United Nations System
Standing Committee on Nutrition

 

Working Group on Emergencies

held during the ACC/SCN's 30th Session in Chennai, India, March 2003

Chaired by Marjatta Tolvanen
 

Infant feeding in emergencies  Reporter: Lida Lhotska (IBFAN)

Achievements:

  • A training module 1: "Infant Feeding in Emergencies, for relief staff" is ready and distributed. An evaluation of the use of the module is being carried out.
  • A training module 2:" Infant feeding in Emergencies, for health workers" is almost ready. To complete the Module there is a need to resolve confusion concerning different protocols for treatment of severe malnutrition in infants under six months.

Plans:

  • The core group will call a meeting to clarify the issue.
     

Training initiatives for capacity development for nutrition in emergencies Reporter Marjatta Tolvanen (UNICEF) on behalf of Annalies Borrel

Achievements:

  • Inventory of training courses compiled and disseminated (copies can be made available)
  • Assessment for training needs conducted in Nairobi by FAO (2001/2) and preliminary proposal outlined
  • Involvement in current training initiatives:
  • Tufts/WFP training: "Food and Nutrition in Emergencies"
  • Tufts/Columbia/CDC: training of UNICEF Health and Nutrition officers: "Training for Improved Practice: Public health and Nutrition in Emergencies"
  • SPHERE Project Health and Nutrition Training

Plans for 2003-4: 

  • Plans to support training courses in the following institutions:
    • University of Nairobi (ANP)
    • Affod University, Khartoum
    • Kabul University/Ministry of Health
    • 1-2 institutions in crisis affected countries
  • Strengthen links with other working groups
    • Capacity Development Working Group
      - Establish contact with regional training focal points
      - Participate in August 2003 "Capacity Development" meeting
  • Share and disseminate inventory of training materials and strategy
     

SMART: Standardized Monitoring and Assessment of Relief and Transitions Reporter: Marjatta Tolvanen (UNICEF)

The objective of this inter-agency initiative is to improve the monitoring, reporting and evaluation of humanitarian assistance, in order to ensure that reliable data is available as needed for making policy, funding and program decisions.

Achievement: A workshop in July to make a standard recommendation for assessing population stress:

Basic, essential indicators:

  • Crude mortality rate (CMR)
    • The most significant public health indicator for all populations, particularly for societies in crisis.
    • Combine CMR with anthropometric survey
  • Nutritional status of children under five
    • An essential indicator to assess the overall nutritional status of a population

Sampling:

  • Simple or systematic random samples where feasible;
    • the clusters should be selected randomly with a chance of selection proportional to the population size
    • 30 x 30 cluster is recommended
    • Include all children in the household in the sample, also those without children

Reporting:

  • A standardized reporting format should always be used, which includes all the information needed to evaluate the quality of the survey and demonstrate that the appropriate methodology has been used.
  • Results should be provided in both Z score and percentage of median as they have different purposes
  • Interpretation in the context of the situation, including food security

Plans:

  • CIDA funds available through UNICEF for the SMART Project (2 years)
  • Develop the "SMART Manual for Dummies" on methodology on crude mortality rate (CMR) and nutritional status
  • Pilot project to test the manual and implementation: Angola Website for the SMART project for further information: http://www.smartindicators.org/initiatives.htm
     

Sphere Project Reporter: Anna Taylor (SCF/UK)

Achievements:

  • Evaluation of the use of the first version and revision process under way 

Plans:

  • Revised Sphere standards - document to be ready in October
     

www.Nutritionnet.net Reporter: Saskia Van Saskia van der Kam (MSF/Holland)

Achievement:

  • Active working environment of nutritionists for nutritionists
  • Large African participation

Plans:

  • Increase involvement of experts in certain field related problems
     

Adult malnutrition

Achievements:

  • Focal points resigned, so no reporting
  • The need to continue the work on assessment of adult malnutrition, was brought up, especially with new demands due to malnutrition caused by the HIV/AIDS epidemic

Plans:

  • Revive group
  • Research anthropometric assessment adults
  • Explore approaches of adult malnutrition in the context of HIVAIDS
     

Main topic: Home-based treatment of severe malnutrition

Experiences with, and research on, home based treatment of severely malnourished as an alternative to therapeutic feeding centres—4 presentations:

  • Update on the CTC programme-Steve Collins (Valid International)
  • Social and ethical issues related to CTC-Joseph-Matthew Mfutso-Bengo (University of Malawi & Valid International)
  • Experiences in CTC in North Sudan- Anna Taylor (Save the Children Fund UK)
  • Protocol for Home Treatment, Implementation of a clinical trial in Sierra Leone- Carlos Navarro-Colorado (Action Contre la Faim)

Concept:

  • Move away from centralised therapeutic feeding centres (TFCs)
  • Stabilisation centres (phase 1)
  • Home treatment (phase 2)
  • Home visitors, Ready To use Therapeutic Foods (RTUTF), also made locally
  • Overcoming coverage and defaulter problems in TFCs  Empowering mothers and communities

Achievements:

  • 5 projects
    • positive results: increased coverage; increased cure rate; low mortality; low default; weight gain rate lower; costs not different
  • ethical auditing of the project is being carried out

Plans

  • at least 3 more projects
  • increase community mobilisation
  • local production of RUTF
  • formal comparison TFC versus home treatment
  • explore alternatives for traditional TFCs
  • Technical Workshop to clarify concepts and protocols in October