Consultancy to Conduct a Survey on Iodine Nutrition Status of School-Age Children Tender

Procurement Summary

Country : Namibia

Summary : Consultancy to Conduct a Survey on Iodine Nutrition Status of School-Age Children

Deadline : 01 Mar 2019

Other Information

Notice Type : Tender

TOT Ref.No.: 30864442

Document Ref. No. :

Competition : ICB

Financier : United Nations Secretariat

Purchaser Ownership : -

Tender Value : Refer Document

Purchaser's Detail

Purchaser : UNITED NATIONS CHILDREN'S FUND
UN House UNICEF, 1st Floor 38-44 Stein Street Klein Windhoek Windhoek Tel: +264-204.6111 Fax: 204.6206
Namibia
Email :nmbregistry@unicef.org
URL :http://www.unicef.org/

Tender Details

Tenders are invited for Consultancy, to Conduct a Survey on Iodine Nutrition Status of School-Age Children in Namibia, Windhoek, Namibia (for Internationals Only).

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. To save their lives. To defend their rights. To help them fulfill their potential.

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Background and Justification

Iodine deficiency disorders (IDD) are a significant challenge to Namibia's efforts to sustainable social and economic development. IDD is responsible for impaired brain development causing mental retardation in children[1], poor pregnancy outcomes, reduced productivity, academic performance and earning capacity as adults. Iodine deficiency in utero and childhood can result in the loss of up to 13.5 IQ points that affects learning ability and overall academic performance[2]. Children born to mothers with deficiencies in iodine are at increased risk of being small at birth, and at much greater risk of permanent physical or mental disability and death.

The main intervention for the prevention of iodine deficiency is the universal iodization of all edible salt (USI) which provides enough iodine to meet physiological requirements and achievement of optimal iodine intake in the population. In 1994, the Government of the Republic of Namibia (GRN) passed a decree on mandatory salt iodization that specified the salt types, chemical composition, storage and labelling including the penalties for defiance of the regulations. The regulations stipulate that all salt, including that for animal consumption, should be iodized with potassium iodate (KIO3). The potassium iodate content added in the salt should be not less than 50ppm and not more than 80ppm[3]. The salt was to contain not less than 98.4 % of sodium chloride in its water-free substance and not more than 4% of moisture. The 2013 Demographic and Health Survey estimated that about 76% of households are using salt with any iodine, suggesting that large segments of the population are consuming non-iodized salt. Furthermore, a recent assessment of the programme indicated that these fixed limits set by the law represent a challenge for the producers as KIO3 is not part of the National Core Medical Supply and is expensive for small producers.

The revised Food and Nutrition Security Policy (2018-2028) explicitly highlights salt iodization as the main strategy to address IDD and reaffirmed the need to 1) continue mandatory iodization of all salt for human consumption; 2) promote the consumption of adequately iodized salt; 3) effectively enforce the legislation on salt iodization; 4) maintain salt control using quantitative and qualitative methods, and 5) ensure a monitoring of iodine deficiency disorders through sentinel site surveys.

Furthermore, to help support implementation of the program, GRN put in place a regulatory body under the leadership of Ministry of Health and Social Services (MoHSS) that has several members: Ministries (Trade, Agriculture, Home Affairs and Justice), salt producers and partners (UNICEF, WHO, and USAID). This regulatory body was established and mandated to help coordinate and enforce regulations on salt iodization, strengthen surveillance mechanisms on IDD and promote the consumption of iodized salt but has rarely met nor been called upon to provide inputs to health sector plans.

The first local survey on IDD was conducted in 1994 in the Caprivi which showed a high prevalence of IDD (34.5%) in children aged 6 to 18 years. In response the MoHSS launched a campaign to sensitize the public on the consumption of iodized salt and passed legislation on mandatory salt iodization. The campaign involved use of various media houses that included TV, radios and newspapers that conveyed messages on the negative consequences of iodine deficiency on the child and mother. To further reach-out to most vulnerable categories, leaflets, posters and distribution of T-shirts with messages on iodine deficiency translated in the local languages were undertaken in the community, places of worship and health facilities. The massive campaigns were highly successful and a follow up survey in 1999 indicated complete elimination of goitre.

