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    1. Infant and Young Child Feeding in Emergencies (IFE) Working Together in Emergencies IFE Core Group Work with the charity, the Emergency Nutrition Network, or ENN, and I m going to describe a positive experience of working together on infant and young child feeding in emergencies (IFE). This relates to an interagency collaboration that has become known as the IFE Core Group., a group concerned with developing policy guidance and capacity building in IFE. This collaboration developed in response to a need identified at an IBFAN-hosted International Meeting on Infant Feeding in Emergency Situations in Croatia in 1998. Which ofr the last 7 yearsor so has been working on policy guidance and capac buiindg onit Work with the charity, the Emergency Nutrition Network, or ENN, and I m going to describe a positive experience of working together on infant and young child feeding in emergencies (IFE). This relates to an interagency collaboration that has become known as the IFE Core Group., a group concerned with developing policy guidance and capacity building in IFE. This collaboration developed in response to a need identified at an IBFAN-hosted International Meeting on Infant Feeding in Emergency Situations in Croatia in 1998. Which ofr the last 7 yearsor so has been working on policy guidance and capac buiindg onit

    2. IFE Core Group - since 1999 So first who is the Core Gorup? The current members of the Core Group are a combination of UN agencies (UNICEF, WHO, UNHCR, WFP), and NGOs (IBFAN-GIFA, CARE USA, Fondation Terre des homes and ENN). Our associate members are agencies that we have strengthened our involvement with to address specific field issues and whose field experiences have particularly informed our work. Members of the Core Group are also members the IFE Thematic Group of the WG on nutrition in emergencies and we have used this annual SCN meeting as the key forum for sharing our working with the international nutrition sector.So first who is the Core Gorup?The current members of the Core Group are a combination of UN agencies (UNICEF, WHO, UNHCR, WFP), and NGOs (IBFAN-GIFA, CARE USA, Fondation Terre des homes and ENN). Our associate members are agencies that we have strengthened our involvement with to address specific field issues and whose field experiences have particularly informed our work. Members of the Core Group are also members the IFE Thematic Group of the WG on nutrition in emergencies and we have used this annual SCN meeting as the key forum for sharing our working with the international nutrition sector.

    3. How does IFE Core Group work? Each member agency key participant Until 2004, co-ordination by NGOs, ENN since 2004 Member agency contribute technically and financially Work reflects a much wider network of collaborators Each of the member agencies has a key person who participates in the core group. Until 2 years ago, co-ordination of the group was informally led by individuals and NGOs. In 2004 ENN took on a more formal coordination role. As an agency, membership means you commit to technically and financially supporting the work of the Core Group. It has to be said that the Core Group has survived on a shoestring and insecure budget. Until very recently, we have relied on whatever money the Core Group members could scrape together. The work of the Core Group actually reflects a much wider network of collaborators who have contributed over the years. This has ranged from technical contributors who have written chapters to field teams that have reviewed content or contributed case material to use. Each of the member agencies has a key person who participates in the core group. Until 2 years ago, co-ordination of the group was informally led by individuals and NGOs. In 2004 ENN took on a more formal coordination role. As an agency, membership means you commit to technically and financially supporting the work of the Core Group. It has to be said that the Core Group has survived on a shoestring and insecure budget. Until very recently, we have relied on whatever money the Core Group members could scrape together. The work of the Core Group actually reflects a much wider network of collaborators who have contributed over the years. This has ranged from technical contributors who have written chapters to field teams that have reviewed content or contributed case material to use.

    4. The Mandate Not a stand alone initiative Article 24, Convention on on the Rights of the Child UNICEF/WHO Global Strategy on IYCF (2003) Innocenti Declaration on IYCF (2005) Lancet Child Survival Series - breastfeeding save 13% of U5 deaths worldwide (Jones et al, Lancet 362: 6571, 2003) Breastfeeding protection and support at the cornerstone IFE Core Group work This is by no means a stand alone initiative. Our work is grounded in the CRC, the Global Strategy and the Innocenti Declaration 2005, that was supported by this very meeting last year. The Global Strategy not only reinforces the importance of addressing IYCF in emergencies, it calls on us to do something about it. That is exactly what we are doing. The Lancet Child Survival Series, describes how breastfeeding could save 13% of child deaths worldwide. The immediate need to protect and support breastfeeding is all the more critical in emergencies, and realising this is at the cornerstone of the Core Groups work. . This is by no means a stand alone initiative. Our work is grounded in the CRC, the Global Strategy and the Innocenti Declaration 2005, that was supported by this very meeting last year. The Global Strategy not only reinforces the importance of addressing IYCF in emergencies, it calls on us to do something about it. That is exactly what we are doing. The Lancet Child Survival Series, describes how breastfeeding could save 13% of child deaths worldwide. The immediate need to protect and support breastfeeding is all the more critical in emergencies, and realising this is at the cornerstone of the Core Groups work. .

