Yemen

Requester:

ADRA

Background

 More than 18 million people required health services including 7.5 million children and pregnant women who required nutrition services.  To respond to the challenge, ADRA’s Multi-sectoral Assistance and Nutrition Response II program was implemented in Southern Yemen and responded to the health, nutrition, and WASH needs of vulnerable communities in the governorates of Abyan, Lahj, and Al-Dhale’e. In addition, the program strengthened the health systems' support, creating expanded access to basic primary health while the nutrition sector focused on maternal infant and young child nutrition (MIYCN) and management of acute malnutrition. Both sectors worked closely to provide for the needs of the most vulnerable, however, the MAMI approach was not considered. 

The request 

ADRA recognized the suitability for MAMI approach in Yemen and wanted to incorporate it into MANR-II to place a greater emphasis on integrated care for nutritionally at-risk mothers and infants under 6 months. As such ADRA requested GNC Technical MAMI support.

Key Achievements 

• Conducted an orientation for MAMI pathways to ADRA 

• Conducted MAMI Care Pathway adaptation workshop targeting 21 ADRA staff 

• Developed MAMI Care Pathways and materials for program implementation 

• Conducted a 3 day MAMI care pathway training targeting 18 health workers from 9 health facilities. 

• Conducted MAMI webinar for incorporation of MAMI into ADRA nutrition and health project  

Requester: 

ADRA 

Background 

Due to brutal conflict, Yemen was devastated by triple tragedy: famine, cholera, and the daily deprivation and injustice resulting. 

Since March 2015 Yemen experienced conflict which displaced over 3 million people; 2 million IDPs were affected. A needs analysis in July 2017 found that about 20.8 million people needed assistance to meet basic needs, an increase of almost 10 percent in the past year. The worsening humanitarian situation was widespread across the entire country with nearly 22 million people in need of humanitarian assistance of which 11 million were in acute need. The April 2018 Integrated Food Security Phase Classification (IPC) update showed that the food situation deteriorated since the last IPC analysis done in October 2017. Abyan, Lahj, Ad Dhale, and Sana’a governorates were forecasted to drop into IPC4: Emergency by June 2018. A cholera outbreak which commenced in September 2016, significantly affected the country with 121 districts in 21 Governorates affected and more than 1,000,000 suspected cases.  More than 2,200 people died from the epidemic, and the World Health Organization (WHO) predicted that the risk of a new instance was high.  

The request 

The goal of the Technical Support was to support the understanding and use of basic practical behavior change planning and methodologies such as “Designing Behavior Change”, as the basis for evidence-based SBC activities particularly in the nutrition and WASH activities of ADRA’s OFDA- and FFP-funded programming in Yemen. It was anticipated that the SBC plans will impact all programming sectors including Agriculture/Food Security and Early Recovery of Market Systems

Key Achievements 

• Developed DBC, BA, and FGD training materials, including PowerPoints, handouts, facilitator and participant manuals, and brief summary reports of rain.

• Developed BA and FGD reports on key behaviors (2-3). 

• Developed SBC implementation/action plan. 

• Developed draft roll-out plan. 

• Developed a lessons-learned report 

• Conducted an online presentation of the mission (PPT or Prezi) that augments the report, provided to backstop staff at ADRA International. This includes participation in a webinar – one or more remote sessions with ADRA senior staff (in Yemen and Maryland) and possibly other interested parties to foster information sharing and follow up. 

Requester: 

ACF Yemen 

Background 

Due to ongoing conflict in Yemen, humanitarian partners estimated that 21.2 million people, 82% of the population required humanitarian assistance to meet their basic needs. Malnutrition was among the major challenges and estimated that 4.5 million people required treatment and prevention services for malnutrition.  Under-five children, infants, pregnant and lactating women were the most affected.  The situation was worse in IDPS. Of the 4.5 million people in need, nearly 2.2 million were estimated to be acutely malnourished, including 462,000 children suffering from severe acute malnutrition (SAM) and 1.7 million children affected by moderate acute malnutrition (MAM) mostly in IDPS.

In Yemen, a significant technical capacity gap was identified by the Assessment Working Group (AWG) and agencies representing the nutrition cluster. Due to the absence of adequate technical knowledge of representative assessments, including SMART methodology, the functionality and accountability of the AWG were challenged. 

The request 

The GNC TST support was requested to contribute to strengthening the overall emergency nutrition response by building the capacity of response stakeholders in the design, implementation, analysis, and reporting of nutrition assessment at national and sub-national levels.  

Key Achievements 

• Reviewed all of the 2011-2017 Yemen Nutrition Assessments from the Yemen Humanitarian Response repository and created a nutrition assessment database. 

• Facilitated a one-day workshop attended by 7 individuals from Assessment Working Group (AWG) agencies that discussed core indicators (and accompanying questions) to be included in all Governorate level SMART surveys. 

