children in emergencies toolkit

Children are particularly vulnerable to all forms of under-nutrition in times of instability and crisis. The first 1000 days are critical for child development and it is important to make sure that children’s growth is not compromised. 

Standard: Children and their caregivers, especially pregnant and lactating women and girls, have access to safe, adequate and appropriate nutrition services (CPMS, 2019). 

⇒Download a printable risk assessment summarising the guidelines below

Integrate

• Include child protection messages as part of nutrition and community outreach activities
• Combine nutrition programmes with child protection programmes, such as positive parenting programmes or child friendly spaces
• Work with child protection actors to share case management and monitoring of appropriate care
• Consider including specialised gender-based violence and child protection caseworkers as part of nutrition staff 

Keep children safe and avoid causing harm

Understand the context

• Identify groups that have the greatest need for nutritional support, based on prevalence rates of acute malnutrition, and infant and young child feeding practices

Reduce risks of harm within projects

• Ensure that children are not left at home unattended while caregivers or siblings attend nutrition appointments
• Ensure that treatment programmes avoid family separation and take into account the impact on siblings
• Ensure that those working in nutrition have signed up to and been trained in a code of conduct and are fully briefed on child protection concerns
• Know appropriate ways to handle children – e.g. allowing parents themselves to place the child into the hanging weighing scales
• Enable all caregivers of severely malnourished children to feed and care for their children during treatment

Reduce risk of exacerbating existing protection risks 

• Ensure that nutrition interventions do not incentivise family separation, e.g. by delivery of disproportionate benefits to children in residential care
• Ensure that services do not lead to stigma or perceptions of ‘favouritism’ within or between communities

Ensure children’s access to assistance 

• All supplementary or feeding and nutrition programmes for children should use foods rich in or fortified with vitamin A
• Provide clear information on the importance of exclusive breastfeeding in children up to six months, and continued breastfeeding up to 24 months
• Mothers who are having difficulties in breastfeeding should receive counselling and support to help them continue, or to find appropriate alternatives
• Promote improved quality of food given to children aged 6-24 months, such as fortified-blended foods, micronutrient powders or lipid-based nutrient supplements as well as other nutrient-rich diets in general

Make sure the most at-risk children are accessing services

• Develop proactive strategies to ensure access to nutrition services for specific groups of excluded children:
  • children on the street
  • children with disabilities
  • children living in institutions
  • child-headed households
  • unaccompanied and separated children
• Pay particular attention to especially vulnerable infants and young children:
  • low birth-weight infants
  • infants and children of depressed mothers
  • children under two years not breastfeeding
  • those from populations with medium or high HIV prevalence
  • children with feeding difficulties
  • infants and young children with acute malnutrition, stunting or micronutrient deficiencies
• Regularly monitor default rates and failure to respond to treatment

Adapt programming to remove barriers to access

• Make sure there are adequate numbers of female staff and nutritional promoters
• Take local privacy norms into account e.g. by providing private spaces for screening of malnourished children
• Ensure that nutrition staff know how to provide psychosocial stimulation for infants and young children

Include feedback and participation

• Work with community stakeholders to identify vulnerable individuals and households
• Set up support groups such as mother-to-mother groups
• Establish clear feedback mechanisms and respond quickly to any concerns

Respond effectively and appropriately to incidents of abuse

• Nutrition staff should know how to identify and refer suspected cases of violence, abuse or exploitation, and how to detect signs within nutrition activities
• Create a child protection focal point within the nutrition programme to raise awareness and receive complaints/reports, as well as registering separated children

Strengthen systems and help children to claim their rights

• Staff should be able to signpost other services, including legal services to respond to incidents of abuse, if required
• Staff should know how to identify parents and caregivers who might be under psychosocial distress and need support

Monitor and evaluate

Check that nutrition programmes are reaching the most at-risk children by collecting data disaggregated by age, gender and specific community, and by gathering feedback.

Sample objectives and indicators:

• % of nutrition projects where child safety and wellbeing, including family unity, are reflected in design, monitoring and evaluation
• % of nutritional feeding centres for which referral pathways for child protection cases exist and are used
• % of supplementary or therapeutic feeding centres with a trained child protection focal point

Key references, standards and guidelines

These guidelines are based on:

•  Minimum Standards for Child Protection in Humanitarian Action Standard 25: Nutrition and Child Protection
• Humanitarian Charter & Minimum Standards in Humanitarian Response (SPHERE)

And additional guidelines and resources listed here