Nutrition needs assessment

Emergency Phase

i. Compile pre-crisis information and conduct analysis of initial assessments to establish the nature and likely severity of the nutrition situation.

• Gather information about malnutrition levels and infant and young child feeding practices before the emergency.
• Review what the likely causes of malnutrition are, including immediate, underlying, and basic factors. Consider the displacement crisis as a potential basic cause. Use relevant secondary data obtained from sources such as UNHCR's databases and reports and those of other UN agencies such as UNICEF and WFP, NGOs working in the affected areas, and key informants.
• Gather characteristics and cultural habits of the refugee population that might affect food preference, influence the effectiveness of coping strategies or early interventions.
• Review the results of the assessment carefully and use the findings to construct the pre-assessment situation. This includes the baseline understanding of the nutritional status before the crisis, likely impact of the crisis on nutrition outcomes and vulnerable groups within the population who might be at a higher risk of malnutrition during the crisis. This is useful to inform initial planning.

ii. Primary data collection steps:

• The food security and nutrition checklist under the Needs assessment for refugee emergencies (NARE) multi-sectoral tool, should be used in the first two to three days of the emergency. This should be accompanied or followed by the nutrition screening and infant and young child feeding in emergencies assessment either immediately or within the first two weeks of the emergencies following below.
• Assess the nutrition situation by conducting bilateral oedema screening and mid upper arm circumference (MUAC) screening for all children aged 6-59 months at a reception centre during registration or initial contact. It is also recommended to conduct MUAC screening for pregnant and breastfeeding women, if possible.
• Screen households with an infant younger than 6 months at a reception centre during registration or initial contact using a short questionnaire on feeding practices to determine if the child is facing any breastfeeding difficulties.
• Conduct focused group discussions (FGD) or key informant interviews (KI) to obtain a general assessment of infant feeding among children aged 6-23 months.
• Ascertain if there are any feeding problems related to breastfeeding, care of non-breastfed infants, and complementary food.
• Determine if infant formula and/or baby bottles/teats have been distributed since the emergency started.
• Identify priorities expressed by parents/caregivers regarding feeding their infants and young children from birth to 2 years of age.

iii. Identify groups with specific needs or that have the greatest need for nutritional support. Engage with communities to identify at-risk groups, paying attention to age, sex, disability, chronic illness, or other factors. (FGDs or KIs)

iv. Review information on the causes of undernutrition from primary or secondary sources, including the community’s perceptions and opinions. (Review multisectoral initial reports or liaise with the various multi-sectors to gather information). Use the conceptual framework of malnutrition as a guide.

v. Assess resource capacity to lead and support the response.

vi. Determine an appropriate response based on an understanding of the context, the emergency, cultural habits among the refugee population and specific refugee vulnerabilities. Consider both prevention and treatment options.

Related risks:

• Inadequate data and assessment may lead to an inaccurate understanding of the nutrition situation and hinder effective response planning.
• Failure to consider cultural habits and preferences may result in ineffective interventions and low community engagement.
• Insufficient attention to specific vulnerable groups may lead to unequal access to nutritional support.
• Inadequate coordination among different sectors may impede the implementation of a comprehensive and efficient response.
• Lack of resources or capacity may limit the scale and effectiveness of the response efforts.

Presentation of results: The findings of an initial rapid nutrition assessment should be reported using the Rapid MUAC & IYCF-E screening report template.