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Framework

Framework. The IYCF Assessment Process: Assessment Objectives. Initial Rapid Assessment (often a multi-sectoral rapid assessment):

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Framework

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  1. Framework

  2. The IYCF Assessment Process:Assessment Objectives Initial Rapid Assessment (often a multi-sectoral rapid assessment): • Provides a rapid overview of the situation related to nutrition in general and IYCF in particular in order to identify the immediate impacts of the crisis and estimate the needs of the affected population for resources (including human and logistics) in the first weeks following the crisis. The focus should include mapping of all available resources, including those under the purview of the government. Ensure recommendations and dissemination for action and response. • Timing: as soon as possible(within days) after acute onset emergency Comprehensive (in-depth) Assessment (sector-specific): • A more thorough analysis that provides information to more thoroughly assess the situation, to inform program development, determine resource requirements, and disseminate additional information to the international community in addition to the national audience. Often includes: • Sector-specific rapid assessment • Survey data (can be single-sector or multi-sectoral: nutritional, anthropometry, IYCF practices, other data): to document baseline • Timing: 4-8 weeks

  3. IYCF Assessment ProcessKey information (Ops Guidance) Initial Rapid Assessment (often multi-sectoral): • Demographic profile. Are the following groups under or over-represented: infants and young children, pg and lactating women, orphans/unaccompanied young children? • Feeding practices pre-crisis; any notable changes. Observed and pre-crisis approaches to feeding orphaned infants (including acceptability of wet-nursing). • Reported problems (by caregivers, key informants, stakeholders and health staff) feeding infants and young children (including BF difficulties, poor access to infant complementary foods) • Access to safe water, sanitation, hand-washing • Conspicuous availability of BMS, milk products, bottles and teats in population or commodity pipeline • Who is available to provide immediate assistance? • [Situation related to [mortality], morbidity, nutritional status of infants/young children] • [Security risks to women and children] • [Vulnerability assessment of women & children: HH heads, disability]

  4. IYCF Assessment ProcessAdditional information (Ops Guidance) Comprehensive Assessment: obtain information on the following • Food situation -- Availability of government and HH food stocks; market survey [food costs]; nutritional adequacy of food ration; availability of appropriate foods for infant complementary feeding (in general ration; in targeted feeding programmes) -- Pregnant and lactating women: is multiple-micronutrient supplementation available; fortified or unfortified blended foods • Health environment -- water quantity and quality, fuel, sanitation, housing, facilities for food preparation and cooking -- support offered by health facilities providing antenatal, delivery, postnatal and child care -- immunization; micronutrient supplementation • Care environment -- feeding: Feeding Technique: cup, bottle; frequency; amount – same, less, or same as before methods of encouraging complementary feeding); factors disrupting breastfeeding (open-ended question); why; Infant Formula? -- capacity of potential support givers (BF mothers, trained HWs, trained IYCF counsellors, experienced women from community) Ask mothers. FG: was there any infant ; health staff interview; key NGOs -- identify key decision-makers at HH, community and local health facility level -- identify cultural barriers to relactation, expressing BM or wet-nursing

  5. IYCF Assessment ProcessAdditional information (Ops Guidance) Comprehensive Assessment: Surveys • Population statistics: numbers of accompanied and unaccompanied infants and young children <24 months (data stratified by age: 0-5 months, 6-11 months, 12-23 months), children aged 24-59 months (2-5 years), pregnant and lactating women; HH heads, in addition to other standard socio-economic indicators • Mortality of infants / Y children and other HH members before (3 months, sample size of 1000), during and after the emergency event • Morbidity of infants/Y children: diarrhea and ARI in last 2 weeks (measles) DEPENDING on the SITUATION: • Infant and young child feeding practices: Dip-stick (questions on BF and CF) OR • Infant and young child feeding practices: Global standards -- questions for calculation of standard indicators -- questions on receipt of donated BMS and bottles, and use in past 24 hours

  6. IYCF Assessment and MonitoringAssessment Approaches Initial Rapid Assessment: (called Multi-sectoral Rapid Assessment, Box 1 on Framework) Approach: Secondary Data; Qualitative Assessment Comprehensive Assessment: Sector-Specific Rapid Assessment (Box 2 on Framework) Comprehensive Assessment: Multi-sector Surveys (Box 3 on Framework: see next slide for suggested approaches)

  7. IYCF Assessment and MonitoringSurvey Approaches: Box 3 Quick Dip-Stick Approach To understand possible gaps in current practice and make recommendations for programming. Multi-stage cluster sampling; need to consider infant feeding practices in design Suggested questions provided (see next slide) WHO methodology/gold-standard approach To provide information on IYCF practices using global indicators for comparison with other countries or to monitor change over time within emergency contexts or programmes Use standard questions and analysis approaches (WHO, DHS, UNICEF MICS, Child Survival KPC)

  8. Suggested Suggestions for Dip-Stick Survey: (Box 3 and Box 2)(results will not be comparable to WHO indicators) MODIFY QUESTIONS AS PER CONTEXT BREASTFEEDING • Have you ever breastfed? ( Y/N) • Are you still breastfeeding? (Y/N) If YES: Why did you stop breastfeeding? (Record mother’s response) • Is this child separated from mother? (Y/N) • Are you giving any foods or fluids other than breastmilk? • Are you giving infant formula? COMPLEMENTARY FEEDING (CF): asked about children >6 months of age • Are you feeding your child any solids, semi-solids or soft foods? Are you feeding your child more, less or the same amounts than before the emergency? • In the past 24 hours, how many times have you fed your child solids, semi-solids or soft foods? • Yesterday did your child get any foods from each of the following food groups: i) grains, roots & tubers; ii) legumes & nuts; iii) dairy products (milk, cheese & yogurt); iv) flesh foods (meat, fish, poultry, liver/organ meats); v) eggs; vi) vit-A rich fruits and vegetables; vii) other fruits and vegetables; viii) oils and fats • Has your child received a micronutrient supplement (time period?)

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