Nutrition Cluster

2018 Annual Bulletin, March 2019, Issue 1

NutritionNutrition ClusterCluster Bangladesh Country Overview About Bangladesh Nutrition Cluster Risks and Vulnerabilities • In 2012, the Government of Bangladesh Bangladesh Nutrition Cluster Coordination Team • Marshy tropical coastline, large (GoB) established a national cluster floodplains and low sea elevation, system to address emergency which create constant exposure to preparedness and response directly, it is natural shocks and disasters. not an Inter-Agency Standing ACKNOWLEDGMENT • 97.7% of its population are at risk of Committee constituted Cluster. All staff of IPHN and NNS multiple hazards including cyclones, floods, mud and flash floods, World Food Programme • NC works under the Humanitarian earthquake and water-logging Action Against Hunger and UNICEF for their contribution Coordination Task Team (HCTT). HCTT, under the Local Consultative Group for 2014 Bangladesh Demographic and Health Survey Report Disaster and Emergency Response (LCG DER) is a coordination platform to EDITORIAL TEAM • 14% prevalence of Global Acute strengthen the collective capacity of Abigael Nyukuri-Nutrition Cluster Coordinator malnutrition Government, national and international Mohammad Mainul Hossain Rony- • 3% prevalence of Severe Acute actors to ensure effective humanitarian Nutrition Cluster Information Management Officer Malnutrition. • 36% Stunting levels preparedness for, response to, and • 33% Underweight recovery from the impacts of, disaster in • 55% Exclusive Breastfeeding rate Bangladesh.

2013 National Micronutrient Survey • NC is co-led by UNICEF and the Institute Report of Public Health Nutrition (IPHN) under • 33.1% Prevalence of anemia among the National Nutrition Services (NNS) in pre-school age and Ministry of Health and Family Welfare • 26.0% Prevalence of anemia among (MOHFW). pregnant and lactating women

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02 Front cover Inner 03 Strengthening preparedness for Nutrition Recommendations and Lessons Learnt in Emergencies on Preparedness • Preparedness actions in Disaster prone locations should not be undertaken as • To strengthen capacities in preparedness separate actions but mainstreamed in the regular developmental programmes in line for natural disasters at sub-national with the recommended ‘new way of working’; bridging the level, Nutrition Cluster Coordination Bangladesh Nutrition Cluster humanitarian-developmental nexus to reduce and mitigate needs, risk, and Team in collaboration with Institute of vulnerabilities. Public Health and Nutrition conducted one-day orientation sessions to • Humanitarian interventions Government and Nutrition actors aiming to prevent the working in Nutrition sensitive and deterioration, or promote Nutrition Specific interventions. recovery, of nutritional status should be carefully • The over-arching principle was tailored to the nature of strengthening preparedness for a each disaster and seek to predictable response; in line with Strengthening Preparedness for address underlying causes. envisaged Natural Disasters of sudden Nutrition in Emergencies Preparedness actions and slow onset origin in the various REPORT BY ABIGAEL N NYUKURI, BANGLADESH NUTRITION CLUSTER COORDINATOR should encompass actions Disaster-Prone Districts. The orientation 26TH DECEMBER 2018 [email protected] to ensure both the sessions were based on Emergency prevention and treatment Response Preparedness (ERP) approach of all forms of which was aligned to Bangladesh Workshop Participants in District. under-nutrition. Contingency Plans and Disaster Bangladesh Nutrition Cluster website: https://www.humanitarianresponse.info/en/operations/bangladesh/nutrition Management Framework. • Coordination platforms for Nutrition as well as for Disasters Response and Management in District, Upazilla and Union level should be adequately supported and resourced to prioritize and mainstream preparedness for nutrition in emergencies in Chattogram Division- 19th Nov 2018 meeting discussions and respective contingency plans in pre-disaster periods. Durigram District- 25th Nov 2019 • Pre-crisis information and data is useful to quickly inform the scale of need for new Orientation disasters before under-taking a comprehensive assessment. A robust and Schedule Lamonirhat District- 26th Nove 2018 comprehensive nutrition surveillance system needs to be developed, rolled out and scaled up ensuring linkage to existing Nutrition Information System. - 4th Dec 2018 • To adequately assess progress as well as timely identify and address challenges in Bharguna District- 5th Dec 2018 preparedness for nutrition in Emergencies, the national Nutrition Information Systems (DHIS2) needs to be expanded to include an Nutrition Cluster preparedness actions emergency component. in 2018 were on 7 key components This will also be useful to assess quality and Coordination progress of nutrition forums for Information Needs Assessment responses in Strategic Planning Nutrition in Management and Analysis emergencies. Emergency

Accountability to Dr. Samir Kanti Sakar, Resource Implementation Affected Former Director NNS, Mobilization and Monitoring Poputation IPHN in orientation workshop held in District

