MATERNAL AND CHILD NUTRITION UNICEF PROGRAMMING PRIORITIES TO RESPOND TO THE SOCIO-ECONOMIC IMPACTS OF THE COVID-19 PANDEMIC RESPOND, RECOVER, AND ...
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MATERNAL AND CHILD NUTRITION
UNICEF PROGRAMMING PRIORITIES TO RESPOND
TO THE SOCIO-ECONOMIC IMPACTS OF THE
COVID-19 PANDEMIC
RESPOND, RECOVER, AND REIMAGINE
1 June 2020
The COVID-19 pandemic is a child rights crisis. Even though UNICEF COVID-19 Guidance Note on Programming Priorities,
children are less likely to fall ill from the virus, wide-ranging the upcoming UNICEF Nutrition Strategy 2020-2030, and the
actions are needed so that children do not become the UNICEF corporate emergency level 3 scale-up procedure.
hidden victims of the pandemic. In particular, the pandemic The document summarizes the pathways through which the
and required mitigation measures have worrying impacts on COVID-19 pandemic is likely to have a negative impact on
household incomes and food, health, education and social the nutrition situation of children and women and outlines
protection systems. Owing to these impacts, millions of UNICEF’s nutrition programming priorities in five areas, based
vulnerable children and women may not benefit from the on the universal premise that prevention comes first in all
diets, services and practices they need to support adequate contexts and when preventions fails, treatment is a must.
nutrition. This document aims to provide a top-line narrative The implementation of these priorities will be a key pillar of
on UNICEF’s nutrition programming to protect, promote UNICEF’s efforts to respond, to recover, and to reimagine
and support maternal and child nutrition in the context of nutrition, for every child.
the COVID-19 pandemic. The document is aligned with the
1. I M PAC T OF THE COV I D -19 PAN DE M I C ON M ATE RN AL AN D C H I LD NUT R IT ION
The COVID-19 pandemic is a global crisis of far- short, medium and long term, particularly in low- and
reaching consequences. With rising death tolls middle-income countries where children and women
across the world, societies and economies are facing who are already most vulnerable and affected by
extreme pressure from both the direct impact of malnutrition live.
the virus as well as the indirect impact of measures
to prevent transmission. In many countries, food Entering 2020, 47 million under-fives globally were
systems are increasingly vulnerable to disruptions, wasted, 144 million stunted, and at least 340 million
health systems are overburdened, education systems suffered from micronutrient deficiencies. In addition
are substantially altered, and social protection to the burden of undernutrition and micronutrient
systems are facing a sharp increase in demand as a deficiencies, 38 million underfives were affected
result of a sudden economic downturn and rapidly by overweight, a figure that keeps growing in every
spiraling unemployment. As the clinical impacts of region, including in Africa. These figures underline the
COVID-19 are better understood, many families are scale of the malnutrition challenge the world already
experiencing, or will soon experience, major hardship faces. The pandemic may further exacerbate maternal
resulting from interruptions to essential services and child nutrition through three major pathways:
and loss of income. Yet again, the poorest families,
communities and countries will be hardest hit. These A. Poor access to nutritious diets: Despite
impacts, when combined, are likely to have profound the fact that the supply of nutritious foods is
consequences on maternal and child nutrition in the currently abundant globally due to relatively high
1MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
stocks and good harvests, the world faces a major response to the pandemic may impact on the health
challenge in terms of securing access to this food system’s ability to deliver services, disrupt the
for all children and mothers in the right quantity, manufacture and transportation of key commodities,
frequency, and diversity. As pandemic measures and negatively influence care-seeking behaviours
to prevent transmission are implemented, there is and access to care. To illustrate, antenatal care,
concern that nutritious food will not be available to infant feeding counseling, and the early detection
vulnerable groups in places that they can access and management of wasting may be partially or
and at prices they can afford. Economic purchasing fully disrupted by changes to care delivery models;
power for nutritious foods may collapse due to inequities in access may also arise as a result of the
loss of employment or income. As a result, many alternative delivery channels proposed, such as online
caregivers and families will resort to coping strategies or telephone consultations. Population-based events
whereby nutrient-rich foods that tend to be more such as vitamin A supplementation and deworming
expensive will be replaced by less expensive are likely to be suspended as movement of people
foods of poorer nutrition quality. This shock will be within and/or between communities is restricted to
dampened where social protection is more extensive reduce transmission of COVID-19, and school-based
and coverage broad, but in many contexts adequate nutrition services are widely interrupted because of
social protection and support is lacking. Where social school closures. In some contexts, loss of insurance
protection benefits and financial assistance are coverage due to a change in employment or an
insufficient or foods provided are not of appropriate inability to make out-of-pocket payments as a result
nutritional quality, diets will suffer. At the same time, of financial hardship may also negatively impact on
restrictions on the movement of people and goods, access to nutrition services for women and children.
