NUTRITION CLUSTER

Regional Nutrition Sub-Cluster Coordination Meeting of Bakool, Date: 30 th June 2018 Time:Regional 10:00am – 12:00pm

The meeting was attended Bakool Nutrition Cluster Participants (International & Local organizations), these include: GREDO, MARDO, ARD, ACF.

The Meeting was hosted & chaired by GREDO. It was held in GREDO Meeting hole.

After a round introduction, All the nutrition cluster participants shared their Key Nutrition Updates, Challenges and Gaps, even did a review and endorsement of the last cluster meeting minutes which occurred on 5 th May 2018.

Draft agendas

1) Welcome and round Introductions 2) Review and endorsement of the last cluster meeting minutes on May 2018 3) Key Nutrition services and Situation highlights 4) Gaps and challenges 5) AOB Meeting Representatives:

GREDO, ACF, MARDO, XIDIG, SRCS, ARD & Ministry of Health (MoH).

Minutes discussions among nutrition partners

Agendas Discussion Action Point After prayer of Allah and a round introduction, GREDO Nutrition 1. Welcome & the meeting was opened, the chaired person Acting Focal Point, Round thanked & warmly welcomed to all the cluster Dr. Abdimajid Introduction partners those attended this nutrition Yousof Ali. coordination meeting. All the cluster meeting participants have deeply All Bakool Nutrition 2. Review and discussion on the previous meeting and they Cluster Partners endorsement of agreed true meeting minutes the action points of the last cluster the last meeting minutes also discussed meeting minutes accordingly,. MoH representative told that they will invite all Bakool Cluster Partners for planning

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on May 2018 monthly cluster meeting and even checking nutrition activities in the region. Some cluster partners complained about overlapping problems in their functional sites.

Bakool Nutrition 3. Key Nutrition Cluster Partners services and ACTION AGAINST HUNGER NUTRITION CLUSTER Situation highlights UPDATES for June 2018

Action against Hunger has currently 4 bases in Bakool region, namely: , Elbarde, Wajid and Yeed. The organization provides health, nutrition, WASH and livelihood programs that complement one another. The health and Nutrition are integrated to provide comprehensive services that address the root causes of the individual, household and community problems. AAH health and nutrition program continued to provide basic primary health care service to vulnerable communities in Hudur and Wajid districts mainly (IMCI service) treatment of childhood illness for under five children and pregnant and lactating women (PLWS) those attending the MCH/Mobile sites and seeking free medical services. All the beneficiaries received integrated services through routine screening, Medical consultation, and treatment through appropriate medications. At the same time Health and nutrition promotion and sensitisation for all caretakers and their children with aim of reducing poor health seeking behaviours and reduction of diseases morbidity. Consequently during the period under review 4248U5and>5received medical consultation. 90% of these consultations were conducted in while the rest are from Wajid. This huge gap has been occasioned by the low coverage in Wajid due to insecurity as well as Hudur having bigger population. HUDUR Stabilization Centre (SC).

During the reporting period 71 patients were admitted .It’s worth noting that46 % of the admitted children had Upper Respiratory tract infection, 37 % had diarrheal diseases while the rest had other

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bacterial infections. The admission rates have been fluctuating with an average of 62 admissions for the past 4 months.

OTP AAH continued its routine OTP activities at fixed and mobile facilities. During the reporting period there were 861 children were admitted in OTP program (387male and 474 ) female), the program admission rate decrease from by 4% as compared previous month due inaccessibility of far outreach sites during the rainy session mean. At community level health education sessions and community sensitization, counselling and referral of SAM children continued.A total of , 991 (467 male 524 ) female were discharged as cured from the program after they reached the target weight and transferred to TSFP TSFP During the period under review there were no admissions for moderately malnourished children owing to the fact that there were no supplies available. However the screened children who meet the admission criteria were referred to local partners who provided these services. Performance Indicators- The performance indicators were excellent indicating quality programing with a cure rate of 99%, defaulter 0%, death rate 0% and non-responder of 0%. . Nutrition promotion focuses on infant and young child feeding practices (IYCF) for caretakers of children and MTMSG. During the reporting 2939 benefited from AAH health promotion activities conducted during distribution days. In Hudur topics covered included complementary feeding, importance of immunization and handwashing. 92% of these were female while the remainder was children and men. At the same time 3 Mother to mother support groups were established 30 weekly sessionsheld ELBARDE UPDATES Stabilization Centre and OTP The total admissions for the period under review in the SCs and OTPs in Elbarde are 54 and 205 respectively; the total admission is lower than

