Country: Madagascar
Closing date: 23 Jul 2015
Assignment/Project Title:Individual Consultancy for the development of a Nutrition Business Case for Madagascar
Location:Antananarivo, Madagascar
Section:Nutrition
Assignment Duration:38 days
Assignment Type:Individual Consultancy
Closing date: 23 July 2015
BACKGROUND
In Madagascar, despite the adoption of a national nutrition policy in 2004 and two generations of national nutrition strategic plans, the progress made in addressing undernutrition has been limited and is insufficient to ensure the country meets Millennium Development Goals, especially MDG 1. Despite a slight decrease observed since 1992, stunting is still the most prevalent form of malnutrition in Madagascar. It affects 47 % of children under 5 years of age which translates in nearly 2 million stunted children[1]. Stunting is more prevalent among younger children (those aged less than 2 year) and affects more rural areas (49%) than urban areas (39 %). Besides stunting, children are also affected by underweight (33%) and acute malnutrition ̶ wasting or edema (9%). Undernutrition is due to poor maternal nutritional status, inadequate infant and young child feeding (IYCF) practices, inadequate access to food (qualitatively and /or quantitatively) and recurrent illness that in turn is associated to poor access to health good quality health services. These factors are further exacerbated by the fact that the most deprived segment of the population has very limited access to the existing social services. The latest data show that in Madagascar, 66 % of new-borns are given breast milk within one hour following birth, only 42% of infants aged 0-6 months are exclusively breastfed and 31% of those aged 6-23 months receive acceptable diversified diet (MDG 2012). It is proven that stunting (the main nutritional problem in Madagascar) is also due to the intergenerational cycle of growth failure which is transmitted across generations through the mother. In Madagascar, 22% of children are low birth weight, which points to poor maternal health and nutritional status (DHS 2008-2009). Indeed, 33% of women of child bearing age are underweight (DHS 2008-2009) and 30% of women are stunted (CSFVA 2010). Micronutrient deficiencies are also prevalent. Despite a significant decrease, anaemia remains high among children (50%) and women of child bearing age (35%) (DHS 2008-2009).
Between 2009 and 2013, Madagascar has gone through a political crisis that was associated with sanctions resulting in diminished external aid and a signification reduction of the domestic resources for social sectors, including nutrition. The elections were successfully completed in late 2013 and marked the end of the crisis. Since then a number of actions have been taken by the government to re-convey its commitment towards the nutrition agenda, including the change in the management of the national nutrition office, several statements and speeches from high level authorities clearly recognizing nutrition as priority. Furthermore, a high level round table held in April 2014 resulted in sectorial ministries making public commitments to engage their individual sectors in the effort to reduce under nutrition. Other initiatives are planned but have not yet been completed including the WFP-led Cost of Hunger study to be used as advocacy tool with the decision makers. Despite these actions, nutrition remains largely underfunded.
In order to increase donor awareness on the magnitude of malnutrition and enable more donor funding commitments and an increase in external resources to help resume with development activities. Furthermore, the Government of Madagascar plans to hold a donors’ roundtable on 17-18 November 2015 at which engagement with key donors will be reinforced. . Four priority areas have been identified to be discussed during the event, namely) rural development; 2) urban development; 3) infrastructure and 4) nutrition. The government has requested UNICEF to help them prepare the background document for the nutrition component. UNICEF agreed and proposed to help develop an investment case for nutrition. The current ToRs are developed for a consultancy in this regards.
PURPOSE OF THE CONSULTANCY
Under the supervision of the chief of the nutrition section, in collaboration with the national technical committee[2] and in consultation with UNICEF regional office:
· Estimate the human and economic cost of undernutrition for the country
· Propose a package of nutrition specific interventions to address undernutrition with three scenarios of coverage and cost
· Estimate the human and economic return on investment for each of the proposed scenarios
METHODS
The work method will involve field mission and remote work and will include:
a) Careful analysis of background documents (part or all of this could be done remotely)
· MDG 2013 survey report,
· The situation of children and women,
· The national development plan and its implementation plan,
· The national nutrition strategy and related common result framework
The analysis of these documents aims to provide an initial list of indicators to be included in the costing exercise.
b) Hold and facilitate an inception workshop with a local technical group made of a) technical representatives of the national nutrition office; b) the sectorial ministries; c) highly reputed local economists; d) technical delegates of the UN agencies and e) the UNICEF regional and national partnership/resource mobilization and nutrition staff. The aim of these consultations is to reach an agreement on the documents and database used, the indicator selected and build local ownership of the process and the final product.
