1. IPC The Integrated Food Security Phase Classification Prototype IPC Nutrition Phase Classification for Acute Situations Why we need it & the development process GNC Meeting, Rome 17 Sept. 2014

2. IPC The Integrated Food Security Phase Classification Prototype IPC Nutrition Phase Classification for Acute Situations What is IPC? Why is a nutrition classification needed? IPC Nutrition Classification - technical development process Presentation Outline

3. IPC The Integrated Food Security Phase Classification What is IPC?

4. IPC The Integrated Food Security Phase Classification THE IPC IS….. tools and procedures  A set of tools and procedures (protocols) for classifying the nature and severity of food security situations process for multiple stakeholders  A process for multiple stakeholders to share information and build technical consensus.

5. IPC The Integrated Food Security Phase Classification IPC FOUR CORE FUNCTIONS (1)Building Technical Consensus (2)Classifying Severity and Driving Factors (3)Communicating for Action (4)Quality Assurance  EACH HAS A SET OF SUPPORTING TOOLS and PROCEDURES

6. IPC The Integrated Food Security Phase Classification 6 Understanding evidence with an integrated Analytical Framework Referencing evidence against international standards Transparently methodically & consensually analyzing evidence Transform analyses into concise information for action The 4 Functions of IPC TWG MATRIX ANALYTICAL FRAMEWORK REFERENCE TABLES ANALYSIS WORKSHEETS COMMUNI- CATION TEMPLATE Multi-agency stakeholders to do collaborative analysis Assuring for quality SELF ASS. PEER REVIEW 1. Building Consensus 2. Classifying Severity & Driving Factors 3. Communication for Action 4. Quality Assurance Functions Tools Procedures for:

7. IPC The Integrated Food Security Phase Classification Why is nutrition classification needed?

8. IPC The Integrated Food Security Phase Classification IPC Acute Food Security Phase Classification Proven Applicability and Relevance - Globally Asia & Near East Africa Central America & Caribbean North Africa & Near East Central Asia Why an IPC Nutrition phase classification for Acute Situations - Background

9. IPC The Integrated Food Security Phase Classification Why do we need an IPC Nutrition Classification for Acute Situations? Two Situations We Observe: 1. Low severity of acute Food Insecurity and High levels of acute Malnutrition – Why? Casual factors are not food security related – A public health issue, related to social and care environment and access to health services and health care environment

10. IPC The Integrated Food Security Phase Classification Example: FSNAU Nutrition & Food Security Situation in Somalia

11. IPC The Integrated Food Security Phase Classification 2. High severity of acute Food Insecurity and Low levels of acute Malnutrition 2. High severity of acute Food Insecurity and Low levels of acute Malnutrition Why? 2 possible reasons  Lag effect o Body Tissue and muscle loss related to underlying causes of food insecurity – depends on severity of food inadequacy o Can take time before it manifests, some cases ‘’late indicator’’ Why do we need Both Classifications?

12. IPC The Integrated Food Security Phase Classification Why do we need Both Classifications?  Mitigating Factors o Coping strategies in household, e.g. prioritize the children, until deplete their coping strategies. o Accessible and Effective Public Health Services, that mitigate effects of acute malnutrition, though food insecurity still problem  IF there are social protection programme, strong coping capacity: nutrition indicators - lag effect or no manifestation

13. IPC The Integrated Food Security Phase Classification How is Nutrition Currently Integrated in IPC?

14. IPC The Integrated Food Security Phase Classification To date - IPC focused on the analysis and classification of food security situations and outcomes Nutrition is integrated within the IPC FS analysis, – Not a full analysis of the Nutrition situation and outcomes – Nutrition only in relation to Food Security – Malnutrition caused by non-food security are not included, i.e. inadequate caring practices and disease Identified Gap & Country Requests

15. IPC The Integrated Food Security Phase Classification UNICEF’s Conceptual Framework on the Causes of Malnutrition Inadequate Food Intake Disease Household Food Security Social and Care Environment Access to Health Care & the Health Environment Immediate Causes Underlying Causes Basic Causes National Policies Formal and Informal Structure Context and Potential Resources Malnutrition & Death Core outcomes

16. IPC The Integrated Food Security Phase Classification How is IPC FS linked with the Nutrition Classification? Household Food Security Malnutrition & Death Inadequate Food Intake IPC Acute Food Security informs the Analysis of Household Food Security

