Food distributions in Myanmar: Responding to the COVID-19 pandemic and the coup d’etat

Christian Doerfel is the Grants, Communications & Learning Coordinator at the Center for Social Integrity

Paing Soe is a Program Manager at Community Partners International

Nicki Connell is a Nutrition Advisor at the Humanitarian Assistance and Resilience Programme Facility (HARP-F)

Background

In Myanmar, the food security and nutrition status of women and children has been threatened by the COVID-19 pandemic from 2020 and the coup d’etat in February 2021. Armed conflict and COVID-19 related restrictions have resulted in rising food prices, a widespread lack of job opportunities, disruption to livelihoods, reduced access to farming, land conflict and mobility restrictions, all of which have increased food insecurity. Before these events, according to the Myanmar Humanitarian Assistance and Resilience Programme Facility (HARP-F) an estimated 1 million people and 336,000 internally displaced people (IDPs) required humanitarian assistance (HARP-F, 2021a). In 2022, the Myanmar Humanitarian Response Plan estimates that there are now 14.4 million people and 556,000 IDPs in need. The majority of the newly displaced fled violent campaigns perpetrated by regime forces, abandoning their livelihoods and leaving them in need of support. The latest DHS, conducted in 2015 prior to these shocks, shows that at that time, national wasting and stunting rates remained high at 7% and 29% respectively (DHS, 2017). In Rakhine State, several SMART surveys and DHS data showed pockets of a much higher wasting prevalence, with wasting at double the national average (14%) (Save the Children International, 2016; Action Contre La Faim 2015; DHS 2017). Given recent events, these figures are now likely to be much higher.

Several cash and food distribution programmes were in place prior to the onset of COVID-19 and the coup d’etat, including the World Food Programme’s (WFP) general food distribution and the maternal and child cash transfer (MCCT) programme – run by the Department for Social Welfare under the previous government. The food basket included in the food distribution programme provided pulses, oil, rice, blended food (wheat soy blend (WSB)/ wheat soy blend ++ (WSB++)) and salt, estimated at 2,100 calories per person per day calculated based on five people per household (HARP-F, 2021b). In areas with functioning markets, cash was provided instead of food with the amount determined by market prices. Food distribution was provided to populations in Rakhine, Kachin, and Shan states.

In response to increasing numbers of IDPs and the associated need for immediate food assistance, HARP-F funded the Center for Social Integrity (CSI) and Community Partners International (CPI) to implement a food distribution programme to address increasing food insecurity, especially for vulnerable groups (pregnant and lactating women, children 6-59 months, the elderly) in Myanmar. This brief case study aims to capture their experiences, including the impact of any changes made to the foods/products distributed to communities living in Myanmar.

Programme description 

CSI and CPI, in collaboration with HARP-F, discussed and agreed the most appropriate foods and products to distribute, weighing up the pros and cons of each item by balancing optimal nutrition-dense foods for vulnerable groups against the cost and practicality of distribution. The locations for food distribution were decided based on needs and vulnerability assessments, whether they were conflict-affected, their accessibility to support from other humanitarian actors – including ethnic health organisations and civil society organisations – and the location of existing programming by CSI and CPI. CSI focused mainly on Northern Rakhine State in two townships, Buthidaung and Maungdaw, while CPI had a wider geographic coverage across multiple states: Kaya, Chin, Rakhine, Kachin, Sagaing, and Shan. In Rakhine, CPI focused its distribution in the Thandwe and Taungup townships, which were not part of CSI’s programme area. CSI provided blanket distribution to all households in the targeted villages with a total of 23,368 beneficiaries targeted in 4,141 households. CPI targeted 135,000 IDPs from the identified vulnerable population (children, elderly, and pregnant women) who were internally displaced in camps or villages. CSI and CPI worked closely with local stakeholders and organisations to obtain travel authorisations to implement projects or alternatively implement projects through local staff and volunteers, reducing the need for government-mandated travel authorisations, which can take a long time to obtain.

Cash or Food?

While cash distributions were initially discussed as the distribution modality, food instead of cash was used to ensure nutrient-dense items were consumed instead of risking the use of cash to purchase nutrient-sparse foods, non-food items, or milk powder – which violates the International Code of Marketing of Breastmilk substitutes. Additionally, during the COVID-19 pandemic, access to markets was limited for all due to travel restrictions, which occurred on top of the standard restrictions to movement already experienced by stateless Rohingya communities.