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previous months. This drop can partly be attributed to inaccessibility of roads due to the heavy rains in the district. The OTP admission rate has reduced by 23% while the SC by 11% compared to the month of April. During the reporting month 54 children were managed in the AAH SC (the only one of its kind in the district). At the same time, a total of 205 (Female 108 and male 97) cases of acute severe malnutrition without medical complication were admitted to the OTP. As per the cases referred to the distribution sites, 87% were spontaneous, 6% were by the community mobilizer while the rest were from the CHNWs. 15% of the caseloads are from the IDPs (Gargaar and Wargarweyn) while the rest of the admissions are from the host community. 65% of the children admitted in the month of May were from Elbarde town. This is chiefly due to access. The other sites registered low numbers because the roads were impassable Mother Led MUAC Training- ACF Elbarde program is piloting this initiative. So far 1500 mothers whose children are in program have been trained on MUAC measurements. This is meant to increase timely referrals and detect malnutrition early

GREDO/SCI Nutrition updates for months of June 2018

Gargaar Relief and Development Organization (GREDO) presence in the wajid and Huddur districts of Bakol region implementing for integrated Life saving Assistant Drought Affected in population in Bakol region funded by OFDA the life saving activities are mainly outpatient therapeutic feeding (OTP), Target supplementary Feeding Program (TSFP) and pregnant lactation women (PLW) is for severe Acute malnutrition (SAM) cases admissions without medical complication treatments ,. Outpatient therapeutic feeding admitted children without medical complication through screened by the teams according the criteria standards of OTP. The children are given the systematic treatments through diagnostics made by the OTP nurses at the center and RUTF for weekly home utilization given the children while the team have ensures the mothers are properly meet the RUTF demonstrations proper handling and preservations held in the center in the initial, therefore in each the team counts down the empty sachets of RUTF

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consumed by the children at their home that mothers obligated to be brought in the OTP centers for next distributions . Outpatient therapeutic feeding (OTP) directly admitted the children transferred from other SC after recovery and through other OTP transferred from. Most of children had not received immunization after AS composed control and against the humanitarian agencies which ready to support the communities because children were very week their immune were not function well and susceptible in any every diseases and linked to malnutrition IYCF The IYCF team and NHHP/CNV for early childhood developments and community awareness throughout educating the BNF and caretakers visiting the GREDO Nutrition centers and OTP, breastfeeding and psychosocial support and attention were given to the lactation and optimal infant young child feeding .the GREDO nutrition staff set up good purposes to give psychosocial support to bring the children for the treatment centers and outreach mainly OTP. Exclusive breastfeeding is the healthiest ways to feed a baby less than six months, babies who are exclusive breastfeed receive no pre lactates water, teas or complementary foods. The all mothers in the OTP were brainstormed the importance of the breastfeeding massages by the GREDO CNVs and the staff in separate sessions in every week 20—35 minutes each sessions. GREDO conducted father 2 father and mother 2 mother support group sessions for towns and villages which for the three months period For father2 father support group session has already completed but mother 2 mother support group are remaining sessions The content massages disseminated are the followings. 1. Breastfeeding should be continued for at least the first two years of life at the age of six months, 2. young children require energy dense foods in addition to breast milk its recommended that 30% of the energy content of their diet comes from fat sources, 3. when children aged 6-24 months don’t have access to breast milk foods must be sufficient to meet all their nutritional requirements and efforts should be made. 4. Good breastfeeding to prevent early pregnancy to the mothers and helps the health of both the infant and mothers. This figure shows details about in these months in 2018

