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Infant and Young Child Feeding in Emergencies (IYCF-E). Programming in The Context Of COVID-19: Considerations for Adaptations

Author: Save the Children and the Nutrition Technical Rapid Response Team (Tech RRT) with the support of the members of the IFE Core Group
Year: 2020
Resource type: Field tool

Introduction

The COVID-19 pandemic is an unprecedented global emergency with 216 countries affected, more than 19 million confirmed cases and more than 900,000 deaths as of September 2020.i The United Nations has declared the pandemic a health and human crisis that is threatening the food and nutrition security of millions of people living across the world – more so for those that were already living in humanitarian and fragile environments.ii According to WFP’s Hunger Map 2020; If current trends continue, the number of hungry people will reach 840 million by 2030.iii 

The disruption and/or reduction of key maternal and child health and nutrition services in low and middleincome countries (LMIC) is expected to have a disastrous effect on maternal and child morbidity and mortality. A recent model provides for three potential scenarios where the disruption in coverage and access to services was factored in. The most conservative estimate suggests that a 9.8-18.5% reduction in coverage of essential maternal and child health and nutrition services and a 10% increase in wasting over a six-month period may lead to an additional 253,500 child deaths and 12,200 additional maternal deaths. iv A model using the Alive & Thrive cost of not breastfeeding toolv estimated the impact of COVID-19 on breastfeeding prevalence, and found that the effect of small (5%) up to severe (50%) relative reductions in the prevalence of breastfeeding would result in 16,469 (small reduction), and up to 138,398 (severe reduction) child deaths across 129 LMICs over a one-year period.vi COVID-19 is also likely to have a serious implication on the food systems and food security situation, affecting households’ access to nutritious food and compromising the quantity and quality of foods offered to children in the complementary feeding stage.

During the COVID-19 pandemic, reductions in breastfeeding prevalence will plausibly occur due to limitations in the provision and use of health services and disruptions to the enabling environment. Some of the other individual and social factors that affect breastfeeding prevalence’s include increased fear, myths, and misinformation about breastfeeding and complementary feeding practice in this context, including among service providers, that have shown in some contexts low confidence in offering infant and young child feeding (IYCF) services. Fears are also exacerbated in some contexts by facility-based policies and practices that have not considered the WHO and UNICEF IYCF recommendations and standards in the context of COVID-19.vii Additionally, with the information overload in some contexts, evolving evidence, publications, social media, and other communications channels can spread misinformation and confusion.

Disruption in IYCF services may also be linked to national or sub-national level requirements for disease prevention. These include the general effort to enforce social distancing (a minimum of 1-metre), using remote modalities and limited person-to-person contact, limit group gatherings of any sort with increased recommended respiratory hygiene practices with enforcement of face covering for community agents and other health and nutrition workers. Considering these elements, implementing IYCF programmes is needed but with some adaptations.

This tool is developed to assist programme implementers in determining scale up/scale down of IYCF/ IYCF-E activities in response to national or sub-national guidelines related to COVID-19 on:

1. Mobility of staff, community agents and/or population
2. Restrictions or limitations related to meetings, trainings, and gatherings
3. Other related measures

This tool is not meant to illustrate the “How” part: further guidance on programmatic adaptations and on reducing viral transmission while ensuring the effective delivery of different IYCF/IYCF-E services and activities can be found in the resources section on page 15.

This IYCF-E programme adaptation tool gives generic guidance and should be used in alignment with national and/or sub-national guidance developed for the COVID-19 context.

Read more...

i WHO. COVID-19 updates. https://www.who.int/emergencies/diseases/novel-coronavirus-2019

ii UN. Policy Brief: The Impact of COVID-19 on Food Security and Nutrition, June 2020: https://namibia.un.org/sites/default/files/2020-06/sg_policy_brief_on_covid_impact_on_food_security.pdf

iii WFP. Hunger Map 2020: https://www.wfp.org/publications/hunger-map-2020

iv TRobertson T. et al (2020) ‘Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality in low-income and middle-income countries: a modelling study’, The Lancet Global Health, published online on 12 May 2020: https://doi.org/10.1016/S2214-109X(20)30229-1 . The detailed results by countries and regions are available in a dashboard format at https://data.unicef.org/topic/child-survival/covid-19/ with other resources, data and analysis on COVID-19 and child mortality. While the study covers both maternal and child mortality, this brief focuses on the results of the analysis on under-5 mortality.

v UNICEF. Alive & Thrive, The Global Cost of Not Breastfeeding https://www.aliveandthrive.org/wp-content/uploads/2019/08/Global-Cost-of-Not-Breastfeeding_V5.pdf

vi J Busch-Hallen, D Walters, S Rowe, A Chowdhury and M Arabi, ‘Impact of COVID-19 on maternal and child health’, The Lancet, August 03, 2020:: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30327-2/fulltext

vii UNICEF. Infant and Young Child Feeding in the Context of the COVID-19 Pandemic: Eastern, Central and Southern Africa https://www.unicef.org/esa/documents/infant-and-young-child-feeding-context-covid-19-pandemic-eastern-central-and-southern

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IYCF_E-Adaptations-in-COVID-19-Context-Tool_Oct20.pdf (PDF, 1.6mb)

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Save the Children and the Nutrition Technical Rapid Response Team (Tech RRT) with the support of the members of the IFE Core Group (2020). Infant and Young Child Feeding in Emergencies (IYCF-E). Programming in The Context Of COVID-19: Considerations for Adaptations. www.ennonline.net/iycfecovid19adaptationstool

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