Midline SMART Survey Consultancy for Enhanced Responses to Nutrition Emergencies (ERNE) Program in West Kordofan and South Kordofan State, Sudan

1. Background

Concern Worldwide (Concern) is an international humanitarian non-governmental organisation dedicated to the reduction of suffering and working towards the elimination of extreme poverty in the world’s poorest countries. Concern has been working Sudan since 1985 in response to refugees entering the country from Ethiopia. Currently, Concern Worldwide works in three main areas in the Republic of Sudan; West Darfur State, and South and West Kordofan States. Our programmes focus on Nutrition, Health, Food Security and Livelihood and WASH targeting the host communities, internally displace communities and refugees. Recently, Concern initiated a nutrition program entitled “Enhanced Responses to Nutrition Emergencies (ERNE)” in South and West Kordofan, Sudan. The Programme aims to contribute to reducing malnutrition morbidity and mortality among children under five through increased scale, efficiency and effectiveness of humanitarian preparedness and response for food and nutrition security in South and West Kordofan states. The ERNE programme is composed of three pillars:

· Pillar 1: Life Saving Response ensures the provision of primary health, nutrition services and cash transfers in times of humanitarian need

· Pillar 2: Preparedness and local capacity to respond to reduce the impact of nutrition and food security shocks.

· Pillar 3: Nutritional resilience focuses on understanding and addressing the underlying factors that make people vulnerable to undernutrition.

2. Purpose of the Consultancy:

The main purpose of this consultancy is to conduct a SMART survey to assess the current nutritional and health status in the West and South Kordofan state in the 8 localities in South and West Kordofan that make up Concern’s ERNE programme area (including disaggregation by State and, specifically, for Eleri Locality, see below). The programme is now in its second year and the SMART survey will determine the midline value for a number of key programme indicators, as outlined below. **

Key tasks for the consultant to carry out in accordance with the terms and conditions of the consultancy contract include:

a. Lead the finalisation of the survey protocol, training materials and any survey job aids in line with the SMART survey standards

b. Finalise the set of data collection tools using Concern’s digital data gathering (DDG) system and pre-built indicators and questionnaires (in coordination with the Concern Sudan team and HQ Advisers who will provide training resources on DDG)

c. Conduct a pre-test of the methodology and questionnaires as part of the training before starting the survey

d. Conduct and analyse pre and post test training results for accuracy of anthropometric measurements and address any weaknesses with targeted training.

e. Develop a clear survey plan (movement plans, sequence of data collection/ mapping of selected villages) plan and ensure it is understood by all who need to participate and support Concern in its execution

f. Design and carry out training of data collectors and supervisors on the survey methodology, anthropometric measurement techniques, effective interview techniques, essential infection and prevention control methods in the context of COVID-19 (see Concern guide) and DDG (Concern staff will support training on DDG)

g. Ensure all necessary equipment is in place and functioning before the survey starts by liaising with Concern logistics team and other key staff members

h. Coordinate all data collection from the field and supervise the team on a daily basis to ensure quality data is collected. This will involve developing quality control measures, supporting the team in sampling of households and taking anthropometric measurements and interviews in accordance with COVID-19 prevention measures.

i. Provide daily field briefings to the Concern Worldwide project coordinator and health and nutrition advisor on progress and any challenges from the field

j. Clean and analyse the survey results using the standard ENA software and any supplementary software (EPI-Info is recommended) required for those indicators that fall outside the core ENA analysis function (software must be agreed ahead of time with Concern and consultant must provide it themselves)

k. Provide a draft report in an agreed standard format with preliminary results for all indicators, including confidence intervals for indicators and a full plausibility report for review

l. Present preliminary results to Concern and any relevant stakeholders for feedback (verbal and written) and facilitate a discussion on relevant and practical recommendations finalisation of the survey report

m. Based on feedback, finalise the report with clear and relevant recommendations and present findings to a wider group as requested (potentially remotely)

3. Essential and Desirable Experience/Qualifications

Education: The consultant should hold an Advanced University Degree in Nutrition, Public Health, Epidemiology, Biostatistics, Social Sciences or related discipline with the relevant technical knowledge in Survey Methodology, Research Methods etc.

Experience:

· The consultant must have proven experience in managing SMART nutrition surveys in fragile contexts. Must know EPI info and ENA for SMART and all relevant computer applications in general

· Proven team leading and managerial experience

· Knowledge of working with conflict-affected populations

· Demonstrated non-anthropometric data gathering and analysis experience

· Excellent reporting and presentation skills.

· Excellent knowledge of, and experience working with, humanitarian guidelines and principles

· Fluency in English and Arabic is required and other local languages spoken in the working area is an advantage

4. Objectives of the survey and specific tasks to be undertaken by the Consultant(s)

Overall Objective: To assess the nutrition situation among children aged 6- 59 months in the areas targeted by Concern for nutrition programming in South Kordofan and West Kordofan States**

Geographical scope: The SMART survey will be conducted in 8 localities across West Kordofan and South Kordofan that make up Concern’s ERNE programme area:

• The West Kordofan programme area (5 localities)

• The South Kordofan programme area (3 localities),

• Eleri Locality in South Kordofan as whole

Specific objectives:

· To estimate the prevalence of acute malnutrition (wasting according to weight-for-height z-score and/or oedema) among children aged 6-59 months.

