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 since IYCF is part of IMAM package.
Participants’ Comments Some of the members wondered why their organizations did not feature in the best reporting and quality lists presented. Abdullahi advised them to write to Anna for clarification. Action Point: Circulate the Nutrition Information Management updates presentation to partners. Partners to submit pending reports (SC-OTP-TSFP-IYCF) for January – October by 10th of November
Nutrition Cluster Coordination
UNICEF Somalia Support Centre (USSC) Tel: +254-20-7628400
4 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
5. Agency profile presentation CAFDARO (Community Activity for Development Relief Organization)
CAFDARO is a private, humanitarian, nonprofit making organization committed to saving lives and alleviating suffering through relief and development programs. The organization was established in January 2005 by local experienced intellectual professionals from Luuq town with a task to improve the quality of life through implementation of emergency nutrition and resilience projects with support of International organizations, UN Agencies and Somali Diaspora.
Vision; To improve lives, knowledge, understanding, information sharing and empowered to effectively participate in decision that affect their lives and attain greater opportunities with communities, organizations, and governments towards achieving Millennium Development Goals (MDGs) and beyond.
Mission; To alleviate human suffering in emergency and disaster situations by providing relief assistance to the most vulnerable groups in the south and central parts of Somalia in order to improve their well-being.
CoreValues;Impartiality,trust,transparency,accountability,commitment,credibility,Non-violence, neutrality, gender fairness, respect for community values, traditions and beliefs and lastly respect for equity and fairness when dealing with donors, beneficiaries and general communities.
Programs; Nutrition, Water and sanitation, Agriculture and livelihood, Health, Community development
and Emergency response.
Nutrition Programs;
5 TSFP in Luuq district supported by WFP. 10 OTP centers in Luuq, Dolow, Belet-Hawa districts supported by UNICEF and CHF. FFA (Food for asset) in Dolow district supported by World Vision and WFP. . .
SURDO was not present at the meeting.
Action Points: Circulate CAFDARO profile presentation
6. Key agency/organization Programme highlights. HIRDO; planning to implement Blanket Supplementary Feeding Program (BSFP) in Gedo region, discussion between HIRDO and WFP is on the final phase.
ACF; Introduced 20 trained voluntary TBA at community level by conducting mother to mother support groups and IYCF counseling in Hodan, Abdulaziz, Wardhigley and Kahda districts in Banadir region.
WOCCA; experiencing access problems outside its target area. The agency cannot reach destitute beneficiaries living outside the agency’s target area due to restrictions from WFP’s FLAs. Nutrition Cluster Coordination
UNICEF Somalia Support Centre (USSC) Tel: +254-20-7628400
5 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
WFP informed members everything reflected in the FLA is based on the partners’ proposals. He said the main reason for confining programs on the target area is to avoid duplications with other agencies providing the same services. He said partner could reach the needy community out of their target area as long as they avoid duplication.
CAFDARO: Inquired whether the release of UNICEF PCAs depends on the implementation of the EPHS.
Dr. Farah confirmed that there is no relation between UNICEF PCAs and EPHS.
SRCS; Established almost 20 cold chains for twenty clinics plus three regional branches cold chains in the South Central Zone. This aims to improve EPI Programme for better prevention of polio and other preventable diseases.
Participants’ Comments Dr. Farah encouraged agencies running EPI in the country to coordinate with the Doctorate of Health. He confirmed that the government is planning to implement three sub-national cold-rooms in Banadir, Gedo and Galgaduud regions with offices, then cold-chains in other regions.
Action Points: To contact UNICEF to seek information on PCAs’ delay
7. Updates from Nutrition Cluster Coordinator Abdullahi Nur the nutrition cluster coordination assistant updated the partners on the following points on behalf of the Nutrition Cluster coordinator.
Common Humanitarian Fund (CHF): ERF proposal from two partners (IMC - Galkayo south and Somalia Aid- Marere nutrition programmes) were reviewed and shared with OCHA, as response to the MSF pull out.
