1. Nutrition Information Management in South Sudan
Experiences on progress and challenges
Ismail Kassim – SSD -Nutrition Specialist –UNICEF

2. Outline of Presentation
Description and analysis of South Sudan nutrition information system before 2014 conflict
Key actions taken by UNICEF/cluster to improve the nutrition information system in South Sudan
Key achievements
Opportunities and Challenges
Lessons learnt
Key questions

3. Nutrition and FS situation at a glance
Nutrition Situation
IPC- September 2018
(A) SEPTEMBER 2018
6.1 million people (59% of population) facing severe food insecurity
4.3 million in Crisis; 1.7 million in Emergency; 47,000 in Catastrophe
(B) OCTOBER – DECEMBER 2018
4.4 million people (43% of population) facing severe food insecurity
3.4 million in Crisis; 960,000 in Emergency; 26,000 in Catastrophe
(C) JANUARY – MARCH 2019
5.2 million people (49% of population) facing severe food insecurity
3.7 million in Crisis; 1.5 million in Emergency; 36,000 in Catastrophe
Slight improvement-no county reporting extreme critical levels (GAM above 30%)
31 counties reported ‘Critical’ (GAM (WHZ) 15.0 – 29.9%) levels of acute malnutrition
20 counties -‘Serious’ (GAM (WHZ) %) levels of acute malnutrition.
Central and Western Equatoria recorded ’Alert’ (GAM (WHZ) %) and ‘Acceptable’ (GAM (WHZ), <5.0%) levels of acute malnutrition.

4. New admission trends for Children with SAM 2016-2018

5. New admissions trends for Children with MAM 2016- 2018

6. Nutrition Information prior to conflict
Nature of Crisis
Rapid onset, 740,400 individuals displaced (OCHA, Jan 31st 2014) – fluid population, IDP camps (PoC)
Livelihoods & access to basic services impacted
Pre-crisis: Only SMART surveys, weak and unsophisticated data collection with delayed validation of results.
Information gaps: Limited access to population and funding, lack of HR capacity (both CLA IM and data collection/management).
Catalysts: Introduction of IPC and IPC for AMN -demand for information, increased use of evidence based planning

7. Action taken to fill the gaps
Capacity and HR
Dedicated nutrition information staff both at cluster and CLA
External support – ACF and CDC technical support
Advocate for strengthening of Cluster/NIWG
Conduct training needs and SMART trainings and establishments of sub-sub WGs- NIS, survey tools etc
Scope and sources of information
Integration nutrition indicators in FSNMS
Prioritize counties with highest information gaps and Rapid SMART surveys in areas of insecurity
Active participation in the IPC analysis and introduction of IPC for acute malnutrition
Reporting
Robust program reporting tool-develop, evaluate, pilot, train and use
Annual plan and Funding
Annual SMART surveys plan and advocacy for funding

8. Sources of Nutrition Information South Sudan
SMART surveys
Food security and nutrition monitoring Systems (FSNMS)- 2 rounds per year
Program data- NIS- Reported by all partners routinely (monthly)
In depth assessments- causal studies, Urban assessments etc
IPC analysis and IPC for Acute Malnutrition
Evidence Generation
Other Studies- causal analysis, urban assessment
Program data
Surveys/
Assessments/IPC
SMART surveys-
County based assessments
50-55 surveys annually
Undergoes rigorus review and validation process
Conducted by many nutrition partners
Food security and nutrition monitoring Systems (FSNMS)
State level representative (2 rounds per year)
Data quality improved to provide national estimates of all nutrition indicators
Last round included anthropometry for 0-59months
Funded by FAO/WFP/ UNICEF
Supported by all partners of FS and Nutrition
Over 10,000 children assessed
Program data- NIS- Reported by all partners routinely (monthly)
In depth assessments- causal studies, Urban assessments etc

9. Annual Survey plan and identification of priority areas
Partners develop survey plan for the next year using NIWG matrix
Survey plan consolidated
Based on the most recent IPC analysis priority areas identified both in terms of severity and information gap
Survey plan matrix updated with the priority counties
For counties identified as priority not captured by partners are included in the plan and partner identified
Ad hoc surveys in areas of displacement, IRNA reports etc
Partner also indicate in house capacity or use of consultants to do the survey
Matrix updated twice a year