    5. Point of departure Much depends on: Perceptions and understanding of breastfeeding in the emergency setting Existing policies and their implementation by key actors Levels of knowledge and practical skills among those actors But while the message is simple breast is best, tit not tea much depends on the.But while the message is simple breast is best, tit not tea much depends on the.

    6. Breastfeeding the natural way?OR... Venezuela, 2005 Discussion with flood victims Picture removed The context is critical Weve got .breastfeeding the natural way (here in DRC or in Venezula) orThe context is critical Weve got .breastfeeding the natural way (here in DRC or in Venezula) or

    7. breastfeeding - the last resort? OR... OR... Still weak from the birth, she was forced to breastfeed her 21-month-old child. "I had to, I couldn't give him anything else. [Mark Coultan, The Age, New Orleans, September 6, 2005] Picture removed Breastfeeding the last resort a quote from a mum caught up in Hurricane Katrina in the US in 2005Breastfeeding the last resort a quote from a mum caught up in Hurricane Katrina in the US in 2005

    8. not breastfeeding at all Lebanon, 2006 Or we have not breastfeeding at all. (During the recent crisis in Lebanon, field teams we faced with mothers who had formula fed their babies from birth and were now need of acute support with poor water and sanitation, difficult logistics and ongoing insecurity.)Or we have not breastfeeding at all. (During the recent crisis in Lebanon, field teams we faced with mothers who had formula fed their babies from birth and were now need of acute support with poor water and sanitation, difficult logistics and ongoing insecurity.)

    9. Many players in emergencies Some obvious. We also have many players in an emergency response that can influence infant and young child feeding and outcomes some of them obvious..like staff directly involved with mothers and babies on the groundWe also have many players in an emergency response that can influence infant and young child feeding and outcomes some of them obvious..like staff directly involved with mothers and babies on the ground

    10. .some less so and some of the less so. like the military, whose humanitarian related operations, often in the very early days of an emergency response, can have a significant bearing on infant feeding in emergencies, - we have strong examples from 1999 Kosovo crisis.and some of the less so. like the military, whose humanitarian related operations, often in the very early days of an emergency response, can have a significant bearing on infant feeding in emergencies, - we have strong examples from 1999 Kosovo crisis.

    11. Dafur, 2006 Infants and young child feeding need protection and support whereever a crisis hits in the world, be it post tsunami in Indonesia, in the never ending crisis in West Dafur or in post-Hurricane in America.Infants and young child feeding need protection and support whereever a crisis hits in the world, be it post tsunami in Indonesia, in the never ending crisis in West Dafur or in post-Hurricane in America.

    12. Approach adopted by the IFE Core Group The devil is in the detail Concerned with protection and support of: breastfed AND non-breastfed infants and young children complementary feeding in emergencies Policy development and implementation Capacity building in programme management Capacity building in practical knowledge and skills translate into implementation of interventions that support appropriate infant feeding practices We need the frameworks and global strategies to guide our thinking but as they say, the devil is in the detail. And is it figuring out this detail in emergencies that the IFE Core Group is all about. We are concerned with breastfed AND non-breasted infants and young children AND complementary feeding in emergencies. IFE has to be addressed at all levels, and so we have concerned ourselves with: We need the frameworks and global strategies to guide our thinking but as they say, the devil is in the detail. And is it figuring out this detail in emergencies that the IFE Core Group is all about. We are concerned with breastfed AND non-breasted infants and young children AND complementary feeding in emergencies. IFE has to be addressed at all levels, and so we have concerned ourselves with:

