COVID-19

The global COVID-19 pandemic is a challenge for everyone and affects nutrition programming globally. To support your nutrition programs, the GNC Technical Alliance is collecting and developing guidance and tools on an on-going basis.

COVID-19 Technical Support

To support adaptation to prepare for and mitigate the effects of the COVID-19 pandemic the GNC Technical Alliance is compiling, curating and presenting adaptations that are being rolled out in countries for Infant and Child Wasting, Infant and Young Child Feeding and Micronutrients, as well as Nutrition information Systems.

If you have good additional examples of adaptations please share them with us here so your experience can help others. You can also request specific support from GNC Technical Alliance here.

If you have particular questions or have experiences that you would like to share with your peers and global nutrition colleagues via an open discussion that others can feed into, please visit the en-net forum , we will also be compiling experiences and challenges shared on the forum for reflection in the collection

Guidance and Tools for programmatic adaptations

General 

GNC Technical Alliance, UNICEF and GNCGuidance on financial and in-kind contributions from the food and beverage industry in emergency context. The brief outlines some key considerations when working on nutrition in humanitarian contexts around accepting financial contributions or contributions in-kind from the food and beverage sector. Agencies who have not yet, but would like to endorse this guidance should contact the GNC Technical Alliance Coordination Team (Colleen_Emary@wvi.org)

Podcasts - Catch these GNC Technical Alliance Conversations with programmers on the impact of COVID-19 on nutrition programming. *new* Listen here for a discussion with UNICEF Supply Division on Adaptations made in light of COVID19. Learn about how COVID-19 is affecting the delivery of routine nutrition services in Jigwa State, Northern Nigeria.

United Nations Policy Brief: The Impact of COVID-19 on Food Security and Nutrition The policy brief calls for concerted action to avoid some of the worst impacts for food security and nutrition due to the COVID-19 crisis. 

WHO Estimating mortality from COVID-19, Scientific brief, 4 August 2020. This document is intended to help countries estimate case fatality ratio (CFR) and, if possible, infection fatality ratio (IFR), as appropriately and accurately as possible, while accounting for possible biases in their estimation.

WHO Water, sanitation, hygiene, and waste management for SARS-CoV-2, the virus that causes COVID-19 This document is an update to the interim guidance document entitled ‘Water, sanitation, hygiene, and waste management for the COVID-19 virus’, published on 23 March 2020. It is intended for water and sanitation practitioners and providers, and health-care providers who want to know more about WASH and waste risks and practices in relation to COVID-19.

WHO Community-based health care, including outreach and campaigns, in the context of the COVID-19 pandemic This joint WHO, UNICEF and IFRC guidance addresses the role of community-based health care in the pandemic context. It includes practical recommendations for decision makers to help keep communities and health workers safe, to sustain essential services at the community level, and to ensure an effective response to COVID-19. Using this comprehensive and coordinated approach will help countries strengthen the resilience of community-based health services throughout the pandemic, into early recovery and beyond.

GOAL Community Engagement in the Context of COVID 19The purpose of this SOP is to provide a decision-making framework for GOAL staff to decide which community engagement activities they can continue and what measures are required to undertake these engagements, balancing safety with the need to continue critical lifesaving and life sustaining programming. This SOP should inform the adjustment of ongoing and planned community engagements under current programming and the design of new community engagement activities for COVID-19 responses.

GOAL COMMUNITY-LED ACTION (CLA) FOR COVID-19 A RESOURCE GUIDE FOR COUNTRY OFFICES This Resource Guide was developed to support GOAL Country Office management to operationalise GOAL’s Community-Led Action (CLA) approach. CLA is GOAL’s community engagement approach that recognises that communities have the power to stop the spread of COVID-19 through their collective decisions and actions. This resource guide focuses on the operationalising of CLA within community level but please note that CLA can also be applied where there are groups of people who have a common purposes such as market ‘communities’. (See annex 1). The guide can also be used by other organisations as part of COVID-19 responses.

GOAL COMMUNITY-LED ACTION (CLA) FOR COVID-19 A FIELD MANUAL FOR COMMUNITY MOBILISERS This Field Manual was developed by GOAL for GOAL Community Mobilisers implementing the Community-Led Action (CLA) approach to reduce the spread of COVID-19 in their communities. It can also be used by other organisations who wish to implement the CLA approach as part of the COVID-19 pandemic response.