· To estimate the prevalence of wasting according to MUAC among children 6-59 months.

· To estimate the prevalence of stunting (according to height-for-age z-score) among children aged 6 to 59 months, in the eight localities Concern targets for nutrition programming in South Kordofan State (3 localities) and West Kordofan State (5 localities)

· To estimate the prevalence of low MUAC among the mothers of the targeted children.

· To estimate the prevalence of minimum dietary diversity of children 6-23 months (using both the 2010 and 2021 WHO standard indicators),

· To estimate the percent of households with a handwashing facility (with soap and water) at the household level

· To estimate the percent of households in which women are at least consulted in key areas of household decision-making using Concern’s custom tool.

· To provide essential disaggregation of the above indicators according to sex and age groups as appropriate.

· To provide the comparison of assessed GAM rate with 2021 GAM rate

· To estimate all of the above using methods in line with global standards for nutrition surveys and summarise findings in report that provides practical and feasible recommendations based on the survey findings to improve the nutritional status of the surveyed population in consultation with the Nutrition Manager in Concern Worldwide and other stakeholders.

Methodology:

· A cross-sectional two-stage cluster sampling following SMART methodology that allows for reliable estimates of the above prevalence rates.

· Sample size calculations and analysis using the Emergency Nutrition Assessment (ENA) for SMART software updated on January 11, 2020 as well as EPI-Info and/or EPI-Info/ENA and/ or SPSS (ensuring for SPSS that it allows for a clustered sampling design).

· The Consultant, in consultation with Concern Health and Nutrition team and Nutrition Cluster, will design a more detailed survey methodology and survey protocol for final approval. The detailed design must include among others; survey design, sample size, and quality control, data collection and management processes.

Concern Worldwide will support in the following ways:

· Cover all costs related to training, equipment and enumerators.

· Share all necessary documents to the Consultant to finalize the SMART survey design, protocols and tools for data collection tools

· Support digital data collection, use of tablets and the DDG system, as well as support on finalising the data collection tool.

· Train enumerators on the DDG system can be provided by Concern Worldwide.

· Provide input in the SMART survey methodology, data collection tools and report, and coordinate comments / feedback from the organisation.

· Hire vehicles to support the SMART survey process

· Provide a working space for the Consultant while in South and West Kordofan

· Provide security briefings relating to how the survey can be conducted (and for the manager’s safety).

· Coordinate with local authorities throughout all the phases of SMART survey, keeping communication with the Consultant throughout all phases

· Provide support to the Consultant during field visit processes

· Engage the SMART survey audience including MoH, UNICEF and thers in the validation of the findings.

· Accommodation will be provided in the team house in South and West Kordofan

5. Deliverables

Deliverable

Timeframe

%

Survey protocol, adapted to local conditions, outlining survey design and indicators, along with a detailed work plan. For submission for approval to Nutrition Coordination Unit

One week after the signing of the consultancy

10

Final data collection tools

One week after the signing of the consultancy

10

Training Report – results of standardisation test indicating all enumerators are trained to the necessary standard.

Upon completion of the training

10

Preliminary findings/report and submitted to Concern Worldwide.

1 week after completion of data

30

Presentation of the key findings and recommendations to CWW, MoH and Nutrition Cluster

1 week after feedback on draft report is received from Concern

10

Final survey report (in accordance with stated requirements)

Within two weeks after preliminary presentation/submission

30

The final SMART survey assessment report should be structured as follows:

• Executive summary: Analysis of nutrition anthropometric indicators assessed among children 6-59 months and the report will also include analysis of key variables of interest.
• Introduction: Geographic description of the survey areas, season, description of the population and Objectives of SMART survey.
• Methodology: Full SMART survey design, sampling and data quality control and plausibility checks.
• Results: Point GAM and SAM estimates according to WHZ and/or oedema and low MUAC with 95% confidence interval.
• All other non-anthropometric indicators must be reported with 95% confidence intervals.
• Discussions including the interpretation of the results
• Conclusions and recommendations
• Annexes: Maps, tools used, plausibility check, results of the standardisation test (full list provided in standard Concern report format.

Final payment is dependent on the submission of a good quality, well-written final report or completion of agreed outputs (as detailed in the TOR).

A digital copy of all reports will be required by Concern at the end of the piece of work.**

6. Lines of Communication:

· Line manager of the Final Evaluation during the work – Program Director

· Technical support/liaising with –Health and Nutrition Advisor

· In the field while collecting data – Concern field staff

· Final approval of the work/payment – Concern Country Director

7. Time frame:

The consultancy will last 45 days. The Consultant should be able to undertake some of the tasks concurrently to fit within the planned time-frame, without compromising the survey standards. The assignment is expected to commence in May 2022.