International Consultancy (individual contractor) for a Nutrition Policy Gap Analysis in Georgia

International Consultancy (individual contractor) for a Nutrition Policy Gap Analysis in Georgia

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1. Background

According to the 2009 national nutrition survey supported by UNICEF, over one third of pregnant women and children in Georgia suffer from anaemia, iron and other micronutrient deficiencies. The prevalence of anaemia among pregnant women is 25.6 percent, which is amongst the causes for the high maternal mortality in Georgia, the 2nd highest in the Europe and Central Asia region. At the same time, the prevalence of folic acid deficiency in reproductive age women (15-49 years of age) is 36.6%, which is also high compared to other countries in the region. Furthermore, anaemia is a common health problem for children below the age of 5 years and the prevalence reaches 22.8% percent. In addition, the prevalence of chronic protein-energy malnutrition (stunting) in children less than 5 years of age is 11.3 percent, which is significantly above the level of the WHO Child Growth Standard (2.3 percent).

In 2011, a monetization exercise of Georgia's malnutrition consequences carried out by UNICEF concluded that that within a timeframe of 10 years the national burden of malnutrition is estimated at $1.3 billion (https://www.unicef.org/georgia/media/1971/file/IMPROVING%20HEALTH%20and%20BUILDING%20PROSPERITY.pdf). However, state funded activities in the field of nutrition still remain fragmented in the absence of related policies and regulations lack effective governance and oversight by the state. The ongoing nutrition interventions in Georgia are mainly supported by donors.  

In1996 Government of Georgia, with the support of UNICEF and USAID, initiated the process of elimination of Iodine Deficiency Disorders and the implementation of a Universal Salt Iodization (USI) Strategy through advocacy, capacity building, programme communication and M&E.  In 2005, the Law on Prevention of Iodine, other Microelement and Vitamin Deficiencies was adopted. The law outlaws import, production and sale of non-iodized salt & forms the basis for food fortification policy and regulations in the country.

The Georgian Government also unsuccessfully attempted to enforce wheat flour fortification with iron and folic acid during the period 2006-2009. This process was financially supported by the Global Alliance for Improved Nutrition (GAIN).

In addition, UNICEF supported the development of a life-cycle nutrition strategy for the country and some of its recommendations were taken into consideration by the Government since 2012. Since 1 July 2014 (i) every pregnant in Georgia receives folic acid supplementation free of charge during their first antenatal visit and (ii) every pregnant with detected iron deficiency are provided with free iron tablets.

Furthermore, in 2015 the National Centre for Disease Control and Public Health with the support of UNICEF and CDC Atlanta established a nutrition surveillance system with four sentinel sites in four regions of Georgia to track the nutritional status of reproductive age women and U5 children in Georgia. Based on the findings and due to UNICEF's strong advocacy, in June 2016 the Government initiated multiple micronutrient supplementation program for 6-24 months babies from vulnerable families. The program implementation proved to be problematic, has questioned its continuation and is suspended till the latest information on children's nutritional status will become available.

In 1999-2000, the Law on Protection and Promotion of Breastfeeding and Regulation of Artificial Feeding and the respective bylaws were adopted. However, in the process of massive health care reform in Georgia, the law enforcement mechanisms have been lost (the Ministry's structural unit, responsible for the law implementation monitoring, has been abolished without delegating this particular role).

Finally, school nutrition is not a priority for the Government of Georgia. Only 640 out of 2,085 schools have canteens and those offer mainly unhealthy food. Also, nutrition education is neither part of the school curricula nor any teachers' training.

The above situation calls for a comprehensive response to nutrition issues which must be based on an in-depth understanding of the gaps and difficulties in the field of nutrition in Georgia.

For the purpose of such a gaps analysis, UNICEF Georgia is seeking to recruit an international consultant who will work together with one national consultant. This Terms of Reference sets out the purpose, objectives, methodology and operational modalities for the international consultant who will be the team leader of the gaps analysis. The consultants are expected to carry out the assignment between September 2019 and February 2020.

2. Objective

The overall objective of this consultancy is to support UNICEF Georgia in obtaining a comprehensive understanding of the existing regulatory environment in the field of maternal, young child and adolescent nutrition in order to accelerate the process of developing a comprehensive nutrition agenda in Georgia.