17. IPC The Integrated Food Security Phase Classification What is needed in IPC?

18. IPC The Integrated Food Security Phase Classification What is needed to complement the IPC Acute Food Insecurity Phase Classification? Malnutrition & Death The Prototype IPC Nutrition Classification for Acute Situations -elaborates and measures the non-food factors and drivers of malnutrition Disease Social and Care Environment Access to Health Care & the Health Environment

19. IPC The Integrated Food Security Phase Classification UNICEF’s Conceptual Framework on the Causes of Malnutrition Malnutrition & Death Inadequate Food Intake Disease Household Food Security Social and Care Environment Access to Health Care & the Health Environment IPC Nutrition Classification for Acute Situations IPC Acute Food Security Classification

20. IPC The Integrated Food Security Phase Classification IPC Acute Food Security Classification IPC Acute Food Security Classification – provides the full analysis of acute food security, and food security factor analysis for the IPC Nutrition Classification for Acute Situations IPC Nutrition Phase Classification for Acute Situations IPC Nutrition Phase Classification for Acute Situations – provides the full analysis of acute malnutrition outcomes, nonfood factors and food factor analysis. Where food factors analysis is provided by the IPC Acute Food Security (Inter-locking) Complementary Inter-linking Phase Classifications Complementary Inter-linking Phase Classifications – IPC Acute Food Security Phase Classification & IPC Nutrition Phase Classification for Acute Situations complementary & inter-locking – IPC Acute Food Security Phase Classification & IPC Nutrition Phase Classification for Acute Situations are to be complementary & inter-locking full analysis of acute food and nutrition security situation – Together provide the full analysis of acute food and nutrition security situation Prototype IPC Nutrition Classification for Acute Situations

21. IPC The Integrated Food Security Phase Classification Development Process: Nutrition Phase Classification for Acute Situations

22. IPC The Integrated Food Security Phase Classification IPC Global Steering Committee Endorsement IPC Global Steering Committee endorsed In 2013 - the IPC Global Steering Committee endorsed resolution to develop IPC Nutrition Phase Classification for Acute Situations The SC endorsed the use of Food Security and Nutrition Analysis Unit (FSNAU) Acute Nutrition Classification Tool as a base – Developed & Implemented along side the IPC Food Security Phase Classification, since 2007 in Somalia IPC Nutrition Working Group Formation of IPC Nutrition Working Group of the IPC Global Technical Advisory Group (TAG) – to lead technical development & piloting – Technical Experts from both the global food security and nutrition community

23. IPC The Integrated Food Security Phase Classification Based on the Acute Nutrition Classification Tool, an IPC Nutrition Classification for Acute Situations prototype has been developed. Prototype is the refined version of the FSNAU Nutrition Classification Tool Prototype is the refined version of the FSNAU Nutrition Classification Tool – Analytical Framework IPC Analytical Framework UNICEF & Lancet Conceptual Framework – Reference Tables for Nutrition Classification – Mapping Protocol Prototype IPC Nutrition Classification for Acute Situations

24. IPC The Integrated Food Security Phase Classification Prototype IPC Nutrition Phase Classification for Acute Situations Prototype IPC Nutrition Phase Classification for Acute Situations – Focused on analysis of Acute Malnutrition – Classification of the Severity of Acute Malnutrition & identification of contributory factors Pilot test and revise by the global IPC NWG for universal applicability Pilot test and revise by the global IPC NWG for universal applicability Prototype IPC Nutrition Classification for Acute Situations

25. IPC The Integrated Food Security Phase Classification Share same IPC Protocols and Four Core Functions Share same IPC Protocols and Four Core Functions (1) Building Technical Consensus (2) Classifying Severity and Contributory Factors (3) Communicating for Action (4) Quality Assurance Prototype IPC Nutrition Classification for Acute Situations

26. IPC The Integrated Food Security Phase Classification IPC Prototype Nutrition Classification for Acute Situations Reference Table – Outcome Indicators IndicatorAcceptableAlertSeriousCriticalVery critical GAM among children 6-59 months (%) <55-9.910-14.915-29.9≥30 MUAC <125 mm among children 6-59 months (%) <2.0% 2.1-5.5% with increase from seasonal trends 5.6-8.0% 8.1-19.9 %, or where there is significant increase from seasonal trends ≥20.0%, Or where there is significant increase from seasonal trends Sentinel Site Data Very low (<5%) and stable levels Low levels (5 to <10%)and one round indicating increase, seasonally adjusted Low (5 to < 10%) & increasing or moderate (10 to <15%) levels based on two rounds (seasonally adjusted) High levels (> 15%) of malnourished children and stable (seasonally adjusted) High levels (> 15%) and increasing with increasing trend (seasonally adjusted) HMIS Data V. low ( 2yr seasonal trends Low proportion (5 to 2yr seasonal trends Moderate (10 to 2yr seasonal trends High (> 15%) and stable proportion in the preceding 3mths relative to >2yr seasonal trends High (> 15%) and increasing proportion in the preceding 3mths relative to >2yr seasonal trends Programme DataTBD Screening (purposive) (%)<1.0 1.0-2.02.1-3.03.1-5.5

