and in humanitarian response This presentations is made for a duration of approx. 60 min. In this session you will need a few hard copies of the SPHERE handbook 2011. Module 21 Oct-05-11 1

Learning objectives Be familiar with basic principles of standards and accountability Know some universal standards for humanitarian response Be familiar with some inter-agency accountability initiatives being implemented Be familiar with the difference between SPHERE minimum standards, key actions, key indicators and guidance notes Source: UCL + Makerere University School of Public Health, Uganda Oct-05-11 2

Introduction Standards and Accountability are linked. Standards establish the thresholds or levels required to achieve the necessary quality for a particular good or service. Accountability* is about being responsible to someone that certain standards have been achieved. *being accountable = being responsible to someone for some action and that certain standards have been achieved (in this context) Accountability: means by which individuals/ organizations are held responsible for their actions Discuss examples in the work experience of the participants

Various standards Legal standards – laws/rights Principle-based, voluntary standards – codes of conduct Technical standards – e.g. SPHERE standards A standard can be understood as a descriptor of the quality of a good or service. Standards tend to be based on technical or experience-based evidence as well as principles, and can be qualitative or quantitative in nature. Standards can be legally binding, voluntary moral claims or entitlements that gain their strength through their wide application Oct-05-11 5

Various standards Legal standards – laws/rights Principle-based, voluntary standards – codes of conduct Technical standards – e.g. SPHERE standards Oct-05-11 6

Legal standards - some examples International Human Rights Law (IHRL) international law that describes the rights of all persons and the obligations (or duties) of States. Within this e.g. UN Convention on the Rights of the Child the Convention on the Elimination of all Forms of Discrimination Against Women International Covenant on Economic, Social and Cultural Rights (includes ‘right to food’!) the Universal Declaration of Human Rights of 1948: International Human Rights Law (IHRL) is a body of international law that describes the rights of all persons and the obligations (or duties) of States. IHRL includes treaties which have legally binding effect with respect to parties that have signed them. The main treaties in IHRL relevant to humanitarian contexts are: the UN Convention on the Rights of the Child (CRC), the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW); the International Covenant on Economic, Social and Cultural Rights (ICESCR); and the International Covenant of Civil and Political Rights (ICCPR).

for all peoples and all nations, Article 25.1 states that “…everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age, or other lack of livelihood in circumstances beyond his control.”

The right to food All human beings have the right to adequate food and the right to be free from hunger. Such right cannot be suspended even in emergencies (emergencies are sometimes used for justifying suspension of some rights) The right to food is not a right to be fed, but primarily the right to feed oneself with dignity. The right to food is considered in terms of the right to an adequate standard of living, as stated in the Universal Declaration of Human Rights

Legal standards- Human rights law The Right to Food requires States to provide an enabling environment in which people can use their full potential to produce or procure adequate food for themselves and their families. However, when people are not able to feed themselves with their own means, for instance because of an armed conflict, natural disaster or because they are in detention, the State has a responsibility to provide food directly. Reference: UNHCHR/FAO, 2010. Pages 3-4 © UNICEF/NYHQ2007-1004/Olivier Asselin 9

National legislation on foods and supplements, GMOs, labelling and marketing of breast milk substitutes are all examples of relevant national legal standards that can guide a nutrition-focused humanitarian response. Upper Photo credit: © UNICEF/NYHQ2010-1440/Susan Markisz GMO=Genetically Modified Organisms

Various standards Legal standards – laws/rights Principle-based, voluntary standards – codes of conduct Technical standards – e.g. SPHERE standards Oct-05-11 6

The Red Cross/NGO Code of Conduct 10 Principle Commitments of the Code of Conduct The humanitarian imperative comes first; Aid is given regardless of the race, creed or nationality of the recipients and without adverse distinction of any kind. Aid priorities are calculated on the basis of need alone; Aid will not be used to further a particular political or religious standpoint; We shall endeavor not to be used as an instrument of government foreign policy; We shall respect culture and custom; We shall attempt to build disaster response on local capacities; Ways shall be found to involve program beneficiaries in the management of relief aid; Relief aid must strive to reduce vulnerabilities to future disaster as well as meeting basic needs; We hold ourselves accountable to both those we seek to assist and those from whom we accept resources; In our information, publicity and advertising activities, we shall recognize disaster victims as dignified human beings, not hopeless objects. The Red Cross/NGO Code of Conduct Source: MTV for UCL + Makerere University School of Public Health, Uganda The Code of Conduct has sought to make more explicit the nature of agencies’ accountabilities Produced in 1994, the Red Cross/NGO Code of Conduct outlines a set of commitments and responsibilities of signatory organisations that guide humanitarian action. The Code incorporates the three fundamental humanitarian principles discussed earlier, plus operational principles that are based on experience Global Nutrition Cluster Oct-05-11 12

The humanitarian imperative Everyone has the right to receive Humanitarian Assistance in times of disaster. Source: MTV for UCL + Makerere University School of Public Health, Uganda Oct-05-11 13

Additionally the Code of Conduct has values Humanity: to prevent and alleviate human suffering wherever it may be found Impartiality: no discrimination – relieve suffering guided by needs Independence: maintain autonomy to be able to act in accordance with the principles Neutrality: not taking sides in hostilities Source: UCL + Makerere University School of Public Health, Uganda Impartiality: no discrimination on any basis (race, religious beliefs, political opinions, etc.) Neutrality: not taking sides in hostilities (non-allegiance) or engaging at any time in controversies of a political, racial, religious or ideological nature Oct-05-11 14

Code of Conduct In 2007, > 400 organizations signed up to the Code of Conduct but there is no agency/body who can hold signatories to account… Source: UCL + Makerere University School of Public Health, Uganda Oct-05-11 15

The International Code of Marketing of Breast-milk Substitutes Another example of a ‘code’ (of conduct).

