Acting Now to Avert a Nutrition Crisis across West and Central Africa

The UNICEF-WFP response to the nutrition crisis: Integrating COVID-19 response for longer-term impact in the Sahel

UNICEF and WFP are developing a joint approach to deliver an integrated package that focuses on the continuum of care from prevention to treatment of acute malnutrition in priority areas, as identified by the Hotspot analysis.

Immediate scale-up of an integrated package for the prevention and treatment of acute malnutrition in priority areas

UNICEF-WFP renewed partnership to address acute malnutrition in young children is critical in this current context. The partnership supports the implementation of an integrated package of care, placing emphasis on scaling up prevention interventions, to avoid that children become acutely malnourished and ensure adequate growth and development. 

UNICEF and WFP believe that a prevention package which supports maternal nutrition, optimal infant and children feeding practices, access to clean water, hygiene and sanitation, food assistance to vulnerable children and mothers and household food security are critical.  In addition to prevention, UNICEF and WFP, support primary health care systems to ensure early detection and treatment of acute malnutrition, as well as management of childhood disease, in ways that achieve impact for children and can be sustained by national systems. UNICEF and WFP are working in close collaboration with countries, so the approach is context specific, and so that efforts focus on the quality delivery of essential services at scale, while mitigating the spread of COVID-19.

Mitigation of COVID transmission

In Burkina Faso, Chad, Mali, Mauritania, Niger and Senegal, UNICEF, WHO, WFP and other partners support Ministries of Health and Nutrition partners to maintain the nutrition programme while mitigating the spread of the virus and its negative impacts on under-5 children and mothers. As a result, and based on global and regional guidance, national institutions, UNICEF, WHO, WFP and key partners have already adapted country nutrition programs. In addition, within all nutrition activities, key messages on the COVID-19 have been integrated and are being disseminated widely at both community and health facility levels to better protect the health and nutritional status of children under five and mothers.

Continuity of essential services

Essential nutrition services are aiming to prevent malnutrition in early childhood. UNICEF works in collaboration with governments, WHO, WFP and other partners to support adequate feeding practices and ensure that the critical nutritional needs of infants and young children are met through the protection, promotion and support of breastfeeding, complementary feeding and healthy diets, as well as continuity and adaptation for vitamin A supplementation and deworming. Work in this area includes strong advocacy to ensure that newborns are not separated from their mothers and infants and young children are breastfed adequately, intensify support to families on young children’s diets using practical communication tools and platforms, promote and support availability and access to healthy foods and control the illicit/unethical promotion or distribution of BMS and unhealthy foods.

In the context of COVID-19 Pandemic, capacities of the already weak health systems in the six Sahel countries are challenged by the increased demand for care within health facilities and the increased risks of contamination of health workers which could result from the pandemic. UNICEF continues to technically and financially provide in-country support to Ministries of Health aiming to strengthen health systems. A special emphasis is also being oriented on existing community platforms that can play a critical role in the continuity of services for under-5 children and mothers. As results, the use of MUAC (Mid-Upper Arm Circumference) malnutrition screening tape, family approach is currently being expanded in-countries ensuring that under-5 children are continuously screened for acute malnutrition and referred accordingly.

UNICEF and WFP continue to explore and support initiatives to adapt approaches that make early detection, treatment and care for children with acute malnutrition feasible at health and community levels. Given the COVID-19 context, which is further destabilizing systems in addition to the civil insecurity, treatment protocols need to be adapted wherever health workers are not available and community health workers and volunteers need to be called to replace them. This will ensure that available resources across both agencies are used in the best possible way to guarantee the highest coverage possible for both treatment and prevention, as one programme.

Securing supply chain and prepositioning of essential supplies

For the treatment of moderate wasting, WFP is working on ready-to-use supplementary food (RUSF) and other specialized foods, UNICEF continues working on essential medicines, including drugs, fortified Milk and ready-to-use therapeutic food (RUTF) required for the treatment of severe wasted children. This includes market shaping, optimized procurement, logistics, support to geographical decentralized production and in country supply chain to the last mile in order to optimize costs. Integration to the national health systems and supply chain will continue to be strengthened. In areas where access to services is challenged, UNICEF and WFP will jointly implement innovative and simplified approaches, including the testing of one single product for the treatment of wasting in order to gain efficiencies,  increase coverage of nutrition services and support the development of a more effective nutrition service delivery model.

