REQUEST FOR QUOTATION – Service contract

“Consultancy to lead moderate wasting initiaitive”

Closing Date: Friday, March 25, 2022, at 23:59 EST

Background

The Global Nutrition Cluster Technical Alliance (GNC Technical Alliance or The Alliance) is an initiative for the mutual benefit of the nutrition community, and affected populations, to improve the quality of nutrition in emergency preparedness, response, and recovery. The Alliance Partners are made up of the GNC partners and other individuals, organizations, initiatives, and academia at global, regional and national levels that hold nutrition technical expertise across the humanitarian and development spheres. The Alliance’s Technical Support Team (TST) is comprised of a Coordination Unit, Help Desks and deployable Advisors who provide on-demand technical support for nutrition in emergencies both remotely and in-country, and participates in many initiatives to support better nutrition outcomes, one of which is the Moderate Wasting Initiative.

This initiative will seek to find programmatic solutions for managing moderate wasting at scale with a range of options, including the current gold standard of traditional SFP with the provision of specialized nutritious foods, for those that require it. This initiative addresses the challenges that nutrition stakeholders have in accessing and utilizing feasible and effective solutions to respond to moderate wasting in children under five years old at scale. With the focus on severe wasting due to high risk of mortality, moderate wasting is frequently overlooked whilst these children do have increased risk of morbidity, mortality and the risk of their condition becoming severe. 

Global levels of wasting are astronomical with 47 million children estimated to have experienced wasting in 2019. Of those, 32.7 million children were moderately wasted, accounting for nearly 70% of the wasted children. However, attention is focused on the severest form, with great neglect for those not yet reaching this precarious state of life or death from the condition. Naturally, the humanitarian community focuses on saving lives, however, this is counterintuitive from a policy and public health perspective. Do we wait until the effects of malnutrition are so severe that they are life threatening and nearly irreversible before we do anything? Or do we aim to address the 70% of the burden with less intense interventions to reduce to a minimum those becoming severely wasted? In essence, we are putting a plaster over a leak at the very last moment but ignoring the source that is feeding it – flawed thinking and a reset is needed. The issue is that humanitarian nutrition actors are not ‘in charge’ of this – multi-sectoral action with stakeholders across the development/humanitarian continuum are required to be able to achieve scale for these nearly 33 million children per year. 

The current solutions for treating moderate wasting by using a similar approach to severe wasting, hereinafter referred to as the ‘traditional SFP’ are prohibitively costly and intense given the numbers, making them nearly impossible to take to scale as they are – it is unrealistic for governments to consider feeding all of their moderately wasted caseload with an imported ready-to-use food (RUF) through an already overstretched health system and we should be questioning whether that is necessary.  

While Community-based Management of Acute Malnutrition (CMAM) is supposed to be the solution that covers the full prevention-moderate-severe wasting continuum, we have seen that attempts to manage moderate wasting in this way are often frustrated by ruptured supply chains and most systems lack the capacity and resources to deliver treatment at the scale necessary. Health systems experience great difficulties to maintain a consistent pipeline of RUF – meaning children that come for treatment are turned back – causing additional harm as people lose confidence in the health system as a whole. And prevention is a distant hope within the CMAM scene, as the lion’s share of funds get taken up by treatment of the severest form of acute malnutrition. A rethink is essential. Should RUF, considered the gold standard, be reserved for the most challenging cases and situations where it is essential, while prioritising less intense, less expensive, and less medical options wherever possible? 

Advocacy is also needed to increase the priority and importance given to moderate wasting at every level – it is often invisible, to governments, communities as well as parents. With the family MUAC[1] approach becoming more prominent, this gives the opportunity to identify a portion of moderately wasted children sooner[2], making parents and communities more aware of its importance and helping them to treat it sooner. National and global level policy makers should, therefore, be the target of such advocacy.

The overall objective of the Moderate Wasting Initiative is to find feasible, replicable solutions with country-level actors to bring moderate wasting management to scale. 

Through this initiative, the TST proposes to co-create a process with up to three interested fragile, low or low-middle income countries to map out and design context specific solutions with multi-sectoral stakeholders ranging from governmental bodies and UN agencies to local and women-led organisations aimed at achieving scale for moderate wasting. The idea is to create a pathway with options for differing levels of intensity that will identify and provide feasible means to start and/or scale up the management of moderately wasted cases. As this is exploratory work, it would likely focus on a sub-national level with the aim to scale up in time and with experience and learning.  