The International Code of Marketing of Breastmilk Substitutes The International Code = World Health Assembly (WHA) Resolution (1981) + subsequent relevant World Health Assembly Resolutions Protection from commercial influences on infant feeding choices. It does not ban the use of infant formula or bottles. Controls how breast milk substitutes, bottles and teats are produced, packaged, promoted and provided. The Code prohibits free/low cost supplies in any part of the health care system. Governments encouraged to take legislative measures. Adoption and adherence to the Code is a minimum requirement worldwide. Upholding the Code is even more critical in emergencies. The International Code of Marketing of BMS is referred to as the Code or the International Code. The Code of Marketing of BMS was adopted as a WHA Resolution in 1981. Subsequent relevant WHA resolutions have equal weight. They are collectively known as ‘the Code’. The Code is intended to protect the mothers/carers of both breastfed and non-breastfed infants and young children from commercial influences on their infant feeding choices. It does not ban the use of infant formula or bottles, but controls how they are produced, packaged, promoted and provided. The Code prohibits free/low cost supplies in any part of the health care system. Governments encouraged to incorporate the Code in legislation. However compliance with the Code does not depend on legislation - adoption and adherence to the Code is a minimum requirement worldwide. The Code is even more critical in emergencies. 17

Various standards Legal standards – laws/rights Principle-based, voluntary standards – codes of conduct Technical standards – e.g. SPHERE standards Oct-05-11 16

The Sphere Project General concern with quality and accountability has been ongoing Humanitarian practice from past no longer sufficient (complexity and number of disasters increasing, changing nature of humanitarian community and increasing diversity, increasing number of actors) Post-Rwanda 1994: Multi-donor evaluation “Unnecessary deaths” Source: UCL + Makerere University School of Public Health, Uganda Oct-05-11 17

The Sphere Project Aims to improve quality and accountability Launched in 1997 by group of NGOs and Red Cross SPHERE project’s Handbook begins with a Humanitarian Charter (mix of ethical/legal rights/obligations/beliefs) Source: UCL + Makerere University School of Public Health, Uganda Oct-05-11 18

The Sphere Handbook 2004 Sphere Handbook 2011 revised Sphere Handbook Humanitarian Charter and Minimum Standards in Humanitarian Response The Humanitarian Charter - three principles: The right to life with dignity The right to protection and security The right to receive humanitarian assistance New in 2011 is: A number of emerging issues are now in the handbook, e.g. Impact of climate change Disaster risk reduction Cash transfer Civil-military relations Preparedness Early recovery Two further themes have been strengthened: Education in emergencies Psycho-social issues Oct-05-11 19

Sphere 2011 The handbook is structured around six minimum standards common to all sectors: Community-centered humanitarian response Coordination and partnership Assessment Analysis and design Performance, transparency and learning Aid worker performance Source: UCL + Makerere University School of Public Health, Uganda SPHERE is the best-known tool establishing quality standards for key areas of humanitarian response including Food Security and Nutrition. It also emphasizes the process of engagement through its Minimum Standards in 6 Core Areas. People-Centred Humanitarian Response (affected people participation is integral to humanitarian response) Coordination and Collaboration (between agencies and governmental authorities engaged) Assessment (to be systematically conducted) Design and Response (based on needs assessment, context and capacity) Performance, Transparency and Learning (effectiveness, quality and appropriateness) Aid Worker Performance (accountability) Oct-05-11 20

Sphere 2011 Assessment and analysis Infant and young child feeding One chapter is dedicated to Food and Nutrition Security Assessment and analysis Infant and young child feeding Food assistance Food security and livelihoods Treatment of acute malnutrition and micronutrient deficiencies Other chapters on standards from other sectors (which are directly related to the underlying causes of malnutrition): water, sanitation and hygiene promotion; shelter/settlement, non-food items; and health services. Source:MTV for UCL + Makerere University School of Public Health, Uganda Oct-05-11 21

Structure of 2011 Sphere handbook Each section includes: Minimum standards: qualitative, specifying minimum levels to be attained in the provision of food security, nutrition and food assistance responses Key actions: activities needed to achieve standards Core indicators: signals that show whether a minimum standard has been attained (quality/quantity) Guidance notes: specific points to consider, guidance on tackling practical difficulties, advice on priority issues, dilemmas, controversies, gaps in knowledge Source: UCL + Makerere University School of Public Health, Uganda Oct-05-11 22

