1. 1 Emergency Nutrition Response in Whole of Syria MAP 13 th – 15 th October, 2015 GNC Annual Meeting, Nairobi, Kenya

2. Country Context 2 Pre-crisis (Nutrition Indicators)Current Situation GAM prevalence U5 was 9.3% (7 % MAM & 2.3 % SAM) GAM prevalence U5 of 7.2% (2.3% SAM and 4.9%MAM) Stunting level of children U5 was 23 % Stunting U5 22.3% IYCF indicators: 43 % Exclusive Breastfeeding 63% EBF 46% initiating breastfeeding within the first hour of birth Nd 37% providing timely introduction of complementary food Nd Micronutrient deficiencies: 29.2% anemia and 12.9% iodine deficiency Nd

3. Nutrition sector Coordination Structure WoS Nut sector (UNICEF &ACF) Jordan (H&N WG) (WHO/UNICEF) Gaziantep Nut Cluster (UNICEF/GOAL) Damascus Nutrition Sector (UNICEF/MoH) Four Sub-National Coordination

4. Overview of Needs Assessments and Analysis Nutrition Cluster used the findings from the below surveys to develop Severity Ranking Scale in order to inform strategic priorities of response:  2009 Syrian Family Health Survey.  2014-15, a series of Rapid Nutrition Assessments conducted from Damascus, among IDPs in 13 of the 14 governorates. 3 SMART surveys, 1 KAP study and 1 Anemia Survey conducted from Cross border through Turkey (IDP and Host communities in 3 governorates) + 1 SMART survey conducted through cross border from Jordan.  Monthly 4Ws data  Findings of other sectors such as Food Security, Health and WASH are also used to identify needs. →Conducting assessments inside Syria is one of the main challenges due to security, capacity and sensitivity. 4

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6. Syria SRP: 2015 Strategic Nutrition Priorities 1.Promote preventive nutrition services for vulnerable groups (IYFC, micronutrient & optimal maternal nutrition) 2.Strengthen the systematic identification, referral & treatment of acutely malnourished cases (use of standard guidelines & treatment products) 3.Promote nutrition situation analysis using standard tools + screening for children & women 4.Promote response and practices enhancing nutrition well- being of Syrians through multi-sectoral analysis, integrated response, coordination & capacity strengthening

7. Gaps in Resource Mobilization  Highlight key gaps (max 6 bullet points):  Human Resources:  Capacity of partners to implement NiE interventions and to scale-up  Insufficient capacity of cluster leads in coordination of NiE interventions  Restrictions on the work of INGOs inside Syria  Supplies:  Gap in procurement of MAM supplies and supplies for in-patient SAM treatment  Access restrictions to deliver supplies to partners and beneficiaries  High influx of uncontrolled BMS  Financial:  Only 18% ($8.5 M) of the total sectoral needs ($ 48 M) for WoS is funded 7

10. Challenge at WoS level 1.Limited level of data details available (dependent on hub); no recent national data is available for situation analysis 2.There is no sector-wide nutrition strategy and CMAM operational Guideline adapted to the Syrian context 3.Despite advocacy, partners facing challenges of capacity, visa, authorization to operate in the 3 hubs (due to host government procedures) – hampering capacity building activities 4.Unique programme environment hence different approaches in Jordan, Syria, S/Turkey, Lebanon & Iraq  capacity, coordination with government vs policies, etc 5.Dealing with multiple governing structures; e.g. SSG, UNCT, ISCCG, etc & derive the complementarity to enhance program outcome 10

11.  Breastfeeding is being undermined by a proliferation of myths/misconceptions about breastfeeding.  Widespread donations and untargeted distributions of breastmilk substitutes (BMS) and other milk products,  Lack of skilled support for breastfeeding mothers  Negative influence of private sector on IYCF-E  Lack of appropriate support for children with no possibility to breastfeed.  Lack of complementary foods; concern about the poor micronutrient content of food and restrictions on CF.  Patchy health services with little IYCF/IYCF-E capacity  Poor/strained WASH facilities impacting on ‘safe’ infant feeding outcomes. 11 Specifically on IYCF-E