Closing Date : 2017-01-20
Duty Station : Islamabad, Pakistan
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Organization: Action Against Hunger USA
Country: Pakistan
Closing date: 20 Jan 2017

Context

ACF together with scientific partners, have developed a standardized method of analyzing the causes of malnutrition and consequently improving the relevance and effectiveness of stakeholders programming in a given context: the Link NCA.

The nutritional situation is Pakistan is alarming since many years; according to the National Nutrition Survey (NNS) 2011, 8.1 out of 100 children do not live till the age of 5 years, 43.7% of children are stunted, nearly 15.1% are dangerously thin (wasted) and the proportion of wasted children is lower in urban areas (12.7%) than in rural areas (16.1%). About 31.5% of the children are underweight, with higher rates in rural areas (33.3%). The NNS 2011 also revealed that 58% of households in the country are food insecure (28.4% are food insecure without hunger, 19.8% are food insecure with moderate hunger and 9.8% are food insecure with severe hunger. The province of Sindh appeared as the most food-deprived province of Pakistan. Only 28% of households in the province were found as food secure; 21.1% were food insecure without hunger, 33.8% food insecure with moderate hunger and 16.8% were food insecure with severe hunger.

According to MICS 2014, more than four out of ten children under the age of five in Sindh are underweight (42 percent) and 17 percent are classified as severely underweight. Almost half of the children under five years (48 percent) are stunted or short for their age and one quarter (24 percent) children are severely stunted. The results also show that 15 percent of the children are wasted or thin for their weight and only 1 percent of children are overweight or too heavy for their height. The nutrition indicators according to MICS 2014 show worse situation in Sindh province, as compared to NNS 2011. One reason for this might be the effect of continuous disasters in the province, including flooding from 2010 to 2013 and drought 2014-15, to have further aggravated the situation.

Several initiatives have been launched by the Government, donor community, UN agencies and civil society to tackle the nutritional crisis in Sindh. Long awaited Government PC1 has been recently launched (2016) in 02 of the 09 priority districts in Sindh with the support of World Bank. UNICEF through its implementing partners is implementing stunting program in 03 priority districts of Sindh, while EU funded four-year multi-sectoral WINS program (2013-2016) is ongoing in 03 districts namely Dadu, Shikarpur, Thatta including Sajawal of Sindh. ACF International and Save the children are implementing this multi-sectoral EU WINS project in the above mentioned districts. This project is based on the findings of the NCA study conducted in 2012 that was carried out by ACF international in the selected districts of Dadu and Thatta, Sindh, Pakistan.

Dadu district has four Talukas (Dadu, Johi, Mehar and Khairpur Nathan Shah), which are further sub-divided into 52 Union councils (UCs), with a population of 1.1 million people. The district is estimated at 7,866 square kilometres. The rural and urban population of the district constitutes 75% and 29% of the total population respectively. The average household size of the district is 5.6 persons in rural and 6.2 in urban areas. The overall literacy rate in Dadu is 36%, which is much lower than the national figure of 49%. The health care services provided by the public health sector in district Dadu consist of 1 DHQ Hospital, 3 THQ Hospitals, 3 Rural Health Centres, 44 Basic Health Units and 2 MCHCs.

ACF is implementing EU funded WINS project in Dadu since 2012; the program focuses on implementation of Community Management of Acute Malnutrition (CMAM), including IYCF and nutrition education components while food security and livelihoods (FSL) and Water Sanitation and Hygiene (WASH) also form an integral part of the program, with the aim of addressing underlying causes of malnutrition. According to ACF SMART survey 2014 conducted in district Dadu, the prevalence of GAM (Global Acute Malnutrition) rate is 14.3% (CI 10.8 18.7) with 2.6% (CI 1.5 4.4) SAM (Severely Acute Malnutrition) and 10.5% (CI 7.5 14.6) wasted. More than half of the children under 05 are stunted or short for their age i.e. 52.6% (CI 47.1 58.1) children, though the stunting.

Factors and pathways leading to under-nutrition are diverse, complex, and most often interconnected. The immediate determinants are related to food and nutrient intake and to health while the underlying determinants include low access to quality water, sanitation and hygiene, gender inequality, household food insecurity and inappropriate care practices. Moreover, all these factors increase vulnerability to shocks and long term stresses. Like a vicious cycle, these chronic stresses such as poverty, under-nutrition, gender inequality, unsafe environment and climate change impact are both a cause and a result of poor resilience among rural Pakistanis.