CAP: The Consolidated Appeal Process (CAP) has been delayed but will now be fast-tracked and hopefully finalized by the beginning of December. Being a light process, no new NGOs registrations will be allowed for CAP. Only partners already in CAP for 2013 and which received funding likely to be considered, plus those who are in the EPHS , rationalization plans, as well as those assessed (capacity assessment and passed). All other NGOs will have to get funding through PCAs and/or FLAs from UNICEF and WFP as donors are looking at exponentially reducing risk. CAP guidance note will be shared within a week and only partners fulfilling the criteria should revise their projects. If a project is not revised then it gets dropped automatically.
DoH chair update:
DoH is looking for reputable and competent nutritionist to be part of the nutrition unit - Head of Nutrition, Preventive and Promotional Services Officer and Curative Services Officer. DoH advocated to share the vacancies (already shared with the partners) as widely as possible.
Dr. Farah reported that DOH will form a health and nutrition sector. Health will be separated into developmental and emergency preparedness, as well as nutrition. Health and nutrition activities will be integrated into WASH sector. Zonal and thematic working groups will be formed composed of IYCF, IMAM and others. The cluster will develop emergency preparedness plan and also to build up the capacity of the partners in the case of an emergency. Coordination plan will be developed allowing partners to work
Nutrition Cluster Coordination
UNICEF Somalia Support Centre (USSC) Tel: +254-20-7628400
6 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
together as planned in the EPHS. Maternal and child health is a component of EPHS that links health, nutrition and WASH sectors.
Action Points:
To share CAP guidance note with the partners
AOB EPHS: The Essential Package for Health Services (EPHS) was developed through a series of consultative workshops involving hundreds of representatives from the Somali health sector, NGOs, UN agencies and donors active in all zones of Somalia. It has been reviewed by representatives from Ministries of Heath in both Puntland and Somalia and approved in principle. It was meant to come up with one program that could be implemented by partner selected in transparent manner with the desired capacity to implement this programme. Galgaduud, Banadir and Gedo are the first regions where EPHS implementations are to take place. Should one need to familiarize with the EPHS components she/he should go through the document endorsed by the health sector for Somalia.
Floods update: Severe floods have been reported in Middle Shabelle region since April. Almost 30 villages are said to be affected; some flooded with properties destroyed and villagers displaced. Displaced people moved to in Congo, Shimbirow and other villages situated in highland areas. The main problems caused by floods include; population displacement, disruption in the roads links, inflation in the price market, increase in malnutrition cases, and crop destructions. SYPDO is planning to conduct joint nutrition rapid assessment in the affected area. Business vendors in the regions are reported to be assisting affected population through selected wet feeding programmes.
WOCCA is using boats to reach beneficiaries affected by the floods as the bridge built by ICRC has been destroyed by floods.
WASH Cluster: Middle Shabelle is in disaster level. WASH Cluster is planning to conduct joint assessment in the affected area. WASH kits have been already distributed by the stakeholders working in the area. Food and shelter are still the persisting major gaps to address the needs of affected populations.
Government requested partners to attend a government-chaired stakeholders meeting aimed at conducting resource mapping prior to conducting the needs assessment.
WFP: Communicated with implementing partners (IPs) on the administrative measure that WFP has taken which provides WFP with the ability to review and realign the current programmes into 2014 to:
Accommodate the anticipated funding situation, Realign and streamline programming costing structures to align with the nutrition cluster's recommendation on the provision of nutrition services, and finally Restructure/rationalize the scale and scope of programmes operational footprint.
Nutrition Cluster Coordination
UNICEF Somalia Support Centre (USSC) Tel: +254-20-7628400
7 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
WFP is committed to coordination of nutritional programming through the nutritional cluster, and through Head of Nutrition, WFP will keep all IPs apprised of evolution of this process.
Action Points: Government to meet with partners in Middle Shabelle on response to the floods
Action Points
Action Points- Meeting of 04.11.2013 Focal Agency/Person Status
Circulate the findings of SQUEAC survey by SCI Nutrition Cluster-Abdullahi Done Circulate the Nutrition information management updates Nutrition Cluster-Abdullahi Done presentation to partners. Circulate CAFDARO profile presentation Nutrition Cluster-Abdullahi Done Contact with UNICEF to seek information on delay in the PCA Nutrition Cluster-Abdullahi Done Share CAP guidance note to the partners Nutrition Cluster Coordinator Done Government to meet with partners in middle Shabelle in DoH-Dr Farah Done response to the floods.
