Minutes of Sana a Nutrition Cluster Coordination Meeting Date: 9:00 11:00 am, 5th March, 2013 Venue: UNICEF office Agenda: Attendees Name Agency Email Address Anteneh Gebremichael Cluster coordinator adobamo@unicef.org Lenna Abdullah MOPH eryan_7@yahoo.com Dr.Wisam Al-Timimi UNICEF waltimimi@unicef.org -i Dr Ali Dowelbaitt UNICEF adali@unicef.org Ematlveca Bevoci MSFF Msff-sanaa-medco@paris.msf.org Dr Amal Alsuqaf MSFF msff-sanaa-medco-assist@paris.msf.org Nagib Abdulbaqi UNICEF nabdulbaqi@unicef.org Dr.Saja Farouk Abdullah UNICEF sabdullah@unicef.org Afrah Al qershi YFCA a.alqershi@yfca-ye.org Shabib Alqobati Information Manager-NC salqobati@unicef.org Anne Claire Bremard ADRA Anneclair.bremrd@adrayemen.org Dr Abdul Hameed CSSW drhidar@gmail.com Nader Makki IMC nmakki@internationalmedicalcorps.org Review of Action Points from the previous meeting Updates from Partners on nutrition response UNICEF update on Nutrition Assessment Plan Cluster Capacity Building Plan for 2013 MOPH and Nutrition Cluster Recommendations for provision of nutrition services through mobile team. AOB o CMAM Guideline review workshop o Nutrition Program quality consultative workshop I. Review of Action Points from Last meeting Action Point Who Status Oxfam to share results of case study on referral rate and Oxfam Not done cost effectiveness of community volunteers MOPH to share the Monitoring report of MOPH run MOHP Not done CMAM program (Leena) Discussion on mobile team to be incorporated on next NC done cluster meeting agenda NC to give update on WFP led discussion on Mobile team meeting which was held in November NC Not done
II. Update from Partners IMC : IMC is working in Sana a zone districts; interventions cover health, nutrition and hygiene /sanitation in districts (Sanhan, Belad Al Roos, Bani Matar) Sana a governorate So far 20 facilities have been functional providing nutrition services through Outpatient therapeutic program OTP). In addition to the static facilities there are 4 supplemental sites. Trained 50 community volunteers by end of 2012. Additional will be trained in 2013 to increase number of volunteers and ensure 15 per facility coverage. 5 Mobilization campaigns to improve case finding of acute malnourished children are planned in the coming months In total IMC plans to directly address about 14,000 children through SAM,and BSFP (Blanket Supplementary Feeding Program) IMC had signed PCA (Project Cooperation Agreement) with UNICEF to further scale up the response through 15 more health facilities in district (Mawiyah, Maqbanah. Dimnat Khadir) Taizz governorate. To date, 125 volunteers were trained, OTP supplies request had been sent to UNICEF (MOHP?),community mobilization and sensitization meetings are going on. OTPs will start service provision by end of this month. MSF-France MSF had been implementing OTP and TFC in Amran (Khamir) district. The OTP has been handed over to MOPH while the TFC is still function though the complicated SAM cases are admitted pediatric ward. Services had been suspended since September 2012 due to insecurity staff not willing to go to duty station being afraid of the insecurity. However, Karmar- has been reopened after 10 days MSF reported that health workers in their facilities are diagnosing cases of overt Vitamin D deficiency. Most cases came with respiratory infections. Clinicians checked the serum level of Vit D and was found very low. The traditional practice of not exposing newborns to sun in Yemen could be associated with such cases of Vit D deficiency. MSF would like to bring to the attention of partners that clinically detected cases are snapshot of the prevalent situation of Vitamin D deficiency. As Vitamin D deficiency affects the development of a young children,overall nutritional status will be affected. Hence, wider awareness campaigns should be embarked on. Surveys done in 2007 and 2009 revealed the Vitamin D deficiency prevailing in Yemen. Action Point : MSF to share to Nutrition Cluster the case report of cases and relevant studies in Yemen UNICEF : UNICEF recently signed PCAs with IMC and Vision Hope to support the provision of emergency nutrition services in Taizz with IMC, Hajja and Al Hudaydah with Vision Hope.