Composition of food distribution package

The types of nutrient-dense food which were distributed were identified by CSI and CPI with additional suggestions from HARP-F’s Nutrition Advisor. Based on previous experience, CSI and CPI tailored the distributed foods to items which were available locally, were appropriate for local dietary customs, and which met budgetary constraints. As a result, the standard package of foods distributed varied across communities and differed to previous years, which had been either based on WFP’s standard food distribution package or donor requirements. CSI also previously carried out a consultation with target communities on which items they wanted, which previously led to the inclusion of dried fish, onions, and chillies. However due to budgetary constraints, only dried fish remained in these distributions and for pregnant and breastfeeding women only.

In Northern Rakhine townships, the foods distributed during 2021 followed the standard food basket distributed by other actors (WFP and ICRC) in adjacent areas. CSI initially proposed milk powder and sugar to be included in the supplementary nutritional support provided to pregnant and lactating women based on previous examples of foods distributed with other NGOs, but these were replaced with higher protein items such as dried fish and chickpeas. Distributing milk powder was also not advised to avoid the displacement of breastfeeding. Items such as eggs and fresh vitamin A-rich vegetables (carrots, sweet potatoes or leafy greens) were also considered, but transporting and delivering fresh produce was a challenge and these were ultimately removed from the food basket.

As a result of these discussions, CSI agreed a final food basket that provided 13.5kg of rice, 0.5 litres of cooking oil, 1.5 viss¹ of chickpeas, and 1 viss of salt per person.  A total of 2,065 kcal and 45.5g of protein per person per month were included in this ration (table 1).

Table 1: Nutritional value of CSI food kit compared to other standards

CSI complemented these distributions with additional nutrition assistance to pregnant and lactating women (1 viss of dried fish and 0.5 viss of chickpeas per woman). CSI further implemented a large-scale home-gardening program, providing inputs (seeds, material to create gardening structure, fertiliser, and gardening tools) and training (including how to produce organic pesticide and fertiliser) for beneficiaries to grow produce in their own gardens, reaching 2,017 households. This produce was planned to further increase and diversify the foodstuffs available to target households, as well as support small-scale livelihood activities.

Across Myanmar, CPI provided various combinations of food items to different IDP camps and villages. For example, in villages and camps in Rakhine state, IDPs received rice, oil, beans, salt, dried fish, potatoes, and fish cans. CPI rarely directly implements programmes, instead opting to sub-grant to local partners for a more effective and efficient response. Additionally, CPI sub-granted to the Rakhaing Women’s Union – a partner in Rakhine State for humanitarian assistance – who provided IDPs with rice, chickpeas, vegetable oil, dried noodles, vermicelli, salt, and textured protein. There was no need to adjust the foods distributed throughout the programming. A total of 1,532 kcal and 42.5g of protein per person per month were included in this ration. Some camp locations also had various types of peas donated by local organisations and camp committees requested protein soups suitable for women and children, which were provided in addition.

Distribution logistics

To deliver humanitarian assistance including food distributions, travel authorisation needs to be obtained from respective authorities. As authorisations are time-limited, CSI regularly applied for these throughout the project period and were able to obtain them. CPI worked with local organisations with TAs already in place to implement programmes. Food was distributed through local partners and volunteers to enable food supplies to reach the intended beneficiaries in both camp and village settings. In the process of planning and carrying out distributions, the organisations’ established relationships and history of collaboration with local communities was beneficial.

CSI organised their food distributions directly. Depending on logistical considerations and project plans, they were followed or preceded by distributions of hygiene kits and COVID-19 prevention items. Usually, given the volume of items to be distributed, these distributions did not coincide. CSI allocated times for each household to come to distribution points and collect the items. CSI further asked beneficiaries to wear a mask, sanitise their hands, practice social distancing, and participate in temperature checks. The distribution points were chosen together with the community based on logistical considerations, including distance to beneficiaries’ houses and safety in accessing the distribution points for women.

The food distributions organised by CPI varied from place to place according to needs, supplies, and transportation available. In most places, items were distributed in one sitting to avoid the difficult transportation of supplies. In some places, items were distributed separately due to the prohibition of local authorities to transport large quantities of supplies at once. COVID-19 preventative measures were followed by all partners and beneficiaries at the distribution points. In camps, food distributions were provided in coordination with the respective camp committees. 

