A systems approach for Emergency preparedness and contingency planning with an IYCN-E Lens Brenda AKWANYI Nutrition Sector Coordinator / UNICEF Kenya Global Nutrition Cluster Annual Meeting Geneva, 9 – 11 July 2013

Nutrition Situation and Operational context 2 Protracted emergency context defined by Multiple repeatedly hazards combination of cyclic drought-induced crop failure, Floods influx of refuges from (Daadab, kakuma), Insecurity : Alshabaab, IDPs, inter-communial violence and terrorist attacks Disease epidemics( cholera, polio, measles) Food insecure population: 1.1M down from 2.1 M in 2012 (KFSSG Feb 2013). Nutrition indicators : – 6.7 % of under-five children suffer from wasting and 35% of children under the age of five suffer from stunting. )** – The total estimated caseload of boys and girls who will require treatment for acute malnutrition in both the rural and urban areas 356,296 and women affected by acute malnutrition are 27,570 (NTF2013) – Iron Folate coverage remained far below the 50% target set by the nutrition sector. – (Exclusive Breastfeeding (EBF) rate increased from 13%(2003)to 32% (2009)** – Early initiation increased from 52%(2003) to 58%(2009)** – Pre-lacteals - 42%** – Bottle feeding at 25%** Source: **KDHS 2008/09 ;

Policies: Breast Milk Substitutes (Regulation and Control) Act 2012 MIYCN Policy and Strategy, Operational Guidelines on IFE New constitution where nutrition is a clear human right Devolution and new constitution Lesson learnt from PEV2009 Government leadership Strong national and county coordination platforms institutionalized contingency planning frameworks for resilience programming Health Systems Strengthening (BFHI/BFCI), HiNi technical support Partnership/Advocacy with non-tradition partners, capacity building on IFE, Sensitization/simulations Community efforts (MtMSG), Continous communication/ready to use comms & response packs CODE monitoring, CODE monitoring, Scaling up best practices, Institutionalizing scalability model

Results 4 Partners and actors were ready to scale- up(international & national)network at community levels established(MtMSG) Deterioration of the nutritional status of young children mitigated (measurable??) Communication widely disseminated Synergy in learning, collaboration, resource sharing and mobilization resulted when stakeholders were brought together around discreet preparedness activities.

Lesson Learnt A strong policy / strategy environment is critical  Strong policy and advocacy addressing violations of breast milk substitutes (donors, parliamentarians, private sector and community leaders) as well as the inclusion of IYCF in the HINI package which is adopted at national scale  National Government frameworks for resilience programming in ASAL where addressing under-nutrition in fragile areas is a critical pillar (high focus on improved IYCN) Government leadership and coordination  Mainstreaming sector/cluster coordination capacity in key line ministries develops national and local capacities for preparedness and response and is a key component for resilience Innovation  Not doing business as usual: preparedness commitment from donors, partnership with non -traditional partners and Multi-sectoral approach(KIRA) adopted by GoK  Common analysis: Support to Govt leads revised vulnerability analysis of hazard prone areas

Challenges Inadequate human resource for health Particularly in ASAL / most vulnerable areas Human resource task shifting. Less capacity in IYCN and partner support. Partners to come out of their comfort areas of work Frequent change in global guidance on IYCN (IF/HIV)- delays in HW& Partner updates Private sector during emergency/crisis times

Recommendations: Implication for global level Integration:  Systems strengthening utilizing platforms (MCH, BFHI, support groups) to accelerate emergency responses and sustain progress  Strong policy and advocacy addressing violations of breast milk substitutes Scaling up  Moving from single hazards to multi hazards guidance and support needed for National capacity to add multi risks  Contexts of high risk(multiple hazards) institutionalization of cluster/sector coordination & contingency planning strengthens scalable systems to react timely and appropriately to emergencies.

Successful preparedness in MIYCN will depend on system and communities capacities. Invest now for better response!