Individual Consultant to assess the Impact of Core Supplies Pipeline break down (RUSF and RUTF) on CMAM programme new admissions among under-five children in Sudan (3 months - open for both national and international consultants)

The consultant will be responsible to carry out an assessment in the selected states to assess the impact of core supplies (RUSF and RUTF) pipeline break on CMAM new admissions/re-admissions in SC, OTP and TSFP; assess the implementation of the simplified approach to identify the average length of stay and average consumption of RUTF sachets/cartons per child in OTPs using the simplified approach; estimate the contingency of RUTF stock to ensure continuum of care from SAM to MAM condition until when they are completed cured and discharged from treatment programme; and undertake a comparative analysis of simplified approach Vs traditional CMAM approach in terms of average length of stay, RUTF consumption and treatment outcomes.

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For every child, Health

Background and purpose of assignment:

Malnutrition in Sudan is a major public health concern, with a stunting prevalence of 36.4 per cent which is above the WHO critical level. The Global Acute Malnutrition (GAM) stands at 13.6 percent; over 611,000 children have Severe Acute Malnutrition (SAM) and 2.4 million have Moderate Acute Malnutrition (MAM).

Children with acute malnutrition are treated through the Community Management of Acute Malnutrition (CMAM) programme. The CMAM was rolled out in 2010 as one of the country's approaches to reducing child mortality and acute malnutrition. UNICEF and development partners such as WFP and WHO are supporting the delivery of life-saving interventions across all the states in the country.

To ensure the continuum of care for acutely malnourished children, SAM cases are admitted and treated for severe acute malnutrition in 1,838 Outpatient Therapeutic Programme (OTPs) sites and MAM cases are admitted in 1,362 to 1482  Targeted supplementary feeding programme (TSFPs)sites.  OTP and TSFP complementarity were at 68% of the OTPs and 90% with respect to the TSFPs with OTPs by end of September. This mean, 32 % of OTP sites were without TSFP.  Following TSFP suspension in some of the sites, TSFP sites decreased from 1362 to 1189 by the end of 2022. The sector estimates that, the complementarity between OTP and TSFP dropped accordingly during the 4^th Quarter of 2022.

Following the pipeline breaks of Ready to Use Supplementary Food (RUSF) used to treat MAM children, the simplified approach was implemented to improve the efficiency, effectiveness, coverage, and quality of CMAM programmes across Sudan.  The simplified approach guidance/circular focused on two elements. First, treating acute malnutrition as one continuum (transition from SAM to MAM) using Ready to Use Therapeutic Food (RUTF) at OTPs where there is no TSFP programme and OTPs with RUSF stockout.  Second, treating MAM cases using Plumpy Doz where RUSF is not available.

Nutrition Sector Partners and stakeholders including donors have been calling for better understanding of the impact of the core supply pipeline break especially following suspension of about 20% of the TSFP sites during the last quarter of 2022.  The nutrition sector coordinator approached UNICEF- Nutrition Section requesting financial support to implement such an operational study.  As part of UNICEF's commitment to generate evidence to better understand the impact of the core supplies (RUTF and  RUSF) pipeline break on CMAM new admissions among under-five children and the implementation efficiency of the simplified approach, UNICEF has accepted the nutrition sector request to fund this operational study. In view of this, UNICEF will be hiring a  consultant on behalf of the sector.  The consultant will be responsible to carry out an assessment in the selected states to:
1) Assess the impact of core supplies (RUSF and RUTF) pipeline break on CMAM new admissions/re-admissions in SC, OTP and TSFP.  
2)Assess the implementation of the simplified approach to identify the average length of stay and average consumption of RUTF sachets/cartons per child in OTPs using the simplified approach. 
3) Estimate the contingency of  RUTF stock to ensure continuum of care from SAM to MAM condition until when they are completed cured and discharged from treatment programme. 
4) Undertake a  comparative analysis of simplified approach Vs traditional CMAM approach in terms of average length of stay, RUTF consumption and treatment outcomes

Scope of Work:

In guidance and consultation with the National Nutrition Sector Information Technical Working Group (NISTWG) and the Strategic Advisory Group (SAG) the specific task of the consultant includes:

