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Programmatic Adaptation Support in the Context of COVID-19

Critical guidance on Nutrition Programming to support Nutrition in Emergencies (NiE) practitioners and coordination teams in their ability to continue to deliver humanitarian assistance during the COVID-19 outbreak.

To support adaptation to prepare for and mitigate the effects of the COVID19 pandemic the Global Technical Assistance Mechanism for Nutrition is compiling, curating and presenting adaptations that are being rolled out in countries for Infant and Child Wasting, IYCF and Micronutrients, as well as Nutrition information Systems.

If you have good additional examples of adaptations please share them with us here so your experience can help others. You can also request specific support from GTAM here.

If you have particular questions or have experiences that you would like to share with your peers and global nutrition colleagues via an open discussion that others can feed into, please visit the en-net forum , we will also be compiling experiences and challenges shared on the forum for reflection in the collection

 

Prevention and Management of Wasting 2

 

You can find here a collection of potential adaptations and related tools and resources according to different contextual scenarios/challenges.

GTAM Management of Child Wasting in the context of COVID-19 Brief No.1 (March 27th, 2020): This brief is meant to provide information specific to services and programmes for the management of child wasting in the context of COVID-19, and it contains information that is not already available elsewhere. This Brief does not cover wider mitigation and response measures available in other guidance. Arabic, Spanish and French versions are also available. Download English webinar slides and recordingDownload French webinar slides and recording. Download Spanish webinar slides and recording. Download Arabic slides

Wasting and COVID 19 Programme Adaptations Information Note 1 This information note has been prepared to outline potential options when RUTF and RUSF are unavailable.

Wasting and COVID 19 Programme Adaptations Information Note 2 This information note recommends trial phone-based screening using recommended questions where standard screening processes or family/mothers’ MUAC is not possible.

John Hopkins modelling COVID-19 indirect impact models This models the impact of various levels of wasting increases and drop in coverage of services (based on least severe and worst-case scenarios) on child and maternal mortality. Least severe envisaged scenario is coverage reduction 9.8-18.5% and wasting increase of 10% over 6 months resulting in 253,500 additional child deaths and 12,200 additional maternal deaths. Most severe scenario (coverage reductions of 39·3–51·9% and wasting increase of 50%) over 6 months would result in 1 157 000 additional child deaths and 56 700 additional maternal deaths. These additional deaths would represent an increase of 9·8–44·7% in under-5 child deaths per month, and an 8·3–38·6% increase in maternal deaths per month, across the 118 countries.

Supporting Children’s Nutrition during the COVID-19 Pandemic UNICEF and WFP are scaling up efforts to prevent and treat child wasting, in response to the impact of COVID-19. The pandemic puts malnourished children at an ever-high risk of death and – for the children who survive – poor growth, development and learning.

Adapting Community-based Management of Acute Malnutrition in the context of COVID-19 This guide is designed to assist Concern's health and nutrition staff responsible for the management and coordination of Community-based Management of Acute Malnutrition (CMAM) operations to adapt and modify programme modalities in the context of COVID-19. The guide attempts to provide practical steps based on the current international guidelines and recommendations to ensure essential treatment services for acute malnutrition continue as much as possible while minimising the risk of COVID-19 transmission. Download French version. 

Simplified Protocol for Acute Malnutrition Updated simplified protocol 2-pager A simplified, combined protocol is intended to simplify and unify the treatment of uncomplicated severe and moderate acute malnutrition for children ages 6-59 months into one protocol in order to improve the coverage, quality, continuity of care and cost-effectiveness of acute malnutrition treatment in resource-constrained settings.

The State of Acute Malnutrition The Family MUAC Approach also known as MUAC for mothers or Mother-MUAC, trains mothers and other caregivers to identify early signs of malnutrition in their children using a simple to use Mid-Upper Arm Circumference (MUAC) tape. By moving this task to mothers (or other family members), who are able to do it as effectively as Community Health Workers (CHWs), the cases are detected earlier, leading to less hospitalisations. Some countries have adopted this approach during the context of COVID-19.

IASC Interim Recommendations for Adjusting Food Distribution Standard Operating Procedures in the Context of the COVID-19 Outbreak – developed by World Food Programme (WFP).  Version 2 (March 2020)  Interim Guidance for field coordinators, site managers and public health personnel, as well as national and local governments and the wider humanitarian community working at food distribution sites, who are involved in the decision making and implementation of multi-sectorial COVID-19 outbreak readiness and response activities.