    13. Policy basis Operational Guidance Non-technical Key audience: national governments, UN agencies, national and INGOs, donors International Code for Marketing of Breastmilk Substitutes embedded Version 2.1, Feb 2007 Available from ENN, http://www.ennonline.net Our work in policy guidance is embodied in the Operational Guidance on IFE. It is a neat 26 page booklet of non-technical guidance (a sort of dos and donts) and is targeted at all emergency players, from national government to donors to agencies. The first version was produced in an interagency collaboration in 2001. An updated version 2.1 was produced by the Core Group in May last year, and this has been just upgraded to produce V2.1, Feb 2007 and is available at this meeting Our work in policy guidance is embodied in the Operational Guidance on IFE. It is a neat 26 page booklet of non-technical guidance (a sort of dos and donts) and is targeted at all emergency players, from national government to donors to agencies. The first version was produced in an interagency collaboration in 2001. An updated version 2.1 was produced by the Core Group in May last year, and this has been just upgraded to produce V2.1, Feb 2007 and is available at this meeting

    14. Module 1 Emergency relief staff -policy makers -managers -logisticians -coordinators and -other non technical relief workers Use: local, regional, international level Delivery: 1- 2 hours Our work in capacity building takes the form of two training modules. Module 1 supports the practical implementation of the Ops Guidance and was produced in 2001 by the Core Group and many other contributors. It targets all emergency relief staff. And is available online, in print or on CD.Our work in capacity building takes the form of two training modules. Module 1 supports the practical implementation of the Ops Guidance and was produced in 2001 by the Core Group and many other contributors. It targets all emergency relief staff. And is available online, in print or on CD.

    15. Module 2 5+3 hours * health and nutrition staff * technical knowledge and practical skills to support appropriate IFE Module 2 was completed in 2004 and launched at the SCN meeting in Brasilia that year. Building on Module 1, it is designed for health and nutrition staff directly involved with infants and young children and their mothers. The core component concerns breastfeeding support, and it also includes additional sections on artificial feeding in emergencies and managing malnourished infants under the age of six months. Module 2 was completed in 2004 and launched at the SCN meeting in Brasilia that year. Building on Module 1, it is designed for health and nutrition staff directly involved with infants and young children and their mothers. The core component concerns breastfeeding support, and it also includes additional sections on artificial feeding in emergencies and managing malnourished infants under the age of six months.

    16. Working documents Responsive updates to policy development and field experience Version 2.1 of Ops Guidance, Feb, 2007 Filling gaps Module 2 Managing malnourished infants under six months Picture removed We consider these materials are working documents, to enable us SO THAT WE CAN QUICKLY REFLECT to respond quickly to policy developments and learn from field experiences in implementation. A good example of this is Version 2.1 of the Ops Guidance that has just been produced to reflect the new WHO consensus statement on IF in the context of HIV/AIDS and the experiences of SC in monitoring implementation of the Ops Guidance and the Int Code during the recent crisis in Lebanon. This update by the Core Group took just two months from start to finish, which is pretty quick in the grand scheme of things. The content of the training modules are evidence based where it exists, and based on technical expertise and field experience where it does not. A good example of this is on Module 2. In our contact with field teams while we were developing Module 2, we identified a key gap in specific guidance for managing severe malnutrition in infants under six months of age. As an interm measure a chapter was developed by two experts to address this, which then went for expert technical consultation outside the Core Group. We consider these materials are working documents, to enable us SO THAT WE CAN QUICKLY REFLECT to respond quickly to policy developments and learn from field experiences in implementation. A good example of this is Version 2.1 of the Ops Guidance that has just been produced to reflect the new WHO consensus statement on IF in the context of HIV/AIDS and the experiences of SC in monitoring implementation of the Ops Guidance and the Int Code during the recent crisis in Lebanon. This update by the Core Group took just two months from start to finish, which is pretty quick in the grand scheme of things. The content of the training modules are evidence based where it exists, and based on technical expertise and field experience where it does not. A good example of this is on Module 2. In our contact with field teams while we were developing Module 2, we identified a key gap in specific guidance for managing severe malnutrition in infants under six months of age. As an interm measure a chapter was developed by two experts to address this, which then went for expert technical consultation outside the Core Group.

