Improving emergency nutrition preparedness and response in the Latin America and Caribbean region
Yvette Fautsch Macías is a consultant on Nutrition in Emergencies with UNICEF Latin America and Caribbean region.
Stefano Fedele is the Regional Nutrition Specialist at UNICEF Latin America and Caribbean.
Introduction
Latin America and the Caribbean (LAC) is one of the most disaster-prone regions in the world and increasingly vulnerable to a range of hazards, including droughts, storms and floods, which have increased in frequency, intensity and unpredictability in recent years1. After Asia, LAC has the second highest number of natural disasters, predominantly occurring during the hurricane season between May and November. Almost half (16) of the 33 countries in LAC experience a high or very high level of exposure and vulnerability to natural disasters and human conflicts. The other half (17) experience a moderate or low level of the same risk2.
Natural disasters and other man-made crises impact on a range of factors that can increase the risk of undernutrition, illness and death: livelihoods and food crops are lost; food supplies are interrupted; infectious diseases increase in frequency and severity; and feeding practices are threatened and possibly impeded, leading to an increased risk of acute malnutrition and micronutrient deficiencies. It is therefore crucial to support the protection of vulnerable groups like children, adolescents and women who are particularly affected by emergencies. There is a growing recognition by national authorities in the LAC region of the importance of incorporating risk-informed programming and ‘resilience-building into national development policies and plans. However, awareness of factors that affect nutritional status in emergency situations and the preparedness and response capacity for nutrition in emergencies (NiE) is generally low.
A regional support group for NiE
Since 2013, UNICEF’s LAC Regional Office has been supporting a regional group for nutrition resilience (Grupo de Resiliencia Integrada de Nutrición) (GRIN-LAC). Its aim is to increase awareness and understanding of issues related to NiE and to support the strengthening of national capacities to prepare for and respond to those issues.
GRIN-LAC is a network of key stakeholders at regional and national levels in all countries in the region. The group aims to identify, engage and support the national Nutrition Focal Points (NFPs) and other government officials (usually the nutritionists working at the Ministry of Health) responsible for coordinating nutrition-specific issues at times of emergencies and who make up half of the group’s 150 members. Other members of GRIN-LAC include people working on nutrition, disaster risk reduction and/or emergency response, such as NGOs, UN agencies and aid agencies, based at regional and national level. GRIN-LAC supports its members to engage with development-focused actors at the national level to strengthen the nexus between humanitarian and development actions and balance immediate short-term responses with lasting and sustainable interventions that aim at reaching results in the long term.
Supporting countries to improve preparedness and response
GRIN-LAC has enabled countries to institutionalise NiE by providing support in three main areas: evidence generation, knowledge management and capacity development. These contribute to strengthening nutrition resilience by building capacities of individuals and institutions to better manage underlying risks that can affect the nutritional status of women and children in emergencies.
Evidence generation
GRIN-LAC supports the NiE risk assessment, a model that has been developed to help identify gaps in nutrition preparedness on the basis of an analysis of risks, capacities and vulnerabilities of each country in the region, resulting in a risk profile for each country. This has been used to raise awareness of nutrition capacity gaps and vulnerabilities, strategies to mitigate these risks and guide prioritisation of support.
Nicaragua case study: In 2016 GRIN-LAC, together with UNICEF Nicaragua, supported the Nicaraguan Government to carry out the NiE risk assessment. Results were presented to the Health Commission of the National System for Disaster Prevention, Mitigation and Attention, who subsequently agreed that guidelines for NiE needed to be produced for individuals and institutions working in emergency preparedness and response. An operations manual was produced for the Emergencies Committee by the Ministry of Health (MoH) with UNICEF and in collaboration with other actors at national and local level. This helped to ensure broad ownership and application by other relevant governmental bodies and organisations.
“Generation of evidence at national level about capacity gaps and vulnerabilities in emergencies and its dissemination to decision-makers in each country are fundamental to create awareness of risks, encourage reflection and promote concrete actions.”
Maria Delia Espinoza, a Health Officer with UNICEF Nicaragua
Knowledge management
It is crucial to ensure that country experiences are documented and shared so that evidence of what works well or otherwise contribute to learning. GRIN-LAC supports countries to document experiences and lessons learnt related to NiE and share them through quarterly, sub-regional webinars.
Antigua and Barbuda case study: The NFP from the Antigua and Barbuda MoH reviewed the experience of the emergency nutrition response to hurricane Irma (2017) and documented lessons learnt, challenges and support needs, with support from GRIN-LAC. This experience was presented to the GRIN-LAC webinars and triggered reflection about gaps in the emergency nutrition response and the lack of frameworks around NiE. The NFP is now in contact with the National Office for Disaster Services to include nutrition considerations and is planning to develop an infant and young child feeding policy in 2018 that would take NiE considerations into account.
Capacity development
GRIN-LAC also provides remote strategic guidance and technical support to NFPs on a one-to-one basis on request, for further discussion, guidance and/or clarification.
Guyana case study: Remote technical support was provided to the Guyana MoH on emergency nutrition preparedness. As a result the MoH is planning to host a one-day stakeholder meeting in 2018 to chart the way forward for the establishment of the nutrition coordinating body, beginning by clarifying roles and responsibilities of various agencies.
Next steps
In a survey conducted by GRIN-LAC members in 2017, the challenges to strengthening NiE at national level most cited were lack of trained human resources and lack of country NiE frameworks. This highlighted the need to strengthen training/capacity development for NiE and the need to advocate for the inclusion of NiE in national policies and programmes. To support this, GRIN-LAC plans to:
- Develop and disseminate an NiE toolkit to provide countries with practical tools on key aspects of emergency nutrition preparedness and response and checklists and briefing notes on NiE topics; and
- Launch a report on the state of NiE preparedness in LAC countries to increase evidence-based advocacy efforts on the importance of emergency nutrition preparedness and response in order to increase political commitment on NiE.
For more information on GRIN-LAC or to join the network, visit the online community and document repository or contact the GRIN-LAC coordinator.
1The World Bank, Preventative Resettlement of Populations at Risk of Disaster: Experiences from Latin America, The World Bank and Global Facility for Disaster Reduction and Recovery, International Bank for Reconstruction and Development, Washington, DC, September 2011.
2Inter-Agency Standing Committee Reference Group on Risk, Early Warning and Preparedness, European Commission. InfoRM - Index for Risk Management, Latin America and the Caribbean. February 2017. Available at: www.inform-index.org/Subnational/LAC