STUDY EFFECTIVENESS OF DISTRIBUTING MICRONUTRIENT SPRINKLES THROUGH I) CBN AND II) CHD MODALITIES TO IMPROVE COMPLEMENTARY FEEDING PRACTICES AND REDUCE MICRONUTRIENT DEFICIENCIES IN UNDER-2 CHILDREN
Source: World Bank — Ethiopia Nutrition (FY08)
REQUEST FOR EXPRESSIONS OF INTEREST
Federal Democratic Republic of Ethiopia
Ethiopian Health and Nutrition Research Institute (EHNRI)
Consulting Services: Study effectiveness of distributing micronutrient Sprinkles through i) CBN and ii) CHD modalities to improve complementary feeding practices and reduce micronutrient deficiencies in under-2 children
World Bank/IDA supported Nutrition Project
Project ID: P106228, Grant Number: H376-ET
Background:
The Government of Ethiopia officially launched the National NutritionProgram (NNP) in 2009, which aims to reduce malnutrition in Ethiopia by integrating nutrition into community-based health and development programs. The World Bank supports the Government's implementation of NNP components through its Nutrition Project. Operational research (OR) is an important component of the NNP, intended to study and resolve problems and challenges that arise during its implementation and to test alternative intervention modalities.
Rationale:
Micronutrient Sprinkles were developed by the Sprinkles Global HealthInitiative (www.sghi.org) to treat and prevent anemia among young children aged 6-24 months through fortification of foods at home. Community-based studies have shown Sprinkles can be safely distributed under programmatic conditions[1]. Distributed in sachets, Sprinkles contain a blend of iron and othermicronutrients in powdered form which are mixed into foods prepared at home. Typical home fortification calls for 60 single-dose sachets tobe consumed by a single child (6-24m) over 60-120 days. This has beenshown to be efficacious in treating and preventing anemia for at least 6 months. Community-based studies have found Sprinkles are well accepted both by children, because they do not change the taste of food, and by caregivers because they are easy to use.
The use of Sprinkles could be an important strategy to control micronutrient deficiencies in Ethiopia, where the 2005 DHS found that more than half of children aged 6-59 months are anemic[2], and dietary diversification and fortification strategies are not operating at sufficient scale to address the problem. Two modalities delivered through the Health Extension Program appearto offer the greatest opportunities to effectively distribute Sprinkles to children 6-24 months and deliver related behaviour change communication activities for caregivers: i) Community Based Nutrition (CBN) or ii) Community Health Days (CHD).
CBN builds community capacity in the triple-A-approach (assessment, analysis, and action) through monthly growth monitoring and promotion of children under 2 and community conversations to mobilize actions that support child growth. Community Health Days (CHD) are held quarterly in CBN woredas for delivery of a package of services that includes screening of under-5 children and pregnant/lactating women for acute malnutrition, referral for targeted supplementary food (where available), and biannual deworming and high-dose vitamin A capsule supplementation.
Objectives:
CBN and CHD offer different potential advantages as platforms for Sprinkles distribution. Monthly community contact points through CBN offer good opportunities for caregiver communication, community mobilization, and monthly follow-up for Sprinkles. However, CHD has better community mobilization and higher coverage than CBN, although less opportunities for caregivercommunication or follow-up. Neither approach has been tested in the Ethiopian context.
The aims of this study, not lasting more than 24 months, are to develop and pilot test approaches to distribute micronutrient Sprinkles to under-2 children through i) CBN and ii) CHD modalities; compare the operational feasibility and acceptability of each approach to program stakeholders and caregivers; and make recommendations for a scalable program strategy to distribute Sprinkles.
This may include (for both CBN and CHD):
a. Development and implementation of education and behaviour change communication strategies at two levels: i) for those involved in distributing and promoting Sprinkles; ii) for caregivers on how to obtain and correctly use Sprinkles for home fortification;
b. Assessment of the quality of implementation and acceptability among program delivery stakeholders of i) the delivery system and ii) behaviour change communication strategies;
c. Assessment of the acceptability of Sprinkles with caregivers, including perceived benefits, side effects, and utilization.
Grant process:
Grants will be awarded through a two-step application process. First,applicants will submit an expression of interest (EOI). From these, a selected candidate will be asked to submit a full proposal. A Proposal Screening Committee (PSC) will evaluate the EOIs and the full proposal.
EHNRI now invites eligible organizations to indicate their interest in carrying out the OR study outlined below. Interested organizations must provide information indicating that they are qualified to carry out the OR study through submission of an Expression of Interest (EOI). Organizations may associate to enhance their qualifications.
The Expression of Interest (EOI) shall include:
• Organizational profile, to include organizational structure, experiences in the relevant field, and staff profiles
• CVs of PI and co-investigators / lead supervisors with a description of their roles
• Documentation such as Articles of Incorporation or Registration showing that organisation is recognised as a legal entity in country specified
• A summary of research approach, no longer than 3 pages (A4 paper, single spaced, Times New Roman 12-point font and 2.5cm borders), to include: a) specific research questions associated with the above outlined objectives; b) summary of methodology, to include study design, targetpopulation, sampling strategy; c) summary of planned analyses; d) composition of team, responsibilities, and experience relevant to objectives.
These will be evaluated based on:
• The strength of the EOI to meet objectives
• Demonstrated understanding of country context
• The quality and appropriateness of the methodology and analysis plan
• Demonstrated organizational capacity
• Experience in relation to the aims of the study
• Level of innovation demonstrated in the EOI
The deadline for EOI submissions to EHNRI in soft copy (secure PDF) format is 5pm, Monday 4th July 2011
Consultants will be selected in accordance with the procedures set out in the May 2004, Revised October 2006, edition of the World Bank's Guidelines: Selection and Employment of Consultants by World Bank Borrowers.
Key project milestones:
1. Candidates provide expression of interest, to include all informationrequested above, for review by PSC
2. Selected candidate develops and submits full proposal to EHNRI by agreed deadline for review/comments by PSC (Full proposal to include: research methodology and sampling strategy, analysis plan, activity plan and timeline, training and supervisorystrategy, and detailed budget)
3. Selected candidate incorporates comments into full proposal by agreed deadline
4. Selected candidate invited to negotiate contract (including technicaland financial aspects)
5. Awardee develops and pretests study tools (interview guides, questionnaires and supervisors manual) and revises accordingly
6. Awardee submits full proposal for ethical review
7. Conduct data collection and agreed supervision strategy
8. Analyse data and produce an initial report including methods, detailed findings related to objectives, and action-oriented recommendations
9. Circulate initial report to key stakeholders for comments; update report as required by EHNRI
10. Hold dissemination workshop, finalise report as required by EHNRI
11. Submit soft and hard copies of the finalised report to EHNRI
What costs are covered:
The funding can be used to pay for salaries, supplies, equipment, andtravel that are related to meeting project objectives
Contact information:
Interested organizations may obtain further information on this assignment from 9am # 5pm, Monday to Friday, using the below contact information:
Mr. Imailaf Muluken,
Coordinator, Procurement & Supplies Management team,
Ethiopian Health and Nutrition Research Institute,
PO Box 1242, Addis Ababa, Ethiopia
Tel: +251 11 2771056
Fax: +251 11 2754744
Email: imailafm@ehnri.gov.et
www.ehnri.gov.et
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