Interim Guidance on Mitigating the Effects of the COVID-19 Pandemic on Food and Nutrition of Schoolchildren. This is joint guidance from FAO, UNICEF and WFP to guide countries on how to maintain the continuity of school nutrition programmes, including school feeding in the context of the COVID-19 pandemic.

United Nations System Standing Committee on Nutrition (UNSCN). Resource List on Food Systems and Nutrition Responses. Provides links to UN agencies’ responses, food systems, IYCF, school aged children, adults, emergency nutrition responses and articles of interest.

WHO Key planning recommendations for mass gatherings in the context of the current COVID-19 outbreak (Interim Guidance – Published 19 March 2020) For consideration for nutrition programmes conducting mass gatherings (e.g. during distributions organised by supplementary feeding programmes).

WHO Reducing excess mortality from common illnesses during an influenza pandemic (2008) Guideline which provides strategies for prevention and treatment, at the community and household levels, of the most likely contributors to mortality from common illnesses during an influenza pandemic and recommendations to support a minimum level of continuity for priority public health programmes during a pandemic. Covers acute malnutrition programmes (p. 24).

WHO IPC during health care when COVID-19 infection is suspected (Published 19 March 2020) Includes standard precautions for facilities to take with all patients (e.g. those attending health and nutrition facilities for treatment of malnutrition) 

WHO Advice on the use of masks in the community, during home care and in healthcare settings in the context of the COVID-19 outbreak. (19 March 2020) Rapid guidance for public health and IPC professionals, HCWs and community health workers on use of medical masks. Also see COVID-19: Contact and Droplet Precautions - Personal Protective Equipment (PPE) 

WHO Resource Page on COVID-19 Occupational Health (Multiple Resources)  Includes guidance rights, roles and responsibilities of health workers, health workers exposure risk assessment and management, rational use of PPE and a risk communication package.

Nutrition for Infants & Young Children – IYCF & Micronutrients 2

You can find here a collection of potential adaptations and related tools and resources according to different contextual scenarios/challenges.

GTAM Infant & Young Child Feeding in the context of COVID-19 Brief No. 2 (v1) (March 30th, 2020): This brief is meant to provide information specific to infant and young child feeding (IYCF) in the context of COVID-19. This Brief does not cover wider mitigation and response measures available in other guidance. Arabic , French, Spanish and Russian versions are also available. Download Arabic webinar slides and recording. Download English slides and recording. Download French webinar slides and recording. Download Spanish webinar slides and recording

GTAM Maternal Diets and Nutrition Services and Practices in the Context of COVID-19 This brief provides recommendations to support the nutritional needs of women in the context of partial or full population mobility restrictions, to be implemented in line with national guidelines. The brief is available in English, French, Arabic and Spanish languages.

GNC This Template for Joint Statement on Infant and Young Child Feeding in the Context of Covid (April 2 2020) includes a consolidation of available recommendations related to IYCF in the context of Covid-19. It is to be adapted by countries or nutrition clusters and to be issued at the national level. It was developed by the IFE Core Group. It is available in English, French and Arabic. 

COVID-19, Maternal, and Child Health, Nutrition – what does the science tell us? is compiled by the Johns Hopkins Center for Humanitarian Health and provides an overview of what peer-reviewed journal articles currently state on COVID-19, maternal and child health (including infants), and nutrition. As the pandemic is ongoing more and more research results are published. The service aims to provide the user with a snapshot of what is published with updates every few days.

UNICEF and USAID-funded Advancing Nutrition have developed a package of Infant and Young Child Feeding Recommendations when COVID-19 is Suspected or Confirmed. Developed with technical support by the Infant Feeding in Emergencies Core Group, represented by Save the Children and Safely Fed Canada – the Counseling Package includes a set of 10 Counselling Cards and Recommended Practices Booklet.  

Save the Children IYCF Tools in the Context of COVID-19 These resources provide an overview of the latest global evidence-based recommendations related to IYCF and COVID-19. Documents here outline suggestions and reflections around communication about breastfeeding with health care providers and caregivers and programming adaptation in the context of COVID-19. This is an effort to support implementing partners on how to prepare and respond to the pandemic with information specific to IYCF-E.

WHO FREQUENTLY ASKED QUESTIONS: Breastfeeding and COVID-19 for health care workers This FAQ complements the WHO interim guidance: Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected (13 March 2020) and provides responses to questions that have arisen about the recommendations. The FAQ also draws on other WHO recommendations on Infant and Young Child Feeding and the Interagency Working Group Operational Guidance on Infant and Young Child Feeding in Emergencies. A decision tree shows how these recommendations may be implemented by health workers in maternity services and community settings, as part of daily work with mothers and families.