as well as limits on certain forms of food retail, have
the potential to interrupt physical access to nutritious C. Poor feeding and dietary practices: As described
foods. Other containment measures such a school above, major disruptions to the food, health, education
closures – with 1.5 billion children out of school – may and social protection systems are expected as a result
result in children missing out on critical nutritious of COVID-19. These disruptions are likely to have
meals. Combined, these dynamics may undermine significant negative knock-on effects for child feeding
access to nutritious foods and in some settings may and dietary practices. For example, interruptions
perversely encourage consumption of fast food and in skilled breastfeeding support may decrease
processed, long shelf-life foods high in saturated fats, recommended breastfeeding practices. Health
sugar and/or salt. workers, mothers, and families may have unfounded
fears that active virus can be transmitted to the
B. Poor access to essential nutrition services: breastfed child through breastmilk, which is a fear
Many health systems that were already struggling that may be used by breastmilk substitute producers
prior to the pandemic are likely to become even more (BMS) to promote their products. Interruptions of
strained. These systems face service disruptions health service counseling and social and behavior
because of containment measures or inadequate change activities may also lead to reductions in
access to personal protective equipment, and as appropriate complementary feeding practices and
they focus efforts on expanding their capacity to maternal diets. A further constraint is that many
respond to COVID-19, such as by freeing up hospital caregivers are now juggling work with the demands
beds, securing medical supplies and equipment, of full-time childcare and homeschooling. Physical
and deploying trained workers to the immediate distancing rules may also mean that family support
emergency response. As human, financial, and networks become less available, leaving caregivers
logistical resources are diverted to the COVID-19 will little spare time to prepare quality meals and
response and funding for health systems decreases feed their children appropriately, including through
with impending recessions, essential nutrition responsive feeding practices. As the pandemic
services for children and women risk being disrupted and the socio-economic impact of the measures
or suspended. In addition, physical distancing to prevent its spread become more protracted,
measures and restrictions on mobility adopted in the cumulative risk to child feeding and dietary
2MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
practices will become even more pronounced, with diabetes and some forms of cancer) have become
possible long-term impacts on children’s nutritional the world’s leading cause of mortality. Poor nutrition
status, their development, and the desirability and also affects COVID-19-related outcomes. To illustrate,
acceptability of certain foods. immunologic impairments among wasted children
may increase COVID-19-related mortality, while
All these possible impacts matter for children overweight and diet-related non-communicable
because malnutrition has immediate and lasting diseases are potent risk factors for COVID-19-related
effects. Children with nutritional deficiencies are mortality in the general population. The global
more likely to die, while those who survive grow response to the COVID-19 pandemic must therefore
poorly, perform less well at school, and go on to have integrate and respond to nutrition concerns to prevent
lower earnings throughout their lifetime. At the same and, where necessary, treat malnutrition.
time, overweight and diet-related non-communicable
diseases (such as stroke, heart disease, type-2
2 . UN I CEF NUT R IT ION PROGR AM M ING IN THE CONTE X T OF THE COV I D -19 PAN DE M I C
The COVID-19 pandemic is a complex emergency programing in the context of the COVID-19
and the highest level of mobilization is required across pandemic.
the organization. The UNICEF corporate emergency
• Advocating for the rights and voices of children,
level 3 scale-up procedure for the pandemic has been
adolescents and women as an integral component
instituted for 16 April to 15 October 20201 alongside
of nutrition programing in the context of the
organizational guidance on programming approaches
COVID-19 pandemic.
and priorities to prevent, mitigate, and address the
impacts of the pandemic.2 Guided by the upcoming
Our actions will be guided by overall support to
UNICEF Nutrition Strategy 2020-2030, this document
COVID-19 infection prevention and control as well as
details UNICEF’s programmatic response to the
innovative approaches to ensure continued access
COVID-19 pandemic for the period from 1 June –
to nutritious diets, essential nutrition services and
31 October, 2020.
positive nutrition practices both during and after the
mitigation phase.
