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Dietary Diversity | ReliefWeb



https://www.crs.org/about/bid-opportunity Please visit CRS.org website for the full Scope of Work and attachments.



Solicitation Number: ET1580.04.2022



Consultancy Title: Consultancy to conduct research challenges to improving household dietary diversity



Date Issued: 3/28/2022 Inquiry Date: 4/4/2022 Proposal Deadline: 4/8/2022



Statement of Work (SOW) for challenges to improving household dietary diversity of women, adolescent girls, and children aged 6-24 months in Oromia region, Ethiopia



Please note this SoW and its annexes may change before contract signature, based on USAID and other stakeholder input.



Background



As a continuation of previous Development Food Security Activity, the CRS-implemented Ifaa activity is 5-year program supported by USAID Bureau for Humanitarian Assistance with the goal to brighten the future for poor communities in the Oromia region by reducing intractable poverty, vulnerability, and food insecurity. Ifaa will target 9 woredas in East Hararghe Zone based on poverty, Productive Safety Net Programme (PSNP) caseload, potential for continuum of response with other programs, partner presence, and opportunity for impact. Ifaa will prioritize pregnant and lactating women (PLW), with a particular focus on first-time mothers, caregivers, and influential community members to ensure children aged less than two years (CU2) receive adequate nutrition, vulnerable community members are reached, and behavior change leads to lasting change. Within this frame, Ifaa will conduct research around barriers to improving dietary diversity of pregnant and lactating women, adolescent girls, and children 6-24 months of age. Some key elements include local availability, access to resources, family size, family dynamics, and meal frequency and feeding frequency, home gardens, decision making role and seasonal fluctuations.



Adequate and nutrient-dense food during the 1,000-day period between the start of a woman’s pregnancy and her child’s second birthday is critical for future health and wellbeing of the child. The Ethiopian National Nutrition Plan (NNP), as well as recognized nutrition policies and practices (such as the first 1000 days principles and the GoE’s Seqota Declaration require programming to target age appropriate, nutrient-dense food. The right nutrition during this window of opportunity can have a profound impact on a child’s ability to grow, learn and rise out of poverty. It also benefits society, by boosting productivity and improving economic prospects for families and communities.



A diverse, frequent, and acceptable diet is essential to preventing micronutrient deficiencies, stunting, and wasting. If appropriate complementary feeding practices were scaled up to nearly universal levels, globally, approximately 100,000 deaths in children under five could be averted each year (Tseganesh Habtamu et al. 2021). The most direct causes of stunting are inadequate nutrition (not eating enough or eating foods that lack growth-promoting nutrients) and recurrent infections or chronic diseases that result in poor nutrient intake, absorption, and utilization. According to the 2019 DHS report, 37% of children under age 5 are stunted, 21% are underweight, only 11% of children aged 6-23 months were fed a minimum acceptable diet (24 hours before the survey), and only 14% of children have an adequately diverse diet (Ethiopia Mini DHS 2019: Final Report).



Minimum dietary diversity is a proxy for adequate intake of nutrient dense foods. Consumption of food from at least five groups means that the child has a high likelihood of consuming at least animal sources of food, fruit, or vegetable, plus a staple food. Similarly, Minimum meal frequency and feeding frequency are also a proxy for meeting energy requirements (2019, Cost of the Diet Analysis in Ethiopia (CRS-LRO).



Problem Statement / Theory of Change Information Gap Summary



In the Oromia region woredas for the Ifaa activity, persistent drought and continuous crop failures have hindered agricultural production in recent years. Due to these factors, key minimum dietary diversity components like cereal and legume production have been below average and contributing to lengthening lean seasons, which result in food shortages. As such, many of the communities are facing food shortages and lack of resources to purchase from local markets; all these factors are contributing to ongoing and increasing food and nutrition insecurity.