IMC Nutrition Programming: Adjusting to COVID-19 The guidance document outlines adaptations to global nutrition programming during the COVID-19 pandemic. The document summarizes key global recommendations made for community-based management of acute malnutrition (CMAM), infant and young-child feeding practices (IYCF), general food distribution (GFD), community mobilization and sensitization, and nutrition surveys and assessments. The document addresses only global guidance and not country-specific guidance. This is a working document that will be updated frequently.

Save the Children Guideline for remote support on nutrition during COVID 19 pandemic version 1.0 The purpose of this guide is to help nutrition advisors and managers to provide remote support for staff working at community/health facility level. It important to note that this guideline and the tools (annexes) are intended for use primarily in the humanitarian nutrition interventions.

World Vision's Growth Monitoring and Promotion guide during COVID-19 provides suggestions for decentralized Growth Monitoring and Promotion (GMP) activities in the context where mobility is restricted. A video on capacity building of decentralized GMP during COVID-19 is also available here.

Tech RRT Technical Rapid Response Team (Tech RRT) approach to technical assistance to nutrition emergencies during the COVID-19 pandemic Version 3.0:This document outlines how the Tech RRT will continue to provide technical support to nutrition emergencies in the COVID-19 context. This will enable requesting partners to know what they can expect from the Tech RRT support during the COVID-19 pandemic

ENN The en-net provides a place to submit questions surrounding the emergency response to COVID-19. Current threads include infant and young child feeding, breastfeeding, prevention and treatment of MAM,  and nutrition programming

Prevention and Management of Wasting

You can find here a collection of potential adaptations and related tools and resources according to different contextual scenarios/challenges.

UNICEF & WHO Prevention, Early Detection and Treatment of Wasting in Children 0-59 Months through National Health Systems in the Context of COVID-19, 2020. This document serves as a tool for implementing the recommendations reflected in existing WHO and UNICEF guidance on the delivery of services through national health systems for the prevention, early detection and treatment of child wasting in the context of COVID-19. This note reflects broad guidance for all levels of the health system, including community health services that offer prevention, early detection and treatment services for child wasting.

The GNC Technical Alliance Management of Child Wasting in the context of COVID-19 Brief No.1 (March 27th, 2020): This brief is meant to provide information specific to services and programmes for the management of child wasting in the context of COVID-19, and it contains information that is not already available elsewhere. This Brief does not cover wider mitigation and response measures available in other guidance. Arabic, Spanish and French versions are also available under the same link. Download English webinar slides and recordingDownload French webinar slides and recording. Download Spanish webinar slides and recording. Download Arabic slides

Podcast: Listen in to GNC Technical Alliance Conversations with programmers on the impact of COVID-19 on nutrition programming. Hear from programmers on the preparations for use of Family MUAC in Ethiopia and experience in using Family MUAC in a refugee context in Ethiopia

Wasting and COVID-19 Programme Adaptations Information Note 1 This information note has been prepared to outline potential options when RUTF and RUSF are unavailable.  

Wasting and COVID -9 Programme Adaptations Information Note 2 This information note recommends trial phone-based screening using recommended questions where standard screening processes or family/mothers’ MUAC is not possible. 

Wasting and COVID-19 Programme Adaptations Information Note 3 This information note outlines options in the case that provision of in-person monitoring or supervision by CHWs is not possible. 

Wasting and COVID-19 Programme Adaptations Information Note 4 This information note provides information about apps and tools available for remote training of CHWs in context where the responsibility for treating wasting was transferred to CHWs due to COVID-19. 

Wasting and COVID-19 Programme Adaptations Information Note 5 This information note outlines adaptations required to existing community-based MAMI programmes in the context of COVID-19.

Resource Lists of articles/tools that are referenced in the Wasting - COVID-19 related outputs of the Wasting GTWG:

Statement on management of at-risk mothers and infants under six months (MAMI) in the context of COVID-19 (August 2020) This statement was issued by members of the MAMI Special Interest Group in collaboration with the Wasting Thematic Working Group of the GNC Technical Alliance, in response to concerns related to COVID-19 and its potential impact on the wellbeing of infants under six months (u6m) and their caregivers

Adapting Community-based Management of Acute Malnutrition in the context of COVID-19 This guide is designed to assist Concern's health and nutrition staff responsible for the management and coordination of Community-based Management of Acute Malnutrition (CMAM) operations to adapt and modify programme modalities in the context of COVID-19. The guide attempts to provide practical steps based on the current international guidelines and recommendations to ensure essential treatment services for acute malnutrition continue as much as possible while minimising the risk of COVID-19 transmission. Download French version. 

