World Health Organisation
|Name||Department of Nutrition for Health and Development (NHD), World Health Organisation||Year formed||2005 (with Nutrition in Emergencies as a programme area)|
|Address of head office||20, Avenue Appia, CH-1211 Geneva 27, Switzerland||Director||Dr Jørgen Schlundt, Acting Director, Department of Nutrition for Health and Development|
+41 22 7914440 (direct)
|No of Nutrition Staff (HQ)||50 (48 nutrition and support staff plus 2 nutrition staff that fall under the Health Action in Crisis (HAC) umbrella). Additional small number of national programme officers at country level with nutrition terms of reference.|
|Website||http://www.who.int/nutrition/en||Approx annual budget for 2007||USD 500,000 (HQ Nutrition in Emergencies programme only).|
By Jeremy Shoham, ENN
Zita on a WHO field trip
The ENN interviewed Zita Weise Prinzo, who works in the Nutrition in Emergencies (NIE) programme of the WHO's Nutrition for Health and Development Department (NHD), for this issue's agency profile slot. Zita has been a focal point for WHO's emergency nutrition work for many years now. Her first work for WHO was in Nepal between 1992-5, where she worked as an APO, effectively seconded to the Ministry of Health (MoH) nutrition unit. In 1995 she took on the first of a series of short term assignments in the nutrition department of WHO in Geneva and has remained at head office since then. Zita's professional background includes a Masters in Science and Food Technology and a further Masters in Nutrition at LSHTM (1990-1).
WHOs interest and involvement in nutrition emerged at the First Health Assembly in 1948, where nutrition was included as one of six WHO priorities. In the early years, WHO nutrition work was mainly focussed on nutrition in development contexts. Early emergency related work included provision of technical support to WFP through the food aid programme (FAP) situated in WHO. FAP provided technical appraisals of WFP programmes and participated in joint interagency evaluation missions. However, the programme was mostly involved in 'developmental' programming, like school feeding and food aid for Maternal and Child Health (MCH) programmes, and had a limited emergency role. During the 1990s, WHO always had at least one nutritionist working at headquarters on NIE issues. However, it was not until 2005 that the WHO nutrition department formally instituted a nutrition in emergencies programme. The NIE programme was one of seven programmes being implemented within the Nutrition for Health and Development Department in WHO. The other programmes were growth assessment and surveillance, micronutrients, nutrition policies and programmes, infant and young child nutrition, obesity, and HIV and nutrition.
During the 1970s and 80s, WHO's nutrition department produced a number of key guidelines and management tools, some of which were specifically for the NIE sector, e.g. Seaman and Goyet's Nutrition in Emergencies handbook. However, more recently, the scope of WHO involvement in NIE has increased substantially. In addition to development of guidelines and tools for managing nutrition programmes, capacity development at national level, as a component of preparedness and recovery and operational support during emergencies, is now a key element of the NIE programme.
The capacity development work has mainly focussed upon regional and in-country training for the management of severe malnutrition. WHO have worked, and continue to work closely with, UNICEF in this area. In the 1990s, WHO undertook a series of regional trainings in the management of severe malnutrition. Capacity development involving the training of national staff has included curricula on infant and young child feeding and Nutrition and HIV. The NIE programme works closely with the HAC department in WHO by, for example, feeding into the HAC pre-deployment training of staff.
Provision of operational support in acute emergencies is perhaps the newest element of NIE work. Zita feels that, in some ways, WHO are not currently well set up to undertake this kind of work in nutrition. In the past, WHO sent out HQ staff to assist government or WHO country offices when requested to do so following the onset of an emergency. However, this did not have a sustainable impact at the country level. Zita explained "there was not a great deal of sense in suddenly getting involved in nutrition when there had been no previous involvement or presence on the ground". It was recognised that WHO needed to build up a network of nutritionists at country and regional level in advance of an emergency, in order to be able to provide operational support adequately. This would allow more appropriate responses as in situ staff "would be building upon ongoing partnerships when an emergency struck". The NIE programme has now put together a proposal that would fund nutritionists at country level. This was completed at the end of 2007 but there has, so far, been little interest from donors. Zita fears that this may partly be due to competing demands of the UNICEFled Interagency Standing Committee (IASC) Nutrition Cluster and the perception amongst donors that this should be a Nutrition Cluster rather than a WHO role - thus failing to see the complementary role of the agencies.
