SOMALIA NUTRITION CLUSTER QUARTER II, 2016 AFTER ACTION REVIEW MEETING Meeting Proceeding and Highlights 15 th - 16 th August 2016, Jacaranda Nairobi, Kenya Page 0
Contents Introduction... 2 Day 1, Session 1: Welcoming, Introduction, Objective and Expectations... 2 Purpose:... 2 Attending participants... 2 Day 1, Session 2: NCC 2 nd quarter performance report... 3 Key areas/topics covered... 3... 3 Key action points drawn/ major priorities agreed upon:... 3 Day 1, Session 3: Update from the Nutrition Coordination Team on the progress made towards the implementation of the 2 nd Quarter 2016 coordination meetings action points, challenges and bottlenecks.... 4 Key areas/topics covered... 4... 4 Key action points drawn/ major priorities agreed upon:... 4 Day 1, Session 4; Progress/review of Mid-Year HRP 2016 performance... 5 Key areas/topics covered.... 5... 5 Day 1, Session 5: Nutrition cluster AIMWG Progress and Initiatives update... 5 Key areas/topics covered.... 5... 5 Day 1, Session 6: Update on National Development Plan... 6 Key areas/topics covered;... 6 Key areas/topics covered... 6... 6 Key action points drawn/ major priorities agreed upon:... 6 Key areas/topics covered;... 7... 7 Key action points drawn/ major priorities agreed upon:... 7 Day 2, Session 8: Progress on Geotagging project... 7 Key areas/topics covered;... 7... 8 Key action points drawn/ major priorities agreed upon:... 8 Day 2, Session 10: Bottleneck Analysis (BNA) to Improve Access and Effective Coverage of IMAM Services (Overview and Progress);... 8 Key areas/topics covered... 8... 8 Day 2, Session 11: SCOPE;... 9 ;... 9 Day 2, Session 12: SUN Project update... 9 ;... 9 Day 2, Session 13: School Nutrition Breaking Inter-Generational Cycle of Malnutrition;... 10 ;... 10 Page 1
Introduction The Nutrition Cluster conducted Quarterly after Action Review Meeting/workshop with nutrition partners technical and management staff from the Ministry of Health (MoH) and Nutrition Cluster stakeholders across Somalia. The workshop held in Nairobi from 25 th to 26 th of April 2016. Day 1, Session 1: Welcoming, Introduction, Objective and Expectations The two day meeting was opened by UNICEF- Chief of Nutrition and the Director General of Puntland MoH. They both appreciated the importance of the review meeting and the presence of participants in identifying challenges, consolidate achievements and pave way for improved nutritional status of Somalia children and women. The Nutrition situation in Somalia was highlighted to be still dire, hence needs to keep on strengthening quality of existing response services and scaling up interventions. Efforts made by partners, cluster leading agencies and the Ministry of health towards achieving this goal were appreciated. There was a round of brief introduction of all participants followed by discussion on the main purpose, objectives and expected outcomes of the two day meeting that has been agreed upon as follows; Purpose: To Strengthen and improve the cluster/sector coordination and information management. The objectives of this consultative workshop are: To review 2 nd quarter NCC performance, review mid-year review actions progress, and identify challenges, bottleneck and lessons learnt. To review emergency preparedness and response actions as well as stakeholder consultation on nutrition chapter of the social pillar of the NDP (National Development Plan) To provide a structured platform for discussions, sharing information and lessons learned from cluster partner s perspective with an aim to improve coordinated response, information flow and learning. To review Emergency Preparedness and Response actions as well stakeholder consultation on nutrition chapter of the social pillar of the national development plan (NDP). To provide structured platform for discussions to provide a forum for presenting technical updates relevant to improving effective emergency nutrition response including ENN-SUN project, School Nutrition Initiative, SCOPE and other research updates etc... Expected outcomes Reviewed and endorsed documents including ToRs for National Nutrition Assessments and survey guideline, National Integrated imam guideline, Revised AIMWG ToR, plan for improved performance on HRP, and replacement of Co-Chair. Endorse pre-selected BNA National Core Team and implementation plan Reviewed Emergency Preparedness and Response actions as well stakeholder consultation on nutrition chapter of the social pillar of the national development plan (NDP). Contribution and renewed commitment to nutrition chapter of the social pillar of the NDP. Attending participants Meeting was attended by approximately 95 participants; Ministry of health officials, Management and technical staff from NGOs and other nutrition stakeholders. Page 2
