Nutrition Consultant

• Given the dire humanitarian situation & needs, our client supports a wide range of health & nutrition responses across Yemen. This ranges from preparedness & reporting to the immediate needs of responding to the risk of famine, disease epidemics / pandemics (ongoing COVID-19 pandemic, cholera, diphtheria & measles among other potential outbreaks), to preservation of the collapsing health system at all levels. 
• According to most recent Yemen situation analysis report (June 2020), key child outcomes are a manifestation of Yemen’s weak health system. The national under 5 mortality rate has hovered around 55 per 1,000 children, although national under 5 mortality rate data are outdated. There have been sustained levels of chronic malnutrition in children under 5, hovering between 45 & 47 % since 2013. Acute malnutrition (wasting) levels in Yemen at any given time during the past 3 decades ranged between slightly above 10 % to slightly above 15 %. This is indicative of minimal changes in the acute malnutrition situation in the country between 1991 & 2019. However, more prominent declines have been observed in the severe acute malnutrition situation ranging from 3.6 % to 1.7 % between 1991 & 2019. The reduction of the severe acute malnutrition is attributed to the country wide scale up of the CMAM program
• OCHA estimates that 36 % of people in Yemen are malnourished, with over 9 % of all children suffering from Severe Acute Malnutrition (SAM). Yemeni women bear the burden of caring for malnourished children while also facing increasing malnutrition themselves (e.g., an estimated 7 out of every 10 women of reproductive age in Yemen are estimated to be anaemic), in addition to other adverse health outcomes.
• To address the nutrition situation in Yemen, our client continues to provide leadership in the nutrition cluster inter agency coordination, continuous monitoring & assessment of the health & nutrition situation through SMART surveys & other health facility assessments in addition to continued scaling up of high impact health & nutrition services for children & their families.

• Our client has prioritised the scaling up of the CMAM, including through the provision of technical & financial assistance to 38 implementing partners. CMAM is a community based approach to detect & treat acute malnutrition among children, pregnant & lactating women in the community. It has 4 components:

1. Community outreach with support of CHNVs.
2. Management of Moderate Acute Malnutrition (MAM) through Supplementary Feeding Programs (SFPs).
3. Management of Severe Acute Malnutrition (SAM) without complications through Outpatient Therapeutic Program (OTPs) mobile teams & outreach sessions.
4. Management of SAM with complications through Therapeutic Feeding Centres (TFCs).

• Our client currently provides OTP support in 3,934 sites in 2019 covering 85 % of functional health facilities (compared to 223 OTPs in 2011 & 3,593 in 2018) reaching a total of 339,546 children with SAM in 2019.

• Our client supports & promotes optimal & safe infant & young child feeding practices in health facilities at all levels of the PHC system (health units, centres & hospitals) as corners for counselling.
• Our client also supports IYCF activities in the community through Community Health & Nutrition Volunteers (CHNVs), Community Midwives (CMWs) & Community Health Workers (CHWs), mobile clinics & integrated outreaches where health workers & health volunteers receive IYCF training in a CMAM training module.
• In spite of the scale up of interventions to reach 1,660,788 children (50 % girls) in 2019, 27 % of the districts had poor IYCF coverage.

• Our client provides support to ensuring children & women receive vitamin A, micronutrient powders & iron folate supplementation, respectively. Through & an adolescent & youth program, our client has initiated a pilot approach to prevent iron deficiency anaemia in adolescent girls & boys through weekly iron & folic acid supplementation in 2 governorates.
• As a strategy to improve access to both preventive & curative services in Yemen due to low facility coverage & poor access to services, our client supports scale up of nutrition programs beyond health facilities through Mobile Teams (MT), CHNV’s & CHW’s.
• Our client also supports supportive supervision at all health system levels including central, governorate & district level. Each of the different programs like nutrition, IMCI, MNH & EPI, cholera have supervision mechanisms. In addition, since 2017 our client supports integrated supportive supervision through which all the different program focal persons conducts joint supervision visits to the health facilities.
• In 2019 & beyond, in addition to maintaining & expanding its support to the above & other critical health & nutrition services, our client will focus & invest in improving & strengthening the primary health care system in Yemen, including quality of care & services during the implementation of its health & nutrition program. 

• Despite the significant investments & scale up of nutrition programs in Yemen, coverage gaps remain across all program areas. Bottlenecks & gaps identified include local insecurity, import restrictions on supplies, limited number of health facilities & health workers including community health volunteers & unpaid health workers. Furthermore, our client's internal nutrition HR capacity remains inadequate despite having 1 of the highest funding levels in the CO & the significant scale up of the nutrition program over the years. Currently there are 15 full time dedicated nutrition staff in Yemen:

1. YCO nutrition team 10.
2. National nutrition cluster 3.
3. Aden nutrition cluster 1 & 1 double hatting cluster & program.
4. Sanaa 1 double hatting cluster & program.
5. Hodeida 1 double hatting cluster & program.

• In addition to the dedicated nutrition staff H&N Program Officers & IMOs in each hub provide some support to nutrition programs in the 5 FOs, however these staff do not spend 50% of time on nutrition despite 50% of all H&N posts including PA’s & Information Management Offices (IMO’s) salaries being covered by the nutrition program. There is an immediate & urgent need to fill this HR gap to support direct follow up & support of the nutrition program.
• It is anticipated that this will meet the immediate HR needs whilst the ongoing strategic moment of reflection & program strategic note development will make medium to longer term nutrition staffing recommendations.

