nutrition month 2014 presentation

7/21/2019 Nutrition Month 2014 Presentation

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2014 Nutrition Month


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OUTLINE

1. Nutrition Month theme and objectives

2. Why nutrition in emergencies (NiE)

3. Nutrition management in emergencies

- Nutrition Cluster

- Minimum Nutrition Service Package

4. Current resources available

5. Preparedness checklists

6. Strengthening NiE preparedness


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THE PHILIPPINES

WARM OCEAN WATERS

DEFORESTATION

COASTAL HOMES

RING OF FIRE

UNDERDEVELOPMENT

Available at: http://news.nationalgeographic.com/


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THE PHILIPPINES

Annual Disaster Statistical Review 2012, CRED


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Annual Disaster Statistical Review 2012, CRED

THE PHILIPPINES


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To promote interventions to address nutritional

needs in emergencies and disasters including

preparedness, response and recovery

To mobilize responders to address gaps in

nutrition in emergency response

To increase awareness on coping and resiliencystrategies to prevent malnutrition and worsening

of nutritional status

Objectives of NM 2014


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Nutrition services that are part of

emergency preparedness, response and

recovery to prevent deterioration ofnutritional status and death

Nutrition in emergencies (NiE)


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Nutrition services include:

Nutritional assessment

Infant and young child feeding promotion,protection and support

Management of acute malnutrition

Micronutrient supplementation

Other food or non-food-based interventions

Nutrition in emergencies (NiE)


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To prevent death and protect the right of

nutrition

Malnourished population groups more

vulnerable to illness and death during

emergencies

Affected populations more likely to experience

malnutrition due to lack of food and water,

poor access to health services, civil insecurity,

inadequate delivery of assistance

Why is NiE important?


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Philippines Nutrition Facts and Figures, 2011



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19.5 % of Filipinos are anemic 55.7% infants 6-11 months most effected

42.5% pregnant women

15.2% of 6 mos-5 y/o children have Vitamin Adeficiency

Iodine level among pregnant women below

recommended level 66.9% households did not meet their dietary

energy requirements.


Source: DOST-FNRI. 2008 National Nutrition Survey.


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Acute malnutrition

severe decline in nutritional status in short

period of time of insufficient intake of food

and/or from infections and other illnesses

marked by muscle wasting

Nutritional problems during

emergencies


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Chronic malnutrition

long term effect of undernutrition

manifested by stunting and impairedphysical and mental development


emergencies


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Micronutrient deficienciesVitamin A, iron,

iodine

disrupted food supply

incidence of illnesses, particularly diarrhea,

which impairs nutrition absorption and

increases the need for these micronutrients


emergencies


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Adoption of the National Policy on Nutrition

Management in Emergencies and Disasters To guide actions for provision of quality

nutrition and related services to minimize risk

of further deterioration of nutritional status

NNC GB Resolution No. 2 s. 2009

Nutrition in emergencies


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Institutionalization of the Cluster Approach inthe Philippine Disaster Management System,

Designation of Cluster Leads and their Terms of

Reference at the National, Regional and

Provincial Level

National Disaster Risk Reduction Management

Council Circular No. 5, Series 2

Nutrition in emergencies


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Health

NutritionNNC as Chair

Water, Sanitation and Hygiene (WASH)

Mental Health and Psychosocial Support

Implementation of Cluster Approach

DOH Department Order 2007-2492A s. 2007:Creation of the Health Cluster with Sub-Clusterson Nutrition, WASH and Health


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Expanded Agency Partners

ARUGAAN


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Role of Nutrition Cluster

To ensure that nutritional status of affected

populations will not worsen

Facilitates strategic collaboration andcomprehensiveness of emergency

management, resource mobilization and

integration of cross-cutting nutrition concernswith other clusters


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The Nutrition Cluster

National Nutrition

Cluster

National Level

Regional NutritionCluster

Regional Level

Local Nutrition ClusterProvincial/City

Municipal/Barangay Level

Global Nutrition Cluster


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Minimum NutritionService Package

