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Consultancy Title: Documenting lessons learned and recommendations in the implementation of simplified approaches in relation to the new WHO Guideline

Section/Division/Duty Station: Nutrition and Child Development Programme Group, Programme Division, NYHQ

Duration: 1 November 2024 to 31 May 2025

Home/ Office Based: NYHQ / Remote

 About UNICEF – DO NOT EDIT

If you are a committed, creative professional and are passionate about making a lasting difference for children, the world's leading children's rights organization would like to hear from you. For 70 years, UNICEF has been working on the ground in 190 countries and territories to promote children's survival, protection and development. The world's largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, good water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments. UNICEF has over 12,000 staff in more than 145 countries.

BACKGROUND

Purpose of Activity/ Assignment:

In 2023, an estimated 45 million children under five years old still suffer from wasting, of which 13.6 million are estimated to suffer from its most severe form. While treatment coverage has increased with an estimated 9.3 million of children under five treated for severe wasting in 2023 and 9.4 million supplemented for moderate wasting, considerable efforts are still needed to reach the most vulnerable children. WHO recognizes that in order to maximize the number of malnourished children cared for, interventions need to be as feasible and low-cost as possible without compromising the health of children—and these principles were incorporated into the development of the WHO Guideline for the prevention and management of wasting (2023).

The 2023 WHO guideline has a broader scope than the 2013 guideline and aims to integrate care across inpatient and outpatient/community settings. New areas such as the inclusion of recommendations such as the identification and management of wasting by Community Health Workers, management of moderate acute malnutrition (MAM), management of infants at risk of poor growth and development, post-exit interventions and prevention will result in national governments updating their national policies and guidelines. Understanding the feasibility and practical considerations, including challenges and solutions, will inform UNICEF’s strategy when it comes to supporting countries in scaling up these interventions in line with the new WHO recommendations, and learning from previous programme implementations.

The package of the ‘simplified approaches’ has been instrumental in testing new ways of delivering services to children and their families in a variety of contexts. While the Simplified Approaches were not adopted in the new guidelines, there are elements from some of the approaches that are (e.g., Delivery of Treatment by Community Health Workers) reflected in the guidelines. Efforts to-date on documentation of the simplified approaches have largely focused on evidence generation and research outcomes, and not necessarily on operational aspects of implementing these adaptations, particularly in light of the new WHO Guidelines.

Supporting countries to adopt the new guidelines is a priority for UNICEF, and one way to provide this support is to document experiences of countries who have rolled out adaptations, in order to inform scale- up of these interventions within the context of the new WHO Guidelines. Some of the interventions of focus (but not only) are the delivery of treatment by community-health workers, “reduced “dosage of RUTF when child transitions from SAM to MAM, and the management of MAM with RUTF. Understanding the feasibility, challenges, and solutions to these challenges will help inform UNICEF’s strategy on the next stage of the new WHO guideline implementation.

Scope of Work:

The purpose of this assignment to review and gather lessons learned from countries who have experience in operationalizing these interventions and to document those operational learnings in the form of practical recommendations in order to support future implementation and roll out of recent programmatic shifts related to the new WHO Guideline recommendations.

This review should explore boosters and challenges in the implementation of these interventions and will draw similarities, strengths across contexts in order to provide practical solutions and recommendations on how these interventions can be taken to scale once adapted to the latest WHO Evidence-based recommendations. These recommendations/solutions should focus on the short, medium and long term and should span across different programmatic aspects and levels of the national health system.

Example of questions to explore (non-exhaustive list):

 - What does it mean for a CHW to spend significant amount of their time on wasting activities in terms of delivery of other child health actions?

 - How do CHWs when both SAM and MAM children are managed under same program?

 - Considerations when deciding between CHWs weighing children vs. assessing using MUAC Only

 - What would be the requirements to ensure all children with wasting are weighed and height measured in line with the new WHO recommendations?

 - How was the decision to reduce dose of RUTF made?

 - What tools were the most useful for CHWs and health workers?

- What are the programmatic and logistical challenges when introducing the “reduced” dosage of RUTF when child transitions from SAM to (and where relevant)?

 - What are the programmatic and logistical challenges when using one single product (RUTF) for both SAM and MAM with higher risk management?

 Key areas of focus:

- Process of introduction and roll-out of intervention (e.g., how was the decision made to introduce this adaptation?)

 - Programmatic elements: supportive supervision; trainings; other operational considerations (e.g., monitoring, logistics/equipment).