The problem is that given the changing agricultural and Covid-19 context, the Ifaa activity does not sufficiently understand the behavioral, cultural, and market impediments, limited access to resources and decision-making gaps that prevent women and children aged 6-24 months in the Ifaa implementation woredas of the Oromia region from consuming a sufficiently nutrient dense and diverse diet. This knowledge gap will prevent the Ifaa activity from effectively support the adoption of behaviors to improve diets.



Key Research Objectives



The purpose of this study is to identify challenges to improving diets of pregnant and lactating women and children aged 6-24 months in the nine (9) RFSA targeted Woredas of East Hararghe Zone, Oromia region of Ethiopia. The consultant will identify enabling/ impeding factors that support/ impede improvements of dietary diversity and consumption of nutrient dense foods. Additional considerations are maintenance of healthy diets during fast periods and adequate meal frequency.



Specific Objectives:



  1. Identify enabling and impeding factors for improvements diet and consumption of nutrient dense foods among PLWs and children aged 6-24 months


  2. Identify and analyze the necessary IYCF related resources mothers and care givers have access to and the differences among new vs. experienced mothers/care givers in accessing these resources


  3. Examine availability of nutrient dense foods and impact of variability of seasons and market on resource allocation for food


  4. Identify existing practices and experiences around home gardens and analyze their role for dietary diversity


Research Methods



This study will require use of qualitative data collection (focus group discussions, key informant, or semi-structured interviews) and analysis methods (Excel matrices or other qualitative software that can handle larger data sets). A detailed table of each research question, data source, method, and justification are in Annex 1.



Research Questions. What barriers prevent caregivers from improving household dietary diversity and nutrient density, and what enabling factors might support improvements? There are several sub-questions to examine necessary resources, market availability, and applicability to pregnant and lactating women, adolescent girls, infants, and children aged 6-24 months. Please see Annex 1 for a detailed list of research questions.



Data Source/Collection Methods. Given that CRS only broadly understands barrier to improved dietary diversity, it is not possible to develop a detailed household survey with pre-identified responses. For this reason, focus groups discussions will be held in randomly determined communities that are segmented by the experience and sex of the caregiver and the age of children in the household. Semi-structured interviews or other participatory methods may also be used, with the particular approach to be agreed upon by CRS and the consultant following a discussion of consultant capacity and prior experience with particular methods and inputs from CRS staff on methodologies perceived as feasible and most relevant to the context and/or particular research questions



Key informant interviews will be used with market actors trading key identified nutrient dense foods. These interviews will be conducted with private shops (selling food), individuals selling in open markets and small organized enterprises existed in the targeted Woredas. In addition, key informant interviews (KII) will be conducted with health extension workers, health development armies, and lead mothers.



Please see Annex 1 for a detailed list of data sources linked to research questions.



· Data Analysis Methods*.* All data collection methods will be qualitative. For focus group discussions, there will be too many to conduct simple analysis in Excel. For this reason, R’s RQDA package is recommended. If the consultant has use of ATLAS.ti, MAXQDA or NVIVO, they may also use it for data analysis. Consultants should use software for organizing responses and identifying key themes for analysis.



If fewer than ten KIIs with a given respondent type are conducted, consultants can use an Excel matrix for data entry and to identify key themes for synthesis.



Research Justification*.* Please see Annex 1 for a detailed list of justifications by research question. Essentially, Ifaa must better understand the household and community dynamics, and available resources (including food markets) that prevent PLW and children aged 6-24 months from consuming a diverse and nutrient rich diet.



Data Handling*.* Consultants may wish to create audio recordings of focus group discussions, or interviews, for later transcription or adding detail to notes. If audio recordings are created, they should be destroyed once transcription/ detailed notes are completed. Audio recordings need not be shared with CRS and participants must consent to audio recordings.



For focus group discussions or participatory research exercises, consultants may ask individual names to establish rapport with study participants, however those names should not be captured. Focus group notes should only note segment targeted (i.e., female caregivers of children aged 6-24 months in new woredas, etc.) and the community where they were conducted. Interviews should follow the same protocol (i.e., KII with female health extension worker).