• The objectives of the assignment are aligned to supporting the implementation of the nutrition components of our clients rolling work plan specifically under AWP outputs 1.4, 1.5 & 1.6 through the recruitment of 10 Nutrition Consultants to meet the current nutrition HR gaps in our clients YCO team. It is proposed that of the 10 consultants, 6 will be allocated to the FO, 1 in each FO except Aden FO which will have 2 consultants due to its larger geographical coverage. At central level, 4 consultants are proposed to support nutrition assessments, information management, supplies management, CMAM, the CHNV program & to provide technical leadership support to the nutrition cluster (CMAM IYCF & nutrition information).

The consultant will have a broad role but his / her’s main role will be to provide additional technical support & follow up across all nutrition program functions in various locations across Yemen. In addition, the role & tasks will be adapted as required based on the location & needs within a specific location. The functions below are cognizant of the existing health & nutrition section program structures & nutrition cluster & sub cluster coordination structures in YCO. Therefore, the consultants recruited are expected to work alongside staff & structures already in place & play a facilitative & supportive role across all key nutrition program functions. The central level consultants will be given more specific roles & tasks depending on program areas to be assigned:

• Support micro planning & strengthening health & nutrition planning at all system levels including at community level.
• Coordinate monthly / quarterly progress meetings with IP’s (govt. & NGO partners) at the various levels, where appropriate & as required.
• Support GHO’s & districts to document & follow up action points / recommendations from regular nutrition related program meetings or reviews.
• Participate in nutrition cluster coordination meeting to improve links between the cluster & YCO nutrition program at all levels. Central level consultants may be expected to lead aspects of technical support for the nutrition cluster.
• Support the planning, development & oversight of H & N Program Cooperation Agreements (PCA’s) at field or CO level. There is currently inadequate capacity at FO level to support the implementation of the recent YCO decentralisation strategy which empowers FO’s to develop their own PCA’s. Nutrition consultants recruited will be expected to play a critical role in supporting these processes. 
• Support FO & central level nutrition staff or focal points to develop clear expenditure plans aligned to the annual work plans & facilitate their implementation & monitoring. This will include any nutrition related cash transfers, direct payments, reimbursements & follow up of any outstanding accountabilities among others.
• Specifically, as part of our new risk strengthening measures (HACT+) as reflected in newly introduced our clients SOP's, the consultants will assist the nutrition program in the verification of direct payments, verification of beneficiary or payee lists & any other related tasks.

• Provide technical backstopping & follow up support across all nutrition program areas as & when required specifically:

1. CMAM: Support delivery of services through the more than 3900 treatment sites across the country at national & district levels in collaboration with govt. & IP’s.
2. ICYF program: Provide oversight of the IYCF counselling services through IYCF corners & at various health service delivery points.
3. Micronutrients: Support the follow up of ongoing micronutrient supplementation activities, vitamin A supplementation, deworming, micronutrient supplementation of children 6 - 23 months & iron folate supplementation of pregnant & lactating women.
4. CHNV: Support to liaise with GHO’s, DHO’s & or MOPH to streamline CHNV lists, follow up CHNV activities (screening of malnutrition,  micronutrient supplementation, IYCF counselling among others, review meetings, support supervision) in close collaboration with the CHNV GHO / DHO focal points & ensure regular & timely submission of reports. Identify program bottlenecks, constraints & seek local solutions in consultation with our clients nutrition staff or focal points.

• Initiate, support & monitor nutrition capacity building activities across all nutrition program areas.
• Provide supervision & monitoring support of nutrition related activities. Note that COVID-19 restrictions may limit movements & the ability to rigorously oversee nutrition programs thus, the consultants will need to devise alternative or remote approaches to ensuring oversight of the nutrition programs.
• Conduct & / or support donor requested 3rd party monitoring as & when required.

• In collaboration with Nutrition Information Specialists & IMO’s ensure the submission of timely & quality nutrition related information through DHO’s, GHO’s & PCA partners.
• Participate in & support regular nutrition assessments or SMART surveys / FSLA & IPC analysis among others.
• Supporting information management systems including innovations (RapidPro, LMIS & other mHealth interventions, DHIS 2), as necessary.
• Ensure HMIS registers & other nutrition data tools are available & used correctly in the facilities.
• Support program monitoring, reporting & lessons learned documentation.
• Support the development of program documents & planning tools for nutrition programming.
• Participate in & support nutrition related program evaluations.
• Support knowledge management & evidence generation.

• Support nutrition program staff to appropriately define the supply needs, to forecast & procure nutrition supplies in an efficient & timely manner to avoid stock outs.
• Support the preparation and follow up of nutrition supply distribution plans in consultation with IP’s (govt. & PCA partners) according to the needs of the various delivery platforms HFs, CHVs, MT’s among others.
• Provide monthly updates on nutrition supply stock levels including end user monitoring at HF’s, district & governorate levels to ensure a more efficient nutrition supply chain system including ensuring the contingency stock at all levels.
• Conduct at least 1 visit per quarter to the nutrition warehouses at the governorate level & conduct on the job training for the storekeepers on nutrition supply management including storage conditions.

• Monthly nutrition progress report based on agreed up on parameters & indicators.
• Other reports in line with work plan key tasks articulated in scope of work (includes donor reports, other thematic reports).
• Real time flagging of issues (e.g. nutrition supply stock outs, pending payments or accountabilities etc.).
• Final consultancy report.