|Reaching Mothers and Children at Critical Times of their Lives (WFP)|
|POLICY ISSUES AND OPERATIONAL CHALLENGES|
45. When an emergency strikes, expectant and nursing mothers and small children are at greater risk than others of malnutrition and mortality. Food relief in emergency situations is usually managed at two levels: general distribution (per capita ration for the whole population) and selective feeding (specific foods targeted to specific groups of malnourished individuals). In order to examine the appropriate balance between general distribution and supplementary feeding, it is useful to distinguish three phases in relief situations: the acute emergency phase, the intermediate phase and the longer-term rehabilitation phase.
46. In the acute emergency phase, i.e., during the first weeks after the arrival of refugees or displaced people in reception areas, there is often a need to complement the distribution of general rations with supplementary feeding of children under five and expectant and nursing mothers. Screening new arrivals to determine their food needs is crucial to reduce the risk of mortality and long-term damage related to malnutrition. Existing MCH services can play an important role in the planning and organization of selective feeding programmes. MCH centres have also been used to provide supplementary food rations for malnourished children in natural disasters.
47. In the intermediate phase of a relief operation, i.e., after appropriate feeding and health arrangements have been put in place, the general food ration is normally adequate to prevent any malnutrition problem. Supplementary food assistance is limited to short-term, curative interventions where pre-existing nutrition and/or specific health problems (epidemics, diarrhoea) lead to malnutrition in some children and mothers. Monitoring of nutritional status is nevertheless important during this phase. Where operational problems such as a break in the food pipeline or the lack of adequate donor support force aid agencies to prioritize and limit the distribution of available commodities, MCH structures will help to reach the neediest.
48. Relief operations often take place in remote, food insecure areas of very poor countries and require relatively large financial, technical and administrative resources. In managing these (temporarily) available funds and capacities there can be opportunities to also promote longer-term development in these areas. In particular, health/MCH facilities can benefit from rehabilitation measures and training of staff. WFP and its United Nations and NGO partners should pay more attention to the scope for creating lasting benefits in relief. For WFP this may require flexibility to use a small share of relief resources for supporting MCH facilities that benefit the local population (both immediately and in the longer term) as well as those acutely affected by emergencies.
49. During the rehabilitation phase, food assistance is progressively phased out. In this situation WFP sometimes provides food assistance through MCH centres, thereby creating a "safety net" for vulnerable women and children. MCH centres can play a strategic role in checking early malnutrition during phase-down/phase-out of general food rations in relief operations. Growth monitoring through MCH centres can also serve as an "early warning system", indicating when it is the time to switch (back) to other methods of ensuring minimum food security.