LINK TO RFP DETAILS: https://www.elrha.org/career/request-for-proposal-multi-sectoral-prevention-package-development-for-food-insecure-contexts/

BACKGROUND

The R2HC continuously monitors current and anticipated humanitarian crises with a view to identifying crisis contexts in which evidence gaps already – or may soon – hinder the ability to conduct effective humanitarian response, and minimise morbidity and mortality amongst affected people.

The current food insecurity situation in the Horn of Africa (and beyond), has been compounded by the Russia-Ukraine armed conflict and the ongoing climate emergency. This escalating crisis will have a profound impact in both the short and long term on the nutrition and health needs (and development indicators) of already stressed populations and health systems, exacerbating existing vulnerabilities.

According to the Global Report on Food Crises: 2022 is “the fourth consecutive year of rising levels of acute food insecurity,” with up to 205.1 million people in 45 countries in crisis or worse (IPC/CH phase 3+) levels of food insecurity. Per the UNICEF/WHO/World Bank 2020 estimates, 6.7% (45.4 million) children are affected by wasting and 22.0% or 149.2 million children are affected by stunting globally. WFP reports that over 9 million people die from hunger every year, that is 24,000 per day.

The drivers of food insecurity crises include acute and protracted conflict, economic shocks (including ongoing impacts of the Covid-19 pandemic and the international armed conflict in Ukraine) and the increasing effects of climate change. Food insecurity represents a significant driver of malnutrition, with the latest projections suggesting a dramatic increase in the prevalence of undernutrition worldwide. As of 2021, global projections suggest that none of the key nutrition targets will be met by 2030. The impacts of the Covid-19 pandemic, including the constraints from reduced services and inadequate diets on child undernutrition are still yet to be fully realised. In 2021 a report by UNICEF/WHO/World Bank Group estimated that the pandemic could have resulted in a 15% increase in children affected by wasting due to reductions in household finances, and disruptions in food and nutrition services.

To identify possible areas where R2HC could add value to the current crisis and future food insecurity crises, we undertook a consultation process interviewing over a dozen experts in the field of food insecurity, nutrition and health. Consultations with key informants identified that there is no standard operational package of preventive measures that is being implemented in humanitarian settings, and that could potentially be adopted as standard practice at a system-wide level. A clear gap in evidence-based practice was identified in the lack of a food security and nutrition preventive package for children under age 5 and pregnant and lactating women (PLWs). Given the limited funding available in crises, what funds are made available tend to be targeted to treatment of malnutrition, as opposed to the prevention of it, despite the known negative impacts on the health and wellbeing of PLWs and children when they suffer episodes of undernutrition (e.g. low birth weight infants, anaemia, susceptibility to infection, reduced physical growth and cognitive effects).

This research initiative proposes the consultative development and testing of packages of multi-sectoral preventive intervention aligned with the IPC Acute Food Insecurity phases, that have clear indicators for activation in IPC/CH phases 1, 2 and 3 to avoid households and communities falling into IPC 4 & 5. We acknowledge that the link between food insecurity, malnutrition and ill-health is not always linear, hence our focus on a multi-sectoral prevention package.

The objectives for this work are as follows.

• Objective 1: To conduct a scoping review to understand existing food security and nutrition preventive packages for children and PLWs in humanitarian settings. (Note: that if the provider identifies that there are other vulnerable groups that should be included in this scoping review, this can be discussed with R2HC and this scope may be expanded)

• Objective 2: To develop and define the preventive package(s) for children and PLWs that would be appropriate to implement in different IPC phases of food insecurity, with particular focus on differential vulnerabilities including IDPs, Refugees, Host Community, Nomadic Groups, People in areas with access challenges. This will include a matrix of how “wide” the preventive package extends in terms of inclusion of activities in Health, WASH, Livelihoods, Social Protection etc.

• Objective 3: To test (refine) how the proposed preventive package(s) interacts with nutrition / food insecurity interventions (and other sectors) in various IPC phases (e.g. malnutrition treatment / food assistance / cash / social protection schemes).

• Objective 4: To conduct a cost-effectiveness analysis of the proposed preventive package(s) to both compare to nutrition/food insecurity treatment interventions in food insecure settings and to evaluate benefits of linked prevention/treatment.

• Objective 5: To develop a model for prevention that can be integrated into global policy and guidelines, based on a cross-country analysis of the tested packages.

Ultimately this work aims to influence funders and governments to invest earlier to prevent cyclical food crises, acknowledging that such crises are not simply a result of an evidence-gap in how to respond, but that the funding and political will to act earlier is essential.

R2HC intends that this work will be split into 4 distinct phases, with this ToR seeking to solicit applications from qualified providers with experience in humanitarian food security and nutrition for the Inception Phase & Phase 1. We include some detail on Phases 2 & 3 for context only.

