Consultancy To Implement Research On Linking Management – UN Children’s Fund

Background and Justification
The treatment of acute malnutrition was for a long time restricted to facility-based approaches, greatly limiting its coverage and impact. This changed over the last decade informed by new evidence that large numbers of children with acute malnutrition can be treated in their communities, with weekly or bi weekly visits to primary health facilities, without being admitted to a health facility or a therapeutic feeding centre. Recent evidence from across the world has shown that community health workers (CHWs) can easily identify the children affected by acute malnutrition and if effectively linked with a facility-based therapeutic care for referral could prevent the deaths of hundreds of thousands of children. Faced with the programmatic and ethical question of how to expand access and coverage of management of acute malnutritionin children, especially in the hard-to-reach and underserved areas, nutrition stakeholders have recently started to explore the potential for linking Community Management of Acute Malnutrition (CMAM) and Integrated Community Case Management (iCCM). The hypothetical advantages of linking iCCM and nutrition services seems obvious given that malnutrition and iCCM targeting conditions of diarrhoea, malaria and pneumonia are intertwined in a self-reinforcing cycle and their prevention and management overlap considerably. An integrated approach to addressing the twin problems of disease and malnutrition would make it possible to break the vicious cycle by addressing the presenting and underlying aspects of a child’s illness, thus contributing to reducing the burden of common childhood illnesses and maximising child survival in vulnerable communities.
To date, management of malnutrition in the Kenyan context remains confined to the health facilities by the skilled health workers who are guided by the natial protocol- Integrated Managment of Acute Malnutriton (IMAM). Bringing free and effective treatment close to communities therefore, will likely improve access to and utilization of services for management of malnourished children that often takes weeks of follow up. The big wins of integration of management of acute malnutrition with iCCM is expected to be in sparsely populated Arid and Semi-Arid Lands (ASAL) Counties where access to facilities is relatively limited with long distance as well as harsh environment to walk. . For this to be effected, there is need to determine the practicality and effectiveness of case management at communmity level, through CHVs once they are equiped with the techcnial skills and materials to enable them carry out this role.
The Ministry of Health, UNICEF, Save the Children, WFP and Action against Hunger have partnered for the development of an implementation research. A research protocol has been drafted and several consultations undertaken both with Emergency Nutrition Advisory Committee (ENAC) and iCCM National Technical Working Group (iCCM-TWG) to refine the research approach and methods. After considering several factors, Isiolo and Turkana Counties were selected for the implementation research and preparation is underway to start the implementation. A principal investigator affliated to a research institution to lead this research is required to revise and finalize the draft study protocol, implement the research and document and present the findings at the end of the study period.

Objectives and Scope of Work
The main objective of this consultancy is to provide an independent, critical and detailed findings on effectiveness, efficiency and impact of integrating management of acute malnutrition into iCCM through an implementation research. The research seeks to:

To examine the feasibility and effectiveness of integrating management of acute malnutrition (both MAM and SAM) and iCCM including performance and coverage
1. To determine the enabling factors for effective integration of management of acute malnutrition and iCCM.
2. To identify the challenges, constraints and potential pitfalls in integrating management of acute malnutrition and iCCM.
3. To document lessons and best practices in integrating management of acute malnutrition into iCCM
4. Provide policy and programmatic recommendations emanating from the research
From this implementation research, it is expected that there will a documentation of findings and list of specific recommendations for policy makers. The intended audience of this work are MOH policy makers, UN agencies, implementing partners and wider health practitioners.

Key Tasks/Activities
The implementation research will be undertaken in Turkana and Isiolo counties where MOH, in collaboration with Save the Children in Turkana and Action against Hunger (ACF) in Isiolo, will implement community management of acute malnutrition integrated and delivered through the iCCM platform. From the start of the implementation, the institution is expected to take key tasks and activities to monitor and document lessons as key observant of the implications of linking iCCM with IMAM at community level. This includes:
Identify Principal Investigator and Train Qualified Research Team(s)
The selected institution is required to present the name and curriculum vitae of the principal investigator (PI) together with the application for this TOR. In addition, the institution will be responsible for the recruitment and contract (as appropriate) and train the research team members required to complete the research.