From 2000 onwards, salt iodization campaigns have not received particular attention in the country and no major public awareness activities have been conducted. It's therefore perceived that this could have derailed the gains made in combating IDD in the 1990s. The National Demographic and Health Surveys of 2006/7 and 2013 found only 60% and 76% of the population consume iodized salt respectively. The low levels of iodized salt consumption probably reflect the limited knowledge of people on the nutrition benefits of iodized salt and negative consequence of un-iodized salt.

Namibia's close proximity with the Atlantic Ocean presents it with rich deposits of salt that resulted in the establishment of a number of industries mainly along the south-western coastline. Due to rich salt deposits, Namibia produces sufficient amount of salt for home consumption as well as for export. The country is a major exporter of salt to Angola, Nigeria, Democratic Republic of Congo, Zambia, Zimbabwe, South Africa and Botswana. The volume of salt mined and exported has increased overtime. In 2016, the country produced about 880, 000 metric tons of salt, an increase of 20% from the previous years. Of this annual production, 5% was locally consumed. The major salt producing company include: Salt and Chemical Limited, Salt Company Limited, Walvis Bay Salt Refineries Limited and Bay Salt Holdings Limited. Salt and Chemical Limited is leading salt producer with a market share of about 75%.

The WHA (2005) mandates member states to provide data every three years on the iodine nutrition status of their population. However, the Global Scorecard of Iodine Nutrition in 2017, indicates that Namibia does not have data on the iodine nutrition status of its population. The MoHSS with support from UNICEF and USAID therefore has planned to conduct a survey on the iodine nutrition status of the school age children in the whole country. The findings will inform policy and interventions tailed to elimination of IDD in Namibia.

Justification

Micronutrient deficiencies are major impediment to socio-economic development and contributes to a vicious cycle of malnutrition and underdevelopment in Namibia. It has long-term effects on health, learning ability and productivity. Micronutrient malnutrition leads to high social and public costs, reduced work capacity in the populations due to high rates of illness, disability and mortality. Iodine deficiency in particular, is a leading cause of preventable mental retardation. In countries affected by iodine deficiency, its sustainable elimination through universal salt iodisation (USI) can contribute to socio-economic development. Universal Salt Iodisation is a cost-effective strategy capable of covering a wider at-risk population even in remote areas that are often neglected by national programs. Through the implementation of USI programs, the world has made remarkable progress in the last decades in the elimination of Iodine Deficiency Disorders (IDD) with iodine deficient countries decreasing from 54 in 2004 to 32 and the number of countries with adequate iodine intake increased from 67 to 107[4].

In 2005, the World Health Assembly (WHA) called on national governments to report on their iodine nutrition every three years. However, the 2017 Iodine Global Network Global Scorecard indicated that Namibia has no data on iodine status of its population. Studies conducted in 1990s reported high prevalence of iodine deficiency with over 50 percent of the population with urinary iodine of less than 100µg/L. The highest prevalence of iodine deficiency was reported in the northern regions[5]. The need to conduct an assessment on the iodine nutrition status of the Namibian population is apparent and results are critical in guiding the government and development partners to develop cost-effective interventions to address the IDD challenge.

Under WHA (1986) resolution on the prevention and control of IDD and WHA (1990) resolution on the global elimination of IDD, the Government of the Republic of Namibia committed to providing data regularly on the iodine nutrition status of its population. In pursuant of this commitment the Ministry of Health and Social Services (MoHSS), UNICEF and USAID will undertake a survey to determine the iodine nutrition status of the population. The findings will be instrumental in guiding the government policies and interventions on.

Scope of Work

Goal and objectives

The assignment will involve collecting urine from school age children 6-12 years and salt samples from households. The information about the type of salt used and the frequency of consumption of processed foods will be collected from households. The assignment will also involve working closely with MoHSS, Ministry of Education Arts and Culture (MoEAC), and Namibia University of Science and Technology. The overall supervision will be provided by the Chief Program Officer-MoHSS and Chief CSD UNICEF, supported by the Nutrition Specialist, UNICEF.

In collaboration with stakeholders mentioned and based on the survey framework, the consultant will: develop technical documents, including but not limited to:

§

§ Detailed survey protocol, including sample design and sampling methodology

§ Data collection and entry tools

§ Training modules for fieldworkers and supervisors

§ Field manual

§ Management of urine specimen collection and transport to a central lab

§ Strategy for data quality control;

Documents

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