Contents From the Editor Field Articles 2 Constraints to achieving Sphere any pieces in this issue of Field HIV/AIDS between 1993 and 2005 on individuals, minimum standards for SFPs in Exchange strengthen our understanding households and communities in Zambia. The West Darfur: a comparative of best practice in nutritional emergen- research focused on two locations in Zambia: analysis Mcies. We highlight four in this editorial. Mpongwe – close to the Copperbelt towns, and Teta, a remote rural area. A unique aspect of the 12 Breastfeeding Support Groups in Victoria Sibson from Concern Worldwide work was the fact that it used a ‘cluster’ approach Tajikistan describes efforts to establish why SFPs, imple- to help understand how individuals and house- mented as part of CTC programming in Darfur, 19 Comparing cash and food transfers: holds had either adapted or disintegrated as a have often failed to meet SPHERE standards. findings from a pilot project in Sri result of ill health, and specifically HIV/AIDS. A Concern Worldwide undertook a study in two SFP cluster can consist of various households, usually, Lanka locations with very different performance results. though not necessarily, living in the same geo- In El Geneina SFP, cure rates were only 26.9% and 23 Can height-adjusted cut-offs graphical area. A significant benefit of the concept default rates were 47.5% while in Mornei SFP, per- improve MUAC’s utility as an is that it allows the most important relationships formance was much better, almost reaching assessment tool? between individuals of different generations and SPHERE targets. A number of contextual factors gender, marital and kinship statuses to be identi- explaining the different programme outcomes fied and understood. 5 Research came to light. For example, in El Geneina there is • Community based approaches to a larger internally displaced population (either in The study identified a number of factors that camps or living with residents) that has greater determine the relative vulnerability and resilience managing severe malnutrition: case trading opportunities, so that the opportunity cost of a cluster to the impact of a death, e.g. length study from Ethiopia of participating in the programme is far greater and degree of incapacity during AIDS-related ill- • Sexual exploitation and food than in Mornei. Other factors are the greater cov- ness, overall cluster composition, etc. Another key distribution in Burundi erage of the general food distribution (GFD) in finding was that the inherent adaptability and flex- • Niacin deficiency and pellagra in Mornei, better access to protected water sources ibility of the matrilineal social system in Zambia Angola and the existence of more complementary pro- enables it to accommodate deaths and changing • Understanding HIV/AIDS and gramming, e.g. health, livelihoods, etc. economic and demographic circumstances. The authors set out a number of very significant les- livelihoods: new cluster analysis These findings raised a number of questions for sons for those making policy and designing pro- Concern. For example, does the widespread inabil- • Population movement as a livelihood grammes. For example, in programmes working ity of many agencies currently working in Darfur strategy in northern Uganda with the poor, targeting should be directed at to meet minimum standards for SFP performance • Nutritional status of children and resource-poor clusters rather than poor house- indicate that the general ration needs to be pregnant and lactating women in holds and for targeting, a broad based multi- increased, and whether cure, death and non- faceted definition of vulnerability is needed, i.e. relief camps in post-tsunami Sri response (failure) rates should be used to judge one that is not just AIDS-related. Lanka programme quality alone, or are they also indica- • Measuring household food insecurity tors of the quality of the supporting services Another notable research piece in this issue is in emergencies: WFP’s approach (health, water and sanitation, food security, GFD, a summary of an important study instigated by etc). WFP in conjunction with the government of Angola and various implementing partners to investigate 13 News Concern’s experience is very timely in that the the prevalence of niacin deficiency in post-war • Making Sense of the Code: new ENN is currently completing a study on the effec- Angola. The study found that the expected tiveness of emergency SFPs in a large number of training materials decrease in pellagra incidence after the end of the emergency settings. The study has involved the • ODI website on cash in civil war in 2002 had not occurred. This is the first analysis of data sets from 82 SFPs implemented emergencies report of a household population survey of niacin by 16 agencies between 2002-5. One of the key • Evaluation of Field Exchange status in a region with a pellagra endemic and has aspects of this analysis is an examination of the demonstrated