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File: Nutrition Therapy Pdf 144525 | Enu Issue 8 Oct Dec2010
emergency nutrition update enu october december 2010 issue 8 in the spotlight emergency nutrition in large scale emergencies in this edition latest highlights on recent research in emergency nutrition updates ...

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         EMERGENCY NUTRITION UPDATE
       ENU OCTOBER–DECEMBER 2010 ISSUE 8
         ........................................................
          In the Spotlight Emergency 
                                                                                                       Nutrition 
                                                                                                       in Large Scale 
                                                                                                       Emergencies
                                                                                                       In this edition: 
                                                                                                         • Latest highlights on recent research in emergency nutrition
                                                                                                         • Updates on changes to Nutriset F75 and F100 formula 
                                                                                                           calculation
                                                                                                         • ey successes and challenges of undertaing emergency 
                                                                                                           nutrition in large scale emergencies oth gloally and for 
                                                                                                           orld ision 
                                                                                                         • ringing hope in  aistan – one mother’s eƒperience of 
                                                                                                           ho„ …†‡† is changing liˆes
                                                                                                       and as al„ays‰ lots more important pieces to eep you 
                                                                                                       updated on deˆelopments in emergency nutrition‰ „ithin 
                                                                                                       orld ision and eyondŠ
                                                                                                       œ€€L•‰ ¡UI¢£LIN£• 
                                                                                                       & ¤£…€††£N¢‡œI€N•
                                                                                                       The Latest Scoop!
                                                                                                       Nutriset has recently released updated guidelines on ho„ to calculate 
                                                                                                       F75 and F100‰ used for seˆerely malnourished children in inpatient careŠ 
                                                                                                       Nutriset’s F75 and F100 therapeutic mils come in sachets of ‹10g and 
                                                                                                       ‹5Œg and are miƒed using the follo„ing calculation: 1 sachet Ž ‘ litres of 
                                                                                                       oiled’potale „ater “ ‘Š‹ litres of therapeutic milŠ
                                                                                                        In ‘00‹‰ in response to re”uests for assistance in calculating and miƒing 
                                                                                                       smaller amounts of mil‰ Nutriset egan including a red scoop „ith its 
                                                                                                       therapeutic mils along „ith instructions on ho„ much „ater should 
                                                                                                       e added per scoop of po„derŠ •ince then‰ these instructions haˆe een 
                                                                                                       reˆie„ed‰ and the follo„ing reˆised guidelines should no„ e used for 
                                                                                                       smaller ”uantities of therapeutic mil using Nutriset’s red scoops –red 
                                                                                                       scoops specifically proˆided y Nutriset and containing Nutriset’s log on 
                                                                                                       the handle˜:
                                                                                                       F100: 1 leˆel Nutriset red scoop „ith 1‹ ml of „ater
                                                                                                       F75: 1 leˆel Nutriset red scoop „ith 1™ ml of „ater
                                                                                                       Nutrisets red scoops are included in all procurements for Nutriset 
                                                                                                       therapeutic milŠ In order to assist the aoˆe process‰ Nutriset is currently 
                                                                                                       in the process of deˆeloping smalleršsi›e sachetsŠ
                                                                                                       orld ision note – œo date orld ision’s no„ledge of the use of the 
                                                                                                       Nutriset red scoop in field settings is limitedŠ If you haˆe eƒperiences using 
                                                                                                       the Nutriset red scoop please email nutritionžcoeŸ„ˆiŠorg and let us 
                                                                                                       no„Š e are particularly een to understand „hat the ey adˆantages and 
                                                                                                       challenges you haˆe faced procuring‰ measuring‰ miƒing and deliˆering F75 
          …hild in ¥aiti  hoto y ¦on arren Noˆ ‘010                                                  and F100Š
                                                                                                                                                                                           1
       ........................................................
