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  • Organization: UNICEF - United Nations Children’s Fund
  • Location: Maputo
  • Grade: Consultant - Contractors Agreement - Consultancy
  • Occupational Groups:
    • Social Affairs
    • Civil Society and Local governance
    • Aviation and Air traffic management/services (ATM/S)
    • Nutrition
  • Closing Date: 2018-09-25

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Consultancy to provide independent, critical and detailed findings on quality, effectiveness and efficiency of the pilot on the CMAM at community level.

Maputo (Mozambique)

Consultant to carry out a monitoring and evaluation of the community management of acute malnutrition pilot intervention in Mozambique

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, Clean Water

In Mozambique about six per cent of under five children are affected by acute malnutrition, according to DHS (2011), resulting from insufficient food consumption and /or diseases in a recent past as the most direct causes, which contributes to weight loss and /or edema. To ensure an efficient treatment and nutrition rehabilitation of children, the Nutrition Rehabilitation Program (PRN) was revised in 2010, and the following five components where enclosed in the intervention package: (1) in-patient treatment, (2) out-patient treatment, (3) supplementary feeding, (4) community involvement and promotion, and (5) nutrition education with cooking demonstrations aiming at improving infant feeding practices.

The main objectives of the PRN are to contribute to the reduction of undernutrition; to reduce the mortality rate among under five children suffering from severe acute malnutrition; and increase the coverage of treatment of acute malnutrition cases.  

UNICEF has been a key partner in the strengthening and scaling up of the PRN in Mozambique for more than 20 years, through the provision of therapeutic products as well as financial resources (including equipment and training materials) and technical support. However, it has been observed that the community involvement and promotion component introduced in 2010, has not been very effectively implemented due to some weaknesses in the package of intervention, including a weak linkage between the health workers in the health facilities and the community health workers. Defaulter rate at the inpatient treatment was estimated at 20%¹ in 2016 aggravated by the long distances between the communities and the health facilities, which prevent mothers from the remote areas to easily access the health services while actual program coverage of PRN is estimated to reach less than 30% of children in need in any given year (2015 PRN report).

At the same time initiatives are under way in several countries in using Community Health Workers (APE’s /ACS’s) to identify and treat children affected by acute malnutrition and prevent their deaths.

Faced with the programmatic and ethical question of how to expand access and coverage of management of SAM and MAM in children, especially in the hard-to-reach and underserved areas, in the second semester of 2017 the Ministry of Health introduced a pilot intervention on the Community Management of Acute Malnutrition, with an Integrated Community Case Management (ICCM) approach in rural communities in the provinces of Nampula (Monapo district), Zambézia (Gurúe district) and Tete (Changara district), covering one remote community in each district in the initial stage.

Based on the experiences gained in the first year of implementation and on the preliminary results achieved to date (670 children screened; 165 MAM and 8 SAM children admitted to treatment; 109 children cured successfully in Zambézia and Nampula), the Ministry of Health has recommended a scale up of the pilot intervention to other remote communities in the same provinces as well as in another three provinces (Cabo Delgado, Manica and Sofala) in 2018, depending on the support available from partners, such as UNICEF, WFP, WHO, MCSP and FHI.

Moreover, the adoption of the CMAM with ICCM into the national protocol of nutrition rehabilitation program needs to be built on evidence based interventions to ensure its efficacy and sustainability. According to the AWP 2018, UNICEF is committed to support an evidence based implementation and expansion of the pilot intervention in nine districts in the provinces of Tete (Changara and two other to be selected), Zambezia (Gurúe, Molumbo, Lugela) and Nampula (Monapo, Ribaué and Nacala-a-Velha).

However, the piloting process of the Community Management of Acute Malnutrition (CMAM) with an ICCM approach needs a close follow-up and monitoring by a nutrition public health expert which should be able to carry out the monitoring and evaluation component as well as to provide technical assistance for quality assurance throughout the implementation of this initiative. The consultant will also liaise and coordinate with the PRN technical working group at the MoH Nutrition Department and UNICEF on operational related matters to report on findings and lessons learned.

Objective

The main objective of this consultancy is to provide independent, critical and detailed findings on quality, effectiveness and efficiency of the pilot on the CMAM at community level.

Methodology and Technical Approach:

The monitoring and evaluation of this pilot intervention seeks to:

  1. Examine the feasibility and effectiveness of integrating CMAM with ICCM including a review of global and national experience in other programs in Mozambique, e.g. pneumonia and malaria treatment through APEs
  2. Determine the enabling factors for effective integration of CMAM into ICCM
  3. Identify the challenges, constraints and limitation of CMAM with ICCM
  4. Alert the MoH and UNICEF team whenever the pilot face programmatic challenges (e.g. supplies shortage, human resources availability etc.) or when the program performance falls below the global standards
  5. Document lessons and best practices in integrating CMAM with ICCM
  6. Provide programmatic recommendation and overall policy recommendation for review by the PRN technical working group (composed of staff from the MoH, partners and stakeholders, UN Agencies and NGOs)

The consultant or institution will work in coordination of the Ministry of Health - Nutrition Department and under the supervision of the UNICEF Nutrition Specialist to whom will report on monthly basis on the status of implementation of the pilot intervention in the provinces of Tete, Nampula and Zambezia. He/she will focus his support at district and community levels where 80 per cent of the time will be spent during the consultancy.