Programming principles
UNICEF’s global nutrition programme is guided by
Programming approaches
the following programming principles: rights-based,
The following programming approaches are of special
equity-focused, gender-responsive, context-specific,
relevance for our COVID-19 response over the next
evidence-driven and systems-centered. In the context
six months:
of the COVID-19 response, we will reinforce a human
rights-based approach to programming by:
• Advocacy and communication – Develop a
strong nutrition narrative on how the COVID-19
• Addressing inequalities in analysis, programme
pandemic threatens children’s right to adequate
design, implementation and monitoring, recognizing
nutrition. While the initial phase of the pandemic
that the COVID-19 pandemic may cause or
focused on limiting the spread of the infection and
exacerbate nutrition vulnerabilities and disparities.
the immediate health risks, safeguarding maternal
• Strengthening the capacities of national and child nutrition alongside infection control will be
governments, NGOs and community organizations, crucial in subsequent phases of the response.
and national systems for effective nutrition • Capacity development – Strengthen capacities
of decision makers at national and sub-national
1 UNICEF Executive Director. Email communication, April 16, 2020.
2 UNICEF (2020). Guidance Note on Programming Approaches and Priorities to Prevent, Mitigate and Address Immediate Health and
Socio-economic Impacts of the COVID-19 Global Pandemic on Children.
3MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
levels to protect maternal and child nutrition in the We will continue to work with national governments,
context of the pandemic. We will publish specific civil society organizations and non-governmental
programming briefs and tools, offer webinars and organizations, UN agencies, bilateral partners,
e-learning seminars, and use other context-specific multilateral development banks, academia, private
dissemination platforms to share information on sector, and media—including in the context of the
maternal and child nutrition. SUN movement —and seek modalities to best
support the COVID-19 response. For our donor
• Supply provision – Accelerate supply planning
partners, we are identifying priority needs and develop
to sustain services in the event of supply chain
costed plans. We also welcome engagement from
disruptions from the COVID-19 pandemic. With
Global Public Partnerships and International Financial
UNICEF Supply Division, UNICEF Nutrition
Institutions, as well as private sector to support our
programmes will engage in demand forecasting,
nutrition programming in innovative ways that protect
distribution planning and procurement, pre-
and promote children’s right to nutrition
positioning and distribution.
• Knowledge and innovation – Generate, share, and Strategic directions
use evidence to guide actions and test innovations The COVID-19 pandemic represents both a challenge
to respond more flexibly to the evolving pandemic and an opportunity for UNICEF nutrition programmes.
in different contexts, also with a view to the longer- The challenge is that children’s needs will be greater
term utility of some of the innovations. Guided and the resources available may not be commensurate
by the UNICEF COVID-19 Nutrition Evidence to children’s needs, hence the importance of
Generation Framework and aided by UNICEF- prioritizing our interventions and sharpening the focus
supported data collection systems at national of our response. The opportunity is that the response
levels, we will assess the effect of the pandemic to the pandemic may offer room to accelerate
and related responses on nutrition outcomes, diets, policy changes, simplify and innovate in programme
services and practices. approaches, streamline management processes, and
help governments and partners respond in ways that
• Context specificity - Tailor the response to each
prioritize children with the greatest needs.
context -based on 1) the direct and indirect impacts
of the COVID-19 pandemic on the nutrition situation
In the context of the COVID-19 pandemic, UNICEF
of children and women; 2) the potential pathways
is uniquely positioned to mobilize global, regional
for positive nutrition impact on children and women;
and national partners across the public and private
and 3) the resources and partnerships available.