Zita on a WHO drought survey
Zita reflected that, in the past, WHO have put out guidelines and management tools as WHO documents but have learnt that they need to work more inclusively with other agencies in order to get comprehensive buy in. The current development of tools on the integrated management of severe malnutrition (community-based and hospital based approaches) follows this model, with other non-governmental organisations being involved in developing the guidelines. Zita and her colleagues are also aware that in the past some guidelines and tools have simply gathered dust as dissemination and roll out has been poorly planned. "To be effectively used, these finely honed documents need to be disseminated through mechanisms based on long-term relationships between WHO and governments and other local agencies".
Zita sounded a little downbeat in response to my question about NIE funding. In short she said that it was a continual struggle. Certainly, the advent of the Nutrition Cluster with UNICEF as the lead has not helped the NIE programme cause. There are also battles to be won in house, as some NIE funding traditionally comes through HAC, and there are staff at the country-level that in turn have questioned whether certain NIE activities fall more within the domain of UNICEF. At the moment there are 25 staff in the WHO nutrition department, three of who work in the NIE programme (Zita and Chantal Gegout on the technical side and one support staff).
Zita was far more upbeat about NIE plans for the future. Work in a number of key areas is planned including;
- Updating the WHO training for hospital based management of malnutrition
- Reviewing the implications of new growth standards for operational practice
- Producing policy guidance on integrated management of malnutrition
- Reviewing and providing guidance on management of moderate malnutrition through supplementary feeding programmes and dietary counselling
- Reaching greater clarity on preventing and controlling micronutrient deficiencies in emergencies, e.g. use of iron in malaria endemic countries
- Infant and Young Child Feeding in Emergencies (IFE)
- Improving maternal nutrition in emergencies.
Zita on a WHO field trip
I left the most controversial questions until the end. I couldn't finish the interview without asking about WHO and UNICEF's relationship and any problems therein. Zita was surprisingly frank in stating that things can get a "little competitive," especially at country level, and that the outcome (good or bad) depends very much on personalities involved and level of resources available. I also asked her about the view that WHO take 'forever and a day' to produce guidelines and manuals and that by the time these eventually come out, knowledge and practice have moved on. Again Zita held her hand up on behalf of WHO, saying that the length of time it can take is unacceptable but that delays also included late inputs from stakeholders and Member States on certain standardsetting work. She did, however, say that WHO are now producing fact sheets as a way of getting information out more quickly. She observed that delays are not just due to the technical discussions but also that fact that documents have to be cleared by so many stakeholders and parties within the organisaorganisation. Apparently WHO now have guidelines on how to develop guidelines.
Zita on well-earned R and R!
A final question for Zita was how she saw WHO's NIE programme fitting into the sector. She quickly identified the fact that it's location, i.e. within a health organisation, allows for integration of nutrition with health and vice versa in all activities. She also believes that the NIE programme has the potential of doing excellent work in providing an evidence base for the management of nutrition in emergencies, as well as supporting and developing the capacity of member countries to undertake this management.
An overriding and familiar impression from the interview was that, as seems to occur in so many agencies, nutrition and therefore NIE, has to continually fight its corner to survive. In Zita it is clear that WHO and the nutrition community have an individual who is more than able to go the 10 rounds.
More like this
FEX: Nutrition in health response in emergencies: WHO perspectives and developments
By Zita Weise Prinzo, Adelheid Onyango, Dr Ferima-Coulibaly Zerbo, Hana Bekele, Dr Ngoy Nsenga and Adelheid Marschang View this article as a pdf Lisez cet article en...
FEX: Global Technical Assistance Mechanism for Nutrition (GTAM): The story so far
View this article as a pdf Lisez cet article en français ici By Isabelle Modigell and Tanya Khara Isabelle Modigell is the Project Manager for Global Technical...
FEX: The impact of the NiE regional training initiative: the Lebanon experience 2010-2014
By Hala Ghattas (American University of Beirut), Linda Shaker Berbari (International Orthodox Christian Charities) & Omar Obeid (American University of Beirut). Hala Ghattas...
FEX: WHO emergency nutrition response in South Sudan
By Marina Adrianopoli and Allan Mpairwe Marina Adrianopoli has been supporting WHO in South Sudan as Emergency Nutrition Focal Point since 2014. She has over 10 years'...