    17. Added dimensions Influencing policy, e.g. UNHCR policy on handling milk products in refugee settings (2006) Instances where suspicious of commercial ventures around IFE Proactively promote Ops Guidance and training materials in real time emergencies, e.g. Pakistan, Indonesia, Mozambique Informing research agendas that have practical implications, e.g Southampton University developing weighing scales for 0-5 years The Core Group is about more than just developing materials. So these are the materials we have developed, but there is a lot more to the Core Group than meets the eye. Through this very basic mechanism that I have described we have successfully influenced policy. A good example of this is the UNHCR .A revised version, updated from the 1989 policy, was produced in 2006 with significant input by Core Group and drawing heavily upon the Operational Guidance. Our concern not just with development of materials but how they are implemented, has added another dimension to our working together. This is best reflected in some working examples: There have been instances when we have been suspicious of commercial ventures around IFE and we have got involved to voice our concerns and raise the warning flag to others. One example was proposed research at Bath University in the UK involving infant formula in Sri Lanka, another recent example concerned a commercial venture in the UK to market disposable teats in emergencies. We have also promoted the Operational Guidance and training materials in real time emergencies for example in Pakistan and in Indonesia, and in doing so engaged directly with field teams grappling with the reality of implementing guidance. The Core Group is about more than just developing materials. So these are the materials we have developed, but there is a lot more to the Core Group than meets the eye. Through this very basic mechanism that I have described we have successfully influenced policy. A good example of this is the UNHCR .A revised version, updated from the 1989 policy, was produced in 2006 with significant input by Core Group and drawing heavily upon the Operational Guidance. Our concern not just with development of materials but how they are implemented, has added another dimension to our working together. This is best reflected in some working examples: There have been instances when we have been suspicious of commercial ventures around IFE and we have got involved to voice our concerns and raise the warning flag to others. One example was proposed research at Bath University in the UK involving infant formula in Sri Lanka, another recent example concerned a commercial venture in the UK to market disposable teats in emergencies. We have also promoted the Operational Guidance and training materials in real time emergencies for example in Pakistan and in Indonesia, and in doing so engaged directly with field teams grappling with the reality of implementing guidance.

    18. International Strategy Meeting on IFE Oxford, 1-2 Nov, 2006 Funded by UNICEF, IBFAN-GIFA, CARE USA, organised by ENN 58 delegates, UN,INGO, academics, trainers, regional staff (Indonesia, Kenya, India, Mexico, Lebanon) to identify key constraints to supporting and protecting appropriate infant feeding practices in emergencies come up with strategy directions and practical steps to address these. OUTCOME: Practical action points Despite our efforts to promote our work, we had increasing concerns that the developments in policy guidance and improved awareness of IFE we had seen over the years, were still not been reflected on the ground in emergencies. This led us to call an international strategy meeting on IFE, that was held in Oxford in November last year. Funded UNICEF, IBFAN-GIFA, CARE USA, it was attended by 58 delegates with a good cross-section NGO, UN, trainers, academics, regional staff. The aim of the meeting was to identify key constraints to supporting and protecting appropriate infant feeding practices in emergencies and to come up with strategy directions and practical steps to address these. We wanted a working meeting and we got it. We produced practical action points, assigning agency responsibilities and time frames and a detailed proceedings report is available at this meeting. But more than this, this meeting has marked a move to a whole new level of working together. Despite our efforts to promote our work, we had increasing concerns that the developments in policy guidance and improved awareness of IFE we had seen over the years, were still not been reflected on the ground in emergencies. This led us to call an international strategy meeting on IFE, that was held in Oxford in November last year. Funded UNICEF, IBFAN-GIFA, CARE USA, it was attended by 58 delegates with a good cross-section NGO, UN, trainers, academics, regional staff. The aim of the meeting was to identify key constraints to supporting and protecting appropriate infant feeding practices in emergencies and to come up with strategy directions and practical steps to address these. We wanted a working meeting and we got it. We produced practical action points, assigning agency responsibilities and time frames and a detailed proceedings report is available at this meeting. But more than this, this meeting has marked a move to a whole new level of working together.