27. IPC The Integrated Food Security Phase Classification IPC Prototype Nutrition Classification for Acute Situations Reference Table – Contributory Factors (1/3) Food security IndicatorAcceptableAlertSeriousCriticalVery critical Food Consumption Score (FCS) Acceptable consumption Acceptable consumption (but deteriorating) Borderline consumption Poor consumption [below] poor consumption Coping Strategies Index (CSI) Reference, stable Reference, but unstable Reference and increasing Significantly > reference Far > reference Household Hunger Score (HHS) None (0)Slight (1)Moderate (2-3)Severe (4-6)Severe (6) Household Economy Approach (HEA) No livelihood protection deficit Small or moderate livelihood protection deficit Substantial livelihood protection deficit or small survival deficit of <20% Survival deficit >20% but <50% with reversible coping considered Survival deficit >50% with reversible coping considered Consolidated Approach for Scoring Indicators of Food Security (CARI) See attached table

28. IPC The Integrated Food Security Phase Classification IPC Prototype Nutrition Classification for Acute Situations Reference Table – Contributory Factors (2/3) Social and care environment IndicatorAcceptableAlertSeriousCriticalVery critical Breastfeeding (BF) Practices i) Exclusive BF for 6mths ii) Continued BF at 1 year iii) Continued BF at 2year reference >90% 50-89% 12-49% 0-11% Complementary feeding in addition to breastfeeding i) Introduction of complementary food at 6 months of age: %introduced ii) Meeting minimum recommended feeding frequency ≥95% 80-94% 60-79% 80-94% 0-59% Maternal Wellbeing IndexTBD Caregiver workload

29. IPC The Integrated Food Security Phase Classification IPC Prototype Nutrition Classification for Acute Situations Reference Table – Contributory Factors (3/3) Access to Health Care & Health Environment Diseases/nutritional deficiencies IndicatorAcceptableAlertSeriousCriticalVery critical Diarrhoea  Normal levels, & seasonal trends,  Review data in relevant context -AWD 1 case -Suspected cholera 1 case -Suspected measles 1 case -Suspected malaria–doubling of cases in 2 weeks in hyper endemic areas–using RDT (WHO); OR increasing weekly trend (UNICEF) Outbreak not contained and/or in non-endemic area – limited access to treatment: CFR for AWD >2% rural CFR for AWD >1% urban AWD – duration exceed >6 wks Cholera ARI Measles Malaria Micronutrient deficiency outbreaks Anaemia Severe ≥ 40 Moderate 20 – 39.9 Mild 5 – 19.9 Severe ≤ 4.9 IndicatorAcceptableAlertCriticalVery critical Availability of iodised salt at the HH levelTBD Vaccination coverage (Measles and vitamin A) >95% 80-94.9% ANC CoverageTBD Low Birth WeightTBD Coverage of outreach programmesTBD Access to safe WASH IndicatorAcceptableAlertSeriousCriticalVery critical Population have access i) to a sufficient quantity of water for drinking, cooking, personal & domestic hygiene–min 15lts pp/ day ii) sanitation facilities 100% 100% TBC TBC TBC TBC TBC

30. IPC The Integrated Food Security Phase Classification Communication for action

31. IPC The Integrated Food Security Phase Classification Two Year - Piloting and development period (2014-2015) – 2014-15 development of IPC Prototype based on FSNAU tool, Pilot and Refine/Revise – 2016 Expected Roll-out of V.1.0 IPC Nutrition Classification Process – Technical Consultations & Deliberations combined with Country Pilots & Learning for Refinement of tool 2014 Timeline & Work Plan – Launch of IPC Global Nutrition Working Group, March 25, 2014 – First IPC NWG Meeting: June 23-25 – Development of Tools and First Round of Pilots: July – Aug 2014 (Kenya and South Sudan) – Second IPC NWG Meeting: Sept 2014 – Second Round of Pilots: Oct – Nov 2014 (Bangladesh, Haiti, and Niger) – Third IPC NWG Meeting and planning for 2015, Dec 2014 Timeline & Work Plan

32. IPC The Integrated Food Security Phase Classification Thank you Thank you www.ipcinfo.org www.ipcinfo.org