FEX: Experiences of the Nutrition in Emergencies Regional Training Initiative
By Abigail Perry, Jessica Meeker, and Andrew Seal, UCL Centre for International Health and Development (UCL-CIHD) Abigail Perry is a nutritionist with extensive experience in...
FEX: Bangladesh Nutrition Cluster: A case in preparedness
By Andrew Musyoki and Anuradha Narayan Andrew Musyoki is a Nutrition Specialist with UNICEF Bangladesh Anuradha Narayan is the Chief of the Nutrition Section, UNICEF...
FEX: Institutionalising acute malnutrition treatment in Lebanon
By Linda Shaker Berbari, Dima Ousta and Farah Asfahani Linda Shaker Berbari is Country Representative at International Orthodox Christian Charities (IOCC) Lebanon and...
FEX: Experiences on Nutrition in Emergencies Training for Syrian refugees response in Jordan
By Caroline Abla Caroline Abla is the Director of the Nutrition and Food Security Department at International Medical Corps. Caroline has over 22 years of international...
FEX: Building national capacities for emergency nutrition preparedness and response in East Asia and the Pacific
View this article as a pdf Lisez cet article en français ici By Mueni Mutunga, Caroline Abla, Alexandra Rutishauser-Perera and Sri Sukotjo Mueni Mutunga is a regional...
FEX: UNICEF experiences of the nutrition response in Lebanon
By Najwa Rizkallah Najwa Rizkallah was Nutrition Specialist with UNICEF Lebanon until September 2014, having led the nutrition in emergencies programme in Lebanon for Syrian...
FEX: Philippines Nutrition Cluster: lessons learnt from the response to Typhoon Haiyan (Yolanda)
By Aashima Garg, Andrew Rene Bucu and Rene Gerald Garela Aashima Garg is Nutrition Specialist based in UNICEF New York. At the time of writing, she was Nutrition Manager with...
FEX: Philippine Nutrition Cluster’s battle for the best: the breast
By Ms. Florinda Panlilio, Department of Health, Philippines Ms. Florinda Panlilio is a Nutritionist-Dietitian IV in the Department of Health -Health Emergency Management...
FEX: Nutrition response in Syria: UNICEF’s perspective
By James Kingori, Dr Hayder Nasser, Muhiadin Abdullahi and Dr Khaldoun Al-Asaad James Kingori is the UNICEF Regional Nutrition Specialist for UNICEF's Middle East and Northern...
en-net: human resources for health and nutrition integration and WASH
I find nutrition interventions working in a different way in humanitarian than in normal public health systems. Lack of integration of services within the same health and...
Video: ENN hosted Webinar on WHO Wasting Guidelines and Development
In light of the upcoming update to the WHO guidelines for the management of wasting, this webinar was hosted to improve understanding of the WHO guideline development process...
MAMI Global Network Coordination and Governance
MAMI Global Network Coordination and Governance The MAMI Global Network Strategy for 2021-2025 is now available here. An overview of the Network's governance structures and...
FEX: Feinstein International Famine Centre
Name Feinstein International Famine Centre Address Friedman School of Nutrition Science and Policy, Tufts University, 126 Curtis St. Medford, MA02155, USA Year...
FEX: Management of SAM in the Philippines: from emergency-focused modelling to national policy and government scale-up
By Aashima Garg, Anthony Calibo, Rene Galera, Andrew Bucu, Rosalia Paje and Willibald Zeck Lisez cet article en français ici Aashima Garg is Nutrition Specialist based...
FEX: New UNHCR Policy on handling Milk Products
The revised edition of the UNHCR Policy Related to the Acceptance, Distribution, and Use of Milk Products in Refugee Settings is now available. The 2006 version replaces the...
FEX: Contributing to the Infant and Young Child Feeding in Emergencies (IYCF-E) response in the Philippines: a local NGO perspective
By Romelei Camiling-Alfonso, Donna Isabel S. Capili, Katherine Ann V. Reyes, A.M. Francesca Tatad and Maria Asuncion Silvestre Romelei Camiling-Alfonso has worked for the...
Reference this page
Jeremy Shoham (). World Health Organisation. Field Exchange 32, January 2008. p27. www.ennonline.net/fex/32/agencyprofile