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Concern seeking Trials for Improved Practice Study consultant, Uganda

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Kate Golden

Senior Nutrition Advisor/ Concern Worldwide

Normal user

23 Apr 2013, 16:18

Proposed Visit Date: June 2013 Reports to: RWANU Health and Nutrition Director and ACPD-Programmes 1. Introduction & Background: Concern Worldwide (Concern), ACDI/VOCA and WeltHungerHilfe (WHH) have designed the Resiliency through Wealth, Agriculture and Nutrition in Karamoja (RWANU) program to respond to Food for Peace’s (FFP) overall strategic objective for the Title II program in Uganda: reduce food insecurity among chronically food insecure households. RWANU proposes to implement in 16 sub-counties in Napak, Moroto, Amudat and Nakapiripirit Districts of South Karamoja, an area selected because of the high levels of malnutrition, the existing social and economic interrelationships, the relative security of the area, and the potential for sustainable results. The program has a five year duration, and began in late August/early September 2012, with full implementation beginning in January 2013. In total the RWANU program is expected to reach a total of 200,399 beneficiaries. ACDI/VOCA will lead livelihood activities, monetization and distribution, as well as the overall management of the project ensuring integration of activities across strategic objectives. WHH will lead on livestock activities. Concern will have primary responsibility for the nutrition, health and hygiene activities. The project goal is: Reduced Food Insecurity among Vulnerable People in 4 districts in Karamoja, with two primary objectives and supporting intermediate results, as follows: Objective Intermediate Result 1: Improved availability and access to food 1.1: Improved smallholder farm management practices adopted 1.2: Improved smallholder livestock management practices adopted 1.3: Increased linkages to markets 2: Reduced malnutrition in pregnant and lactating mothers & children < 5 2.1: Improved health and nutrition practices at the household level 2.2: Improved prevention and treatment of maternal and child illness Objective 1: Interventions will be tailored to the two different livelihood zones, the green belt and the agro-pastoral zone. Activities will reduce the risks associated with rain-fed agriculture, identify and promote low-risk, higher-return commodities and increase livestock ownership while at the same time drawing households into market systems. RWANU will build the capacity of farmer groups and small producer groups through training in technical skills, savings mobilization, basic business skills and marketing. Objective 2: (Concern) Activities will focus on preventing malnutrition during the first 1,000 days of life through a package of curative and preventative health care, behavior change activities, and improved consumption of micro- and macronutrients. RWANU will implement activities around proper infant and young child feeding practices, the nutritional needs of pregnant and lactating women (PLW) and children under 2 while promoting equitable intra-household food distribution. Concern will implement the social behaviour change activities through the Mother Care Group approach, male change agents, livelihood trainings, and working with religious and opinion leaders, and will also support health service provision in health centres and outreach services. Background to Concern Nutrition programming In Karamoja: Since 2009, Concern has been implementing programs in Karamoja that focus on building Ministry of Health and community capacity for the roll-out of Integrated Management of Acute Malnutrition (IMAM). This programme was supported mainly by UNICEF and drew to completion in late 2012. The majority of the SO2 team are therefore familiar with IMAM, IYCF and capacity building approaches with health staff (clinical and managerial) and with the community health system. The team are now also familiar with Barrier Analysis using a Doer/Non-Doer survey. However, the team are not familiar with TIPs with the exception of the Senior Nutritionist. 2. Objective of the Visit: The consultant will use TIPs to study three different behaviours that the RWANU project will be promoting, one of which was also studied in the barrier analysis. Trials of improved practices (TIPs), also known as household trials, involves a series of visits to selected homes to test new behaviors to improve child nutrition. The reason it is helpful is to provide an individual counseling with caregivers to adopt key optimal behaviours. The basic process is: an initial home visit to gather background information and interview the caregiver about the diet of her young child, a second visit with the caregiver to present several options for improving her child’s feeding, to record her reactions to the options, and to negotiate with her to choose one or more options that she is willing to try during the following week, and a third follow-up visit to see how the caregiver has progressed and address challenges found . The scope of this TOR work includes but is not limited to developing all tools necessary to carry out the TIPs, conducting a training on TIPs including all three interview phases, providing technical support and field supervision during the TIPS, carrying out all data analysis, and being responsible for producing a final report of the process, findings and recommendations, as well as integrating learning into the current Social Behaviour Change – Strategy and Action Plan. 3.Key Objectives and Activities: --Conduct a literature review of all relevant documents and available reports from Karamoja and Uganda pertaining to the health and nutrition behaviours being studied. --Conduct a full training (in phases) on the Trials for Improved Practices methodology for the RWANU team and enumerators. --Develop the TIPS questionnaires for all three interviews with the input of the team. --Lead on pre-testing and finalising interview questionnaires. --Lead and provide technical support and supervision during the TIPs field work. --Collect, summarize and analyse field data and produce a final report of the findings and recommendations. --Integrate learning into the SBC-SAP document. --Facilitate a stakeholder workshop to present the key findings and recommendations and solicit feedback to be incorporated into the final report and SBC-SAP. 4. Key Deliverables --A final report on the findings and recommendations of the TIPs study. --An updated Social Behaviour Change-Strategy and Action Plan that incorporates the findings and recommendations of the TIPs and is adapted to be a useful tool in guiding the overall SBC component of the project. --A short activity report (maximum 10 pages plus annexes) on the TIPs consultancy including details on training including lesson plan, planning and implementation of TIPs. The TIPs training guide and all tools will be annexed to this report. --A Powerpoint presentation of the key findings and recommendations of the TIPs as well as the new components of the SBC-SAP. Activities and time frame --Agreement on behaviours to be studied followed by a document review (2 days) --Interview 1 questionnaires prepared and sent to team for translation (1 day) --Travel to Uganda & Moroto (2 days) --Meet w/ team; prepare for training and field work; review interview 1 questionnaire (1 day) --Training on overall TIPs methodology and interview 1 (2 days) --Lead on pilot test of interview 1 in the field & revise questionnaire as necessary (1 day) --Supervise and support interview 1 in the field (3 days) --Conduct data analysis and prepare counselling guides for Interview 2 (2 days) --Train team on counselling guides/Interview 2; finalise counselling guides w/ team (2 days) --Supervise and support Interview 2 in the field (3 days) --Prepare interview 3 questionnaires, write summary report, begin data analysis and final report writing (3 days during gap between Int 2 & 3) --Train team on Interview 3 (1 day) --Support and supervise team in the field for Interview 3 (3 days) --Analyse TIPS data; prepare a final report on the findings and recommendations (3 days) --Revise/update the SBC-SAP, meeting with staff to discuss revisions to SBC-SAP (2 days) --Prepare presentation on key findings, recommendations & revised SBC-SAP (1 day) --Present findings at a stakeholder workshop (1 day) --Travel back from Uganda (2 days) Please submit an Expression of Interest by April 30th outlining your exact availability in June and July, as well as a cost summary for the work, and email to Technical queries can be addressed to Sonya Kibler, Nutrition Advisor with Concern Worldwide US,

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