       £NU • €œLI¡¥œ
                                                                                                                  Submitted by Kaitrin Both,
       Nutrition                                                                                     Emergency Nutrition Advisor World Vision 
                                                                                                       Australia and World Vision International
       in Large Scale 
       Emergencies
       Large scale emergencies continue to tae     „ounded and ª million affectedŠ  rior to    Challenges
       place around the „orld‰ ranging from         the emergency‰ stunting „as estimated to      • UN capacity – œhe ¡loal Nutrition 
       rapid onset such as most recently in ¥aiti   e ‘«¬‰ eƒclusiˆe reastfeeding ‹1¬‰ and       …luster „as running at one third 
       and  aistan‰ to slo„er onset such as in     gloal acute malnutrition 5¬Š ‡s part of       of capacity at the time the disaster 
       NigerŠ In most of these situations‰ food     the UN …luster •ystem for coordination         occurred‰ in part due to lac of fundingŠ 
       and related nutritional concerns are a       in emergencies‰ the Nutrition …luster          UNI…£F indentified an internal lac 
       ma§or concernŠ                               led y UNI…£F „as actiˆated „ithin             of surge capacityŠ hile a disaster 
       €ˆer time the aility of the UN and          one „ee of the eath”uae striingŠ            response roster had een drafted 
       N¡€’s to respond to nutrition in             ¤epresentatiˆes from the UN‰                   prior to the disaster‰ there „as still 
       emergencies has improˆedŠ œhere has          goˆernment and N¡€s‰ including orld           significant need to dra„ on capacity 
       een greater coordination through            ision‰ „ere actiˆe participantsŠ              from other countries‰ „hich left gaps in 
       mechanisms such as the UN Nutrition          Highlights                                     some countries losing ey staffŠ 
       …luster‰ as „ell as deˆelopments              • ¤egular meetings enaled sharing of        • Implementing partner capacity – œhere 
       in capacity uilding‰ emergency                information et„een UN‰ ¡oˆernment           „as an indentified lac of implementing 
       preparedness‰ monitoring and surˆeillanceŠ     and N¡€’s‰ „hich assisted in                 partners for programming‰ particularly 
       hile acno„ledging the adˆances‰              identifying needs and aˆoiding oˆerlapsŠ     in the area of seˆere malnutritionŠ 
       responses in emergencies‰ particularly                                                      Finding sufficient health staff „as also 
       in large scale emergencies‰ continue to       • ¤apid agreement and dissemination of        difficult as many had een in§ured or 
       face challenges including reaching affected    a ¥aiti •pecific UN interagency §oint        diedŠ 
       populations‰ otaining accurate rapid          statement on IF£ to all operational         • Language š Locating French or …reole 
       assessment data‰ prioritising needs‰ haˆing    agencies                                     speaing nutrition eƒperts „as 
       sufficient capacity including technical‰      • ¤apid deˆelopment and dissemination         particularly challenging 
       logistical and monetary‰ and monitoring        of a UNI…£F’¥€ technical note on           • …onflicts et„een needs and mandates 
       and eˆaluating responsesŠ                      infant feeding in the conteƒt of ¥I and     – For eƒample the Nutrition …luster 
       Cluster Experience                             ¥aitiŠ                                       identified that there „as a need for 
                                                     • ¤apid proˆision of demographic              nutritional support to the elderly¯ 
       ‡ recent reˆie„ of the …ountry and             reado„n proˆided y œhe …entre for         ho„eˆer this conflicted „ith UNI…£F’s 
       ¡loal Leˆel …oordination eƒperience in        ¢isease …ontrol assisted in identifying      mandate to „or „ith children onlyŠ 
       ¥aiti follo„ing the earth”uae in ¦anuary      needs and maing programming                 ‡s such the …luster had to adˆocate to 
       ‘010 highlights some of the ey challenges     decisionsŠ                                   other groups „ho could respondŠ
       and opportunities for emergency               • •uccessful implementation of a range       • Intercepting unsolicited formula 
                1
       nutrition Š                                    of actiˆities „ithin the first month‰        – œhere „ere many groups „ho 
       …onteƒt – In ¦anuary ‘010 an earth”uae        including a „esite „here all releˆant       re”uested and accepted unsolicited 
       in ¥aiti measuring 7Š0 on the ¤ichter          information „as accessile –„„„Š             infant formula in reach of the 
       scale‰ damaged large parts of the country      oneresponseŠorgŠnutrition˜‰ mapping of       International …ode on †areting 
       including the capital  ortšauš rinceŠ          resources and gaps‰ a draft response         of reast †il •ustitutesŠ œracing 
       y mid Feruary it „as estimated that          strategy‰ and the startšup of ˆarious        and addressing this proˆed ˆery time 
       ‘17‰000 people had een illed‰ ª00‰000        programmesŠ                                  consuming
       1Š Information for the £NU sumission piece has largely een dra„n from the follo„ing articles:
       • ¢olan‰ … & erˆers‰ †Š –‘010‰ •eptemer˜Š œhe ¥aiti £arth”uae …ountry and ¡loal …luster …oordination £ƒperiences and Lessons LearntŠ Field £ƒchange‰ Issue ‘«‰ p‘š7
       • Nutrition …luster …oordination œeam and UNICEF ¥aitiŠ –‘010‰ •eptemer˜Š UNICEF’s perspectiˆe on cluster coordination and programme response in ¥aiti ‘010Š Field £ƒchange‰ Issue ‘«‰ 
       p7š™Š
       2
        ........................................................