1. Develop a study approach (design the methodology, data collection tools, training material, analysis plan … etc ) to assess the impact of the RUSF and RUTF  pipeline break on CMAM new admissions/re-admissions in SC, OTP and TSFP.
2. Present the operational study approach/methodology to NISTWG members and address comments as required.
3. Present the operational study  methodology to nutrition sector partners and stakeholders for inputs and reach consensus on the methodology.
4. Carry out the study in the selected locations to assess the impact of the RUSF/RUTF pipeline break on CMAM new admissions  (data collection, data management, processing, analysis and writing up the preliminary report).
5. Assess the challenges (Collect data) on the implementation of the simplified approach.
6. Analyze the availability of data regarding nutritional supplies (pipeline and site level availability) and provide recommendations on frequency of reporting and which data collection tools to be used.
7. Present comparative analysis of simplified approach Vs traditional CMAM approach in terms of average length of stay, RUTF consumption and treatment outcomes.
8. Draft and present the preliminary report to NITWG/SAG members, nutrition sector partners and other stakeholders and develop consensus on the findings.
9. Finalize the study report in consultation with NISTWG and  SAG members and other stakeholders and submit the final report.

Work Assignment Overview:

Activity #1: develop a study approach (design the methodology, data collection tools, training material, analysis plan … etc ) to assess the impact of the RUSF and RUTF  pipeline break on CMAM new admissions/re-admissions in SC, OTP and TSFP.

Deliverables/outputs under activity #1:

• Development of study approach outlining the detailed methodology for assessing the impact of the RUSF and RUTF pipeline break on CMAM new admissions/re-admissions in SC, OTP and TSFP.
• Present the operational study approach/methodology to NISTWG members and address comments as required.
• Present the operational study methodology to nutrition sector partners and stakeholders for inputs and reach a consensus on the methodology.
• Finalise the study methodology.

Timeline to complete the group of deliverables/outputs under activity #1: by 23 April 2023.

Activity #2: 

• Carry out the study in the selected locations to assess the impact of the RUSF/RUTF pipeline break on CMAM new admissions. This includes data collection, data management, processing, analysis and writing up the preliminary report. 
• Assess the challenges (Collect data) on the implementation of the simplified approach. 
• Analyze the availability of data regarding nutritional supplies (pipeline and site level availability) and provide recommendations on frequency of reporting and which data collection tools to be used.
• Present comparative analysis of simplified approach Vs traditional CMAM approach in terms of average length of stay, RUTF consumption and treatment outcomes.

Deliverables/outputs under activity #2: draft and present the preliminary report to NITWG/SAG members, nutrition sector partners and other stakeholders and develop consensus on the findings.

Timeline to complete the group of deliverables/outputs under activity #2: by 23 May 2023.

Activity #3: Finalize the study report in consultation with NISTWG and  SAG members and other stakeholders and submit the final report.

Deliverables/outputs under activity #3: submission of the final report and dissemination to partners. 

Timeline to complete deliverables/outputs under activity #2: by 02 July 2023.

Travel considerations:

The consultant should be based in Sudan while working on this assignment. The consultant is expected to travel to some regions in Sudan, this will be determined based on the study methodology.

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

• An advanced university degree (Master’s or higher) in Nutrition, Medicine, Statistics, Public health, biostatistics, Information technology or other related fields.
• A minimum of 7 years of relevant professional experience in epidemiology, nutrition epidemiology, nutrition studies and surveillance.
• Extensive experience with CMAM programming in  both emergency and normal contexts.
• Strong statistical and analytical skills including study designs, inferential statistics, analytical studies and computer programs skills.
• Developing country work experience and/or familiarity with emergency is considered an asset. 
• Fluency in English is required. Knowledge of local language (Arabic) is an asset.

Qualified candidates are requested to submit:

1. Proposed methodology/approach to managing this assignment.
2. All-inclusive financial offer.

For every Child, you demonstrate… 

UNICEF's values of Care, Respect, Integrity, Trust, Accountability, and Sustainability (CRITAS). 

To view our competency framework, please visit  here. 

 UNICEF is here to serve the world’s most disadvantaged children and our global workforce must reflect the diversity of those children. The UNICEF family is committed to include everyone, irrespective of their race/ethnicity, age, disability, gender identity, sexual orientation, religion, nationality, socio-economic background, or any other personal characteristic.

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment. 

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. 

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.