Editorial
Dear readers
Since its inception over ten years ago, the Global Nutrition Cluster (GNC) has progressed from its early focus on the development of technical tools and materials and filling research gaps to a much greater emphasis on strengthening country coordination and providing surge support to secure appropriate and high-quality nutrition programming in emergency contexts.
As well as the changes evident at country level, the GNC has very strong strategic partnerships with its members. Referred to as the GNC Collective, members are guided by the GNC Standard Operating Procedures and a small elected group serve as representatives on the GNC Strategic Advisory Group (SAG), which helps guide priorities and positioning of the GNC within the wider architecture. Today the GNC has 44 partners (including ten observers) contributing their time and efforts, often freely.
Without them, the Cluster would not be able to achieve the progress evident today.
The ambitious GNC Strategy (2016-2020), summarised in this issue of Field Exchange, and the related work plan guide the work of the Collective. Indeed, a review of the previous GNC strategy concluded that strong partnership was most evident where partners led aspects of the work plan in line with their respective strengths and skillsets. Maintaining and growing this commitment is always a challenge, however, as much of the work of the Collective relies on the continued goodwill of the individuals representing their agencies and organisations – with an uneven distribution of the workload that is perhaps inevitable.
When an emergency is declared, several immediate steps are taken by the GNC. First, there is the deployment of the stand-by surge capacity, either for coordination or for technical support or both, depending on context. Two valuable rapid response mechanisms have been developed to meet need: Rapid Response Teams (RRTs) that provide coordination and information management ‘surge’ support and an interagency Nutrition Technical Rapid Response Team (Tech RRT), funded by the Office of US Foreign Disaster Assistance (OFDA) (see article by Andi Kendle in this issue), that provides rapid, flexible, nutrition technical expertise.
Both are vital cogs in the Nutrition Cluster wheel as they provide immediate support for national coordination and the design of technical programmes and they help strengthen national capacities. Surge is a support, not a substitute, for longer-term Nutrition Cluster Coordinators (NCCs) and Information Management Officers (IMOs) – a vital partnership in coordinating the 4Ws (Who, What, When, Where) – and an incredible resource at the heart of the Nutrition Cluster. In addition to these key on-the-ground personnel, the GNC manages and staffs a 24-hour helpdesk, which provides country teams with immediate support; be it in soft skills (coordination, advocacy, etc) or in technical resources (survey design, access to global or normative guidance, etc).
The GNC also has key overarching documents which guide its focus and work. These include an Advocacy Framework and tool kit, a Framework for Accountability to Affected Populations (AAP), a Framework for fostering linkages with the Scaling Up Nutrition (SUN)
Movement in fragile and conflict-affected states (FCAS) and an emerging inter-cluster collaboration with the Food Security Cluster (see news item in this issue of Field Exchange). Together, these are all steps in the right direction in terms of better linkages with global initiatives and other clusters.
The AAP has built on and more formally recognised the work done over the past ten years, which is to ensure that affected populations are consulted and that they participate throughout the response, so they are not passive recipients of aid but active stakeholders in the shape and design of programmes. We see AAP in action in Somalia, where the Nutrition Cluster has led development and adoption of an AAP Framework and where pooled funding is now contingent on minimum AAP implementation, and in South Sudan, where partnership and accountability cut across all cluster activities and are crucial to programme quality.
GNC work is enabled by constant developments in information management, which has involved toolkits to help standardise the use of information across the Nutrition Cluster – although how information is managed between clusters is an ongoing challenge. Knowledge Management (KM) is another cross-cutting activity and crucial to the GNC in order to capture what is working well and identify where change is needed. The body of work reflected in this issue has involved considerable support by ENN to help NCCs unpack, dig into and document their wealth of insights and experience through 2016 and 2017. The engagement of NCCs in this process in the face of huge operational demands, and the quality and number of articles in this special issue of Field Exchange, are testament to the desire by NCCs, IMOs and RRTs to share their learning.
Despite all these achievements, the GNC faces a number of challenges and opportunities as it looks towards the next decade of emergency coordination and response in a rapidly changing global architecture.
It is apparent that there is a limited understanding among donors and other actors of the impact the Cluster is having, as evidenced by the gradual decline we are seeing in thefinancing of the GNC work plan (see below).
There is now an urgent need to better showcase the vital work going on in countries, particularly as we are facing an unprecedented number of emergencies that are often chronic in nature and span years. We share experiences from Somalia, South Sudan, Ethiopia and Syria in this issue; all have featured in our pages many times before.
