REQUEST FOR PROPOSAL FOR MICRONUTRIENT SURVEY IN SOMALIA

Description :

Organization: UN Children’s Fund
Country: Somalia
Closing date: 03 Mar 2017

TERMS OF REFERENCE FOR 2017 MICRONUTRIENT SURVEY IN SOMALIA

BACKGROUND

In 2009, UNICEF Somalia, in collaboration with the Food Security and Nutrition Assessment Unit (FSNAU) of FAO and the ministries of health, carried out the National Micronutrient Survey, to assess anemia, Vitamin A deficiency and urinary iodine among women and children. The survey also collected information on infant and young child feeding (IYCF) practices, malaria prevalence, as well as anthropometric data in children under-5. The results pointed to high levels of micronutrient deficiencies among pregnant and lactating women and children under-5. Iron deficiency in women of child bearing age stood at 41.5 per cent, 59.3 per cent in children under-5 and 73.7 per cent in children under-2. Vitamin A deficiency rates among women, at 33.3 per cent, were well above the 20 per cent WHO cut-off. With household utilization of iodized salt at 3.9 per cent and excess median urinary iodine levels above the WHO cut off (300μg/L were reported.

Since the 2009 survey, UNICEF Somalia has implemented and scaled up a number of programs to combat micronutrient deficiency, notably the semi-annual Vitamin A supplementation for children aged 6-59 months through routine and mass supplementation, as well as micronutrient supplementation for prevention and treatment of anaemia in pregnant and lactating women through provision of iron, folate and multiple micronutrient tablets. Significant efforts have also been made to improve children’s access to management of diarrhoea through zinc and oral rehydration salts and the delivery of micronutrient powders for home fortification have been integrated in IYCF to improve the status of anaemia in children under-5. To date, despite the excess levels of urinary iodine reported in the 2009 micronutrient survey, as a result of lack of conclusive evidence on the main source of iodine excess, no iodine programming has been implemented. Further investigation is required to inform any policy or future actions for Somalia.

OBJECTIVES

The main objective of the 2017 micronutrient survey is thus to provide updated estimates of the micronutrient status of particularly vulnerable population groups namely, children aged 6-59 months, non-pregnant women aged 15-49 years, and pregnant women. By 2017, the survey will specifically:

(i) Determine the prevalence of iron deficiency and anaemia in children aged 6-59 months, pregnant and non-pregnant women aged 15-49 years using biological indicators;

(ii) Determine the prevalence of Vitamin A deficiency among children aged 6-59 months, pregnant and non-pregnant women aged 15-49 years using biological indicators;

(iii) Determine the iodine nutritional status among school aged children both pregnant and non-pregnant women using biological indicators;

(iv) Estimate the coverage of households using adequately iodized salt and estimate the iodine content in water samples;

(v) Assess key IYCF practices among caregivers of children aged 0-24 months;

(vi) Assess the nutritional status of children aged 6-59 months using anthropometry.

RATIONALE

Since the 2009 micronutrient survey, no other survey has been conducted to assess the micronutrient status of the population in Somalia. As a result, there is no up-to-date data on the prevalence of deficiencies of iodine, iron and Vitamin A. The 2017 National Micronutrient Survey aims to fill this information gap by providing comprehensive and updated estimates of micronutrient deficiencies in Somalia at national and sub-national levels. The survey results will help inform priorities and investments for the next UNICEF Somalia country program (2018-2022) including partner programing, as well as address any gaps in knowledge. The process will help inform policy decisions and will contribute evidence for program review and implementation of a National Nutrition Strategy and Action Plan. In addition, survey findings will guide the planning, monitoring and evaluation of micronutrient interventions, as well as support the tailoring of micronutrient interventions to fit current gaps.

Furthermore, at the time of the 2009 survey that reported excess iodine in Somalia, the sources and consequences of the excess iodine were not well understood. Since then, some research conducted by FSNAU has confirmed the presence of high iodine in the water table. The proposed survey will thus complement findings from the secondary analysis of iodine data supported by the UNICEF Eastern and Southern Africa Regional Office in conjunction with Eidgenössische Technische Hochschule (ETH) Zürich, the Swiss Federal Institute of Technology. Within Somalia, this information is essential for UNICEF to make appropriate recommendations to the Government and other stakeholders regarding micronutrient programming and policy directions especially for iodine

DESCRIPTION OF ASSIGNMENT

The survey will be a national, cross-sectional, population-based survey as well as disaggregation in terms of urban and rural areas, gender analysis (boys and girls) and areas with high concentrations of internally displaced persons (IDPs). With a sample size to be determined to ensure satisfactory precision to make programmatic decisions specific to Somalia and to sub-national estimates. The sampling frame will be based on enumeration areas from the national population estimates, however, each geographical area (Somaliland, Puntland, and the states (4 states and federal government) of central southern regions of Somalia) will be treated as a separate stratum, allowing for separate estimates for each stratum and after appropriate statistical weighting, combinations of strata and for Somalia as a whole. Two-stage sampling will be conducted and the sample size required for each stratum will be based on the estimated prevalence; the desired precision; the expected intra-class correlation coefficients based on previous surveys, where data is available; and the resulting design effect for each indicator, taking into account an expected maximum non-response of 6 per cent (including refusals) at the household level and an 80 per cent individual response.