Key Tasks/Activities
The implementation research will be undertaken in Turkana and Isiolo counties where MOH, in collaboration with Save the Children in Turkana and Action against Hunger (ACF) in Isiolo, will implement community management of acute malnutrition integrated and delivered through the iCCM platform. From the start of the implementation, the institution is expected to take key tasks and activities to monitor and document lessons as key observant of the implications of linking iCCM with IMAM at community level. This includes:
1. Identify Principal Investigator and Train Qualified Research Team(s)
The selected institution is required to present the name and curriculum vitae of the principal investigator (PI) together with the application for this TOR. In addition, the institution will be responsible for the recruitment and contract (as appropriate) and train the research team members required to complete the research.
1. Review and finalize the implementation research design and protocol
The PI/ Research institution will finalise the design of implementation research. The Principal Investigator (PI) will review the draft research protocol and be responsible for its finalization; which will include:
• Refine the research questions for approval by the Technical Advisory Group (TAG)
• Review and finalization of methodology, data collection and analysis plan
• Review and finalization of a Sampling Plan
• In consultation with Nutrition Information Working Group (NIWG), the PI will define the sample sizes required to generate the required statistical power to estimate programme impacts, as well as the sampling strategy. This will include:
• The outcome indicator(s) that are used to determine the sample size(s)
• The minimum impacts that the study should be designed to measure
• The number of CHVs and communities in each of the control and treatment groups
• Definition of the sample inclusion/ exclusion criteria and sampling methods
Validate the study design: The Principal Investigator is responsible for undertaking appropriate statistical tests and consolations to validate that the study design answers the objectives of the implementation research
1. Develop research tools
2. Reviewing methods and tools to measure:
1. effectiveness in terms of coverage, quality of care, and treatment outcomes for children suffering from acute malnutrition and/or the iCCM conditions (malaria, pneumonia and diarrhoea)
• tools and questionnaire templates and adapting them to the country specific context
3. Lead in questionnaire and tool pretesting
4. Review methods, tools and questionnaire with TAG
5. Finalize methods, tools and questionnaire based on feedback from pilots and TAG
6. Lead the process for ethical approval
The PI is responsible to fulfil all the requirements for ethical approval in consultation with the TAG. Specifically
• Adress questions/comments from the ethical reviewers in the final research protocol
• Liaise with co-investigators to avail bio-data and CV as may be required for ethical approval
• Oversee preparation and implementation of the research activities
The PI will oversee all activities related to preparation and implementation of research, including:
• Developing the Field Work Plan with the Survey Team (s)
• Development / adaptation of training materials for Survey Teams
• Recruitment and training of enumerators
• Pilot testing with field team(s)
• Data collection, compilation and analysis
• Collection and compilation of any required secondary data (e.g., health provider reports, community surveys, etc.)
• Lead in dissemination of findings of the research at various levels both at county and at national level.

The Principal Investigator is responsible for ensuring data quality assurance mechanisms are in place for data collection, entry and management.
1. Manage Data Documentation and Storage
The PI and the selected institution is responsible for ensuring proper, comprehensive documentation of the study activities and ensuring all data and corresponding documentation is stored on an appropriate, secure location identified jointly with the ICCM Nutrition TAG.
Work relationships
The consultant team will work under direct supervision of Nutrition Specialist – IMAM.
The selected institution will be responsible for the design, implementation, analysis and dissemination of results. Technically, the PI /research institution will collaborate with and be accountable to the Technical Advisory Group (TAG).
Administratively, the PI/research institution is accountable to submit all the deliverables mentioned in this TOR to UNICEF.
Expected Deliverables and Reporting Requirements
Expected Deliverables
Phase 1: preparation
1. Revised implementation research protocol
2. Detailed plan for baseline survey(s) together with research tools
3. Ethical clearance
Phase 2: Implementation of research activities
1. Report of baseline survey (s)
2. Quarterly consultant report on: Ongoing data collection and analysis to monitor the progress of the implementation research in line with research protocol.
Phase 3: Implementation completion and final report
1. End line survey(s) report (in line with research protocol)
2. Comprehensive research report together with datasets and all relevant documentation.