 - Development of training materials/job aids

 - Integration into existing health structure (e.g., planning, budget, national protocols/guidelines)

Methods for collecting information will include a desk review and Key Informant Interviews (KIIs) with relevant stakeholders in different contexts and countries. Deliverables will include an inception report, 2-3 presentations on findings, a final report and a possible article/abstract for external publication.

The development of this work will be a collaborative approach, and will require close consultation with UNICEF country, regional and HQ offices and implementing partners.

Terms of Reference / Key Deliverables:

Work Assignment Overview, Deliverables/ Outputs, Delivery deadline

The purpose of this assignment to review and gather lessons learned from countries who have experience in operationalizing these interventions and to document those operational learnings in the form of practical recommendations in order to support other countries interested in introducing and/or scaling these interventions in line with the new WHO Guideline recommendations.

• Inception Report, including proposed country selection – By December 1 2024
• 2-3 presentations on findings developed for specific audiences  - May 1 2025
• Article/abstract for external publication May 1 2025
• Final Report (s) May 31  2025

Qualifications

Education:

Masters in a science related field (e.g. public health, nutrition, health science), with 5 years of relevant experience.

Work experience:

Knowledge/Expertise/Skills required *:

Masters in Nutrition or associated public-health discipline

• At least 5 years professional experience in nutrition programming.

 • Firsthand knowledge and experience in the implementation of new programmatic approaches (Family MUAC, CHW-led treatment, Simplified Protocol, etc.) in the treatment of child wasting

• Experience in providing programmatic and technical guidance related to acute malnutrition for program staff delivering public health interventions in resource-limited setting.

Outstanding communication skills, with ability to write and speak in a clear and practical manner in English is mandatory, French and/or Portuguese is an added advantage.

Requirements:

Completed profile in UNICEF's e-Recruitment system and

- Upload copy of academic credentials

- Financial proposal that will include/ reflect :

• • the costs per each deliverable and the total lump-sum for the whole assignment (in US$) to undertake the terms of reference.
  • travel costs and daily subsistence allowance, if internationally recruited or travel is required as per TOR.
  • Any other estimated costs: visa, health insurance, and living costs as applicable.
  • Indicate your availability

- Any emergent / unforeseen duty travel and related expenses will be covered by UNICEF.

- At the time the contract is awarded, the selected candidate must have in place current health insurance coverage.

- Payment of professional fees will be based on submission of agreed satisfactory deliverables. UNICEF reserves the right to withhold payment in case the deliverables submitted are not up to the required standard or in case of delays in submitting the deliverables on the part of the consultant.

U.S. Visa information:

With the exception of the US Citizens, G4 Visa and Green Card holders, should the selected candidate and his/her household members reside in the United States under a different visa, the consultant and his/her household members are required to change their visa status to G4, and the consultant’s household members (spouse) will require an Employment Authorization Card (EAD) to be able to work, even if he/she was authorized to work under the visa held prior to switching to G4.  

Only shortlisted candidates will be contacted and advance to the next stage of the selection process

For every Child, you demonstrate…

UNICEF’s core values of Commitment, Diversity and Integrity and core competencies in Communication, Working with People and Drive for Results. View our competency framework at: Here

UNICEF offers reasonable accommodation for consultants/individual contractors with disabilities. This may include, for example, accessible software, travel assistance for missions or personal attendants. We encourage you to disclose your disability during your application in case you need reasonable accommodation during the selection process and afterwards in your assignment. 

UNICEF has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UNICEF, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. UNICEF also adheres to strict child safeguarding principles. All selected candidates will be expected to adhere to these standards and principles and will therefore undergo rigorous reference and background checks. Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check. 

Remarks:  

Individuals engaged under a consultancy will not be considered “staff members” under the Staff Regulations and Rules of the United Nations and UNICEF’s policies and procedures and will not be entitled to benefits provided therein (such as leave entitlements and medical insurance coverage). Their conditions of service will be governed by their contract and the General Conditions of Contracts for the Services of Consultants. Consultants are responsible for determining their tax liabilities and for the payment of any taxes and/or duties, in accordance with local or other applicable laws. 

The selected candidate is solely responsible to ensure that the visa (applicable) and health insurance required to perform the duties of the contract are valid for the entire period of the contract. Selected candidates are subject to confirmation of fully-vaccinated status against SARS-CoV-2 (Covid-19) with a World Health Organization (WHO)-endorsed vaccine, which must be met prior to taking up the assignment. It does not apply to consultants who will work remotely and are not expected to work on or visit UNICEF premises, programme delivery locations or directly interact with communities UNICEF works with, nor to travel to perform functions for UNICEF for the duration of their consultancy contracts.