• Facilitated a two-day Yemen Nutrition and Mortality Guideline workshop that was attended by 9 individuals representing AWG agencies. The objective of the workshop was to present all proposed sections that will be included in the Guideline and agree on content. 

• Created a draft version of the Yemen National Guidelines for Conducting Integrated Anthropometric and Mortality Surveys.

Requester:   

Save the Children 

Background 

Conflict in Yemen spread to 21 of Yemen’s 22 governorates prompting a large-scale protection crisis and compounding an already dire humanitarian crisis brought on by years of poverty, poor governance, conflict, and ongoing instability. The 2013 Yemen National Demographic and Health Survey (YDHS) estimated that as little as 10% of children under six months were exclusively breastfed. In addition to breastmilk, 26% of infants under six months were given water, while 3% were given non-milk liquids and juice, and 30% were given milk other than breastmilk. Furthermore, 24% of infants under six months were given complementary foods and breast milk. By the age of 6-9 months, only 65% were given complementary foods. 44% of infants under six months were fed using a bottle with a nipple. 

The request 

Following a review of IYCF practices in Yemen in November 2016, using a tool from WHO, the need for a national IYCF Strategy was identified by the MoPHP and partners. As such the main aim for this TST was to support the development of this national strategy and IYCF-E Emergency response plan. 

Key Achievements 

• Development of the final draft National IYCF Strategy for 2017-2021. 

• Development of a draft IYCF-E Response Plan for 2017. 

• Strengthening of the IYCF TWG through revision of the ToRs; organization and chairing of several meetings during deployment; and the development of an action plan for Q2. 

• Revision of the national BMS Reporting Format and set-up of a reporting mechanism. 

• Revision of the Joint Statement on IYCF – endorsed by the NC. 

• Revision of key IYCF indicators for intersectoral assessments – shared with ICCM. 

• Capacity building through orientation on IYCF-E and BMS for 26 nutrition cluster members; one-day training on IYCF for 17 Save the Children (8) and Ministry of Social Affairs (9) CP staff; and provision of an orientation session on IYCF for Save the Children’s media and communications team. 

Resources 

Yemen IYCF response plan 

IYCF Technical Working Group Terms of Reference

BMS Code Violation reporting form 

Joint statement calling for IYCF support 

IYCF-E Orientation to the nutrition cluster 

International Code of Marketing  BMS- Presentation 

IYCF Strategy 

Requester: 

IMC 

Background 

Yemen was gripped by a combination of civil conflict and drought that left an estimated 21.2 million people (82% of the population) in need of some form of humanitarian assistance, including 10.3 million who were in acute need. An estimated 14 million people were food insecure, including 7 million people failing to find their next meal. About 3.3 million children and pregnant or lactating women were acutely malnourished, including 462,000 children under 5 suffering from severe acute malnutrition. This represented a 63 percent increase since late 2015 and threatened the lives and life-long prospects of those affected. 

In 2016, the nutrition cluster agreed on a joint CMAM program scaling up, with the objective of drastically increasing the geographical coverage and program convergence. 

The request 

The GNC TST support was requested to support and strengthen the implementation of Community Management of Acute Malnutrition (CMAM) programs through the provision of technical support and capacity building to the nutrition cluster members. 

Key Achievements 

• Updated National CMAM guidelines, standards, and protocols to international standards and Yemeni context zero drafts shared with the nutrition cluster 

• Finalized and shared CMAM Protocols (field cards/quick referral cards)  

• Shared CMAM barrier/obstacle and SWOT analysis findings and recommendations  

• Updated reporting and monitoring tools per the revised guidelines. 

Requester: 

IMC 

Background 

Ongoing conflict continued to devastate Yemen. Humanitarian partners estimated that 21.2 million people 82 % of the population, required humanitarian assistance to meet their basic needs or protect their fundamental rights. Malnutrition rates were rising in Yemen, and partners estimated that 3 million people required treatment or prevention services for malnutrition, a 65% rise in people in need since late 2014. Children under the age of five – including infants – and pregnant and lactating women were the most affected. Of the 3 million people in need, nearly 2.1 million are estimated to be malnourished, including 320,000 children suffering from severe acute malnutrition (SAM) and 1 million children affected by moderate acute malnutrition (MAM).

The request 

The Yemen CMAM protocol was developed in 2013 and therefore was not in line with the latest 2013 WHO recommendations and did not allow a context/need-based implementation of nutrition services. In order to enable the scale-up response to reach its objective, a revision of the CMAM protocol was therefore needed. Primary work was done with inputs from partners shared with MoH – In order to ensure a timely consolidation and finalization of the revised protocol, GNC TST support was requested.

Key Achievements 

• Developed final and updated CMAM National Guideline.