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Evaluation of regional IFE workshop

A mother and her baby in a temporary shelter following Cyclone Nargis

Summary of evaluation report1

An evaluation was undertaken by the Emergency Nutrition Network (ENN) to determine the impact of a regional workshop on infant and young child feeding in emergencies (IFE), held in March 2008 in Bali, Indonesia2. The workshop was a joint initiative between the IFE Core Group, UNICEF and MOH Indonesia and funded by the Inter-Agency Standing Committee (IASC) Nutrition Cluster and IBFAN-GIFA3.

Key outputs of the workshop were country/territory action plans, a model joint statement on IFE, and a pledge for action4 agreed by all individuals attending.

The objectives of the evaluation were:

Responses were solicited in this evaluation in relation to progress on specific goals agreed in country action plans. Two major emergencies occurred in the region since the workshop took place, Cyclone Nargis in Myanmar and the Sichuan Earthquake in China. Feedback on the impact of the workshop on IFE response to these specific emergencies was also sought, and a detailed analysis undertaken of media reports on IFE released during both responses.

Contact details were identified from participant lists. Participants were contacted with a questionnaire by email, with follow-up phone interviews. The response rate was 30% with fourteen countries represented.

Key findings

Key progress reported by participants included:

Policy: The majority of countries have now either completed or are planning to complete national policies on IFE (or are incorporating IFE into the national nutrition policies on Infant and Young Child Feeding (IYCF)). Three countries have completed or planning to complete a policy on managing donations of breastmilk substitutes (BMS).

Training: Training of staff was completed in one country, in progress in seven and planned in another four countries. Feedback suggested rolling out training on IFE via:

Co-ordination: This was a key constraint identified in the Bali workshop and the majority of countries have nominated an IFE co-ordinator (or body). Regarding implementation of the cluster approach, four out of five countries had completed or are progressing with this action point; UNICEF and Ministry of Health for that country were identified as those bodies who should lead co-ordination activities.

Communication: Developing a media/ communication strategy occurred/is currently underway in most countries, although some participants indicated more technical support in this area would be worthwhile.

Emergency preparedness: Pre-emergency planning and training activities are essential but seen as challenging actions to achieve as funding is considered "not easily available" from donors.

Networking: Participants valued the resources shared at the workshop (the Operational Guidance on IFE and Resource CDs, in particular), the opportunity to network with peers, donors and experts in this domain. Representation of several representatives from each country facilitated the development of technical 'working groups' upon return to work. Thirteen from 21 respondents stayed in touch with participants from other countries.

Over 80% of responses indicated that a workshop was considered the best approach for people to start or continue working in the area of IFE. Some input into the organisation and development of the workshop by relevant personnel in key agencies (at field office level) may infer greater support (via a sense of greater ownership for progress) of action postworkshop.

Supports for action

Supports identified that would greatly facilitate action in IFE if available, included:

A strong lead agency

  1. to provide follow-up support after the workshop
  2. to facilitate co-ordination
  3. to facilitate training
  4. to recognise expertise available and use it when required.

Funding for activities such as:

  1. Translation of IFE resources into other working languages
  2. training of more health professionals in IYCF to increase technical expertise (especially as emergency preparedness)
  3. printing and dissemination of messages /media strategy rollout
  4. adequate budgeting to include supportive supervision and monitoring activities.

More involvement of international expertise

For example, human resources for implementation and monitoring of IFE activities, technical support (capacity building) in developing a Media Strategy (messages and promotion).

Networking

Consider a website for the group (highlighting annual achievements/progress on IFE, facilitating networking/discussion groups) or a follow-up forum to facilitate more exchange to learn from other countries.

Register of skilled/trained personnel

Availability of a register of appropriately skilled people at both country and regional level that could be called upon in an emergency by agencies.

Regional events

Two major emergencies occurred in the region since the workshop took place - Cyclone Nargis in Myanmar and the Sichuan Earthquake in China. Responses from countries which supported the Myanmar government and agencies included Afghanistan, Indonesia, Bangladesh, Sri Lanka and the Philippines. Responses from countries which supported the Chinese government and agencies included Indonesia, Nepal, Sri Lanka, Taiwan. UNICEF Afghanistan was also involved in assisting in India and Bangladesh flooding emergencies. Examples of impact of the workshop included:

A detailed analysis of media reports revealed that IFE messages were commonly communicated via the media. Some of the common and pertinent messages in media reports were: babies are vulnerable, that women breastfeed in emergencies but breastfeeding is a sign of weakness, and providing infant formula will save babies. Messages rarely reported in the media included that artificial feeding leads to diarrhoea and death in emergencies and that breastfeeding is a sign of resilience and protects infants in emergencies. This analysis suggests that current reporting patterns of the media may encourage the inappropriate donation and distribution of infant formula and powdered milk in emergencies, and so contribute to increased morbidity and mortality in infants and young children.

Recommendations

Recommendations made by participants to improve capacity to respond on IFE included:

Resources

Workshop

Co-ordination

Media and communication

Show footnotes

1Full evaluation report available at www.ennonline.net in Resources section, or email:marie@ennonline.net

2Regional IFE workshop in Bali. Field Exchange, Issue No 34, October 2008. p37. http://fex.ennonline.net/34/regional.aspx

3International Baby Food Action Network - Geneva Infant Feeding Association

4See Annexes 1,2 and 3of Bali workshop report. Making it Happen. Proceedings of a regional strategy workshop. March 2008. ENN, UNICEF, IASC. Nutrition Cluster, IBFAN-GIFA.

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Evaluation of regional IFE workshop. Field Exchange 36, July 2009. p22. www.ennonline.net/fex/36/evaluation

(ENN_3947)

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