sector to safeguard maternal and child nutrition. This
role is facilitated by 1) UNICEF’s mandate to improve
Collaborations and partnerships nutrition for every child, including those facing
As the Cluster Lead Agency for Nutrition, UNICEF humanitarian crises, through its role as Cluster/Sector
supports the sectoral coordination of the COVID-19 Lead Agency for Nutrition; (2) UNICEF’s multisectoral
response through at the Global Nutrition Cluster expertise for children in nutrition, health, water and
Coordination Team and country nutrition cluster/sector sanitation, education, protection, and social policy;
coordination mechanisms, linking stakeholders, and (3) UNICEF’s wide on-the-ground presence, with
ensuring effective communication and collaboration. over 12,000 staff and nutrition programmes in more
As the pandemic evolves, it will be important that than 120 countries; and (4) UNICEF’s long-standing
UNICEF’s nutrition programmes continue to adapt role as a trusted advisor to national and sub-national
their programming approaches and collaboration governments and their development and humanitarian
with other UNICEF core sectors. To this end, we will partners.
regularly assess whether our own capacities to deliver
high-quality technical, programmatic and managerial UNICEF programmatic priorities for nutrition in the
support across systems and programming contexts context of COVID-19
are fit for purpose and make necessary course UNICEF’s nutrition response to the COVID-19
corrections. pandemic aims to ensure that all children and
4MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
women have access to nutritious and affordable warrant, UNICEF will support plans to re-establish
diets, adequate nutrition services, and information population-based VAS events. UNICEF will also work
and counselling on practices to protect, promote and closely with the social protection system to ensure
support adequate nutrition. The response considers that coverage of transfers is expanded to include all
the major impacts of the COVID-19 pandemic vulnerable families with children under two years,
on maternal and child nutrition, the availability of benefits are increased, vouchers for fresh food
evidence-based interventions, and UNICEF’s mandate or fresh food transfers are included and nutrition
and expertise for programme implementation communication and services are better linked to the
in support of national systems. UNICEF’s global social protection scheme. To assess the impact of the
programmatic response is organized around five pandemic, UNICEF will work to include key indicators
results areas (Table 1). UNICEF Country Offices will on early childhood nutrition in data collection systems.
prioritize interventions from these results areas based
on national and sub-national contexts: Prevention of malnutrition in middle childhood
and adolescence: UNICEF will work so that the
Table 1: UNICEF priority results areas for the COVID-19 program- nutritional and learning needs of children in middle
matic response childhood and adolescence are not ignored. In the
1) Prevention of malnutrition in early childhood mitigation phase characterized by school closures,
UNICEF will support innovative delivery mechanisms
2) Prevention of malnutrition in middle
childhood and adolescence to maintain the provision of school meals and
essential nutrition services, and promote the inclusion
3) Prevention of maternal malnutrition of vulnerable school children and their families in
4) Early detection and treatment of life- social protection schemes.6 In parallel, UNICEF will
threatening malnutrition in early childhood support nutrition education programmes through
5) Governance for maternal and child nutrition adequate mass media and digital channels and
engage parents and children through appropriate
e-learning platforms. As schools reopen, providing
Prevention of malnutrition in early childhood: school meals, essential nutrition services, and
UNICEF will support governments to prevent all forms ensuring a healthy food environment in schools will
of malnutrition by ensuring that the critical nutritional support efforts to bring children back to school and
needs of children under five years of age are met safeguard their nutrition. Throughout the entire crisis
through the protection, promotion and support of response, UNICEF will strengthen data systems to
breastfeeding, complementary feeding and healthy assess the impact of the crisis and the effectiveness
diets,3,4 as well as continuity and adaptation of of response measures. UNICEF will work closely
essential services such as vitamin A supplementation with partners such as WFP to leverage resources and
(VAS), deworming and micronutrient powders. Work achieve programmatic synergies.
in this area will include strong advocacy to ensure
newborns and young children are not separated from Prevention of maternal malnutrition: UNICEF
their mothers to support breastfeeding, intensify will work to protect the diets, nutrition services and
support to families on young children’s diets using practices of pregnant women and breastfeeding
practical communication tools and platforms, promote mothers to minimize the negative impacts of
and support access to healthy foods, and control the COVID-19 mitigation measures. To this end, UNICEF
illicit/unethical promotion or distribution of breastmilk will support continued antenatal care service provision
substitutes and unhealthy foods5. Once conditions by bringing nutrition services closer to communities.