Key messages on breastfeeding and COVID-19 prepared by the Global Breastfeeding Collective.

WHO Clinical management of severe acute respiratory infection when COVID-19 infection is suspected (13 March 2020). Guidance for clinicians caring for hospitalised adult and paediatric patients. Section 13 contains comprehensive breastfeeding and some artificial feeding guidance.

Academy of Breastfeeding Medicine Statement on COVID-19. (10 March 2020)

International Lactation Consultants Association (ILCA) Statement on Breastfeeding and Lactation Support during the COVID-19 Pandemic. (18 March 2020)  

Royal College of Obstetricians and Gynaecologists (RCOG) COVID-19 Infection in Pregnancy. Information for healthcare professionals. Version 4.1 (Updated 26 March 2020)  Resource for United Kingdom HCWs. Includes advice to share with pregnant women and advice for services caring for women with or recovering from COVID-19. Section 4.9.2 (p. 31) on infant feeding covers shared decision making and precautions caregivers with suspected or confirmed COVID-19 infection should take to prevent transmission when feeding their infant (covers both breastfeeding and formula feeding).

UNICEF COVID-19: What Parents Should Know. (Accessed 26 March 2020) General information for parents, including precautions families can take to avoid infection and guidance for symptomatic women who are breastfeeding, including recommended precautions to prevent transmission to an infant.  

Safely Fed Canada Compilation of COVID-19 resources and statements related to breastfeeding: Includes also COVID19 Infant Feeding Resources for Parents and Caregivers and Statement on skin-to-skin

UNFPA Statement on COVID-19 and pregnancy (Published 5 March 2020) Synthesis of evidence on risks for pregnant women as well as preventive measures and supportive therapies recommended. Includes guidance for symptomatic women who are breastfeeding, including recommended precautions to prevent transmission to their infant.

WFP COVID-19 and Breastfeeding. Version 2 (12 March 2020). Interim guidance.

WHO Home care for patients with suspected COVID-19 infection presenting with mild symptoms and management of contacts. (Published 17 March 2020) Guidance for public health professions and HCWs on issues related to home care for patients with suspected COVID-19 presenting with mild symptoms. See footnote on p. 2 for breastfeeding guidance.

WHO Five keys to safer food. Poster – applicable to preparation of complementary foods. Available in French and Arabic.

WHO Q&A on COVID-19, pregnancy, childbirth and breastfeeding 

WHO Breastfeeding advice during the COV D-19 outbreak. Flyer

WHO IYCF and COVID19 infographics  

UNICEF The use of Multiple Micronutrient Supplementation (MMS) for Maternal Nutrition and Birth Outcomes during the COVID-19 pandemic

GAVA Consensus Statement on Universal Vitamin A Supplementation for Preschool-Aged Children in the Context of COVID-19. This statement provides interim guidance on delivery of VAS through mass campaigns and routine health and nutrition services during this public health crisis. This will also be made available in French very shortly.

Nutrition Information Systems  2

You can find here a collection of potential adaptations and related tools and resources according to different contextual scenarios/challenges.

GTAM Nutrition Information Management, Surveillance and Monitoring in the context of COVID-19 This brief is meant to provide broad recommendations specific to nutrition information management, surveillance and monitoring in the context of COVID-19. The brief is available in four languages (English, French, Arabic, Spanish). Download English webinar slides and recording. Download Spanish webinar slides and recordingDownload French webinar slides and recording.

IPC Guidance on how to build assumptions for IPC AMN projections in the context of COVID-19 pandemic - Version 1 This document intends to provide guidance to country IPC Technical Working Groups and/or Nutrition Clusters/Sectors on developing assumptions for IPC Acute Malnutrition projections in the context of COVID-19 pandemic. 

IPC The IPC in the context of COVID-19 This page describes and answers what IPC is doing during the current context of travel restrictions and containment; How does the IPC virtual analysis process work? Can IPC trainings also be conducted virtually?; What are the evidence requirements for IPC analyses in the context of COVID-19?;  How to develop scenarios and project food security and nutrition situations in the context of COVID-19; and Can the IPC assist in providing information on the food security situation of the most vulnerable populations in urban settings? 

ACF Nutrition Information Systems review with a particular emphasis on innovations in nutrition information systems that support collection, analysis and dissemination of nutrition data. As nutrition assessments will prove to be challenging in the coming months, we hope that this document will spark some ideas and discussions on creative adaptations to the current way we monitor nutrition situations.
 

OCHA IM Toolbox on COVID-19 This page will provide links to IM reference material, guidance, standards, templates, and examples of products and services related to COVID-19 preparedness and response activities. It is intended for OCHA IMOs but other humanitarians may find helpful resources.

