International Consultant - Development of High Impact Nutrition Interventions (HINI)... Tender

Procurement Summary

Country : Fiji

Summary : International Consultant - Development of High Impact Nutrition Interventions (HINI) Framework and Capacity Building on HINI for RMI

Deadline : 14 Sep 2018

Other Information

Notice Type : Tender

TOT Ref.No.: 26389736

Document Ref. No. :

Competition : ICB

Financier : United Nations Secretariat

Purchaser Ownership : -

Tender Value : Refer Document

Purchaser's Detail

Purchaser : UNITED NATIONS CHILDREN'S FUND
Third Floor Fiji Development Bank Building 360 Victoria Parade Suva Tel: +679-330.0439 / 330.1091 / 330.1881 / 330.1918 Fax: 330.1667
Fiji
Email :suva@unicef.org
URL :http://www.unicef.org/

Tender Details

Tenders are invited for International Consultant - Development of High Impact Nutrition Interventions (HINI) Framework and Capacity Building on HINI for RMI.

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.

Across 190 countries and territories, we work for every child, everywhere, every day, to build a better world for everyone.

And we never give up.

For every child, quality health and nutrition services

The UNICEF Pacific Islands- multi-country programme covers the Cook Island, Fiji, Kiribati, Republic of the Marshall Islands (RMI), Federated States of Micronesia, Nauru, Niue, Palau, Samoa, Salomon Islands, Tokelau, Tonga, Tuvalu and Vanuatu. Together, these fourteen countries and territories are home to 2.45 million people, living on more than 660 islands and atolls stretching across 17.2 million square kilometers of the Pacific Ocean. The countries have small and culturally diverse populations, and vary in terms of population size, fertility and growth rate.

The Republic of the Marshall Islands (RMI) covers an area of 181 square kilometers and comprises 29 atolls and five major islands. The estimated population in the 2010 Census was 54, 440. Two-thirds of the population lives on the two major urban atolls, Majuro and Kwajalein (including Ebeye Island). The RMI has the highest teenage fertility rate in the region and is more prevalent in the outer islands[1]. As a result of high levels of fertility, the Marshall Islands has one of the youngest populations in the region. Over eighteen percent (18.7%) of teenage mothers have low birth weight (LBW) babies.

Infant mortality rate (IMR) was estimated at 14.7 infant deaths per 1000 live births as of 2016. Prematurity is the leading case of infant deaths[2], and other factors associated with infant deaths include low birth weight[3], chronic maternal health conditions3, [4], and unplanned and teenaged pregnancies4. The under-five mortality rate (U5MR) decreased by 25% between 2009 and 2015, and most child deaths are due to malnutrition, diarrheal disease, prematurity and birth defects, and are influenced by poverty and educational level of the mother, availability and quality of health services, nutritional status, and access to safe water and sanitation4.

RMI is experiencing a double burden of malnutrition with high prevalence of both under- and over-nutrition. Stunting is a public health problem with 35.3% of children under-5 being stunted. The prevalence of stunting increases with child age and poverty level, but stunting is still high (20%), even in the wealthiest households[5]. While overweight among children in low (3.8%), three out of four caregivers with a child under 5 in RMI are overweight with nearly one in two caregivers are obese.5

In general, the coverage of essential nutrition interventions, including infant and young child feeding practices, de-worming and vitamin A supplementation among children under five are low. While delivery in health facilities is almost universal, only 60.8% of infants were breastfed within one hour of birth, and only 42.3% were exclusively breastfeeding to 6 months of age. Similarly, only 29.6% had a minimum acceptable diet of acceptable quantity and quality. Only around half of children under-5 received Vitamin A (54.4%) while deworming was low at 32.1%5.

RMI implements several evidence based nutrition interventions with focus on the first ‘1000-day-s window of opportunity -from conception to the child-s second birthday - including promotion of breastfeeding, complementary feeding, maternal nutrition and micronutrient supplementation. The services are delivered through the MoH delivery platforms. However, coverage remains inadequate due to limited planning, implementation, monitoring and lack of awareness among communities on the need for optimal care practices to reduce stunting and improve child nutrition status and to decrease the risk for later overweight and NCDs. The lack of a comprehensive high impact nutrition intervention package has resulted in a less than optimal understanding of the full complement of measures needed to prevent stunting by MoH staff at multiple levels. While high impact nutrition interventions that address the immediate causes of malnutrition are mainly implemented through the health sector, engagement with relevant sectors will raise awareness on the importance of implementing programs with a ‘nutrition lens- to address malnutrition and to ensure optimal child growth and development.

