Wasting in Mozambique affects a large number of the population. As per DHS 2011, in Mozambique, more than 260,000 children under five years of age, and 7 percent of women in reproductive age present signs of wasting. Therefore, already in 2010, the MoH has introduced a Protocol of Nutrition Rehabilitation (in Portuguese, PRN). The PRN defines the operations that health units must implement to rehabilitate children, adolescent and adults with signs of acute malnutrition. In 2017, a PRN-based task force led by the Department of Nutrition of the MoH, with support from its partners, started to develop a community-based version of the PRN (PRN-Com in Portuguese). PRN-Com is the closest version to what is globally called Community-based Management of Acute Malnutrition (CMAM).
Estimating the effectiveness of the PRN-Com is important and urgently needed. The Mozambican population resides mostly in rural areas. Health units are scarcely distributed on the territory. The Government has not implemented a policy requesting the population to settle around specific areas (roads, e.g.) to maximize the provision of basic service delivery (e.g: health, education, etc.). On the other hand, the capacity to support the health services outreach in rural communities living beyond 5 to 10 km from health facilities is challenged by limited financial, structural, logistic, human resources and programmatic capacities.
Therefore, it is not surprising to find some remote districts such like Milange, Nicoadala, Dondo e.g., respectively in the Central region Sofala and Zambézia province, with wasting prevalence (e.g. > 5 percent – SETSAN/IPC 2019 and 2018,) above the cut-offs suggesting the need for an emergency response (> 5 percent with aggravating factors, e.g. limited access to health services – source: Global Nutrition Cluster 2016).
Information on the actual percentage of the eligible population enrolled into the PRN programme (Coverage) is limited. Globally, it is recommended to estimate Coverage using primary-data collection, rather than secondary[1]. PRN Coverage can be measured at least using three methods (S3M, SLEAC and SQUEAC). Each one of them present distinctive pros and cons. SLEAC and SQUEAC have been used in Mozambique in Cabo Delgado in 2018.
Therefore, in Mozambique, even in the districts mentioned above, with moderate to high prevalence of wasting, and in the rest of the country, the information around PRN geographical coverage is scarce. Even with a secondary data approach, recent estimations of this sort (WFP 2019) suggest that districts reached 39 to 41 percent of coverage only, for children under five years of age. This is not encouraging because the expected global (Sphere) Standard is minimum 50 percent (rural areas). The same low Coverage estimation was reported also in districts benefitting from NGO’s support, and which would be supposed to reach, instead, a higher performance.
Furthermore, the available secondary data cannot offer information about the causal path for such a low coverage estimation. Therefore, pragmatic recommendations for improvements of PRN-Com programs are crippled.
Because of the reasons above, there is a great need to support the MoH, its provincial authorities and their field-based partners to introduce, estimate and, in the future, regularly monitor the PRN-Com program coverage. Therefore, WFP is looking for a Consultant with experience in capacity strengthening of Coverage surveys for PRN-Com programmes.
Therefore, the overall purpose of this consultancy is twofold:
Where possible, the combination of the two (or more) districts in each of the above-mentioned provinces will allow to draw important recommendations to improve and up-scale PRN-Com programs, and about the effectiveness of the support from NGOs.
More in detail, based on the two-fold purpose described above, four sets of objectives, activities and deliverables (and one optional) can be foreseen in this Consultancy.
The duration of the consultancy will be 60 days. The number of days in the field will be agreed with WFP but not less than 25 days will be based in the field. The phases will match the objectives and the activities described above and will include at least:
WFP Nutrition Emergency Coordinator of Maputo Country Office will directly be supervising the Consultants, with inputs from the WFP Nutrition Monitoring and Evaluation, and once in the field, from the WFP Head of the provincial Sub-Office and WFP Nutrition Emergency Coordinator assistant. One of the consultants will lead the process and will be accountable for deliverables of both surveys.
Experience:
[1] Secondary data Coverage method consists basically of employing not-up-to-date demographic data (denominator) against the number of PRN beneficiaries enrolled in the rehabilitation programme (numerator).
The interested Candidate will send an email:
· to be sent to both carla.ganhao@wfp.org and franck.gressard@wfp.org
· Deadline for application: 26.02.2020
IMPORTANT – Please, kindly note that only pre-selected Candidates will be contacted and invited to participate to the selection process follow up. **