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Prototype IPC Nutrition Phase Classification for Acute Situations Why we need it & the development process GNC Meeting, Rome 17 Sept. 2014. Presentation Outline. Prototype IPC Nutrition Phase Classification for Acute Situations What is IPC? Why is a nutrition classification needed? - PowerPoint PPT Presentation
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IPCThe Integrated Food Security Phase Classification
Prototype IPC Nutrition Phase Classification for Acute Situations
Why we need it & the development process
GNC Meeting, Rome
17 Sept. 2014
IPCThe Integrated Food Security Phase Classification
Prototype IPC Nutrition Phase Classification for Acute
Situations• What is IPC?• Why is a nutrition classification needed?• IPC Nutrition Classification - technical
development process
Presentation Outline
IPCThe Integrated Food Security Phase Classification
What is IPC?
IPCThe Integrated Food Security Phase Classification
THE IPC IS…..
A set of tools and procedures (protocols) for classifying the nature and severity of food security situations
A process for multiple stakeholders to share information and build technical consensus.
IPCThe Integrated Food Security Phase Classification
IPC FOUR CORE FUNCTIONS
(1) Building Technical Consensus (2) Classifying Severity and Driving
Factors(3) Communicating for Action (4) Quality Assurance
EACH HAS A SET OF SUPPORTING TOOLS and PROCEDURES
IPCThe Integrated Food Security Phase Classification
6
Understanding evidence with an integrated Analytical Framework
Referencing evidence against international standards
Transparently methodically & consensually analyzing evidence
Transform analyses into concise information for action
The 4 Functions of IPC
TWG MATRIXANALYTICAL FRAMEWORK
REFERENCE TABLESANALYSIS WORKSHEETS
COMMUNI-CATION TEMPLATE
Multi-agency stakeholders to do collaborative analysis
Assuring for quality
SELF ASS. PEER REVIEW
1. Building Consensus
2. Classifying Severity & Driving Factors
3. Communication
for Action
4. Quality Assurance
Fu
ncti
on
sTo
ols
Pro
ced
ure
s
for:
IPCThe Integrated Food Security Phase Classification
Why is nutrition classification
needed?
IPCThe Integrated Food Security Phase Classification
IPC Acute Food Security Phase Classification
Proven Applicability and Relevance - Globally Asia & Near East Africa Central America &
Caribbean North Africa & Near East Central Asia
Why an IPC Nutrition phase classification for Acute Situations - Background
IPCThe Integrated Food Security Phase Classification
Why do we need an IPC Nutrition Classification for Acute Situations?
Two Situations We Observe:1. Low severity of acute Food Insecurity
and High levels of acute Malnutrition– Why? Casual factors are not food
security related– A public health issue, related to social
and care environment and access to health services and health care environment
IPCThe Integrated Food Security Phase Classification
Example: FSNAU Nutrition & Food Security Situation in Somalia
IPCThe Integrated Food Security Phase Classification
2. High severity of acute Food Insecurity and Low levels of acute Malnutrition Why? 2 possible reasons
Lag effect o Body Tissue and muscle loss related to underlying
causes of food insecurity – depends on severity of food inadequacy
o Can take time before it manifests, some cases ‘’late indicator’’
Why do we need Both Classifications?
IPCThe Integrated Food Security Phase Classification
Why do we need Both Classifications?
Mitigating Factors o Coping strategies in household, e.g. prioritize
the children, until deplete their coping strategies. o Accessible and Effective Public Health
Services, that mitigate effects of acute malnutrition, though food insecurity still problem
IF there are social protection programme, strong coping capacity: nutrition indicators - lag effect or no manifestation
IPCThe Integrated Food Security Phase Classification
How is Nutrition Currently Integrated in IPC?
IPCThe Integrated Food Security Phase Classification
To date - IPC focused on the analysis and classification of food security situations and outcomes
Nutrition is integrated within the IPC FS analysis, – Not a full analysis of the Nutrition situation and
outcomes– Nutrition only in relation to Food Security – Malnutrition caused by non-food security are not
included, i.e. inadequate caring practices and disease
Identified Gap & Country Requests
IPCThe Integrated Food Security Phase Classification
UNICEF’s Conceptual Framework on the Causes of Malnutrition
Inadequate Food Intake
Disease
Household Food
Security
Social and Care
Environment
Access to Health Care
& the Health
Environment
Immediate Causes
Underlying Causes
Basic Causes
National Policies Formal and Informal Structure
Context and Potential Resources
Malnutrition & Death
Core outcomes
IPCThe Integrated Food Security Phase Classification
How is IPC FS linked with the Nutrition Classification?
Household Food
Security
Malnutrition & Death
Inadequate Food Intake
IPC Acute Food Security informs the Analysis of Household Food Security
IPCThe Integrated Food Security Phase Classification
What is needed in IPC?
