Emergency response preparedness: Rollout of the Global Nutrition Cluster’s toolkit for country coordination teams

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Cecile Basquin is an Emergency Response Preparedness Consultant with the Global Nutrition Cluster (GNC) and UNICEF

Marie Cusick is a Communications Specialist with the GNC and UNICEF

Mabasa Farawo is a Nutrition Cluster Coordinator with the Myanmar Nutrition Cluster and UNICEF Myanmar

Mayang Sari is a Nutrition Specialist with UNICEF Bangladesh

Ruhul Amin is a Nutrition Officer with UNICEF Bangladesh

Ifuk-ibot John Ala is a Nutrition Cluster Coordinator with Action Against Hunger in northeast Nigeria

Qutab Alam in an Information Management Officer with the Nutrition Cluster and UNICEF Afghanistan

Victor Mallelah is deputy Nutrition Cluster Coordinator with Action Against Hunger Afghanistan

The authors would like to acknowledge the contributions and ERP work undertaken by various Global Nutrition Cluster colleagues and Nutrition Cluster/Sector coordination teams and their respective partners. In particular, the authors thank Stefano Fedele, the GNC Global Nutrition Cluster Coordinator; Rasha Al Ardhi, Deputy Global Nutrition Cluster Coordinator – Operational Field Support; Briony Stevens, Deputy Global Nutrition Cluster Coordinator – Partnerships, Programmes and Advocacy; all nutrition coordination mechanisms that have participated in the GNC-led ERP efforts. In particular, Piyali Mustaphi, Chief of Nutrition, UNICEF Bangladesh, Gisele Rutayisire, Emergency Specialist, UNICEF Myanmar. Lastly, a special thanks to all national actors and other community members that the GNC are here to support and that have been involved in various preparedness initiatives to-date; the authors thank you for your invaluable contributions.

Key messages:

• Since prioritisation of emergency response preparedness (ERP) in the 2022–2025 Global Nutrition Cluster (GNC) Strategy, the GNC has developed extensive ERP resources and provided tailored support to countries to help them create preparedness plans.
• To date, only eight of the 70 priority GNC countries have incorporated preparedness into their response plans.
• More work is needed to explore why countries are not adequately prioritising ERP, as well as to address emerging challenges such as insufficient awareness and/or access to ERP resources (particularly at sub-national level) and inadequate tailoring of ERP planning to local needs.
• In the future, the GNC should consider sharing the experience of other countries during the development of ERP plans, as well as providing guidance and support around advocacy for, and mobilisation of, domestic financing for ERP.

Background

In 2022, global challenges, such as the ongoing war in Ukraine and droughts in the Horn of Africa and the Sahel, disrupted food supply chains, caused crop failures and loss of livestock and led to increased hunger and malnutrition worldwide. According to the 2022 Global Humanitarian Overview, 274 million people required humanitarian assistance and protection – a significant increase from 235 million in 2021. Effects from these simultaneous global crises, combined with the effects of persistent conflict and climate change, highlight the need for more resilient and sustainable country responses to climate-related disasters and other humanitarian emergencies.

To increase their resilience, countries must be prepared for emergencies and have a timely and efficient response plan in place. Since mid-2022, the GNC has been providing tailored country support on preparedness, working remotely with multiple Nutrition Clusters/sectors to enrich draft ERP plans (Bangladesh and Myanmar), design ERP workshops (Niger, Madagascar and Nigeria), facilitate orientation sessions on the ERP approach (Mali and Somalia) and co-facilitate ERP workshops (Bangladesh and Nigeria).

However, to date, few GNC priority countries have incorporated ERP into their work. This article presents the results from an online GNC survey on countries’ ERP efforts, and showcases how four countries (Afghanistan, Bangladesh, Myanmar and northeast Nigeria) have started to mainstream ERP into their work.

The ERP approach and toolkit

In an article published in issue 67 of Field Exchange (Dobamo, 2022), the author described increased prioritisation of ERP in the 2022–2025 GNC Strategy. After one year of the strategy’s implementation, the GNC committed to delivering on this priority by transforming its existing preparedness guidance into an extensive ERP Toolkit (Global Nutrition Cluster, 2022). The toolkit includes everything a country needs to create a preparedness plan, including a step-by-step guide, an ERP plan template, a preparedness actions workplan template, and additional tools to support standardising and systematising the ERP approach to effectively respond to the next emergency. A complementary e-learning short course was also produced to further support a country’s preparedness efforts (UNICEF & Global Nutrition Cluster, 2022).

