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In line with the World Humanitarian Summit Health consultation, the purpose of this framework is to outline WV’s basic package of Health and Nutrition services in different types of emergencies, the types of interventions and technical approaches to be employed. 

STRATEGY Addressing the health and nutrition needs of populations affected by disasters has always been a priority focus for World Vision. The Emergency and Nutrition Framework is integral to World Vision’s work during an emergency response because it leads to improved health outcomes for children and communities affected by disasters. It also helps to ensure consistent, quality results. World Vision’s responses for Health during emergencies are aligned to the universally-agreed Sphere Minimum Standards for Health in Action.

OBJECTIVE: TO REDUCE MORTALITY AND MORBIDITY IN VULNERABLE POPULATIONS AFFECTED BY HUMANITARIAN EMERGENCIES AND RESTORE ACCESS TO CURATIVE AND PREVENTATIVE HEALTH AND NUTRITION SERVICES.

OUTCOME 1: Vulnerable groups such as women and children can access essential health and nutrition services in the immediate aftermath of a disaster.

SERVICES: Provision of lifesaving health, psychosocial and nutrition services in acute phase of emergency or in the event of health system collapse.

Examples: Establishment of WAYCS incl. IYCF services, Mobile Medical Services, CMAM screening and treatment units

OUTCOME 2: Health and nutrition systems are strengthened to meet the immediate and longer term needs of the affected populations.

SERVICES: Strengthen basic package of primary health, psychosocial and nutrition services (incl. RMNCAH) by partnering with and building capacity of the Ministry of Health at national, district and health facility level.

Examples: staffing support, provision of supplies, resourcing trainings, rehabilitation and equipping health facilities

OUTCOME 3: Families and communities are supported to understand, monitor and protect themselves from public health risks, ensure each other’s wellbeing and access to health and nutrition services.

SERVICES: Support community and family health by recruiting, equipping, training and strengthening supervision of CHWs (Health posts) to undertake community mobilization, health

DRDDR

education, referral system strengthening, surveillance and where appropriate health-focused conditional cash transfers.

Examples: provision of job aids, digital platforms, IEC materials, incentive provision, health and hygiene promotion BCC, surveillance of disease and malnutrition.

OUTCOME 4: Early Warning and Surveillance are established to enable rapid detection and response to public health issues of concern.

SERVICES: Strengthen assessment, monitoring and surveillance diseases of outbreak potential at community and Health Facility level (incl. communicable diseases and malnutrition)

Examples: HeRAMS, EWARN, HIS, training and support to health workers with case definitions and reporting, observational assessments, SMART surveys.

OUTCOME 5: Inter-agency level health and nutrition coordination platforms (area / country / regional levels) are supported, effective and meeting key needs of target groups

SERVICES: Coordination and advocacy with the humanitarian community in order to inform and contribute to cluster and inter-agency initiatives.

Examples: contribute data and information to the Health and Nutrition Clusters, feed into planning and appeals, advocate for specific needs in areas of operation.

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ds over time (prosurveys, FDGs, Klection on IYCF a

AM and SAM in aroor nutritional sts appropriate and

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ming i.e. changes ipopulation moveuld include scale

nt / scale up of C

conditions, PLHIV

ood shortages, inficators of househ

oportion of CMAKIIs or support naand if possible Mreas of operationtatus pre-emerged to contribute t

g data and informpping, ensure WVent. ic and supplemen

in health and hygement up of existing CM

CMAM / IMAM th

V do not have acc

festation of food hold food insecur

AM admissions froational surveys wUAC screening.

n and aggravating ency. Use WV trito overall country

mation. V’s role is determ

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giene promotion m

MAM / IMAM, He

hrough:

cess to ARVs.

crops, significantrity. om the total numwith resourcing, st

factors against biggers for action. y level surveillanc

mined and MoUs

messaging, chang

ealth and WASH

tly increased

ber screened). taff, logistics

enchmarks. ce efforts.

are in place.

e in the type of

interventions

‐

‐ ‐

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‐ ‐ ‐ ‐

Identificsupplies

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wards. Resourc

units). Resourc Collabo Provisio Support Provide Ensure Link wit Where

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ere availability an

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cation and mappins, equipment etc.)g and mobilizatiot the scale up of ce and organize t