Day 1, Session 2: NCC 2 nd quarter performance report The Somalia Nutrition Cluster team presented the performance of the 2016 second quarter and the progress made against the Somalia nutrition cluster plan. information presented on the state of nutrition activities based on partner s reporting. Key areas/topics covered Major Accomplishments during second quarter of 2016 2016 Cluster progress towards HRP targets, Challenges and Way forward Completeness and Timeliness: Low reporting rate was considered to be a continued problem. Partners raised some of the challenges contributing the low reporting rate. UNICEF Nutrition: partners were encouraged to keep parallel reporting to mnutrition and the HMIS has been used in the past years. The same was agreed in the past 1st quarter review meeting. UNICEF confirmed they have enough supplies in stock for time being and partners with active PCAs have supplies as well as the cash component. Similarly, WFP Nutrition expressed that all their implementing partners have active FLAs till end of the year with enough supplies. Government & Reporting: MoH worried the low reporting rates in some regions specially Bari where nutrition key actors like SCI, MDM, Care International and HADO have full presence. To enhance the reporting rate and address the challenges, MoH officials noted that they have invited nutrition partners in NEZ for a meeting on the reporting and will share the outcome of that meeting. FMoH HMIS Coordinator explained the reasons of low coverage in some of the regions like Hiran which was mainly due to inaccessibility. Banadir Hospital: MoH s HMIS coordinator reminded the need to support Banadir hospital where the death rate of malnourished cases was reported to be extremely high in the stabilization centre. UNICEF worried if the unacceptable rate of death was reported from Banadir Hospital what about other hospital who don t have the capacity. There is need to have site discussion. Page 3 Key action points drawn/ major priorities agreed upon:- The outcome of Bossaso meeting on reporting issues will be shared Immediate Puntland with the cluster partners MoH/Cluster Focal Point Cluster IM to make more detailed analysis of Bakool, Lower Juba, Immediately IMO-Ahmed Bari and Hiran reports most probably in the three years report Extra mass screening and awareness to reach more children so that In the third SCI/SNS to reach the target. Quarter Special case management training for AWD areas on how to Before the end UNICEF/NCC manage diarrhoea cases with Malnutrition. of the year Monthly data analysis and presentation in the zonal coordination On going IMO and Zonal mechanisms Focal Points All operational partners to do two nutrition Mass Screening to make early detection of case and reaching more children as well. Sep and Nov 2016 All partners with active nutrition activities
Day 1, Session 3: Update from the Nutrition Coordination Team on the progress made towards the implementation of the 2 nd Quarter 2016 coordination meetings action points, challenges and bottlenecks. The nutrition cluster team presented the status of the action points drawn from monthly zonal coordination meetings as well as national cluster coordination meeting. Key areas/topics covered National/regional Action Points tracking matrix update Achievements and bottlenecks PCA/FLA: Both UNICEF and WFP confirmed to the implementing partners that the obstacles pertinent to the agreements (PCA and LFA) will be addressed. Capacity Building and SUN: UNICEF informed possibilities of Capacity Building support from two sources, one from a DFID sub-contracted agency and WHO, which is bringing a consultant to develop a comprehensive result framework for Nutrition involving all the actors that will be