Somalia

Requester:   

UNICEF- NCC

Background 

In 2016, a mixture of drought, soaring food prices, and conflict led to a serious deterioration of the humanitarian situation in Somalia.  In the preceding years, the country-wide median prevalence of Global Acute Malnutrition (GAM) was significantly higher than the WHO emergency threshold of 15%. While in 2016, nutrition analysis revealed a sustained critical nutrition situation and acute malnutrition was a significant public health problem due to famine. Humanitarian actors, on the other hand, were concerned about the use of Breastmilk substitutes. However, many nutrition actors including non-traditional actors such as business members, well-wishers, and government authorities did not have experience in IYCF and hence could not provide concrete advice to reduce breast milk substitutes. 

The request  

A Tech RRT support was requested to develop an IYCF-E response/action plan, provide capacity building on IYCF-E Practices, provide guidance on BMS monitoring and management of BMS donations, provide guidance on the establishment of breastfeeding safe and strengthened linkages between health, nutrition, and WASH sectors focusing on IYCF-E. 

Key Achievement 

• Conducted a response planning workshop where partners developed IYCF-E indicators, an action plan, and a timeline for IYCF Activities 

• Created Breastmilk Substitute management guidelines with a clear reporting system 

• Developed a technical specification sheet for Mother Baby Areas (MBA’s) 

• Conducted training on IYCF-E practices, including BMS management and how to set up and run MBAs for members of multiple sectors (WASH, Health, Nutrition, MOH, etc) 

• Advocated for integration of IYCF-E indicators in existing and future programs

Requester: 

African Relief Development Initiative  

Background 

Protracted conflict leading to internal displacement, droughts, locust infestation, famine, and the COVID-19 pandemic affected communities’ sources of livelihoods, food security, and public health including a high prevalence of malnutrition. African Relief Development Initiative (ARD) provided nutrition, food security, livelihood, and WASH intervention to communities in Somalia. ARD previously supported UNICEF in nutrition activities such as screening and treating severe acute malnutrition in OTP, IYCF-E, and Expanded Program for Immunization. Despite efforts provided by ARD, their capacity was shrinking due to untrained staff in the Integrated Management of Acute Malnutrition (IMAM). 

The request 

ARDI requested support from the Global Nutrition Cluster Technical Alliance (GNC Technical Alliance) to build the technical capacity of their team; initially focusing on NiE-IMAM training. 

Key Achievement 

• Delivered a presentation about GNC Technical Alliance, and proposed activities for ARD 

• Conducted ARDI staff capacity assessment. 

• Supported training scheduling for ARDI staff 

• Supported ARDI self-administering training and conducted a post training webinar  

Requester: 

Jubba Valley Development Center 

Background 

Over 4.1 million people across Somalia, or over 25 percent of the total population, needed urgent humanitarian food assistance to prevent food consumption gaps or the accelerated depletion of livelihood assets. According to the results of 39 separate nutrition surveys, Global Acute Malnutrition (GAM) in Somalia remained very high across all survey results.  Non-food drivers of acute malnutrition, such as high morbidity, low immunization, low vitamin-A supplementation, and low access to clean water, have maintained elevated GAM levels in Somalia for several years. Jubba Valley Development Center (JVDC) is a local organization that has been working to support vulnerable populations including internally displaced and drought-affected populations including children under five and PLWs in the Gaher area of Wadjir district in Banadir region. The organization also aims to improve maternal and child health (immunization, antenatal care & postnatal care), nutrition (screening, SFP, sensitization, short projects for distributing food), communicable disease surveillance, water, sanitation and hygiene (WaSH), human rights activism and culture conservation.    

The request 

JVDC seeks to improve access to nutrition services, however,  faced with several challenges including low and irregular funding and limited technical capacity of staff. JVDC, therefore, requested support from the GNC Technical Alliance to provide technical capacity building for their staff to deliver high-quality treatment of both SAM and MAM services.  This will help them improve nutrition delivery and attract funding. The GNC Technical Alliance contacted Action Against Hunger Somali to provide support to JVDC on behalf of the GNC which is part of the localization effort that the GNC is promoting.  