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Outpatient Therapeutic program (OTP) Children admitted in TSFP programs at GREDO respective sites • Total number children 6-59months were 418 • Total cured =319 • Death =2 • Defaulter =18 • None cured= 0 • Transfer =4 • Total discharge =343 Target Supplementary feeding program (TSFP) • Total number Children admitted in TSFP program were =574 • Total cured rate =472 • Death =2 • Defaulter= 3 • None cured =0 • Transfer= 1 • Total discharge =512 PLW data for June 2018 • Total number of PLW admiited in TSFP were 377 • Total cured =331 • Oedama =0 • Death =0 • Defaulter =4 • None cured= 0 • Transfer =0 • Total discharge =349.

LLIN distribution updates for Rainfall period

At least 1360 of mosquito net had been distributed to the pregnant mothers that 1st ,2nd and 3rd Trimester and other host Community and six main IDPs camps which unable sleeping without mosquito net those at risk of malaria , children fully immunized have participated on distributed days with also received LLIN. ARD- Nutrition program updates for June 2018

1. TSFP: 528 new cases U5 AND 47 PLWs were admitted in the months of May and June 2018; 753 of U5 and 202 PLWs were discharged cured and 1 death case was reported so far and no defaulters yet. 2. BSFP: 2000 of U2 children were targeted and

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received 1.5 KG of Plumpy Doz in May and June 2018. 3. OTP: we conduct OTP activities in 3 sites; I fixed and 2 mobiles. We admitted 272 SAM children in the program and 244 were discharged cured 2 were defaulted and no deaths reported so far. 4. SC: 15 SAM children with medical complications were admitted and systematic treatment were administered during their stay at the SC. After they were stabilized, the staff transferred them to OTP for continuity of the therapeutic treatment. 5. EPI: 240 children were immunized in the months of May and June 2018. Penta vaccine supply shortage was experienced during the reporting period. 6. NHHP: 951, IYCF 996, De-worming 1286, Micronutrient: 2165 and Vitamin A supplementation 1170. ARD plans to carry out nutrition intervention in Washaqo area for treatment of malnourished children and PLWs

4. Gaps and Most of the Cluster participants not faced All the cluster challenges such any challenges and gaps. GREDO stated partners & that the last month of June were lack of participants supply, and HIDIG organization representative told that they were new at the field of nutrition in its newly implemented project of Huddur District and they have faced such challenge of selecting and assessing sites. 5. AOB All participants agreed and suggested that it is All Nutrition Cluster better in discussing cluster agendas and Partners including progressive agendas for the field of work and the surrounding community. Cluster Partners suggested and recommended so far holding Monthly Regional Sub Health Cluster Meeting as Nutrition cluster is done.

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List of Cluster Participants

S/ Name Organization Title Email N 1 Dr. Abdimajid Yousof GREDO H & N Supervisor drcanady111@g Ali mail.com 2 Dr. Abdirahim GREDO Medical Doctor arbaciin40@gm Mohamed Ibrahim ail.com 3 Mostaf Mohamed MoH RMO Mustaf.rmo.iswa Ahmed @gmail.com 4 Hassan Abdullahi Hidig Nutrition Field Officer hidigngo@gmail Mohamud .com 5 Abdullahi Kasim ARD M & E Dhaaysile21@g Ahmed mail.com 6 Hassan Mohamed AAH/ACF Nutrition Officer [email protected] Adan onagainsthunge r.org 7 A.shukri Mohamed SRCS Health & Nutrition Hudurbho.srcs@ Adan gmail.com 8 A.karim A.llahi MARDO Nutrition Officer mardosom@gm ail.com

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