IYCF-E and SBC Deployment: 26/01/2016-24/02/2016 and 10/02/2017-31/03/2017

Reason for request:

At the time of deployment, an estimated 13.5 million people were in need of humanitarian assistance in Syria, 4.5 million located in so called ‘hard to reach’ and besieged areas. The principal objective of the Nutrition Cluster is to rapidly scale up both preventive and curative nutrition services across areas that can be reached by partners. Whilst these are predominantly in Northern Syria, they also include ‘hard to reach’ and besieged areas, some of which are in Central and Southern areas of Syria, relying on remote management and support.

Over the past year, the Nutrition Cluster has worked closely with the Health Cluster to promote an integrated package of nutrition and health services at both facility and community level; incorporating general health promotion, IYCF-E counselling and support, IMCI, screening and treatment for acute malnutrition, reproductive health, routine immunization and micronutrient supplementation. There has also been a concerted effort to work together with the Food Security and Livelihoods Cluster in terms of joint guidelines and support for designing general food assistance, blanket supplements for vulnerable groups and nutrition-sensitive agriculture and livelihoods interventions.

Prior to the Syrian crisis, IYCF were already far from optimal with just 46% of babies being put to the breast within 1 hour of birth and 43% exclusively breastfeeding. Formula and bottle feeding were common practices. These practices are expected to have worsened since then. Recent assessments report that all risk factors are present to indicate infants and young children are at increased and significant risk, including the widespread and uncontrolled distribution of infant formula in often unsanitary conditions. The most commonly quoted breastfeeding challenges are related to misconceptions & beliefs (e.g. “not enough milk”). In response, responders are implementing humanitarian nutrition programs with a strong emphasis on Infant and Young Child Feeding in Emergencies (IYCF-E) programming. However, this is a relatively new area for most responders and significant technical support is still required.

The cluster has recently developed a three-year IYCF-E strategy together with a detail costed plan for IYCF in Emergencies. The strategy was launched in December 2016 and the partners are working together with the cluster to scale up the IYCF plan for 2017-2020. However, in order to have successful and effective IYCF programing, the context needs to be better understood after years of conflict, mass displacement and influences on social and cultural norms by non-state actors. Evidence based IYCF-E interventions are essential in this context for sustainable development.  It was therefore important to understand the current knowledge, attitudes and practices towards IYCF among the people of Syria as well as the potential barriers hindering optimal practices, with high quality KAP surveys and barrier analyses allowing partners and other stakeholders to implement IYCF-E strategy more effectively.

Tech RRT Advisors (IYCF-E and SBC) were deployed to:

  • Work with the cluster and its members to undertake a baseline KAP assessments
  • Conduct a Barrier Analyses inside Syria
  • The IYCF-E Adviser was also required to provide senior leadership, technical support and capacity building for these assessments, the ongoing advocacy campaign and IYCF-E programming to strengthen the overall delivery of the IYCF-E response.

Outcome:

  • Provided technical support to all aspects of the design, preparation, implementation and finalization of the IYCF/IYCF-E KAP assessments undertaken by partners and led by the Tech RRT SBC Adviser and in close collaboration with the SAG and the IYCF-E Technical Working Group. This included the following:
    • The development of the assessment methodology, selection of priority assessment locations, development of questionnaires, and input into the design of training plan and materials.
    • Collaborative facilitation of the 5-day training (ToT) on all aspects of KAP survey for approximately 20 participants, including support to trainers to prepare for cascade trainings.
    • Support to nutrition cluster partners during the implementation of the baseline IYCF/IYCF-E KAP survey, including supervision and monitoring of the data collection, if possible, and support to finalize preliminary reports and recommendations.
  • Provided technical IYCF-E input in the preparation and finalization phases of the barrier analyses undertaken by cluster partners.
  • Provided technical support to establish a rapid response system for IDPs for IYCF-E.
  • Developed an IYCF-E Rapid Response mechanism including development of MBA Guidelines, Standard Operating Procedures for BMS, Integration of WASH and IYCF-E
  • Supported/facilitated engagement with other sectors (Food Security and Livelihoods, WASH, Health, etc.) for the start-up of the IYCF/IYCF-E scale up plan
  • Provided input and technical support in the rollout of the Advocacy and Awareness raising campaign.
  • Document and share lessons learned from the process (KAP & BA), in collaboration with the SBC Tech RRT Adviser.