aligned under the National Development Plan (NDP). Supply Issues: UNICEF committed to provide supplies that can be enough for a quarter nutrition to Kismayo and other districts in advance should there be access constrains. UNICEF is also flexible to give up to six month supply so long the partner has active PCA and partners have the capacity to store it. Integration of Health and Nutrition: the need to integrate nutrition/imam components first and then to think of other sectors was discussed. In addition, participants mentioned importance of maintaining standalone single service delivery platform for integrated nutrition programmes in an area where there are no health facilities. Partners with risk issues: UNICEF or any other UN agency can t work with high risk rated partners by Risk Management Unit of the UN. When a primary partner related to risk issues, either of the secondary or tertiary partner would be on board to provide the services. Hiran Emergency: Low level of emergency response in Baletweyne-In May 2016, the floods affected adversely in Baletweyne and Bulo Burto district of Hiran region and most of the partners in the area have no active PCA to reach the outside villages. Nonetheless, UNICEF and WFP airlifted supplies to Bulo Burto district during the emergency time in Beletweyn. Key action points drawn/ major priorities agreed upon: There is need to link the zonal coordination mechanisms with improved On going All zonal performance, coverage and reports clusters Regardless of the presence of the JHNP/EPHS, nutrition projects will continue On going UNICEF partners Partners with active PCA were given the option to request 3 or even 6 month s On going UNICEF supplies as long as they have capacity to properly restore. partners WFP will start working on 2017 FLA in October, partners need to submit their October WFP partners proposals in October. 2016 Page 4
Day 1, Session 4; Progress/review of Mid-Year HRP 2016 performance The Nutrition Cluster Country Team provided update on the progress of mid-year HRP 2016 performance. Key areas/topics covered. Progress towards cluster Objectives Cluster 2016, key tasks Challenges and Achievements Key actions to be taken Geotagging: Disk review of the current data, tools, process is on good progress. Plan of action for implementation prepared. BNA and Scale up Plan: National Core Team established and fully functional while the cluster drafted ToR. A consultant from New York is present to do the training of the core member for the country. imam GUIDELINES and Training Modules: Additional needs identified including C4D, IYCN, survey and assessments and Micro nutrient. ToR developed and upon review it ll be advertised. Mapping of the existing Guidelines completed and ToR developed. CHF/SHF: Drought affected regions and IDPs were prioritized for first 2 allocations of CHF funding, second envelope was allocated for the IDPs (of Kismayu and Baidoa). Banadir allocation (3 rd round) is currently on progress. Capacity building In collaboration with UN-RMU, 4 round of Risk management trainings were concluded with 30 participants in each round. With the assistance of GNC, Regional/Sub-cluster focal training was also finalized. Nutrition in Emergency (NiE) workshop for all NEZ partners was also conducted. Field Visits: Emergency field visits in drought affected area (Puntland and Somaliland). Possibility of break in supply core pipe line and hence prioritization any On going NCC/OCHA possible SHF funding after the 3 rd round/banadir on agreed upon Page 5 Day 1, Session 5: Nutrition cluster AIMWG Progress and Initiatives update FSNAU as the lead of AIMWG presented the progress of the Assessment and Information Working Group for the months of January to June 2016. Key areas/topics covered. Progress made from January to June Surveys reviewed and Endorsed Key output from AIMWG meetings Surveys/Assessments endorsed: For the last quarter, The AIMWG had vetted and endorsed different surveys and assessments. These include FSNAU s 2015 Deyr survey covering all Somalia, SCI s SMART survey in Somaliland covering Awdal (Borama, Lughaye, Baki, Zaylac) and W.Galbeed (Gabiley and Hargeisa. SNS s Integrated SMART survey in SNS operational area. And FSNAU s IYCF survey covering SC, NE and NW.
