Where We Work

Bangladesh

Name of Sector IYCF-E

Date of Deployment: December 1 to 20, 2017 and January 5 to 20, 2018

Reason for request: 

Since 25 September, more than  half a million Rohingya have crossed into Bangladesh, fleeing large-scale violence and human rights abuses in Rakhine state, Myanmar. This new wave of displaced Rohingya adds on to a pre-existing Rohingya community in Cox’s Bazar area, amounting to approximately 821, 055 in total.

Nutrition and IYCF-E Situation Analysis

The nutrition risks and vulnerabilities amongst the displaced Rohingya children under the age of five, pregnant women and mothers/caregivers of children under the age of 2 and adolescent girls are very high.

The findings from Kutupalong refugee camp and the makeshift settlements indicate the prevalence of acute malnutrition among all children 6-59 months of age significantly exceeds the WHO emergency threshold (15%) in all the three areas (24.3%, 19.3% and 15.8% respectively); particularly in Kutupalong refugee camp which was assessed earlier in the response and days after a large influx of new arrivals. All three surveys indicate that nearly half of children suffered from anemia (Hb<11.0g/dL), representing a severe public health problem according to WHO classification threshold (40%).

Results suggest the majority of children are breastfed, however, exclusive breastfeeding is dangerously low considering contextual and aggravating factors, particularly in the makeshift settlements. All three surveys indicate that less than 16% of children are achieving a minimum acceptable diet for their optimal growth and development.

Deterioration in infant and young child feeding practices puts young children at increased risk of acute malnutrition and therefore a linked and integrated response is needed and encouraged in the ongoing Cox Bazar emergency response. [i]

Bangladesh has been on the forefront in strengthening their Infant and Young Child Feeding Programming, major efforts are underway to ensure that also the IYCFE component will be strengthened.

A Joint Statement on Infant and Young Child Feeding in Emergencies, issued by the Institute of Public Health Nutrition (IPHN) and the Ministry of Health and Family Welfare and supported by all partners, reaffirms the importance of protecting, promoting and supporting infant and young child feeding practices among the affected populations, even for those few cases needing breast-milk substitutes support.[1]

The Terms of References agreed with the Nutrition Sector were as following:

  1. Establish a system and facilitate the implementation for the monitoring of the IYCF-E response plan, explore the possibilities of mainstreaming the IYCF-E in the IYCF programs.
  2. Plan and deliver orientations and trainings on IYCF-E, as per the capacity building plan within the IYCF-E response plan
  3. Ensure adequate coordination for IYCF-E through leading and providing substantial support to the IYCF-E technical working group and working with other sectoral and cross thematic working groups
  4. Provide support to humanitarian actors on minimum standards, tools and guidelines in place in Bangladesh for IYCF-E as major component of the national IYCF strategy.
  5. Reinforce the system for the monitoring and reporting of violations of the code of BMS,
  6. Advise on, advocate and actively support integration with other sectors (WASH, Food Security and Livelihoods, Child Protection, Health) using the IYCF framework
  7. Provide support to partners to strengthen monitoring and evaluation systems and tools to be used across the IYCF-E response to ensure quality, consistency and assist comparability and learning
  8. Conduct joint monitoring visits to IYCF-E activities to provide support and guidance to partners.

Key Outputs:  Bullet point the main outcome of the deployment

  • The following were the key achievements of the deployment:
    • Finalized M&E tools
    • Finalized draft for endorsement to the Nutrition Sector of a technical guide to support the infants less than six (6) months that are not breastfed
    • Coaching done bilaterally with eight (8) partners implementing IYCF activities
    • Integration of IYCF reporting with CMAM reporting requirements
    • Trained 25 Trainers for IYCFE Counselling Training
    • Reviewed a draft of the 1st National IYCF-E guidelines and the full consolidated document
    • Coordinated the IYCFE TWG during the period of the mission
    • Represented the IYCFE TWG during the Nutrition Sector meetings
    • Agreements with Child Protection and GBV sub sector for integration of IYCF-E services in Women and Girls Safe Spaces (WFS) and orientation of 20 CP case workers.
    • Review and contributed in the adaptation of the 5-day IYCF-E training developed by SCI
    • Development of a rapid assessment tool to identify and refer infants less than six (6) months that are not breastfed
    • Supervise the ongoing rapid assessment to identify infants less than six months that are not breastfed
    • Engaged bilaterally with agencies reportedly providing BMS donations to affected populations (5 agencies)
    • Contributed in the drafting of the Joint Response Plan for 2018
    • Developed a proposal for the adaptation of the global health media video tools to be adapted in the local languages.

[1] Joint Statement: Infant and Young Child Feeding in emergencies, October, 2017

[i] UNICEF. Nutrition in Emergencies. Module 13: Management of Severe Acute Malnutrition. 2011.