Also called Recommended Nutrition Cluster

Response

Guide for the national, regional and local

nutrition clusters on actions for emergencymanagement


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Timeline National/Regional

Nutrition Cluster

Local Nutrition

Cluster

Pre-disaster 1. Set up system for

updating logistics2. Advocacy to

partners on

supplementary

feeding3. Capacity building

on NiE

1. Formulate

emergencypreparedness plan

on nutrition

2. Capacity building

3. Resource mappingand prepositioning



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Timeline National/Regional/Local Nutrition Cluster

Alert Phase 1. Update resource inventory

Vitamin A capsules

Multiple micronutrient powders

Ferrous sulfate with folic acid tablets

IEC materials for nutrition

Mid-Upper Arm Circumference (MUAC)

tapes

Weighing scale

Weight-for-height reference table

Height board

Ready-to-use therapeutic food (RUTF)



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Timeline National/Regional/Local Nutrition Cluster

Alert Phase 1. Update resource inventory

Ready-to-use Supplementary Food (RUSF)

Antibiotics, deworming tables Human milk banks

Breastfeeding kit (container/katsa, feeding

cup with cover, food container with spoon

and fork, 1 L glass tumbler with cover, IECmaterials, birth registration form)

2. Mapping of partners using the 4Ws

Who, What, When and Where



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Timeline National/RegionalNutrition Cluster

Local NutritionCluster

Pre-emptive

evacuationphase (alert

warning)

1. Coordinate with

partners onsupplementary

feeding and

setting-up of

breastfeedingspaces in

evacuation

centers

1. Set-up

supplementaryfeeding for 6-59

months old

children, pregnant

and lactatingwomen



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Nutrition Cluster

Local Nutrition

Cluster

Pre-emptive

evacuationphase (alert

warning)

2. Alert notification

to health facilitiesregarding

management of

severe acute

malnutrition

2. Vitamin A

supplementation3. Set-up BF corners/

spaces in

evacuation centers

4. Activate teams



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Local Nutrition Cluster

Pre-emptive

evacuation

phase (alertwarning)

3. Activate rapid

assessment

teams, IYCFsupport groups

4. Pre-deployment

5. Conduct Cluster

coordination

meeting

5. Refer cases of severe

acute malnutrition

(SAM) with infectionsto Integrated

Management of

Acute Malnutrition

referral hospitals

6. Conduct Cluster

coordination

meeting



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Nutrition Cluster

Local Nutrition

Cluster

Within 24

hours ofimpact

1. Deploy

assessment team

1. Deploy

Assessment team2. Conduct Rapid

nutrition

assessment



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Timeline National/Regional Nutrition

Cluster

Local Nutrition

Cluster

Within

25-71hours

1. Establish contacts; gather

baseline and identifyimmediate priorities

2. Assist in gap analysis &

planning of nutrition

interventions3. Disseminate daily

situation report

1. Conduct

assessment ofInfant feeding

in emergencies

2. Cluster

coordination3. Planning for

intervention



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More

than 72

hours

1. Provide technical

assistance

2. Resource

augmentation and

generation

3. Policy monitoring ofMilk Code (EO 51)

4. Lead/facilitate cluster

coordination

initiatives

1. Implement

nutrition

interventions

Rapid screening

for acute

malnutrition usingMUAC tape



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More

than 72

hours

5. Advocacy for services

6. Activate 3Ws

7. Technical assistance

for exit strategy

Blanket & targeted

supplementary

feeding

Integrated

management of

acute malnutritionactivity

components



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More

than 72

hours

Promotion, protection &

support of IYCF in

emergencies

Micronutrient

intervention

2. Informationmanagement

3. Referral for psychosocial

high-risk cases



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More

than 72

hours

4. Referral to WASH, health

clusters and other

interventions

5. Cluster coordination

6. Policy monitoring of the

Milk Code (EO 51)7. Develop exit strategy



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To identify level of malnutrition in affected

area

To identify severe and moderate acute

malnutrition cases for immediate treatment

and referral

Nutrition Assessment


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Within first 2 days following emergency

