Sectoral impact:
The already fragile nutrition situation of infants, young children, and pregnant and breastfeeding women is under threat due to pre-existing shocks. These include constrained access to nutritious and diverse diets, suboptimal feeding and care practices among children, adolescents and women, increased incidence of diarrhoea and vaccine preventable diseases, and inadequate access to health care services across Syria.
Most women in the newly displaced and temporary shelters are facing significant breastfeeding and child feeding difficulties, including lack of shelter, poor hygiene and sanitation. Additionally, the random distribution of baby milk substitute exposes children to the risk of diarrhoea and malnutrition, which could be fatal.
Many health and nutrition facilities in Idleb, Manbij, northern Aleppo, coastal regions, Deir-ez-zor and Al-Hasakeh remain suspended or closed for security reasons. Some of these facilities were severely damaged by shelling in recent months and most have run out of funding. This impacts the availability of nutrition services for host communities and IDPs in the region. Nutrition commodities for prevention of malnutrition and treatment for wasted pregnant and lactating women (PLW) remains constrained. Many cases are currently being referred, but not all are able to receive the treatment or preventative support needed, due to many nutrition partners lacking supplies.
Warehouses belonging to the United Nations Children's Fund (UNICEF), WFP and the Syrian Arab Red Crescent have recently been looted in Damascus, Lattakia, and Tartous. In addition, the high transportation costs within the governorates hinder access to the service, imposing a significant burden on both nutrition/health providers and beneficiaries who are already impoverished.
Immediate needs:
- Maintain and expand the delivery of life-saving preventative and curative nutrition interventions for conflict-affected and displaced populations, targeting children under 5, pregnant and lactating women and adolescent girls.
- Prevent micronutrient deficiencies and boost the immunity of children, women and adolescent girls through the provision of multiple micronutrient powders for 346,162 children 6-59 months; Vitamin A supplementation for children 6-59 months; micronutrients including iron folate for 247,504 PLWs and 215,607 adolescent girls; and deworming for 58,480 children 12-59 months.
- Prevent malnutrition through counselling on infant and young child feeding (IYCF) to 325,796 PLWs and caregivers in the 1,000 days window (between conception and a child’s second birthday), including support for mother and child safe spaces across the emergency response and in underserved areas.
- Prevent malnutrition in the 1,000 days window (from conception to a child’s second birthday) by providing skilled support to 325,796 pregnant women and primary caregivers of children aged 0-23 months to adopt recommended IYCF practices, including both breastfeeding and complementary feeding.
- Provide cash for nutrition vouchers to 52,642 PLWs/caretakers of children under 2 years and provide lipid nutrient supplement paste-small quantity blanket supplementary feeding programme (BSFP) for 73,700 children 6-23 months to support dietary diversity and prevent malnutrition.
- Provide treatment for children 0-59 months with severe acute malnutrition (SAM) through outpatient therapeutic programmes for 13,585 SAM children without complications, and through inpatient nutrition sites for 1,295 SAM children with complications.
- Manage moderate acute malnutrition (MAM) for 50,467 children 6-59 months without medical complications and 30,549 PLWs with MAM through a targeted supplementary feeding programme.
- Strengthen referrals and linkages between nutrition and other sector services including health/FSA/WASH/protection/education to strengthen prevention of malnutrition, and relapse for cases that have recovered.
Priority activities:
The response will be guided by the nutrition sector’s existing minimum service package, which covers both preventative and curative nutrition services, delivered through community and primary health care centres. The following activities will be prioritized:
- Scale up implementation of agreed nutrition sector integration package including nutrition specific treatment services across all PHC centres. Nutrition partners to ensure availability of all required nutrition commodities at “point of care” including stabilization centres and primary health care centres.
- Establishing and running a rapid response team to provide preventative and curative nutrition services (only in underserved and newly opened areas, where access to primary health care facilities may be limited).
- Implementing preventative activities, including screening for malnutrition; provision of micronutrients supplementation and deworming; provision of maternal, infant, young child and adolescent nutrition (MIYCN) counselling; monitoring and reporting of the code of breast milk substitute marketing across all governorates.
- Providing cash for nutrition vouchers and BSFP for mothers and children in the 1,000 days window to support dietary diversity and prevent malnutrition.
- Screening of children and mothers for early detection and management of children and PLWs with acute malnutrition.
- Implementing curative activities, including early detection and treatment of acute malnutrition for children 0-59 months (with and without medical complications) and PLWs.
- In collaboration with WASH partners, nutrition sector partners to ensure provision of WASH hygiene kits to caregivers of all malnourished children to ensure a safe hygiene environment is available at community and household-levels in order to prevent any relapse post-treatment.
- Generating evidence (SMART plus surveys, mid-upper arm circumference assessments, MIYCN assessments, etc.) to inform the nutrition response.
Response strategy:
The nutrition response will sustain preventative and curative services across severity 3 and 4 subdistricts in all governorates, along with prioritizing gaps arising from recent displacements. Efforts will target all who need nutrition services, including marginalized communities, PWD, internally displaced, and vulnerable residents without discrimination, while emphasizing the centrality of protection. Partners will maintain accountability, adhere to PSEA guidelines, and ensure zero tolerance for sexual exploitation and abuse while ensuring actionable measures and reporting mechanisms to guarantee accountable, high-quality, and inclusive programming, with specific attention to AAP, PSEA, gender, and protection.