IPCThe Integrated Food Security Phase Classification
What is needed to complement the IPC Acute Food Insecurity Phase
Classification?Malnutrition
& Death
The Prototype IPC Nutrition Classification for Acute Situations
- elaborates and measures the non-food factors and drivers of malnutrition
Disease
Social and Care
Environment
Access to Health Care
& the Health
Environment
IPCThe Integrated Food Security Phase Classification
UNICEF’s Conceptual Framework on the Causes of Malnutrition
Malnutrition & Death
Inadequate Food Intake
Disease
Household Food
Security
Social and Care
Environment
Access to Health Care
& the Health
Environment
IPC Nutrition Classification
for Acute Situations
IPC Acute Food Security Classification
IPCThe Integrated Food Security Phase Classification
• IPC Acute Food Security Classification – provides the full analysis of acute food security, and food security factor analysis for the IPC Nutrition Classification for Acute Situations
• IPC Nutrition Phase Classification for Acute Situations – provides the full analysis of acute malnutrition outcomes, nonfood factors and food factor analysis. Where food factors analysis is provided by the IPC Acute Food Security (Inter-locking)
Complementary Inter-linking Phase Classifications– IPC Acute Food Security Phase Classification & IPC Nutrition Phase
Classification for Acute Situations are to be complementary & inter-locking– Together provide the full analysis of acute food and nutrition security
situation
Prototype IPC Nutrition Classification for Acute Situations
IPCThe Integrated Food Security Phase Classification
Development Process: Nutrition Phase
Classification for Acute Situations
IPCThe Integrated Food Security Phase Classification
IPC Global Steering Committee Endorsement
In 2013 - the IPC Global Steering Committee endorsed resolution to develop IPC Nutrition Phase Classification for Acute Situations
The SC endorsed the use of Food Security and Nutrition Analysis Unit (FSNAU) Acute Nutrition Classification Tool as a base– Developed & Implemented along side the IPC Food
Security Phase Classification, since 2007 in Somalia
Formation of IPC Nutrition Working Group of the IPC Global Technical Advisory Group (TAG) – to lead technical development & piloting– Technical Experts from both the global food security
and nutrition community
IPCThe Integrated Food Security Phase Classification
Based on the Acute Nutrition Classification Tool , an IPC Nutrition Classification for Acute Situations prototype has been developed.
Prototype is the refined version of the FSNAU Nutrition Classification Tool– Analytical Framework
IPC Analytical Framework UNICEF & Lancet Conceptual Framework
– Reference Tables for Nutrition Classification– Mapping Protocol
Prototype IPC Nutrition Classification for Acute Situations
IPCThe Integrated Food Security Phase Classification
Prototype IPC Nutrition Phase Classification for Acute Situations– Focused on analysis of Acute Malnutrition– Classification of the Severity of Acute
Malnutrition & identification of contributory factors
Pilot test and revise by the global IPC NWG for universal applicability
Prototype IPC Nutrition Classification for Acute Situations
IPCThe Integrated Food Security Phase Classification
Share same IPC Protocols and Four Core Functions
(1) Building Technical Consensus (2) Classifying Severity and Contributory
Factors(3) Communicating for Action (4) Quality Assurance
Prototype IPC Nutrition Classification for Acute Situations
IPCThe Integrated Food Security Phase Classification
IPC Prototype Nutrition Classification for Acute Situations
Reference Table – Outcome IndicatorsIndicator Acceptable Alert Serious Critical Very critical
GAM among children 6-59 months (%)
<5 5-9.9 10-14.9 15-29.9 ≥30
MUAC <125 mm among children 6-59 months (%)
<2.0% 2.1-5.5% with increase from
seasonal trends
5.6-8.0%
8.1-19.9 %, or where there is
significant increase from seasonal
trends
≥20.0%, Or where there is significant
increase from seasonal trends
Sentinel Site Data Very low
(<5%) and stable levels
Low levels (5 to <10%)and one round indicating increase, seasonally adjusted
Low (5 to < 10%) & increasing or moderate (10 to <15%) levels based on two rounds (seasonally adjusted)
High levels (> 15%) of malnourished children and stable (seasonally adjusted)
High levels (> 15%) and increasing with increasing trend (seasonally adjusted)
HMIS Data V. low (<5%) proportion in the preceding 3mths relative to >2yr seasonal trends
Low proportion (5 to <10%) and stable trend in the preceding 3mths relative to >2yr seasonal trends
