Consultancy: Breastfeeding Study for Belize
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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, hope.
Location: Belize City, Belize
Duration: 6 months
Start Date: April 2022
End Date: October 2022
Supervisor: M&E Specialist, ECD and Education Officer
Introduction
Breastfeeding is a key intervention to ensure the health and optimal growth of children and the use of optimal breastfeeding practices such as early initiation and exclusive breastfeeding in the first 6 months of life is one of the most effective means to ensure optimal brain, lung and gut development, reduce undernutrition and the risk of female cancers. Further, breastfeeding has been shown to protect children from infections, thereby reducing child morbidity and mortality.
UNICEF Programming Guidance on Prevention of Overweight and Obesity in Children and Adolescents (August 2019) states that breastfeeding (be it ever breastfeeding, exclusive breastfeeding or a longer duration of breastfeeding) reduces the risk of overweight. A recent meta-analysis calculated a 13 per cent reduced chance of overweight for children who were breastfed. Among the pathways for the protective role of breastfeeding is better gut health, achieved by population of the child’s body and gut with maternal microbiome during skin-to-skin contact and early and exclusive breastfeeding. Breastfeeding also establishes better satiety patterns which are related to the nutrients in breastmilk. It also helps avoid the disadvantages of bottle feeding.
Background
The United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO) have specific recommendations on when and how to breastfeed. These include early initiation of the first feed to a newborn, exclusive breastfeeding for the first six months of life and continued breastfeeding thereafter, with the introduction of semi-solid and solid foods at age-appropriate times.
Information from the UNICEF Nutrition Strategy 2020-2030 shares that infancy and early childhood (i.e., the first five years of life) are a time of rapid growth and nutritional vulnerability during which young children undergo vast physiological changes. The first two years of life are especially crucial. The absence of exclusive breastfeeding in the first six months, and the lack of diverse and nutritious complementary foods thereafter, can lead to stunting, wasting and micronutrient deficiencies and can predispose children to overweight, obesity and diet-related noncommunicable diseases.
Breastmilk has no substitute. UNICEF and the World Health Organization (WHO) recommend that infants start breastfeeding within one hour of birth, be exclusively breastfed for the first six months and continue breastfeeding until 2 years of age or beyond. Globally, only about half (49 per cent) of newborns are put to the breast in the first hour of life and less than half (44 per cent) of infants under 6 months of age are exclusively breastfed.
Available data in Belize shows early initiation for breastfeeding in Belize is 68.3% and that exclusive breastfeeding rate in Belize is 33.2%, undernutrition starts from birth in Belize, with 12.1% of children weighing less than 2,500 grams at birth. About half of children less than 6 months are predominantly breastfed and by one year of age, still only approximately half of children continue any kind of breastfeeding. Across results, urban children are the least likely to be breastfed. Current available data, taken from the 2015 MICS survey, reveal patterns across the country but do not address the reasons why breastfeeding is low nor does it show the views of women on breastfeeding. From then on, the nutrition status of children under 5 years of age is at 4.6% underweight, 15% stunted, 5.7% wasting and 7.3% overweight.
Objective
It is expected that the consultant will employ a hybrid framework consisting of a mixed-method design (triangulation of quantitative and qualitative information methods) and analysis underpinned by a human rights-based approach (equity and child rights). To this end, the consultant is expected to:
1. Conduct In-depth analysis of Belize MICS data (MICS 3, 4, and 5) to develop a nuanced understanding of what the levels of breastfeeding are Belize over time and the factors associated with changes in breastfeeding across the country. (Study 1)
The aims of Study 1 are:
- Describe the levels and inequalities of key indicators for different breastfeeding and other feeding practices ;
- Describe macro-level trends in these outcomes from MICS 3 to MICS 5;
- Identify the factors associated with changes in these outcomes over time.
2. The second study (Study 2) is a follow-up qualitative study on breastfeeding to be conducted nationally for women who gave birth within the last two years. The areas may change for the study if the results from Study 1 show some variations. Some of the factors identified in study 1 will inform tools/instruments or questions in study 2. This information will provide an in-depth analysis of why women breastfeed, their motivations for breastfeeding and the barriers to it.
- Describe how and why women practice breastfeeding;
- Understand the barriers to breastfeeding; Examine the barriers and enablers at four stages: i) early initiation of breastfeeding 1hour after birth; ii) exclusive breastfeeding; iii) continuation of breastfeeding to 2 or more years.
