National Consultant (Community-based Nutrition Consultant)

Consultant Medical & Health Programme & Policy

Contract

This is a Consultancy contract. More about Consultancy contracts.

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Background:

Maternal and child undernutrition is the cause of 45% of all deaths in children aged 0-59 months in low and middle-income countries (LMICs). Among surviving children, undernutrition impairs children’s physical growth and brain development, school readiness, educational achievement, and earning potential and productivity in later life. Globally, about 151 million children under 5 remain stunted, their physical and brain development compromised. Evidence indicates that a large proportion of childhood undernutrition has its origins in the fetal period. Maternal undernutrition in the form of short stature and low body mass index is related to small for gestational age births and other adverse pregnancy outcomes. In all, it is estimated that small for gestational age births may account for ~20% of the stunting burden observed in low- and middle-income settings as well as~20% of neonatal mortality.

In Bangladesh, as reported by BDHS 2014, 24% of women of reproductive age (15-49 years) are thin (a body mass index (BMI) of less than 18.5). Around 13% of women of reproductive age are severely stunted (less than 145 cm) leading to prolonged/obstructed labour, the proportion of which out of the causes of maternal death has remained unchanged for a decade in Bangladesh. Fifty percent of women suffer from iron deficiency anaemia and 2.8% from night blindness. Though women’s nutritional status has improved slightly over the years, maternal malnutrition still contributes to a high rate of maternal mortality and low birth weight (LBW), and further contributes to high stunting rates in children under 5, especially in the first 2 years of life. At the same time, overweight and obesity are increasing, thus contributing to an increase in Non-Communicable Diseases (NCDs) and pregnancy-associated metabolic risks. Obesity in pregnancy is associated with gestational diabetes and preeclampsia. In Bangladesh, eclampsia and preeclampsia (24%) are common causes of maternal deaths followed by ante and postpartum haemorrhage (31%). Maternal deaths due to eclampsia increased from 20 % in 2010 to 24% in 2016.[1]

Bangladesh has the highest rate of LBW in the world, with approximately 860,000 – or 28% of infants in the country born with LBW annually[2], [3]. This greatly increases their risk of death, stunting and wasting, and developing non-communicable disease in their adult lives. According to 2019 estimates, only 52 per cent of live birthweights in Bangladesh are recorded[4],[5].

The GoB with support of development partners, including UNICEF, has made significant efforts to improve the coverage and quality of key maternal and infant and young child nutrition services in order to accelerate stunting reduction and other WHA and nutrition related SDGs. The efforts include the strengthening and extension of essential basic services to communities beyond the Community Clinic (CC) – the lowest tier platform for primary healthcare, nutrition and family planning services at the community. Currently there are over 13,500 Community Clinics across Bangladesh. In a CC, there are three categories of staff; Community Health Care Provider (CHCP), Health Assistant (HA) and Family Welfare Assistant (FWA). The CHCP provides services 6 days a week at a community clinic, where the HA is designated to sit 3 days a week and the other 3 workdays in the community to provide immunization services, health and nutrition education sessions and conduct household visits. FWAs have been appointed to assist CHCPs at community clinics 3 days a week and visit households of eligible couples in the remaining 3 days. There are a Community Group (CG) and 3 Community Support Groups (CSGs) for the management of each CC and community mobilization. In addition, local government including Union and Upazila Parishad have oversight and supportive roles for the development of community health.

The community-based interventions for both maternal nutrition and infant feeding are of inconsistent quality, scattered coverage and are uncoordinated. While a few platforms are in place with support of CSOs, their implementation is limited to small geographical areas. For example, Mother Support Group (MSG) under the CC are coordinated by the CHCP and implemented by the Institute of Public Health and Nutrition (IPHN) with support from the Bangladesh Breastfeeding Foundation (BBF). The government also intends to engage the multi-purpose health volunteer for community outreach to improve the coverage of nutrition services.