Assessments/Surveys Pending: SCI s SMART survey in Puntland Bari, Nugal and Sanaag Regions of Puntland, TROCAIRE s IYCN KAP survey in Gedo and REACH s SIRNA covering Punt land and Somaliland are bending for endorsement. Government representation to AIMWG: it s necessary to have government representation in the AIMWG meetings, the government was supposed to be permanent in all the critical working groups be it AIM or SAG. There is meeting planned to happen on Friday in which the government to have full participation and lead if possible. Day 1, Session 6: Update on National Development Plan Key areas/topics covered; NDP advisor to the ministry of the National Planning from the federal government, presented the process of the national development plan specially the nutrition chapter. Key areas/topics covered NDP GUIDANCE QUESTIONS NDP PILLARS Outcome, Goals and Targets The nutrition cluster had already shared with partners for their inputs, comments and suggestions and give their feedback to the focal point of the NDP. Key action points drawn/ major priorities agreed upon: The draft document was shared with partners and inputs, ASAP All partners comments and suggestions area expected to be share with the focal point of the NDP. Day 2, Session 8: Nutrition Cluster Preparedness and Response on the Emergencies The cluster coordinator briefed the participants on the gloomy outlook of nutrition with imminent deterioration of malnutrition as a result of ongoing deterioration among the drivers. Insecurity may escalate due to the forthcoming elections in August and the upcoming military offensive in some areas, Drier than normal conditions are expected through 2016. Overall, the 2016 Gu cereal harvest in southern Somalia is expected to be 30 to 50 per cent below post war average (1995 to 2015), Milk availability is expected to be below normal is most areas over the next six months. In addition, food prices have started increasing. All resulting to extreme negative causality factors creating causality traps (poverty, diseases, food insecurity, access ) that compounds already fragile food security and malnutrition in those areas. Hence, critical need for contingency as well as preparedness and response plans for the Nutrition in Emergency. It was highlighted the need to strengthen field coordination mechanisms to make sure they are much stronger to be able to develop their own preparedness plans for their respective area of operations. Page 6
Key areas/topics covered; Preparedness action, costing and next step. Surveillance and Risk Analysis: In response to the emerging situation, NC will Work closely with partners, including the government, to obtain and disseminate detailed updates on evolution of situation plus Strengthening and continuing on regular mass screening. In addition, work with partners to map the geographical areas that are most likely to be affected and not reached/covered Coordination: NC will also Enhance/strengthen the coordination at regional level and work with other clusters as well Scale up of response: Establish alternative options including mobile services in the remote areas likely to affect drought and Train health workers on MUAC screening, detection of danger signs, referral and treatment of uncomplicated case of acute malnutrition Supplies: NC will ensure Pre-positioning of supplies in areas most likely to experience the impacts of La Nina based on a risk analyses Human Resources: Conduct a review of internal HR capacity and plans to identify HR needs and gaps in case the situation deteriorates and requires surge. Participants reflection: Integration of mobile nutrition services to health and WASH programmes. Key action points drawn/ major priorities agreed upon: Zonal level coordination mechanisms need to immediately develop and come up with preparedness plan and plan of action for nutrition mass screening. UNICEF and WFP to give feedback to the cluster on their supplies in the pipeline and prepositioning plan specially the potential areas where La Nina may affect. Day 2, Session 8: Progress on Geotagging project September 2016 Immediate All zonal focal points UNICEF/WFP The Cluster coordinator updated the Geotagging process and progress made so far in terms of mapping the nutrition facilities across the country. The project is supported by WFP and UNICEF while it is implemented by Forcier Consulting firm. The company had already started contacting the partners as an entry point and confirmation of nutrition sites prior moving to the next step which is the actual mapping. Key areas/topics covered; Project overview (phases one and two) Approaches Limitations and timelines Tools Page 7
Operational Nutrition Sites: In the presentation it was mentioned the number of nutrition centres in the cluster database which was 1,357, the consulting agency had confirmed 14 operational centres, 7 new facilities, and 12 centres were closed. Geotagging Process:- Puntland MoH officer mentioned that the Geotagging or geo-referencing is to map out the current nutrition services delivery sites, this is all about having a scale plan for Integrated Management of Acute Malnutrition once the Nutrition Cluster knows the exact numbers of sites then the cluster can easily define the number of nutrition sites needed against the population. This doesn t mean we are isolating nutrition sites. The consulting agency should have communicated the local authorities and the focal points prior communicating directly to the partners on the ground know that such information is always sensitive in some contexts. Collaboration with Geotagging firm:-partners were requested to cooperate with the company to make sure accurate information as this is done for the cluster partners. Else, partners