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e BSFP in additionall nutrition and fth food aid to en populations are s through MMS inYCFe g of existing suppling and educationopriate establish WHWs. Provision of

nity volunteers eh provision of safe the provisions o

milk Substitutes –f micronutrientveillance througand CHW record

nd access to quali

ssment of availabedicines, medical al bilitation of HFs d

ng of SC / OTP / ) n of CHWs throstaffing where re

trainings with Mo

trainings with MoEF and WFP to etine medicines, m with monitoring

n to TSFP during food aid suppliessure packages aredisplaced as a resn coordination w

port services at cn for PLW, and rWAYCS or strenf resources accor

engaged in these ae feeding kits.

of the Operationa– ensure code viot deficiency thogh observation, suds and reports.

ty health services

bility and quality osupplies, equipme

damaged by disas

SFP sites to supp

ough HFs and DHquired i.e. incent

oH in CMAM for

oH / DHO in CMnsure regular sup

medical supplies ag and reporting annutrition emerge meet with WV pe appropriate forsult of food insecith MoH and the

linic and communre-lactation suppongthen existing serding to WV comactivities. Ensure

al Guidance on inolations are monitugh the provisionupporting active c

s is poor impleme

of health servicesent and kits acco

ter

port in conjunctio

HO. Support with tivizing MoH staff

HWs at all levels

AM for Health popply chains of RUand equipment (innd ensure serviceency or if food dispolicies including r context and nutcurity and access Nutrition Cluste

nity levels such asort. ervices to providemmodity list such support to artific

fant feeding in emtored and reportn of micronutriencase finding mech

ent the continuin

in areas of operarding to need and

on with MoH and

active recruitmef to increase wor

s (including clinica

osts / CHWs. UTF, RUSF and suncluding anthropoes are of sufficienstribution is not the WVI milk potrition needs. to nutrition cura

er.

s breastfeeding c

e all aspects of th as infant feeding cially fed children

mergencies (IFE) ted. nts to food aid dehanisms, SMART

ng response healt

ation d WV commodit

d full needs asses

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al training for SC

upplementary fooometric and Hosnt quality (IQA toin place at the onolicy.

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and the Internati

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th activities listed

ty list

ssment of site cap

ts / CHWs wheremanage SC in add

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od. spital equipment fool). nset or if there a

ifficult, implemen

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tions. T surveys, mass s

d in Type I:

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e required. ition to existing

s with existing

for SCs).

re problems.

nt nutrition

rt groups,

ng HWs, SBAs s and ir mothers i.e.

arketing of

screening

‐

‐

‐ ‐ ‐ ‐ ‐ ‐

LINK

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ufficient time peri

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bolstering Healthth equipment andng of MoH staff anblic health measuroductive and Ma

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OTHER SECTORS

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vices (where app

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S

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s the next rainy s

ropriate) i.e. to r

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h causal analysis ad food assistance

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rate to identify valth promotion a

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season and harve

reach displaced co

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ulnerable beneficactivities th and hygiene ca

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to meet the need

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mmunity Gender issues

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ated Health

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mation cable diseases wi

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aternal child on-

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ESSMENT

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ALTH SYSTEMS S

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sessment of avng at availabilit

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national and districhnical represento establish opporBOs to assess op

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delivery care inclunization: EPI, IMC

ssessment and tr

treatment and coease prevention agovernment heal

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NG - PRIMARY H

rary measures of insecurity, fearEstablish MMS annjunction with nanditional Cash To pooled (insuranar panels) for col

acity building –

ere it is a standaloict level for progrtatives for sharingrtunities for collapportunities for p

uality of healthy, human resou

uding EmONC, pCI

eatment (CMAM

ontrol: preventionand management lth services, conddicines, equipmens, donors and othnutrition resource

HEALTHCARE

in the event ofr of movement od temporary HFsational / local autransfers (CCT) fonce) funds. Underld chain, repair oWhere Health ca

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partnership and c

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postpartum care,

M / IMAM) and IYC

n, diagnosis, treat(includes chronic

duct an assessmennt and medical suher NGOs and toes).

f health systemr remote locatios providing PHC horities and the hor predictable hertake structural rf infrastructural dadres are insuffic

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capacity building.\

eas of operatioent and medici

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vention and treat

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here communitpulation is living irequired with natonsider Health canancy related, chHFs damaged by dng etc. consider alternati

