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UNHCR Technical Workshop
on the Operational Guidance
on the use of Special
Nutritional Products
By Sarah Style and Andrew Seal
Sarah Style is an ENN
consultant working on
the UNHCR/ENN
Anaemia Control,
Prevention and
Reduction Project.
Andy Seal is a lecturer and researcher
at the UCL Centre for International
Health and Development and a
senior technical advisor to the ENN
on the UNHCR/ENN Anaemia Control,
Prevention and Reduction Project.
News
Table 1: Summary of Food Supplementation Products
(FSP) and Fortified Blended Food (FBF) for use in
children aged 6-59 months that are covered by the
Operational Guidance
FSP / FBF
Micronutrient
powder
Low quantity
LNS*
Target
age
group
Product descriptions
6-59m MNPs provide no energy (kcal) in the
diet. They are usually packaged in
individual sachets to provide a dose
of selected vitamins and minerals in
powder form, to be added to foods
directly after cooking. MNPs have
been shown to be efficacious in
treating and preventing anaemia.
Branded products include Sprinkles
and MixMe
6-24m Highly fortified peanut-based paste
that contains vitamins and minerals
in addition to providing energy. It is
usually packaged in individual daily
sachets and is to be eaten either
directly from the sachet or added to
complementary food. It has been
shown to improve linear growth in
young children. Product brands
include Nutributter® 2
In July 2011, UNHCR, in collaboration with
ENN, held a five-day technical training
workshop to introduce the recently finalised
‘Operational Guidance on the Use of Special
Nutritional Products to Reduce Micronutrient
Deficiencies and Malnutrition in Refugee
Populations’.
The Operational Guidance (described
further in Field Exchange 41) deals with certain
food supplementation products (FSP) (including
micronutrient powders (MNP) and certain
lipid-based nutrient supplements (LNS)) that
are currently being used, or being considered
for use, in blanket supplementary feeding
programmes within UNHCR operations. These
products are designed for use in programmes
aiming to prevent malnutrition, with a particular
focus on micronutrient deficiencies. The
guidance has been developed to help country
staff deal with the challenges and confusion in
designing, implementing, monitoring and evaluating
programmes using these new FSPs.
The workshop was designed to provide both
training on the use of the Operational Guidance
and the opportunity for sharing of information
and experiences of using these products in
refugee camps across UNHCR operations. The
overall aim was to enhance best practice and
contribute to participants being better able to
meet the needs of the refugee populations with
whom they work.
The specific objectives of this technical workshop
were to:
a) Provide standardised guidance on best
practice in planning, implementing,
monitoring and evaluating programmes
using special nutritional products
b) Improve the design, implementation and
monitoring & evaluation of programmes
using special nutritional products
c) Build the capacity of technical health and
nutrition staff from UNHCR and WFP in
effectively managing programmes using
these products in refugee situations.
Twenty health and nutrition staff from
UNHCR and WFP attended the workshop,
which was held in Mombasa, Kenya.
Participants represented operations in 12 countries:
Algeria, Bangladesh, Chad, Djibouti,
Ethiopia, Kenya, Nepal, Rwanda, Sudan,
Tanzania, Uganda and Yemen.
Workshop activities and agenda
The workshop followed the general structure of
the Operational Guidance beginning with Stage
1 on the first day (define the nutritional problem)
through to Stage 6 (monitoring and
evaluation) 1 . The workshop covered the key
operational components relating to
programmes using specific FSP intended for
preventative purposes. See Table 1 for further
product information.
A variety of different learning methods were
incorporated throughout the workshop, including
presentations, case studies, individual
exercises, group work, testing of various tools
in the Operational Guidance, and optional
evening sessions. Participants were invited to
present their experiences, learning, and the
challenges on the ground concerning
programmes using FSPs. At the end of the
workshop, participants were allocated time
with facilitators to discuss any questions or
challenges that they were facing relating to
their country of operation and the way forward,
and how to incorporate the principals and best
practice outlined during the workshop.
Follow up
Workshop evaluation findings (daily feedback
and final evaluation) were positive and constructive.
The main challenge that
participants identified for practice are
budgetary constraints to purchase and
manage products due in part to other
competing operational needs. The
main actions identified by participants
to improve product related practice
was to review their camp behaviour
change and communication (BCC)
strategy and to improve M&E systems
including use of the M&E tools
provided in the Operational Guidance.
A clear expectation of the workshop
was that all participants would
conduct follow up training on their
return to help build institutional
knowledge.
1
See news piece in Field Exchange 41 for
schematic.
2
This is the only product currently approved for
use by UNHCR. Products are approved on a
case by case basis. Similarly, only Plumpy’doz
is approved as a medium quantity LNS.
Credit: / UNHCR /F. Courbet, Ethiopia,
2008
Medium
quantity LNS
FBF+ / ++ 6-59m /
6-24m
6-36m Highly fortified peanut-based paste
that contains vitamins and minerals
in addition to providing energy. It is
usually packaged in individual
weekly pots. However it will also be
available in the form of daily sachets,
which is the preferred form for distribution.
It has been used in
programmes to prevent increases in
GAM in young children during periods
of food insecurity. Product
brands include Plumpy’doz®
FBF+ e.g. Corn-Soy Blend (CSB) is a
food for young children and other
vulnerable groups, as well as the
general population. Its content of
vitamins and minerals has been
modified compared to previous
formulations. It is recommended as a
partial replacement for nutritionally
inadequate local diets.
FBF++ is a newly developed FBF for
infants over 6 months and young
children. It contains milk powder and
has a higher energy density than
other types of FBF.
Feedback from participants have been incorporated
in the final version of the Operational
Guidance which will shortly be available for
public dissemination and download via
http://info.refugee-nutrition.net
For further information, contact Caroline
Wilkinson at UNHCR, Geneva,
email: wilkinso@unhcr.org
Eritrean refugees in Shimelba
refugee camp, Ethiopia
48