can directly communicate with the company should their sites were not included those contacted. Key action points drawn/ major priorities agreed upon: All concerns to be sent to Maryan Duale, who is elected as ombudsperson, will then compile and share with the consulting agency ASAP Maryan Dualle PL MoH Day 2, Session 10: Bottleneck Analysis (BNA) to Improve Access and Effective Coverage of IMAM Services (Overview and Progress); Dr Ibrahim, BNA consultant had presented an overview of the planned BNA training to identify the challenges faced the IMAM programmes and ways to overcome. BNA is a systematic way to look at the main determinants of effective coverage focusing on most critical bottlenecks and being able to give guidance to address them. Key areas/topics covered Background Rationale Coordination Structure Introduction Tanahashi Model and determinants of coverage Key steps of BNA approach BNA for IMAM Services Initiatives and Progress Main challenges Lesson learnt and Way forward BNA Training: - With the support from UNICEF consultant from the HQ there will be two day training for country core team followed by regional training in Hargeisa, Mogadishu and Garowe. Contextualization of BNA indicators: - BNA Indicators need to be reviewed and contextualized for the Somali country to avoid future confusion. Page 8
Day 2, Session 11: SCOPE; WFP presented SCOPE which is WFP s Digital Platform for Beneficiary and Transfer Management platform. It s a single, electronic repository to manage the beneficiaries and helps manage the assistance delivery cycle to beneficiaries from registration to analysis. ; Introduction of SCOPE Integrated programme approach Biometrics in SCOPE Assistance Programmes Emergency Opportunities and Specific Applications of Principles WFP trained its cooperating partners (CPs) to do the registration of the beneficiaries to avoid things were messed out. SCOPE also enables flexible delivery, so no matter what the assistance is (goods, cash, vouchers or other items, it can all be managed from the same place. The amount of information available is always directly related to the delivery mechanism being used cash for example typically has less information available vs. and electronic voucher deployed by SCOPE. This should be determined as appropriate in line with programme objectives. Information is available almost immediately, again this depends on who is making the transfer and when the information is synched back to the platform. Day 2, Session 12: SUN Project update The SUN focal point for Somalia, Dr Mohamed Abdi Farah gave brief updates on SUN movement and upcoming events. ; - Country report - Puntland consultative meeting - Stakeholder analysis report - First UN network meeting - Upcoming African workshop on financial tracking for nutirion - SUN coordinator visiting to meet Somali Team (Minister for Health, Commerce and Planning will meet the coordinator) - NDP SUN Update; - There was a SUN workshop whereby more than 35 participants participated to comment on the SUN report from Somalia. Similarly, a consultative meeting was held in Puntland for policy formulation. It was hosted by the VP of Puntland, the VP declare the he will be a champion for nutrition. Page 9
- The first draft for policy and stakeholder analysis was produced which has also covered strategy for integration of nutrition into other sectors. It is expected to be finalized within these weeks Upcoming Events; - Workshop: Public financing and managing results for children in Africa 22-25 August; workshop aims to accelerate efforts of African countries in alignment among sectors by reporting on nutrition budgets and costs of nutrition plans. This will contribute to, making the investment case for nutrition and to mobilize resources towards improved nutrition. The workshop also aims to make a contribution to strengthening public finance management systems and procedures for improved nutrition - SUN coordinator's visit to Somalia 24th of August 2016; the coordinator will all meet stakeholders. Ministers for Health, Commerce and Planning are expected to meet her. The partners specially the Strategic Advisory Group (SAG) members to meet with her as this is an opportunity. Day 2, Session 13: School Nutrition Breaking Inter-Generational Cycle of Malnutrition; Marian Dualle presented School Nutrition initiative which the nutrition cluster recommended as key strategy to break intergenerational cycle of malnutrition in Somalia context in its latest field report. ; Background Comprehensive School Nutrition Framework for school nutrition and its scope Characteristics of Agency-specific School Health and Nutrition Programs, within the FRESH framework Roles of Agencies, Partners, and Stakeholders in School Nutrition Programs Common Interventions within a School Nutrition Program Opportunities NDP/SHF And M&E Background; Garowe IDP visit & observation of IGCM in play, NCA findings, Nutrition cluster position - School nutrition initiative considered as strategic engagement for long term resilience perspective and developmental nutrition. Recommendation made on school nutrition as key strategy to break intergenerational cycle of malnutrition in Somalia context in its latest field report, which is currently under ENN review and possibly soon published. The school initiative project will be piloted in Baidoa of Bay region to be implemented by SCI. UNICEF is not in position to support School Nutrition hence advised partners not expect support on such projects because doesn t have the resources. However UNICEF as Cluster member and lead agency will be part of the efforts to advocate for the School Nutrition and this has to be the top agendas for government and for the UN agencies. Page 10