Nutrition in Consolidated Appeals Process – a review

In late 2008, the Global Nutrition Cluster commissioned a review of 'How Nutrition is Framed in the Consolidated Appeals Process (CAP)' by Tufts University. The report just out (May 2009) examines the ways in which nutrition has been used to make a case for, and design responses to, humanitarian crises in the context of the consolidated appeals process (CAP) from 1992 to early 2009. Based on an extensive desk review, and interviews with key players in the nutrition community, it identifies broad trends in the global appeals process and uses seven case-studies to highlight details that are sometimes county-specific.

There is growing recognition of nutrition as a key element in crisis management, not simply as a measure of how bad things have become. The evolution in thinking is reflected in changes in the consolidated appeals process (CAP).

Since the initiation of the CAP process, a number of important trends can be identified in the treatment of nutrition as a theme and/or sector. These include an increasing distinction between nutrition, on the one hand, and food, water, and health, on the other; the importance of synergies across sectors if the goals of any one sector are to be achieved; and the importance of technical rigor in nutrition assessment and surveys.

More and more countries choose to present nutrition as a priority sector, theme or activity within their appeal. By 2008, the global CAP's mid-year review highlighted nutrition as a separate 'sector' for the first time, on par with education, health and water. This visibility has not only brought more resources to bear on specific nutrition problems and tailored interventions, it has also raised expectations of what nutrition programming can achieve in the context of major emergencies.

It remains difficult to specify how much humanitarian aid is dedicated to nutrition. More disaggregated budgeting that allows for nutrition activities to be specifically identified and tracked would be enormously helpful in assessing how well defined needs are resourced, and how effectively those resources are used.

UNICEF, as lead agency for the Nutrition Cluster, has invested in strengthening its own capacities since 2006, and the cluster has been productive in developing training and guidance aimed at building a stronger cadre of field practitioners around the world. But, the challenge remains huge.

With regard to the work of the Global Nutrition Cluster several key issues were identified that need to be tackled by the Nutrition Cluster including capacity building, enhancing preparedness, and improving data management in the context of assessment, monitoring and surveillance. The review suggests that each of these three areas requires much more investment of effort and resources if the gaps (that remain wide) are to be closed.

While many appeals identify gaps in human and institutional capacity, and increasingly request funding to promote local training and national institution-building relevant to nutrition, the funding necessary rarely materialises.

This suggests that the Cluster should push for priority dialogue with donors on the urgent need to establish human and institutional capacity as essential to more effective future programming during disasters, and a key link between relief operations and longer-term development.

The misuse of terms and misrepresentation of nutrition data has declined in recent years, as terms, thresholds and metrics have become increasingly standardised across the international community. The role of the Nutrition Cluster in this regard has been important. Building on other international activities, the Cluster has helped in formulating guidelines for the preparation of appeals and developed training, assessment and analytical tools. All are needed in improving how nutrition problems are defined and how to make a convincing case for intervention.

Additional information needs, still rarely addressed in the CAP, relate to costs and effectiveness. Clear analysis of cost-effectiveness of different interventions is commonly lacking. Yet this is increasing essential to enable recommendations on optimal ration compositions, targeting and exit criteria, and on the appropriate mix of complementary activities to improve nutrition outcomes.

How Nutrition is Framed in the Consolidated Appeals Process (CAP): A Review of 1992 to 2009. Available from the Nutrition Cluster website, visit http://www.humanitarianreform.org/ and click on 'Nutrition'.