Bangladesh Nutrition Cluster I 2 Bangladesh Nutrition Cluster I 3

04 05 NUTRITION CLUSTER PARTNER ACTIVITIES CONDUCTED IN 2018

• Supported IPHN to develop the first draft of Infant and • in Ukhiya, Teknaf and Moheshkhali Upazillas host communities Young Child in Emergency Operational Guideline. of Cox Bazar District; World Food Programme (WFP) supported screening of a total of 58,843 children (29,167 Boys and • Supported IPHN to procured and prepositioned 29,667 Girls) aged 6-59 Months as well as 14,225 Pregnant essential Nutrition Supplies including therapeutic Milks and Lactating (PLWs). 20,952 children (8,572 Boys and and anthropometric equipment to cater for 10,000 12,380 Girls) and 14,332 PLWs identified as MAM treatment children in emergencies received MAM treatment provided through Government community clinics. • From the Months of August-November 2018. UNICEF supported IPHN to provide training on reconstitution • 274,512 (24,969 Male and 249,543 Female) participants, process for the newly improved therapeutic Milks to including caregiver of children under five, PLWs and male 306 SAM units in the Country. family members received Infant and Young Child Feeding (IYCF), maternal and hygiene practice messages for prevention • In Ukhiya, Teknaf, Ramu and Pekua Upazillas of Cox of acute malnutrition. Bazar District Host Communities, supported active case finding through Mid Upper Arm Circumference • In Ukhiya, Teknaf, Moheshkhali, Pekua and Kutubdia Upazillas (MUAC) measurements of 28,000 (14,300 boys and host communities of Cox’s Bazar District; ACF screened a total 13,700 Girls) aged 6-59 months. 468 children (226 of 59,577 children (29,513 Boys and 30,063 Girls) aged 6-59 Boys and 242 girls) were identified as Severe Acute Months for acute malnutrition. A total of 1859 (645 Boys and Malnutrition (SAM) and 11,167 (6,732 boys and 1,214 Girls) received SAM treatment. 162 children (76 Boys 4,435girls) were identified as Moderate Acute and 86 Girls) aged 0-59 Months having SAM with medical Malnutrition (MAM). 419 children (202 boys and 217 complications received in-patient management in in girls) were admitted and treated in Government run Stabilization Centers. MAM treatment was supported by WFP in-patient SAM unit. 58,764 pregnant and lactating and has been reported by WFP. women received high quality Infant and Young Child counselling and messaging. • 274,512 (24,969 Male and 249,543 Female) participants, including caregiver of children under five, PLWs and male family members received Infant and Young Child Feeding (IYCF), maternal and hygiene practice messages for prevention of acute malnutrition.

Action Against Hunger Malnutrition Mortality Morbidity and Immunization Coverage SMART and Coverage Survey Matrix 2018

GAM SAM Meslease (WHZ <- (WHZ <- Underw Vaccina Vitamin Stunting CDR U5CDR Sl Survey |Area 2 and/or 3 and/or eight (<- Diarrho tion A Start date End date (<-2 z (10,000 (10,000 Fever ARI Surveys in No (Camps/) oedema) oedema) 2z ea Coverage Coverage score) /day) /day) 5-59 5-59 score) 2018-Conducted month month

by Action 1 Moheshkhali 25-Dec-17 8-Jan-18 10.6% 1.1% 46.1% 33.0% DNC DNC 13.4% 53.4% 44.1% 91.0% 93.5% Against Hunger 2 Ukhiya Teknaf (Overall) 18 Feb 18 4Mar 18 11.4% 1.5% 33.1% 27.25 DNC DNC 9.8% 48.6% 28.0% 89.8% 86.4% 3 Ukhiya (Proxy) 18 Feb 18 24 Feb 18 11.6% 2.0% 35.5% 30.8% DNC DNC 9.1% 44.8% 27.4% 89.8% 92.9% 4 Teknaf (Proxy) 23 Feb 18 4 Mar 18 11.2% 1.2% 31.3% 24.5% DNC DNC 10.3% 51.5% 28.5% 89.7% 81.5% 5 Makeshift Camps 28 Apr 18 9 May 18 12.0% 2.0% 37.7% 31.1% 0.38 0.86 20.9% 10.0% 26.1% DNC DNC 6 Nayapara RRC 17 May 18 28 May 18 13.6% 1.4% 40.4% 39.8% 0.21 0.22 23.9% 40.5% 21.5% DNC DNC 7 Makeshift Camps 20 Oct 18 31 Oct 18 11.05 1.15 26.95 25.1% 0.13 0.42 28.4% 38.0% 10.9% DNC 92.1% 8 Nayapara RRC 1 Nov 18 8 Nov 18 12.15 0.95 38.3% 35.0% 0.21 0.56 25.2% 33.65 9.5% DNC 93.6%

