Public nutrition in emergencies: An overview of debates, dilemmas and decision-making

This paper introduces and discusses the main themes and issues arising from the workshop 'International Public Nutrition in Emergencies: The Potential for Improving Practice'. Good co-ordination within the nutrition sector of the international humanit arian response system has led to a range of achievements in recent years. M ajor constraints to improving programme impact remain, however, including m isconceptions about the scope of nutrition among the wider humanitarian sys tem, which tends to give it a narrow focus on malnutrition and feeding peop le. In contrast to this limited view, the Public Nutrition approach brings a more broad-based emphasis to assessing and responding to nutritional prob lems in emergencies, and takes into account the wider social, economic and political causes of malnutrition. Six case study presentations illustrated the various components of a Public Nutrition approach, including in-depth assessment, analysis and tailoring programmes accordingly. Additional presentations considered the nature of v ulnerability, the concept of Public Nutrition, the responsibilities for add ressing nutritional problems and some of the operational tools and framewor ks in current use. Participants agreed on the necessity of raising levels of awareness and und erstanding among all actors in the humanitarian sphere about the impact of their actions on nutrition. Strategies for achieving this included developi ng better multisectoral working relationships and also strengthening relati onships with donors and key decision-makers in the humanitarian system. Oth er related strategies included institutional learning, training and capacit y building, particularly in relation to institutions based in developing co untries and building upon initiatives such as the Sphere Project, which has successfully brought together the various actors within the humanitarian s ystem in order to improve quality of response.