The target populations will be pre-school-aged children aged 6-59 months, school aged children six years or older for iodine analysis, non-pregnant women of reproductive age (15-49 years) and pregnant women. Vitamin A status will be assessed in women of reproductive age, using serum retinol, and in children aged 6-59 months, using retinol binding protein. Iodine status will be measured in pregnant and non-pregnant women. Investigating malaria prevalence among key populations will provide better understanding of the etiology of anaemia, including iron deficiency and other micronutrients, and inform appropriate interventions to address it.

For pre-school-aged children, key nutrition indicators to be collected include prevalence and severity of anaemia and iron and vitamin A deficiency. For non-pregnant women, indicators include prevalence and severity of anaemia and iron, vitamin A and iodine deficiencies. Markers of inflammation will also be assessed to aid in the interpretation of findings. For pregnant women, information on gestational age will be collected together with key indicators including prevalence and severity of anaemia and iodine deficiency. Additional variables, such as socio-economic status, household and individual food consumption patterns, infant feeding practices and intake of micronutrient supplements, will also be assessed, as they may influence various types of micronutrient deficiencies or play a causative role.

Interested research agencies are expected to submit a technical proposal with detailed methodology including recommended laboratory methods and procedures for all biomarkers. The technical proposal should contain the minimum list under the specific task below:-

1. Review and develop background and literature review on the nutrition status of children and women in Somalia considering contextual factors and interventions
2. Develop and finalize a survey protocol and methodology with design, sampling procedures, selecting households and subjects, estimating the sample size
3. Support the listing and updating of survey households to be sampled based on the latest population estimates
4. Develop a study framework and detailed implementation plan for the period of consultancy
5. Develop, pre-test, translate and finalize survey questionnaires, standardize other survey tools ass applicable
6. Develop list of biomarkers, indicators and how they will be assessed and details of specimen handling
7. Develop logistics plan including cold chain requirements, transportation and shipment of samples to reference laboratories and quality control measures
8. Presentation of an inception report to the “Assessment and Information Management Working Group (AIMWG)”
9. Assist in recruitment of survey teams using pre-approved criteria for selection
10. Develop detailed training curriculum/plan and conduct training for interviewers, analysts and data entry staff
11. Support ethics request for government ethical committee approval process in collaboration with UNICEF
12. Develop detailed budget and supply plan of the survey based on required sample size
13. Supervise in data collection, data entry, biological sample collection and analysis
14. Develop, submit and implement data management plan including cleaning, analysis and report writing
15. Write and submit draft and final report of micronutrient survey to UNICEF with clear recommendations and follow up actions
16. Presents survey results during stakeholders’ workshop for validation and request government’s final endorsement and approval
17. Support drafting, journal identification and peer review, submission and peer review of survey report/papers to scientific journals

DELIVERBLES AND TIMEFRAMES

Task 1: Review and develop background and literature review on the nutrition status of children and women in Somalia considering contextual factors and interventions

End Product: Included in the Inception report

Timeframe: 5 working days

Task 2: Inception report outlining the detailed implementation plan, survey protocol and process, quality control procedures, survey budget, supplies requirement and logistics plan, data entry, cleaning, and processing protocols and plans

End Product: Inception report in electronic format and hard copy

Timeframe: 4 working days

Task 3: Inception meeting at Nairobi level and 3 inception meetings in Somaliland, Puntland and Mogadishu

End Product: Inception meeting report in electronic format and hard copy

Timeframe: 4 working days

Task 4: In Country capacity assessment of laboratories, cold chains

End Product: capacity assessment with recommendations on in country capacity to assess the survey biomarkers and keeping the samples safe.

