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National Nutrition Cluster Meeting Minutes SOMALIA NUTRITION CLUSTER Minutes of National Nutrition Cluster Meeting 04 November 2013, 10.00 Hrs, DoH meeting hall, Afgooye road, Wadajir, Mogadishu, Somalia 1. Welcome and Introduction The meeting was chaired by the Director of Public Health Department of the DoH, Dr. Mohamed Abdi Farah and co-chaired by Abdullahi Nur. The meeting commenced with a holy Quran prayer followed by introductions. Dr. Abdihamid, the director of department of planning and coordination in the Directorate of Health gave opening remarks on behalf of the government. The director mentioned that this was the first time the National Nutrition Cluster Meeting was being conducted in Mogadishu chaired by the Directorate of health. He congratulated the Nutrition Cluster for proactively engaging in this decision of shifting the meeting from Nairobi to Mogadishu. Dr. Farah further elaborated that the nutrition outcome of a meeting held within the country is more fruitful and advantageous since it’s accessible to all partners at field level. The solutions to problems affecting the Somali society in the country could be established within the country if partners collaborate with their government to provide better services. Dr. Farah confirmed that the government has plans to integrate a health and nutrition sector which is important for all the stakeholders. Dr. Farah introduced the meeting agenda and called out for additional agenda items. Suggestions included the floods in Middle Shebelle’s Jowhar District. 2. Review of previous meeting minutes and action points Minutes of the previous meeting (07th October, 2013) were reviewed and endorsed as correct. Action points were also reviewed and their status updated (See Action points section). 3. Bossaso, Garowe & Beletweyne coverage surveys results report Save the Children carried out a presentation on the results of Semi-Quantitative Evaluation of Access and Coverage (SQUEAC) surveys conducted in Bossaso, Garowe and Beletweyne from May 2012 –May 2013. The purpose of the SQUEAC survey was to determine the final coverage of OTPs in the three districts. Objectives • To determine coverage of OTP in IDP camps of Garowe, Bossaso and Beletweyne regions. • To identify factors positively and negatively influencing the coverage. • To develop feasible recommendations to improve the coverage and performance of CMAM programmes in the three districts. Methodology Semi-Quantitative Evaluation of Access and Coverage (SQUEAC) which entailed; Semi-quantitative Assessment, Small Area Survey and Wide Area Survey. Nutrition Cluster Coordination UNICEF Somalia Support Centre (USSC) Tel: +254-20-7628400 1 United Nations, Block Q, Nairobi, Kenya Fax: +254-20-7623989 http://somalia.humanitarianresponse.info/clusters/nutrition Page Page For more information, contact Leo Matunga, Nutrition Cluster Coordinator: [email protected] or Komborero Chirenda, Deputy Nutrition Cluster Coordinator: [email protected] SOMALIA NUTRITION CLUSTER Performance indicators measured Bossaso Beletweyne Garowe Performance indicator Achievement Achievement Achievement Cured rate 90.5% 92.6% 89.1% Death rate 0.7% 1.0% 1.1% Defaulter rate 6.1% 5.6% 8.8% Non-response rate 2.7% 0.8% 0% Major barriers. Inadequate counselling about the treatment and follow up visit. SAM child first going to traditional healer & pharmacy. Care takers’ refusal and prioritising of other task. One OTP team works in two sites on the same day. Inadequate furniture in waiting area for care takers. Frequent relapse. Poor health seeking behaviour. Poor awareness among the community key actor (madrasa teachers, traditional healers) Inaccessibility of OTP sites due to long distance rains and floods. Poor knowledge of RUTF feeding practices. Inadequate follow up of defaulters. Major Boosters: Good understanding and perception of CMAM programme by community members and key figures. Active role of raising awareness of community key figures. Absence of malnutrition stigma. Well trained OTP staff. Good understanding of malnutrition by majority of community members. Well organized referral system between the different programmes. Sites are very close to beneficiaries. Staff acceptance and good community collaboration. Common and well known problem in the IDP. Trained OTP staff. Establishment of hand washing facility at OTP sites and distribution of hygiene kits to SAM incharges. Monthly house to house screening and weekly home screening by CNVs. Good community linkage with the other programs Completed and updated records. Good community mobilization. Sample size selection: Nutrition Cluster Coordination UNICEF Somalia Support Centre (USSC) Tel: +254-20-7628400 2 United Nations, Block Q, Nairobi, Kenya Fax: +254-20-7623989 