Case Study: Ensuring continuous and adequate nutritional support in Libya after Storm Daniel

Storm Daniel pummeled north-eastern Libya in September 2023, which resulted in severe flooding in cities like Benghazi, Al-Jabal Al-Akhder, Al-Marj, and elsewhere. The city of Derna particularly suffered from extensive damage to its infrastructure and homes when two dams broke, killing more than 2,300 people. At least 5,000 people were killed in the storm nationwide, and at one point, 30,000 people were missing. Urgent humanitarian assistance was needed to prevent further loss of life. 

It was critical to address the nutrition needs among those in the flood-affected areas – especially the most vulnerable groups, including children, older people, and those living with disabilities. That’s because floods often disrupt access to food and clean water, leading to an increased risk of malnutrition, especially among children. Ensuring continuous and adequate nutrition was vital for their growth, development, and overall well-being.

Strengthening the IYCF-E technical capacity of primary health care providers

In response, UNICEF, in collaboration with the Ministry of Health, Primary Health Care Institute, and local health authorities, implemented a three-month screening program for children accessing primary health care services in the flood-affected areas. Out of the 4,158 children who were screened during that time, 1,366 children (1 in 3) were diagnosed with some form of malnutrition.

UNICEF’s team on the ground and its partners responded with nutrition interventions like Ready-to-use Therapeutic Food, breastfeeding support, and more, but there were gaps in technical capacity. The healthcare system and infrastructure had been significantly affected, with many hospitals and primary healthcare facilities either non-functional or only partially functional. Additionally, it became evident that there was a capacity gap in understanding appropriate feeding practices, identifying malnutrition, and managing nutrition-related complications among primary health care providers in the flood-affected eastern region.

To address these gaps and ensure effective support was provided, UNICEF requested support from the Global Nutrition Cluster (GNC) to strengthen the technical capacity of primary health care providers in the area of Infant & Young Child Feeding in Emergencies (IYCF-E) through a Training of Trainers (ToT) event.

The GNC’s IYCF-E Advisor, Rahab Kimani – together with UNICEF’s Program Specialist in Child Nutrition and Development in Humanitarian Action, Najwa Aldheeb – carried out the training, which targeted primary health care providers such as doctors and program managers. Fifteen health care practitioners attended the five-day, in-person training.

The training aimed to provide comprehensive knowledge on IYCF-E and ultimately enhance the providers' ability to deliver effective nutrition support and improve the well-being of affected infants and young children. A pre- and post-training self-assessment was conducted to measure the impact of the training on participants, and the training was evaluated afterwards using the  GNC evaluation form and Save the Children IYCF-E curriculum evaluation form.

Significant attention was paid to contextualizing the training materials to the local culture and context, and the entire ICYF-E ToT Training Package was developed in both English and Arabic. Gender and GBV-related interventions and activities were also included in most of the training modules to ensure health care practitioners were sensitive to the specific needs and inclusion of women and girls in their responses.

Lessons learned

Overall, the IYCF-E technical support in Libya was successful in equipping practitioners with the knowledge to identify and treat malnutrition in their work. The availability of UNICEF in-country and their commitment to IYCF-E helped tremendously and the technical support proved appropriate for the context. The majority of the participants came from the Ministry Of Health from across Libya, which demonstrated the Ministry’s support of IYCF-E capacity building across the country.

A few action points that were noted could strengthen the capacity of health care providers in Libya to respond to nutrition needs in emergencies in the future include:

• Creating an online option for practitioners unable to attend the in-person training due to personal issues or travel constraints to extend the reach of the training.

• Building an active list or pool of trainers who can be utilized for future IYCF- and IYCF-E-related training events.

• Enhancing IYCF-E advocacy-related activities with key stakeholders, including the media.

• Activating an immediate roll-out plan to disseminate the training to frontline workers to enhance IYCF-E knowledge and skills.

• Developing national contextualized guidelines and policies.

• Establishing a Libya Nutrition Cluster and upload related key documents on the website and making them available to practitioners.

• Mapping all the health and nutrition actors in Libya and updating the 5Ws matrix.

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