Overview of contents on Food security and nutrition in SPHERE handbook Oct-05-11 23

Appendix 1: Food security and livelihoods assessment checklists Appendix 2: Seed security assessment checklist Appendix 3: Nutrition assessment checklist Appendix 4: Measuring acute malnutrition Appendix 5: Measures of the public health significance of micronutrient deficiencies Appendix 6: Nutritional requirements Useful annexes in SPHERE handbook on Food security and nutrition Oct-05-11 24

Example of standard Oct-05-11 25

Management of Acute Malnutrition standard 2: Example Management of Acute Malnutrition standard 2: Severe acute malnutrition is addressed Oct-05-11 26

Key Actions Example Include in-patient care, out-patient care, referral and community mobilisation components interventions for the management of SAM (see guidance note X) Provide nutritional and medical care according to nationally and internationally recognised guidelines for the management of SAM. (see guidance notes X and Y). Investigate and act on causes of default and non- response or an increase in deaths (see guidance notes X, Y and Z). Oct-05-11 27

Core Indicators Example More than 90% of the target population is within <1 day’s return walk (including time for treatment) of the programme site Coverage is >50% in rural areas, >70% in urban areas and >90% in camp situations (see guidance note X). The proportion of discharges from therapeutic care who have died is <10%, recovered is >75% and defaulted is <15% (see guidance note Y). Oct-05-11 28

Guidance notes more details on what and how p.170 of Handbook Example Oct-05-11 29

Another Example Oct-05-11 30

Food Security – Food transfers standard 2: Example Food Security – Food transfers standard 2: The food items provided are appropriate and acceptable to recipients so that they can be used efficiently and effectively at the household level. Oct-05-11 31

Key Actions Example Consult disaster-affected people during assessment and programme design on the acceptability, familiarity and appropriateness of food items, and ensure the results inform decisions on food choices (see guidance note X). Assess people’s ability to store food, their access to water and fuel, and cooking times and requirements for soaking when selecting food types (see guidance note Y). When unfamiliar food is distributed, provide instructions on appropriate preparation to people who prepare food, preferably in the local language (see guidance note X). If whole grain cereal is distributed, ensure recipients have either the means to mill/process it at home or access to adequate milling/processing facilities (see guidance note Y). Ensure disaster-affected people have access to culturally important items, including condiments (see guidance note Z). Oct-05-11 32

Core Indicators Example All recipients receive food that is ‘fit for purpose’: for safety, food should not pose a risk to health; for quality, food should match quality specifications and be nutritious (see guidance notes X, Y and Z). Monitoring tracks all the beneficiaries’ complaints received and resolved (see guidance note X). Oct-05-11 33

Guidance notes more details on what and how p.187 of Handbook Example Oct-05-11 34

Achieving the standards may also require long periods of time SPHERE Standards Focus on response phase but be alert to transition and recovery: (Some standards will have some indicators which will look at the longer term). Used for M&E of nutrition programmes as proposing minimum standards for programme performance. Often used as a tool in evaluations of humanitarian response – can highlight gaps To some extent universal, BUT indicators need adjustment on an emergency-specific basis. Achieving the standards may also require long periods of time In what contexts standards and core indicators cannot be met Source: UCL + Makerere University School of Public Health, Uganda Oct-05-11 35

Constraining factors include Insecurity or denial of access Displacement Lack of staff Cultural factors Bureaucracy Logistical constraints Lack of finance etc. If core indicators are not met, identify and understand the reasons why and consider alternative strategies Source: UCL + Makerere University School of Public Health, Uganda Constraining factors that impede standards and core indicators to be met Oct-05-11 36

Limitations No body or agency has overall responsibility for technical standards in NiE response Application of minimum standards can create differences in standards of living of emergency- affected and surrounding populations Lack of funds restrict delivery of humanitarian assistance Accountability to whom? Source: UCL + Makerere University School of Public Health, Uganda Oct-05-11 37

Key messages Standards may be: legal, based on principles and/or voluntary or technical. Everyone has the right to adequate food and to be free from hunger. Everyone also has the right to receive humanitarian assistance in times of disaster. This is known as the humanitarian imperative. The humanitarian principles of humanity, impartiality, independence and neutrality provide a principle-based foundation for nutrition in emergencies. The Code of Conduct sets out ten principles to guide humanitarian action. The Sphere project’s Humanitarian Charter reaffirms that all people affected by disaster and conflict have a right to life with dignity; the right to receive humanitarian assistance; and the right to protection and security. However, there is currently no incentive, or obligation for humanitarian agencies to be accountable to affected communities, other than a voluntary commitment to do so. The Sphere standards specify the minimum acceptable levels to be attained in a humanitarian response. The Food Security and Nutrition standards cover assessment, infant and young child feeding, management of acute malnutrition and food security (food transfers, cash transfers and livelihoods). One of the main unresolved issues in relation to standards and accountability is that there is no body with overall responsibility for technical standards in nutrition in emergency response.

Any questions?

You endured the whole course of 21 modules, congratulations! Source: UCL + Makerere University School of Public Health, Uganda You endured the whole course of 21 modules, congratulations! Oct-05-11 38