                                                                                                                                  ¥aiti  hoto y ¦on arren Noˆ ‘010
        World Vision’s Experience                            • £nsuring a nutritionally ade”uate food           fleƒiility to leaˆe ongoing „or to rapidly 
        orld ision eƒperience and capacity                   ration for the eneficiaries                     respondŠ 
        in nutrition has continued to gro„ from             €ne challenge in particular has een                ‡ ne„ly adˆertised position‰ the 
        national office to gloal‰ particularly oˆer        repeatedly raised in recent responses¯              £mergency Nutrition •pecialist‰ „ill 
        the past fe„ yearsŠ It’s interesting to note        staff capacityŠ  has made eƒcellent               strengthen the capacity of I to 
        that many of the successes and challenges           progress in scaling up nutrition staffing           respond in a timely manner to nutritional 
        faced y the UN …luster •ystem and                  capacity in the past fe„ yearsŠ e haˆe             needs during humanitarian crisesŠ œhis 
        Nutrition …luster •ystem are not                    seen the estalishment of the  ¡loal             position „ill serˆe 50¬ of their time as 
        dissimilar to ’s o„n eƒperienceŠ †ost             ¥ealth …entre including an £mergency                part of the ¡¤¤œ‰ for deployment‰ to 
        recent responses haˆe highlighted that              ¥ealth ¢irector¯ the formation of the             largešscale emergency any„here in the 
        „hile  has een ale to achieˆe a lot             Nutrition …entre of £ƒpertise including             „orld „here  responds directlyŠ œheir 
        there remain areas for strengtheningŠ               one £mergency Nutritionist ‡dˆisor                  remaining 50¬ „ill e ased „ithin  
                                                            position‰ and the addition of a ¥ealth              …anada’s Nutrition and ¥ealth teamŠ 
        Highlights and Challenges                           and Nutrition •pecialist on the                   ¥iring is currently taing place for this 
        •ome of the ey challenges  has faced             ¡loal ¤apid ¤esponse œeamŠ In addition‰            positionŠ 
        in recent times and is „oring hard to              Nutritionists haˆe een employed in the 
                                                            ˆarious ¤egions and one …†‡† ‡dˆisor                ‡s emergencies continue to arise‰  
        address include:                                    has een hired for the ‡frica regionŠ œheir         sees to continuously to reflect on and 
         • £nsuring a ”ualified £mergency                   roles haˆe included assisting National              improˆe its aility to prepare and respond 
           Nutritionist is deployed at the onset of         €ffices and uilding capacity of staff in           to emergencies through nutritionŠ If you 
           an emergency for Nutrition & ¥ealth              areas such as …†‡† and IF£Š ¢espite                 haˆe suggestions on „ays „e can do this‰ 
           strategy and proposal deˆelopmentŠ               this oˆerall increased National €ffice              e sure to share these ideas „ith your 
         • £nsuring ade”uate monitoring &                   capacity‰ the timely aˆailaility of staff for      ¤egional Nutrition ‡dˆisorŠ
           eˆaluation systems are included in               deployment in an emergency has remained             A special thankyou to Sarah arr and laire 
           programme designs from the eginningŠ            a challenge due to staffing „orloads and           Beck or their contribution to this piece 
                                                                                                                                                               3
       ........................................................
