J Spector, Valid Int, EthiopiaJ Spector, Valid Int, EthiopiaNewsWHO meetingreport oncommunitybasedmanagementof severemalnutritionMinistry of Health staff workingin outpatient therapeutic carein a clinic in EthiopiaA meeting of experts was organised by theDepartment of Child and Adolescent Healthand Development and the Department of<strong>Nutrition</strong> for Health and Development of theWHO, by UNICEF and by the UN Standingcommittee on <strong>Nutrition</strong> in Geneva on 21-23November 2005, to review recent developmentsin community-based management of severemalnutrition and to formulate recommendations.In preparation for this meeting, five backgroundpapers were prepared:• A review of methods to detect cases ofseverely malnourished children in the communityfor their admission into communitybasedtherapeutic care programmes. MyattM, Khara T, Collins S.• Efficacy and effectiveness of communitybasedtreatment of severe malnutrition.Ashworth A.• Key issues in the success of communitybasedmanagement of severe malnutrition.Collins S, Sadler K, Dent N, Khara T,Guerrero S, Myatt M, Saboya M, Walsh A.• Local production and provision of ready-tousetherapeutic food for the treatment ofsevere childhood malnutrition. Manary M.• The sustainability of Community-basedTherapeutic Care (CTC) in non-acute emergencycontexts. Gatchell V, Forsythe V,Thomas PR.These, along with the meeting report, are allavailable athttp://www.who.int/child-adolescent-health/publications/NUTRITION/CBSM.htmTaking MUAC measurement of a child in EthiopiaRevised Operational Guidanceon IFEAn updated version of the OperationalGuidance for <strong>Emergency</strong> Relief Staff andProgramme Managers on Infant and YoungChild Feeding in Emergencies is now availablefrom the ENN. First developed by theInteragency Working Group on IFE in 2001, ithas been revised by the IFE Core Group(UNICEF, UNHCR, WHO, WFP, IBFAN-GIFA,CARE USA, Fondation Terre des hommes,and ENN) co-ordinated by the ENN.The aim of this short document is to provideconcise, practical (but non technical)guidance on how to ensure appropriate infantand young child feeding in emergencies. Anumber of elements are also applicable innon-emergency settings.The Operational Guidance focuses especiallyon infants and young children under 2years of age and their caregivers, recognisingtheir particular vulnerability in emergencies.It is intended for emergency relief staff andprogramme managers of all agencies workingin emergency programmes. It applies to emergencysituations in all countries.Beginning with a summary of key points,this 24 page document is organised into sixpractical steps:1 Endorse or Develop Policies2 Train Staff3 Coordinate Operations4 Assess and Monitor5 Protect, Promote and Support IFE throughIntegrated Multi-Sectoral Interventions6 Minimise the Risks of Any ArtificialFeeding.Key definitions are included at the end andsupporting information on how to implementthe guidance is referenced throughout.The revised Operational Guidance is currentlyavailable in English and Bahasa (Indonesia)and translation into other languages is underway.Agency support and feedbackThe 2001 OperationalGuidance was supportedby 30 INGOs/NGOs/UN agencies.The IFE Core Groupwish to define andestablish agency supportfor this revisededition with futureprints listing supportingagencies.If you or youragency would liketo engage in thisprocess, would like to receive printcopes, or have any feedback or comments youwish to share, contact the IFE Core Group c/o<strong>Emergency</strong> <strong>Nutrition</strong> <strong>Network</strong>, 32, LeopoldStreet, Oxford, OX4 1TW, UK.Tel: +44 (0)1865 324996, fax: +44 (0)1865 324997,email: ife@ennonline.netThe Operational Guidance can also be downloadedfrom http://www.enonnline.net inpdf or html formatInternational Food and <strong>Nutrition</strong>Security Course 2007An international training programme on foodand nutrition security is planned to take placebetween 12 February – 27 April, 2007, atWageningen International, The Netherlands.It aims to provide the course participants