10. Funding / Implementation in 2017

11. UNICEF role on assessments as CLA
Provision of dedicated staff on Nutrition Information
Funding of assessment (over 40%)
Evidence generation is a key output of nutrition section
Chair the NIWG
Resource mobilization
Use of evidence based in partner agreement
Member of the IPC TWG and lead in the IPC for Acute malnutrition
Mobilization of partners on analysis and reporting
Data storage and access- Cluster and UNICEF
Outcome
Improved and equitable provision of evidence-based nutrition interventions for children, and for women of child-bearing age, including pregnant and lactating women
Output 1
Provision of quality of IMSAM
Output 2
IYCF
Output 3
Evidence Based Nutrition Intervention
Output 4
Nutrition EPRP

12. Role of NIWG and MOH Role of MOH Chair the meeting
Members
MOH/RSS, UN agencies and NGOs,
Chair – MOH and Co-chair and secretariat – UNICEF
Criteria for Membership
All Nutrition partners are eligible if the staff meets the criteria
Key nutrition information technical expert from nutrition cluster partners
Trained on nutrition assessments (SMART, SQUEC, KAP…)
Proven experience in Information management and/or statistical background
Specific Role of the TWG
Planning
Nutrition information guidelines
Capacity building of partners
Quality assurance
Technical support
Liaison and Coordination
Information Management
Advocacy
Role of MOH
Chair the meeting
Participate in the deliberations
Organise for meeting Arrangements at the Ministry
Provide final approval letter addressed to the State and county Government
Meetings
Meeting every other Thursday
Held MOH/ UNICEF

13. Nutrition cluster contribution to the IPC analysis and IPC Acute in South Sudan
Generate malnutrition and mortality data needed for the IPC
Cluster partners support FSNMS
Mobilization of partners to attend IPC analysis and IPC TWG members (UINCEF, CARE, SC etc )
Resource mobilization for assessments with donors/partners
Collates the monthly reporting program data
Makes nutrition information as a top agenda in cluster meeting

14. Challenges of nutrition information management
Lack of national nutrition survey - last survey was done in 2010
Widespread insecurity – affect assessments
Lack of data beyond nutrition
Data quality concerns on FSNMS
Ever changing countrywide situation- frequent assessments, ad hoc
High turn over of members of NIWG
Lack of NIWG functions in TOR of partner NIWG members
Possible potential of conflict of interest
Too many surveys
Capacity gap as most surveys are conducted by consultants which is expensive
Mortality in emergency where standard assessment is not possible

15. New initiatives Improve FSNMS data quality
Looking at few partners (max 3) with surveillance capacity doing assessments
Support capacity building of Government staff- deploy staff in the next country program
Linking NIS with the DHIS2 is currently under discussion
Update of NIS
SMART Capacity building
Improve FSNMS data quality and scope through
Use FSNMS for national and State level estimates of most nutrition indicators
increased support from nutrition partners
Separate Nutrition TOT training conducted in Juba
TOT used to conduct state level training in order to standardize training
Use of Mobile phone enabled real time quality checks
Quality control introduced on phones
SMART Capacity building
Trained about 25 participants with half being from MOH
Requested to delay certificates until the participants participates in one survey at any level
Partners contributing to cost of training

16. What do we learn from South Sudan experience
Absolute need for the management of nutrition information
Unlike Somalia where there is a unit in FAO that does nutrition information management all other counties do not have such arrangement
In many counties there is no clear lead of nutrition information management
Dedicated nutrition information management staff is key starting point in setting a robust information management system
Establishment of GC nutrition information function to supports countries establish systems
The cluster need to advocate for
Government/Cluster or CLA to take the lead in nutrition information management
Use of consensus evidence based planning
Resource mobilization for assessments
Unhindered access on nutrition information for internal and international level use

17. Key questions
What leadership/capacity is needed by the CLA and partners to improve on nutrition information systems?
What are the predictable arrangements needed at global level for agencies specialising in nutrition information systems?
What does the CLA need to put in place at country level?
How can humanitarian agencies build capacity/strengthen government systems within humanitarian programming in complex contexts like South Sudan?
Are there further examples of this?
Where does funding for this come from, e.g. Pool fund, CERF, bilateral donor funds?