Nutrition programmes: Integrating Child protection

Nutrition-1

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: Child protection concerns are reflected in the assessment, design, monitoring and evaluation of nutrition programmes. Girls and boys of all ages and their caregivers, especially pregnant and breastfeeding women and girls, have access to safe, adequate and appropriate nutrition services (CPMS). 

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:

And additional guidelines and resources listed here


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