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