- Examine how much women recognize breastfeeding interventions implemented by the Ministry of Health and Wellness vis-à-vis the Baby Friendly Initiative in hospitals and breastfeeding counseling during pregnancy
- Examine the feasibility of mobile health interventions to promote breastfeeding.
The study is framed around the Health Beliefs Model (HBM), which is an explanatory theory to explain why behaviours occur. The HBM will elucidate why women breastfeed, and the beliefs, barriers and benefits of breastfeeding. Further, the study will identify if and to what extent women recall Ministry of Health interventions such as the Baby Friendly Initiatives, and breastfeeding counseling given during and after pregnancy. These data are not available in MICS and are key to uncovering drivers of why breastfeeding patterns exist as they are in Belize.
Another limitation is that the MICS 2015 survey provides the only available data on breastfeeding since household data collection in Belize is not conducted regularly.
3. Prepare draft and final report. Final report should be no more than 30 pages and should include infographics.
4. Validate findings. Initial findings will be presented to UNICEF Staff in a (virtual) workshop to assess the validity / accuracy of the findings to the Belize context and programmes.
Ethical Considerations
UNICEF supports evidence generation conducted in full compliance with ethical considerations, including during the review, research and data collection. Ethical considerations will be assessed and documented, and clearance will be sought before data collection can commence. All data collection exercise undertaken will be in accordance with ethical recommendations as set out in the UNICEF Procedure for Ethical Standards and Research, Evaluation review and Data Collection and Analysis (2015).
All informants should be offered the possibility of confidentiality, for all methods used. Dissemination or exposure of results and of any interim products must follow the rules agreed upon in the contract. Unauthorized disclosure is prohibited. Any sensitive issues or concerns should be raised, as soon as they are identified, with the M&E Specialist.
To View Detailed TOR Click Here: Breastfeeding Study TOR Final.pdf
Deliverable Timeframe
The timeframe below is restrictive and will be updated regularly in alignment with COVID-19 developments and related measures put in place by the Government of Belize.
Deliverables****Month1. Inception ReportM12. Data Analysis (MICS 3, 4, 5)M1 & M23. Data Collection (qualitative)M1, M2, & M34. Data Analysis (Study 2)M45. Draft Reports (2)M5 & M66. Final ReportM77. Presentation to Stakeholders (including power point)M6 & M78. A Scientific Journal Article (1). Journal will be produced to share the findings of the study globally. M7A total of 120 working days are estimated for completion of the Breastfeeding study and associated deliverables. The planned duration of this consultancy is 6 months, with expected start on 1 April 2022 and completion by 30 October 2022.
Management and Quality Assurance
Breastfeeding Management Group (BMG)
The Breastfeeding Management Group (BMG) is chaired by the M&E Specialist, UNICEF and includes, ECD/ Education Officer, UNICEF, Health UNV, Nutrition Specialist (RO), MICS Focal point (LACRO) and key technical advisors from the Maternal Child Health and Nutrition units in the Ministry of Health and Wellness.
Primary responsibilities include:
1.1 Advise and take decisions on the scope, timing and resources for the Breastfeeding Study;
1.2 Contributions to, and approval of the draft of the ToR (TOR has to be signed off by the Representative);
1.3 Support with the lists of contacts, data and information to be shared with the Consultant
1.4 Agreeing and scheduling visits, providing admin support;
1.5 Contributing to quality assurance through comments and feedback on draft deliverables.
1.6 Engagement in the drafting of the journal on the finding of the study.
Breastfeeding Reference Group
Breastfeeding Reference Group (RG) comprises of Child Protection Officer, ECD and Education Consultant, National Representatives including Ministry of Health and Wellness, NCFC M&E Committee, Statistical Institute of Belize, ECD TWG, Parenting Taskforce. The purpose of the BRG is to provide external insights and perspectives to the light review process.
The BRG expected support and contributions include:
2.1 Engagement in the Breastfeeding study processes and sharing relevant documents and updates with their organizations;
2.2 Identification of the participants for the key Informants interviews;
2.3 Provide inputs contributing to quality assurance of deliverables through comments on draft deliverables;
Supervision
The consultant will be supervised and managed by the UNICEF Monitoring and Evaluation Specialist.
Payment Schedule
Payment of professional fees will be based on submission of agreed deliverables which receive satisfactory quality review. In general, individual contracts shall not allow for fee advances. However, a maximum of 30 per cent of the total contract value may be authorized by the Approving Authority in cases where advance purchases, for example for supplies or travel, may be necessary.