    19. New level of working together ENN/IFE Core Group joined the UNICEF-led Inter Agency Standing Committee (IASC) nutrition cluster Cluster funding, realise action points Development of a UN joint policy on handling milk products underway, coordinated by the Core Group Integrate breastfeeding support into guidance and training on the management of severe malnutrition Translation of materials Regional orientation workshop on IFE, Indonesia, 2007 Broadening our horizons Other sectors, e.g. reproductive health, and other players, e.g. donors, media, military One of the key outcomes of the meeting was that ENN joined the UNICEFled nutrition cluster on behalf of the IFE Core Group, to represent IFE in cluster work. The cluster approach aims to improve the predictability, timeliness, and effectiveness of humanitarian response, at both an international and regional level. This development means we are bringing the IFE Core Group effort and work to around this table. Through cluster funding we are now making progress on key action points that were recommended by the Oxford meeting. There are many, but they include: Based on the good experience of updating the UNHCR milk policy, the development of.., which Translation.. (The latest veriosn of the Ops Guidance is now available in Eng and French; Spansih, Portuguese, and Arabic are well underway, Russian and KisSwahali are scheduled). A review of training materials on IFE, assessing the need for a third training module And work to integrate.. both community and hospital based approaches. And we are planning a regional orientation workshop on IFE, scheduled for Indonesia later this year. We are also broadening our horizons, and looking at how we can work more closely with others. For example, ENN has established contact with military training on humanitarian operations in the UK. One of the key outcomes of the meeting was that ENN joined the UNICEFled nutrition cluster on behalf of the IFE Core Group, to represent IFE in cluster work. The cluster approach aims to improve the predictability, timeliness, and effectiveness of humanitarian response, at both an international and regional level. This development means we are bringing the IFE Core Group effort and work to around this table. Through cluster funding we are now making progress on key action points that were recommended by the Oxford meeting. There are many, but they include: Based on the good experience of updating the UNHCR milk policy, the development of.., which Translation.. (The latest veriosn of the Ops Guidance is now available in Eng and French; Spansih, Portuguese, and Arabic are well underway, Russian and KisSwahali are scheduled). A review of training materials on IFE, assessing the need for a third training module And work to integrate.. both community and hospital based approaches. And we are planning a regional orientation workshop on IFE, scheduled for Indonesia later this year. We are also broadening our horizons, and looking at how we can work more closely with others. For example, ENN has established contact with military training on humanitarian operations in the UK.

    20. Elements of successful working together Money isnt everything.. Staying power of individuals and agencies Fuelled by a strong belief in the need to address this issue Consistency and institutional memory amongst members Political and strategic thinking combined with technical expertise and good contact with the field So what can we learn about working together from the Core Group experience. Lack of funding is the bane of all our lives, but I think this group is a great example that money isnt everything. We have survived on a shoestring budget and have achieved a lot over the last 8 years or so. I think there a few key elements of our successfully working together and our survival as a group: The staying power of the individuals and agencies involved fuelled by the strong belief in the need to address this issue. A consistency and institutional memory amongst members - many of the agencies and individuals that were involved in the beginning, are still involved now. And perhaps the greatest strength of all, this group has been a powerful combination of political and strategic thinking with . So what can we learn about working together from the Core Group experience. Lack of funding is the bane of all our lives, but I think this group is a great example that money isnt everything. We have survived on a shoestring budget and have achieved a lot over the last 8 years or so. I think there a few key elements of our successfully working together and our survival as a group: The staying power of the individuals and agencies involved fuelled by the strong belief in the need to address this issue. A consistency and institutional memory amongst members - many of the agencies and individuals that were involved in the beginning, are still involved now. And perhaps the greatest strength of all, this group has been a powerful combination of political and strategic thinking with .

