Balanced Energy Protein Supplementation Research Consultancy

MOMENTUM Country and Global Leadership is a five-year global project funded by the U.S. Agency for International Development (USAID). MCGL provides targeted maternal, newborn and child health and nutrition (MNCHN), family planning (FP) and reproductive health (RH) technical and capacity development assistance (TCDA) to countries in support of their journeys to sustainable development. MCGL contributes global technical leadership and learning to support globally endorsed MNCH/FP/RH initiatives, strategies, frameworks, guidelines, and action plans. This consultancy will be hired and managed through Save the Children US, an MCGL consortium partner, as part of MCGL’s nutrition portfolio.

Context

In 2020, the World Health Organization (WHO) recommended Balanced Energy-Protein (BEP) Supplementation in countries with a high prevalence (> 20%) of malnourished pregnant women (PW) to decrease the risk of stillbirth and small for gestational age (SGA) newborns. BEP provides health benefits for the mother, including improving weight gain and reducing risk of anemia. To be successful, countries must address challenges encountered in operationalizing the recommended supplementation. This requires the existence of a strong antenatal care (ANC) system to serve as a delivery platform including trained health providers and a BEP supplement that is inexpensive, accepted by PW and easy to store and distribute during ANC visits. It also requires an effective and sustainable supply and distribution system for BEP, including BEP being listed in the essential medicines and commodities list. Furthermore, social and behavior change (SBC) approaches and monitoring tools are required to address adherence and minimize sharing. The Bill & Melinda Gates Foundation (BMGF) convened an expert panel in 2016 to create guidelines for macronutrient and micronutrient composition of BEP supplements and develop a “Use-Case” for BEP distribution and consumption.

Scope of Work

MCGL is seeking a qualified consultant to conduct a policy and programmatic landscape mapping of USAID’s nutrition priority countries that include BEP supplementation in national ANC or nutrition guidelines and programs. This mapping should identify barriers encountered in adapting the recommendations within national policies or guidelines, as well as the enablers and challenges faced in programming BEP supplementation through facility and community ANC platforms.

The mapping will be used to develop a policy brief that serves as a guidance document on policy and programmatic considerations for countries seeking to introduce BEP supplementation through health facilities and community ANC platforms. The brief will be shared with MCHN experts at USAID Missions who provide technical support and make funding decisions regarding the introduction of BEP supplementation as part of ANC/nutrition programs.

Tasks

• Review WHO’s recommendations and supporting reviews to summarize the evidence base and identify initial assessments/implementation research or policy and programmatic issues that countries should consider when adopting the recommendation.

• Conduct a literature review and approximately 21 key informant interviews (KII) with:

  • Global experts with relevant experience in ANC service provision and BEP supplementation programming, or other food/supplementation services (6);
  • Three in-country Maternal Health and Nutrition experts from five USAID priority countries with high prevalence of malnutrition in pregnant women (15).

• Use the literature review and KIIs to identify policy and programmatic considerations for introducing BEP as part of comprehensive facility or community ANC as a service delivery platform. The considerations should include (at a minimum):

  • Enabling environment: what enabling environments (e.g. BEP supplementation supply chain, advocacy etc.) are required to effectively introduce and scale up BEP supplementation;
  • Service readiness: what should preliminary service readiness assessment countries do to introduce and implement BEP as part of the ANC package (e.g. barriers and enablers related to ANC, capacity strengthening of ANC service providers and SBC tools needed to screen for malnutrition and deliver and support malnourished PLW to receive and consume BEP supplementation)?;
  • BEP product selection and distribution system: recommended reviews or implementation research to identify an appropriate BEP product that is inexpensive and acceptable by PW and appropriate to distribute as part of ANC visits;
  • Monitoring of BEP supplementation: data monitoring needs, as part of HMIS/DHIS, to monitor service coverage and adherence to prescribed BEP supplementation; and
  • Other considerations based on the review and KII.

• Prepare an inception report, including an outline of the landscape review report on policy and programmatic considerations, and the policy brief for review by MCGL.

• Prepare a policy and programmatic landscape report on issues that countries should consider in operationalizing or introducing BEP as part of ANC (max. 15 pages).

• Prepare a policy brief to guide countries and USAID Missions to introduce BEP supplementation as part of comprehensive ANC and eight ANC visits (max. 3 pages).

PROPOSED TIMELINES

The amount of time allocated for this assignment is 30 days to begin as soon as the Consultant’s background check clears. This includes an initial briefing by the Save the Children nutrition focal point for MCGL, routine check-ins as needed with the MCGL program team, and the tasks/deliverables described below:

Tasks/Deliverables, Estimated days

Outline of policy landscape mapping: 2 days

Confirm list of stakeholders to interview from USAID nutrition priority countries and conduct interviews: 8 days

Prepare the landscape report: 7 days

Revise landscape report incorporating edits/feedback from MCGL: 2 days

Draft policy brief / key findings PPT: 7 days

Revise policy brief incorporating edits/feedback from MCGL: 4 days

Total: 30 days

Key Deliverables

The following draft schedule outlines the deliverables by timeframe:

Tasks/Deliverables, Approximate Timeframe

Outline of policy landscape mapping: July 10, 2023

Confirmed list of stakeholders to interview from USAID nutrition priority countries: July 14, 2023

Landscape report on policy and programmatic considerations to introduce BEP supplementation;

Key findings PowerPoint presentation slides from KIIs: July 28, 2023

Revised landscape report incorporating edits/feedback from MCGL: August 4, 2023

Draft policy brief: August 11, 2023

Revised policy brief and landscape report incorporating edits/feedback from MCGL: August 25, 2023

ADMINISTRATIVE AND OR LOGISTICAL SUPPORT

The duration of the assignment is July 1 until August 31, 2023.

INFORMATION FOR CONSULTANT

Qualifications

• Qualification in Public Health/Social Science with post graduate qualification in Public Health or other related disciplines.
• Proven experience of undertaking public health research with outstanding writing skills.
• Strong discussion facilitation skills to help in elicitation of the required information.
• Ability to draw empirically strong and valid conclusions and recommendations from a research piece to inform policy, capacity building and implementation of concepts.
• Demonstrated organizational capacity based on previous research assignments.
• Knowledge of maternal and child health and nutrition programs

Payment Schedule

The Consultant is advised to review this ToR and submit a letter of interest including summary of relevant experience and daily rates. Remuneration will be based on submission of deliverables that are satisfactory to Save the Children as approved by Habtamu Fekadu, Nutrition Focal Point.

Child Safeguarding

The Consultant will be working on behalf of Save the Children; therefore, he/she/they will be required to sign and adhere to the Child Safeguarding Policy and ethical guidelines. Background checks are undertaken for all applicants.