Health Cluster (PHT) Gender and Humanitarian Training (UN WOMEN) 14 March 2012 WHO and UNICEF

Health and Nutrition Cluster Globally - 2 separate clusters for Health and Nutrition Pacific: PHT – combined Health and Nutrition cluster as one with two co- leads Rationale: clear linkages between Health & Nutrition; limited nutrition actors on the ground

The Health Cluster : GOAL To serve as a mechanism for participating health organizations to work together in partnership to harmonise efforts and use available resources efficiently within the framework of agreed objectives, priorities and strategies, for the benefit of the affected populations.

Key objectives 1. Coordination and Capacity, Advocacy: To strengthen coordination and active participation with health partners especially with UN agencies and regional/international partners. 2. Preparedness: To strengthen disaster risk management (DRM) for Ministries of Health as requested by Pacific Health Ministers. 3. Response and mainstreaming: To respond to specific requests made to the Health cluster: Development of mental health and psycho-social support (MHPSS) capacities in emergencies and early recovery in PICs. Support the use of the manual – interagency field manual on reproductive health in humanitarian setting (MISP) To support the development of plans to ensure the availability of food supplies and consumer access to safe and nutritious food – using gender lens.

The Nutrition Cluster: Goal At the global level… seeks to strengthen system-wide preparedness, and technical capacity to respond to humanitarian emergencies through… a broader partnership that engages in …  Enhanced standard setting  Establish surge capacity  Securing access to appropriately trained staff  Establishing or improving material stockpiles  Improved response capacity through pooling and complementarity of efforts and resources At the country level… … ensure a more effective response capacity by mobilizing cluster of agencies … specifically to … o Identify gaps and ensure well identified leadership o Create partnerships between NGOs, UN and non-Un Agencies o Strengthen the accountability of cluster leads to the HC o Improve strategic country level coordination and prioritization

Main focus areas for Nutrition Coordination Preparedness, Assessment and Monitoring Capacity Development Supply

Members WHO is Heath Cluster lead with UNICEF the lead for nutrition. UNFPA, UNDP, UN Women, IFRC, World Vision, ADRA, OXFAM, SPC, AusAid and NzAid’, + others. NDMO and MoH are the key partners for coordination on the ground during a response. MoH part of contingency planning and DRM

Platform of agreed mechanism The Inter-agency standing committee (IASC) has given their blessing for the PHT cluster approach in the Pacific

Human capacity – Who are involved ? WHO South Pacific [Suva Office]  Kamal Khatri (temp), environmental health, emergency focal point  Dr Eric Nilles, epidemiology  Peter Hoejskov, food safety/food security WHO offices also in: o Port Moresby: WHO Representative, Papua New Guinea (WR/PNG)  Apia: WR/Samoa (American Samoa, Cook Is, Niue, Samoa & Tokelau)  Nuku'alofa: WHO Country Liaison Officer (CLO/Tonga)  Honiara: CLO/Solomon Islands  Port Vila: CLO/Vanuatu  Tarawa: CLO/Kiribati  Pohnpei: CLO/Northern Microsesia (for FSM, RMI, CNMI & Palau) UNICEF Pacific [Suva Office] –  Ms. Seini Kurusiga - Nutrition lead –  Dr Ingrid Hilman -EPI UNFPA –  Dr. Wame Baravilala,  Maha Muna Joint Presence Offices [UNICEF/UNFPA/UNDP]  Vanuatu  Solomon Islands  Kiribati  Samoa  FSM  RMI  Palau  Nauru

Activities - Health No dedicated Emergency & Humanitarian Action (EHA) staff based in WHO Pacific, but an EHA focal point and experienced team in Suva (as above) plus specialist skills including disease control, immunology and vector control within seven (7) other WHO offices in the Pacific; WHO has a strong, on-going role with partners including UNICEF in the WASH coalition and Fiji WASH cluster including the on-going response to typhoid in Fiji; Feedback on UN OCHA joint proposal for cluster strengthening; Timely response provided to major disasters including Jan 2009/2011 flooding in Fiji, tsunami events in Samoa, Tonga Concerns over lack of water in Tuvalu and Tokelau in 2010 were addressed coordinated through the WHO SP Office and WPRO disaster response.