Before starting work with any country, there is a need to bring together a comprehensive toolbox of evidence-based solutions available for countries to explore. Therefore, a mapping of evidence for different solutions for the prevention and management of moderate wasting that have been used throughout the world will be undertaken at the outset.  

Finally, the governmental and global level advocacy aim for this project will be to learn and share these experiences broadly, with the possibility to set a specific advocacy agenda based on the foundation of the country level work.

  

Objective

To provide strategic and operational support to the TST Coordination Unit through leading activities that make up the Moderate Wasting Initiative

Service description

A Terms of Reference is under development and will be finalized before the consultancy contract is signed. The activities will likely include:

Finalize the concept note about the Initiative.

Lead, coordinate and facilitate the Initiative, working closely with the TST Coordinator and the TST CMAM Adviser, and engaging with a small steering group (or task force) of key stakeholders representing the Alliance Wasting GTWG, UNICEF, WFP, WHO, NGO partners, donors, and country level governmental leads.

Review and feedback on all tools and resources that are developed for the initiative, including the desk review currently being conducted.

Liaise with country leads from two or three countries to develop and co-create the in-country work.

Oversee and provide technical support and guidance (backstop) to the TST CMAM Advisor on work towards the Initiative and especially during the country level work.

Represent the Initiative in networks and external fora through attending meetings and conferences, as necessary.

Follow and stay on top of other related external work that is important for the Initiative, such as the WHO wasting guideline development process, the Advancing Nutrition survey and case studies on alternative approaches and other partners’ works that are synergistic to the Initiative amongst others.

Support the development of the Initiative’s key deliverables, mostly consisting of a learning paper that captures the country level experiences and potentially a guidance tool to support programme managers with the management of moderate wasting including alternative approaches.

TIMELINE

Approximately 15 days of work to start as soon as possible; there is flexibility to determine how the time is allocated, based on the needs of the Initiative and the consultant’s availability. At this stage, it is envisaged as approximately half to one day per week for up to 7 months, but this can be adapted accordingly as the work progresses. If needed and funds allow, there is the potential to extend after this period.

Required profile

QUALIFICATIONS & EXPERIENCE

Required:  

Master degree in Nutrition or Public Health or equivalent   

At least 10 years work experience in nutrition and public health in emergencies, with a minimum of 5 years specifically on the management of wasting (including CMAM, BSFP and TSFP) and other programs on prevention and management of nutrition in emergencies, including monitoring and evaluation

Demonstrated experience in designing and leading programmes to manage wasting, including both treatment and prevention

High level of understanding of the nutrition in emergencies global landscape and actors, including an extensive professional network

Demonstrated experience in coordination and the ability to work effectively with a range of stakeholders, including nutrition clusters, partners and government ministries.

Significant experience working in a variety of contexts, at country, regional and global levels, also including fragile and conflict effected states

Demonstrated understanding of the multisectoral drivers of malnutrition

Desirable:

Working knowledge of French, Spanish and / or Arabic

KNOWLEDGE, SKILLS, ABILITIES AND OTHER ATTRIBUTES

Leadership skills and ability to work independently, with little guidance

Innovative thinker that looks for new solutions to obstacles

Highly developed writing skills – both at a programmatic level (reports, proposals) and a policy level (policy papers, guidance notes).

Strong communications and diplomacy skills (both written and verbal) at a level appropriate for high- level external representation (lobbying, presentations). 

Proven teamwork, partnering skills (facilitating dialogue and communications across diverse sectors, institutions, and geographic administrative levels).

Ability to analyze diverse information and develop recommendations for an appropriate response to emergencies   

Excellent organizational skills and attention to detail

Proven ability to deliver remote technical support

DUTY STATION/LOCATION:

 Home based.

SUPERVISORS

The consultant will be supervised by TST Coordinator and Associate Director of Nutrition

Contract modality

Deliverable based, fixed term contract with Action Against Hunger Canada, starting as soon as possible.

Applications are open to individuals, teams of people or organizations.

How to apply

Proposals responding to this RFQ should include:

Updated CV detailing experience in conducting similar work

Maximum 1 page Cover letter.

Three references for which you have conducted similar work.

Please provide your daily rate in Canadian Dollars (CAD).

Submit the proposal before Friday, March 25, 2022 at 23:59 EST to:

procurement@actionagainsthunger.ca

Please highlight “CONSULTANCY TO LEAD MODERATE WASTING INITIATIVE” in the subject heading.

https://actionagainsthunger.ca/roq-service-contract-march-25-2022/