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POLANGUI COMMUNITY COLLEGE Polangui, Albay SY: 2011-2012 Guidelines for Selective Feeding Programmes in Emergency Situations A Research Paper Presented to Polangui Community College Polangui, Albay In Partial Fulfillment of the Requirements for the Degree Marianne R. Reodique ACKNOWLEDGEMENT The researcher of the “Guidelines for Selective Feeding Programmes in Emergency Situations” would like to extend her gratitude to those in one way as another made this research paper possible. To Dr. Sancita Penarubia, President of Community College, Principal ofPolangui General Comprehensive High School.
Mrs. Ma. Amelia B. Masindo, Dean of HRM, instructors, fellow students for their generous contribution of the accomplishment of this work. To my family, my parents for unending support and guidance. To God, whose mercy and divine assistance is always there to guide in our way to right decision and giving wisdom to pursue our education. INTRODUCTION In emergency situations, WFP and UNHCR try to ensure that the food needs of the population are met through the??provision of an adequate general ration.
However, in certain situations there may be a need to provide additional food for a period of time, to specific groups who are already malnourished and/or are at risk of becoming malnourished. These interventions have to be seen in the context of a general ration being distributed. The impact of Selective Feeding Programmes aimed at compensating for inadequate general rations has proven very limited and not cost-effective. Thus to be effective, the extra ration must be??additional??to, and??not a substitute??for, the general ration.
National health authorities and NGOs have an important role to play in nutritional interventions. In emergency situations NGOs usually organise and implement Selective Feeding Programmes. They form an integral part of the efforts to prevent and treat malnutrition among young children, women and other at-risk groups. Selective Feeding Programmes should have clear objectives and criteria, defined from the beginning, for opening, admission, discharge and closure.
In order to be effective, Selective Feeding Programmes need to be integrated into Community Health Programmes, which offer health and nutrition services like Safe Motherhood, immunisations, nutrition and health education and growth monitoring. Integration facilitates referrals between services and the phasing out of Selective Feeding Programmes. OBJECTIVE 1. What are the purpose of these guidelines? 2. What are the factors influence nutritional status? 3. What are the two mechanisms through which food may be provided? 4. What are the two forms of Selective Feeding Programmes? 5.
What are the two types of Selective Feeding Programmes? 6. What are the advantages of dry ration? 7. What are the learning guide on Guidelines for Selective Feeding Programmes in Emergency Situations? ASSUMPTIONS The purpose of these guidelines are intended to provide guidance to WFP and UNHCR and other relief staff in the design, implementation and monitoring of Selective Feeding Programmes in both emergencies and protracted relief situations. The nutrition strategies addressed in these guidelines are to enable an effective response and nutrition rehabilitation. DEFINITION OF TERMS
Care in Nutrition- refers to the practices of the care givers in the household which translates food security and health care into rehabilitation, growth and development. These practices include care for women, breast-feeding, infant feeding, psycho-social care, sanitation and hygiene practices, food processing and preparation, and home health practices. On-site feeding or Dry Ration- refers to the daily distribution of cooked food/meals at feeding centers. The number of meals provided can vary in specific situations, but a minimum of two or three meals should be provided per day.
Take-home or dry ration- refers to the regular (weekly or bi-weekly) distribution of food in dry form to be prepared at home. It may be necessary to increase the amount of food to compensate for intra-household sharing. FINDINGS 1. The purpose of these guidelines are intended to provide guidance to WFP and UNHCR and other relief staff in the design, implementation and monitoring of Selective Feeding Programmes in both emergencies and protracted relief situations. The nutrition strategies addressed in these guidelines are to enable an effective response and nutrition rehabilitation. . The factors influence nutritional status should therefore be kept in mind that interventions must be multi-sect oral and cover food, health, hygiene, sanitation and care. 3. The two types of mechanisms through which food may be provided are General Food Distribution and Selective Feeding Programmes. 4. The two forms of Selective Feeding Programmes are Supplementary Feeding Programmes andTherapeutic Feeding Programmes. 5. The two types of Selective Feeding Programmes are Targeted SFPs and Blanket SFPs. 6.
The advantages of dry ration feeding are the following, carries less risk of cross-infection as large numbers of malnourished and sick children do not have to sit in close proximity while feeding, takes less time to establish than on-site feeding programmes which require setting up and equipping centers. CONCLUSION 1. Every situation has individual features which lead to different objectives being set, and to different approaches to Selective Feeding Programmes. These guidelines cannot cover the wide range of situations.
