Deployment 6

Name of sector: Social Behaviour Change (SBC)

Dates of deployment: 5 January – 7 March 2019

Reason for request:

Yemen has been devastated by a man-made triple tragedy: famine, cholera, and the daily deprivation and injustice resulting from brutal conflict. Parties to the conflict have so far failed to reach an agreement.

Since March 2015 Yemen has experienced conflict which has displaced over 3 million people; 2 million IDPs are still affected. A needs analysis in July 2017 found that about 20.8 million people need assistance to meet basic needs, an increase of almost 10 percent in the past year. The worsening humanitarian situation is now widespread across the entire country with nearly 22 million people in need of humanitarian assistance of which 11 million are in acute need. The April 2018 Integrated Food Security Phase Classification (IPC) update shows that the food situation has deteriorated since the last IPC analysis done in October 2017. Abyan, Lahj, Ad Dhale and Sana’a governorates are forecasted to drop into IPC4: Emergency by June 2018. A cholera outbreak which commenced in September 2016, and appeared to be under control by the beginning of 2017, significantly affected the country with 121 districts in 21 Governorates affected and more than 1,000,000 suspected cases. The situation significantly worsened in March of 2017, with cases being detected in all governorates and in 305 districts. More than 2,200 people have died from the epidemic, and while the current situation is stable, the World Health Organization (WHO) predicts that the risk of a new instance is high during 2018. It is estimated that “11.3 million people in 168 districts require emergency preparedness and preventative measures to avert likely resurgence of the outbreak in 2018”. An estimated 30,000 local health workers have not received their salaries for over a year and operational costs in 3,500 health facilities have not been paid.

The general goal of the deployment is to support the understanding and use of basic practical behavior change planning and methodologies such as “Designing Behavior Change”, as the basis for evidence-based SBC activities particularly in the nutrition and WASH activities of ADRA’s OFDA- and FFP-funded programming in Yemen, though it is anticipated the SBC plans will impact all programming sectors including Agriculture/Food Security and Early Recovery of Market Systems.

Key achievements:

  1. DBC, BA and FGD training materials, including powerpoints, handouts, facilitator and participant manuals and brief summary report of trainings.
  2. BA and FGD reports on key behaviors (2-3).
  3. SBC implementation/action plan.
  4. Draft roll-out plan.
  5. All associated tools and job aids.
  6. Lessons learned report.
  7. An online presentation of the mission (PPT or Prezi) that augments the report, provided to backstop staff at ADRA International. This includes participation in a webinar – one or more remote sessions with ADRA senior staff (in Yemen and Maryland) and possibly other interested parties to foster information sharing and follow up.

Post depoyment webinar: A post-deployment webinar took place on 29th July 2019. The recording can be found here.

 

Deployment 5

Name of sector: Social Behaviour Change (SBC)

Dates of deployment: 1 April – 25 May 2018

Reason for request:

Key achievements:

 

Deployment 4 

Name of sector: Assessment

Dates of deployment: 30 April – 1 June 2017

Reason for request:

Ongoing conflict is devastating Yemen. Humanitarian partners now estimate that 21.2 million people, or 82 per cent of the population, require some kind of humanitarian assistance to meet their basic needs or protect their fundamental rights. Malnutrition rates are rising in Yemen and partners now estimate that 4.5 million people require treatment or prevention services for malnutrition, which is a 200  per cent rise in people in need since late 2014. Children under the age of five, including infants and pregnant and lactating women, are the most affected. Within this population, IDPs are most at risk. Of the 4.5 million people in need, nearly 2.2 million are currently estimated to be acutely malnourished, including 462,000 children suffering from severe acute malnutrition (SAM) and 1.7 million children affected by moderate acute malnutrition (MAM).

In Yemen, a significant technical capacity gap has been identified by the Assessment Working Group (AWG) and agencies representing the nutrition cluster. Due to the absence of adequate technical knowledge of representative assessments, including SMART methodology, the functionality and accountability of the AWG has been challenged to ensure producing quality data, analysis and reporting on undernutrition and mortality in a timely fashion. In Yemen, there are currently very few agencies with the skills to conduct SMART nutrition surveys.

The Tech-RRT Assessment Adviser was requested to contribute to strengthening the overall emergency nutrition response by building the capacity of response stakeholders in the design, implementation, analysis and reporting of nutrition assessment at national and sub-national level. He will provide senior leadership, technical support and capacity building during in-country support to nutrition cluster partners.

Key achievements: 

  1. Reviewed all of the 2011-2017 Yemen Nutrition Assessments from the Yemen Humanitarian Response repository and created a nutrition assessment database.
  2. Facilitated a one-day workshop attended by 7 individuals from Assessment Working Group (AWG) agencies that discussed core indicators (and accompanying questions) to be included in all Governorate level SMART surveys.
  3. Facilitated a two-day Yemen Nutrition and Mortality Guideline workshop that was attended by 9 individuals representing AWG agencies. The objective of the workshop was to present all proposed sections that will be included in the Guideline and agree on content.
  4. Created a draft version of the Yemen National Guidelines for Conducting Integrated Anthropometric and Mortality Surveys.

 

Deployment 3

Name of sector: IYCF-E

Dates of deployment: 14 February – 11 April 2017

Reason for request:

Since mid-March 2015, conflict in Yemen has spread to 21 of Yemen’s 22 governorates prompting a large-scale protection crisis and compounding an already dire humanitarian crisis brought on by years of poverty, poor governance, conflict and ongoing instability.