Results/outcomes

There was significant uncertainty in the immediate aftermath of the coup d’etat, including the risk involved in carrying out large-scale distributions. As it was not possible to guarantee the safety and security of its beneficiaries, volunteers, and staff, distributions were postponed during this period. Once able to restart, CSI provided cash instead of food during April-May 2021. However, the cash distributions only reached a fraction of the targeted beneficiaries due to the liquidity crisis in Myanmar, during which banks restricted access to cash after the regime change caused bank runs – where many people withdrew cash simultaneously – thereby making it almost impossible to access cash. After this, double or quadruple rations were provided and food distributions changed from monthly to every two or four months. CSI was able to provide double rations in August and October 2021 and quadruple rations in December 2021. The large quantities distributed did lead some beneficiaries to hire motorised vehicles to transport the goods. In some cases, beneficiaries also sold parts of the food assistance provided to cover other needs, such as health or education expenses.

The programme successfully provided nutrient-dense foods to all targeted beneficiaries. CSI reached a total of 23,368 people in Northern Rakhine State. The acceptable food consumption score amongst beneficiaries receiving blanket food distribution in Northern Rakhine State increased from 56% in December 2020 (HARP-F, 2020) to 94% in December 2021 (unpublished). It is noted that other factors may have influenced this increase, such as the ceasefire between the Tatmadaw and the Arakan Army in Rakhine State since 2020. Beneficiaries in Northern Rakhine also reported less harmful coping habits overall as a result of the distributions, a notable qualitative finding. 

Over 2020 and 2021, CPI were able to provide monthly rations 24 times. From July 2020 to Dec 2021, CPI cooperated with 21 partners to provide emergency response activities across sectors (including food, health, and water, sanitation and hygiene (WASH)) to beneficiaries in eight states and regions. For food distributions (one- or two-month rations), there were 24 projects in total.

CPI reached 138,727 people in total across Myanmar. CPI noted that immediate food support to the internally-displaced population provided relief to immediate hunger. Anecdotally, a woman from one of the programme areas reported that the food assistance provided relief for her worries and gave her hope for survival. Unfortunately, due to the deteriorating security situation in most of the implementation areas, it was extremely difficult for CPI to collect additional information to measure the programme's impact. Therefore, anecdotal evidence was the only data possible to collect through CPI’s local partners.

What went well?

Throughout the project, CSI updated the list of targeted beneficiaries to adjust for the dynamic population, accounting for households moving in and out of targeted locations, new births, and deaths. As a result, CSI was able to reach more than the targeted number of beneficiaries. Feedback from the community showed that the foods were well received with no complaints or additional need to change the foods provided.

Even though the provision of essential items, such as food and other materials, to vulnerable IDPs after a coup d’etat is extremely difficult due to the indirect prohibition of local authorities, CPI was able to successfully implement food distributions according to the agreed processes with local partners and avoid any risk to the funding, CPI, or implementation partners. By sub-granting and cooperating with local partners and volunteers, CPI could prevent any risks and obstacles including issues in obtaining travel authorisation. CPI could also strengthen the capacity of partners and volunteers, as well as acquire more trust from local communities. More than 200,000 IDPs received support even when they were in difficult circumstances.

What were the challenges?

The COVID-19 pandemic, especially the third wave in 2021, and the coup d’etat interrupted food distributions. As a result, some communities were left without access to foods for four months2 until cash distributions began. To compensate for missed distributions, extra rations were provided instead. However, that brought challenges in sourcing and transporting supplies, organising bigger distributions, and monitoring whether distributed foods were being consumed by the intended individuals. The transportation of large amounts of food items was also risky for staff in active conflict areas.

There were increased delivery times on supplies in general, including food items, due to the COVID-19 pandemic, as well as an increase in food prices, which affected how far available budgets could stretch and what food items could be included in the ration.

Adhering to COVID-19 prevention guidelines made the logistics of food distributions more difficult. It meant working around the guidelines, resulting in rescheduled distributions, ensuring staff were vaccinated and/or tested, and ensuring additional acceptance of the programme by communities. It meant making a switch in some cases to local procurement, obtaining the support from local suppliers to get supplies to the community, and enhanced coordination with the camp committees to allow distributions to be made in line with COVID-19 preventative measures.

Providing cash transfers was also challenging, after the coup interrupted food distribution. The availability of physical cash was a challenge and banks would not accept transaction amounts greater than their limit. Cash transfers to partners and use of cash for procurement was therefore a significant challenge. However, CPI used multiple methods, such as bank transfer with ID or the use of agents, to overcome this as far as possible.

