UNHCR Technical Workshop on the Operational Guidance on the use of Special Nutritional Products
By Sarah Style and Andrew Seal
Sarah Style is an ENN consultant working on the UNHCR/ENN Anaemia Control, Prevention and Reduction Project.
Andy Seal is a lecturer and researcher at the UCL Centre for International Health and Development and a senior technical advisor to the ENN on the UNHCR/ENN Anaemia Control, Prevention and Reduction Project.
In July 2011, UNHCR, in collaboration with ENN, held a five-day technical training workshop to introduce the recently finalised ‘Operational Guidance on the Use of Special Nutritional Products to Reduce Micronutrient Deficiencies and Malnutrition in Refugee Populations’.
The Operational Guidance (described further in Field Exchange 41) deals with certain food supplementation products (FSP) (including micronutrient powders (MNP) and certain lipid-based nutrient supplements (LNS)) that are currently being used, or being considered for use, in blanket supplementary feeding programmes within UNHCR operations. These products are designed for use in programmes aiming to prevent malnutrition, with a particular focus on micronutrient deficiencies. The guidance has been developed to help country staff deal with the challenges and confusion in designing, implementing, monitoring and evaluating programmes using these new FSPs.
The workshop was designed to provide both training on the use of the Operational Guidance and the opportunity for sharing of information and experiences of using these products in refugee camps across UNHCR operations. The overall aim was to enhance best practice and contribute to participants being better able to meet the needs of the refugee populations with whom they work.
The specific objectives of this technical workshop were to:
- Provide standardised guidance on best practice in planning, implementing, monitoring and evaluating programmes using special nutritional products
- Improve the design, implementation and monitoring & evaluation of programmes using special nutritional products
- Build the capacity of technical health and nutrition staff from UNHCR and WFP in effectively managing programmes using these products in refugee situations.
Twenty health and nutrition staff from UNHCR and WFP attended the workshop, which was held in Mombasa, Kenya. Participants represented operations in 12 countries: Algeria, Bangladesh, Chad, Djibouti, Ethiopia, Kenya, Nepal, Rwanda, Sudan, Tanzania, Uganda and Yemen.
Workshop activities and agenda
The workshop followed the general structure of the Operational Guidance beginning with Stage 1 on the first day (define the nutritional problem) through to Stage 6 (monitoring and evaluation)1. The workshop covered the key operational components relating to programmes using specific FSP intended for preventative purposes. See Table 1 for further product information.
| Table 1: Summary of Food Supplementation Products (FSP) and Fortified Blended Food (FBF) for use in children aged 6-59 months that are covered by the Operational Guidance | ||
| FSP / FBF | Target age group | Product descriptions |
| Micronutrient powder | 6-59m | MNPs provide no energy (kcal) in the diet. They are usually packaged in individual sachets to provide a dose of selected vitamins and minerals in powder form, to be added to foods directly after cooking. MNPs have been shown to be efficacious in treating and preventing anaemia. Branded products include Sprinkles⢠and MixMe |
| Low quantity LNS* | 6-24m | Highly fortified peanut-based paste that contains vitamins and minerals in addition to providing energy. It is usually packaged in individual daily sachets and is to be eaten either directly from the sachet or added to complementary food. It has been shown to improve linear growth in young children. Product brands include Nutributter®2 |
| Medium quantity LNS | 6-36m | Highly fortified peanut-based paste that contains vitamins and minerals in addition to providing energy. It is usually packaged in individual weekly pots. However it will also be available in the form of daily sachets, which is the preferred form for distribution. It has been used in programmes to prevent increases in GAM in young children during periods of food insecurity. Product brands include Plumpy’doz® |
| FBF+ / ++ | 6-59m / 6-24m | FBF+ e.g. Corn-Soy Blend (CSB) is a food for young children and other vulnerable groups, as well as the general population. Its content of vitamins and minerals has been modified compared to previous formulations. It is recommended as a partial replacement for nutritionally inadequate local diets. FBF++ is a newly developed FBF for infants over 6 months and young children. It contains milk powder and has a higher energy density than other types of FBF. |
A variety of different learning methods were incorporated throughout the workshop, including presentations, case studies, individual exercises, group work, testing of various tools in the Operational Guidance, and optional evening sessions. Participants were invited to present their experiences, learning, and the challenges on the ground concerning programmes using FSPs. At the end of the workshop, participants were allocated time with facilitators to discuss any questions or challenges that they were facing relating to their country of operation and the way forward, and how to incorporate the principals and best practice outlined during the workshop.
Follow up
Eritrean refugees in Shimelba refugee camp, Ethiopia
Workshop evaluation findings (daily feedback and final evaluation) were positive and constructive. The main challenge that participants identified for practice are budgetary constraints to purchase and manage products due in part to other competing operational needs. The main actions identified by participants to improve product related practice was to review their camp behaviour change and communication (BCC) strategy and to improve M&E systems including use of the M&E tools provided in the Operational Guidance. A clear expectation of the workshop was that all participants would conduct follow up training on their return to help build institutional knowledge.
Feedback from participants have been incorporated in the final version of the Operational Guidance which will shortly be available for public dissemination and download via http://info.refugee-nutrition.net
For further information, contact Caroline Wilkinson at UNHCR, Geneva, email: wilkinso@unhcr.org
1See news piece in Field Exchange 41 for schematic.
2This is the only product currently approved for use by UNHCR. Products are approved on a case by case basis. Similarly, only Plumpy’doz is approved as a medium quantity LNS.
Imported from FEX website