Terms of Reference for Consultancy- Baseline Survey, UN Joint Nutrition Project
Type of consultancy Individual consultancy
Category of the consultancy Individual consultant to support the conduction of UN Joint nutrition project baseline survey
Level of consultancy NOC

Background
Good nutrition is crucial to live a healthy, productive life, and it represent an important pillar of effort designed to facilitate achievement of all sustainable Development goals. It is important throughout the life cycle, starting with the pregnancy period, continuing through infancy and childhood, adolescence, and later stages of life (1).Nevertheless, globally the double burden of malnutrition including undernutrition and over nutrition persist.
In Rwanda, malnutrition continues to be a public health concern. Despite the positive trends realized in nutrition, Rwanda experiences a double burden of malnutrition (undernutrition and over nutrition) among its under-five population and women. The prevalence of stunting remains above the WHO public health threshold of severity (30%) at 33% (RDHS2019-2020) and still far from the national target at 19% to be reached by 2024. Among the same children from 6 to 59 months, 1% are wasted, 8% are underweight, 37% are anemic, 6% of children are overweight and 26% of women are overweight and obese.

The government of Rwanda has made progress in reducing poverty and increasing agricultural production across the country with a growth domestic product (GDP). In Rwanda, prioritized nutrition has prioritized as an essential human rights and human capital issue and recognizes that malnutrition, especially stunting, is a public health issue that requires multi-sectoral and multi-stakeholder engagement, interventions and coordination. Elimination of stunting and other forms of malnutrition is a high priority for the GoR as witnessed through the integration of nutrition in numerous policies and programmes and through the establishment of National Child Development Agency (NCDA), which is mandated to ensure holistic development of children aged 0-18 years.
As continued support provided to the government of Rwanda, under financial support from UN agencies will implement the nutrition interventions to prevent and manage all form of malnutrition and ensure the food security at household level. The joint project will provide the integrated quality nutrition services through existing government structures as well as strengthening engagement with other stakeholders and engage the private sector. The interventions with a focus on improving the enabling environment for nutrition, improving nutrition services, and empowering communities and households to improve their nutrition situation and will mainly target infants, children, adolescent and women, services care providers.

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The interventions will intend to reach the following 3 outcomes:
Outcome 1: Strengthened Government capacity in effective and equity-focused policy formulation, strategic planning, coordination, M&E and domestic funds mobilization across different sectors, including WASH, ECD, health, social protection, education, and agriculture, along with an increased participation of private sector and civil society actors for sustained nutrition gains.
Outcome 2: Well-equipped service providers working in health, agriculture, social protection, ECD and education that provide quality nutrition-related services to communities contributing to the reduction of malnutrition including stunting in children.
Outcome 3: Empowered communities in targeted districts improve their nutrition situation through creating better access to and consumption of a variety of nutrient-dense foods, early identification and prevention of cases of malnutrition, decreased risk of infectious and diarrheal diseases through improved hygiene and health practices and increased resilience against shocks.
In order to evaluate the impact of intervention for the project, a baseline will be carried out to show the level of the indicators on nutrition and food safety at the starting points of the project and end line survey at the end, then the same indicators from the two rounds of the project will be compared and track the change on the desired outcome and outputs for the project over the cycle of the project

Scope of the one UN joint nutrition
The Project will be implemented at central and decentralized level in 2 selected districts namely Rutsiro and Ngororero due to their high poverty rates, poor food security and high prevalence of stunting in children under five.
Objectives
The overall objective of the survey is to determine the current situation regarding key nutrition and food safety indicators which will be addressed through the implementation of the one UN joint nutrition project phase III. The baseline survey will lay the foundation to monitor and evaluate the impact of the project.