3 UNICEF, USAID, Save the Children, Safely Fed Canada (2020). Infant and Young Child Feeding Recommendations When COVID-19 is
Suspected or Confirmed.
4 UNICEF, Global Nutrition Cluster (2020). Infant and young child feeding in the context of COVID-19.
5 UNICEF (2020). Response to COVID-19: Guidance note on financial contributions or contributions in-kind from food and beverage
companies. Version 2.
6 WFP, FAO, UNICEF (2020). Mitigating the effects of the COVID-19 pandemic on food and nutrition of schoolchildren.
5MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
In addition, UNICEF will facilitate telephone and online among children under two years. To sustain services
support for pregnant and breastfeeding women, and minimize the risk of disruption to life-saving
support procurement and supply management treatment services, UNICEF will support national
systems on essential commodities, and identify governments and implementing partners in procuring
innovative communication strategies to support and pre-positioning essential treatment commodities
culturally appropriate information and counseling (e.g. ready to use therapeutic foods) in anticipation of
on healthy eating, hygiene and physical activity.7 potential disruptions to global, regional, national and
UNICEF will also advocate for social protection sub-national supply chains.
schemes to cover the needs of pregnant women
and breastfeeding mothers and for continued access Nutrition governance: UNICEF recognizes that
to fortified staple foods. To assess the impact of during the COVID-19 pandemic, systems and
the pandemic on nutritional status and service mechanisms to ensure accountability, transparency
coverage, UNICEF will work to include key indicators and responsiveness to children and women are likely
for pregnant and breastfeeding mothers in data to be affected. To support improved governance for
collection systems. nutrition UNICEF will focus on three key priorities: (1)
convening and coordinating strategic partnerships
Early detection and treatment of life-threatening to support the nutrition response, focusing on sector
malnutrition in early childhood: UNICEF will and cluster coordination to most effectively support
work to intensify and diversify efforts to detect life- national governments to design and implement
threatening malnutrition including wasting.8 To this plans to mitigate the impact of the COVID-19 on
end and depending on the context, UNICEF will maternal and child nutrition; (2) strengthening data
scale-up efforts to build the capacity of caregivers and information systems to inform the design and
and communities in the use of low-literacy/ implementation of nutrition plans and programmes,
numeracy detection tools (e.g. MUAC tapes), using focusing on using existing data sources, identifying
online platforms where possible and relevant. To indicators to track needs, and monitoring progress
sustain access, UNICEF will explore opportunities and outcomes, especially for the most vulnerable;10
for decentralizing treatment services closer to the and (3) strengthening the generation, sharing and
communities, including (but not limited to) supporting use of knowledge to inform policies, programmes,
community health workers and other community- advocacy and research to improve maternal and child
health platforms to deliver simplified treatment nutrition and adapt nutrition programming in the
services for children with uncomplicated wasting.9 rapidly evolving COVID-19 context.
Whenever needed, UNICEF will prioritize treatment
for vulnerable children with wasting, in particular
7 UNICEF, World Food Programme, Global Nutrition Cluster (2020). Protecting maternal diets and nutrition services and practices in the
context of COVID-19.
8 UNICEF, Global Nutrition Cluster (2020). Risk of COVID-19 complications in children affected by wasting.
9 UNICEF, Global Nutrition Cluster (2020). Management of child wasting in the context of COVID-19.
10 UNICEF, Global Nutrition Cluster (2020). Nutrition information management, surveillance and monitoring in the context of COVID-19.
6MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
Table 2: UNICEF programmatic priorities for nutrition in the context of COVID-19
PRIORITY AREA WHAT HOW
Results Area 1: Prevention of malnutrition in early childhood
Breastfeeding • Support appropriate feeding and • Support countries to enact evidence-informed policies on
hygiene practices, particularly among breastfeeding in the context of COVID-19
mothers who are suspected or • Strengthen the capacity of health workers in providing skilled
infected with COVID-19 counselling and support for breastfed and non-breastfed
• Support governments in identifying infants by using the IYCF counseling tools adapted to the
and addressing inappropriate context of COVID-19, either safely face to face, by telephone or
promotion and distribution of through e-learning, and ensure that mothers who are too ill to
breastmilk substitutes during the breastfeed are supported to safely feed their infants and re-
emergency response initiate breastfeeding after recovery
• Promote practical multimedia communication tools and
platforms (such as mobile technology, social media, radio, etc.)
and leverage WASH, social protection, and ECD platforms
to reach communities and families with adapted information
and messages on the importance of breastfeeding during
COVID-19
• Identify and act on Code violations such as the promotion
and distribution of breastmilk substitutes in health facilities,
communities, and through food baskets/packages distributed
to vulnerable families during the emergency response
Complementary • Support families with information • Intensify support to families on the importance of healthy and
foods and and practical solutions on feeding safe foods and feeding practices for young children, including
feeding nutritious, safe and affordable diets intake of safe drinking water, using practical communication
to young children tools (such as illustrative images, simplified messages and
videos) and platforms (digital, broadcast and social media)
• Support in maintaining the continuity • Strengthen the capacities of frontline workers (health,
of essential services for young community and others) to counsel caregivers using IYCF
children through health, WASH and counseling tools in the context of COVID-19 and nutrition
social protection systems, such as videos on feeding age-appropriate, diversified and safe diets to
nutrition and hygiene education, their young children
use of micronutrient powders,
• Functioning platforms and services under health, ECD,
access to diverse, nutritious and
social protection and WASH systems should be leveraged to
locally produced foods and fortified
maintain continuity of essential services for young children,
complementary foods
such as nutrition education and counselling, micronutrient
supplements, improved access to nutritious and safe food
• Ensure that nutrition of young including fortified complementary foods, as appropriate and in
children is well integrated in alignment with national policies
parenting and child caring initiatives
• In case of reduced mobility, work closely with the government
and partners to develop alternative service delivery models to
maintain continuity of essential services for young children
• Support the pre-positioning of micronutrient powders (or lipid-
nutrient supplements) in alignment with national policies to
counteract supply chain disruptions
7MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
PRIORITY AREA WHAT HOW
Results Area 1: Prevention of malnutrition in early childhood (continued)
Micronutrient • Adapt delivery platforms for vitamin • Ensure the inclusion of VAS within the package of essential
supplementation A supplementation (VAS), including services that will continue to be implemented in the context of
via routine health system contacts COVID-19
and child health days, to minimize the • Strengthen health worker capacities to distribute VAS through
potential virus transmission routine health system contacts (e.g., immunization) alongside
• Use existing opportunities for VAS infection prevention and control
distribution during the COVID-19 • Support the pre-positioning of VAS and other micronutrient
pandemic (e.g., in the response to a supplements in anticipation of supply chain disruptions and the
vaccine-preventable disease outbreak need to establish additional supply chains to support changes
or with bed net distribution) to programme implementation
• Support plans to re-establish • Monitor and re-evaluate the necessity of delays in population-
population-based VAS events once based VAS events at regular intervals with an aim to reinstate/
conditions warrant and national intensify VAS at the earliest opportunity
authorities allow
Healthy food • Respond to COVID-19 food system • Provide guidance to the community and families on healthy
environments impacts that may limit availability food purchases (types of food to prioritize, where and how to
and affordability of healthy foods for shop safely, tips on food preparation at home) in the context of
children and families, especially the COVID-19 through multiple communication channels
most vulnerable • Advocacy to maintain access to local markets, shops and