http://somalia.humanitarianresponse.info/clusters/nutrition Page Page For more information, contact Leo Matunga, Nutrition Cluster Coordinator: [email protected] or Komborero Chirenda, Deputy Nutrition Cluster Coordinator: [email protected] SOMALIA NUTRITION CLUSTER Garowe: Sample Size: 43 SAM cases. Coverage in Garowe 85% (CI 78.0%-90.1%), slightly below expected coverage of 90%. Bosaso IDP: Sample Size: 29 SAM cases. Coverage in 82.8% (72.1-89.6%), slightly below expected coverage of 90%. Beletweyne: Sample Size: 223 SAM cases. Coverage in 77.8[71.6%-83.1%), above expected coverage of 60%. Recommendations Strengthening of community mobilization. Dissemination context specific IYCF key message. Creation comfortable waiting space for care takers. Increase community awareness on CMAM projects. Establish consistency in RUTF supply. Educate the caretakers and community member on RUTF utilization. Enhance the home visits done by the CNVs to ensure all the beneficiaries are followed up. Develop communication strategy to effectively engage traditional healers and madrasa teachers. Strictly adhere to the Somalia IMAM protocol and communicate any decision with senior staff on time. Involving influential people in the community in the counselling of mothers refusing to access SC and other care takers (especially fathers) to take charge when a mother is sick. Participants’ Comments • Dr. Farah felt that the discussion reveals that there is no standard coverage survey system in Somalia. The coverage surveys conducted by an agency to assess its coverage may not be reliable; hence the Somalia government will come up with a strategy to assess partners’ coverage. Action Point: Circulate the findings of SQUEAC surveys presentation Somalia Government to prepare a strategy to assess partners’ coverage 4. Nutrition Information Management Update Abdullahi Nur, the nutrition cluster coordination focal person in Banadir and the Shabelles, presented updates on the 4W matrix, members and partners’ overview and 2013 SC/OTP, TSFP & IYCF reporting prepared by the Cluster Information Management Specialist, Dr. Anna Ziolkovska. Nutrition Activities (4W Matrix) It was highlighted that currently there are 2,773 operational nutrition sites for SAM, MAM & IYCF including 33 SCs, 1,217 OTPs 1,345 TSFPs and 178 IYCFs. Nutrition cluster Membership Nutrition cluster has 291 partners, members and observers (48 INGOs, 214 LNGOs, 9 UN, 8 Government agencies, 8 Donors and 3 others). Nutrition Cluster Coordination UNICEF Somalia Support Centre (USSC) Tel: +254-20-7628400 3 United Nations, Block Q, Nairobi, Kenya Fax: +254-20-7623989 http://somalia.humanitarianresponse.info/clusters/nutrition Page Page For more information, contact Leo Matunga, Nutrition Cluster Coordinator: [email protected] or Komborero Chirenda, Deputy Nutrition Cluster Coordinator: [email protected] SOMALIA NUTRITION CLUSTER New admissions 2012 and 2013 SAM and MAM New admissions were compared. The graphs used indicated 2012 had a higher number of new admissions for both SAM and MAM as compared to 2013.For SAM, the number of new admissions based on assumption of 100% reporting rate was projected to be slightly higher than 2013 admissions figures while for MAM the projection figures were more or less the same as 2013 current new admissions. 2013 SC/OTP Reporting As usual the main 3 aspects being monitored are; 1) submission of reports (quantity), 2) timeliness of reports submitted, and 3) quality of reporting. A special mention was given to the 17 partners (ACF, AYUUB, BH, BHM, BRH, BTSC, CEDA, GRRN, HARD, HDOS - Hadia, LQC, MARDO, Mercy USA, MGV, RAWA, SWISSO-Kalmo, URDO) who submitted all site reports for last three months (July-September 2013) by the 10th of each subsequent month. Abdullahi encouraged the partners to appear in this category. Partners who did not submit any site report for last three months (July – Sept) by the 10th of subsequent month: (APD, BPHCC, CARE SOMALIA, CCC, EDRO, FERO, HIRDA, HRDO, MERLIN, RAAS, SAF, SARD, SCI, SCI/CPD, SCI/GREDO, SCODO, SDIO, SOADO, Somali Aid, Southern Aid, SRC, SRCS, TUOS, URRO, WCH, WRRS). Partners with lowest reporting rates: BPHCC – 33%, HOPEL – 21%, BMO – 16%, SAMA – 13%, HIRDA, SARD, SHARDO, WARDI, and WCH – 11%. Partners with the best quality reporting: MGV, SOS, IMC, AYUUB, WCH, SAMRADO, ARD, Oxfam-HARDO, SAACID, CWW, ACF. Worst reporting quality partners: SARD, APD, URDO, SOADO, SRDA, Muslin Aid, WOCCA, Swisso-Kalmo, SORDES, CISP. IYCF reporting It was noted that there are less IYCF reports than nutrition sites reported. Partners with pending reports were encouraged to submit them as soon as possible. Partners currently not implementing IYCF were requested to provide an explanation why they are not doing IYCF activities
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