To qualify as an advocate for every child you will have…
- An Advanced Degree or Master’s degree in Public Policy, Economics, Nutrition, Public Health, Social Sciences or related field;
- Proven experience in analytical skills and experience in qualitative data collection and analysis, including the conduct of KII and focus groups virtually;
- Professional experience in conducting analysis using datasets from surveys and admin sources
- Proven ability in coordination of research, dialogue and synthesis of complex information in strategic reports;
- Skills in statistical analysis software;
- Excellent written and oral communication skills in English required;
- Ability to work independently and respond to feedback in a timely and professional manner;
- Experience working with UNICEF would be an asset;
Administrative Matters
The consultant will provide own materials, and ICT equipment.
Application and Submission
Suitable applicants are invited to submit a detailed Technical and Financial Proposal.
The proposals will be assessed based on the following scores:
Technical Proposal: 80 points
Financial Proposal: 20 Points
The scores of the financial proposal and the technical proposal will be consolidated and together generate the overall final score.
Technical Proposal
The technical proposal should be no more than 5 pages, 12 points font and 1.5-line spacing excluding Appendixes. It should address the following areas:
Experience in the Multiple Indicator Cluster Survey Methodology and in conducting in-depth analysis and mentioning at least two similar assignments conducted previously;
Proposed methodology, the review framework, work plan and limitations (with alternatives) for meeting the deliverables in the ToR;
Consultant experience and qualifications (include CV as appendix);
Any other information relevant to the TORs.
Financial Proposal: The financial proposal must be submitted separately from the technical proposal, as per UNICEF standard procurement guidelines. It should provide an all-inclusive budget (fee, logistics, etc) in USD, and a budget breakdown to understand the distribution of costs (daily and monthly rate).
Note: The Financial proposals will be opened only to the consultants considered technically approved (range between 59 to 80 points).
Conditions of Service
Before commencing work, a consultant or individual contractor shall submit a statement of good health and take full responsibility for the accuracy of that statement, including confirmation that he or she has been informed of the inoculations required for the country or countries to which travel is authorized. Consultants and individual contractors shall assume all costs that may occur in relation to the statement of good health. Consultants and individual contractors are required to certify that they are covered by medical/health insurance.
Recourse
UNICEF reserves the right to withhold payment in case the deliverables submitted are not up to the required standard or in case of delays in submitting the deliverables on the part of the consultant. Performance indicators against which the satisfactory conclusion of this contract will be assessed include: timeliness/quality of submission and responsiveness to UNICEF and counterpart feedback.
Title Rights
All materials created by the Contractor which bears a direct relation to, or is made in order to perform, this contract and any intellectual property rights thereof, including but not limited to patents, copyright and trademarks, shall be jointly owned by UNICEF and the Contractor. At the request of UNICEF, the Contractor shall assist in securing such property rights and transferring them to UNICEF in compliance with the requirements of the law governing such rights. Any third-party usage shall require written permission from both parties.
Trainings
Consultants and Individual contractors, even those working from home, must complete the following online courses prior to signature of contract. All certificates should be presented as part of the contract:
- Ethics and Integrity at UNICEF
- Prevention of Sexual Harassment & Abuse of Authority
- Sexual Exploitation Abuse (PSEA)
Consultants and Individual Contractors must complete the following course before commencement of any travel on behalf of UNICEF.
Any consultant or individual contractor who is issued a UNICEF email address must complete the following courses no later than 30 days after signature of contract.
How To Apply
Prospective consultants should apply through UNICEF jobs website using the link provided No later than 24th February 2022. The application package should include the following:
- A cover letter;
- Detailed curriculum vitae
- A proposal stipulating all-inclusive fees, including lump sum travel and subsistence costs, as applicable.
- Technical Proposal
Note: Proposals should be uploaded as a separate document (word, or pdf), and labelled as “Technical Proposal, Breastfeeding Study and “Financial Proposal Breastfeeding Study”
UNICEF is committed to diversity and inclusion within its workforce, and encourages all candidates, irrespective of gender, nationality, religious and ethnic backgrounds, including persons living with disabilities, to apply to become a part of the organization.
UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.
Only shortlisted candidates will be contacted and advance to the next stage of the selection process.
Individuals engaged under a consultancy or individual contract will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures, and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants and Individual Contractors. Consultants and individual contractors are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws.
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Source:
unicef.org