Added to this, we are witnessing a profound deterioration in the nutrition status of populations in FCAS contexts which, if left unchecked, will prevent the realisation of important global targets for reductions in malnutrition. The application of cluster coordination performance monitoring (CCPM), rolled out in several countries, captures some of the impact story but this, too, needs to be better documented and more widely shared. There is also a need to develop and ensure more robust monitoring and evaluation.
While the GNC has an ambitious strategy, to realise it we need to ramp up strategiclevel engagement with the other clusters (Water, sanitation and hygiene (WASH), Health,
Food Security/Cash, etc), development actors,
UNICEF as Cluster Lead Agency (CLA) and donors, as well as with local actors and governments.
Central to this is a need to focus on preparedness, contingency planning, the humanitarian-development nexus and support for workable models of coordination, with greater support for strategic decision making in ‘forgotten’ and complex crises.
Many of these elements are touched on in the articles in this issue. In Ethiopia and Nigeria,
NCCs describe alignment with and capacitating existing government sector coordination mechanisms; preparedness, contingency planning and longer-term ‘development’ goals are a priority in the Turkey cluster-led, cross-border response in Syria; while strategic planning has been taken to a whole new level through the Whole of Syria (WoS) coordination mechanism established in Jordan that constitutes one comprehensive framework, a common response plan and a supporting coordination structure across three operational hubs (Turkey, Syria and Jordan).
We also need the CLA to take a greater leadership role in technical support for the Nutrition Cluster and implementation of the structures for technical leadership, with broadbased engagement from GNC partners. By doing so, it will enable the GNC to focus on the wider strategic engagement needed to deliver on the recent global pledges and targets as set out in the Grand Bargain, the New Ways of Working, the Sustainable Development Goals,
World Health Assembly targets and other initiatives which call for much greater linking of humanitarian and development efforts and for greater localisation.
In this special issue of Field Exchange, the 18 articles by NCCs, IMOs and RRT staff aim to share the work of the Nutrition Cluster across widely varying and challenging contexts. These articles provide frank, open and honest accounts of their achievements as well as the critical barriers that need to be addressed and overcome through actions taken by the GNC, the CLA and all those concerned with protecting the nutrition status of populations living in emergency contexts. This is KM in action: it delves deep into country experiences, it examines context-specific experiences and it helps the GNC to see what we are doing well, what we need to do better and what we need to do differently. The following highlights some of the common themes from these articles.
Firstly, are we focused on the right nutrition problems? Looking at the history of the GNC, the default nutrition problem we have focused on is the treatment of acute malnutrition. This is highly appropriate in contexts where prevalence of global acute malnutrition (GAM) has increased or is in danger of increasing, such as in the famine-risk countries of Somalia, Yemen,
South Sudan and Nigeria highlighted in this issue, but what about other high-impact interventions, and what do we do when faced with populations with low levels of acute malnutrition but high levels of anaemia, stunting, non-communicable disease, low prevalence of breastfeeding and sub-optimal infant and young child feeding (IYCF) practices in general? Over the many decades of emergency response, our default has been to treat acute malnutrition (we call this “the GAM ghetto”). The narrative hasn’t changed, yet the contexts in which emergencies are taking place has and the nutrition problems that populations present with are as diverse as the contexts they live in. We have been unwittingly shooting ourselves in the foot by not having changed the narrative to ensure the coordination and delivery of a package of highimpact, nutrition-specific interventions.
The experiences shared in this issue show some progress. For example, stunting and IYCF feature strongly in the three-year strategy of the Turkey Nutrition Cluster, but what are considered ‘life-saving’ interventions dominate. In order to effect change in our story, we need different partnerships at global and local levels to have the capacity to deliver and, in turn, a reorientation of staff at various levels. Changing the narrative is one step, but how we advocate to donors to fund more comprehensive packages of nutrition interventions while ensuring the partner skillset needed to scale up these interventions is a work in progress.
A recent look at 20 humanitarian response plans over a two-year period showed that, in all contexts, treatment of acute malnutrition is systematically included – unlike the rest of the high-impact nutrition interventions. NCCs describe significant barriers with donors and with government, such as in Turkey and Syria, to accommodating a more holistic approach to nutrition in emergencies (NiE), with any progress eventually achieved being through determined cluster advocacy. Getting ourselves out of the GAM ghetto is going to be a signifi-cant challenge.