• Work with other sectors (e.g. WASH, stores and guarantee supply chains to support availability of
education and social protection) in reasonably-priced fresh foods and essential staples
a coordinated manner to counteract • Identify and act on violations or non-compliance with existing
negative impacts of COVID-19 and food environment regulations (e.g., marketing restrictions) and
adapt measures to ensure continued avoid distribution or promotion of unhealthy foods as part of
local availability and affordability of the emergency response
healthy foods and safe drinking water
• Control the marketing, promotion
or mass distribution of unhealthy
foods (those high in saturated fats,
free sugar and/or salt) to children
and families in the context of the
emergency response
8MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
PRIORITY AREA WHAT HOW
Results Area 2: Prevention of malnutrition in middle childhood and adolescence
School meals • Provide support to maintaining • Apply context-based models for school meal, such as home
and school food continuity in the provision of delivery, take-home rations, cash or vouchers
environments nutritious and safe school meals, • Work with community platforms and youth networks to
including identifying modalities to include out-of-school children and adolescents in nutrition
reach vulnerable children when programmes
schools are closed
• Maintain adequate nutritional value of meals, food baskets or
• Ensure nutritional quality and safety food packages, and avoid providing meals or food products
of meals in compliance with national with low nutritional value
nutrition standards for school meals
• Leverage the focus on ‘reopening of schools’ by reinforcing
• Ensure safe school food protocols for food hygiene, food handling, serving of school
environments including restrictions meals, canteens and food vendors in and around schools, and
on vending, sale and donation of improved systems for inspection and monitoring
unhealthy foods and beverages
Nutrition • Deliver messages on healthy eating • Integrate messages on healthy diets, preparation of healthy
education and positive behaviours through safe meals, physical distancing, WASH and food hygiene through
user-friendly platforms mass media channels (radio/community radio, television, talk
• Develop e-learning tools and shows, television anchors, online, social media)
packages for parents, educators • Engage parents and children through online or distance
and children on healthy eating and learning modules on nutrition and physical education, using
promotion of healthy lifestyle technologies or radio in areas where internet access is not a
viable option
Nutrition • Maintain continuity of essential • Develop models to continue the provision of micronutrient
services nutrition services, such as supplementation at home (to be taken as per the regimen
micronutrient supplementation, under parental supervision) during school closures
despite school closures
9MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
PRIORITY AREA WHAT HOW
Results Area 3: Prevention of maternal malnutrition
Maternal • Adapt antenatal care (ANC) and • Use results of situation analysis and community discussions to
nutrition services postnatal care (PNC) service design local, context-specific modifications to ANC and PNC
delivery to local contexts to ensure service delivery
continuity of essential nutrition • Modify ANC to prioritize the needs of at-risk pregnant
services (nutrition and breastfeeding women with respect to counselling to increase daily energy
counselling, weight gain monitoring and protein intake and/or provide balanced protein energy
and micronutrient supplementation) supplementation, with close attention to follow up.
• Mobilize communities to identify • Support the forecasting and prepositioning of essential
local solutions to ensure continued nutrition commodities for 2–3 months close to service delivery
access to ANC and PNC services points and increase the amount of nutrition supplies dispensed
• Ensure an uninterrupted pipeline of to pregnant women and breastfeeding mothers
essential nutrition commodities and
adapt dispensing practices to ensure
service continuity
Social safety • Expand social protection • Ensure that social protection programmes and other economic
nets programmes and other emergency schemes cover the specific needs of households with
economic schemes to cover the pregnant women and breastfeeding mothers. Such efforts
needs of households with pregnant must ensure that cash, vouchers, and food baskets reach
women and breastfeeding mothers pregnant women and breastfeeding mothers.
• Organize supplementary food • Prioritize social safety net programs in populations with a high
distribution closer to homes/ prevalence of malnutrition
communities to facilitate access
in food insecure settings and/or
in settings with a high prevalence
of underweight among women of
reproductive age
Counseling • Identify innovative channels to • Adapt existing counseling and training materials to focus on
and social support messaging on healthy eating, healthy diets, food safety, hygiene, for health and community
behavior change hygiene, and physical activity/rest workers.