Activities - Nutrition UNICEF has a dedicated Emergency Specialist – recent addition. Nutrition Specialist provides leadership and technical support to the cluster Provision of technical support to i] messaging to safeguard nutrition – importance of BF in emergencies and health of pregnant and lactating mothers etc. ii] determination of food needs re food assistance based on Spheres Standards iii] optimum use of food in an emergency food basket iv] Ensure donations of BMS not accepted as food relief ([Code of Marketing BMS] v] developed a nutrition surveillance tool [to be reviewed] UNICEF Multicluster Emergency training – introduction to Cluster approach and the role of the nutrition cluster in emergencies

Gender support available MISP – Minimum Initial Service Package training has been provided to MoH and key NGO focal points across the Pacific. Those trained would be the focal point persons for SHR, HIV and GBV responses. Gender Advisor (Maha Muna) at UNFPA main focal point from the Health cluster to participate in UN Women Surge capacity group; key entry point for UN Women and the UN Gender Group to help strengthen cluster effectiveness. Gender Task Force [UNICEF] – seeks to ensure attention given to gender issues in UNICEF emergency activities. Minimum Gender Readiness – Tonga Sample

Issues and Future plans Issues: Lack of dedicated staff in WHO SP office, inadequate funding support when required. Limited no. of nutrition actors on the ground Cross-cutting issues mean that substantial number of staff need to be involved in “response”. Future plans: Advocate on health response funds for proposals on disaster management to ensure appropriate capacity for response. Mainstreaming WHO efforts with ISDR, UNICEF and relevant agencies to ensure safer health facilities, lesser casualties during emergencies. Establish country-level nutrition cluster Continue development of nutritional monitoring and surveillance tools and training Pilot selected nutrition interventions e.g. prevention and treatment of micronutrient deficiencies.

StrengthsWeaknesses Multi-agency group Good working relationship (internal and external) Good system for communication Diversity of approaches Strong political commitment Defined boundaries Staff turnover Agencies are not represented in all countries Lack of adopted national standards Low engagement with churches, NGOs and grassroot Cluster monitoring in-country Lack of gender balance in medical staff on the ground OpportunitiesConstraints Good donor relationship Engage more with SPC and other relevant agencies Improve ability to work together towards a common goal Unclear information received from MoH Political and religious agendas in- country Loss of staff in cluster agencies Unavailability of staff to undertake detailed planning

Cluster workplan 2012 Employ inter-agency Standing Committee (IASC) Gender Training tip sheets for health and nutrition cluster activities Provide letter of support from head of agencies to accompany the regional PHT proposal Recruit multi-skilled health cluster coordinator Engage with potential DRM project design and donors specific to health Engage with World Vision Australia in their planned Mental Health and Psychosocial Support (MHPSS) capacity building training workshop Support the use of inter-agency field manual (IAFM) on reproductive health in emergencies Encourage food safety emergency planning Support the work of the Food Secure Pacific Working Group to assist countries in establishing multi-sectoral food security coordination mechanisms Develop TOR for nutrition cluster regionally/country level Establish minimum SOPs for cluster esp. MoH partners

APPENDIX A: RECOMMENDED Food Baskets meeting SPHERES Standards Fiji Food basket

The food basket: full ration

Sample food basket - Fiji Food Items adult/week (2100kcals) 1 adult/month (4 wks) Supplementary ration (1500kcal)/week Rice2kg8kg1kg Flour/sharps1kg4kg1kg Dhal1/2kg2kg1/4kg Tinned fish2 tins81 tin Milk1/4kg1kg1/4kg Sugar1/2kg2kg1/4kg Oil210mls750mls1/4bottle Preschoolers/week: (distribution by Red Cross only) Full cream milk powder 1kg or 1 500g pack; Tinned baby food for infants under 12 months - 2 tins daily