Moderate (10 to <15%) and stable or low (5 to <10%) but increasing proportion in the preceding 3mths relative to >2yr seasonal trends
High (> 15%) and stable proportion in the preceding 3mths relative to >2yr seasonal trends
High (> 15%) and increasing proportion in the preceding 3mths relative to >2yr seasonal trends
Programme Data TBD TBD TBD TBD TBD
Screening (purposive) (%) <1.0 <1.0 1.0-2.0 2.1-3.0 3.1-5.5
IPCThe Integrated Food Security Phase Classification
IPC Prototype Nutrition Classification for Acute Situations
Reference Table – Contributory Factors (1/3)
Food security
Indicator Acceptable Alert Serious Critical Very critical
Food Consumption Score (FCS)
Acceptable consumption
Acceptable consumption (but deteriorating)
Borderline consumption
Poor consumption
[below] poor consumption
Coping Strategies Index (CSI)
Reference, stable
Reference, but unstable
Reference and increasing
Significantly > reference
Far > reference
Household Hunger Score (HHS)
None (0) Slight (1) Moderate (2-3)
Severe (4-6) Severe (6)
Household Economy Approach (HEA)
No livelihood protection deficit
Small or moderate livelihood protection deficit
Substantial livelihood protection deficit or small survival deficit of <20%
Survival deficit >20% but <50% with reversible coping considered
Survival deficit >50% with reversible coping considered
Consolidated Approach for Scoring Indicators of Food Security (CARI)
See attached table
IPCThe Integrated Food Security Phase Classification
IPC Prototype Nutrition Classification for Acute Situations
Reference Table – Contributory Factors (2/3)
Social and care environment
Indicator Acceptable Alert Serious Critical Very critical
Breastfeeding (BF) Practicesi) Exclusive BF for 6mthsii) Continued BF at 1 yeariii) Continued BF at 2year reference
>90%>90% >90%
50-89%50-89%50-89%
12-49%12-49%12-49%
0-11%0-11%0-11%
Complementary feeding in addition to breastfeedingi) Introduction of complementary food at 6 months of age: %introducedii) Meeting minimum recommended feeding frequency
≥95%≥95%
80-94%80-94%
60-79%80-94%
0-59%0-59%
0-59%0-59%
Maternal Wellbeing Index TBD
Caregiver workload
IPCThe Integrated Food Security Phase Classification
IPC Prototype Nutrition Classification for Acute Situations
Reference Table – Contributory Factors (3/3)
Access to Health Care & Health EnvironmentDiseases/nutritional deficienciesIndicator Acceptable Alert Serious Critical Very criticalDiarrhoea Normal
levels, & seasonal trends,
Review data in relevant context
-AWD 1 case-Suspected cholera 1 case-Suspected measles 1 case-Suspected malaria–doubling of cases in 2 weeks in hyper endemic areas–using RDT (WHO); OR increasing weekly trend (UNICEF)
Outbreak not contained and/or in non-endemic area – limited access to treatment:
CFR for AWD >2% ruralCFR for AWD >1% urban
AWD – duration exceed >6 wks
CholeraARIMeaslesMalaria
Micronutrient deficiency outbreaksAnaemia Severe ≥ 40
Moderate 20 – 39.9Mild 5 – 19.9Severe ≤ 4.9
Indicator Acceptable Alert Critical Very criticalAvailability of iodised salt at the HH level TBD TBD TBD TBDVaccination coverage (Measles and vitamin A) >95%
>95%80-94.9%80-94.9%
ANC Coverage TBD TBD TBD TBDLow Birth Weight TBD TBD TBD TBDCoverage of outreach programmes TBD TBD TBD TBDAccess to safe WASHIndicator Acceptable Alert Serious Critical Very criticalPopulation have access i) to a sufficient quantity of water for drinking, cooking, personal & domestic hygiene–min 15lts pp/ day ii) sanitation facilities
100%
100%
TBC
TBC
TBC
TBC
TBC
TBC
TBC
TBC
IPCThe Integrated Food Security Phase Classification
Map IPC Pilot Nutrition Classification, Kenya Map IPC Pilot Nutrition Classification, South Sudan
Communication for action
IPCThe Integrated Food Security Phase Classification
Two Year - Piloting and development period (2014-2015)– 2014-15 development of IPC Prototype based on FSNAU tool, Pilot
and Refine/Revise– 2016 Expected Roll-out of V.1.0 IPC Nutrition Classification
Process – Technical Consultations & Deliberations combined with Country Pilots & Learning for Refinement of tool
2014 Timeline & Work Plan– Launch of IPC Global Nutrition Working Group, March 25, 2014 – First IPC NWG Meeting: June 23-25– Development of Tools and First Round of Pilots: July – Aug 2014 (Kenya
and South Sudan)– Second IPC NWG Meeting: Sept 2014– Second Round of Pilots: Oct – Nov 2014 (Bangladesh, Haiti, and Niger)– Third IPC NWG Meeting and planning for 2015, Dec 2014
Timeline & Work Plan
IPCThe Integrated Food Security Phase Classification
Thank you
www.ipcinfo.org