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Title page 1

Contents 4

Acknowledgements 6

Acronyms and abbreviations 7

Glossary 8

Executive summary 10

1. Introduction 12

Global situation 12

Main drivers of food insecurity crises 12

Wars and protracted conflicts 12

Economic slowdowns 12

Weather and climate events 12

Impact of food insecurity on nutrition and health 13

Goal and strategic domains of the framework 14

Alignment with WHO frameworks for emergency response 17

2. Strategic domains 18

Strategic domain 1: emergency coordination 18

Health Cluster/sector coordination 18

Inter-sector/cluster coordination and collaboration 19

Humanitarian, development and peace nexus: multi-actor coordination 19

Suggested priority actions under strategic domain 1 20

Strategic domain 2: collaborative surveillance 22

Introduction to health and nutrition information during food crises 22

Health information and data 23

Nutrition surveillance, surveys and approaches 26

Monitoring progress towards the global nutrition goals 28

Working in partnership on health and nutrition information 28

Using mortality data to assess the severity of food insecurity 31

Suggested priority actions under strategic domain 2 33

Strategic domain 3: community protection 35

Linkages between food insecurity, disease and malnutrition 35

Managing disease outbreaks and epidemics 36

Suggested priority actions under strategic domain 3 38

Strategic domain 4: safe and scalable care 40

Domain 4a: essential nutrition actions 40

Improving availability of nutrition actions in health systems 41

Prevention and management of acute malnutrition 43

Suggested priority actions under strategic domain 4a 47

Domain 4b: essential health service actions 49

Impact of food insecurity on health service coverage 49

Impact of food insecurity on health programming 50

Adapting and prioritizing essential health services 54

Suggested priority actions under strategic domain 4b 56

3. Cross-cutting areas 59

Preventing and responding to sexual misconduct 59

Addressing the intersection of food insecurity and sexual misconduct in emergencies 60

Accountability to affected populations 62

A common approach to resource mobilization 62

Key principles 62

What donors want 62

Global trends in humanitarian response plan funding 63

Communications for health during food crises 64

WASH and health 66

WASH integration in nutrition programmes 66

WASH in health care facilities 66

WASH in stabilization centres 67

Improving referral pathways 67

Community mobilization and case-finding 67

Making the most of opportunities 68

Risk communication and community engagement 68

References 70

Annex 1. Response priorities and actions for the health sector, per phase of the Integrated Food Security Phase Classification (IPC) 77

Annex 2. The Integrated Food Security Phase Classification (IPC) 78

Annex 3. WHO guidelines, case-studies and existing recommendations 82

Annex 4. Examples of nutrition surveillance systems supported by WHO in countries 89

Annex 5. Nutrition surveillance: methods and approaches 91

Annex 6. Health information for food security analysis 99

Annex 7. Outbreak prevention and control during food crises: key public health interventions 100

Annex 8. Overview of key methods to assess mortality 104

Annex 9. Barriers to health care services and proposed response options 107

Annex 10. Methods 111

Tables 20

Table 1. Priority actions under the domain of emergency collaboration, per IPC phase 20

Table 2. Priority actions for collaborative surveillance, by IPC phase 33

Table 3. Priority actions in domain 3: community protection 38

Table 4. Key nutrition actions for vulnerable groups in emergency settings 43

Table 5. Priority actions under domain 4a: essential nutrition actions 47

Table 6/Table 7. Priority actions in domain 4b: essential health service actions 56

Table 7/Table 8. Suggested priority actions for preventing and responding to SEAH in health emergency events, including food insecurity 61

Figures 14

Fig. 1. The role of health care services in food insecurity crises 14

Fig. 2. Goal and strategic domains of the food insecurity and health framework 15

Fig. 3. Mainstreaming nutrition actions in health systems as part of regular programming 41

Fig. 4. Essential nutrition actions 42

Fig. 5. Examples of barriers during food crises, based on the Tanahashi model for effective service coverage 50

Fig. 6. Global Humanitarian Overview (GHO) requirement and funding (March 2025) 63

Boxes 24

Box 1. Case-study: the role of GIS during the food crisis in the greater Horn of Africa 24

Box 2. Collection of nutrition services data 27

Box 3. Health information used to enrich food security analysis 29

Box 4. Infant feeding in the context of outbreaks 36

Box 5. Case-study: calculating a case fatality rate for a ward 47

Box 6. Integrating MHPSS into nutrition programming 54

Annex Tables 77

Table A1.1. Suggested response priorities and actions for the health sector, per IPC phase 77

Table A2.1. Priority response objectives under the IPC classifications of Acute Food Insecurity and Acute Malnutrition 79

Table A3.1. Coordination and collaboration 82

Table A3.2. Health and nutrition surveillance and information 82

Table A3.3. Outbreak prevention and control 83

Table A3.4. WASH 85

Table A3.5. Nutrition 85

Table A3.6. Maternal and newborn health 86

Table A3.7. Child health 86

Table A3.8. Sexual and reproductive health 87

Table A3.9. Mental health and psychosocial support 87

Table A3.10. HIV/AIDS 87

Table A3.11. Tuberculosis 88

Table A5.1. Overview of methods and approaches for nutrition surveillance 92

Table A6.1. Health information relevant to a food security analysis 99

Table A9.1. Barriers to health services and proposed response options 107

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