WFP and UNHCR have now finalised the UNHCR/WFP Guidelines for Selective Feeding Programmes in Emergency Situations
These guidelines describe the basic principles and design elements concerning food and nutrition related aspects of Selective Feeding Programmes in Emergency and Relief situations. They are intended to provide guidance to WFP and UNHCR and other relief staff in the design, implementation and monitoring of Selective Feeding Programmes in both emergencies and protracted relief situations. The nutrition strategies addressed in these guidelines are to enable an effective response and nutrition rehabilitation. Medical and other care approaches are not dealt with in these guidelines.
Every situation has individual features which lead to different objectives being set, and to different approaches to Selective Feeding Programmes, which these guidelines do not cover. The type of supplementary feeding programme should therefore be designed according to the situation but should nevertheless remain in line with the frame work of these guidelines.
In emergency situations, WFP and UNHCR try to ensure that the food needs of the population are met through the provision of an adequate general ration. However, in certain situations there may be a need to provide additional food for a period of time, to specific groups who are already malnourished and/or are at risk of becoming malnourished.
These interventions have to be seen in the context of a general ration being distributed. The impact of Selective Feeding Programmes aimed at compensating for inadequate general rations has proven very limited and not cost-effective. Thus to be effective, the extra ration must be additional to, and not a substitute for, the general ration.
Many factors influence nutritional status and interventions must therefore be multi-sectoral and cover food, health, hygiene, sanitation and care. A properly designed nutrition survey and complementary analysis of the causes of malnutrition can help to guide the need to implement Selective Feeding Programmes.
National health authorities and NGOs have an important role to play in nutritional interventions. In emergency situations NGOs usually organise and implement Selective Feeding Programmes. They form an integral part of the efforts to prevent and treat malnutrition among young children, women and other at-risk groups.
Selective Feeding Programmes should have clear objectives and criteria, defined from the beginning, for opening, admission, discharge and closure. In order to be effective, Selective Feeding Programmes need to be integrated into Community Health Programmes, which offer health and nutrition services like Safe Motherhood, immunisations, nutrition and health education and growth monitoring. Integration facilitates referrals between services and the phasing out of Selective Feeding Programmes.
In addition to nutritional and medical treatment, care is an essential part of rehabilitation. Care in nutrition refers to the practices of the care givers in the household which translates food security and health care into rehabilitation, growth and development. These practices include care for women, breast-feeding, infant feeding, psycho-social care, sanitation and hygiene practices, food processing and preparation, and home health practices. These issues can be addressed through Selective Feeding Programmes in the form of education, individual counselling, social activities and involvement of caretakers in the programme.
The community must be consulted to the extent possible during programme design and women must take part in the decision making from the outset.
Proximity of feeding centres to the population and availability of trained health staff are a prerequisite when Selective Feeding Programmes are being considered.
The policy of UNHCR and WFP concerning safe and appropriate infant and child feeding, in particular the protection, promotion and support of breast feeding must be respected.
When planning the food needs of Selective Feeding Programmes the energy density as well as the fat, protein and micronutrient content of food commodities must be considered. In addition, micronutrient supplements (especially vitamin A, iron and folic acid) should be given.
It must be kept in mind, that adolescents, adults and elderly persons may also be malnourished and should be included in Selective Feeding Programmes.
The effectiveness of Selective Feeding Programmes, and their impact on mortality and morbidity of affected populations, should be monitored regularly.
The need to set up Selective Feeding Programmes after the initial stage of an emergency often represents a serious warning that the assistance as a whole is insufficient.
The standards mentioned in these guidelines meet the set of minimum standards in disaster response as mentioned in the Sphere Project.
The guidelines have been translated into french and copies of the guidelines can be obtained from the Technical Units at WFP or UNHCR (see addresses below) or on the Web at: http://www.univ-lille1.fr/pfeda/ Engl/Frame/IndexE.htm.
Rita Bhatia/Arnold Timmer - - UNHCR
Health and Nutrition Unit
P.O. Box 2500
CH-1211 Geneva 2
tel: + 41-22-7397681 or 7398308
email: firstname.lastname@example.org or email@example.com
Pieter Dijkhuizen/Anne Callanan - -WFP
Technical Support Unit ODT
Via Cesare Giulio Viola 68
Parco dei Medici
tel:+39-06-6513-2236 or 6513-2718
email: Anne.Callanan@wfp.org or Pieter.Dijkhuizen@wfp.org
The UN ACC/SCN1, which is the focal point for harmonizing policies in nutrition in the UN system, issues these reports on the nutrition of refugees and displaced people with the intention of raising awareness and facilitating action to improve the situation. This system was started on the recommendation of the SCN's working group on Nutrition of Refugees and Displaced People, by the SCN in February 1993. This is the twenty sixth of a regular series of reports. Based on suggestions made by the working group and the results of a survey of RNIS readers, the Reports on the Nutrition Situation of Refugees and Displaced People will be published every three months, with updates on rapidly changing situations on an 'as needed' basis between full reports.
1 ACC/SCN, c/o World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland. Telephone: (41-22)791.04.56, Fax (41-22)798.88.91, Email firstname.lastname@example.org.Information is obtained from a wide range of collaborating agencies, both UN and NGO (see list of sources). The overall picture gives context and information which separate reports cannot provide by themselves. The information available is mainly about nutrition, health, and survival in refugee and displaced populations. It is organised by "situation" because problems often cross national boundaries. We aim to cover internally displaced populations as well as refugees. Partly this is because the system is aimed at the most nutritionally vulnerable people in the world - those forced to migrate - and the problems of those displaced may be similar whether or not they cross national boundaries. Definitions used are given in the box on the next page. At the end of the situation descriptions, there is a section entitled "Recommendations and Priorities" which is intended to highlight the most pressing humanitarian needs. The recommendations are often put forward by agencies or individuals directly involved in assessments or humanitarian response programmes in the specific areas.
The tables, and figures at the end of the report can provide a quick overview. Table 1 gives an estimate of the probable total refugee/displaced/returnee population, broken down by risk category. Populations in category I in Table 1 are currently in a critical situation, based on nutritional survey data. These populations have one or more indicators showing a serious problem. Populations at high risk (category IIa in Table 1) of experiencing nutritional health crises are generally identified either on the basis of indicators where these are approaching crisis levels and/or also on more subjective or anecdotal information often where security and logistical circumstances prevent rigorous data collection. Populations at moderate risk (category IIb in Table 1) are potentially vulnerable, for example based on security and logistical circumstances, total dependency on food aid, etc. Populations in category IIc are not known to be at particular risk. In Table 2, refugee and displaced populations are classified by country of origin and country of asylum. Internally displaced populations are identified along the diagonal line. Figure 1 shows trends over time in total numbers and risk categories for Africa. Annex I summarises the survey results used in the report.