3. Specific objectives

• To analyze existing national nutrition policies, regulations and standards, strategies and action plans in Georgia with focus on women in reproductive age, young children and adolescents.
• To review nutrition programmes, policy and regulatory documents for school nutrition in Georgia; 
• To assess the extent to which the existing national policies, program frameworks, strategies and action plans address (i) the nutrition needs of Georgia's population, including adolescents (needs identified in focus group discussions with teachers, parents and students), as well as (ii) gender inclusion and equity;
• To assess the quality and effectiveness of institutional structures/arrangements at the central and sub-national levels (including schools) and coordination mechanisms supporting enforcement of evidence-based nutrition interventions;
• To map nutrition programs run by non-governmental actors, identify best practices and implementation bottlenecks;
• To map Georgia's nutrition human resources and understand their educational and carrier path;
• To explore nutrition data collection practices in Georgia;
• To review the public sector and donors' investments in the nutrition field over the last 10 years;
• To explore the readiness of the Government to comprehensively reflect nutrition in their policy agenda.

4. Methodology and Technical Approach

It is expected that the methodology will primarily use qualitative data collection tools. The specific methodology will be developed by the consultant and may include desk review/analysis, focus group discussions, semi-structured and in-depth interviews.

At a minimum, the assignment will draw on the following methods:

• Desk review of background documents and other relevant data, including regulations, strategy documents, donor reports and assessments, etc.;
• Key informant interviews with Parliament, Government at central and national levels, academia, donor community and other stakeholders involved in nutrition work;
• Focus group discussions with health care workers, school administrators, parents of adolescents and young children;
• Case studies.

The sampling of key informant interviews and focus group discussions should be carried out in consultation with UNICEF.

The assignment should include the following steps:

Step 1: Desk review of relevant background documents. The purpose is to understand nutrition strategies, regulations and programs over the last 10 years.

Step 2: Preparation of Inception Report that includes the methodology, tools and protocols. The methodology should be prepared to cover all the intended objectives of the assignment. The methodology design will be finalized in agreement with UNICEF and the Government of Georgia.

Step 3: Data collection. The application of qualitative analyses methods is expected, which should be human rights based, including child rights based, and equity and gender sensitive.

Step 4: Data analysis. Collected information should be analysed by using relevant analysis methods that should be clearly described in the report.

Step 5: Sharing preliminary findings. The consultant(s) will share preliminary findings with UNICEF and will take feedback into consideration when preparing the draft report.

Step 6: Draft report. The consultant prepares a draft report with conclusions, lessons learned, and recommendations drawn from the data.

Step 7: Finalisation of the nutrition gap analyses report. The consultant will submit the final draft report, conclusions and recommendations to UNICEF and present them to UNICEF and other key stakeholders in a multi-stakeholder workshop, using a PowerPoint presentation and other methodologies for presenting in a participatory manner. Comments and feedback on the findings and recommendations should be incorporated in final report.

5. Deliverables and Timelines

The consultant is expected to produce the following key deliverables within the following tentative deadlines:

1. Inception report (in English) of maximum 15 pages, excluding desk review, annexes, and a summary note in preparation for data collection, by October 20, 2019;
2. A report of the preliminary findings from primary data collection (in English), including a literature review analysis and a PowerPoint presentation (in English and Georgian) to facilitate a stakeholder consultation exercise, by December 20, 2019;
3. First draft of gap analyses report (in English) of maximum 50 pages, excluding annexes, to be reviewed by the major stakeholders and UNICEF, by January 20, 2020;
4. Second draft of gap analyses report (in English) of maximum 50 pages, and a PowerPoint presentation (in English and Georgian) to be used to share findings with parliament, the Government and other stakeholders for use in subsequent dissemination events, by February 10, 2020;
5. Final report (in English) of maximum 50 pages, excluding executive summary and annexes, and a four-page executive summary (in both English and Georgian) with infographics that is distinct from the executive summary in the report, which is intended for a broader, nontechnical and non-UNICEF audience, by February 25, 2020.

The timeframe for this work assignment is from 20 September 2019 to 28 February 2020. During that period the total number of working days for the international consultant is up to a maximum of 30 days, with the estimated share of days as follows:

• Desk review and submission of Inception report- 7
• Field visits and debriefing (travel to Georgia is required, consultant is expected to arrange his/her travel and accommodation) - 7
• Draft report development - 10
• Final report submission - 4 days
• Presentation for the final conference (travel required) - 2 days.