         N£• F¤€† œ¥£ FI£L¢
        …†‡† ‡frica Update: •ummary of
        Functional Indicators and Influencing Factors •ept 200«š€ct 2010
                                                                                               Submitted by yprian uma – Arica  A  ­echnical Advisor
                                                                                  e
         Country                           a                                                                                                                ra Leone
                               Sudan       y                                                   er
                                           en
                              S.           K           Ethiopia      Somalia      Zimbabw      Nig          EDRC         WDRC         Zambia      MauritaniaSier
         Project        Tonj Sth, 
         areas /        Tonj Nth    10           13           1             2            18           2            6           2             5         2
         ADP’s          & Gogrial 
         covered        West
         Project        Up to                                 Somaliland    O in                      O in                     Phased 
         status         end of      Up to end  O              closed.       Lupane &     O            Masisi &     O           out.          O         O
         (O =           2011        of 2011                   Puntland      Rushinga                  Rwanguba                 Waiting 
         ongoing)                                             opened.                                                          for funds
                                                                            Poor –                    Poor –       Poor – 
         Food           Poor -      Very poor  Very poor  Poor –            receiving    Poor –       receiving    receiving    Poor – 
         security       receiving   – need       – need       receiving     food aid     receiving    food aid     food aid     receiving    Poor      Poor
         situation      food aid    food aid     food aid     food aid      in some      food aid     mainly       mainly       food aid
                                                                            areas                     due to       due to 
                                                                                                      conflict     conflict
                                                                                                                   Good – 
                        Poor -                                                                        Poor -       but can 
         General        cattle      Poor -       Generally    Very poor                  Moderate     sporadic     change       Generally 
         security       rustling    cattle       good         – clan wars   Good         to good      rebel        rapidly      good         Good      Good
                        and clan    rustling                  in Somalia                              attacks      due to 
                        violence                                                                                   rebels 
                                                                                                                   activities
                                                              Poor                                                             Good 
         Access to      Poor due    Moderate     Good         due to        Good         Good         Poor         Good        except        Good      Good
         population     to rains                              insecurity                                                       during 
                                                                                                                               rains
         Total          OTP=31      OTP= 66  OTP=61           OTP=39        OTP=11       OTP=47       OTP=17       OTP=21      OTP=16        OTP= 
         number of      SFP=31      SFP= 83      SFP=N/A      SFP=33        SFP=11       SFP=52       SFP=0        SFP=0       SFP=16        22 
         sites                                                                                                                               SFP= 0
         Number         OTP&SC  OTP=                                                                  OTP=                                   OTP= 
         admitted       =3096       4333         OTP=         OTP= 1216  OTP=            OTP=         1808         OTP=         OTP= 524  NA           OTP= 
         since          SFP=        SFP=         6812         SFP= 10838 385 SPF=  2877               SFP=         1649         SFP= 969     SFP=      7
         programme  9686            312734       SFP= N/A                   NA           SFP= 7622 6467            SFP= 0                    479
         setup
         Number         CV=265      CV=330       CV=560       CV=1692       CV= 210      CV= 1329  CV=333          CV= 89       CV=795 
         trained in     MOH=10  MOH=53  MOH=                  MOH=11        MOH=23  MOH=              MOH=14  MOH=53  MOH=36  DU                       DU
         CMAM           WV=44       WV=82        173          WV=95         WV=4         282          WV=6         WV=11        WV=12
                                                 WV= 14                                  WV=16
         Recovered      85%         >80%         85%          82%*          70%          77.4%        90%          97%          85%
         Deaths in      <3%         <3%          <3%          <3%           <3%          3.9%         <3%          <3%          <3%
         programme
         Default        14%         <15%         1.7%         9%            24%          13%          6%           2%          6%
                                                                                                                               53% 
         Coverage       67.1% in    63% in       67% in       42.7% in      >50%         <44% in      76%          53% in      Sinazonwe 
                        Tonj Sth    Turkana      Durame       Burkahaba                  Maradi                    Lwambo      & 67% 
                                                                                                                               Musele
         CV = Community Volunteers, OTP: Outpatient therapeutic programme, SFP: Supplementary feeding programme, ADP: Area development programmes, CMAM: 
         Community management of acute malnutrition DU: Data unavailable CV: Community Volunteers MOH: Ministry of Health *Average figure between SFP& OTP
        4
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...Emergency nutrition update enu october december issue in the spotlight large scale emergencies this edition latest highlights on recent research updates changes to nutriset f and formula calculation ey successes challenges of undertaing oth gloally for orld ision ringing hope aistan one mother s eperience ho is changing lies as alays lots more important pieces eep you updated deelopments ithin eyond l ui lin n scoop has recently released guidelines calculate used seerely malnourished children inpatient care therapeutic mils come sachets g are mied using folloing sachet litres oiledpotale ater mil response reuests assistance calculating miing smaller amounts egan including a red ith its along instructions much should e added per poder ince then these hae een reieed reised no uantities scoops specifically proided y containing log handle leel ml nutrisets included all procurements order assist aoe process currently deeloping smallersie note o date noledge use field settings limited if epe...

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