TERMS OF REFERENCE NUTRITION AND FOOD SECURITY BARRIER ANALYSIS IN WESTERN AREA

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1 TERMS OF REFERENCE NUTRITION AND FOOD SECURITY BARRIER ANALYSIS IN WESTERN AREA Title: Location: Tentative timeline: Nutrition and food Security Barrier analysis Western Area Sierra Leone Data collection in September Key Working Contacts: Head of Department Nutrition Nutrition Programme Nutrition Security Expert Deputy Country Director Field Coordinator East Freetown 1. BACKGROUND Overall nutrition security context: Hunger and malnutrition indicators in Sierra Leone showed improving but still challenging figures in 2014 when the overall nutritional situation seemed to be improved as compared to GAM had reduced to 4.7% (4.3%-5.2%), SAM to 1% (0.9%-1.2%, 95% C.I.), and stunting to 28.8% (27.5%-30.2%, 95% C.I.) 1. With specific reference to Western Area District, the 2014 NSS showed the following rates (Table 1): Table NNS Malnutrition indicators for Western Area 2014 NNS Western Area Urban Areas Slums Rural Areas GAM 1.9% (1.2% - 3.1%, 95% C.I) 4.8% (3.8%-6.0%, 95% C.I.) 2.3% (1.6%-3.5%, 95% C.I.) 1 Ministry of Health and Sanitation Sierra Leone and UNICEF Sierra Leone, (2014) Sierra Leone National Nutrition Survey Freetown, Sierra Leone 1

2 SAM 0.1% (0%-0.9%, 95% C.I.) 0.8% (0.4%-1.6%, 95% C.I.) 0.7% (0.3%-1.8%, 95% C.I.) Stunting 17.4% (12.8%-23.2%, 95% C.I.) 17.0% (13.6%-21.0%, 95% C.I.) 22.3% (19.2%-25.8%, 95% C.I.) Although the nutrition situation was slowly improving in 2014 as compared to 2010, Sierra Leone just faced a major crisis with the EVD outbreak. The effects on the outbreak on the nutrition situation are not known as there was no specific nutrition survey done since then, but it is undeniable that the outbreak had a heavy impact on the already weak health system shifting priorities from development toward emergency response and therefore de-prioritising routine preventative and curative programmes such as IMAM and IYCF. In terms of food security, although the area of Western Area District (Urban, Rural) is found to be at the bottom of the stress scale, and in minimal phases of food insecurity (Phase 2 and Phase 1), respectively, quite a considerable number of individuals are reported to be in a Crisis Phase of food insecurity, thus at risk of facing substantial food deficit, malnutrition, or deficit in food consumption 2. According to the latest Harmonised Framework analysis conducted in Sierra Leone in October 2015, Western Area was the 1st and the 4th district for number of people in Phase 2 - Stressed (291,856 people) and Phase 3 Crisis (59,953 people) of food insecurity, respectively; and is expected to be the 1st and the 2nd during the next lean season (June-August 2016)3. The level of food insecurity in the country is the result of the negative impact of the EVD outbreak on farming activities, trade and livelihoods caused, in particular, by the implementation of GoSL emergency measures since August Since September 2015, GoSL and its partners have started to implement the GoSL Ebola Recovery Plan aiming to lead the country back to its development agenda, the Agenda for Prosperity, by The needs to strengthen the health system, at community and health facility level, as well as to reduce the risk of food insecurity of the most vulnerable people are key priorities included in this strategy. Furthermore, GoSL remains committed to implement the Sierra Leone National Food and Nutrition Security Implementation Plan (FNSI) (officially launched in July 2015), which provides guidance on the main targets Sierra Leone 2 FEWSNET, Harmonised Framework for identifying risk areas and vulnerable population in the Sahel and West Africa, Country Sierra Leone, October ibid. 4 ibid 2