Key Achievement 

• Conducted nutrition in emergencies capacity assessment of JVDC staff and develop a capacity assessment tool 

• Conducted a 5-day in-person training on the prevention, early detection, and treatment of acute malnutrition. 

• Developed action plan with JVDC and conducted a weekly mentorship taking JVDC Staff to ACF sites 

• Developed evaluation form. 

Requester:

UNICEF 

Background 

Somalia faced the worst drought since 2017, resulting in a significant increase in the prevalence of acute malnutrition among children, and pregnant and lactating women.  According to the Food Security and Nutrition Analysis Unit (FSNAU) 2021, Global Acute Malnutrition (GAM) affected more than 15% of children under 5 years of age. More than 370,000 children were estimated to be affected by severe malnutrition.  To alleviate the burden, UNICEF scaled up its treatment of Severe Acute Malnutrition (SAM) targeting 80% of health facilities with an integrated SAM approach. However, aside from SAM, there was poor Supplementary feeding and blanket feeding such that more than 600,000 children and women were at risk of malnutrition and mortality. To mitigate this, UNICEF together with partners proposed a comprehensive strategy to guide the management of MAM and SAM.  

The request 

The Somalia Nutrition Cluster led by UNICEF developed a draft Standard of Operation Procedures to help partners implement Integrated Management of Acute Malnutrition (IMAM). Given that this approach was new to partners, UNICEF requested Technical Support from GNC to help in expediting the process. 

Key Achievement 

• Developed Simplified approaches to SOP document  

• Developed PowerPoint slides for Standard Operational Procedure 

Resources 

CMAM simplified approaches  

Report on training of facilitators o Inpatient Management of SAM

Requester:  UNICEF  

Background 

According to the DHS 2020, 12% of children were wasted and 27.8% were stunted. Anemia and Vitamin A deficiency were also prevalent at 43% and 34% respectively. In addition, poor infant and young child feeding practices were among the drivers of poor malnutrition in Somalia. UNICEF developed a 2021-2030 nutrition strategy and call upon Somalia to promote nutrition particular Maternal Infant Young Child and Adolescent nutrition (MIYCN). Maternal, infant, young child, and adolescent nutrition (MIYCAN) is a package of interventions that are essential in preventing malnutrition in children, adolescents, and women. The Somali National nutrition strategy prioritizes the implementation of MIYCAN interventions in Somalia. There was a need for guidelines that provide a clear direction for the implementation of the MIYCAN program as well as ensure the provision of all the required tools for smooth implementation, monitoring, and evaluation.

The request 

The MIYCN guidelines and tools strategy wasn’t updated (developed 2011-2018) as such in view of changing global recommendations there was a need to update the strategy. The updated strategy would help the government and CSO to implement it, especially at the point CSO signed a multilateral partnership with UNICEF to implement MIYC across the country. Therefore, with regard to the urgency of the guidelines UNICEF requested technical support from the GNC to develop the strategy. 

Key Achievement 

• Developed and inception report for the MIYCN process which was shared in the country with MoH 

• Developed MIYCN operational and programmatic guidelines which was validated by the Technical Working Group and shared with MoH. 

• Developed MIYCN training and operational toolkit to support the implementation of the guideline 

Requester: 

UNICEF Somalia Nutrition Cluster  

Background 

Somalia faced the worst drought since 2017, resulting in a significant increase in the prevalence of acute malnutrition among children, and pregnant and lactating women.  According to the Food Security and Nutrition Analysis Unit (FSNAU) 2021 Deyr season and Follow up Assessments nutrition surveys, the overall Global Acute Malnutrition (GAM) prevalence was estimated to affect 13% of children under 5 years with some districts having more than 15% GAM. In 2022, it is projected that 44% (1.5 million) of the children under 5 years would be acutely malnourished, including 386,000 severely malnourished. To address the rising cases of acute malnutrition, UNICEF scaled up its treatment of severe acute malnutrition (SAM) integrated into health facilities and outreach/mobile reaching over 80% of the affected population in the accessible areas.  Low coverage of service especially TSTP continues to affect the continuum of care. The poor coverage of TSFP and other nutrition-preventative interventions e.g., Blanket Supplementary Feeding Programme (BSFP) exposed over 600,000 children under five and women to elevated risks of mortality. 