c) Undertake the costing of the economic loss for Madagascar if the undernutrition situation remain high as it is now and unaddressed for the coming 10 years, The costing to be based on specific indicators including anthropometric indicators, micronutrient deficiencies and key behaviours such as exclusive breastfeeding. This analysis should use a “consequence model” and should result in Damage Assessment Report (DAR) for Madagascar
d) Facilitate a consultation with relevant government stakeholders from health and nutrition as well as finance, economics and labor to validate and build ownership of the methodologies, data, assumptions and conclusions of the cost of malnutrition exercise.
e) Discussion with a local technical group (made of technical representative of the national nutrition office, the sectorial ministries, a highly reputed local economist who will work closely with the consultant, technical delegate of the UN agencies) on most urgent and feasible interventions to address the human and economic losses. This includes review of ongoing programs, assessment of capacity, feasible coverage and associated budgets.
f) Facilitate a validation workshop and present proposed budgeted package of nutrition specific interventions, objectives for coverage and effectiveness, projected benefits and 10-year benefit-cost.
g) Write up of a complete narrative and illustrative (where necessary) investment case that will be attractive enough for the Madagascar and government external and trigger and increased attention and strong commitment to invest more (domestic and external) financial resources in the sector. It is worth noting that as most of the traditional donors of the country are considering taking the budget the support approach, it is important to ensure that the final investment case is flexible enough to allow for support through UNICEF which is the lead agency in nutrition in Madagascar.
h) Applicants will submit technical offer describing in details the methodology to be used for each of the steps presented above.
EXPECTED DELIVERABLES AND TIMELINE
\*1.**Report on the desk review analysis of the back ground documents (30 July 2015):*
Ø PowerPoint for economic cost of malnutrition in Madagascar for presentation at half-day validation workshop (10 days)
\*2.**Inception report following meeting with local committee (*August 5 –12, 2015)*:*
Ø Not more than 5 pages detailing the main elements related to background document, indicators and methods on which the group has reached an agreement as well as those on which there is a disagreement
\*3.**Intermediate report on the costing of the human and economic impact of undernutrition (August 25, 2015 for 8 days):*
Ø Not more than 20 pages providing 1) the human cost of under nutrition and 2 the economic cost of undernutrition on an indicator by indicator basis.
\*4.**Report on proposed scenarios of nutrition specific interventions and return on investment\with a package of nutrition specific intervention and the return in investment ( 5 days :* September 12, 2015):
Ø PowerPoint for presentation to stakeholder consultation at half-day validation workshop.
\*5.*****PowerPoint and 2 pages report on the national technical workshop to share finding ( 2 days: September 30, 2015):
Ø This will involve preparing a PowerPoint presentation summarizing the method and results the various steps of the work
\*6.*****Presentation for a working session with traditional donors local representatives ( 1 Day- Octobre 6, 2015):
Ø PowerPoint
\*7.*****Final investment case ( 7 days : October 31, 2015):
Ø Final document in English with and Executive summary in French - Not more than 50 page (not including annexes). The report should be concise, precise to attack government and donors interest in financially supporting nutrition in Madagascar through direct Budget support or through UNICEF
The work program outlined above will be based on work from remote office as well as two missions to Madagascar tentatively scheduled for July 29-Aug 12 and October 1-October 15.
QUALIFICATIONS, SKILLS AND ATTRIBUTES
- Advanced university degree in health economics, public health, or advocacy and communication
- Advanced university degree in economic with strong knowledge on public health, nutrition;
- At least 10 years of relevant professional working experience at the national and international level;
- Experience in programme evaluation, including quantitative and qualitative research
- Familiarity with the developing countries government and environment.
- Excellent communication, coordination and facilitation skills
- Strong analytical and report writing skills;
- Knowledge on nutrition
- Demonstrable evidence of production of similar investment cases
- Mastering of the available costing tools and consequence modeling techniques
- Good skills and experience in cost benefit analysis
· Duration and remuneration
Taking into account the skills and expertise required to implement the ToR, the fee is currently estimated the UN reference scale (level 5). The actual remuneration fee will be negotiated with the selected individual based on what he/she proposed in the financial offer.
The duration of the consolation is expected to not exceed 25 working days distributed in a total period of 4 months Payment will be scheduled as follows
- 20% payment upon completion of deliverable 1 and 2
- 40% payment upon completion of deliverable 3, 4,5 and 6
- 40% payment upon submission of final assessment report, deliverable 7
[2]A national committee will be set up with representatives of government ministries ( health, economic and plan, agriculture Water) INSTAT and strong economist to reach a consensus on the data to be used , the damage assessment and to ensure local capacity building
How to apply:
Submission:
Please send your application to : Chargée des Ressources Humaines, UNICEF Antananarivo, Madagascar, E-mail: hrantananarivo@unicef.org no later than 23 july 2015