After completion of data analysis and final reporting, consultants should provide transcription/ detailed notes and any script used for analysis to the Collaboration, Learning and Adaptation Advisor (CLA) Advisor at CRS. Any syntax or bundled data from qualitative software analysis should also be provided. Data will be stored on a secure server, and only share with other staff needed for new analysis of the data. The consultant should not retain any copies of this data, as they will not need it once this consultancy is complete.



Mitigating risks and handling unexpected or adverse events*.* The two risks, and their associated mitigations strategies, are:



COVID-19- Increase in the transmission of COVID-19 and accompanying government restrictions will require the consultant to apply safety measures to protect research participants and staff. This will include but not limited to:



o Provision of personal protective equipment (masks, sanitizers) to all research participants including respondents and staff



o Social distancing will be maintained



o Clearly communicate COVID-19 safety protocols and expectations to all research participants so that they understand what is expected of the researchers and monitor their management of the interviews



o If tentative interviewee expresses potential symptoms of COVID-19, the interview will need to be re- scheduled or replaced with another interviewee



Security – In case where security issue is observed the following measures will be taken



o Sampling of Kebeles will be in accordance with their security status i.e. Some Kebeles will be intentionally removed from the frame before selection for staff and participant safety reasons



o Necessary approvals and guidance from GoE (Zonal and Woreda) prior to collection of the data will be secured, as required.



o Phone interviews will be an option for KIIs



Ethical Considerations



The consultant is expected to follow American Evaluation Association’s Guiding Principles for Evaluators (https://www.eval.org/About/Guiding-Principles). Dependent upon participants in the study, the consultant should specify steps that will be taken to ensure informed consent, confidentiality, protection of minors, and minimization of Covid-19 transmission. The consultant should specify steps taken to safeguard data collected and data management procedures to be used in this study. There will be a data rights clause in the signed contract, and the consultant should obtain permission from CRS before sharing the final study report with any external party, including posting it to their organization’s website.



Team Composition / Team Lead Competencies



This study will be carried out by an external consultant or consulting firm, led by a Lead Researcher under the supervision of the CRS CLA Advisor. The ideal composition of the team is outlined below, but deviations are acceptable, if the entire team has the desired competencies:



Lead Researcher



· With a 5-year higher education diploma, preferably a master’s or higher in nutrition, or an equivalent field.



· At least 10 years of professional experience in health and/ or nutrition behavior change, including experience as research lead in the conduct of studies and evaluations, preferably for health and nutrition projects.



· Knowledge of the study methods, as demonstrated by the completion of at least three similar studies.



· Demonstrated ability to lead and supervise a multidisciplinary team.



Technical Expert in Health and/or Nutrition



· Bachelor's degree, + 4 years’ experience in nutrition, or equivalent field



· At least 6 years of professional experience in the field of health and/or nutrition behavior change, with at least two studies/evaluations in the similar field.



· Strong knowledge of the socio-cultural and food & nutrition security context of Oromiastate



· Strong communication and interpersonal skills



Technical Expert in Behavior Change Communication



· Bachelor's degree, + 4 years’ experience



· At least 4 years of professional experience in the field of health and/or nutrition behavior change, designing and implementing successful SBCC activities and products



· Strong knowledge of the socio-cultural and food & nutrition security context of Oromiastate



· Experience providing SBCC technical assistance to NGOs, government or other counterparts



· Strong communication and interpersonal skills



Data processing and qualitative information management specialist



· Bachelor’s degree or equivalent in social sciences, with at least 5 years of experience in qualitative data analysis



· Have at least 5 years of professional experience in the design of data collection, management, and data cleansing methodologies for qualitative data



· Strong ability to use computer-based software analysis tools and applications for qualitative analysis such as ATLAS.ti, R (basic text mining), Dedoose, Taguette, or other.