IYCF: The 2013 Yemen National Demographic and Health Survey (YDHS) estimated that as little as 10% of children under six months were exclusively breastfed. In addition to breastmilk, 26% of infants under six months were given water, while 3% were given non-milk liquids and juice, and 30% were given milk other than breastmilk. Furthermore, 24% of infants under six months were given complementary foods and breastmilk. By the age of 6-9 months only 65% were given complementary foods. 44% of infants under six months were fed using a bottle with a nipple.[1]

According to a Knowledge Attitude and Practices (KAP) survey conducted by UNICEF in 2015, 57% of mothers indicated that infants should be breastfed immediately after birth; however 14% believe that a baby should not be breastfed within the first 24 hours after birth and 10% believe that the first food a newborn should receive is water and sugar. While 60% of both males and females believe that a newborn should receive nothing other than breastmilk during the first 6 months, 94% of mothers gave their children water, 60% gave them Breastmilk Substitutes (BMS)[2], 42% gave their children juice, and 33% gave their children infant formula the night before the interview.[3]

Following a review on IYCF practices in Yemen in November 2016, using a tool from WHO the need for a national IYCF Strategy was identified by the MoPHP and partners. The main objective of this deployment was therefore to support the development of this national strategy. The second key objective was the development of an IYCF in Emergencies (IYCF-E) response plan.

Key achievements:

Stated outcome of the deployment including statistics if applicable (i.e. number of people trained and on what, assessment results, and any other outputs/documents that were completed during the deployment)

  • Development of the final draft National IYCF Strategy for 2017-2021.
  • Development of a draft IYCF-E Response Plan for 2017.
  • Strengthening of the IYCF TWG through: revision of the ToRs; organization and chairing of several meetings during deployment; and the development of an action plan for Q2.
  • Revision of the national BMS Reporting Format and set-up of a reporting mechanism.
  • Revision of the Joint Statement on IYCF – endorsed by the NC.
  • Revision of key IYCF indicators for intersectoral assessments – shared with ICCM.
  • Capacity building through: orientation on IYCF-E and BMS for 26 nutrition cluster members; one day training on IYCF for 17 Save the Children (8) and Ministry of Social Affairs (9) CP staff; and provision of an orientation session on IYCF for Save the Children’s media and communications team.

[1] Yemen National Demographic and Health Survey 2013

[2] Any food being marketed or otherwise represented as a partial or total replacement of breastmilk, whether or not suitable for that purpose. For example – infant formula.

[3] Maternal New-Born and Child Health in Yemen, UNICEF KAP Survey Report

Post depoyment webinar: A post-deployment webinar took place on 22nd May 2017. The slides can be found here.

 

Deployment 2

Name of sector: CMAM

Dates of deployment: 29 January – 9 March 2017

Reason for request:

Yemen is current gripped by a combination of civil conflict and drought that has left an estimated 21.2 million people (82% of the population) in need of some form of humanitarian assistance, including 10.3 million who are in acute need. An estimated 14 million people are currently food insecure, including 7 million people who do not know where their next meal will come from. About 3.3 million children and pregnant or lactating women are acutely malnourished, including 462,000 children under 5 suffering from severe acute malnutrition. This represents a 63 per cent increase since late 2015 and threatens the lives and life-long prospects of those affected.

In 2016, the nutrition cluster agreed on a joint CMAM programme scaling up, with the objective of drastically increasing the geographical coverage and programme convergence.

The main objective of the Tech RRT CMAM Advisor deployment was to support and strengthen the implementation of Community Management of Acute Malnutrition (CMAM) programs through the provision of technical support and capacity building to the nutrition cluster members.

Key achievements:

  1. National CMAM guidelines, standards, and protocols updated to international standards and Yemeni context zero draft shared with the nutrition cluster.
  2. CMAM Protocols (field cards/quick referral cards) finalized and shared.
  3. CMAM barrier/obstacle and SWOT analysis findings and recommendations shared.
  4. Reporting and monitoring tools updated as per the revised guidelines.

 

Deployment 1

Name of sector: CMAM

Dates of deployment: 21 March – 30 April 2016

Reason for request:

Ongoing conflict is devastating Yemen. Humanitarian partners now estimate that 21.2 million people – or 82 per cent of the population – require some kind of humanitarian assistance to meet their basic needs or protect their fundamental rights. Malnutrition rates are rising in Yemen, and partners now estimate that 3 million people require treatment or prevention services for malnutrition – a 65 per cent rise in people in need since late 2014. Children under the age of five – including infants – and pregnant and lactating women are the most affected. Within this population, IDPs are most at risk. Of the 3 million people in need, nearly 2.1 million are currently estimated to be malnourished, including 320,000 children suffering from severe acute malnutrition (SAM) and 1 million children affected by moderate acute malnutrition (MAM).

The nutrition actors set up a plan of action for nutrition preventative activities and CMAM scale up in 2016. To address emergency needs, ensuring the efficiency and efficacy of the scale up plan is therefore crucial. The Yemen CMAM protocol was developed in 2013 and therefore is not in line with the latest 2013 WHO recommendations and do not allow a context/need-based implementation of nutrition services. In order to enable the scale up response to reach its objective, a revision of the CMAM protocol is therefore needed. Primary work has been done with inputs from partners shared with MoH – In order to ensure a timely consolidation and finalisation of the revised protocol, an external support was needed from the Tech RRT.

Key achievements:

  • A final and up dated CMAM National Guideline.