The type of supplementary feeding programme should therefore be designed according to the situation but should nevertheless remain in line with the frame work of these guidelines. 2. The factors influence nutritional status should therefore be kept in mind that interventions must be multi-sect oral and cover food, health, hygiene, sanitation and care. 3. The two types of mechanisms through which food may be provided are General Food Distribution and Selective Feeding Programmes. General Food Distribution??provides a standard general ration to the affected population ith the aim to cover food and nutritional needs. 4. The two forms of Selective Feeding Programmes are Supplementary Feeding Programmes and Therapeutic Feeding Programmes. Supplementary Feeding Programmes (SFPs) ??provide nutritious food in addition to the general ration. They aim to rehabilitate malnourished persons or to prevent a deterioration of nutritional status of those most at-risk by meeting their additional needs, focusing particularly on young children, pregnant women and nursing mothers. 5. The two types of Selective Feeding Programmes are Targeted SFPs and Blanket SFPs.
The main aim of a Targeted SFP is to prevent the moderately malnourished becoming severely malnourished and to rehabilitate them. 6. The advantages of dry ration feeding are also less time consuming for mothers who only have to attend every week or fortnight and as a result leads to better coverage and lower default rates, keeps responsibility for feeding within the family, is particularly appropriate for dispersed populations many of whom would have to travel long distances to attend daily. 7. A learning guide on “Guidelines for Selective Feeding Programmes in Emergency Situations” was developed on the findings of the study.
DISCUSSION Many factors influence nutritional status (as shown in Figure 1). It should therefore be kept in mind that interventions must be multi-sectoral and cover food, health, hygiene, sanitation and care. A properly designed nutrition survey and complementary analysis of the causes of malnutrition can help to guide the need to implement Selective Feeding Programmes. In addition to nutritional and medical treatment, care is an essential part of rehabilitation. Care in nutrition refers to the practices of the care givers in the household which translates food security and health care into rehabilitation, growth and development.
These practices include care for women, breast-feeding, infant feeding, psycho-social care, sanitation and hygiene practices, food processing and preparation, and home health practices (1). These issues can be addressed through Selective Feeding Programmes in the form of education, individual counselling, social activities and involvement of caretakers in the programme. The community must be consulted to the extent possible during programme design and women must take part in the decision making from the outset (2).
Proximity of feeding centres to the population and availability of trained health staff are a prerequisite when Selective Feeding Programmes are being considered. The policy of UNHCR and WFP concerning safe and appropriate infant and child feeding, in particular the protection, promotion and support of breast feeding must be respected (3). When planning the food needs of Selective Feeding Programmes the energy density as well as the fat, protein and micronutrient content of food commodities must be considered.
In addition, micronutrient supplements (especially vitamin A, iron and folic acid) should be given. It must be kept in mind, that adolescents, adults and elderly persons may also be malnourished and should be included in Selective Feeding Programmes. The effectiveness of Selective Feeding Programmes, and their impact on mortality and morbidity of affected populations, should be monitored regularly. The need to set up Selective Feeding Programmes after the initial stage of an emergency often represents a serious warning that the assistance as a whole is insufficient.
For interpretation of nutrition surveys, results are presented both in weight-for-height Z-scores and percentage of the median. However, during admission and discharge to feeding programmes, percentage of the median is often being used. At present, no consensus has yet been reached on the use of Z-score in feeding programmes. SFPs are short-term measures and should not be seen as a means of compensating for an inadequate general food ration. The objectives of the feeding programme should be realistic and should be achieved within a period determined in advance.
Figure 2 illustrates the different types of feeding programmes. RECOMMENDATIONS 1. The study of Guidelines for Selective Feeding Programme in Emergency Situations can still be improved and continues studies if they have enough financial assistance from the government, and having more knowledge or idea to get information about the Selective Feeding programmes. 2. The factors influence nutritional status are properly designed nutrition survey and complementary analysis of the causes of malnutrition can help to guide the need to implement Selective Feeding Programmes. 3.
The two types of mechanisms through which food may be provided are General Food Distribution and Selective Feeding Programmes. SFPs are short-term measures and should not be seen as a means of compensating for an inadequate general food ration. The objectives of the feeding programme should be realistic and should be achieved within a period determined in advance. 4. The two forms of Selective Feeding Programmes are Supplementary Feeding Programmes andTherapeutic Feeding Programmes. Therapeutic Feeding Programmes (TFPs)??are to rehabilitate severely malnourished persons. . The two types of Selective Feeding Programmes are usually provide a food supplement to the general ration for mild and moderately malnourished1??individuals and for selected pregnant and nursing mothers and other nutritionally individuals at-risk. 6. The advantages of dry ration feeding keeps responsibility for feeding with in the family. CURRICULUM VITAE Name : Address : Date of birth : Place of birth :