3 wants to achieve to improve the nutrition security of the population, particularly children underfive and women, while recognising the role men play in ensuring the nutritional status of the households. ACF in Sierra Leone As key nutrition and food security partner, ACF has supported GoSL in the design of key documents mentioned above, as well as of the development strategies related to both sectors. Projects are designed to remain in line with the national policies and strategies concerning food and nutrition security, in particular the FNSI. ACF is working in Western Area (Urban and Rural) District since 2009 implementing Nutrition, Health, Food Security and Livelihood, and WASH interventions. Since January 2012, ACF is supporting 32 PHUs in Western Area for the provision of OTP services and 2 hospitals for the treatment of SAM cases with complications (Ola During and 34 Military Hospitals). At community level, ACF is supporting a network of community volunteers (Community Health Workers and mother to mother support group) to ensure the detection and referral of malnourished cases. Community groups (CHWs and M2M groups) have been supported to deliver primary health and nutrition education and behavior change communication at community and household level, with the goal of empowering caregivers and children to keep them healthy. Justification for a Barrier Analysis Recent studies including KAP of ACF programs and teenage mothers care practices case studies in the Western Area 2015 revealed slow progress in nutrition indicators related to maternal, infant child nutrition behaviors. Most notable are gaps in Infant and young child feeing IYCF practices like Early Initiation of breastfeeding, Exclusive breastfeeding of children under six months of age, Introduction of appropriate complementary feeds at six months access, feeding the sick child/malnourished child and Hand Washing with soap. In addition, the Emergency Food Security assessment disclosed that poverty and the exposure to international food price volatility are underlying causes of vulnerability in Sierra Leone; in fact, the main source to access food is by far the market (57%), and the most common strategies used to cope with food shortages are to reduce meal portions and eat less preferred food 5. The food intake of the households with not-acceptable food consumption (45.5% of the population 6 ) is almost exclusively 5 Ibid. 6 WFP, MAFFS (2010) Comprehensive Food Security and Vulnerability Analysis,

4 limited to cereals, vegetables (mainly cassava and potato leaves) and oil, and they never or barely consume animal proteins or dairy products 7 ACF conducted a case study on the multi-sectoral approach implemented by integrating both food and nutrition intervention in the work with Mother Support Groups (MSGs), which showed that combining the nutritional knowledge with the provision of tools and training have allowed the groups to achieve great results in terms of improving the nutrition security at household and community levels. For instance, some of the groups have revealed an interest to expand their activities to increase the quantity of vegetables produced for consumption as well as for income. Considering the lack of information regarding the key determinants in relation to nutrition and food security that impact the feeding practices of children under 5 and PMLW, ACF has decided to engage in this barrier analysis to develop in collaboration with the community a behaviour change strategy and tools. 2. PURPOSE The purpose of the BA is to analyse key behavioural determinants associated with nutrition and FSL practices at community level and identify barriers and enablers to appropriate feeding practices in order to define a behaviour change strategy. ACF aims at understanding the perception of the community in order to develop adapted approach, activities and co-produce with the community key messages that would positively impact the prevention and treatment of under nutrition in children and PWLM in WA. ACF will involve specific groups, such as teenagers, fathers and mothers, to identify their specific roles and needs in order to include them in the behaviour change processes. In addition ACF will engage with traditional healers and religious leaders in order to involve them in the behaviour change strategy. The result of the analysis will serve as basis to develop a theory of change and a behavior change strategy adapted to the Western area context with the participation of specific groups like teenagers, fathers and mothers groups in order to maximize the impact of BCC intervention. The results of the BA will include recommendation for the development of key messages and IEC material and tools, what medium/format/material is most appropriate for what target group with the community 7 ibid 4