IRC/UNICEF Toolkit for CHW Community-based Treatment of Uncomplicated Wasting for Children 6-59 months in the Context of COVID-19. This document aims to provide an implementation protocol and simplified toolkit to assist implementers in providing treatment for uncomplicated wasting through community health workers (CHWs) in the context of COVID-19, based on current global recommendations. The simplified toolkit can be found here and is provides simplified CHW registers, job aids and Training videos in several languages.

Simplified Protocol for Acute Malnutrition Updated simplified protocol 2-pager A simplified, combined protocol is intended to simplify and unify the treatment of uncomplicated severe and moderate acute malnutrition for children ages 6-59 months into one protocol in order to improve the coverage, quality, continuity of care and cost-effectiveness of acute malnutrition treatment in resource-constrained settings.

The State of Acute Malnutrition The Family MUAC Approach also known as MUAC for mothers or Mother-MUAC, trains mothers and other caregivers to identify early signs of malnutrition in their children using a simple to use Mid-Upper Arm Circumference (MUAC) tape. By moving this task to mothers (or other family members), who are able to do it as effectively as Community Health Workers (CHWs), the cases are detected earlier, leading to less hospitalisations. Some countries have adopted this approach during the context of COVID-19.

IASC Interim Recommendations for Adjusting Food Distribution Standard Operating Procedures in the Context of the COVID-19 Outbreak – developed by World Food Programme (WFP).  Version 2 (March 2020)  Interim Guidance for field coordinators, site managers and public health personnel, as well as national and local governments and the wider humanitarian community working at food distribution sites, who are involved in the decision making and implementation of multi-sectorial COVID-19 outbreak readiness and response activities.

Interim Guidance on Mitigating the Effects of the COVID-19 Pandemic on Food and Nutrition of Schoolchildren. This is joint guidance from FAO, UNICEF and WFP to guide countries on how to maintain the continuity of school nutrition programmes, including school feeding in the context of the COVID-19 pandemic.

United Nations System Standing Committee on Nutrition (UNSCN). Resource List on Food Systems and Nutrition Responses. Provides links to UN agencies’ responses, food systems, IYCF, school aged children, adults, emergency nutrition responses and articles of interest.

WHO Key planning recommendations for mass gatherings in the context of the current COVID-19 outbreak (Interim Guidance – Published 19 March 2020) For consideration for nutrition programmes conducting mass gatherings (e.g. during distributions organised by supplementary feeding programmes).

WHO Reducing excess mortality from common illnesses during an influenza pandemic (2008) Guideline which provides strategies for prevention and treatment, at the community and household levels, of the most likely contributors to mortality from common illnesses during an influenza pandemic and recommendations to support a minimum level of continuity for priority public health programmes during a pandemic. Covers acute malnutrition programmes (p. 24).

WHO IPC during health care when COVID-19 infection is suspected (Published 19 March 2020) Includes standard precautions for facilities to take with all patients (e.g. those attending health and nutrition facilities for treatment of malnutrition) 

WHO Advice on the use of masks in the community, during home care and in healthcare settings in the context of the COVID-19 outbreak. (19 March 2020) Rapid guidance for public health and IPC professionals, HCWs and community health workers on use of medical masks. Also see COVID-19: Contact and Droplet Precautions - Personal Protective Equipment (PPE) 

WHO Resource Page on COVID-19 Occupational Health (Multiple Resources)  Includes guidance rights, roles and responsibilities of health workers, health workers exposure risk assessment and management, rational use of PPE and a risk communication package.

Nutrition for Infants & Young Children – IYCF & Micronutrients

You can find here a collection of potential adaptations and related tools and resources according to different contextual scenarios/challenges.