Activities and Tasks:

  1. Design the monitoring and evaluation protocol and submit to the PRN technical working group for review and approval
  2. Oversee implementation of the pilot intervention activities
  • Develop the field work plan with relevant field-based stakeholders
  • Field test tools and methods
  • Carry out jointly with MISAU Nutrition department and DPS Tete, Nampula and Zambezia supportive supervision, monitoring and evaluation
  • Provide regular (at least monthly) update on findings to UNICEF, MISAU, the PRN technical working group and the staff at the DPS Tete, Nampula and Zambezia
  • Conduct continuous follow up visits to the targeted provinces and districts to review progress
  • Propose corrective actions and in coordination with the DPS and district team contribute to the implementation of them
  • Participate in the technical meetings related to the CMAM strengthening and support the liaison with technical partners at central, provincial and district levels

   3.  By the end of the consultancy provide a detailed report of the pilot intervention with key findings and recommendations

Deliverables and Payments:

The consultant or institution will provide:

  • A monitoring and evaluation protocol in place and submitted to the PRN WG for technical review, including field level tools and methods
  • Monthly progress reports including review/analysis of CMAM performance indicators and actions undertaken for strengthening the monitoring and evaluation component of the CMAM pilot intervention in the provinces of Tete, Nampula and Zambezia
  • Intermediate (3 months) and final progress report with documented lessons, best practices and recommendations in integrating CMAM with ICCM
  • Policy brief with programmatic and policy recommendations

Payments will be processed upon acceptance of the corresponding deliverable and against an invoice that will refer to the contract and the below indicated deliverable numbers. Payments will be approved by the respective Section /Program Chief.

Deliverable 1:

Delivery timeframe: October 2018                  

Deliverable/product(s): Operational research protocol for the monitoring and evaluation component of the CMAM pilot intervention in the provinces of Tete, Nampula and Zambezia, submitted and approved by the PRN technical working group.

Deliverable 2:

Delivery timeframe: November 2018                             

Deliverable/product(s): Monthly progress report based on progress over the CMAM pilot and field mission reports, including review/analysis of CMAM performance indicators and actions undertaken for strengthening the monitoring and evaluation component of the CMAM pilot intervention in the provinces of Tete, Nampula and Zambezia,   

Deliverable 3:

Delivery timeframe: December 2018                             

Deliverable/product(s):

  • Monthly progress report based on progress over the CMAM pilot and field mission reports, including review/analysis of CMAM performance indicators and actions undertaken for strengthening the monitoring and evaluation component of the CMAM pilot intervention in the provinces of Tete, Nampula and Zambezia       

• Intermediate (3 months) progress report with documented lessons and best practices in integrating CMAM with ICCM    

Deliverable 4:

Delivery timeframe: January 2019                   

Deliverable/product(s): Monthly progress report based on progress over the CMAM pilot and field mission reports, including review/analysis of CMAM performance indicators and actions undertaken for strengthening the monitoring and evaluation component of the CMAM pilot intervention in the provinces of Tete, Nampula and Zambezia     

Deliverable 5:

Delivery timeframe: February 2019                

Deliverable/product(s):

  • Monthly progress report based on progress over the CMAM pilot and field mission reports, including review/analysis of CMAM performance indicators and actions undertaken for strengthening the monitoring and evaluation component of the CMAM pilot intervention in the provinces of Tete, Nampula and Zambezia
  • Draft final report with documented lessons and best practices in integrating CMAM with ICCM and recommendations and realistic follow up actions

Deliverable 6:

Delivery timeframe: March 2019      

Deliverable/product(s):

  • Monthly progress report based on progress over the CMAM pilot and field mission reports, including review/analysis of CMAM performance indicators and actions undertaken for strengthening the monitoring and evaluation component of the CMAM pilot intervention in the provinces of Tete, Nampula and Zambezia
  • Policy brief with programmatic and policy recommendations
  • Final report with documented lessons and best practices in integrating CMAM with ICCM, recommendations and realistic follow up actions

Management and Supervision  

The position will report to the Nutrition Specialist. The incumbent is expected to travel 80% of its time to the provinces, up to the targeted communities.

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

Academic qualifications: at least university degree in nutrition or public health and nutrition or other relevant disciplines.

Work experience: At least 2 years of relevant work experience in nutrition with focus on the management of acute malnutrition programs.

Language skills: Fluency in Portuguese and English

For every Child, you demonstrate…

UNICEF’s core values of Commitment, Diversity and Integrity and core competencies in Communication, Working with People and Drive for Results.

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.

Remarks:

Only shortlisted candidates will be contacted and advance to the next stage of the selection process.

We do our best to provide you the most accurate info, but closing dates may be wrong on our site. Please check on the recruiting organization's page for the exact info. Candidates are responsible for complying with deadlines and are encouraged to submit applications well ahead.
Before applying, please make sure that you have read the requirements for the position and that you qualify.
Applications from non-qualifying applicants will most likely be discarded by the recruiting manager.
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What does it mean?

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