communication • Adapt counseling to emphasize • Create tools and facilitate creation and functioning of virtual
importance of healthy diets for mother support groups for pregnant women and breastfeeding
immunity, safe preparation of foods, women that provide accurate advice and appropriate support
tips for eating well on a budget, as • Integrate messages on healthy eating, hygiene into
well as focus on hygiene communications and messaging using various channels (social
• Modify training materials and train media, television, radio, digital platforms/mobile phone –
frontline health and nutrition workers WhatsApp, SMS)
and community workers with • Design social behavior change communications on healthy
information to support healthy diets eating and hygiene taking into account local gender and social
and hygiene practices norms
10MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
PRIORITY AREA WHAT HOW
Results Area 4: Early detection and treatment of life-threatening malnutrition in early childhood
Early detection • Intensify efforts to strengthen the • Introduce and/or scale-up capacity building efforts including
of child wasting capacity of mothers, caregivers, and through digital channels to build the capacity of caregivers
community-based health workers to to use low-literacy/numeracy tools including Mid-Upper Arm
detect and monitor their children’s Circumference (MUAC) tapes
nutritional status
Treatment of • Initiate/intensify decentralization of • Provide guidance for community health workers on training
child wasting treatment for uncomplicated wasting caregivers to use MUAC measurements while adhering to no-
by shifting to community-based touch assessment protocols
treatment whenever possible • Strengthen community health worker capacities to provide
• Initiate/intensify efforts to prevent treatment for uncomplicated wasting with a limited/no touch
disruptions in the availability of key simplified treatment approach
commodities for the treatment of • Develop videos, online tools and tailored e-learning to build
child wasting capacities, provide refreshers, and provide updates on specific
COVID-19-related adaptations when face to face sessions
cannot be undertaken
• Develop context-specific simplifications of treatment protocols
for child wasting, including simplified anthropometric criteria,
dosage and distribution schedules for ready-to-use foods
and other specialized nutrition foods, as well as potential
adaptations to inpatient management for complicated cases in
the context of COVID-19
• Support the pre-positioning of essential commodities for
nutrition programming (e.g. RUTF, MUAC bands, etc) and
routine medicinal supplies, with a minimum buffer stock of two
months
• Strengthen real-time monitoring and surveillance systems for
child wasting with mobile technologies to inform response and
allocation of resources
11MATERNAL AND CHILD NUTRITION
UNICEF Programming Priorities to Respond to the Socio-Economic Impacts of the COVID-19 Pandemic
PRIORITY AREA WHAT HOW
Results Area 5: Governance for maternal and child nutrition
Coordination • Ensure effective and functional • Develop/strengthen (sub-)national nutrition coordination
leadership and coordination for mechanisms to align programmatic intra- and intersectoral
maternal and child nutrition, in line responses and assign roles and responsibilities in the short-
with UNICEF Core Commitments for and medium-term
Children in Humanitarian Action • Where government coordination capacity is limited or
constrained, lead the international emergency response for
nutrition, with government co-leadership where appropriate
and support NGO contributions to leadership functions
• Ensure that nutrition sector/cluster leadership and coordination
functions are adequately staffed and skilled at national and sub-
national levels
Data, information • Use existing data and information to • Provide technical support on nutrition data and information
systems and inform planning and implementation systems to government and partners
nutritional for COVID-19 nutrition response • Gather evidence on the type, degree, extent and drivers of
assessments • Review the functionality of existing malnutrition and the population groups most at risk (e.g., urban
monitoring and information systems slums, high-density areas, migrants).
during the pandemic • Include essential nutrition indicators and questions as per the
• Define indicators to monitor the nutrition-COVID evidence generation framework
impact of COVID-19 on nutrition • Provide technical support for nutritional assessments, including
programming and outcomes proposing innovations to collect and analyse nutrition data
• Review the feasibility of nutrition (e.g., digital technology or community-based screening for
assessments and/or consider malnutrition)
innovations to support data collection
and analysis
Evidence • Identify evidence generation priorities • Establish a framework for evidence generation, formulate
generation, for the COVID-19 nutrition response, priority questions and coordinate research/evidence generation
knowledge and coordinate evidence generation activities, as well as clarify related processes and roles and
management and activities, both internally and with responsibilities
partners, to fill these knowledge gaps • Capture and document lessons from nutrition programming,
visibility
• Maintain visibility of nutritional including innovations
considerations in global COVID-19 • Support global and local agenda-setting processes ensuring
response and strategically position that nutrition is well-positioned and strategically included in
UNICEF’s nutrition work in response narratives and discussions
• Ensure that UNICEF’s work is appropriately recognized and
positioned
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