Bangladesh Nutrition Cluster I 4 Bangladesh Nutrition Cluster I 5

06 07 Final results of the CCPM validated Results 2018 Nutrition Cluster Performance Monitoring (CCPM) Core Function Results 1. Support Service Delivery Good • In line with Global Guidance for • CCPM is a simple process 2. Informing strategic decision-making of the HCTT for the humanitarian response Satisfactory Monitoring performance of designed by members of the Nutrition Clusters, and with support from Inter-Agency Standing Committee Cluster 2018 3. Planning and implementing Cluster Strategies Satisfactory Global Nutrition Cluster, Nutrition (IASC) to assess whether clusters Final CCPM Results 4. Monitoring and evaluating performance Satisfactory Cluster initiated a Cluster fulfil the six core functions, meet Coordination Performance the needs of constituent members 5. Building national capacity in preparedness and contingency planning Good Monitoring (CCPM) Survey in the and support delivery to affected 6. Advocacy Satisfactory month of November 2018. people. 7. Accountability to Affected Population Good

• The 2-day planning workshop was facilitated by Global Nutrition Cluster and RedR UK with participation from all Cluster Partners. The first day focused on training on Cluster approach based on Bangladesh context whilst the second day was the validation of the CCPM report and planning exercise.

2018 Cox Bazar Nutrition Sector Response

Joint Response Plan (JRP) Strategic Objectives (March-December 2018)

• To reduce excess mortality and morbidity among boys and girls under 5 years old, PLW and other vulnerable groups through provision of life-saving interventions to treat Severe and Moderate Acute Malnutrition.

• To reduce the burden of malnutrition among boys, girls, PLWs and other vulnerable groups through the strengthening and scale up of malnutrition prevention interventions. CCPM workshop participants held in long beach suites, Dhaka on 10th and 11th February 2019 • To strengthen the collective nutrition The CCPM exercise consisted of three steps; sector response through timely • Cluster coordinators, IPHN and Nutrition Cluster partners completed the collection and analysis online assessment questionnaire developed by Global Nutrition Cluster (GNC). of nutrition data, • The results of these questionnaires were compiled into a Coordination information Performance Report by GNC. management and • Cluster members; through a planning workshop met to discuss the report and effective coordination. to agree on follow-up action for improvement which has been reflected in the 2019 cluster workplan and strategy

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08 09 Nutrition Sector 2018 JRP Targets and Achievement

Indicator Target Achievement % Achievement Number of Boys and Girls aged 0-59 Months with Severe Acute Malnutrition newly admitted for treatment 35,093 29,716 85%

Number of Boys and Girls aged 6-59 Months with Moderate Acute Malnutrition newly admitted for treatment 103,773 42,959 41% Number of Boys and Girls aged 6-59 Months reached with NUTRITION CLUSTER Vitamin A Supplementation 187,576 195,323 104% Number of Boys and Girls aged 6-59 Months reached with MEMBERSHIP Blanket Supplementary Feeding Programme 138,900 214,766 155%

Number of Adolescents Girls reached with Iron 1 Ministry of Disaster Management and Rehabilitation Folate Supplementation 45,246 39,484 87% 2. Ministry of Health and Family Welfare-Institute of Number of Pregnant and Lactating Women and Care-givers of Public Health Nutrition children aged 0-23 months provided with IYCF counselling 85,956 41,328 48% 3. United Nations Fund for Children 4. World Food Programme 5. World Health Organization 6. United Nations Population Fund Key Contacts 7. Food and Agriculture Organization 8. Bangladesh Breast Feeding Foundation Title / Area of Organization Focal Point Phone number Email responsibility 9. BRAC 10. Department for International Development Cluster co-coordinator / Line Director Dr. Md Yunus 01711577786 [email protected] IPHN co-chair IPHN (NNS), 11. European Commission Humanitarian Aid DGHS, MoHFW 12. United States Agency for International Development

Cluster co-coordinator / PM (NNS), Dr. Taherul 01716217838 [email protected] 13. Save the Children International IPHN co-chair Designate IPHN, DGHS, Islam Khan 14. Action Against Hunger MoHFW 15. World Vision International 16. Concern Worldwide Cluster UNICEF Abigael Nyukuri 01700703818 [email protected] Coordinator/CLA Co-Chair 17. CARE Bangladesh 18. Hellen Keller International

Information FAO-UNICEF- Mohammad 01791009007 [email protected] 19. Plan International, Management Officer WFP Mainul Hossain 20. Terres De Hommes Rony 21. International Food Policy and Research Institute Strategic Advisory Save the Children Golam Mothabbir 01714088400 [email protected] 22. World Fish Group Focal

Technical working WFP Md. Sameul 01755642162 [email protected] group Focal Point Nawaz

Infant and Young Child UNICEF Mayang Sari 0175344048 [email protected] Feeding TWG Focal Point

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