Reporting Requirements
The report will be prepared in English, according to reporting standards for research. Each report must be submitted to TAG for review and approval.
Desired competencies, technical background and experience
The consultant is subject to the relevant ethical requirements, including for this consultancy those pertaining to independence and conflict of interest relating to financial audit engagements. Relevant ethical requirements ordinarily comprise of Parts A and B of the International Ethics Standards Board for Accountants’ Code of Ethics for Professional Accountants (IESBA Code) related to an audit of financial statements.
CVs of the Principal Investigator must be provided to the office. The CV must include details on relevant professional qualifications, education and experience in undertaking similar research. Work experience descriptions must include details on the responsibilities assumed for completed and ongoing engagements.

The qualification of the Principal Investigator should be:
• Advanced degree in relevant field, preferably public health and / or nutrition with community focus.
• Minimum 5 years of research and evaluation experience
• Minimum 5 years’ experience in designing and implementing quantitative and qualitative studies using randomized or otherwise controlled designs
• Relevant experience designing and coordinating field work for large household surveys and community health and or / health facility surveys
• Extensive experience in iCCM and or IMAM
• Relevant experience analysing quantitative data using statistical analysis software
• Relevant experience on collecting and analysing qualitative data
• Relevant experience in coordinating implementation research field work
• Excellent written English communication skills, with focus on research protocols, research papers and descriptive reports for diverse audience
• Ability to facilitate communication between various levels of management and work independently in order to meet deadlines
• Ideally, the country PI should have published evaluations in peer reviewed journals.
Administrative issues
Contractor:
1. The contractor will report to UNICEF administratively, and will present all deliverables after they are cleared by the technical advisory group
2. The contractor will seek guidance from the country office in terms of the processes and methodology involved in carrying out the exercise.
UNICEF:
1. UNICEF will provide necessary and complete documentation and briefing to the contractor for them to carry out the exercise which includes the draft research protocol, and minutes of earlier discussions, FACE forms for request for funds and liquidations received, contact points in the relevant implementing partners’ office.
2. UNICEF will coordinate with the iCCM-nutrition technical advisory group to introduce the institution so that the institution solicits comments for the appropriate deliverables indicated above.
Conditions
As per UNICEF DFAM policy, payment is made against approved deliverables. No advance payment is allowed unless in exceptional circumstances against bank guarantee, subject to a maximum of 30 per cent of the total contract value in cases where advance purchases, for example for supplies or travel, may be necessary.
The candidate selected will be governed by and subject to UNICEF’s General Terms and Conditions for individual contracts.
The firm selected will be governed by and subject to UNICEF’s General Terms and Conditions for institutional contracts.

HOW TO APPLY:
Sealed Proposals are invited for the provision of services as specified in this Request for Proposal (LRFP)No.9129620
The Technical proposal to be put in envelop No 1 (MARKED “TECHNICAL PROPOSAL”) and Financial Proposal to put in envelop No 2 (MARKED “FINANCIAL PROPOSAL”) and then put in one bigger envelope CLEARLY MARKED on the outside with the LRFP Number and returned, addressed to: Supply and Procurement Manager, UNICEF Kenya Country Office, P.O. Box 44145 – 00100, Nairobi, Tel. 254 20 7622571, UN Complex Gigiri, to reach UNICEF offices on or before 08 February 2017 at 11.00 HRS (East Africa Time). Proposals are to be placed in the bid/tender box located at Block “D” next to Room D107, UN Complex, Gigiri.
Proposals should be HAND DELIVERED and to the location stipulated on Page 1 of this bidding document.
Bidders residing out of Nairobi, Kenya may send their proposals by Courier services to the below address. Proposals sent by courier should reach UNICEF offices before the closing date of this bid which is 08 February 2017 at 11.00 Hrs (East Africa Time)
UNICEF KENYA COUNTRY OFFICE
BLOCK D, ROOM 107
P O BOX 44145 – 00100
UN GIGIRI COMPLEX
UN AVENUE
NAIROBI, KENYA
TEL: +245 20 7622419
Questions and Clarifications on RFP/TOR
All inquiries including formal clarification on this RFP/TOR must be addressed to suochieng@unicef.org and copied to skarmacharya@unicef.org by 16 January 2017, otherwise response to your inquiries will not be guaranteed. Please make sure that the e-mail mentions the RFP reference number. Responses to the queries/clarifications will be provided to all the invitees by 18 January 2017.
Only written inquiries will be considered. Written response (including an explanation of the queries without identifying the sources) will be sent to all the bidders that have received the solicitation document.
Bid Form
Bidders are required to fill and sign “Bid Form” on Page 3 of this RFP and return back with the proposal

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