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Working together for the nutritional health of
vulnerable populations
Nutrition Sub-Cluster of the Health and Nutrition Cluster Кластерная группа по питанию Кластера здравоохранения и питанияhttps://www.humanitarianresponse.info/operations/ukraine/nutrition
Health Cluster
The overall objective of the Health Cluster Response is to reduce avoidable morbidity and mortality associated with the conflict and subsequent displacement.
Objective 3: To prevent excessive nutrition-related morbidity and mortality of vulnerable groups including acutely malnourished children pregnant and lactating women (PLW) and elderly.
Indicator: Number of vulnerable groups including children pregnant and lactating women (PLW) and elderly reached out with interventions to support, protect and promote appropriate nutrition
Why this presentation?
• Importance of protecting, promoting and supporting safe and appropriate infant & young child feeding (IYCF) -& the nutrition of other vulnerable groups (PLW; elderly)
• Inform what the current context in eastern Ukraine means for nutrition
• Identify the need for nutrition-specific & nutrition-sensitive approaches, targeting the most nutritionally vulnerable groups
Protecting, promoting & supporting nutrition
Children <2 years most vulnerable to illness & death
- Critical period for physical, mental & emotional development
- Age-specific nutrition needs; risk of infection; complete dependency
on others for care
Infants should receive breast milk exclusively until the age of 6
months, followed by the introduction of soft, semi-solid & solid
complementary foods, while continuing breast-feeding up to the age
of two years or beyond
Appropriate and timely support of IYCF-E saves lives
Context in eastern Ukraine
• Suboptimal young child feeding practices
- Low rates exclusive breastfeeding , infants <6 months (mean 13.8% ; 25.8%)
- Mixed feeding –breastfeeding and infant formula (intro mean 3.1 mo; 4.2
mo)
- Use of teas & water for infants <6 months (intro mean 3.1 mo)
- High use of bottles/teats (mean 68.1% - 72.5%)
- Early introduction of complementary foods (mean 4-5 mo)
- Duration of continued breastfeeding (mean 31.8%; 53.5% at 1 year)
• Indiscriminate distributions of infant formula by agencies
• No elevated wasting in children 6-23 months (prevalence below 1%)
Context in eastern Ukraine (cont.)
• Financial/ affordability constraints
• Disruption to social support networks
• Low capacity of health services to support optimal feeding
(HR; finance)
• Maternal psychosocial stress
(UNICEF - Save the Children IYCF-E Assessment June 2015: IDPs. Kramatorsk; Sloviansk; Svytahirsk; Kharkiv; Dnipropetrovsk; Zaporizhia)
Reasons for stopping breastfeeding of child <2 years: (HHQ n=114)
(UNICEF - Save the Children IYCF-E Assessment June 2015: IDPs. Kramatorsk; Sloviansk; Svytahirsk; Kharkiv; Dnipropetrovsk; Zaporizhia)
28.1% caregivers children <2yrs (45% infants <6 mo) stopped breastfeeding due to stress related to conflict “Stress made my milk dry up”. …No time to wait in queues…Lack of social interaction with other mothers/friends…
9 KEYS MESSAGES
‘Nutrition-sensitive’ & ‘Nutrition-specific’
Nutrition-specific interventions address the immediate causes of under-nutrition, like inadequate dietary intake and some of the underlying causes like feeding practices and access to food
Nutrition-sensitive interventions can address some of the underlying and basic causes of under/malnutrition by incorporating nutrition goals and actions from a wide range of sectors. They can also serve as delivery platforms for nutrition-specific interventions
”Seek to integrate psychosocial considerations as relevant into all sectors of humanitarian assistance” (IASC. 2007)
IYCF - MHPSS Sector Linkages
Formulating integration of sectoral activities• Assess/monitor/evaluate mental health/psychosocial issues & needs of mothers
with young children
• Promote gender- & age-disaggregated information systems incl registration
• Know & communicate the linkages between mental health & nutrition
• Collaborate with nutrition sector to develop key messages & resources
• Promote exclusive & continued breast-feeding & responsive feeding
• Support the controlled distribution & use of infant formula
• Support activities for caregivers (peer support & action-oriented groups
• Build staff capacities to integrate psychosocial support & infant feeding
• Ensure caregiving support for dependants of maternal mental health concern
• Train staff on identification of cases of feeding concern
• Establish coordinated referral systems for cases of concern
Nutrition sector
• A minimum response on Nutrition Emergency Interventions must be
coupled with a specific set of complementary psychosocial and emotional
relief interventions to greatly enhance a positive outcome of interventions
• Nutrition programmes that contain a psychosocial component are more
effective in promoting growth and positive child development than
nutritional programmes without a psychosocial component. They may also
help to decrease maternal depression
Integrating MHPSS activities into the Nutrition sector• Support training of nutrition/IYCF staff on basic psychosocial counselling
• Psychosocial support and education for appropriate feeding practices be
provided to caregivers
• Integrate psychological and social impacts into nutrition analysis
• Implement activities that strengthen mothers coping adaptation
mechanisms & psychosocial well-being, to improve feeding practices (e.g.
peer support & action-oriented activities; counselling)
• Ensure referral of caregivers with potential mental health issues or
depression to appropriate psychosocial services
• Collaborate with the MHPSS sector for development of communication
strategies, design of activities, capacity-buildings…
THANK YOU Nutrition Sub-Cluster of the Health and Nutrition Cluster Кластерная группа по питанию Кластера здравоохранения и питанияhttps://www.humanitarianresponse.info/operations/ukraine/nutrition