Use of Growth Chart in Emergencies WFP Perspective

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Use of Growth Chart in Emergencies WFP
Perspective Regional Workshop to Introduce WHO
New Growth Chart EMRO Muscat 12 14 September
2005 World Food Programme, Regional Bureau for
Middle East, Central Asia and Eastern
Europe Pushpa Acharya
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Likely Scenario in Emergencies Affecting
Growth/Nutritional Status

• Destructions of Livelihood
• Lack of food and cooking facilities
• High prevalence of diarrhea
• High risk of measles and ARI
• Disruption of breast feeding and complementary
  feeding
• Emotional stress affecting caring practices
• Death of care-takers
• Heighten insecurity

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Results

• Protein Energy Malnutrition
• Marmus
• Kwashiorkor
• Marasmic Kwashiorkor

• Micronutrient Deficiencies
• Fe, I, Vit A, C, B1, Niacine

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Results
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What Action?

• Assessment/Analysis
• Programme Design
• Implementation
• Monitoring/Evaluation

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Assessment/Analysis

• Severity availability, access, and utilization
• What kind of support?
• Who?
• How many?
• Where? - VAM

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Severity Index of the Nutritional Status
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Intervention

• Provision of food
• Adopt 2,100 kcal/person as reference
• Adjustment of the ration based on environmental
  temperature, health and nutritional status,
  demography, and physical activity
• Protein and fat context taken into account
• Adjustment made to account for nutritional needs
  of all sub-groups
• Strategies outlined for further adjustment
• Establishment of Supplementary Feeding

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Decision-Making Framework
Acute Malnutrition Rate gt 15
SERIOUS Blanket SFP Therapeutic Feeding Programme
Acute Malnutrition Rate 10 14 and Aggravating
Factors

• Aggravating Factors
• Inadequate general ration
• CMR gt 1
• Epidemic of measles or whooping cough
• High incidence or respiratory or diarrhoeal
  disease

If the general ration is lt2100 kcal pppd always
improve general ration
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ALERT Situation
Acute Malnutrition Rate 10 - 14
ALERT Targeted SFP Therapeutic Feeding Programme
OR
Acute Malnutrition Rate 5 9 and Aggravating
Factors

• Aggravating Factors
• Inadequate general ration
• CMR gt 1
• Epidemic of measles or whooping cough
• High incidence or respiratory or diarrhoeal
  disease

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Monitoring Evaluation

• Food basket
• Qualalitative survey
• Household survey
• Anthropometric Surveys
• Household Food Economic Assessment
• Food and livelihood security Assessment
• Growth Monitoring
• Impact Assessment

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Use of Reference Growth Chart in WFP
Programme/Projects

• Assessment
• Programme/Project Design
• Implementation
• Monitoring
• Evaluation

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Challenges/Opportunities WFP Programme/Projects

• Reassessment of the trends of nutritional status
  for programme design and monitoring
• Adoption of the new growth chart by technical
  partners
• Screening, enrolment and discharge criteria

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Potential Action

• Sharing of the information (CO, Partners)
• Provision of technical advise
• Data adjustment
• Support to MoH and WHO/UNIECEF for implementation
  in WFP project areas/health centres

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• THANK YOU