Strengthening community-based interventions to increase the coverage and to improve the quality of maternal, infant & young child nutrition is one key prioritized support of Nutrition Section, UNICEF. As such, new initiatives on community-based engagement have been started, including for example the review, mapping and assessment of the existing community-based interventions towards establishing a standardized and evaluable package with accountability framework interlinked to the PHC. The community-based programme will also explore the linkages with nutrition-sensitive interventions such as social protection and food security, particularly to prevent maternal malnutrition and LBW, and to ensure care for LBW infants.

Additionally, as part of RWP 2021, UNICEF and MoHFW, along with relevant stakeholders will demonstrate a model to use EPI platforms as contact points to provide maternal and infant and young child nutrition services and conduct implementation research to establish an innovative and comprehensive community model to improve access and the use of community-based maternal nutrition services and nutritional care for newborns and LBW infants. In the Cox’s Bazar context, GoB has been implementing a community-based nutrition programme with UNICEF support. These initiatives involve comprehensive consultations and coordination among relevant Line Directorates of MoHFW and key stakeholders supporting maternal, infant and young child nutrition programmes in Bangladesh. For this, the Nutrition Section of UNICEF would like to hire a national consultant to support the implementation of community-based engagement related activities.

Purpose of Activity/Assignment:

Below are key activities/assignments for the consultancy:

1. As liaison to NNS, support consultations and coordination between NNS and other relevant OPs under DGHS and DGFP, particularly MNCH, MCRAH, CBCH and MIS for overall community-based related work;
2. Support the inception and implementation of community-based preventive measures to improve nutrition services coverages to be implemented in selected districts of Sylhet and Khulna Division;
3. Support the inception of innovative comprehensive community model to improve access and the use of community-based maternal nutrition services and nutritional care for newborns and LBW infants in selected districts in Chattogram, Khulna, Mymensingh and Sylhet Division;
4. Facilitate engagement with MoWCA and MoA to explore the linkages with nutrition-sensitive interventions such as social protection and food security to prevent maternal malnutrition and LBW, ensure care for LBW infants;
5. Support consultations and facilitation of consultations with GoB and DP for Phase-2 and Phase-3 of community-based engagement;
6. Work with Cox's Bazar team to establish coordination with Cox's Bazar for alignment of community-based approach to improve the coverage and quality of MIYCN services;
7. Conduct field visits to monitor the implementation of community-based engagement;
8. Facilitate quarterly review meetings led by NNS in collaboration with relevant OPs and DPs on the implementation of community-based engagement;
9. Support to collect information for lessons learned and knowledge management products for community-based engagement and interventions;
10. Develop final report of consultancy with key lessons learned and recommendations to improve the implementation.

Tasks/Milestone:

Deliverables/Outputs:

Timeline

1

Develop inception report for overall assignment and each task (listed below) with clear objectives, methodology and detailed timeline with Gantt Chart

1. Inception report, including planning for coordination and consultation meetings with GoB

June 2021

2

As liaison to NNS, support consultations and coordination between NNS and other relevant OPs under DGHS and DGFP, particularly MNCH, MCRAH, CBCH and MIS for community-based related work

3

Support the inception and implementation of community-based preventive measures to improve nutrition services coverages to be implemented in selected districts in Sylhet and Khulna division

3.1

Support capacity strengthening of the existing community-based volunteers and community support groups (i.e. multipurpose volunteers, mother support groups) on community-based MIYCN

2. Training Report and recommendations for improvement

July 2021

3.2

Enhance community-based approach for preventive measures of MIYCN

3. Implementation plan for community-based interventions for MIYCN

August 2021 (for both #3 and #4)

3.3

Strengthen community-based adolescent nutrition interventions

4. SoP on community-based interventions for adolescent nutrition

4

Support the inception of innovative comprehensive community model to improve access and the use of community-based maternal nutrition services and nutritional care for newborns and LBW infants in selected districts in Chattogram, Khulna, Myamunsingh, and Sylhet Division

4.1

Support consultations with the GoB to develop detailed implementation plan during inception stage