The President of the RMI used the evidence from the recently conducted 2017 RMI Integrated Child Health and Nutrition Survey for advocacy with World Bank for USD $12 million dollars over five years to address stunting in the context of early child development through multisectoral approach. The recently conducted 2017 Pasifika Conference on Early Child Development (ECD) for high level decision makers of 14 Pacific Island countries including RMI reinforced the value of adopting a multi-sectoral and holistic approach for ECD. The Government of the Republic of the Marshall Islands plans to establish a multi-sectoral coordination approach for ECD to address optimal child development in all domains including nutrition, health, hygiene, learning and protection. Nutrition will be a core focus area for ECD given the high stunting rate and its relationship to brain development.

In addition to the findings from the health policy review, UNICEF Pacific and the MHHS are in the process of generating the following evidence: health sector review and formative study on Nutrition-WASH social norms and practices which will complement this consultancy.

Following the results of the 2017 Integrated Child Health Nutrition Survey, revealing high rates of stunting, UNICEF Pacific and the MHHS are seeking a consultant to design the High Impact Nutrition Interventions (HINI) framework including the operational approaches and to build the capacity of the health staff in RMI for the delivery of high impact nutrition interventions.

[1] Government of Republic of the Marshall Islands. Republic of the Marshall Islands: National Report May 2013. Produced by the RMI Ministry of Foreign Affairs in preparation for the Third International Conference on Small Islands States in Apia, Samoa 2014

[2] Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet. 2016;388(10063):3027-35. http://www.who.int/news-room/fact-sheets/detail/preterm-birth, Accessed 31 Jul 2018

[3] WHO. Global nutrition targets 2025: low birth weight policy brief (WHO/NMH/NHD/14.5). Geneva: World Health Organization; 2014.

[4] Maternal and newborn health. 2009. The state of the World-s Children, 2009. UNICEF

[5] RMI 2017 The Republic of the Marshall Islands Integrated Child Health and Nutrition Survey, 2017

How can you make a difference?

The overall purpose of the assignment is to work in collaboration with the Ministry of Health and Human Services (MHHS), RMI to identify a package of evidence based High Impact Nutrition Interventions (HINI) taking into consideration the local context, global recommendations and best practices.

Specific questions to be addressed include:

- What are the nutrition specific high impact nutrition interventions, specific to the evidence and context of RMI, to improve maternal and child health and nutrition outcomes?

- What additional interventions should be considered to address the double burden of malnutrition including undernutrition and overweight and obesity and micronutrient deficiencies?

- What are the service delivery options for engaging nutrition sensitive sectors (e.g. water and sanitation, education, early childhood development/parenting, natural resources, social protection) to address the determinants of malnutrition?

The HINI package is intended to be used by health and nutrition care providers (doctors, nurses and program staff) working at all facility levels of health and nutrition service provision and at national and sub-national levels as well as by policy makers and civil society organizations. In addition to technical guidance, the package is expected to detail operational guidelines for health service providers at all levels to implement integrated health and nutrition service delivery aimed at enhancing coverage and quality.

Furthermore, the evidence based nutrition specific HINI package is expected to inform the proposed Nutrition Task Force and the multi-sectoral Early Child Development strategy planned by the Government of the Republic of the Marshall Islands.

To qualify as an advocate for every child you will have…

· A Post-graduate degree in Nutrition, Public Health, social sciences, global/international health and nutrition, or medicine. All consultants (if institutional consultancy) are required to have the required advanced degree.

· At least 5 years of recent documented work experience in developing nutrition policies, strategies and guidelines

· Solid understanding of integrated service delivery and community platforms for multi-sectoral nutrition service delivery

· Substantive knowledge on maternal, neonatal, child health and nutrition (MNCHN) issues/ policies, strategies, guidelines, tools, checklists, SOPs

· Documented recent experience developing training curriculum and materials, job aids and tools. Demonstrable recent experience in capacity development

· Strong inter-personal, teamwork and organizational skills

· Familiarity with information technology, including proficiency in word processing, spreadsheets, and presentation software

· Previous working experience in the Pacific and with health and nutrition progra

Documents

 Tender Notice