Monitoring and evaluation was also cited as a challenge. In Rakhine State, authorities do not allow surveys of the kind necessary to monitor food security and livelihood programmes and interventions. Hence, all monitoring work must be undertaken with a low profile. It was not possible to do in-person monitoring due to insecurity and there were also communication blackouts which disrupted monitoring, so it was difficult to obtain accurate and required information. That meant that instead of regular in-person monitoring, the only monitoring possible was through review of reports, data, and photos, and by conducting online review meetings.

Lessons Learned

Community consultation to guide decisions around which food items to distribute is important to identify which nutrient-dense foods are accepted by the community.

While fresh produce rich in vitamin A and protein, such as green leafy vegetables and eggs, would ideally be included, the timely transportation and storage of these items is too challenging to make these practical items to distribute.

Cooperation with local suppliers can help overcome challenges with food shortages and cash flow challenges. Partners were able to coordinate and make deals with suppliers as soon as the project was approved, so they were able to overcome increased market prices and shortage of stocks. Local suppliers could provide sufficient stock and they had the added benefit of knowing the local context well.

Monitoring and evaluation needs to be strengthened to better understand the impact and causal pathways of the food distributions. There is also a need to improve coordination internally between the project, monitoring and evaluation, and logistics teams, and between the field teams and headquarters, to ensure accountability towards beneficiaries and accountability of suppliers. Finally, information sharing between departments given disruptions to communications connectivity can sometimes be challenging, and so mitigation strategies must be put in place.

Conclusion

As of 31 January 2022, an estimated 441,500 people remain internally displaced across the country in addition to the 370,400 people already displaced before February 2021 (OCHA, 2022). Given the ongoing political instability and persistent COVID-19 pandemic, CSI and CPI will continue providing food distributions through seeking ongoing direct funding from the Foreign, Commonwealth and Development Office when HARP-F, also funded by the same source, ends in June 2022.

Recommendations

We have distilled five key recommendations from this case study in Myanmar. 1) involving the community in determining the lowest cost, nutrient-dense foods, that are also culturally acceptable is important to ensuring the appropriateness of food distributed. 2) the use of cash distributions can only be successful if there is a guaranteed cash flow available, with markets remaining accessible and functional. Without this, mobile payment providers and their agents are unable to disperse cash to beneficiaries in locations accessible to them. 3) due to the current situation, local organisations are the most suitable for a rapid and effective response. Networking with and strengthening capacity of local organisations is critically important for better implementation of food and cash distributions in the future. 4) it is useful to engage with key stakeholders, such as local religious leaders in some ethnic areas, to help with distributions as they have the capacity to manage stock efficiently and support distributions. 5) the safety of staff, volunteers and the community who are involved in distributions need to be fully assessed prior to implementation, including having mitigation strategies in place.

This case study shows how organisations can improve the nutrient content of food distributions successfully by using locally available and culturally acceptable foods in Myanmar. It is important that food distributions, or other similar modalities, are continued in the immediate term to address rising food insecurity across Myanmar.

References

Action Contre La Faim (2015) Preliminary Report SMART Nutrition Survey. https://drive.google.com/file/d/1ZXp7R9Y5BdF-MhFPIaz5NQBi75aFDoOU/view

DHS (2017) Myanmar DHS, 2015-16 – Final Report. Dhsprogram.com

HARP-F (2020) Dietary diversity evolution in Northern Rakhine State in 2020. https://www.harpfacility.com/media/filer_public/12/fc/12fc61bf-3e26-4ba6-8e47-212c52cf5ef7/dietary_diversity_evolution_in_northern_rakhine_state__11_months_analysis_1.pdf

HARP-F (2021a) Nutrition in Myanmar: Focus on Rakhine State. https://www.harpfacility.com/resources/nutrition-myanmar-focus-rakhine-state/

HARP-F (2021b) Nutrition baseline and recommendations for Myanmar, April 2021. https://www.harpfacility.com/resources/nutrition-baseline-and-recommendations-myanmar/

OCHA (2022) Myanmar humanitarian update no. 15, 15 February 2022. Reliefweb.int

Save the Children International (2016) Standardized Monitoring and Assessment of Relief and Transitions (SMART) Survey Report. https://docs.google.com/document/d/1O3Mqg4Dp9Rddk3PX7CaKZNOkiPozvXYB/edit