Nita Dalmiya POLICY SEMINAR Virtual Event - Micronutrients in emergencies: How can we prevent an increase in hidden hunger? Co-Organized by the Micronutrient Forum and IFPRI JUN 9, 2020 - 09:30 AM TO 10:45 AM EDT

1. Nita Dalmiya
Nutrition Specialist, Maternal Nutrition
UNICEF HQ, New York
SUPPLEMENTATION IN EMERGENCIES:
A strategy to prevent ‘hidden hunger’

2. UNICEF | for every child
OUTLINE
• Strategy to prevent ‘hidden hunger’ in
routine programmes.
• Global recommendations for
supplementation in emergencies.
• Guidance on protecting maternal and child
nutrition in the context of COVID-19.

3. Supplementation: a strategy to prevent ‘hidden hunger’
in routine programmes
• Integrated into routine programmes
• Meet additional micronutrient needs of
vulnerable populations
• Delivered through diverse systems/platforms

4. UNICEF | for every child
IndiaBangladesh
Routine supplementation impacted by COVID-19
response
• COVID-19 is disrupting nutrition services
• Indirect effects of COVID-19 on maternal and child mortality in LMIC (Roberton et al.)

5. Global recommendations to
prevent ‘hidden hunger’ in
emergencies
Preventive: Population-based to
meet micronutrient requirements
and prevent mortality.
Therapeutic: Targeted to treat
individuals and populations with
micronutrient deficiencies,
measles and diarrhea.

6. UNICEF | for every child
Supplementation in action in emergencies
High-dose vitamin A
supplementation
(children 6-59
months)
Bangladesh
(Rohinga camps,
Cox’s Bazaar)
Weekly iron and
folic acid
supplementation
(Adolescent girls)
Afghanistan
Multiple
micronutrient
supplementation for
(Pregnant women)
Syria
Vitamin C
supplementation
(Scurvy treatment)
Kenya
(Kakuma camp)

7. Global guidance: supplementation for children and
adolescents in COVID-19
Vitamin A and deworming for children 6-59 months :
• Context-specific service adaptations to maintain VAS
delivery with routine EPI.
• Mass campaigns temporarily suspended
• VAS to be integrated into disease outbreak efforts
• Plan for intensified, catch-up VAS distribution when
conditions allow.
Iron and folic acid and deworming for school-going
children/adolescents :
• Identify alternate mechanisms to provide services
• Integrate into strategy for safe school reopening

8. UNICEF | for every child
Maternal supplementation
in context of COVID-19
Multiple micronutrients, deworming and
calcium for pregnant women with
nutritional counseling:
• Maintaining ANC is essential with
context-specific service adaptations.
• Systems approach useful in planning
services.
• Pre-position supplies and
increase dispensed amount.
• E-learning, modify workflow,
redeploy staff.
• Task shift services, home visits,
SMS.
• Mobilize communities
• Measuring coverage and
micronutrient status.

9. Summary:
Supplementation is an essential approach to prevent ‘hidden
hunger’, negative pregnancy outcomes, and additional mortality
during COVID-19.
COVID-19 offers an opportunity to accelerate policy change,
introduce new interventions and simplify and innovate in
programme approaches.
Lessons learned from ongoing/previous emergencies can inform
the response.
A systems approach is important for planning service delivery (HR,
supplies, access, community mobilization)
Data for monitoring coverage, nutrition status and evidence
generation is imperative

10. Thank you!