Field Research Assistants/ Data collectors



· Holder of at least a bachelor's degree in social sciences, humanities, public health, or nutrition



· Has at least 2+ years of professional experience including 3 data collection assignments



· Have experience in the field of public health, nutrition and/or health related behavior change



At CRS, the CLA Advisor with the Program Manager (PM) for Health & Nutrition will ensure the consultant fulfills the terms of the SOW and provide technical oversight. The CLA Advisor will also ensure coordination and collaboration with BHA, other RFSA awards in Ethiopia, and other international actors.



CRS also has a wide pool of regional and HQ technical experts, who will also be available as needed for oversight and quality reviews.



Deliverables



The SoW deliverables are:



  1. Research protocol (including literature review, detailed methodology and explanation of any recommended deviations from this SoW, research questions, summary of qualifications of research team members, etc.)


  2. Data collection tools


  3. Data collection plan, which includes training plan for research assistants/ data collectors


  4. A one pager Weekly data collection reports indicating expected and conducted number interviews/ focus group discussions (FGD), any changes made on tools and processes because of field experience and any challenges faced and actions taken


  5. Detail data analysis plan


  6. Data analysis/ final product (completed in stages):


a. Summary of potential SBC interventions consolidated in an organized matrix/ framework. This should include suggested positioning strategies/ approaches for improving nutrition dense food consumption for PLW and children aged 6-24 months. The identified interventions should be specific, measurable, attainable, relevant, and timely (i.e., ‘SMART’).



b. Validation workshop, including CRS, partner, other RFSAs and GoE staff, conducted that includes suggested further dissemination of this study’s findings. CRS will facilitate logistics of the validation workshop and cover costs related to venue and invited participants.



c. Suggestion/ recommendations for any additional nutrition dense food-related job aids or social behavior change communications.



d. A full written report detailed with all questions (above) answered.



o The final report will incorporate 1 round of feedback from CRS and BHA.



o The final report structure will be determined in consultation with CRS.



o The final report must be compliant with the Americans with Disabilities Act (ADA) and Section 508 of the Rehabilitation Act and be made accessible for people with disabilities. Please see footnote for information on Section 508 compliance and how to make documents accessible.1



e. After completion of data analysis and final reporting, consultants should provide transcription/ detailed notes and any script used for analysis.



Roles and Responsibilities



The roles and responsibilities of CRS and partners include:



· Verification and validation of consultant’s proposed research protocol



· Monitoring and supervision of implementation throughout the study process and provision of regular feedback if necessary



· Access to CRS CommCare license, and data collection tablets (as needed). CRS will not provide access to any other proprietary software (Excel, ATLAS.ti, NVIVO, SPSS, etc.)



· Evaluation of draft and provision of feedback to Team Lead based on following criteria:



o Conformity of output with SOW, and the proposed research protocol



o Concordance of analysis with evidence



o Writing and presentation



o Soundness of conclusions and pertinence of recommendations



o Validation of final report following proposed revisions from CRS and BHA



Roles and Responsibilities of the consultant:



· Provision of research protocol, to include:



o Data collection tools



o Data collection plan, including



§ Detailed outline of sampling frame and procedure



§ Covid-19 mitigation strategy for primary data collection/ in-person enumerator training



o Roles and responsibilities of different team members



o Risk management strategy for changing security context and Covid restrictions



o Logical framework or map linking general research questions to detailed research questions



o Data analysis plan, including statistical management and data analysis strategy



o Lead Researcher-CRS communication plan



o Timeline/flowchart of key phases, including the deliverables



· Collecting and analyzing information in the field according to the proposed methodology



· Collaboration and communication with Ifaa team during the study



· All deliverables described in the preceding section



· Consideration of feedback and recommendations from CRS and USAID throughout the study



· Finalization and submission of the final report, including the validation workshop



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