Data Responsibility in the COVID-19 Response The members of the Inter-Agency Standing Committee (IASC) Sub-Group on Data Responsibility (co-led by the OCHA Centre for Humanitarian Data, IOM, and UNHCR) have developed this FAQ to support organizations and staff around the world working with data in the COVID-19 response. The ongoing response presents a range of challenges and opportunities around the safe, ethical, and effective management of data. This resource will be updated regularly as we receive additional questions and feedback.

General 

ENN and GTAM Nutrition and CoVID19 Technical Brief:This technical brief provides an overview of available guidance and tools on the Novel Coronavirus Disease (COVID-19) to assist Nutrition in Emergencies (NiE) practitioners in integrating COVID-19 preparedness and response into humanitarian nutrition responses. Given the rapidly evolving situation, this brief will be updated every 2 weeks until further notice.

Save the Children Tip Sheet for Disability Inclusion during COVID-19 NUTRITION This Tip Sheet provides practical recommendations to ensure Save the Children and our partners deliver NUTRITION programmes during COVID-19 that are inclusive of children and families with disabilities. We recognize that these recommendations and their adoptability may vary between contexts and locations and that teams may need to adapt or prioritize what is possible in their respective programmes.

Save the Children Guideline for remote support on nutrition during COVID 19 pandemic version 1.0 The purpose of this guide is to help nutrition advisors and managers to provide remote support for staff working at community/health facility level. It important to note that this guideline and the tools (annexes) are intended for use primarily in the humanitarian nutrition interventions.

WHO Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic This joint WHO, UNICEF and IFRC guidance addresses the role of community-based health care in the pandemic context. It includes practical recommendations for decision makers to help keep communities and health workers safe, to sustain essential services at the community level, and to ensure an effective response to COVID-19. Using this comprehensive and coordinated approach will help countries strengthen the resilience of community-based health services throughout the pandemic, into early recovery and beyond.

Food and Nutrition Essentials in COVID-19 - Focus on Africa Thursday, May 14 has shared the session recording and link to the presentations.

Resources from Infection Prevention and Control (IPC) Global Webinar Series Session 1 Triage of COVID-19 Patients: Operational Considerations and Practical Examples Thursday, May 14, 2020 has shared the session recording and link to the presentations.

Resources from Infection Prevention and Control (IPC) Global Webinar Series Session 2 Triage of COVID-19 Patients: IPC Monitoring and Facility Readiness for COVID-19 Thursday, May 21, 2020 has shared the session recording and link to the presentations.

Tech RRT Technical Rapid Response Team (Tech RRT) approach to technical assistance to nutrition emergencies during the COVID-19 pandemic Version 3.0:This document outlines how the Tech RRT will continue to provide technical support to nutrition emergencies in the COVID-19 context. This will enable requesting partners to know what they can expect from the Tech RRT support during the COVID-19 pandemic

ENN The en-net provides a place to submit questions surrounding the emergency response to COVID-19. Current threads include infant and young child feeding, breastfeeding, prevention and treatment of MAM,  and nutrition programming

GOAL Community Engagement in the Context of COVID 19The purpose of this SOP is to provide a decision-making framework for GOAL staff to decide which community engagement activities they can continue and what measures are required to undertake these engagements, balancing safety with the need to continue critical lifesaving and life sustaining programming. This SOP should inform the adjustment of ongoing and planned community engagements under current programming and the design of new community engagement activities for COVID-19 responses.

GOAL COMMUNITY-LED ACTION (CLA) FOR COVID-19 A RESOURCE GUIDE FOR COUNTRY OFFICES This Resource Guide was developed to support GOAL Country Office management to operationalise GOAL’s Community-Led Action (CLA) approach. CLA is GOAL’s community engagement approach that recognises that communities have the power to stop the spread of COVID-19 through their collective decisions and actions. This resource guide focuses on the operationalising of CLA within community level but please note that CLA can also be applied where there are groups of people who have a common purposes such as market ‘communities’. (See annex 1). The guide can also be used by other organisations as part of COVID-19 responses.

GOAL COMMUNITY-LED ACTION (CLA) FOR COVID-19 A FIELD MANUAL FOR COMMUNITY MOBILISERS This Field Manual was developed by GOAL for GOAL Community Mobilisers implementing the Community-Led Action (CLA) approach to reduce the spread of COVID-19 in their communities. It can also be used by other organisations who wish to implement the CLA approach as part of the COVID-19 pandemic response.

Country level documents

 

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