With the projected deterioration of the nutrition situation in 2020, linked to the impact of COVID-19 on food systems and health systems, UNICEF and WFP are committed to guarantee the availability of nutrition, food and cash supplies to prevent and treat acute malnutrition among children under five years old as well as pregnant and lactating woman. As a result, UNICEF country offices have ordered additional nutrition supplies to preposition stocks at national and sub-national levels and respond to increasing demand in a timely manner. Similarly, WFP prioritized its nutrition, food- and cash-based interventions to treat and prevent further deterioration of the food security and nutrition situation. Additional supplies, for the treatment and prevention of acute malnutrition as well as for general the emergency response, were also ordered and prepositioned closer to the beneficiaries.

Food-based prevention and Stronger Food system  

The closure of markets, shops and businesses due to COVID-19 containment measures by National Governments could affect the purchasing power of consumers and loss of income of retailers and producers. Before the COVID-19 pandemic, analyses carried out in four countries, Burkina Faso, Mali, Mauritania and Niger with support from WFP, demonstrated that on average around half of households could not afford a nutritious diet, which contributed to unhealthy eating practices and malnutrition. These high food prices, coming in addition to pre-existing poor infant and young children diet, will worsen the nutrition situation of young children.

In this context, UNICEF and WFP continue to provide active support to governments to improve young children diets in the complementary feeding period through the implementation of UNICEF First Foods multi-sectoral frameworks. This also includes support to the local production of complementary foods, already ongoing in certain countries with WFP’s technical assistance to the private and public sector. In addition, WFP supports countries work towards ‘local food-based solutions’ to prevent acute malnutrition in children and women as part of the broader approach to improve complementary feeding practices. Indeed, the COVID-19 crisis put additional stress on the global supply of Specialized Nutritious Foods (SNF). While international import of SNF is still possible, WFP is working with all 6 countries in the Sahel to ensure additional strategies are in place and that rely on local supply of nutritious foods. With this approach, WFP gives equal attention to the supply of, demand for, or access to, a diverse and healthy diet composed of locally produced complementary foods or a basket of nutritious foods. This is especially important in a situation of international and/or national food supply chain disruptions, as demonstrated at the onset of the COVID crisis. The dissemination of the UNICEF global framework for improving infant and young children’s diets as well as the study on the production,  quality and market of locally-produced infant flours in the Sahel contribute to  the efforts  of improving the diets of young children through a comprehensive health, social policy, food systems’ approach.

Social protection - Cash transfer

As the pandemic slows down economies, access to safe food will be negatively affected by income reductions and loss of employment, as well as availability of food in local markets. It is critical to focus on implementing adequate social protection measures, such as cash transfers, and investing in early recovery efforts in response to COVID-19 to both protect livelihoods and fulfill the nutritional needs of people, and in particular children and vulnerable pregnant and breastfeeding women. WFP and UNICEF are accelerating efforts to extend social safety nets to mitigate the socio-economic impacts of COVID-19 such as access to healthy and nutritious diets.  This is particularly important in urban settings where households’ daily incomes are generated from the informal sector.

Water, Hygiene and Sanitation (WASH)

The nutritional status of children can be impacted by water-borne diseases such as diarrhea or vector-borne diseases such as malaria, which high transmission season is coming very soon. Several studies including some led by UNICEF have demonstrated the crucial importance of access to water, sanitation and hygiene for children's health and nutritional status in particular.

UNICEF and WASH sector partners will provide an integrated service package through the delivery of water, sanitation and hygiene services at the most vulnerable household level in areas with a high prevalence of undernutrition. Activities focus specifically on children under five years of age and their caregivers, supporting the improvement of sanitation and hygiene practices. UNICEF will also contribute to the provision and maintenance of a minimum WASH services in health and nutrition centers in targeted regions. All operational strategies and standards for integrating WASH and Nutrition activities are developed and validated by all partners within the national WASH-Nutrition working groups.