The request 

To mitigate the effects of the poor TSFP coverage, the Somalia Nutrition Cluster proposed a comprehensive strategy to guide UNICEF, WFP, and Nutrition Cluster Partners to scale up its acute malnutrition treatment interventions to address the gaps in the management of MAM, alongside the management of SAM, for children under 5 years.  Though a draft SOP was developed it required technical, as such the Somalia Nutrition Cluster team requested additional support from the GNC Technical Alliance.  

Key Achievement 

• Developed simple, comprehensive Standard of Operating Procedures 

• Developed PP slides based on SOP 

Requester: 

Somalia Nutrition Cluster  

Background 

Four consecutive failed rainy seasons increased economic pressures deepening the severity of needs and driving the country to the brink of famine.  An estimated 49% of the population – 7.7 million people – required humanitarian or protection assistance, of which 6.13 million were estimated to be affected by the drought.  

More than 6 million people across the country were food insecure, including nearly 1.7 million who were suffering from extreme levels of hunger.  An estimated 2.4 million people required services to treat or prevent malnutrition, including nearly 386,000 who required treatment for acute malnutrition – 1.5 million children under 5 and more than 250,000 pregnant and lactating women (PLW). A total of 6.4 million people lacked access to safe water and sanitation, and 6.5 million people lack access to adequate healthcare.  

UNICEF, WFP, and the Nutrition Cluster partners scaled up the nutrition response to address the deteriorating nutrition situation across the country. There were 82 partners (both international and national) implementing CMAM (either SAM, MAM treatment, or both) across all accessible areas in Somalia. The nutrition response included treatment of acute malnutrition services including an outpatient therapeutic program, stabilization n centers (SCs), and a targeted supplementary feeding programme. To prevent the overall mortality associated with acute malnutrition, UNICEF and Nutrition Cluster (with Somalia Humanitarian Fund finances) embarked on scaling up the coverage of SCs, by establishing an additional 7 SCs and improving the quality of care provided in the existing facilities.  

The request  

The Objective of the support was to provide technical leadership, and training, in the development of a standard operating procedure to support operational partners in Somalia in the decision-making and implementation of certain simplified approaches for the community-based management of acute malnutrition.  

Key Achievement 

• Developed a response plan for proper planning and preparation of activities 

• Developed Stabilization Centre Quality Checklist  

• Developed orientation and training package 

• Conducted training of identified local partners   

• Developed capacity synthesis report  

Requester 

UNICEF

Background 

According to Somalia Demographic Health Survey, (SDHS). In 2020, 12% of children were wasted, 27.8% suffered from stunting and 235 were underweight. Anemia and vitamin A deficiencies were prevalent among children under five at 43% and 34% respectively as per Somalia Micronutrient Survey, 2019. The main drivers of nutrition were poor infant and young child feeding practices. The UNICEF Nutrition Strategy 2021 to 2030 emphasized the prevention of malnutrition first and calls for countries to scale up efforts to prevent malnutrition. Maternal, infant, young child, and adolescent nutrition (MIYCAN) is a package of interventions that was essential in preventing malnutrition in children, adolescents, and women. The Somali National nutrition strategy prioritizes the implementation of MIYCAN interventions in Somalia.  

The request  

Realizing the importance of the MIYCAN strategy, there was a need to update the strategy and guidelines including the development of tools. Furthermore, since guidelines changes over time, it was critical to review the existing guideline to reflect global guidelines. The new guidelines will help partners effectively implement the MIYCAN program. As such the Somalia Nutrition Cluster requested the support of the GNC TST for the development of the guideline. 

Key Achievement

Developed inception report for MIYCAN

Developed MIYCAN operational and programmatic guideline

Developed a draft MIYCAN toolkit

Conducted a validation workshop to discuss the MIYCAN operational and programmatic guidelines and next process.

Conducted training and orientation to partners in the usage of the guidelines