Following the release of the toolkit, three global virtual ERP workshops¹ were organised between July and December 2022 to coach participants on the use of the tools. These workshops aimed to strengthen Nutrition Cluster/sector capacities in ERP planning. In total, 87 personnel from 38 countries and territories participated in the workshops, including staff engaged in coordination and information management (IM) for nutrition and staff from government institutions, United Nations (UN) agencies, and non-governmental organisations (NGOs) based at national and sub-national levels.

GNC online survey

Despite the GNC’s efforts, only eight of the 70 GNC priority countries have incorporated ERP into their response plans (Global Nutrition Cluster, 2023). In February 2023, a survey was sent to 262 Nutrition Cluster Coordinators and IM Officers in GNC priority countries to identify why countries were not adequately prioritising ERP, as well as to explore their challenges regarding ERP planning, so that the support provided by the GNC could be adjusted accordingly.

Not counting ‘bounce-back’ emails and the use of incorrect email addresses, a total of 194 members of country personnel received the survey, of whom 16 responded (6.1% response rate). This number was lower than anticipated, and may further reflect the lack of ERP prioritisation in country response plans. However, to our knowledge, most priority countries are not progressing well in their preparedness plans, and further inquiries must be conducted to fully understand the challenges faced.

Of the 16 respondents, 50% stated that their country’s commitment to ERP was of moderate importance, and 37% reported that it was of high importance. Despite this, six respondents indicated that they lacked the human and/or financial resources, as well as the time, to address ERP. For the five countries that reported ‘low importance’, reasons given for this varied from preparedness not being fully understood by partners or cluster members and nutrition not being seen as a priority, to the need for more orientation and training on how to design and implement ERP plans.

In some cases, survey answers reflected a lack of prioritisation of nutrition in country response plans. In others, they reflected a lack of focus on ERP for nutrition on existing coordination platforms due to competing priorities. The need for continuous advocacy for financial resources for nutrition or allocation within the domestic budget was also reported. Some responses highlighted that, in instances where ERP plans were developed, they might not be implemented, and partners might not even know they exist. Respondents further emphasised the complexity of ERP planning in a challenging operating environment (especially with multiple ongoing crises) and explained that, although ERP planning is more relevant when operationalised at sub-national level, cluster coordination positions are overwhelmed with responsibilities.

Approximately 83% of respondents agreed that reflecting on past emergency responses could help identify bottlenecks restricting the scale-up of their nutrition response, thereby supporting the value of ERP efforts; 40% reported that a lessons learned exercise had either been conducted or was ongoing.

Country experiences

Afghanistan

In 2023, the Nutrition Cluster in Afghanistan recognised the importance of bolstering its emergency preparedness in regions that are vulnerable to risks. Under the leadership and coordination of the Afghanistan Nutrition Cluster IM Specialist and of the Afghanistan Nutrition Cluster Deputy Nutrition Cluster Coordinator, several meetings were held with zonal cluster coordination teams to chart a roadmap for the ERP work. Under the guidance of five zonal coordinators, the teams conducted a hazard and risk analysis, built crisis scenarios and predicted immediate needs.

The National Cluster Coordination team provided support by compiling essential data and information to inform ERP planning. Regular meetings were held to review each dataset and reach consensus on its use. Additionally, partners’ response capacity was mapped to ensure that all available resources were utilised effectively within their project duration.

Next, the regional coordination teams engaged with nutrition partners to develop an early response plan and derive preparedness actions. All ERP planning information was to be consolidated in a finalised nutrition ERP plan, expected by mid-April 2023.

The successful implementation of ERP in Afghanistan has been primarily attributed to effective leadership and engagement of the zonal-level cluster coordinators. While limited availability of hazard information challenged the planning and execution of the ERP, these coordinators played a crucial role in building trust among stakeholders and ensuring access to relevant information and implementing partners. Additionally, the interzonal-level meetings fostered a collaborative approach to reviewing available information and in developing the ERP plan, while improving understanding of ERP and resource utilisation. The proactive efforts of the cluster will help ensure that the most vulnerable communities are adequately prepared and protected during crises.

