Individual National Consultancy for development of Family MUAC implementation guidelines (For Nepalese Nationals Only)

Contract

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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.

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For every child, Health

“Putting mothers at the centre of malnutrition screening strategies acknowledges that they are in the best position to detect the earliest signs of malnutrition and leverages the fact that mothers want to participate as fully as possible in promoting the health of their children******1******”

Prior to the onset of the COVID-19 pandemic, 32 per cent of children in Nepal under five years of age, were stunted and 12 per cent suffered from acute malnutrition or wasting. It is not known with any certainty how many more children have become malnourished since the COVID-19 mitigation and control measures were put in place in late March 2020. What is known from the Child Family Tracker, a household survey administered by UNICEF, is that caregivers report their children are either eating less food at mealtimes, fewer meals per day and or less variety of foods in response to increasing food scarcity and loss of household income or livelihood. Such coping strategies are likely to manifest in more malnourished children if the situation does not improve. The long-term impacts on a generation of children could potentially have disastrous implications for Nepal’s development agenda.

A nutrition emergency preparedness and response are usually informed by results of a rapid assessment, which involves actively screening for malnutrition amongst children under five years of age and identifying those who need referral for treatment. The COVID-19 pandemic has seriously impacted the provision and utilization of nutrition services nationwide. One of the most important activities usually carried out for detecting children who are moderately or severely wasted is community-based screening by using Mid-upper arm circumference (MUAC). Due to the COVID-19 situation and the imposed physical distancing and lockdown measures, screening activities by Female Community Health Volunteers (FCHVs) or health care providers has not been possible. The implication of this is we have not been able to identify children who are at risk of morbidity or mortality due to malnutrition.

Nutrition service statistics tell us there has been an 51% reduction in admissions of children with severe wasting to Outpatient Treatment Centres (OTCs)2, which translates to approximately 5000 fewer children getting essential lifesaving treatment compared to the same time in 2019. The data is supported by reports from caregivers interviewed through the UNICEF child family tracker, that they are afraid to take their children for health and nutrition services or afraid to have health workers or female community health volunteers come to their villages and homes to screen for malnutrition. WFP’s 6th market analysis report indicates that rising food prices and reduced incomes have contributed to household food insecurity. It is therefore unlikely that Nepal will achieve the WHA stunting and wasting reduction targets, and in fact might see a reverse in the downward trend in stunting in the long term.

The UN Social Economic Response Framework for Nepal was informed by a series of stakeholder consultations including government, non-government, I/NGOs, civil society groups, and key focus groups. The framework outlines a mix of short to medium and medium to long term priorities for building Nepal back better and differently. The nutrition stakeholders identified the need to support continuation of essential primary health care and nutrition services. Resource allocation to protect health workers to perform their functions and for FCHVs to resume their function of delivering the community-based nutrition package. ‘No touch’ methods for administering nutrition specific actions; vitamin A to children 6-59months and ‘family MUAC’ approaches are recognized by the nutrition sector as priorities.

There are examples from other countries of what is known as ‘Family MUAC’, whereby parents of children 6-59 months are taught how to use a MUAC tape to measure and monitor their own children. The lessons learned from these countries provide Nepal with an alternative option for detecting children who are mildly or severely wasted and may increase likelihood of parents seeking health care services for their children.

How can you make a difference?

The Purpose of the assignment is to draft implementation and training guidelines for the Family MUAC approach and to support training of trainer workshops.

Draft Family MUAC implementation guidelines

The consultant is expected to draft the guidelines that include the following sections:

• Training of Trainers module for training FCHVs on how to train caregivers for family MUAC
• FCHV orientation manual including instructions on IPC measures, training procedures, training equipment and supply needs
• Training tools including but not limited to visual aids on using MUAC tapes, FAQs etc
• Communication messages/ instructions for caregivers of children 6-59months in the form of a ‘booklet’ or leaflet using visual ques and limited text for a non-literate audience
• Monitoring indicators, data collection tools/registers and monitoring framework/processes

Facilitate stakeholder consultations

• Conduct meetings with stakeholders to garner inputs on the drafts.

Support the training of trainers

• Provide technical assistance to carry out the training of trainer workshops.

Duration of the contract

The total duration of the consultancy is 4 months effective from 01 March to 30th June 2021

Deliverables

1. Submission of zero draft outline of guidelines Implementation road map
2. Submission of second draft of guidelines incorporating one round of inputs from nutrition stakeholders
3. Submission of final draft of guidelines incorporating inputs from stakeholders and ready for implementation in the four target districts.
4. Submission of final guidelines based on the outcomes of the implementation in the field and progress report on implementation of Family MUAC pilot. Submission of report on training of trainer workshops

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

Minimum Qualifications Required

Education: Advanced University Degree in nutrition, Public health and public health nutrition.

Work Experience: A minimum of five years of professional experience in nutrition field, specifically working on Integrated Management of Acute Malnutrition programmes. Excellent technical skills and knowledge about CMAM/IMAM programmes essential.

Skills: Highly skilled in program planning, guideline development, training facilitation, BCC material development and has excellent communication skills in both English and Nepali. Good documentation and report writing skills.

For every Child, you demonstrate…

UNICEF's values of Care, Respect, Integrity, Trust, and Accountability (CRITA) and core competencies in Communication, Working with People and Drive for Results

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.

Remarks:

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.