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
2
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)
3
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
4
Strategic Response Planning
5
How was nutrition cluster strategic
planning developed in South Sudan?
Jan
2014
May
2014
June
2014
July
2014
• 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
6
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
7
Resource Mobilisation
8
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
9
Resource Mobilisation: SUPPLY
10
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
11
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
12
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?
13
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
16
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
17
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
19
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?
20
Thank You
Questions?
21
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