GNC Technical Alliance Infant & Young Child Feeding in the context of COVID-19 Brief No. 2 (v1) (March 30th, 2020) This brief is meant to provide information specific to infant and young child feeding (IYCF) in the context of COVID-19. This Brief does not cover wider mitigation and response measures available in other guidance. Arabic, French, Spanish and Russian versions are also available under the same link. Download Arabic webinar slides and recording. Download English slides and recording. Download French webinar slides and recording. Download Spanish webinar slides and recording

GNC Technical Alliance Maternal Diets and Nutrition Services and Practices in the Context of COVID-19 This brief provides recommendations to support the nutritional needs of women in the context of partial or full population mobility restrictions, to be implemented in line with national guidelines. The brief is available in English, French, Arabic and Spanish languages.

Save the Children/TechRRT IYCF Programming in the Context of COVID-19: Considerations for Adaptions This IYCF/IYCF-E program adaptation tool will assist in determining scale up/scale down of IYCF/IYCF-E activities in response to COVID-19, at national or sub-national levels.

WHO Breastfeeding and COVID-19 - Scientific Brief (June 23rd, 2020) This scientific brief examines the evidence to date on the risks of transmission of COVID-19 from an infected mother to her baby through breastfeeding as well as evidence on the risks to child health from not breastfeeding.

GNC This Template for Joint Statement on Infant and Young Child Feeding in the Context of Covid (April 2 2020) includes a consolidation of available recommendations related to IYCF in the context of Covid-19. It is to be adapted by countries or nutrition clusters and to be issued at the national level. It was developed by the IFE Core Group. It is available in English, French and Arabic. 

COVID-19, Maternal, and Child Health, Nutrition – what does the science tell us? is compiled by the Johns Hopkins Center for Humanitarian Health and provides an overview of what peer-reviewed journal articles currently state on COVID-19, maternal and child health (including infants), and nutrition. As the pandemic is ongoing more and more research results are published. The service aims to provide the user with a snapshot of what is published with updates every few days.

UNICEF and USAID-funded Advancing Nutrition have developed a package of Infant and Young Child Feeding Recommendations when COVID-19 is Suspected or Confirmed. Developed with technical support by the Infant Feeding in Emergencies Core Group, represented by Save the Children and Safely Fed Canada – the Counseling Package includes a set of 10 Counselling Cards and Recommended Practices Booklet.  

Save the Children IYCF Tools in the Context of COVID-19 These resources provide an overview of the latest global evidence-based recommendations related to IYCF and COVID-19. Documents here outline suggestions and reflections around communication about breastfeeding with health care providers and caregivers and programming adaptation in the context of COVID-19. This is an effort to support implementing partners on how to prepare and respond to the pandemic with information specific to IYCF-E.

WHO FREQUENTLY ASKED QUESTIONS: Breastfeeding and COVID-19 for health care workers This FAQ complements the WHO interim guidance: Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected (13 March 2020) and provides responses to questions that have arisen about the recommendations. The FAQ also draws on other WHO recommendations on Infant and Young Child Feeding and the Interagency Working Group Operational Guidance on Infant and Young Child Feeding in Emergencies. A decision tree shows how these recommendations may be implemented by health workers in maternity services and community settings, as part of daily work with mothers and families.

WHO Clinical management of severe acute respiratory infection when COVID-19 infection is suspected (13 March 2020). Guidance for clinicians caring for hospitalised adult and paediatric patients. Section 13 contains comprehensive breastfeeding and some artificial feeding guidance.

Academy of Breastfeeding Medicine Statement on COVID-19. (10 March 2020)

International Lactation Consultants Association (ILCA) Statement on Breastfeeding and Lactation Support during the COVID-19 Pandemic. (18 March 2020)  

Royal College of Obstetricians and Gynaecologists (RCOG) COVID-19 Infection in Pregnancy. Information for healthcare professionals. Version 4.1 (Updated 26 March 2020)  Resource for United Kingdom HCWs. Includes advice to share with pregnant women and advice for services caring for women with or recovering from COVID-19. Section 4.9.2 (p. 31) on infant feeding covers shared decision making and precautions caregivers with suspected or confirmed COVID-19 infection should take to prevent transmission when feeding their infant (covers both breastfeeding and formula feeding).

UNICEF COVID-19: What Parents Should Know. (Accessed 26 March 2020) General information for parents, including precautions families can take to avoid infection and guidance for symptomatic women who are breastfeeding, including recommended precautions to prevent transmission to an infant.  

