Nutrition Sector Coordination Meeting MinuteDate and Venue: 10th April 2014, CRS Conference Hall

Attendees: 17 participants of the present Absent: none

Objectives: 1. Approval of the provisional agenda and Review of the action points from the previous meeting

2. Emergency and nutrition cluster programs update2.1. Update on emergency response to Southern Sudanese 2.2. Review and build consensus on CHF reserve fund for emergency3. Review and endorsement of emergency response framework4. Knowledge sharing – IMC's SQUEAC for Hamedia IDP Camp OTP

(Coverage, Barriers and Boosters, and recommendations)Agenda Item #1:

Approval of the provisional agenda and Review of the action points from the previous meeting

Issues/Points Discussed

No change to the minute

Decisions/Recommendations

Provisional agenda approved by members and No changes made to the previous meeting minutes.

Agenda Item #2:

Emergencies and Nutrition cluster program update

Issues/Points Discussed

Reporting Overall Successful and encouraging February reported: CIS, CRS, Concern, IMC, RI, WV, SpRC and WV –

successfully piloted using the formats March: ARC, CIS, Tearfund, CRS, Concern, RI, WV, SpRC and CRS Major issues – incompleteness on some of basic information, IMC stated

that a deadline on the 3rd of each month is difficult for partners. Emergency updatesAs per reports received from reporting partners during the month of March SD, ND, ED, WD, CD and South Kordofan were emergency affected areas. Total of 186,492 affected people reported of which 31,946 were children and 5,637 were PLWs. Response made so far – in all areas BP-5 distribution and CMAM services are provided. While the CMAM services provision is reflected in performance report the BP-5 distribution is not fully captured. Critical Gaps/Major Challenges and agreed action In ED Lack of PHC unit in Aljalabi around 20 km away from Eddaein

UNICEF and MoH to follow up with Health Sector and Health Ministry, respectively

SK-Talodi: Need for food and NFIs. SK – Abujubiyah : • Increased number of defaulters due to populations movements • The coverage limited to IDPs settlements, while most of beneficiaries comes from outside program catchment areas who need follow up and monitoring • Lack of adequate SMOH staff and high dependence on volunteers who need close follow up and monitoring • Poor security situation to modify strategy of service delivery including mobile clinics

Boys Girls PLW Male Female12,659 14,417 5,637 62,336 67,4454,870 24,765

SD-Marshang: Security situation, IDPs want to relocate. Strategic issue to be dealt with in to be established SAG of NCC

CD – Umm Dhukun: Insecurity situation interrupting service delivery in some locations. Tearfund stopped operating nutrition outreach activities in Salaley location, following security concerns as advised by the HAC and NS. As a result 51 OTP/222 SFP beneficiaries have not received therapeutic care for the last one and a half months. The security situation remains unpredictable in some parts in Umdukhun locality which has affected beneficiary access to the existing TF feeding centres.Suggested Action - till better security situation allows resuming the OTP and SFP in Umdukhun1. ensure SMOH is aware and encourage them to take over the follow up

of beneficiaries coupled with 2. provision of extended ration; as such two weeks ration for OTP cases

and monthly ration for SFP beneficiaries 3. furthermore CL will also follow up with MOH at Khartoum

Lack of SFP supplies in CD/Nertiti and Azum, WD/Kerenik (without Mornie camp) +Foro Baranga+Habila, Partners wondering if it’s possible to get two month supply instead of one month supply.WFP will update cluster within one week on available supplies by quantity and area. Partners should also communicate with sub offices while WFP contact offered his email so partners can communicate with him as well.

ND - Zamzam camp: Tracking the new arrivals as some are getting absorbed with relatives already in camp before verification and registration. Recommendation: RI team to do screening and at entry/registration point | El Malha: * lack of fund to continue mobile OTP and TSFP as from 1st April 2014 – possibly to look at CHF reserve and PCA with UNICEF. * Accessing the population due to Nomad way of life – possibly to look at possibility of mobile OTP. | El Fasher (without Zamzam camp): Insecurity that caused population movement out of Sarafaya and Kunjara. So far TSFP activities in those location were suspended.

WD-Sirba: caregiver (women) working in farms (onion planting season) and volunteers dropped out; only 17 out of 30 active in Kondobe (asking for incentive) – Partners & MoH to look at harmonizing & standardizing incentive issues in long term period. Meanwhile to document all existing incentive mechanisms

In WD - Gobe and Tawanj in Habila locality need urgent nutrition intervention – MoH to follow up with SMOH

Decisions/Recommendations

Monthly info tracking to be filled out by the beginning of the second week of each month, but for emergencies partners to report on population movement / displacement / response, etc as soon as is feasible.

partners to try and segregate boys, girls, men, women, PLW when reporting data and put BP5 beneficiary figures OR carton with ration size

BF corners/shelters to be set up in all new IDP areas even in the absence of camps

To have in depth discussion between UNICEF, WFP and MoH regarding the option of prepositioning a 3 month supply in a few selected critical areas.

All organization in the new displacement and refugee emergencies to identify staff/focal person and coordinate with relevant party (IOM, SRC, UNHRC) to

include MUAC screening upon entry and include in registration data collection.

