South Sudan - Nutrition Cluster

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Scaling Up the Nutrition Response in South Sudan

Key Issues and Challenges

Angeline Grant

Rapid Response Team Member

Global Nutrition Cluster

Needs Assessment and Analysis

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Issues and challenges faced in South Sudan during assessment and analysis

• Lack of systematic approach to nutrition assessments pre-crisis led to the development of under-informed CRP in Jan 2014

• Limited NI available to determine needs and inform IPC

• Recommended: nutrition surveillance system be established, NI TWG be strengthened  SSSS, integrate nut into FSMS, increased capacity

• Caseloads revised mid-May with review of CRP  large jump in targets

• On-going county-level needs analysis conducted through:

Cross-sectional nutrition surveys validated through NITWG and used to inform IPC analysis

County-level response analysis through Nutrition Response Matrix

IRNAs, rapid response mission data & RNAs  qualitative and quantitative data

Programme data (“hotspots” for admissions/increased caseloads)

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Assessment and analysis in South Sudan –

Key points for discussion

• How much data is needed to justify scale-up? data vs. response?

• Difficulties in analyzing programme coverage data to payam level

• Balance between need to rapidly deliver representative anthropometric data and longer time periods needed to collect mortality data

• Carrying out assessments in midst of L3 requires dedicated support and capacity-building initiatives

• Challenges in finding partners able to carry out assessments in priority locations, not their areas of intervention

• Timely turn-around for validation of results and large-scale dissemination

• Low availability of health, WASH and GFD data to feed into analysis

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Strategic Response Planning

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How was nutrition cluster strategic planning developed in South Sudan?

• CRP developed in Jan 2014 (Jan-June 2014) to guide nutrition response crisis-affected states, but limitations

• CRP revision, May 2014  needs analysis, caseload determination, targets, cluster strategic objectives and indicators, cluster operational priorities, priority interventions and cross-cutting themes

• Nutrition Cluster Response Matrix, June 2014  operational analysis of the response

• South Sudan Updated Nutrition Cluster Response Plan,

July 2014  builds on the Nutrition Cluster strategy defined during May 2014 CRP review

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Strategic Response Planning in South

Sudan Issues and Challenges

• Tying macro-level strategy with concrete, operational priorities and actions

• Need for stand-alone logistics strategy for nutrition cluster in South Sudan?

• Improving transparency in prioritisation process particularly with regards to inter-sectoral deployment of assessment/mobile response teams

• New programming strategies such as expanded criteria/simplified protocols hampered by low levels of buy-in at country level and lack of resources

• Inter-sectoral linkages  easy to plan strategic areas for collaboration but operational joint programming requires further partner engagement and leadership

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Resource Mobilisation

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Financial Resource Mobilisation – Issues and Challenges

• Nutrition response req initially set at $83,267,835 in Jan 2014 - May revised up to $131,000,000 (42% funded according to FTS)

• Funding gaps remain, impacting scale-up in a complex situation with extreme needs

• Increased level of donor interest but operational costs extremely high

• Clear articulation of extra supply and logistics requirements on a stand-alone basis?

• Capacity to quickly absorb funding is limited

• Some inter-sector approaches may not always be most appropriate for nutrition sector  heavy focus on mobile teams/mobile responses

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Resource Mobilisation: SUPPLY

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Supply

• Supply requirements estimated by pipeline managers  requirements to take into account revised caseloads May

‘14

• Concerns with stock-outs led cluster to instigate a twoweek deadline for requests with pipeline managers

• Regular pipeline updates at cluster meetings

• New reporting format for supplies implemented UNICEF

• Priority for nutrition supplies increased to extremely high priority by logistics cluster

• Joint WASH-health-nutrition supply mechanism established for Bentiu

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Supply – Issues and Challenges

• Could the determination of supplies best been conducted at cluster level in conjunction with pipeline manager + other independent pipelines?

• Lack of pre-positioning meant re-supply became an issue, even when supplies available in central locations  Low visibility of pipeline at state level

• Reporting of supplies by certain partners poor in first 6 months of year leading to disagreements on allocation vs. consumption

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Supply – Issues and Challenges

• Low visibility of commodities further down the line (ETAs 2-3 months max)

• High dependence on ETA because of low levels of buffer stock

• Focus on conflict-affected states sometimes meant discrepancies at other levels/states

• Dependence on Juba as central hub vs. Rumbek where majority of logistics cluster air assets are stationed

• Cluster pipeline updates remained too general  bilateral meetings chaired by Cluster Coordination Team between organisations and pipeline managers on specific areas/cases better mechanism for addressing bottlenecks?

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Resource Mobilisation:

HUMAN RESOURCES

Human Resource Capacity – Issues and challenges

• Capacity mapping of nutrition partners conducted April 2014 

Demonstrated need to have increased capacity, particularly international staff to expand programmes sufficiently quickly

• Capacity-building initiatives underway and technical capacity-building available through one partner as a stand-alone activity

• Turn to non-traditional nutrition actors to increase coverage and uptake

 implications for capacity-building and quality

• Increasing capacity-building initiatives in midst of L3 requires, dedicated, external support

• Majority of partners express difficulties in recruiting for expatriate nutrition positions for South Sudan

• Insecurity and ability to maintain teams in deep field locations

• Heavy reliance on surge support with resulting high turnover of staff

15 and loss of institutional memory

Implementation and Monitoring

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Implementation – Issues and challenges

• Issues related to lack of logistical support, insecurity, lack of physical access, fragile pipelines, and lack of qualified staff have curbed timely scale-up of nutrition programming in South Sudan

• Funding has been made available but situation requires larger contributions to address major logistical, HR and supply challenges in an effective manner

• Management of humanitarian space  add. partners for existing partners

• Capacity of organisations to rapidly scale-up to new areas

• Need to strengthen IYCF-E programming and sensitize humanitarian community and donors on its importance

• Inter-sectoral programming is apparent in certain locations but focus to be extended to other areas of particular nutrition vulnerability

• Partner programming components may demonstrate some mechanisms of AAP but need to be developed and more widely disseminated

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South Sudan achievements as of 11 September 2014

Monitoring of the response

• In mid-May, the targeted caseloads jumped to 176,283 for SAM and 420,000 for MAM  “catch up” annual projected caseload

• Reporting and monitoring system may underestimate achievements  but by how much?

• Reporting and monitoring of certain components of response are lacking (IYCF, MN)

• Monitoring of achievements  starting to impact programme decision-making but needs to be improved

• Programme database cumbersome and analysis not programmed

• No reporting at site level  revision of database on-going

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Monitoring of coordination

• Initial lack of coordination capacity and turn-over of staff disruptive to partners

• ToR for Co-coordinator role not very clear and currently being reviewed

• Coordination with sub-national level not formalised

• Cluster Coordination Performance Monitoring exercise conducted in April 2014  to be reviewed at end of year given enhanced coordination capacity now in place?

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Thank You

Questions?

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