March 15, 2023 — In response to UNICEF’s latest report “Undernourished and Overlooked: A global nutrition crisis in adolescent girls and women,” IRC has issued the following statement reaffirming its commitment to and call for greater investment in adolescent and maternal nutrition in humanitarian settings:
“The global hunger crisis is driving dramatic increases in malnutrition with catastrophic consequences for adolescent girls, pregnant and lactating women, and young children. The IRC welcomes UNICEF’s new report, Undernourished and Overlooked, which illustrates how adolescents and pregnant and lactating women have been left behind in nutrition programming. This timely report underscores the importance of investing in solutions that can break the cycle of malnutrition.
The IRC recommends four concrete actions for humanitarian and fragile contexts, drawn from our experience implementing nutrition, reproductive, and maternal health programs:
- Include adolescents in national nutrition assessments. A first step in improving adolescent nutrition is to clarify the scope of the problem and create a mechanism for tracking progress. National nutrition surveys rarely capture data on adolescents. Collecting a few key data points on this overlooked population would add minimal time and cost to routine surveys (such as SMART and DHS) while providing critical information to planners and practitioners.
- Engage adolescents in program design. Adolescents have limited contact with and trust in the formal health system in resource limited settings. To better reach them, implementers should engage adolescents in the design of nutrition programming intended to serve them. Evidence from IRC’s sexual and reproductive health and rights programs shows that working directly with adolescents to identify needs and barriers, and design interventions can increase adolescents’ healthcare access and build trust. Participatory action research and user-centered design are two IRC employed strategies that have proven effective in engaging adolescents with positive outcomes. For example, in Uganda and South Sudan, a user-centered design exercise produced five principles to increase adolescents’ access to services, including offering confidential services by one provider in one location, increasing access to clear and accurate information, and ensuring that adolescents are served by a provider with the gender of their choice, resulting in a 17% and 16% increase in adolescent patients, respectively.
- Deliver maternal care at community level. Most women in fragile settings have no access to formal health facilities.Evidence from more stable settings demonstrate that community-based care can reduce maternal deaths by 20% and newborn deaths by 25% yet this model is rarely utilized in humanitarian and fragile contexts where access to facilities remain low and mortality high. IRC is studying optimal service packages and delivery approaches for community-based maternal and newborn care in Somalia and South Sudan via the IRC led EQUAL research consortium.
- Provide integrated services in the first 1,000 days of life to improve maternal and child nutrition. In line with the WHO’s and UNICEF’s Nurturing Care Framework, IRC is providing combined health and nutrition support, in addition to increasing knowledge on responsive caregiving and early learning, to mothers and their children. In Bangladesh, the IRC delivered behaviorally informed messages to promote healthy development for pregnant mothers and their infants. Feedback from caregivers demonstrated the intervention's ability to close knowledge gaps and promote responsive caregiving behaviors, leading to improved infant nutrition. We’ve also seen success providing nutrition counseling, malnutrition screenings, and management for pregnant and lactating women attending antenatal services together, at outreach sites and mobile clinics. In Kenya, clients expressed satisfaction with being able to receive all services in one location and providers said they’ve seen improvement in maternal and newborn health, especially during periods of persistent drought that force families to seek pastures away from static facilities."
If you are interested in learning more about IRC’s ongoing work in this area, we will be co-hosting a concurrent session with IAWG entitled: Success Depends on Collaboration: investigating linkages across nutrition and maternal and newborn health in humanitarian and fragile settings at the upcoming International Maternal Newborn Health Conference in Cape Town in May.