a serious prevalence of low and • Livestock Emergency Guidelines principal factors which may predispose to pro- deficient niacin status in women – nearly one in and Standards (LEGS) gramme success or failure. Findings will be sum- three women were found to be niacin deficient. Investigation of anthropometric marised in the next issue of Field Exchange. • The authors assert that the identification of niacin training by NGOs The ENN and Field Exchange have devoted con- deficiency as a public health problem should refo- • Report on IFE Meeting now siderable print space to the experiences of imple- cus attention on this nutritional deficiency in available menting cash transfers as part of emergency pro- Angola and other areas of Africa where maize is • Development of Rapid and gramming. In this issue WFP, IFPRI and Oxfam the staple. While WFP is now providing fortified Comprehensive Assessment Tools have collaborated to write about a pilot cash inter- maize flour to vulnerable groups in Bie province, this study suggests that there may be a need for for Emergencies vention in Sri Lanka following the 2004 December 26th tsunami. The article examines the relative a national flour fortification initiative and other • Update on the IPC Online Global merits of cash and food aid programme as part of locally targeted interventions. Forum an ongoing WFP Vulnerable Group Feeding pro- Over the coming months, we will be carrying • Nutrition in Emergencies short gramme. The same targeting mechanisms were out an evaluation of Field Exchange. Central to course used for cash and food beneficiaries, with the this evaluation is what you, the readership, think amount of cash disbursed equal to the local mar- • New WHO growth standards: more of Field Exchange - how you use it in your work, ket value of the WFP food ration. The authors draw harm than good? what do you like about the content and format and important conclusions about where one type of • ‘Top 10’ underreported crises in how do you think it could be developed or programme may be more appropriate than the 2006 improved. A questionnaire has been included with other. For example, in areas where markets were this issue and more details are included in the • Public Health in Complex functioning and accessible, cash transfer was news section on page 14. Emergencies course – 2007 dates more cost-effective and preferred by beneficiaries. • IFE training planned in London The converse was also true. The appropriateness As usual, there are also many other field arti- of cash programming was also found to depend on cles, research, news and evaluation pieces in this 17 Views market access and functioning (whether they are issue of Field Exchange and we sincerely hope • The Need to Improve Administration competitive and integrated), and security. Food there is something to interest all readers. Enjoy! aid was found to be more appropriate in contexts in Ethical Organisations where markets were not working well, where Jeremy Shoham security conditions imposed higher market trans- 21 Evaluation actions costs for consumers, and in situations of • Evaluation of international response high and unpredictable inflation. These, and other to the Tsunami findings, are valuable additions to the emerging body of experience on cash programming being documented in a number of fora. 26 Agency Profile Any contributions, ideas or topics for future In the research section of this issue, there is a issues of Field Exchange? Contact the editorial 28 People in Aid fascinating study dealing with the effects of team on email: [email protected] 1 Field Article Dafur, Concern, 2007 Dafur, Figure 1 West Darfur and Concern’s six Constraints to achieving SFP/OTP base locations Sphere minimum standards for SFPs in West Darfur: a comparative analysis Nutritional context This protracted humanitarian crisis necessitates the continued operation of supplementary and therapeutic feeding programmes in many areas of the three Darfur states. The September 2006 Darfur-wide interagency nutrition survey found an estimated global acute malnutrition (GAM)1 of 10.6% in West Darfur, significantly higher than 2005’s finding of 6.2%2. Although low relative to GAM rates in other regions and countries, malnutrition rates still fluctuate out- A view of Mornei camp side acceptable parameters and are likely even By Victoria Sibson and Kate Golden higher in localised pockets. For example, in the West Darfur state capital, El Geneina, the GAM Victoria Sibson started work as a nutritionist with GOAL in Ethiopia in January was estimated at just over 12% in May/June 2004, from where she moved to Darfur in October 2004. She became MSF-H’s 2005 and in 2006, despite the presence of Darfur nutrition coordinator in June 2005 and has been a Nutrition Programme General Food Distributions (GFDs) and selec- Manager for Concern’s West Darfur programme since June 2006. tive feeding programmes3. Kate Golden is one of Concern’s Dublin-based Nutrition Advisors.