Bangladesh

In 2022, the Bangladesh Nutrition Cluster aimed to develop a comprehensive nutrition-specific ERP plan to better respond to recurrent seasonal shocks. The Nutrition Cluster received support from the GNC to design and facilitate a national-level ERP workshop with nutrition partners. Following the workshop, the development of a nutrition ERP plan began (currently in its final stages), and efforts are being made to cascade ERP efforts to risk-prone districts. For example, an ERP planning exercise took place in a flood-prone area in Kurigram district on 16 November 2022, where selected members of the District Disaster Management Committee (DMC) and Upazila (sub-district) DMCs participated. The Nutrition Cluster also organised a sub-district-level ERP workshop on 22 December 2022, with participation from selected members from both the Upazila DMC and the Union DMC from Olipur and Chilmari sub-districts respectively.

While sector-specific ERP plans for risk-prone areas are not typical in Bangladesh, the need for a nutrition-focused ERP plan became apparent during the GNC workshops. Since the workshops were the first time that district and Upazila-level DMC members had heard about the need for a sector-specific plan, it took time to convince them of its necessity for adequate and timely responses to emergencies. The UNICEF team in Bangladesh supported this process by demonstrating the contribution of poor feeding practices and inadequate treatment facilities during and after emergencies to the nutritional status of children under the age of five in their district and sub-districts. As a result, the DMC management are developing a nutrition-focused ERP plan to be finalised at the end of April 2023, and the Bangladesh Nutrition Cluster is planning the development of several other ERP plans at district and sub-district levels in 2023.

From a sub-national workshop participant: “Earlier, we did not realise the importance of a nutrition-focused ERP plan. This is the first time we are going to develop a nutrition-focused ERP plan in Bangladesh with support from GNC.”

Myanmar

Myanmar was among the first countries to pilot an ERP approach, following an initial three-day ERP workshop organised by the Myanmar nutrition sector in April 2021. Since then, a draft ERP dashboard has been developed, and both the workshop and dashboard are serving as the foundation for continued ERP processes in 2023. In addition, under Myanmar’s guidance, the OCHA-led ERP working group has been involved in current ERP efforts, which include holding monthly meetings.

Following attendance at a second GNC ERP workshop in July 2022, the Myanmar Nutrition Cluster held preliminary meetings to agree on utilising the GNC’s ERP tools and templates. The Nutrition Cluster also worked on strengthening coordination platforms in five sub-national areas by training personnel, extending consultations to local NGOs and community service organisations, and designing tailor-made response delivery modalities.

While ERP is led at a national level, considering sub-national levels is critical, as regions experience different emergencies and a national ERP plan would have to be adapted to each area independently. As a result, Nutrition Cluster focal points were engaged to organise orientation meetings with sub-national Nutrition Cluster focal points and share templates for ERP consolidation, to speed up execution of the ERP plan. Additionally, the sub-national Nutrition Cluster engaged with partners on various ERP steps including identifying and ranking likely hazards, budgeting, planning appropriate responses, estimating potentially affected populations and drafting sub-national-level scenarios and responses. Where shortcomings were identified, dedicated support was provided to the consolidation exercises of sub-national states/regions. This, along with strengthening coordination at the sub-national level, aims to contribute to the development of a national ERP plan.

ERP planning in Myanmar has been challenged by a restrictive operating environment complicated by conflict, difficult consultative engagements/restricted access to partners and burn-out of critical staff. Funding gaps have also resulted in the termination of sub-national coordinators’ contracts, and ‘double-hatting’ of several sub-national Nutrition Cluster Coordinators has overwhelmed individuals and resulted in the reprioritisation of their coordination responsibilities.

Completion of the ERP plan is also a time-consuming consultive process, which the Nutrition Cluster team is working on at the same time as it is working on the Cluster workplan. However, the Myanmar Nutrition Cluster aims to finalise the ERP plan before the beginning of the monsoon and hunger seasons in the second/third quarter of 2023.

“Rakhine is one of the state regions with the highest level of acute malnutrition, worsened by the highest number of stateless persons – close to half a million – and more than a third of a million internally displaced persons. Additionally, the region is prone to cyclones, natural disasters and landslides. Therefore, a comprehensive emergency response preparedness plan helps meet the needs of those affected by a protracted humanitarian crisis amidst reduced funding and increasing needs.” – Mr Aung Thu Chai, Sub-National Nutrition Cluster Co-coordinator

Northeast Nigeria

To strengthen northeast Nigeria’s level of emergency preparedness ahead of the general elections and the next lean season, the nutrition sector of the Maiduguri coordination hub (supporting the humanitarian response in Borno, Adama and Yobe States) received support from the GNC to design and co-facilitate a virtual three-day ERP workshop, with additional support from UNICEF and Action Against Hunger. The workshop aimed to strengthen sector partners’ ERP capacity and enable the development of an ERP plan.