ACF anticipates carrying out the Link NCA study that will lead to a common understanding among relevant stakeholders on the causes of under-nutrition. The study findings will analyse risk factors and their interplay with nutrition outcomes, with a more holistic view on the dynamics of undernutrition and a specific emphasis on stunting. Findings will be used for a proper response analysis with concerned stakeholders, inform future programming of ACF and provide the frame for the formulation of action plan. The study will also cover and help assess the extent to which ACF was able to effectively make use of the findings of the previously conducted Link NCA as part of the EU-WINS project.

The study will help to achieve specific objectives:

To estimate the prevalence of known risk factors for under-nutrition among the population and key nutrition vulnerable groups ;

To identify the prime causes of stunting in order to inform the technical strategy and programs for the prevention of the same at local level;

To determine which causal pathways of malnourishment are likely to explain most under nutrition cases in the target area;

To develop an emic definition and understanding of good nutrition, malnutrition and believed causes of under-nutrition within the target population;

To understand the local seasonal and historical pathways to under-nutrition;

To support technical advocacy on causes of undernutrition so as to support technical strategy;

In 2012, ACF Pakistan implemented a Link NCA in Dadu district. This study was done when the Link NCA method was under development, before the Burkina Faso s last pilot study. Therefore the method used was different and more looking undernutrition from a statistical point of view. To have a better and in-depth understanding, the mission had decided to implement a new Link NCA following the final version of the methodology. For this reason, the Link NCA about to be implemented will also help to answer to an additional specific objective:

To compare results with findings of the previous NCA carried out in 2012.

It will specifically answer the following questions

What is the prevalence and severity of wasting and/or stunting in the study population? Even though the study will focus on all, emphasis should made on stunting.

What is the prevalence of known risk factors*1* for under-nutrition among the population and key nutrition vulnerable groups ?

What are the causal pathways of under-nutrition*2* by which certain children in this population have become stunted and/or wasted?

How have the stuntingand wasting in this population and its causes changed a) over time due to historical trends, b) seasonally due to cyclical trends, c) due to recent shocks?

Which causal pathways are likely to explain most cases of under-nutrition? Which sets of risk factors and pathways are likely to be the most modifiable by stakeholders within a given context and within a given period?

Based on the causal analysis results, what recommendations can be made for improving nutrition security programming? How can the analysis be linked to a programmatic response?

Roles and Responsibilities

The Link NCA will be conducted by a Link NCA analyst, hierarchically managed on the mission by a mission focal point (PQA Coordinator; Shahzad Ajmal). This Link NCA focal point at mission level will coordinate and get support from a HQ technical advisor (Interim Nutrition and Health Advisor; Awino Imelda)).

Funded by OFDA, a Link NCA Technical Unit was created in 2015, in ACF-F HQ. This unit is meant to give specific technical support and advice to organizations willing to implement/implementing a Link NCA. For this reason, the Link NCA Unit has proposed to collaborate with Action Against Hunger USA HQ Focal Point for the Link NCA in Dadu district, Sindh Province of Pakistan to guarantee this technical support.

ACF USA (HQ and Pakistan mission) will closely work with the Link NCA Technical Advisor , some of the main stage will have to be validated by the Link NCA Technical Advisor (Blanche Mattern, Link NCA Unit). The following matrix outlines the key tasks and responsibilities of the focal persons in order to carry out this Link NCA:

NCA analyst Profile:

At least a master degree in anthropology, sociology or related social sciences domains; and when possible in one of field of expertise related to nutrition security

Previous experience and demonstrated skills in applied research in particular qualitative research, writing and analytical skills (at least 5 years), (may be required to produce sample of pervious report)

Previous experience in a development or humanitarian context, in particular management and programming experiences

Broad knowledge and experience of nutrition specific and nutrition sensitive principles and programming

Excellent communication and interpersonal skills

Familiarity with ACF and acceptance of ACF principles would be an added value.

Experience and understanding of Pakistan context is strongly recommended


How to apply:

Interested parties should request the full Terms of Reference for this consultancy to

tender.lsc@acf-international.org

Later, applicants should send their applications to the same email referenced under the title LINK NCA Consultancy.

Deadline for submission: Application will be considered on a rolling basis until position is filled.

Applications should include:

Up-to-date curriculum vitae

One supporting document outlining core competencies in line with the assignment, the proposed methodology of work including a detailed work plan, and financial expectations.

Evidence of past experience in undertaking similar assignments (three recent documents of similar works done)

Three (3) references of previous assignments.

Proposed cost per day for this consultancy

Only shortlisted applications will be contacted. The final selection will be done by Action Against Hunger.

For more information, prospective applicants may contact Monday to Friday between 9am and 5pm (GMT+3) at the following email address or by phone: Email: tender.lsc@acf-international.org.

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