Safely Fed Canada Compilation of COVID-19 resources and statements related to breastfeeding: Includes also COVID19 Infant Feeding Resources for Parents and Caregivers and Statement on skin-to-skin

UNFPA Statement on COVID-19 and pregnancy (Published 5 March 2020) Synthesis of evidence on risks for pregnant women as well as preventive measures and supportive therapies recommended. Includes guidance for symptomatic women who are breastfeeding, including recommended precautions to prevent transmission to their infant.

WFP COVID-19 and Breastfeeding. Version 2 (12 March 2020). Interim guidance.

WHO Home care for patients with suspected COVID-19 infection presenting with mild symptoms and management of contacts. (Published 17 March 2020) Guidance for public health professions and HCWs on issues related to home care for patients with suspected COVID-19 presenting with mild symptoms. See footnote on p. 2 for breastfeeding guidance.

WHO Five keys to safer food. Poster – applicable to preparation of complementary foods. Available in French and Arabic.

WHO Q&A on COVID-19, pregnancy, childbirth and breastfeeding 

WHO IYCF and COVID19 infographics  

UNICEF The use of Multiple Micronutrient Supplementation (MMS) for Maternal Nutrition and Birth Outcomes during the COVID-19 pandemic

GAVA Consensus Statement on Universal Vitamin A Supplementation for Preschool-Aged Children in the Context of COVID-19. This statement provides interim guidance on delivery of VAS through mass campaigns and routine health and nutrition services during this public health crisis. The consensus statement is also available in French

GAVA Operational guide on how to safely administer vitamin A supplements during the COVID-19 pandemic. The guide provides practical guidance to countries on the adaptations recommended to safely administer VAS to preschool-aged children and maintain the continuity of VAS services during the COVID-19 pandemic. The guide is also available in French.

 

Nutrition Information Systems

You can find here a collection of potential adaptations and related tools and resources according to different contextual scenarios/challenges.

GNC Technical Alliance Nutrition Information Management, Surveillance and Monitoring in the context of COVID-19 Brief No 1 This brief is meant to provide broad recommendations specific to nutrition information management, surveillance and monitoring in the context of COVID-19. The brief is available in four languages (English, French, Arabic, Spanish) under the same link.

GNC Technical Alliance Nutrition Information Management, Surveillance and Monitoring in the context of COVID-19 Brief No. 2 Building of recommendations from brief#1, this brief #2 provides priority actions and recommendations for undertaking nutrition situation analysis and estimating its magnitude, monitoring impacts of COVID-19 including a proposed list of indicators, and alternative ways of data collection.

SMART Interim Guidance on Restarting Population Level Surveys and Household Level Data Collection in Humanitarian Situations during COVID-19 Pandemic This interim guidance outlines considerations for when and how to resume data collection in the context of the evolving global pandemic. Development of this guidance was led by ACF-Canada and CDC, with review by the GNC Technical Alliance NIS Working Group.

IPC Guidance on how to build assumptions for IPC AMN projections in the context of COVID-19 pandemic - Version 1 This document intends to provide guidance to country IPC Technical Working Groups and/or Nutrition Clusters/Sectors on developing assumptions for IPC Acute Malnutrition projections in the context of COVID-19 pandemic. 

IPC The IPC in the context of COVID-19 This page describes and answers what IPC is doing during the current context of travel restrictions and containment; How does the IPC virtual analysis process work? Can IPC trainings also be conducted virtually?; What are the evidence requirements for IPC analyses in the context of COVID-19?;  How to develop scenarios and project food security and nutrition situations in the context of COVID-19; and Can the IPC assist in providing information on the food security situation of the most vulnerable populations in urban settings? 

ACF Nutrition Information Systems review with a particular emphasis on innovations in nutrition information systems that support collection, analysis and dissemination of nutrition data. As nutrition assessments will prove to be challenging in the coming months, we hope that this document will spark some ideas and discussions on creative adaptations to the current way we monitor nutrition situations.
 

OCHA IM Toolbox on COVID-19 This page will provide links to IM reference material, guidance, standards, templates, and examples of products and services related to COVID-19 preparedness and response activities. It is intended for OCHA IMOs but other humanitarians may find helpful resources.

Highlighted Resources