The nutrition sector coordination team agreed that the sector co-coordinator should lead the ERP workshop, and partners who had played key roles in the previous lean season response were selected to be involved in the preliminary ERP work. This team, known as the ERP Task Team, engaged with the GNC ERP consultant to develop a context-specific Terms of Reference document, an agenda and content for the workshop, as well as to plan for, and support, facilitation of the workshop. The ERP Task Team also selected 25 partners – including UN agencies, international NGOs, national NGOs and the Ministry of Health (with representation at national and state levels) – to participate in the ERP workshop.

Following the workshop, the nutrition sector began developing the nutrition ERP plan, aiming to complete this process within two months. Development involved refining the risk monitoring approach (with a nutrition lens), deriving a short crisis scenario and mapping partner capacity. Feedback from the nutrition sector team during the workshop showed that involving partners and government counterparts from the beginning encouraged buy-in and ownership of the ERP process. It also exposed them to the workshop planning tools and preliminary ERP actions, which would support further development of ERP plans for various contexts and risks, should this be undertaken.

It was noted that the three days did not provide sufficient time for the ERP workshop activities. It was therefore recommended that, in future, a five-day workshop should be held, including two days for ERP training and three days to complete the ERP planning steps.

“I consider the nutrition emergency response planning for northeast Nigeria a stitch in time that could save nine. No doubt, a well-designed nutrition emergency response plan could mean the difference between life and death in the event of an emergency.” – Dr Mike Lawani, Yobe State Nutrition Programmes Facilitator, UNICEF

Conclusion and next steps

Despite support from the GNC on ERP during 2022, uptake of the approach in priority countries is low, and ERP is yet to be mainstreamed into GNC work. Findings from the GNC online survey and the country experiences documented here indicate the need for further support from the GNC, particularly relating to strengthening the capacity of cluster members and sub-national-level actors on preparedness and encouraging countries to develop an ERP plan. More work is required to increase countries’ awareness of the ERP Toolkit – this should include conducting more ERP workshops to continuously orient and train countries on the ERP approach, and providing dedicated support until ERP is truly mainstreamed in the day-to-day work of nutrition coordination teams. One strategy to facilitate mainstreaming may be to include ERP as a key deliverable within the coordination roles of Nutrition Clusters/sectors.

Additionally, too little is being done to reach personnel located at the sub-national level, and that many may have limited access to tools and resources posted on the GNC website and/or other relevant sites such as HR.info or Reliefweb. The Nutrition Cluster/sector coordination bodies based in country capitals have a responsibility to ensure that the ERP Toolkit is disseminated and that ERP planning is fostered locally and tailored to local needs. It may also be worth exploring how to tie ERP planning together with localisation agendas to maximise implementation of early and efficient nutrition responses with locally available capacities – in most large-scale emergencies, local actors are often frontline responders and need to be engaged from the preparedness phase.

While this work has provided valuable insights, further exploration is needed into why countries are not adequately prioritising ERP, as well as to explore the challenges they experience. This will help the GNC better advise on systematic integration of ERP across workstreams and support increased buy-in of the ERP approach in countries. It was also suggested that the GNC should share the experiences of other countries during the development of ERP plans, providing guidance and support around advocacy for, and mobilisation of, domestic financing for ERP.

For more information, please contact Marie Cusick at mcusick@unicef.org

References

Dobamo AG, Nzioka F & Stevens B (2022) Prioritising emergency response preparedness: Global Nutrition Cluster supports countries to plan for potential humanitarian crises. Field Exchange 67. www.ennonline.net/fex/67/gncemergencypreparedness

Global Nutrition Cluster (2022) Emergency response preparedness (ERP) Toolkit. https://www.nutritioncluster.net/emergency-response-preparedness-erp-toolkit

Global Nutrition Cluster (2023) Where We Work. https://www.nutritioncluster.net/where-we-work

UNICEF & Global Nutrition Cluster (2022) Short course: Nutrition emergency response preparedness (ERP), a step-by-step approach. https://agora.unicef.org/course/info.php?id=41059