UNHCR Operational Guidance on the Use of Special Nutritional Products to Reduce Micronutrient Deficiencies and Malnutrition in Refugee Populations

Manual and Guideline
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Micronutrient malnutrition and undernutrition are now widely recognised as priority areas during emergency responses and protracted refugee operations. During 2009, the United Nations High Commissioner for Refugees (UNHCR) commenced implementation of a strategy that aims to achieve a reduction in anaemia and other micronutrient deficiencies / undernutrition, thereby enhancing growth, development and health in refugee populations across their global operations. The approach involves the use, amongst other interventions, of food supplementation products (FSP) including micronutrient powders (MNP) and lipid-based nutrient supplements (LNS).

Project activities were initiated in seven countries during 2009, together with the World Food Programme (WFP) and other partners, and will continue to expand to additional countries during 2011 and beyond. During the initial expansion phase of the project, UNHCR identified the urgent need to improve the assessment of micronutrient, acute, and chronic malnutrition, as well as the design of programmes for their control and reduction in both emergency and protracted situations. As many of the FSPs and home fortification approaches being adopted are still relatively new, there was also a need for additional technical guidance for setting up and maintaining intervention programmes, monitoring and evaluation (M&E) systems, and mainstreaming best practice. This Operational Guidance has been developed to meet this need and to help country staff deal with the challenges involved in designing programmes using new FSPs.

Development of the Operational Guidance

This Operational Guidance builds on already existing frameworks (e.g. WFP / Sight and Life 10 minutes to learn about nutrition programming, 2008) as well as standard selective feeding guidelines (UNHCR / WFP Selective Feeding Guidelines, 2009). Whilst these existing frameworks and guidelines provide useful guidance that is widely applicable, the Operational Guidance deals with a new set of FSP that are currently being used, or considered for use in UNHCR operations. It is aimed at UNHCR health and nutrition field staff and partners and its focus is on children aged 6-59 months but can easily be adapted to other age groups, including women and adolescent girls. The interventions described are not intended for use on their own, but to complement other nutrition and health programmes for this age group.

The Operational Guidance contains six stages covering the key components of planning, implementing, monitoring and evaluating FSP programmes that aim to reduce micronutrient deficiencies and malnutrition in refugee populations. These stages should ideally be conducted in chronological order, although some stages are inter-related and may overlap.