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will provide within

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utrient

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nering with

‐

‐

‐

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other aid agencclinician associalocal medical staand nutrition toor take on additDHO to recruitfocus on commProvision of mkits such as IEHmedicines. Provrules and regulaStrengthen reProvision of cascommunication the event of an operating. Advoneeded in partnActivate Rapigeographical aredeployment as wStrengthen Rehealth policy an Provide Support

referralwithin cbenefitswomenconduct

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STI / HI

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medicines, medHK, Italian Traumavision of hygiene mations allow. Hireeferral through psh transfers for re equipment at all emergency. Streocacy with the Henership with MoHd Response Meeas in coordinatiowell as planning teproductive and MNCH in Eme

e Reproductive Ht essential materns for appropriatecritical 24 to 48 hs of colostrum an. In contexts whet camp and HH vt family planning sriate distribution;s and through heaIV prevention and

linicians on jointlyes in whose origi

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Ws and help to man and education.

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e pharmaceutical provision of vehiceferrals and medi health facility levngthen promotioealth Cluster to i

H / partners such echanism – wheon with clusters ato meet health annd Maternal, Neergencies guidelinHealth Kits: (blocknal and newborn e services i.e. EmOhours after birth nd early initiation ere there is no covisits and provideservices: where c; provision of posalth posts througd management: p

y supported clinicn and medical trad area. Address kProvision of incennational protoco

anage prioritizatio nd equipment fH kits, clean deliv

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ks 1-5) to CHC a care: where posONC which vehiand to provide co of breast-feedingommunity health support to womculture / controllst-rape kits includgh training and jobprevent and contr

cs, consider woraining is from theknowledge gaps tntives for MoH stl and in consultat

on of their worklo

from WV commovery kits, diarrhe

n and Control. If td develop systemsreferral vehicles weliveries and childios and Satellite pworks through trpathways for speccent movement. nd safe, deploy Hs. Provision of bass on a longer terhild Health (RM

and PHC sible and feasiblecles and resourcommunity educatg). Where SBAs a network, hire an

men with maternaing entities allowding (PEP) – RHKb aids and ensurerol STIs/HIV thro

king with Red Cre country of emerhrough resourcintaff and volunteetion with MoH, doad. In contexts

odity list to CHCal disease kits (wtransportation is s to monitor supwithout ambulatod health, immunizphones). Ensure craining / mobilizatcialized services.

H&N RRM team tsic H&N services

rm basis. MNCH) at supp

locate and mobiing where approption on essential are not accessiblend train national sal and newborn ca

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rescent and consrgency. When long and/or leading ers required to wdonors and the H with no CHW n

C, PHC, Health powhere appropriate not feasible, con

pply and usage. ory equipment buzation) esp. if privcommunities knotion of HF staff aProvide Ambulan

to investigate chas, health promoti

ported HFs –in

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work additional hoHealth Cluster. W

etworks, hire nat

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ow how to contacnd CHWs wherences to designate

anges in the situaton and related N

line with WV rep

tablishing referraSBAs to undertakaternal care (therdelivery kits to vismunity health foc

ntion to HFs and ation at all levels al culture and cusamming and awar

with expatriate ng, consider rimary health ours, relocate

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o need including PHC standard hase as donor

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tion in different NFIs during each

productive

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CHWs for of health

stoms. reness raising

‐

‐

‐

throughsupplies

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h health facilities. s. t to victims of Se one trained stafftive. Provide specling entity, work ng and confidentid to SGBV.

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port at the HH levparedness (see tpreparedness plane continuity and sygiene promotionn and preventativof case definitionsd and equipped toequip national stazed due to higherds i.e. by distribut campaigns (esp.

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ns with provision ure health post / unctioning and lev

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work then train aWAYCS. ment) nal and district levrces. gh PHCs, tempor

methods. Provide procedures. Equipand hygiene promcted community , including transah facilities and sureposition reserveblets, insect repeging health workeeholders are awarcontributing to thnd partners about of vehicles, fuel, CHW coverage avel of function. W

e STI case manage

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rary health structresourcing for tr

p staff with appromotion on HH vis members to proctional sex. pporting medicale stocks of materllent, soap, and d

ers in case definitire. Provide HFs whe HIS and EWARt cases of disease incentives and suand continuation