5 3. OBJECTIVES Analyse the current practices and behaviours of the community related to nutrition security in western area Identify main determinants: barriers and enablers impacting the nutrition security of children under 5, PWLM in Western Area To develop in collaboration with the community and ACF Sierra Leone specific recommendations to improve behavioural change communication in Nutrition and food security program in western area To design a BCC strategy that include recommendations for the development of innovative tools for awareness sessions, focussing on how to pass on the messages and identify the key messages in relation to barriers and enablers To define the theory of change for ACF intervention in Western Area To build the capacity of ACF field staff and MOHS in understanding and applying Barrier analysis methodology. 4. ACTIVITIES To achieve the above-mentioned objectives, the consultant will undertake the following: Undertake a literature review of existing surveys and material related to nutrition security Design the survey method 8 and develop comprehensive tools for data collection. (in consultation with ACF coordination team) Conduct training for ACF East Freetown nutrition/fsl staff on Barrier analysis methodology Guide and conduct the assessment in the communities in collaboration with key ACF staff Analyse data and compile a comprehensive survey report Investigation results will be shared in Freetown (technical ACF and MOHS staff) by the consultant for validation. Develop key messages and tools on behavioural change communication Develop a Theory of Change for the ACF activities in Western Area 5. DURATION The proposed consultancy will last for approximately 45 days starting from September The period includes all the various steps of the analysis: from literature review to the handover of BA report, BCC strategy and theory of change. 8 ACF s Assisting Behaviour Change handbook can be used as a reference 5

6 1 week Preparation and literature review 3 weeks Field work and data collection 3 weeks Analysis and Barrier analysis report 2 weeks Development of the BCC strategy and recommendations on tools 6. EXPECTED OUTPUTS At the end of the assignment the consultant should deliver: Inception report (5 pages max) following initial literature review clearly outlining the current situation and the methodology for the BA. Barrier Analysis report A presentation of the methodology, results, BCC proposed and recommendations. The presentation will serve as tool of interaction with ACF staff, Food and Nutrition Directorate, Western Area DHMT, UNICEF, Irish Aid and other partners. BCC strategy, with specific key messages already tested and validated on nutrition security A theory of change to drive future ACF nutrition security in the area All the hard copy data collected (to be kept at ACF Field office) and a CD with the soft copy of the data used for the report. 7. DESIRED QUALIFICATIONS Experience in programming in Nutrition, Food security, public health, anthropology, social science, or related discipline Extensive Experience in leading on Barrier Analysis and development of Behavioural Change Communication or in qualitative survey (Provide evidence of previous assessments undertaken) Extensive experience in communication for development (techniques, tools, etc.) At least 3 years of international and field experience in developing countries Good understanding on nutrition security concepts (preferable) Proven ability to organize and manage surveys in a cross-cultural setting. Ability to train team and ensure quality delivery of outputs within a limited period Excellent report writing, communication and presentation skills Understanding of Sierra Leonean context is desirable Ability to communicate in Krio is desirable 6

7 8. CONDITION OF WORK The consultant will be based in East Freetown. ACF will make available to the Consultant key ACF staff that will facilitate the engagement with the communities, particularly if the consultant doesn t speak the local language. No DSA will be provided. ACF will provide: - Accommodation within ACF Sierra Leone premises - Access to Internet, stationaries (printers and faxes) and mobile phone; - Briefing from Headquarters (can be done by Skype if the Consultant is out of France) - Security and context briefing upon arrival on ACF Mission in Freetown - Transportation in Freetown for the purpose of the assignment - Contacts to ease the works with GWVC and other stakeholders - Identified focal points within ACF for any administrative, contractual and technical questions The consultant will plan for (i.e.: include in financial proposition) - Transport to and from Freetown - Rental vehicle for field work 9. FORCE MAJEURE The consultant and organisation may agree to reschedule or alter some tasks in the organisation, if unforeseen circumstances arise. In the event organisation is not satisfied with the work produced by the consultant, they may opt to terminate the contract on mutually agreeable terms. Likewise, if the consultant is unhappy with new conditions given by its client, she/he may opt to withdraw on mutually agreeable terms. 10. APPLICATION PROCESS AND SELECTION CRITERIA Applicants must provide: - A detailed CV - References of similar expertise - A detailed work-plan based on the scope of the Consultancy. The candidate is encouraged to propose additional outcomes. - A financial proposition for the Consultancy 7

8 Applicants should address applications to: ACF Sierra Leone Mission Charlotte d Elloy, Nutrition Head of Department Healthnut-hod@sl.missions-acf.org & Mumin Kallon, Deputy nutrition head of department deputynutco@sl.missions-acf.org 10 Sall Drive, off Aberdeen Road, Freetown With reference: Consultancy Freetown Nutrition security Barrier analysis Deadline: 29 th August 2016 Only short listed candidates will be contacted, dated on 12 th September