    21. Room for Improvement Do more, quicker with funds? Money talks? Million dollar IFE Core Group Committed individuals have a tough time institutionalising IFE work Notion prevails that breastfeeding is not a priority in early stages of emergency Engage with donors - limited Swiss Agency for Development and Cooperation (SDC): Standards on using dairy products in food aid (Aug 2006) DFID: Humanitarian funding guidelines (due April 2007) Of course there is room for improvement. While we have just about managed with little funding, you have to ask, how much more we could have done in half the time, with funds behind us, and could we have had a much greater impact on emergency operations as a result? Does money talk? it seems to us that funding also lends a credibility that would make initiatitives like ours more acceptable and carry greater weight, than when they are largely sustained by concerted effort and goodwill. If we said this work was carried out by the million dollar funded IFE Core Group, would there be greater notice taken than our more humble effort? And maybe linked to this, there are many committed individuals within agencies and organisations really have a hard time instutionalising this work, and we need to assess and address what the barriers to mainstreaming and integrating IFE are. And last nut not least. we real need to to engage with donors on IFE, which has been pretty limited so far. Whether as donor governments or as funding agencies, they are a key influence on the nature of the emergency response to support infants and young child feeding. Their actions and funding decisions need to be guided by best policy and they can help us realise best practice. We saw the Oxford strategy meeting as a great opportunity to begin this relationship, but out of 22 donors invited, only 2 attended. Despite this, we have made some progress. Through the work of Core Group members, partciualrly TDh, SDCs updated standards on the use of dairy products in the context of food aid reflects and refers to the Ops Guidance. And following the Oxford meeting, CARE USA briefed USAID, and ENN briefed the DFID Operations Team on IFE. Based on this, DFID have signed up to support the Ops Guidance and is the first donor to do this, and a position on the Ops Guidance and the Int Code is now reflected in DFIDs updated funding guidelines Of course there is room for improvement. While we have just about managed with little funding, you have to ask, how much more we could have done in half the time, with funds behind us, and could we have had a much greater impact on emergency operations as a result? Does money talk? it seems to us that funding also lends a credibility that would make initiatitives like ours more acceptable and carry greater weight, than when they are largely sustained by concerted effort and goodwill. If we said this work was carried out by the million dollar funded IFE Core Group, would there be greater notice taken than our more humble effort? And maybe linked to this, there are many committed individuals within agencies and organisations really have a hard time instutionalising this work, and we need to assess and address what the barriers to mainstreaming and integrating IFE are. And last nut not least. we real need to to engage with donors on IFE, which has been pretty limited so far. Whether as donor governments or as funding agencies, they are a key influence on the nature of the emergency response to support infants and young child feeding. Their actions and funding decisions need to be guided by best policy and they can help us realise best practice. We saw the Oxford strategy meeting as a great opportunity to begin this relationship, but out of 22 donors invited, only 2 attended. Despite this, we have made some progress. Through the work of Core Group members, partciualrly TDh, SDCs updated standards on the use of dairy products in the context of food aid reflects and refers to the Ops Guidance. And following the Oxford meeting, CARE USA briefed USAID, and ENN briefed the DFID Operations Team on IFE. Based on this, DFID have signed up to support the Ops Guidance and is the first donor to do this, and a position on the Ops Guidance and the Int Code is now reflected in DFIDs updated funding guidelines

    22. Support the Ops Guidance Reflects your position or where you would like to be and will work towards 19 agencies signed up in support CALL FOR collective support of the participants of this meeting CALL UPON individual agencies/ organisations/institutions to sign up to support the Ops Guidance http://www.ennonline.net Id like to finish with a few calls for action from this meeting. The first regards support of the Ops Guidance. We define support as: Since the Oxford meeting, 19 agencies have signed up in support. The Oxford strategy meeting recommended that the Operational Guidance should be elevated as official guidance by securing the support of the SCN. The SCN steering committee has signed up in support and we now call for the collective support of the participants of the Rome 2007 SCN meeting. Agency ownership of the Operational Guidance is a key step towards field implementation. And we call upon individual agencies and organisations to also sign up in support. You can easily do this on the ENN website.Id like to finish with a few calls for action from this meeting. The first regards support of the Ops Guidance. We define support as: Since the Oxford meeting, 19 agencies have signed up in support. The Oxford strategy meeting recommended that the Operational Guidance should be elevated as official guidance by securing the support of the SCN. The SCN steering committee has signed up in support and we now call for the collective support of the participants of the Rome 2007 SCN meeting. Agency ownership of the Operational Guidance is a key step towards field implementation. And we call upon individual agencies and organisations to also sign up in support. You can easily do this on the ENN website.

    23. Call for Action Extend an invite to anyone who would like to engage with us on IFE, as individuals, as organisations, as groups Complementary feeding in emergencies Replicate this working together at a regional level CALL UPON the cluster initiative grab opportunity to harness the power of bringing people together to work on these issues We extend an invite to anyone who would like to engage with us on IFE to do so all our contact details are on our materials, posted on the display board or online. Finally, we really need to replicate this working together at a regional level and to achieve this, call upon the cluster initiative, of which we are now part, to really grab theis opportunity to harness the power of bring people together to work on these issues. We extend an invite to anyone who would like to engage with us on IFE to do so all our contact details are on our materials, posted on the display board or online. Finally, we really need to replicate this working together at a regional level and to achieve this, call upon the cluster initiative, of which we are now part, to really grab theis opportunity to harness the power of bring people together to work on these issues.

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