International Consultancy: conduct systematic review with meta-analysis on the determinants of child wasting in Sub-Saharan Africa Ethiopia with focus on food systems, Addis Ababa, Home-base

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For every child,

Despite millions of dollars being spent on the treatment of wasting every year, the increased frequency and magnitude of environmental and anthropogenic shocks has halted progress. Ethiopia, home to more than 16 million children under 5 years old, is one of the countries that have high levels of wasting. A time-series analyses of the various rounds of demographic health surveys (DHS) illustrated that some progress was made in reducing the prevalence of wasting: the prevalence was 12.2% in the 2000 DHS and dropped to 7.8% in 2018 (mini-DHS). Although this is encouraging, the irregularities of the changes in wasting prevalence across time have kept the prevalence consistent around 10% between 2005–2016. Significant peaks in the number of wasted children have been observed in 2005 and 2016, which closely matches with periods of the 2002–2004 food crises and the 2015–2016 El Niño crises. Outside these time-points, slight reductions in the number of wasted children were observed, but these meagre changes in prevalence are likely to be overshadowed by another peak expected as a result of the COVID-19 pandemic, locust invasion and civil unrest in the north which is having a lasting effect on the economy, food, and health systems.

For children less than 5 months of age, wasting accounted for 2.7% of the total Ethiopian DALYs in 2019 while nutrition deficeincies are ranked 7th of the ethiopian global health disease. In 2019, the burden of severe and moderate wasting was 3.2 million children under five. The economic burden of wasting, if the prevalence remains around 10%, is estimated to be between 152.1 million and 225.5 million USD. The highest economic burden is related to the cost of supplies and human resources to treat wasting, followed by the economic burden associated with childhood mortality related losses of the workforce. Added to this is the 1.8 million pregnant and lactating women who are wasted needing special attention in 2020 to prevent the vicious, inter-generational cycle of malnutrition. Understanding the timing of wasting, its incidence, and the most critical age, is essential to program effective interventions that can help reach the 5.4% AARR needed versus the actual 0.1% to reach the SDGs and help save over 680 million USD in the next decade and avert 7.9 million cases of wasting. Preventing wasting from happening in the first place would be even more crucial for the well being of the Ethiopian children and the national economy.

Achieving the ambitious nutrition target to prevent wasting and improving the health and nutrition status of children required the partnership of the 5 UN agencies (UNICEF, WFP, WHO, UNHCR and FAO) and collaboration with stakeholders across multiple sectors to adopt an integrated approach that supports and enhances national food and health systems, particularly including in fragile settings (protracted emergencies, displaced, natural shock prone areas, and more recently COVID-19 pandemic), while taking full advantage of the synergies between those organization organizations. For example, dietary diversity was shown to be protective factors for malnutrition. Despite economic growth in Ethiopia, the quality of young children’s (6-24 months) diets remains a concern. More than 80 percent of urban or rural children aged 6 to 23 months do not receive the minimum acceptable diet daily with a large difference between urban (19%) and rural areas (6%). In addition, nutrient-dense foods are highly subject to loss and waste, given their perishability tendency. Therefore, increasing access to healthy diets through faster, stronger implementation of supply and demand-side strategies that address the underlying drivers of today’s faulty food systems is imperative to solve these problems, as well as to address related environmental and economic costs. This failure to provide adequate minimum diet diversity to young children (6-24 months) has a direct impact on their micronutrient status as well as overall growth and development. For example, zinc, iodine and vitamin A deficiencies in pre-school and school aged children are considered a serious public health issue in Ethiopia despite the long-term existence of salt iodization and vitamin A policies and supplementation programmes. Unfortunately, with the projected continued population growth over the next 10 years, estimated to reach 140 million people by 2030 and rapid urbanization, the dominant food and diets that Ethiopians have been producing and eating for the past 50 years will no longer be nutritionally sustainable nor meet the nutrient needs. Hence new approach in every system (Health, WASH, Food, social protection) is needed.

In 2021, these five agencies under the leadership of the Ministry of Health came together to develop a roadmap dubbed Ethiopia’s GAP Road Map costed at 265million United States Dollars to accelerate efforts towards reduction of child wasting in Ethiopia to meet the Sustainable Development Goals. At mid-point of implementation, it is imperative to review progress on key determinants of child wasting and malnutrition broadly. UNICEF is therefore seeking a consultancy to address the determinants, particularly focusing on the food systems. Watch our UNICEF Ethiopia introduction video.

