GOAL-developed COVID-19 infant nutrition guidelines in operation at Ethiopia’s refugee camps

After recently establishing COVID-19 nutrition guidelines for its innovative infant nutrition programme, the ‘Management of At-Risk Mothers and Infants’ (MAMI), GOAL’s programme team in Ethiopia have recently begun the delivery of these adaptation guidelines at two refugee camps in Ethiopia.

Nutrition in the context of COVID-19

This comes as the UN last week warned that an increase in malnutrition due to the COVID-19 pandemic will have ‘‘long-term consequences’’, transforming individual tragedies into a ‘‘generational catastrophe.’’ The agency said that 550,000 additional children each month are being struck by what is called ‘wasting’. The UN also warns that the food security effects of the COVID-19 crisis are going to ‘‘carry on for many years.’’

Social distancing being enforced at IYCF-CMAMI service at Kule Refugee Camp, Gambella.

GOAL currently implements its MAMI programme at the Kule and Tierkidi refugee camps in the Gambella region, providing life-saving and life-sustaining services as part of a wider package of preventative and curative nutrition interventions. Refugees in particular are at an increased risk of contracting infectious diseases, including COVID-19. Harsh living environments, including overcrowding, difficulties in maintaining hygiene and sanitation, and limited access to health care, increases this vulnerability.

In the immediate aftermath of the COVID-19 pandemic,  global guidance was available for nutrition programmes, such as ‘Child Wasting’ in the context of COVID-19, but no such guidance was available for the management of at-risk mothers and infants under six months (MAMI). The lack of global guidance specific to MAMI in the context of COVID-19 was something that GOAL addressed.  The guidance is seen as critical in order to prevent the collapse of existing life-saving and life-sustaining services, especially where vulnerable refugee groups are involved. The gap prompted GOAL’s nutrition team to update and establish their own guidelines for MAMI programming in the context of COVID-19. It is likely that global guidance will follow.

Worsening global hunger

A GOAL staff member screens an infant for malnutrition using the MUAC measurement tape in GOAL’s nutrition centre in Gambella, Ethiopia.

In a call to action, the leaders of four international agencies—the World Health Organization, the United Nations Children’s Fund, the World Food Program and the Food and Agriculture Organization, have also called for at least $2.4 billion immediately to address global hunger. Ethiopia is one of the largest refugee hosting countries in Africa, with over 750,000 registered refugees spread across eight locations. The Gambella region, in the west of the country, is one of the largest, with around 41% of the total refuge population living across a number of camps. Out of this group, women and children make up 88% of the population.

Infants under six months of age are considered a neglected demographic in many low- and middle-income countries. Historically, there have been assumptions that all women could and should exclusively breastfeed infants until their baby reaches 6 months. However, the UN estimates that only around 40% of the global population of babies within this age group are exclusively breastfed, and that approximately 8.5 million infants are suffering from acute malnutrition. In 2016, GOAL became the first International NGO to trial the MAMI programme. The approach specifically targets infants from birth up to six months of age. It was implemented by GOAL in response to the large number of vulnerable mothers and infant refugees who were at risk of malnutrition after fleeing war-torn South Sudan.

To date, Ethiopia has registered 15,200 COVID-19 cases and witnessed 239 deaths. While no COVID-19 cases have yet been registered at either of GOAL’s Gambella refugee camps, the Gambella region itself recorded at least five COVID-19 cases.

More detailed information relating to GOAL’s guidance adaptations for MAMI in the context of COVID-19 can be found here.

For more information relating to GOAL’s guidance adaptations for MAMI in the context of COVID-19,  contact Hatty Barthorp,  Global Nutrition Advisor at GOAL, Email: hbarthorp@goal.ie or Ritu Rana, Nutrition Research Advisor (MAMI), Email: rrana@goal.ie