Action Points- Meeting of 07.10.2013 Focal Agency/Person Status
To discuss modalities on easing challenges of distance in support of Nutrition Cluster Coordinator/ Pending coordination meetings for the Jubas. Subnational cluster FP- Juba
Work on the analysis of the sentinel sites Nutrition Cluster/IM Pending To circulate the Nutrition information management update to partners. Nutrition Cluster Done
To circulate Cash Transfer programming potential impact on Nutrition Nutrition Cluster Done presentation Work on the analysis of the sentinel sites Nutrition Cluster/IM Pending To circulate Progress report on development of micronutrients strategy Nutrition cluster Pending To circulate the agency profiles presentations. Nutrition Cluster Done To circulate final decisions on mechanisms of transitioning from cluster to Nutrition Cluster Pending sector approach
Nutrition Cluster Coordination
UNICEF Somalia Support Centre (USSC) Tel: +254-20-7628400
8 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
List of the participants
Name Organization Name Organization
Dr Mohamed Abdi Farah DoH/Chair Shukri Mohamed Ali WASH Cluster
Dr Abdulhamid Ibrahim DoH Sadia Mohamed Elmi WOCCA
Dr Abdirahman Hufane DoH Abdikadir Mohamed WARDI
Mohamed Issak Abdi DoH Abdihakim Gedi Harun CISP
Abdullahi Nur Aden Nutrition Cluster Mohamed Nur Abdi BTSC
Issak Hasssan Shiekh WFP Abdiwali Ibrahim Ali HIRDO
Dr Lulu Mohamoud Mohamed Banadir Hosp Ahmed Siyad Bunow FERO
Hashim Aden Jelle SORRDO Mohamed Ibrahim Jama HIRDA
Nuh Sh. Ibrahim ACF Abdullahi Ahmed GEWDO
Meymuna Abass Abdullahi IMC Abdirahman Salah Aden HDO
Aden Yusuf Mahdi SCI Abdirahman Mohamed Mumin VAA
Ali HilowleYalahow Aid Vision Maryan Mohdin Arraale HACDA
Asha Hussein Moallim BPHCC Idiris Abdi Yare JCC
Mohamoud Ali Hassan SAACID Mustafa Ahmed SDIO
Liban Abukar Osman SAACID ABAYLE BARE ADEN EREDO
Mohamed Abdulle Ali Mercy USA Abdirizak Mohamed PASOSO
Idle Nur Abdi Muslim Aid Abdinasir Daud HARD
Ibrahim Issak Aden BPSC Mohamed Hashim SRDA
Bakar Haji Omer BRADO Ismail Hassan SERDO
Hassan Shariff SWISSO-KALMO Odowa Hassan SORDES
Abdi Ibrahim INTERSOS Mohamed Abdullahi Barre Direct Aid
Habibo Hashi Awale CCS Said Ali Mumin CAFDARO
Abdirahim Hussein Jamac CWW Adan Sheik Hassan CAFDARO
Nutrition Cluster Coordination
UNICEF Somalia Support Centre (USSC) Tel: +254-20-7628400
9 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
Fatma Issa Adow ARD Ibrahim Abdi Hussein CAFDARO
Dr Abdiasis Warsame RMO Hassan Sharif Hashim SHARDO
Mohamed Ibrahim AYUUB NGO Abdulkadir Moalim Mohamed SYPD
Ibrahim Hassan Roble HRDO Mohamed Abdullahi DEH
Fardowsa Isse SRC Nur Bashir Hassan HDOS
Nur Abdi Ali Technoplan Mohamed Abdulle Ali Mercy USA
Abdullahi Aden Abdirahman. MARDO Sadia Mohamed HAPEN
Da,ud Mo,alin Abdi MARDO Ahmed Mohamud ZAMZAM
Kaho Abukar Aden MGV Abdullahi Omer IGOV
Ibrahim Mohamed Shiekh ARD
Nutrition Cluster Coordination
UNICEF Somalia Support Centre (USSC) Tel: +254-20-7628400
10 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]