Gathering of anthropometric data

Mid-upper arm circumference (MUAC)

Weight and height

Sex, age

Presence of bilateral pitting edema

Target groups: Infants, preschoolers

Data provide magnitude and severity of crisis

Rapid Nutrition Assessment


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Rapid assessment tool

Relief assistance

Shelter

Food security

Sanitation facilities

Health

Nutrition

Child protection

Communication

Access

Emergency education situation



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Assessment of food security access to food

Main sources of food

Percentage of households with food stocks

Life span of existing food stocks

Access to local markets

Availability of clean water at 15

liter/person/day



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Nutrition Presence of donated formula milk

Availability of other nutrition interventions

Micronutrient supplementation

Breastfeeding areas




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Standardized Monitoring and Assessment ofRelief and Transitions (SMART)

Helps determine extent of emergency

response to meet needs of affectedpopulation

Measures nutritional status of children

under 5 and mortality rate



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Nutrition Interventions Against Malnutrition

FOOD BASED NONFOOD BASED

Food Ration or

Family Food Packs

Emergency SchoolFeeding

Food for Work

SupplementaryFeeding

Therapeutic Care

Cash for Work

IYCFE

Health and nutritionservices

Micronutrient

Supplementation andFood Fortification


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Feeding Program against Malnutrition

Blanket Supplementary

Feeding

Targeted Supplementary

Feeding

Provision of food

supplements to all identified

vulnerable groups

To prevent nutritional

deficiencies to affected

population and further

deterioration of nutritionalstatus of children identified

with moderate acute

malnutrition (MAM)

To improve moderately

malnourished children,

pregnant and lactating

women with infants less than

6 months of age, and those

individuals with medical

conditions Protect malnourished

children under 5 y/o from

diseases/death


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Vitamin A

Infants 6-11 months old (100,000 IU)

12-59 months old (200,000 IU)

Lactating mothers (200,000 IU) children with severe diarrhea, pneumonia

and severely underweight unless given the

same dose in the past month children with measles regardless when the

last supplementation was provided

Protocol for micronutrient supplementation


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Iron 5 mg elemental iron/0.6 ml for low birth

weight infants starting from 2 to 6 months

1 tablet 60mg iron with 2.8 mg folic acidweekly for non-pregnant and lactating

women 10-49 y/o

1 tablet 60 mg elemental iron with 400 mcgfolic acid daily to all pregnant women for 180

days starting from determination of

pregnancy



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Iron Therapeutic dose of iron supplements to

anemic patients less than 10 years old

10-49 years must be given 1 tablet of 60mg elemental iron with 400 mcg folic acid

daily until hemoglobin level becomes

normal


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Micronutrient Powder (MNP) 60 sachets for children 6-11 months

120 sachets for children aged 12-23 months

can also be given to children 2459 months,pregnant and lactating mothers

Oral rehydration solution and zinc supplements

Children with diarrhea, given not less than 10

days


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Active nutrition screening through MUAC orweight-for-height

Children 6-59 months old

11.5 cm to


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On screening

Within 1 week

After 2 months

K i f di i f t i


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1. Appropriate (IYCF) practices promoted,protected and supported as infants and young

children are most vulnerable to illness and

death. Exclusive breastfeeding in the first 6 months

Provision of appropriate, safe

complementary foods starting at 6 monthswhile continuing breastfeeding for two years

and beyond

Key concerns in feeding infants in

emergencies



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2. Monitor Milk Code violations

Donations covered by law include infant

formula, bottles and teats

DOH Administrative Order 2007-0017

Guidelines on the Acceptance and

Processing of Local and Foreign Donations

during Emergencies and Disasters


emergencies



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3. Establishment of Mother-Baby Friendly Spacesin evacuation areas

