Mozambique

Requester:  

UNICEF 

Background 

Mozambique faced severe drought due to the impact of  El Niño weather patterns. The Food and Nutrition Security Assessment conducted by SETSAN (Technical Secretariat for Food and Nutrition Security) in March 2016, indicated that approximately 1.5 million people faced acute food insecurity and required urgent humanitarian assistance. Based on the aforementioned assessment, the drought was expected to contribute to a state of acute malnutrition in over 190,000 children aged 6-59 months in the 6 provinces including  86,000 pregnant and lactating women. However, there was criticism of the assessment process and concern that response planning was adversely affected by weak data and analysis.  As such there was a need for a technical expert to improve the quality of data available so as to build the emergency response. 

The request  

The GNC TST Assessment Advisor was requested to contribute to strengthening the overall emergency nutrition response by building the capacity of stakeholders in the design, implementation, analysis, and reporting of nutrition assessments.  

Key Achievement 

• Led anthropometric demonstration sessions for (MUAC, weight, and height) at the national level SETSAN Assessment (SA) training, led MUAC standardization test training, and helped to organize and conduct MUAC analysis for 11 provinces MUAC-only standardization tests (first time for SA) 

• Organized a quality check mechanism using the Emergency Nutrition Assessment (ENA) plausibility checks throughout the SA data collection in the 6 provinces collecting all anthropometry measurements. 

• Created a document for Strengthening Future SETSAN Assessments.   

• Attended Nutrition cluster meetings to provide SA updates and short-term recommendations.   

• Provided preliminary analysis for all 6 drought-affected province data and final results reports for Tete, Manica, Gaza, and Inhambane provinces.   

Requester:  

UNICEF and Save the Children 

Background 

Mozambique faced severe drought in the southern region and parts of the central region due to El Niño prevailing conditions. CMAM programming in Mozambique was beset by numerous difficulties including supply chain bottlenecks, poor reporting at all levels, and a low level of supportive supervision at health facilities. In addition, poor services of SC care and OTP/TSFP services, weak community outreach, and a limited number of partner organizations with high-level technical capacity for Nutrition in Emergencies. The food security and nutritional assessment of the Technical Secretariat for Food Security and Nutrition (SETSAN) released in March 2016 estimated that 1.5 million people were food insecure and in need of urgent food assistance in seven provinces (Maputo, Gaza, Inhambane, Tete, Manica, Sofala, and Zambezia). The Ministry of Health, in collaboration with its nutrition partners,  devised an Emergency Preparedness and Response Plan to scale up nutrition services in the 6 affected provinces, focusing on accelerating nutritional screening and SAM/MAM treatment at the community level.

The request  

A Tech RRT CMAM Advisor was requested to strengthen the overall emergency nutrition response by building the capacity of response stakeholders in the design and delivery of CMAM programs. Particularly focusing on the intensive community outreach component as well as providing a combination of technical training, strategic advice, and operational support on CMAM implementation and rollout to all cluster members (75%). Specific additional support to COSACA agencies (25%).

Key Achievement 

• Developed tools and job Aids for CMAM in an emergency, shared with COSACA partners and Nutrition cluster for comment and review. 

• Screening tools for CV, Monitoring and Evaluation checklist for nutrition managers/officers, and community mobilization engagement shared for comment and adaptation with Nutrition Cluster. 

• Powerpoint presentation CMAM training tools for health/Nutrition staff produced and shared with COSACA members and Nutrition cluster coordinator. 

• Field visit and partial partners review meeting attended for Tete. A report was produced and shared with NCC. 

• Technical Working Group Term of Reference developed and shared with Nutrition Cluster. 

Requester:  

UNICEF  

Background 

430,000 people were displaced due to violence in Carbo Delgado and Nampula in Mozambique. 43% of the displaced were children. Among others, the displaced community suffered diseases, climate shocks, and marginalization. COVID-19 further exacerbated the food insecurity of already vulnerable populations such that 53% of children were chronically malnourished while 160,000 people faced food insecurity and 225,000 stress. The health system was weak in managing Internally displaced people despite at the verge of a cholera outbreak. The Ministry of Health and the Nutrition Cluster agreed to conduct a nutrition assessment with financial support from UNICEF and WFP to excavate the nutrition situation particularly the priority area of intervention and the most affected districts.  

The request 

In order to conduct a well-informed and properly monitored nutrition SMART survey, the GNC Technical Alliance TST adviser was requested. The TST adviser was to support the design, monitoring, and implementation of the SMART survey which would help raise funding and advocacy. 

Key Achievement 

• lead in protocol   development working closely with UNICEF focal point, and in consultation with a taskforce 

• Training of 48 enumerators and 12 supervisors, standardization test, field test, implementation of 11 rapid SMART assessments 

• Overall survey oversight of the whole exercise on data quality and technical challenges in the field including monitoring data collection and analysis 

• Supported data analysis including anthropometric  

• Conducted refresher training after survey round one and provided recommendations shared in final report 

Requester:  

UNICEF  

In Mozambique  Maternal mortality rate (MMR) remains high at 452/100,000. The infant mortality rate (IMR) reduced from 93/1,000 live births in 2007 to 67.3/1,000 live births in 2017  with wide disparities, ranging between 49.4 in Maputo City 83.1/1000 live births in Gaza. Despite the progress, indicators related to maternal, neonatal, infant, and child health remained dismal in Mozambique and were further aggravated by the indirect impact of COVID-19. Mozambique has the highest rates of neonatal mortality in the world (30 deaths per 1000 live births or 28 per 1000 using the latest estimates. The most significant challenges are attributable to prematurity, infections, and birth complications such as asphyxia which are preventable if key bottlenecks are addressed at the service delivery level. Furthermore, there is high rates of adolescent pregnancy which increased from 38 percent in 2011 to 46.4 percent in 2015; it is one of the major risk factors for maternal and neonatal mortality (3,4) and is linked to persistent high rates of child marriage, at 48 percent. In addition to teenage pregnancies and early marriages, there were ongoing conflicts in Cabo Delgado affecting 1.5 million people, and 58% of children, in need of humanitarian assistance and protection.

The request

The Management of Small and Nutritionally At-risk Infants Less than 6 Months and their Mothers (MAMI) Care Pathway Package offers an opportunity to strengthen the capacities to systematically identify nutritionally at-risk infants u6m and to ensure proper quality care for infants u6m and their mothers. As such the GNC TST was requested to provide MAMI support in Mozambique.

Key Achievements

• Conducted capacity assessment and mapping of existing MAMI services and produced a report
• Conducted a ToT MAMI training for cluster partners and a conducted a MAMWI care pathways workshop.
• Conducted a MAMI presentation to IYCF-E TWG
• Developed IYCF-E TWG action plan