Nutrition in Earthquake Emergencies Child Nutrition Week (28 June – 4 July, 2015) Orientation Meeting (21 June 2015)

THE DISTRICTS FOR LAUNCHING CHILD NUTRITION WEEK 1.Sindhupalchok, 2.Kathmandu, 3.Nuwakot, 4.Dhading, 5.Gorkha, 6.Rasuwa, 7.Kavre, 8.Bhaktapur, 9.Lalitpur, 10.Dolakha, 11.Makwanpur, 12.Ramechhap, 13.Okhaldhunga 14.Sindhuli

THE RISK OF MALNUTRITION IN EMERGENCIES Hunger and malnutrition are rampant among emergency affected populations millions people have been affected by the massive earthquake in Nepal. Infants, children, adolescents, pregnant and lactating women suffer from one or more of the multiple forms of malnutrition in such a situation. The levels of risk of malnutrition in emergencies depends on factors such as the degree of civil security, food availability and accessibility, access to health services, adequacy of assistance delivery, WASH practices and health seeking behaviours. In order to address the situation through comprehensive programme interventions, child nutrition week will be launching in 14 severely affected districts

OBJECTIVES OF CHILD NUTRITION WEEK Speed up the key nutrition response actions initiated in all 14 districts in order to protect and fulfill the nutrition needs of under five years children, pregnant and lactating women Promotion maternal and child nutrition behaviours at all levels through effective behaviour change communication

Five Building Blocks (Key Interventions) Promotion, protection and support for breast feeding and complementary feeding Prevention of acute malnutrition through blanket supplementary feeding programme Management of severe acute malnutrition through therapeutic feeding programme Micronutrient interventions especially MNP, Vitamin A supplementation Maternal nutrition including IFA supplementation for pregnant and postnatal mothers

TARGET INTERVENTIONS At least 80% of mothers have access to information, counselling and support on the benefits of exclusive breastfeeding for infants’ o-5 month old and continued breastfeeding for children 6-23 months old. Target: 184,000 breastfeeding mothers. At least 80% mothers/caregivers of children of 6–23 months old have access to information, counselling and support on how to improve the quality of complementary foods and feeding, including the distribution of micronutrient powders (MNPs). Target: 138,000 children 6–23 months old. At least 80% children 6-59 months old are screened for severe acute malnutrition (SAM) using mid-upper arm circumference tapes and children with SAM are referred to the nearest Outpatient Treatment Programme (OTPs) for the treatment of SAM with ready to use therapeutic foods. Target: 3,000 children 6-59 months old.

TARGET INTERVENTIONS At least 80% of mothers/caregivers of children 6–59 months old with moderate acute malnutrition (MAM) receive MNPs and intense counselling on improved infant and young child nutrition to prevent SAM. Target: 52,700 children 6-59 months old. At least 80% children 6-59 months old receive vitamin A supplementation to prevent vitamin A deficiency and strengthen children’s immune system. Target: 397,000 children 6-59 months old. At least 80% children months old receive deworming tablets to eliminate parasitic infestation and improve nutrient absorption. Target: 350,000 children months old. At least 80% of pregnant women and breastfeeding mothers receive iron and folic acid (IFA) supplements and appropriate counselling on maternal nutrition. Target: 204,000 women.

CHILD NUTRITION WEEK FOCUS ON  Scale up coverage: With a particular focus on inter-personal counselling and radio communication on IYCF, distribution of MNPs and care for children with SAM through OTPs: Promotion of IYCF for children 0-23 mo old Blanket supplementary feeding (follow up and monitoring) Distribution of MNPs for children 6-69 mo old (who have not having micro-nutrient blended supplementary feeding) Vitamin A supplementation for children 6-59 mo old Deworming for children mo old Screening of children 6-59 mo and referral of SAM children (+ data on SAM and MAM) Total target: > 400,000 children in 14 districts

SUPPORT IN ROLL OUT OF THE CHILD NUTRITION WEEK BY DLSA Support the MOHP, D/PHOs, health facilities and FCHVs in coordination, planning Mobilize entire district/communities for CNW, Provide supportive supervision and monitoring CNW activities, Record keeping and reporting Review the collected data, support the compilation of data Gap-filling at each stage in order to ensure the smooth implementation of the CNW. Financial management by using MoHP norms and regulations

MONITORING INDICATORS Number of villages covered in each district Number of VDCs covered in each district Number of FCHVs / health workers trained Number of community volunteers mobilized Number of caregivers/mothers of children aged 0-23 months received IYCF counselling Number of children aged 6-23 months received multiple micronutrient powders Number of children aged 6 – 59 months received vitamin A supplementation Number of children aged 12 – 59 months received deworming tablets Number of children 6 – 59 months screened for severe acute malnutrition. Number of children 6 – 59 months screened for moderate acute malnutrition and provided MNPs Number of pregnant and postnatal women received IFA tablets Number of pregnant and lactating women received maternal nutrition counselling services

ROLES OF DLSA AT DISTRICT LEVEL lhNnf :tl/o cfsl:ds kf]if0f ;+of]hssf nflu TOR != 8L cf/ cf/ ;ldlt, lhNnf :jf:Yo / kf]if0f Sn:6/ ;Fu ;dGjo lhNnfdf cfsl:ds :jf:Yo / kf]if0f Sn:6/ sf] a}7s ;+rfng ug{ lhNnf :jf:Yo sfof{nonfO{ ;xof]u ug]{. #= lhNnf :jf:Yo sfof{no ;Fu ;dGjo u/L cfsl:ds kf]if0fsf] P;];d]G6sf] nflu g]t[Tj ug]{. $= ;|f]t cefjsf] klxrfg ul/ ;DalGwt lj1 ;+:yfx? nfO{ ;'lrt ug]{ h:t}M l;dfdsf] nflu o'lg;]km ;Fu %= - MNP, RUTF, MUAC tape _ x?sf] cfk'lt{sf] nflu afn :jf:Yo dxfzfvfnfO{ cg'/f]w k7fpg] ;fy} ;xh ljt/0fsf nflu lhNnf hg÷:jf:Yo sfof{nonfO{ ;xof]u ug]{. ^= lhNnfdf /x]sf kf]if0f ;Fu ;DalGwt ;a} :6]sxf]N8;{ x? ;Fu lgoldt ;dGjo a}7s ug{].

STEPS Orientation and planning at national level Nutrition cluster meeting, district level orientation and planning Supplies transportation to VDCs Team mobilization on VDCs and district wide readiness for CNW launching through local level orientation, planning, social mobilization, supply management and transportation etc… Massive mobilization of media ( centrally/locally) Launching the nutrition week in all 14 district wide Supportive supervision and monitoring Record keeping and reporting Review and recommendations

DLSA SNDistrictsDLSA 1Kathmandu Social Development Promotion Center (SDPC) 2Lalitpur 3Bhaktapur 4DhadingUMN/NTAG 5Gorkha Suahaara 6Nuwakot 7Rasuwa 8Sindhupalchok 9Dolakha 10KavrepalanchowkYWN/Plan International 11RamechhapTamakoshi Sewa Samittee 12SindhuliNEPHEG/WVI 13OkhaldhungaGHAN 14MakwanpurACF

Thank You