Specific objectives are:
For outcome 1
• To document the food safety system governance under the responsibility of key line ministries using an intersectoral and holistic approach (One Health),
For outcome 2
• To assess the skills and practices of service providers at health center level including identification and management of different forms of malnutrition, nutrition education, nutritional care for prevention and management of non-communicable diseases (NCDs).
• To assess the skills and practices of health care providers at hospital, health center and community level to implement the recommendations from national neonatal care protocol (2020) to provide growth monitoring, Infant and Young child nutrition counselling and micronutrient supplementation (iron and vitamin D) to low birth weight babies
• To describe the capacity of food business operators (e.g. local food manufacturers, wholesalers, distributors and retailers) on food safety standards to prevent food-borne diseases
• To determine the capacity of households for production of nutrient dense food as well as processing and preservation after harvest
• To assess the school feeding environment and practices with improved food safety including handling and storage practices.
• To document the skills gained by primary and secondary school teachers as well as the skills gained by students on health and nutrition
• To assess the quality of nutrition data reported by district and health center nutritionists and data managers to national Monitoring and Information System (MIS) and Health Management and Information System (HMIS)

For outcome 3
• To assess the proportion of schools with school gardens set up and maintained
• To assess the level of access of vulnerable households to nutrient dense foods (e.g. vegetables, animal-source foods and bio fortified foods)
• To determine the study population’s household dietary diversity (HDD) and women minimal dietary diversity scores (MDD-W)
• To determine the percentage of community health workers with improved knowledge on the use of the child score card and the percentage of children under two years with up-to-date information on their child scorecard.
• To assess the percentage of targeted village committees (parents committees, village, cell, sector, and district committees) who received training on school aged and adolescent nutrition
• To assess the percentage of households reached by SBCC approaches (interpersonal, mass media) to disseminate nutrition messages.
• To determine the percentage of school aged children in targeted primary schools who can recall hearing or seeing the promoted messages aiming at preventing malnutrition

Methods
The baseline survey will be conducted at centralized and decentralized level in two districts namely Rutsiro and Ngororero. A cross sectional design with quantitative and qualitative approach will be used and will target different participants including of Government staff, private and civil sector actors at central level and Health care providers, CHWs, care giver of children under five, adolescent, teachers. Additionally, a desk review for some reports and other strategic documents will be conducted.
Work assignment
The baseline survey protocol has been previously developed by the WHO Rwanda in partnership with FAO, UNICEF and WFP and approved by the Rwanda National Ethics Committee.

The individual consultant will be requested to conduct the following activities:
• Summarize qualitative data and translate script from Kinyarwanda to English
• Conduct analysis of qualitative data using recommended software
• Conduct analysis and interpretation of nutrition indicators (Minimum Acceptable diet in infants 6 to 23 months, Minimum diet diversity in women of reproductive age, Household food consumption score)
• Conduct a desk review for some reports and strategic documents
• Draft a preliminary survey report
• Finalize and submit the survey report

Deliverables
• Qualitative data/scripts translated from English to Kinyarwanda and summarized
• Qualitative and quantitative data analyzed and interpreted including nutrition indicators (Minimum Acceptable diet in infants 6 to 23 months, Minimum diet diversity in women of reproductive age, Household food consumption score)
• Draft report shared and reviewed
• Final report submitted

Organizational context
The baseline survey of UN joint nutrition project phase work will be performed under supervision with technical support from WHO nutrition officers. The consultancy will be performed all tasks assigned in collaboration with government institutions, WHO partners and UN joint nutrition project technical team.

Qualification/ Requirement
The individual consultant should:
• Hold at least a master’s degree in public health, Research, Epidemiology, or another related field
• Have an experience in quantitative and qualitative research: 5 years’ experience in designing and conducting public health evaluation surveys
• Have a previous experience in analysis nutrition indicators ((Minimum Acceptable diet in infants 6 to 23 months, Minimum diet diversity in women of reproductive age, Household food consumption score)
• Excellent writing skills in English and oral skills of Kinyarwanda
• Have Strong organizational skills, attention to detail, and ability to meet deadline

Time frame and duration
The duration allocated to this assignment is one month and a half from 31st October to 15th December 2022.
Proposal documents and submission
The interested candidates shall submit their CVs in one PDF file by e-mail to afwcorw@who.int
No physical document shall be accepted.
The deadline for application is 18 October 2022.
The selected candidate shall be requested to provide academic documents and ID.
Selection and contract signing
After analysis of proposals, WHO Rwanda will notify the winner in writing and call for discussion followed by contract signing if fully agree. The work is expected to start immediately after contract signing. WHO Rwanda reserves the right to cancel any or all the proposal without assigning any reason thereof.
Done at Kigali, 10th October 2022
Signed By:
Dr Brian CHIROMBO
WHO Representative