Nutrition cluster program updateIssues/Points Discussed

Lack of complete data to make analytical comparison. The reports lack previous month admissions and incomplete # of functional program sites. However it’s expected that admission may increase mainly due to a new wave of displacements and influx.Accordingly in March based on received reports 8,455 new admissions reported in various CMAM services. While cases under prevention and treatment of MAM to that of cases under SAM management is roughly proportional; SAM cases in OTPs and SCs doesn’t seem proportional which may be related to either our early detection capacity or referral issues and lack of sufficient SC centers. It needs further investigation and reporting. While most programs will continue as their current functional status few programs planned to be opened, closed and transit to SMOH. Summary of future program plans

Partner State Locality New PlanARC SD Kalma camp Opening SFP in KalmaARC SD Tullus Mobile SFP/OTP ARC SD Dimsu Mobile SFP/OTP CIS SD Kass camp Start admission in IBSFPRI ND El Fasher (without Zamzam camp) increase by 2 OTPs in rural El-Fasher

Transiting programs

WVSD EL Roseires Transitioning to SMoH management and eventual

Project closure in March 2014. Programs to be closed

RI ND El Malha Close 2 mobile OTPs and 1 TSFPWV SD Kubum OTP closed end of March 2014 due to lack of funding

Screening and referralWe are advocating for regular screening mechanism which could be integrated on existing platforms such as NIDs, VAS, and related CHDs. In ND it was agreed with SMOH and partners to support integrated screening on the current Polio NID which is postponed for next month due to emergency. Thoughts and consensus highly welcomeSummary of screenings: Total of 22 screenings reported in March 2014 covering 22 localities in seven states (five

darfurs, SK and Gadareef). While lowes GAM for U5 MUAC is in Diling locality of SK conducted by SCS (2%) the highest was also in Rifi Ashgri locality of same state done SCS (32.7%). In North Darfur SMOH and state nutrition sector partners reached 32,483 under-five children by MUAC screening in the recent conflict affected areas, namely Al Laeit, Tawisha, Saraf Omera, Shangil Tobaya and part of rural El Fasher. Out of them 7,754 MAM and 2,967 SAM cases (equivalent to proxy GAM of 33.0% and proxy SAM of 9.1%). So far 1,987 under five children received two weeks ration of BP5 in Saraf Omera and Shangil Tobaya. Meanwhile the distribution is continued in Al Laeit, Tawisha , Rural El Fasher and ZamZam. Accordingly 1,855 cartons of BP5 have been released to SMOH and nutrition partners for early response to the emergency. Currently 824 SAM cases are treated in the mobile OTPs in Saraf Omera, Al Laeit, Shangil Tobaya and Kafout with 260 new admission cases.

Capacity BuildingCapacity development and training activity reports received from all reporting partners as of December 2013 while in this report we will summarize only that of March 2014.Major training areas covered include CMAM, IYCF, Positive Deviance approach/Hearth Model and SQUEAC coverage survey. Total of 429 (219 Male and 210 Female) professionals trained. Moreover 903 mothers attended counselling and education sessions.

Surveys / Studies Planned or Completed in March 2014

New Admissions – March 2014IBSFP TSFP OTP SC3,962 2,732 1,681 80

U5 MUAC PLW MUAC

Screened # SAM # MAMProxy GAM (%) Screened # MAM

Proxy MAM (%)

35971 923 3628 12.65 % 4123 389 9.43 %

Partner State Locality Type of Survey / Study Report/StatusTearfund

East Darfur

Eddaein,AbuJabrara,BahrArab,ElFerdo

Localized Nutrition and Mortality Survey

The report Not yet issued

SC Swed WD Habila SQUEAC Survey Completed, WV South

Darfur

Otash camp and Nyala North

Knowledge Attitude and Practices (IBSFP) Survey

was planned for March but delayed to April due to delays in data collection

Decisions/Recommendations

Improved and strengthened reporting Need of standardization in methodology and materials for training Integration/full package training at least the CMAM components Documenting on lessons learnt around capacity development activities

Agenda Item #3:

Review and endorsement of emergency response framework

Issues/Points Discussed

Draft Sudan NUTRITION Cluster Strategic Operating Framework (May-Dec 2014) and Nutrition emergency response activities frame were shared.The Nutrition emergency response activities frame was already in use for WNS response and North Darfur emergency response.CHF reserve fund note was also shared and endorsed

Issues/Points Discussed

To further review the frame and endorse by the next NCC meeting CHF reserve fund to be used among RI project and supplies replenishment for

UNICEF and WFPAgenda Item #5:

Knowledge sharing – IMC's SQUEAC for Hamedia IDP Camp OTP (Coverage, Barriers and Boosters, and recommendations)

Issues Raised Findings from the assessment indicated 75.4% (CI 65.1%-83.5%) period coverage for OTP. While this is slightly below SPHERE minimum standards for camp settings (90%), the program displayed some clear strengths and good practices. Integration of CMAM services in the health facility, strong community mobilization networks, and active community participation all contributed positively to achieving this coverage rate.

Decisions/Recommendations

IMC to prepare in-depth presentation for next meeting knowledge sharing session

WV to give presentation on IGA for volunteers at the next cluster meeting WFP to share IBSFP best practices (June meeting)

Action PointsTask to be done Responsible Due Date (Status)

All partners to submit monthly reporting form by Monday of the second week of each month.All partners to have biweekly reports for emergencies.

All sector partners Monday of the 2nd Week of each month

Every two weeks

Breastfeeding corner should be established in tents / areas for displaced (even if they are not in camp). For example, a shaded area should be established where mother’s may safely BF. UNICEF will mobilize materials (tarps, blankets, etc)

Partners working in the new displacement areas

ASAP

Update cluster on available SFP response plan and guaranteed response period based on supplies including SFP supplies by quantity

WFP one week (17 April 2014)

and area.Each partner to provide one pager on successes and challenges with volunteers. To be submitted with next monthly report.

All sector partners 10 May 2014

share CHF reserve fund note and application formats

Sector lead ASAP (Done)

Agree on the CHF reserve fund envelope/share and submit proposal

RI, UNICEF, and WFP

ASAP

Next Meeting : 8th May 2014 at Tear fund office

List of participants