5. Consultation report and recommendations (Note: all consultations for Task 4)

September 2021

4.2

Develop strategy/frame on the linkages with the existing nutrition sensitive interventions of agriculture and social protection, to prevent maternal malnutrition and LBW, ensure care for LBW infants

6. Strategy document on the linkages with the existing nutrition sensitive of agriculture and social protection

October 2021

4.2

Support development of a plan for operational research on identifying ways to improve measurement of LBW and care of LBW infants at community level and link with health facility-based support for care of pregnant women and their newborns, and impact on LBW prevention

7. Detailed plan and tools for baseline assessment

November 2021

5

Support consultations and facilitation of consultations with GoB and DP for Phase-2 and Phase-3 of community-based engagement

8. Set of consultation reports with key action points (for all consultations task 5)

December 2021

6

Work with Cox's team to establish coordination with Cox's for alignment of community-based approach to improve the coverage and quality of MIYCN services

9. Brief on the learning from Cox's and recommendations for alignment with overall community-based engagement effort

January 2022

7

Conduct field visits to monitor the implementation of community-based engagement

10. Set of field visit reports and recommendations

February 2022

8

Facilitate quarterly review meetings led by NNS in collaboration with relevant OPs and DPs on the implementation of community-based engagement

11. Compiled minutes with clear actions that have been taken, and further recommendations (for all quarterly review meetings)

9

Support to collect information for lessons learned and knowledge management products for community-based engagement and interventions

12. Set of compiled key messages on the lessons learned and messages for KM products

March 2022

10

Develop final report of consultancy with key lessons learned and recommendations to improve the implementation

13. Summary of overall achievements of consultancy with Annex deliverable 1-11

April 2022 (before contract due)

Total

231 days (11.5 mo)

[1] BMMS 2016

[2] *U**nited Nations Children’s Fund (UNICEF), World Health Organization (WHO). UNICEF-WHO Low birthweight estimates: Levels and trends 2000–2015. Geneva: World Health Organization; 2019 Licence: CC BY-NC-SA 3.0 IGO.*

[3] Blencowe, H., Krasevec, J., de Onis, M., Black, R.E., An, X., Stevens, G.A., Borghi, E., Hayashi, C., Estevez, D., Cegolon, L. and Shiekh, S., 2019. National, regional, and worldwide estimates of low birthweight in 2015, with trends from 2000: a systematianalysis. The Lancet Global Health, 7(7), pp.e849-e860.

[4] BBS and UNICEF Bangladesh. 2019. Progotir Pathey,Bangladesh Multiple Indicator Cluster Survey 2019, Survey Findings Report. Dhaka,.

[5] UNICEF, BBS and. Bangladesh Multiple Indicator Cluster Survey 2012-2013, Progotir Pathey: Final Report.” Dhaka, Bangladesh: Banglades https://www.unicef.org/bangladesh/media/1021/file/Mic. 2015.

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.

Minimum Qualification/Knowledge/Expertise/Skills required:

• Master’s in Food & Nutrition or Public Health (Post Graduation Diploma or Masters).
• A minimum of 10 years of relevant professional working experience in Public Health, Maternal/Child Nutrition, especially at the community level.
• Experience in Growth Monitoring and Promotion (GMP) and community engagement and mobilization are mandatory.
• Extensive knowledge and understanding of Community-based Nutrition programing including use of child and community growth charts, plus demonstrated ability in capacity enhancement programs through delivery of high-quality trainings, staff mentoring coupled with highly developed writing skills will be an asset.
• Knowledge and experience regarding linkages with Nutrition sensitive and specific activities.
• Experiences of working with the government at national or sub-national level on community-based nutrition programs will be preferred.
• Strong communications skills and ability to work effectively with wide range of stakeholders, including Government counterparts especially Civil Surgeon, MoHFW and IPHN.
• Experience working with UN or other international organization is an asset.

To view our competency framework, please visit here.

Click here to learn more about UNICEF’s values and competencies.

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.

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.

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Added 2 years ago - Updated 2 years ago - Source: unicef.org