with nutritionists over setting food baskets and negotiating quality, and the various technical and political considerations governing donors’ approval processes. These various steps determine why this can take as little as 24 hours or as long as three months before food items are purchased and start moving toward those needing them. The organization can accelerate its own responses by calling on and borrowing from its Immediate Response Account ($3.5 million) and on donor and NGO expertise, airlifts and emergency reserve stocks.

Important current trends affecting WFP allocations and working methods include:

more commitments to WFP’s stated priorities, allowing greater flexibility in allocations;
more cash committed for local and regional purchases, allowing beneficiaries’ preferences to be met;
growing stringency required in WFP accounting to donors, requiring more administrative time.

Jean-Philippe Floret presented the process at ICRC. Food is involved in only the first of ICRC’s three objectives - assuring nutritional needs, economic support for stabilizing livelihoods, and protection of the population. The organization is set up to act immediately on approval in Geneva of each ’objective’, by means of ensured pre-financing for the first three months of any operation. Funding derives from a combination of the annual appeal, cash donations, and donations in kind. In the case of food, this implies donor financing for transport as well as food purchases.

The main constraints on ICRC effectiveness were said to be bureaucracy, the need to negotiate agreement with donors on the organization’s proposed objectives, and increasingly, earmarking of donations. The concomitant increase in time spent on accounting and reduction in flexibility is somewhat offset by the flexibility afforded by growth of cash and in-kind donations. The management of cash in operations rather than food means potential support for some local economies.

US emergency food aid, allocated by USAID, is triggered by emergency declarations by US embassies, approval of WFP Protracted Refugees Operations (PROs), and response to international emergency food assistance appeals. Details were presented by Tom Marchione.

All US government food aid is in-kind, procured through the US Department of Agriculture. Stocks and food aid allocations, all legislated by Congress, have fallen in recent years, but not as rapidly as development aid budgets. Emergency food aid has been protected at the same level (800,000 MT/yr) as before the rash of complex political emergencies following the end of the cold war. Food aid transport costs are high as it is shipped cargo-preference (i.e. on US ships). Legislation and policy stop short of defining principles for ration composition, especially on micronutrient content.

Trends for improving US food aid include the development of grain-extrusion to reduce cooking time, other methods for enhancing nutrient composition, work on environmental aspects of refugees aid including site protection and the development of a gender policy on food aid information and on food distribution.

Ernest Loevinsohn presented the CIDA perspective on emergency food aid provision. It is Canadian food policy to target the poor in under-resourced areas with high rates of malnutrition - an ’anti-CNN’ policy. CIDA is increasingly requiring evidence for cost effectiveness and potential impact before committing food aid support for food distribution. This increased requirement for information from implementing agencies when requesting aid from CIDA, both for monitoring and for research, has time and budget implications.

Concerns voiced in questions to the presenters focused on:

agencies’ level of relevant specialized skills for needs assessments and market monitoring;
alternatives to food aid in breadth of emergency response;
availability of cash for local purchases;
influence of nutritionists on food aid decision making;
difficulties faced by NGOs caused by frequent delivery shortfalls;
absence of policies on retrospective distributions (i.e. increasing amounts distributed after an interruption to regular distribution schedules);
the nutritional status of refugees compared to that of the local population;
accountability of field-level agencies to programme beneficiaries for commitments made;
targeting issues, including targeting by gender;
data-types and presentation;
continuing discussion among NGOs, donors and UN agencies on food and non-food aid.

The discussion pointed out the great advantage of meetings in which UN agencies, donors and NGOs can meet and air their concerns. Different information needs and priorities became apparent during the discussion. Different uses of qualitative and quantitative data, along with appropriate indicators for measuring needs and impact were discussed.

Further action:

The Working Group will continue discussions among donors, UN agencies and NGOs on appropriate indicators for signaling both needs ad impacts and top better understand the processes of emergency food aid provision.
The RNIS of the ACC/SCN will broaden its scope to pursue these issues as they relate to total response and not just to food.
A fuller report of the session will be distributed to members of the Working Group.