Through IMC 80,823;, including 30,000 aged under 5) will be addressed while will VH will support 38,730, including 21,000 under 5) beneficiaries. UNICEF is working to strengthen the MOPH capacity to scale up the decenterlised provision of nutrition services in 6 governorate (Ibb,Taizz,Hajja,AL Hudaydah,Aden and Lahj) 75 health workers were trained on CMAM management: 50 for 25 new Outpatient Therapeutic Programmes (OTPs) in Taiz; and 25 for 10 new OTPs in the most vulnerable districts of Lahj. Training of Trainers on OTP and IYCF conducted in Aden. A total of 24 government health workers were trained i.e 4 per governorate. The trainers will train staff in their respective governorates. UNICEF under the umbrella of nutrition cluster working with WFP to develop CMAM training package which constitutes both MAM and SAM case management. The package will have a number of sessions to be completed in a Six day training schedule. UNICEF and MOPH working on Final plan to undertake a mother and child health campaign in six governorates i.e. Ibb,Taizz,Hajja,AL Hudaydah,Aden and Lahj, by end of March. A one day national workshop has been conducted. Additional 3 day planning workshops were conducted in the governorates. Distcrict health facility profiles had been compiled,supplies has been dispatched to governorates. The campaign comprises MUAC screeing of under five children,de-worming of 2-5 year children, Vitamin A suplementaion,provision of Zinc tabs and ORS for diahrroeal cases, Iron folic acid supplementation to PLW. Health workers will also provide EPI vaccination. Cases of SAM and MAM will be referred to the nearest health facilities with CMAM services wherever it exists. Action Point : All partners in the governorates to get in contact with MOPH and facilitate referral of acute malnourished cases. Yemen National CMAM guideline revision draft finalized pending final review by technical taskforce. A five day workshop will be conducted to review the document and come up with final version. Days of the workshop will be confirmed. UNICEF recruited two international consultants to conduct IYCF formative assessment in four selected governorates. The consultants are expected to develop a Yemen specific IYCF communications strategy and messages, as well as recommended recipe list for complementary feeding in Yemen. The whole exercise will take about eight months. UNICEF working closely with MOPH and MOPIC (ministry of Planning and International Cooperation) to facilitate Yemen government to join SUN (Scale Up Nutrition) network. MOPH TOT for IYCF master trainers in Aden had been conducted. The roll out of the training to health workers will be done from Mid-March onwards. To further scale up the CMAM service provision in decentralized facilities, health workers will be trained on SAM case management by end of March. IYCF corners will be established once health workers are trained. MOPH with UNICEF working to incorporate nutrition in emergency topics in the curriculum for higher health training institutions in Yemen.
ADRA Implementing food voucher program in Abyan and Lahj. The project has got Nutrition Awareness sessions on for beneficiaries. Plans to start a CMAM program. Approaching UNICEF for PCA. CSSW Recently signed PCA with UNICEF to implement SAM case management in Taizz,Hajja,Al Jwaf,Amran By 20 th of March Health workers will be trained Mobile health team will also be formed to provide service to communities where functional health facilities are not available. YFCA Mainly engaged in Reproductive health ; working in governorates Sana a,aden,lahj and Ibb. Runs 7 mobile clinics which provide Hajja IDPs Got ERF funding for a project which has a nutrition component in Bani Matar, Bani Al Harith and Sanhan Necessary preparation for starting the ERF funded project has been finalized. III. Nutrition Assessment progress and Plan A nutrition survey using SMART methodology conducted in Lawdar, Zunjubar, Khanfar districts of Abyan governorate. Preliminary findings are realeased indicating dire malnutrition situation. A dissemination and microplanning workshop will be conducted by 12 th of March in Aden. Similar dissemination will be done at Sana a level. MOPH and UNICEF have plan to conduct SMART surveys in Dhamar ( End of March ),Al Jwaf (Mid April), Al Mahwit. CSSW will participate in Al Jwaf. Other partners are invited to takepart in the assessment. Action Point : Partners to meet MOPH/UNICEF to confirm their participation in the survey exercise. Contact : Nagib Abdulbaqi A. Ali, Nadbulbaqi@unicef.org.Phone : + 967 1 211400 (Ext. 161) IV. Nutrition Cluster 2013 Capacity Building Plan. Dr Saja from UNICEF ( Cluster Coordinator in 2012) briefed that in several occasions cluster partners identified capacity gaps within their respective organization and ministry of health. In the last year several trainings were conducted mainly in Nutrition in Emergency, IYCF,SMART nutrition methodology,cmam. However, there exists a huge capacity gap to undertake assessments and response in nutrition. There has been also a turnover of previously trained Master trainers. At the moment MOPH and cluster approved trainers are limited in number and are mainly from MOPH. This made it difficult to undertake trainings well in time as the MOPH trainers are busy doing trainings. Hence, increasing the pool of Master trainers at national and governorate level is essential. UNICEF has taken the initiative to allocate resources for training of Master Trainers. The following were recommended by participants :
The trainings to focus on NiE, CMAM, IYCF, SMART, SQUEAC (coverage assessment), others (TBC). Strict criteria to be followed while organizations are nominating potential Master trainers; Cluster to send out proposed criteria to partners. Partners to indicate how many health workers /community volunteers will be trained by the nominated Master trainer from their organization. Cluster to consolidate the training needs and potential list of master trainers to be trained. Action Point: NC to send a matrix to be completed by partners in which they indicate the no /name of master trainer and no of staff who will be trained by the master trainer. V. MOPH and Nutrition Cluster Recommendations for provision of nutrition services through mobile team. Ms. Lenna from MOPH expressed concerns over the way mobile teams mostly run by NGO partners are providing CMAM services. The issues included Partners do little consultation with MOPH at governorate level While forming mobile teams. The service package provided by mobile team is not very clear yet. The composition of a mobile team hasn t been well standardized. Partners at times pay for volunteers and MOPH has got concern over its implication on sustainability of community health services once NGOs phase out In general, MOPH doesn t recommend the way the mobile team is being run at the moment. Hence, suggests that resource allocation from donors and UNICEF for provision of CMAM through Mobile team modality should be halted until there is a clear guidance agreed by cluster and MOPH on Mobile team Modality is issued. Additional recommendations from partners were: To have a standard guideline on mobile team approach of CMAM services delivery should developed by MOPH and cluster Mobile team has got added value in certain contexts where there is less health infrastructure and where population settlements are scattered. Action Point : NC to hold discussion with WFP (took initiative to standardise the mobile team approach) and organise a consultative workshop focusing on developing guidance on Mobile Team. AOB. CMAM Guideline review workshop will be conducted by end of March. Task force members will convene for up to 5 days to review final draft of the guideline. End.