UNICEF is pursuing a paradigm shift that places emphasis on prevention of all forms of malnutrition and when prevention fails, treatment is provided. Management of small and nutritionally at-risk infants under six months of age (MAMI) is one of the pathways that countries can use to ensure at-risk infants do not become severely wasted or die. Early and proactive treatment of nutrition-related issues in infants under 6 months should result in fewer infants needing referral for malnutrition treatment at older ages (i.e., reduced numbers with low weight-for-length and low MUAC at age 6 months and beyond) (Bhutta et al., 2017). Core contents of the MAMI Care Pathway Package (Version 3, 2021) are based on and are intended to help operationalize World Health Organization (WHO) Guidelines for the management of infants under six months (u6m) with severe acute malnutrition (WHO,2013).

ESARO is proposing to support 7 countries (Kenya, Ethiopia, Burundi, Somalia, Malawi, Madagascar, and South Sudan) in implementing action plans for the prevention of waste  either under the Global Action Plan for wasting)1 or under UNICEF’s No Time to Waste Acceleration Plan 2022–20232. These countries contribute to about 70% of the burden of waste in the region. Support will be provided in two phases through a short-term consultancy to conduct landscape analyses of MAMI. The first phase will be a landscape analysis which seeks to detail existing services and the referral pathways and availability of trained staff at each level of the health care system. The landscape analysis will also map out any pilots and innovation actions that are underway to adopt MAMI in the region. The second phase will be informed by findings of the landscape analysis. This phase is about providing technical support to countries to develop or update policies and strategies for scaling up nutrition services for u6m infants and address gaps in the delivery of current nutrition services for children u6m.

The purpose of this consultancy is to support countries in the ESA region to strengthen nutrition services for u6m infants by incorporating elements of the MAMI framework where they are weak or missing. The landscape analysis seeks to detail the nutrition services for children u6m in terms of screening, assessment, management, and exit. An outline of what happens at each stage, who is involved, and where it takes place will be conducted. The scope and scale of any MAMI pilot or related intervention in the region will also be mapped. Depending on the availability of resources at the country level, phase two will be conducted being informed by the findings of the 1st phase. Details of the scope of work for phase two and the related costs will be incorporated by way of amendment of the phase one contract.

Under the supervision of the Nutrition Specialist, the consultant will provide technical support in conducting a landscape analysis of nutrition services for small and nutritionally at-risk children under 6 months in the region.

Scope of Work

Phase 1. Activities and Tasks:    The following are the tasks to be delivered under phase one of the contract:

• To examine the extent to which country policies and programme guidance are in-line with (WHO) Guidelines for the management of infants u6m with severe acute malnutrition (2013) and other existing guidelines (MAMI pathway/framework).
• To examine existing services (quality, availability of tools, compliance with recommended standards), the referral pathways, and availability of trained staff including health worker support materials at each level of the health care system (community, primary health care, and tertiary) for management of small and nutritionally at-risk infants under six months of age.
• To examine the coverage of screening, assessment, and management of small and nutritionally at-risk infants u6m across the health system delivery platforms (community, primary health care, and tertiary) and to identify key barriers and facilitators for uptake of services.
• To map any existing pilot or initiative to implement the MAMI care pathway, and the scope of the pilot.

Phase 2. Activities and Tasks: The following are the tasks to be delivered under phase two of the contract (under an amendment to be made upon completion of phase 1)

• Support development or updating of policy or guidelines for the prevention of wasting in at-risk children u6m.
• Support country adaptation of the MAMI user guides in the 5 targeted countries as required based on the findings of the landscape analysis: MAMI Rapid Screening guide, MAMI Assessment guide, and MAMI Outpatient guide, integrating these in existing national tools.
• Support training for the rollout of MAMI in the targeted countries

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

• An advanced university degree (Master’s or higher) in nutrition, public health, pediatric health, child health, or health-related science.
• *A first University Degree in a relevant field combined with 2 additional years of professional experience may be accepted instead of an Advanced University Degree. 
• A minimum of eight years of relevant professional experience in nutrition programming, including child survival, infant and young child nutrition, and/or maternal, neonatal, and child health and nutrition programs including experience in developing countries.
• Developing country work experience and/or familiarity with emergencies is considered an asset. 
• Ability to read, analyze and interpret complex documents is required.
• Fluency in English is required. Knowledge of another official UN language (Arabic, Chinese, French, Russian, or Spanish) or a local language is an asset. 

For more information on the position and to apply, please see: https://jobs.unicef.org/en-us/job/559702/consultant-regional-landscape-analysis-of-management-of-small-and-nutritionally-atrisk-infants-under-6-months-mami-eastern-and-southern-africa-regional-office-nairobi-90-days-over-a-12-month-period