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News &Views
ENN launches
en-net
National training on IFE in Sri Lanka
By Moazeem Hossain
Dr. Moazzem Hossain is the Chief of
the Health and Nutrition Section of
UNICEF Sri Lanka, and Nutrition
Cluster Coordinator in Sri Lanka.
The author would like to acknowledge the contribution
of the delegates (Drs Renuka, Sudharshini
and Lalith) for facilitating the workshop and Ms.
Chayatri for notes taking and compilation.
An online forum (en-net) for urgent technical
questions on emergency nutrition and
food security has just been launched by the
ENN, funded by the OFDA.
The aim of the forum is to enable field practitioners
to have access to prompt technical
advice for operational challenges for which
answers are not readily accessible in
current guidelines. en-net has been developed
at the request of many agencies and
individuals and hopes to build on the experiences
of earlier fora such as NGONut and
NutritionNet.
A simple online interface has been developed
where users can submit questions or
contribute to the answers to questions
posed by others. Questions and answers
have been organised into seven thematic
areas:
• prevention and treatment of severe
acute malnutrition
• prevention and treatment of moderate
acute malnutrition
• assessment
• infant and young child feeding interventions
• general food distribution
• livelihood interventions (including cash)
• humanitarian systems
A panel of technical moderators has been
created, each assigned to their expert
‘theme’. They will be called upon by the
ENN coordinator to contribute to particularly
challenging questions. The ENNs
online resource library is being expanded
to support the forum.
Visit and bookmark the forum at
www.en-net.org.uk or via the link at the
ENNs website www.ennonline.net
The ENN Resource Library is at
www.ennonline.net/resources
Any feedback can be submitted via en-net
or to the ENN en-net coordinator, Tamsin
Walters, email:tamsin@ennonline.net
This piece summarises an IFE training led by
country delegates as an action arising from the
regional IFE workshop held in Bali 10-13th
March 2008.
The National Workshop on Infant Feeding in
Emergencies (IFE) was held on the 16th and 17th
of June 2008 in Colombo, under the auspices of
the Nutrition Cluster in Sri Lanka in collaboration
with the Family Health Bureau (FHB). The
two day workshop consisted of a series of
presentations, each with questions and answers
opportunities and panel discussions. The workshop
focused on developing an understanding of
the importance of IFE. The specific objectives
were to understand why IFE is important in
emergencies, appreciate the advantages of
breastfeeding and the risks of artificial feeding
and how best to protect and support safe and
appropriate IFE.
The workshop was attended by 35 participants
from United Nations (UN) agencies, project
coordinators from international non-governmental
organisations (NGOs), District Medical
Officers and Medical officers from the Maternal
and Child Health (MCH) Unit.
The workshop started with a welcome
address from the Director of MCH, the FHB and
UNICEF. The first day consisted of four presentations
and group work. Dr. SM Hossain
(UNICEF Sri Lanka) opened the workshop and
introduced the importance of IFE, the
Operational Guidance on IFE and the
International Code of Marketing of Breastmilk
Substitutes. Dr. Anoma Jayatilake gave a very
comprehensive account on breastfeeding and
appropriate counselling skills and Dr. Renuka
Jayatissa gave a brief overview on rapid assessments.
After each presentation, workshop participants
were given practice exercises to test their
grasp of the topic just covered – all showed a
good understanding.
The emphasis on the second day of the workshop
was sharing the experiences of the Bali IFE
workshop , presented by Dr. Renuka Jayatissa.
She concluded her report by sharing the pledge
for action issued by the workshop participants to
promote, protect and support breastfeeding
during emergencies, to prevent the inappropriate
use of breast-milk substitutes and to support
infant and young child feeding in general.
Dr. Lalith Chadradasa followed with a presentation
on IFE media exposure in emergencies. He
explained that the media can play a major role in
emergencies – not only in highlighting problems
but also providing an opportunity for intervention
through communication. However, often the
media delivers the wrong messages during
emergencies, either because the media
writer/source is ignorant of the issues or the
receiver misunderstands the information or has
misconceptions around IFE.
The final presentation of the workshop was on
preventing and controlling micronutrient deficiencies
in populations affected by emergencies,
by Ms.Vishaka Thilakeratne. The major deficiencies
include Vitamin A, Iron, Zinc and Iodine.
She emphasised that in order to meet the
micronutrient requirements during emergencies,
foods fortified with micronutrients should be
provided, e.g. corn-soya blend, biscuits,
vegetable oil enriched with vitamin A, and
iodised salt. It was pointed out that these foods
must be appropriately fortified, taking into
account that other unfortified foods will meet a
share of micronutrient needs. It was also highlighted
that fortified foods may not meet the
requirements of pregnant women, lactating
women and young children. In these cases,
supplementation is warranted and UNICEF and
the World Health Organisation (WHO) have
developed a daily multiple micronutrient
formula to meet the recommended nutrient
intake (RNI).
Ms. Thilakaratne elaborated on micronutrient
supplementation programmes in the context of
Sri Lanka, where a supplementation programme
is already in place for mothers and young children.
She considered the current increase in food
prices would have an impact on nutritional
status and considered it timely to intervene with
supplementation. She concluded by emphasising
that supplementation should not be a long term
intervention strategy.
The participants then broke up into groups
and were asked to consider two scenarios:
Aftermath of the Pakistan earthquake and
Refugees in Tanzania. The four groups were
tasked to select the criteria they would use to
identify best practices and then select best practice
interventions.
The final item of the workshop was the drafting
of a national policy on IFE (modelled on a
process used at the Bali workshop to generate a
Joint Statement), which was facilitated by Drs
Shudharshini Fernandopulle and S.M Hossain.
Inputs were received from participants and it
was agreed that during emergencies, the key
areas to concentrate on are to protect, promote
and support breastfeeding, to prevent donations
of breastmilk substitutes and powdered milks, to
ensure availability of age appropriate complementary
foods and supplements and in only
exceptional circumstances, support replacement/artificial
feeding. Following the workshop,
the national policy directive to Support
and Ensure Appropriate and Adequate Infant
Feeding during Emergencies was finalised and is
pending approval by the Director General of
Health Services, Ministry of Health Care and
Nutrition, Government of Sri Lanka. The whole
workshop was facilitated and coordinated by Dr.
Sudharshini Fernandopulle from MoH FHB,
who attended the regional IFE workshop in Bali
to represent the Government of Sri Lanka.
For more information, including copies of workshop
presentations and the policy directive,
contact: Dr SM Hossain, UNICEF, email: smhossain@unicef.org
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