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e there is no func

tures and MMS wrainings for HWs opriate IEC matersits. Where thereovide camp and H

waste disposal arials and suppliesdisinfectant and hions, reporting anwith test kits. SupRN - monitor wee with outbreak pustenance for vac of community lect Health Office t

provision of medic

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tioning MoH, col

which include info in coordination wrials and NFIs. Ene is no health pos

HH visits. Ensure t

and enhancing vec at HFs that suppand sanitizer. nd referral mechpport with transpeekly or monthlypotential. ccination teams. evel health and nuto actively recruit

cines and

vate space and AYCS as an unity / t for incident vors / those

d (PFA) to proving case Ensure at least ort for CHWs ocus to provide

llaborate with

ormation about with the MoH

nsure CHWs st or CHW treatment of

ctor control port personal

anisms and portation of y

utrition t where gaps

‐

‐

‐

‐

LIN‐

‐

‐

exist and securicommunication target groups i.eeducation. WheStrengtheningnecessary condumorbidities in cand sex. Submitpriority diseasesdata and to guidis manually tallieto implement a implemented. Nutrition survand CHW recoStrengthen acmalnutrition hasStrengthen IYHFs and in the clactation. Suppoalready engagedadolescent and appropriate for women’s healthcomponents of

KAGES WITH OWASH: coordinoutbreak. WherProtection: idenfor IYCFe. YoutLivelihoods: cas

ty allows. Additio devices and incee. LLIN, hygiene ere there is no Cg health monitouct assessments aonjunction with tt surveillance ands and health condde decision-makined (cross check d database i.e. DH

veillance througords and reports sccess to nutritis previously been

YCFe initial WAcommunity such ort existing servicd in these activitieyoung child space standalone WAY

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gh observation, sushowing # screenon curative ser

n a health problemAYCS intervenas breastfeeding

ces to offer the fues with refresher es (WAYCS) as sYCS and authoritate room with as

mentioned in Type

RS oration on HF reand trucking is ree beneficiary groues and observatiogram collaboratio

ensure they offer propriate. Supporbs. Where coverre and train natioeillance – ensurather additional inother agencies. CaHealth Cluster olementary data c

ort to HFs with aaper records at H decided by the w

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ehabilitation, healtequired collaboratups, collaborationon of the increaseon

the full range of rt health promotirage is non-existeonal staff to undee supported healnformation. Ensualculate accurate

on a regular basis onsistently from

accurate data collHFs). Where therworking group. E

case finding mechsions over time. Mappropriate i.e. esd food aid shortas listed in type 1 ing and education

ort to women as ources such as ines where there irvices are adjoine possible. Ensurecal terminology f

th and hygiene cation to ensure inn on meeting thee in CHH and FH

services throughion initiatives, ed

ent, ensure MMS ertake communityth facilities contrre HFs use stand population catch as required and other relevant soection avoiding dre is no functioninsure HFs in area

hanisms, Rapid SMMonitor and repostablishment / images (as per type and 2) Strengthen for PLW, and s detailed in the Wnfant feeding mods need and adapted or incorporatee messaging and sfor WAYCS mod

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MART surveys orort violations of tprovement of IM 1)

en IYCFe supportskilled breastfeed

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trategy in the eve facilities. s of SGBV, CFS in

on of job aids, IEribution of commalth promotion a. HIS and EWARNinitions for all repd estimated propoy required changesurveys, to interpbeneficiaries wheh the MoH and H

contribute to HeR

r full SMART whethe BMS code of

MAM / CMAM wh

t services already ding support, incluy providing HWs erials. Establish wes (i.e. in MEER ithere this is the cawith the context

ding space.

ent of a waterbor

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es in regards to pret surveillance re information

Health Cluster RAMS where

ere feasible, HF conduct. here

provided at uding for re- and volunteers

women, t may not be ase create a t and the

rne disease

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If recoo

ASE OUT / RECO

ecovery stage is aordination with th

OVERY

anticipated to lasthe MoH to ensur

t longer than 4 me ownership and

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end to expand andetail the handover

d continue abover at the close of t

e interventions. Pthe project.

Phase out should

be done in

TY20Ofteshou

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occur during Type3 emergency.

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ally triggered s of trends or al notification of

er of cases. Once s done the MoH outbreak and

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appropria

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ss of prevention aion and mortalityons – timely and go care and treatmte facility level ealth support for

o routine health so clean water andn from Mosquito<5years and oldercial support with IYCF practic

formation amidstte channels

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and Nutriti

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ces monitoring of

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