The international consultant is expected to propose to UNICEF a detailed division of labour with the national consultant which ensures that the maximum number of 30 working days for the international consultant is not exceeded. The maximum number of working days for the national consultant is 21 days. 

6. Ethical considerations

Special measures will be put in place to ensure that the process of the gaps analysis is carried out in an ethical manner and that the participants can openly express their opinion. The sources of information will be protected and known only to the consultant. The consultant will ensure that the process is in line with UNEG Ethical Guidelines, i.e. ensuring ethical conduct in data generation will be imperative.

Specific attention should be paid to issues specifically relating to:

• Harm and benefits,
• Informed consent,
• Privacy and confidentiality,
• Conflict of interest of the informants.

Consequently, the consultant has to ensure that it is clear to all interlocutors that their participation in the research is voluntary. All participants should be informed or advised of the context and purpose of the research, as well as the privacy and confidentiality of the discussions. UNICEF's Procedure for Ethical Standards can be found at:

https://www.unicef.org/supply/files/ATTACHMENT_IV-UNICEF_Procedure_for_Ethical_Standards.PDF

7. Supervision and Organization

The international consultant will work under the direct supervision of UNICEF Georgia's Health and Nutrition Specialist and Health Education Officer, and under the general guidance of the Deputy Representative.

The assignment will be conducted by the international consultant (Team Leader) together with a National Consultant. The international consultant will be responsible for the overall process, including designing the methodology, developing tools, data collection, analysing data, drafting the Inception and the Final Reports with recommendations, and guiding the National Consultant.

No travel within Georgia is foreseen. Ad hoc trips, if needed, will have to be authorized by UNICEF and will then be covered separately by UNICEF. 

8. Conditions of Work

The consultant shall work from home for 21 days and duration of in country mission will compose 9 days (requiring two visits to Georgia at the beginning and towards the end of the project). During the working days in Georgia the consultant can use UNICEF Georgia's office space and internet connection.

9. Required Qualifications and Experiences

• Post-graduate degree in nutrition, or public health, or, epidemiology,
• Minimum of 10 years working experience in designing and implementing similar studies and systematic reviews focused on women, young children and adolescents,
• Excellent analytical thinking and strategic planning skills,
• Familiarity with rights-based approaches and principles of gender mainstreaming,
• Ability to work in a multi-disciplinary team and establish harmonious and effective working relationships,
• Ability to effectively communicate and collaborate with different stakeholders, professionals, communities, families and children,
• Previous working experience with UNICEF/UN is an asset,
• Fluency in English both written and verbal is essential.

10. Remuneration and Payment Schedule

The remuneration for the consultancy will be negotiated between applicants and UNICEF Georgia based on an initial proposal of the applicant. Payment will be carried out upon submission and approval of agreed deliverables. Payment will be made in three instalments:

• 40 % upon submission and approval by UNICEF of the inception report (Deliverable I)
• 20 % upon submission and approval by UNICEF of the preliminary finding reports (Deliverable II)
• 40 % after successful submission and approval by UNICEF of the final report (Deliverables III, IV and V)

11. Intellectual Property Rights

UNICEF will have sole ownership of all final deliverables; no parts of the document produced under the agreement will be reproduced without the permission of UNICEF.

12. How to Apply

Applicants should submit their applications online. Applications must be submitted in English language and have to include:

• A letter of interest,
• CV,
• A technical proposal (maximum 5 pages)
• Two references
• At least three samples or links to samples of previous relevant work authored by the applicant, or to which the applicant directly contributed,
• A financial proposal, including the consultancy fee and all expected travel related costs.

The technical proposal should include, but not be limited to the following:

• Methodology: It should minimize repeating what is stated in the ToR; articulate vision and anticipated challenges of the given assignment and explain the data/information collection approaches. There is no minimum or maximum length
• Work plan, based on the one proposed in the ToR, with comments and proposed adjustments, if any; and
• Detailed timetable by activity (it must be consistent with the general work plan and the financial proposal).
• A table describing the division of work between the international and national consultant, including the number of working days for each of them per activity.

Evaluation criteria for the submissions: Technical criteria - 70%; Financial criteria - 30%.

13. Submission of applications

Applications must be submitted in English.

Only applicant/s selected for further consideration will be informed about the outcome of their submission by email to the address indicated in the submission.