withknowledge, skills and motivation to identify,plan and implement effective action on foodand nutrition security at various levels, rangingfrom (national) policy level to regional,community, household and individual levelprogrammes.The training programme can be followed as acomplete 11 weeks' programme, which leadsto a diploma at postgraduate level or can befollowed as 'stand alone' certificate courses.Course content1. Distance Learning Programme: KeyConcepts in Food and <strong>Nutrition</strong>2. Key Concepts and Current Issues in<strong>Nutrition</strong>3. Food and <strong>Nutrition</strong> Security in theContext of HIV/AIDS4. Seminar on Rights Based Approaches forFood5. Monitoring and Evaluation of Impact onFood and <strong>Nutrition</strong> Security6. <strong>Nutrition</strong> Communication and Promotion;a NewApproach to <strong>Nutrition</strong> EducationA limited number of fellowships to covercosts are available from the NetherlandsFellowship Programme (NFP). Candidatesshould first apply to WageningenInternational for admission to the coursebefore 1st September, 2006. Acceptable candidatesthen apply for a NFP fellowshipthrough the Netherlands Embassy in theirown country (deadline: 1st October 2006). Theapplication deadline for non-fellowship candidatesis 30th January 2007.Apply to Wageningen International online atwww.wi.wur.nl or email: training.wi@wur.nlor contact Wageningen International, P.O. Box88 6700 AB Wageningen, The Netherlands,Tel +31 317 495 495 Fax: +31 317 495 395For further information on the content of thecourse, email: fannie.deboer@wur.nl or wijnand.klaver@wur.nl13
Improved formula for WHO oralrehydration saltsA new improved Oral Rehydration Salts (ORS)formula has been developed by the WorldHealth Organisation (WHO) and UNICEF. Itcontains less glucose and sodium than the standardformula (245 mOsm/l compared with theprevious 311 mOsm/l), which allows for quickerabsorption of fluids. This reduces the needfor intravenous fluids and makes it easier totreat children with acute non-cholera diarrhoeawithout hospitalisation. Because of theimproved effectiveness of reduced osmolarityORS solution, WHO and UNICEF now recommendthat countries use and manufacture, fordiarrhoea of all aetiologies and in all agegroups, the new formulation.Detailed recommendations concerning theprovision and production of ORS are providedin a revised joint WHO/UNICEF publication,'Oral Rehydration Salts: Production of the NewProfile of new ORS formulaNew ORS g/l % mmol/lSodiumchlorideGlucose,anhydrousPotassiumchlorideTrisodiumcitrate,dihydrate2.613.51.512.683 Sodium 7565.854 Chloride 657.317Glucose,anhydrousOrientation workshop on IFEThe IFE Core Group 1 is planning an orientationworkshop on infant and young childfeedingin emergencies (IFE) scheduled for 1-2 November 2006 in Oxford. Organised bythe ENN and funded by UNICEF, IBFAN-GIFA and CARE USA, the overall aims of themeeting are:• to orientate participants on IFE, the workof the IFE Core Group and the IFEresources that have been developed.• to identify and practically address the keyconstraints facing staff in implementingIFE related policies and strategies inemergency settings.• to network technical HQ and regional staffof UN agencies and NGOs with donors,professional bodies and academics.The workshop agenda has been informed bya recent evaluation of the use of Module 2(see summary in this issue) and by field experiencesshared with the IFE Core Group relatingto emergency responses in Pakistan andIndonesia post earthquake and post tsunami.This workshop is not limited to infant feedingspecialists but will include NGO and UNHQ and regional staff, donors, professionalbodies, academics and media representatives.The meeting will:• Facilitate exchange of experiences on sup-752.9 14.146 Potassium 2020.5 100 Citrate 10Osmolarity 245ORS' that is available on the WHO website,along with the revised monograph of the formulaat http://www.who.int/medicines/publications/pharmacopoeia/Oralrehydrationsalts.pdf/ Detailed technical information can befound on the UNICEF site: http://www.supply.unicef.dk/catalogue/bulletin9.htmAdditional information on diarrhoea can befound on UNICEF's Facts for Life websitehttp://www.unicef.org/ffl/07/ and on theWHO Child and Adolescent Health web sitehttp://www.who.int/child-adolescenthealth/New_Publications/CHILD_HEALTH/Acute_Diarrhoea.pdfFor more information contact: DanielaBagozzi, Communications Officer, WHOTelephone: +41 22 791 4544,Mobile phone: +41 79 475 5490,E-mail: bagozzid@who.int or Claire Hajaj,Media Officer, UNICEF New York,Telephone: +1 212 326 7566E-mail: chajaj@unicef.org©UNICEF/SD02-025/Yvonne ThobyThe new ORS packagingporting IFE at a regional and nationallevel, with focus on Asia in particular.• Explore the use of policy guidance inrecent emergency responses to identifystrengths, weaknesses, and constraints toimplementation.• Highlight the recently updatedOperational Guidance on Infant andYoung Child Feeding in Emergencies(2006) and establish criteria that defineagency support.• Demonstrate the use of the trainingmaterials.• Identify training needs and resourcesneeded to support training activities.The IFE Core Group members will meet for athird day to formulate a strategy for movingforward.Anyone who is interested in attending, orwould like to recommend a participant,should contact the IFE Core Group c/o MarieMcGrath, ENN, tel: +44 (0)1865 324996,email: ife@ennonline.net,1Since 1999, an interagency collaboration (IFE CoreGroup) has been committed to developing training materialsand policy guidance on infant feeding in emergencies.The IFE Core Group currently comprises UNICEF, UNHCR,WFP, WHO, ENN, IBFAN-GIFA, Fondation Tdh, and CAREUSA, co-ordinated (since 2004) by the ENN.NewsNew ClassificationTool IntegratingFood Security andHumanitarianActionA new tool has been developed at the FoodSecurity Analysis Unit ( FSAU) to harmoniseand improve the rigour of classifying andproviding early warning of various stages offood security and humanitarian situations.Developed in-situ in Somalia, the TechnicalManual for the Integrated Food Security andHumanitarian Phase Classification (IPC)draws on internationally accepted standardsand so is applicable in a wide array of livelihoodcontexts and crisis types.The IPC is not an assessment method anddoes not replace existing food security informationsystems or methodologies. Rather, itis a complementary classification system thatintegrates multiple data sources, methods,and analyses to provide a ‘common currency’for food security and humanitarian crises,explicitly linking analysis to action.Key aspects of the tool include:• Situation Analysis: where fundamentalaspects of a situation (e.g. severity, cause)are identified.• Classification of food security andhumanitarian situations into one of fivephases based on outcomes on lives andlivelihoods – (1) Generally Food Secure,(2) Chronically Food Insecure, (3) AcuteFood and Livelihood Crisis, (4)Humanitarian <strong>Emergency</strong>, and (5)Famine/Humanitarian Catastrophe.Using key information, Early WarningLevels (EWL) are used to communicatethe risk of a worsening phase: (1) Alert,(2) Moderate Risk, (3) High Risk.• A Strategic Response Framework isprovided for each phase with a view tomitigating immediate negative outcomes,supporting livelihoods, and addressingunderlying/structural causes.Organised into four components, the IPCcomprises a core Reference Table (coveringphases and EWL), Analysis Templates (tohelp organise key information),Cartographic Protocols (mapping and communicationtools to visualise situationalanalysis on one map), and PopulationTables (to aid effective communication ofpopulation estimates).The manual is available from the FoodSecurity Analysis Unit – Somalia, KalsonTowers, Parklands, Box 1230 Village Market,Nairobi, KenyaPh: 254-20-3745734 Fax: 254-20-3745098Email: fsauinfo@fsau.or.keOr online at http://www.fsausomali.orgIdeas for future improvements are welcomeand should be directed to the FSAU.Ref: FAO/FSAU 2006. Integrated FoodSecurity and Humanitarian Phase Classification: Technical Manual Version 1. Nairobi,FAO/FSAU Technical Series IV.1114