Safe and comfortable venue

Avail of information, counseling and support

4. Wet nursing, tandem nursing, cross nursing,

feeding with donated breastmilk


emergencies


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Mother-Baby Friendly spaces

Why donations of breastmilk substitutes


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1. infant formula are not sterile and may becontaminated

2. lack of safe and clean water, utensils and fuel to

prepare formula and sterilize bottles and teats3. insufficient knowledge on preparation and use of

artificial feeding may result to over or under

dilution of infant formula


are not allowed during emergencies



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5. infant formula does not contain protectiveproperties such as antibodies found in

breastmilk

6. poor sanitation increases risk of contaminationduring preparation

7. supplies of infant formula are often not

sustainable after the emergency


are not allowed during emergencies


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1. Human resources/technical assistance Global, National and Local Nutrition

Clusters

Barangay Nutrition Scholars

Infant and Young Child Feeding support

groups

Volunteers

Other organizations

Resources available during emergencies

il bl d i i


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2. Materials NiE Training Manual for LGUs

Operational Guidelines on IYCF in

Emergencies Documentation from DOH and other

local and international organizations

IEC materials on nutrition and nutrition

in emergencies

il bl d i i


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c. Sphere Handbook, Humanitarian Charter

and Minimum Standards in Humanitarian

Response

Universal standard for humanitarianresponse (visit www.sphereproject.org)

d. Communication and reporting National to local nutrition cluster

Global Nutrition Cluster


LGU P d t iti h kli t
http://www.sphereproject.org/http://www.sphereproject.org/


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LGU Preparedness nutrition checklist

Packaging of Nutrition in Emergencies (NiE)Training Kits and conduct of NiE and IYCF-E

training

Early Warning Information and Disaster Risk

Reduction and Management Orientation among

employees and residents

Inventory of essential micronutrients and other

resources Implementation of Regular Program on Nutrition

Updating of database of NiE trained personnel

Cluster Coordination Meetings

LGU P d t iti h kli t


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Inventory of essential micronutrients and other

resources Vitamin A capsules

Multiple micronutrient powders

Ferrous sulfate and iron with folic acid tablets

IEC for Nutrition

MUAC tapes

Weighing scale

Weight for height reference table Height Board

Ready-to-Use Therapeutic Food (RUTF)

Ready-to-Use Supplementary Food (RUSF)

Antibiotics, deworming tablets

LGU Preparedness nutrition checklist

Family emergency


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Store 3-day supply of:Water stored in clean plastic bottles (2 L for drinking and

2 L for food preparation and cleaning per person, per day)

canned sardines/meat/fruits/vegetables

canned juices/milk for adults cup noodles

dried fish/fruits

high energy foodspeanut butter, crackers, jelly

foods for infants/elderly/persons on special diet

comfort foodsbiscuits, hard candy, instant cereal, instant

coffee

paper cups, plates and plastic utensils

Family emergency

preparedness checklist

Family emergency


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Families with breastfeeding children should

prepare BF Kit with:

malong

feeding cup with cover

food container with spoon and fork

1 liter glass tumbler with cover IEC materials

Birth registration form

Family emergency

preparedness checklist

Ways to strengthen nutrition in


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1. Organize local nutrition clusters, identify roles

and responsibilities and lines of authority

2. Build capacity of local nutrition clusters oncluster coordination and nutrition in

emergencies management

3. Give attention to rapid nutrition assessment

4. Foster participation of other sectors


emergencies preparedness/response



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5. Strengthen logistic systems and ensure

availability of supplies

6. Establish human milk banks

7. Early detection of cases of moderate and

severe acute malnutrition

8. Organize and sustain IYCF support groups


emergencies preparedness/response


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Lets do our part!

Provide for the future

Donate

Be informed

Be concerned and save lives

Spread the message

Be alert, be prepared


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For more details:

National Nutrition Council

2332 Chino Roces Ave Extn., Taguig City

http://www.nnc.gov.phfacebook.com/nncofficial

youtube.com/user/NNC1974

[email protected]. (02) 843-0142 Fax. 843-5818

nutrition month 2014 presentation

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