Inception Phase: Steering Committee

A Steering Committee will be established to guide this research programme and to ensure that outputs are made available to those actors best positioned to influence global and national policy. The Steering Committee will consist of experts in humanitarian Food Security, Nutrition, Health and related sectors, with a particular view to equity of participation with LMIC actors (including national Ministries) prioritized for inclusion. This process will be guided by Elrha, and we anticipate that the Steering Committee will play an active role in guiding all 3 phases of the work.

Phase 1: Scoping and Preventive Package Development

This formative research phase will aim to answer Objectives 1 & 2 of this programme of work through a jointly developed methodology. The selected provider will lead on this work, with the support of R2HC, and we anticipate that the work will take 23 months, following contracting.

Phase 2: Testing and Cost-Effectiveness (NOT included in this RfP)

The trial phase of this research programme is expected to be complex, with R2HC launching a call for proposals for academic-humanitarian consortia to evaluate the preventive package, and to conduct cost-effectiveness analyses in a variety of geographies over a 2-year timeframe. The work from Phase 1 will feed directly into the development of the call for proposals.

Phase 3: Cross-Country Comparison (NOT included in this RfP)

Following completion of all field studies, a research team will be contracted to conduct a cross-country comparison of findings, with the aim of developing a model that can then be integrated into global policy and guidelines.

ACTIVITIES

The key activities envisaged to complete this work are as follows:

• Identify (with R2HC guidance) key individuals to sit on the Steering Committee for this work, induct them into the Committee, co-develop a ToR for their governance oversight and keep them engaged through regular meetings and reviews of key documents over the course of the consultancy period.

• Develop and implement a research protocol for a scoping review to understand existing food security and nutrition preventive packages for children and PLWs in humanitarian settings. The boundaries of this scoping review will be co-developed with R2HC and the Steering Committee.

• To convene influential stakeholders (with the support of R2HC and the Steering Committee) to define and develop the preventive package(s) for children and PLWs that would be appropriate to implement in different IPC phases of food insecurity. This may involve in-person and/or online meetings.

• Socialise the proposed package(s) with stakeholders that may not have been involved in the development process to raise awareness and link these packages with ongoing food insecurity programmes being implemented in various contexts.

APPROACH AND METHODOLOGY

This scoping review and multi-sectoral prevention package development aims to contribute to knowledge and practice in preventing the impacts of food insecurity and malnutrition in humanitarian settings on vulnerable groups. We anticipate that the scoping review will narratively bring together evidence on what interventions work in preventing food insecurity and malnutrition, that could be rolled out in IPC levels 1, 2 and 3. The proposed methodology should include academic as well as grey literature, with a well described search and extraction strategy to ensure that the resulting paper is robust and publishable in a peer-reviewed journal.

The package development process methodology could include interviews, focus groups, convening meetings (in person or remote), surveys or other tools that that applicants feel would be most beneficial in getting the views and engagement of key actors who are best placed to then advocate for and implement the package. A clear description of who and how the applicants will engage key stakeholders in the process is required, and we encourage applicants to consider if there are particular policy initiatives that this work could align with.

The methodology proposed should clearly describe how ethical considerations will be addressed during the research.

The applicants will be responsible for the methodology design, which should be outlined in the proposal and will be jointly agreed upon during the inception phase.

Note that we are open to suggestions that diverge from what it is outlined above. If needed we are prepared to fund international travel at a reasonable level (eg. to convene a meeting or to meet face to face with key actors or to attend relevant events), however Elrha has a travel policy that carefully considers the impacts of travel on climate change therefore all travel plans will be reviewed carefully.

Note that R2HC will commission any needed infographics, format and design the outputs and pay any Article Processing Charges. As such these costs do not need to be included in the proposed budget.

PROPOSAL REQUIREMENTS

We anticipate contracting a team comprised of different specialty areas to conduct this work. The team is expected to be made up of individuals or organisations that bring skills in research, humanitarian food insecurity and nutrition and guideline-development and policyinfluencing. It is essential that the team are strongly networked into the humanitarian food security, nutrition and health spaces at global and regional levels.

CVs and other provided documents should demonstrate that the team possess the following essential criteria:

• Advanced degrees (PhD or similar) in public health, epidemiology, humanitarian nutrition, food insecurity or similar

• 10+ years experience in implementation, policy and or research in humanitarian settings where food insecurity is a major concern

• At least 5 years experience in conducting multi-sectoral scoping reviews

• At least 10 years experience convening multi-sectoral normative bodies to develop guidelines in humanitarian food security and nutrition

• An extensive record of engagement with humanitarian food insecurity and nutrition actors at global, regional and national levels

• Experience in setting up and managing Steering Committees in humanitarian research

• Excellent writing skills with a proven record of publication

• Experience translating research findings into easily digestible formats (eg. guidelines/package documents, slide-decks)

We anticipate proposals with budgets in the range of £125,000, however well-justified proposals above this budget may be considered.

Budgets should exclude applicable UK VAT but include any taxes overseas suppliers may be liable for outside the UK. Please indicate if you/your company is VAT registered and where. The budget submitted to us should be broken down by activity and with any allocations for individual team members shown clearly. This should include any travel costs (including for proposed in-person meetings) and other expenses.