How can you make a difference?

The purpose of the consultancy is to conduct systematic review with meta-analysis on household food insecurity focusing on below outputs:

1)Factors associated with household food insecurity in Africa a systematic review with focus on Ethiopia

2) Land size and use, Rainfed agriculture and food security in Africa a systematic review with focus on Ethiopia.

3) Use the evidence from the two systematic reviews to develop into a functional conceptual framework for food systems in Ethiopia, that clearly defines the drivers of household food insecurity to guide programme design and interventions

4) Presentation of results at a Global Nutrition Event

These systematic reviews need to adhere to the PRISMA guidelines, and where possible and feasible include a meta-analysis. Meta-analytical quantification of the results will allow a more precise estimate of the effect of the underlying-level causes of child wasting. Given the diversity of shocks experienced in Ethiopia and sub-Saharan Africa in general, the meta-analyses will examine variability or heterogeneity in study results and undertake sensitivity analyses to eliminate the effect of outliers. A poorly performed search with limited access to databases may fail to identify most existing studies, leading to erroneous conclusions. The systematic review will include a range of databases and the grey literature.

Work Assignments Overview: Development of the systematic review protocol (e.g. the full search strategy including search terms. databases, quality assessment, and articulation of analytical methods) including registration of the protocol as per PRISMA) by 20 May 2024 (to be reviewed by UNICEF Team).

Deliverables/Outputs: 1) Factors associated with household food insecurity in Africa a systematic review with focus on Ethiopia. 2) Land size and use, Rainfed agriculture and food security in Africa a systematic review with focus on Ethiopia.

Delivery deadline: 60 days (by June 30, 2024)

Work Assignments Overview: Implementation of the protocol including data extraction, quality assessment, and analyses and drafting of manuscripts by 30 August (to be submitted to UNICEF and all co-authors for review).

Deliverables/Outputs: 1) Factors associated with household food insecurity in Africa a systematic review with focus on Ethiopia. 2) Land size and use, Rainfed agriculture and food security in Africa a systematic review with focus on Ethiopia.

Deliverable deadline: 65 days (August 15, 2024).

Work Assignments Overview: Feedback loop including addressing all comments plus submission (formatting manuscripts according to the journal’s REQUIREMENTS, managing the journal review processes, revisions according to reviewer’s comments) and up to the publication to the publications of the papers.

Deliverables/Outputs: 1)Factors associated with household food insecurity in Africa a systematic review with focus on Ethiopia. 2) Land size and use, Rainfed agriculture and food security in Africa a systematic review with focus on Ethiopia.

Deliverable deadline: 15 days (August 30, 2024).

Work Assignments Overview: Using the UNICEF global conceptual framework as a guide, use the evidence from the two systematic reviews to develop into a functional conceptual framework for food systems in Ethiopia, that clearly defines the drivers of household food insecurity to guide programme design and interventions.

Deliverables/Outputs: 3) Use the evidence from the two systematic reviews to develop into a functional conceptual framework for food systems in Ethiopia, that clearly defines the drivers of household food insecurity to guide programme design and interventions. Deliverable deadline: 30 days (September 30, 2024).

Work Assignments Overview: Presentation of results at a Global Nutrition Event.

Deliverables/Outputs: 1) Factors associated with household food insecurity in Africa a systematic review with focus on Ethiopia. 2) Land size and use, Rainfed agriculture and food security in Africa a systematic review with focus on Ethiopia. 3)Use the evidence from the two systematic reviews to develop into a functional conceptual framework for food systems in Ethiopia, that clearly defines the drivers of household food insecurity to guide programme design and interventions.

Deliverable deadline: 10 days (October 30, 2024)

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

• Master’s degree in nutrition, health, social science, epidemiology, and biostatistics.
• Minimum of 8 [Eight] years in research
• High level Experience in writing peer-reviewed articles for publications
• High level experience with Systematic Reviews with Meta-alysis
• Good writing and analytical skills
• Proficiency in English

For every Child, you demonstrate…

UNICEF's values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS).

Core Competencies:

• Demonstrates Self Awareness and Ethical Awareness (1)

• Works Collaboratively with others (1)

• Builds and Maintains Partnerships (1)

• Thinks and Acts Strategically (1)

• Drives to achieve impactful results (1)

• Manages ambiguity and complexity (1)

• Innovates and Embraces Change (I)

To view our competency framework, please visit here.

UNICEF is here to serve the world’s most disadvantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic.

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment.

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:

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.

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.