Bangladesh

Requester:

Save the Children International Bangladesh  

Background 

n September, more than half a million Rohingya crossed into Bangladesh, fleeing large-scale violence and human rights abuses in Rakhine state, Myanmar. The nutrition risks and vulnerabilities among displaced children under the age of five, pregnant women and mothers/caregivers of children under the age of 2 and adolescent girls were very high. The prevalence of acute malnutrition in all the camps among children 6-59 months exceeded WHO thresholds of 15%, The three camps had a prevalence of 24.3%, 19.3% and 15.8% respectively. All three surveys indicate that less than 16% of children were achieving a minimum acceptable diet for their optimal growth and development. The majority of the problems of malnutrition were due to poor breastfeeding and complementary feeding, and poor Infant and Young Child Feeding in Emergency (IYCF-E). 

The request  

The Institute of Public Health Nutrition (IPHN) and the Ministry of Health and Family Welfare issued a statement to reaffirm the importance of protecting, promoting and supporting infant and young child feeding practices among the affected populations. As such a Tech RRT Advisor was requested to provide IYCF-E support to the population. 

Key Achievements: 

• Finalized M&E tools 

• Finalized draft for endorsement to the Nutrition Sector of a technical guide to support infants less than six (6) months that are not breastfed 

• Coaching done bilaterally with eight (8) partners implementing IYCF activities 

• Integration of IYCF reporting with CMAM reporting requirements 

• Trained 25 Trainers for IYCFE Counselling Training 

• Reviewed a draft of the 1st National IYCF-E guidelines and the full consolidated document 

• Coordinated the IYCFE TWG during the period of the mission 

• Represented the IYCFE TWG during the Nutrition Sector meetings 

• Development of a rapid assessment tool to identify and refer infants less than six (6) months that are not breastfed 

• Supervise the ongoing rapid assessment to identify infants less than six months that are not breastfed 

• Engaged bilaterally with agencies reportedly providing BMS donations to affected populations (5 agencies) 

• Contributed in the drafting of the Joint Response Plan for 2018 

• Developed a proposal for the adaptation of the global health media video tools to be adapted in the local languages. 

Requester:  

Save the Children International Bangladesh

Background 

 Following the population movement of the Rohingya community, two rounds of emergency health and nutrition assessments were conducted in Oct- 2017 and April 2018 using the SMART methodology in the Settlements camps. The findings indicated Global Acute Malnutrition (GAM) of 14.3% in round 1 and 13.6% in round 2. Furthermore, there was high mortality above the WHO threshold of 1/10,000 persons/day in both sites in the two rounds. Chronic malnutrition for under-five children was near the WHO critical threshold (40%) in both sites. The survey showed that over half of infants and young children aged 6-23 months were anemic. In addition to the worsening nutrition situation, there was ongoing rain resulting in landslides, flooding, and sewerage system destruction of some health & nutrition facilities and shelters of the refugee community.  This deteriorated the overall camp situation, particularly the health and nutrition status of children and pregnant and lactating mothers. Outbreaks of waterborne diseases such as cholera was expected to increase the severity and magnitude of acute malnutrition. 

The request  

The purpose of the Tech RRT CMAM Adviser’s support was to provide Technical Support in improving the quality of CMAM programs by focusing on building the capacity of partners and refining monitoring tools and analytical methods through multisectoral collaboration.  

Key Achievements: 

• Reviewed and Harmonized CMAM Tools and Job Aids 

• CMAM Training Materials were reviewed and TOT Training conducted  

• Conducted Joint Supportive Supervision (JSS) 

• Developed a Guidance Note for Mobile Nutrition Team (MNT) 

• Developed Standard Operational Procedures (SOP) for Community Nutrition Volunteers 

• Standardization of service delivery for all CMAM (Minimum package) 

Requester: 

Action Against Hunger Bangladeshi 

Background 

Adaptive humanitarian response was required to address and mitigate the poor health and nutrition status of the most vulnerable population in Cox’s Bazar.  Partners had done several nutrition assessments to enlighten the challenge and develop a sound response strategy.  However, partners planned a nutrition assessment to determine the nutrition status of women of childbearing age and children under five, as well as select indicators of morbidity, mortality, and access to health services. The data collected through the survey was to help in planning and targeting humanitarian interventions. The assessment was designed to provide estimates separately for Kutupalong Refugee Camp, Nayapara Refugee Camp, and the makeshift/informal settlements outside the camps. Refugee Influx Emergency Assessment (REVA) was implemented concurrently with the SMART survey to understand the linkages between food security and nutrition information. 

The request  

The Tech RRT Assessment Advisor was requested to support the design, implementation, and analysis of the SMART survey as well as handle the external communication related to the survey with the UN Agencies, the Government, Partners, and the Assessment Technical Working Group (ATWG) and the nutrition cluster.  

Key Achievement: 

1. Developed preliminary SMART survey report 

2. Developed final SMART survey report 

3. Developed PowerPoint presentation of the preliminary SMART survey findings 

4. Developed PowerPoint presentation of the final SMART survey findings 

5. Developed training materials 

Resources

Emergency Nutrition Assessment Final Report  

Requester:

Save the Children International Bangladesh

Background

More than half a million Rohingya fled violence and conflict in Myanmar and found refuge in Bangladesh from September to November 2017. In Bangladesh, they were already Rohingya as such this huge influx of people created enormous pressure on already fragile humanitarian conditions. Nutrition among under-five children was very high requesting immediate attention. The nutrition surveys conducted from October to November indicated that the Global Acute Malnutrition among the displaced communities exceeded WHO emergency cut off points of 15% ( 24%, 16% and19% .). The assessment also indicated that children suffered frequent diarrheas, anaemia and Acute Respiratory Infection. Breastfeeding was also extremely low exacerbating the conditions.

The request

The National Strategy for Infant and Young Child Feeding in Bangladesh, states that “Every effort should be made to keep breastfeeding mothers and their children together, to re-establish breastfeeding among mothers who have stopped, and to identify alternative ways to breastfeed infants whose biological mothers are unavailable, including the provision of a healthy wet-nurse.”. Taking advantage on the already existing plan the GNC TST team was requested to 1) facilitate implementation of the IYCF-E plan, 2) Coordination of the IYCF-E through capacity building of the IYCF-E technical working group, 3) advocate and reinforce the systems for monitoring violation of the code for Breastmilk substitutes.

Key Achievements:

• Facilitated the implementation of the IYCF-E plan
• Established code violation monitoring mechanism, including acting on violations reported Integration of IYCF-E into other sectors
• Delivered an orientation on priority capacity building in IYCFE, based on the capacity building plan in the response plan
• Represented the IYCFE TWG during the Nutrition Sector meetings
• Coordinated the IYCFE TWG during the period of technical support
• Developed a draft of a technical guide to support  infants under 6 months who are not breastfed