Name of Sector: IYCF-E

Dates of Deployment: 31 August- 2 October 2019

Reason for request:

The Syrian refugee situation started in Jordan in 2012. Currently, Jordan is one of the countries most affected by the Syria crisis, hosting the second highest share of refugees per capita in the world. The first refugee camp, Zatari Refugee Camp, was established in July 2012 in Al-Mafraq city (North East Jordan) and hosts over 78,000 people with an average of 80 births per week and 14,000 consultations[1]. Azraq Refugee Camp was opened in April 2014 and is now home to over 35,000 refugees, among whom  22% are children under five years old[2].  Currently, the majority, nearly 84%, of Syrian refugees live in urban areas throughout governorates[3] with 94% of Syrian children under five living in urban areas experiencing “multi-dimensional poverty”, meaning that they are deprived of at least two of the five following basic needs- education, health, water and sanitation, child protection, and child safety[4].

By the start of July 2019, the total Syrian refugee population in Jordan had reached 662,2603.  The population find themselves forced to financially prioritise their basic needs over the health and nutrition of their families with four out of 10 Syrian families remaining food insecure and an additional 26% vulnerable to becoming food insecure including examples of parents skipping meals to allow their children to sufficiently eat[5].  A large proportion of mothers/caregivers remain in need of appropriate Infant and Young Child Feeding (IYCF) support. Without these interventions the high rate of suboptimal feeding practices negatively impact health, nutritional status, and overall wellbeing and development of the population.

The mental health and psychosocial wellbeing, which is known to impact a caregiver’s ability to recognise and respond to their child’s needs, of refugees in Jordan also remains a significant concern[6]. Behaviour change communication interventions and IYCF-E support using strategies appropriate for the Syrian refugee population in camps and urban communities which target beliefs and practices related to IYCF-E need to be delivered by trained frontline health and nutrition actors to allow for optimal feeding practices to be put into place.

In 2017 alternative programming approaches were introduced and integration of IYCF-E and CMAM into primary health care began.  Since the transition, staff operating in both CMAM/IYCF and Reproductive Health (RH) programmes have not received a comprehensive, harmonised IYCF-E training.  As a result, programme quality is lacking and there is significant room for improving the services currently being provided.

IYCF-E programs are minimally implemented in urban settings and are located exclusively at the primary health care level. Activities are currently limited to breastmilk substitute (BMS) prescription and group education sessions. Staff turnover, a lack of trained staff, and recruitment of new, untrained staff have affected the cohesiveness of CMAM/IYCF-E integration into primary health care.

Key achievements: 

The Tech RRT advisor worked with the Nutrition Working Group and Reproductive Health actors to provide orientations on IYCF-E to health staff as well as a five-day IYCF-E Counselling Training of Trainers to both health and nutrition actors where trainers were identified to continue to roll out IYCF-E counselling and integration trainings.  Additionally, a Joint Response Plan that outlines clear steps to move the IYCF-E integration forward was created and disseminated to partners.

The key achievements of the deployment were:

  • Development and delivery of three, one day reproductive health orientations in both camp and urban settings
  • Development and delivery of a contextualised, five-day IYCF-E ToT Counselling training package of which 14 trainers were identified.
  • A comprehensive and contextualised Joint Action Plan was developed and disseminated to partners
  • Monitoring and Evaluation tools were reviewed and revised as needed

Post deployment webinar: A post-deployment webinar took place on 8th January 2020. The recording can be found here and the slides can be found here.