Timeframe: 10 working days

Task 5: Training of survey teams, pretesting/ translation/standardization and finalization of questionnaires and survey tools

End Product: training conducted for survey teams in Puntland, Somaliland and Mogadishu and report drafted and submitted to UNICEF in electronic format and

Timeframe: 15 working days

Task 6: Data collection, organize the shipment of samples to reference laboratories

End Product: Draft status report shared with UNICEF and Ministries of Health in electronic word format

Timeframe: 30 working days

Task 7: Analysis of samples and other results and sharing of draft results tables with UNICEF

End Product: Draft results tables shared with UNICEF and Ministries of Health in electronic word format

Timeframe: 30 working days

Task 8: Write and submit draft and final report of micronutrient survey to UNICEF and then at this stage with government MoH

End Product: Survey report submitted to UNICEF and Ministries of Health for review in electronic word format

Timeframe: 45 working days

Task 9: Dissemination/validation of draft report to stakeholders

End Product: A draft survey report with executive summary, and a power point presentation of key findings to be organized for the presentation of key findings to key stakeholders at Nairobi, Mogadishu , Puntland and Somaliland state level for validation of results

Timeframe: 4 working days

Task 10: Submission of final report, data sets and syntaxes to UNICEF Somalia

End Product: Revised report with comments of validation included and submitted to UNICEF and Ministries of Health in electronic format including all data sets (both cleaned and raw) and syntax

Timeframe: 5 working days

Task II: Draft at least 3 publications with UNICEF and MoH based on survey results identify potential journals and submit for peer review

End Product: At least 3 peer review publications produced from the survey results and submitted to scientific journals

Timeframe: 28 working days

DELIVERABLES/REPORTING REQUIREMENTS

· 1 Inception report in electronic format and hard copy

· 1 training conducted for survey teams in Hargeisa, Mogadishu and Garowe and report drafted and submitted to UNICEF in electronic format and hard copy

· Draft results tables shared with UNICEF in electronic word format

· Survey report submitted to UNICEF for review in electronic word format

· A draft survey report with executive summary, and a power point presentation of key findings to be organized for the presentation of key findings

· Report results and methodology presented in power point format to key stakeholders at Nairobi level and zonal level for validation of results

· Revised report with comments of validation included and submitted to UNICEF in electronic format including all data sets (both cleaned and raw) and syntax

· At least 3 peer review publications produced from the survey results

LOCATION

The survey will take place in Somalia in collaboration with the Ministries of Health the consulting firm is expected to spend about 50% of time in Somalia during survey planning and implementation and dissemination of results at zonal level and 50% in Nairobi during final report writing and dissemination.

DURATION

Survey timeline is 1st May –30st November 2017. It is expected that the project will commence on 1st April 2017. The maximum duration of the contract will be 180 days over 240 day’s period.

REQUIRED QUALIFICATIONS

· A reputable firm or institution with documented experience in conducting nutrition surveys with particular strength in conducting micronutrient surveys is essential.

· The institution should have at least at least 5 years progressive experience in the administration of large nutrition related household surveys at national and international levels. This is an essential requirement.

· Highly familiar with sampling methodologies, concepts of statistics including health related issues

· Solid experience in research, analytical and statistical interpretation skills and corresponding to linking quantitative and qualitative data

· Knowledge and experience of Somalia operational context or similar contexts is desirable, Readiness to travel to Somalia when necessary

· Excellent reporting and presentation skills

· The contractor is expected to have already well-established partners that can be leveraged in the design and implementation of the surveys. This is desirable

· Must be familiar with statistical packages or relevant computer applications in general e.g. CS Pro, SPSS, STATA

· Prior experience with UN and other international Organizations in carrying out large scale surveys

· Fluency in English, with excellent writing skills.

· Excellent presentation skills and coordination competencies Demonstrated ability to effectively work with others and communicate in a multicultural environment

· Evidence in ability to mobilize qualified personnel

· The institutional contractor must provide UNICEF with a Certificate of Incorporation/documentation as a registered institution

PROJECT MANAGEMENT

The survey will be conducted in close consultation with Federal and state Ministry of Health and Somaliland and Puntland Ministries of Health, implementing partners, other UN agencies, ETH Zürich, Nutrition Information Working group of Somalia. The survey will be managed by the Nutrition Section of UNICEF Somalia Support Centre (USSC) based in Nairobi, Kenya and UNICEF zonal nutrition teams. The Nutrition Specialist will be responsible for the strategic direction of the consultancy work and provide hands on support in planning, coordination and supervision of the consultancy deliverables.

KEY ROLES

a) Ministries of Health

(i) Provide input to survey methodology and data collection tools

(ii) Have the planning and coordination role during the exercises

(iii) Provide ethical clearance and research approval letter

(iv) Recruit and organize survey teams (data collectors and supervisors) in consultation with contractor and in line with criteria provided by the contractor

(v) Participate and support trainings, planning and implementation at all levels of the exercise

(vi)Supervision of survey teams

(vii) Review and validation of survey results

b) UNICEF

(i) Provide input to survey methodology and data collection tools

(ii) Approval of survey methodology and data collection tools

(iii) Supervision of survey teams

(iv) Facilitate and support ethical approval process from Ministry of Health

(v) Review and validation of results and analysis

(vi) Facilitate dissemination of findings

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