Kenya: Nutrition support to the Gedo Regional Health Programme

Terms of Reference

Nutrition support to the Gedo Regional Health Programme

INTRODUCTION Gedo Regional Health Programme is a primary health programme supported by Trócaire Somalia. The programme supports health and nutrition services in five of the seven districts in Gedo Region, Southern Somalia. The security situation in South Central Somalia has deteriorated significantly over the life of the programme with a resultant reduction to respond to this reduced access.

Nutrition has a direct impact on health outcomes, learning potential, income earning potential and poverty within a community. Nutrition is an aspect of food aid, food security, health, livelihoods, education and agriculture programming and many of these have their own overlaps with one other.

The emergency and nutrition programme is based on screening and referral in 12 OTP sites by Gedo staff at the MCHs and the outreach teams. Trócaire would like to start Community Management Accurate Malnutrition (CMAM) in 1 of the OTPs as a pilot project.

PURPOSE OF THE CONSULTANCY

The purpose of this consultancy is to: • Review Trócaire current nutrition programme & strategy and rationale for adjustments from the perspective of adequate access to food. • Assess nutritional programme and advice ways of improving quality, relevance, impact and sustainability. • Support the Trócaire staff in the supervision and the management of the CMAM programme. • Plan and provide nutrition support to the field staff in order to improve quality of the ongoing activities. • Review of the current literature/thinking on food aid and food assistance programmes in emergency and in protracted situation, including analysis and recommendations of new food assistance tools. • Make practical recommendations which will help strengthen the programme and future way forward. • Perform any other necessary duties required to implement a quality nutrition programme.

The consultancy findings will be used to implement the Trócaire health & nutrition programme in Gedo in the future.

BACKGROUND Gedo Gedo Region is situated in south western Somalia. With an estimated population of 380,000, Gedo is divided into seven administrative districts. The population is mainly pastoral with agriculture practised along the Juba and Dawa river valleys. The Gedo region has historically been one of most underdeveloped areas of Somalia, with minimal infrastructure, a weak economic base and only very basic health and education services available to the communities. The region is largely food insecure due to its dependence on erratic rainfall for the production of crops and pasture.

Gedo has been chronically insecure due to on-going inter and intra-clan conflicts largely related to control of resources. Currently the security risks in the region are linked to external threats and influences associated with the political situation at the national level intertwined with the internal conflict. Three of the five operational districts are controlled by pro TFG forces and two are under the Al Shabaab control. Guerrilla tactics used by Al Shabaab result in surprise attacks upon towns, mining of roads, IEDs etc. This limits access and compromises supplies and requires a flexible operational mode. In this environment, traditional conflict mitigation and resolution mechanisms previously used by Trócaire are less effective and the use of community acceptance as a security mechanism for programme staff and resources has become less reliable resulting in a reduction in time technical staff can spend in Gedo.

Trócaire Trócaire has been implementing a variety of humanitarian and community development programmes in Gedo region since 1992 and currently focuses on health & nutrition, education and emergency response programmes.

Gedo Regional Health Programme The Gedo Regional Health Programme supports primary health service delivery to an estimated population of 220,000 in five of the seven districts of Gedo, (Belet Hawa, Dollow, Luuq, Garbahaarey and Burdhubo) with the support of 5 District Health Boards. Three district hospitals, 5 OPD/MCH units, 5 district outreach teams and 50 Health Posts receive support in terms of maintenance, expatriate & national technical staff, national staff salaries, transport, supplies and capacity building. Trócaire has offices in Nairobi and Mandera. The broader programme is funded by DFID, EC, Trócaire, UNICEF and Irish Aid.

SPECIFIC OBJECTIVES OF THE CONSULTANCY The specific objective of the consultancy is to work with the Trócaire Nutrition/EPI officer, Trócaire Public Health Coordinator and Trócaire Health Advisor to strengthen the programme by: • Reviewing Trócaire current nutrition programme & strategy and rationale for adjustments from the perspective of adequate access to food and recommending strengthen of the programme to meet needs. • Assessing nutritional programme and advising ways of improving quality, relevance, impact and sustainability. • Assessing the appropriateness of the current strategy and programme management and implementation structure for the current operating context. • Working with Trócaire staff to strengthen the reporting and the analysis. There is a need for sex disaggregated data for reporting, average length of stay in the OTPs and SCs and linkage between the two services. • Working with the team to reinforce the management of supplies. • Supporting the Trócaire staff in the supervision and the management of the CMAM programme. • Leading and participating in the training of the OTP staff. • To develop specific recommendations based on the above analysis and current Somalia/Gedo context, which will guide the strategy and methodology of Trócaire’s health interventions for the future proposal.

OPERATIONAL MODE OF CONSULTANCY The consultant will work with the field programme staff, in particularly with Trócaire Public Health Coordinator, Trócaire Nutrition/EPI officer and Trócaire Health Advisor, for a period of 2 months. The consultant will be based in Mandera for the period of the visit but with travel to Gedo Region for supervision and training with the Trócaire staff as allowed by security.

EXPECTED OUTPUTS & REPORTING FORMAT • A clear and concise written evaluation report (25 – 30 pages, including the executive summary, but excluding annexes), structured around the objectives of the evaluation, clearly analysing and answering the key questions identified. • A clear and concise written strategy for the new phase implementation 2012/2013, with realistic and practical recommendations for future phases of the programme with strong focus on delivery of results. • Clear recommendations to strengthen the reporting and the analysis. • A clear and concise written report per training within one week of completion of the training. • A clear and concise written report within two weeks of completion of field visits in Gedo region, detailing the work done, problems identified, recommendations, and a plan of work for the next visit. • Debriefing in Mandera with the Trócaire Mandera team after each field visit in Gedo region & training. • Debriefing in Nairobi with the Trócaire team at the end of the consultancy.

The final report should be written in English and the final version provided in hard copy and soft copy. Maps and photos should also be provided in soft copy (CD; DVD).

TIMELINE 2 months – August/September 2012

REQUIRED EXPERTISE OF CONSULTANT The proposed consultant should have the following expertise: • Post- graduate qualification in food security and nutrition. • At least seven years of field experience in nutrition/food security in developing countries preferably in emergency context and/or complex emergencies. • At least two years of experience in training of staff on nutrition. • Proven experience in research, analysis and programme design in the area of nutrition/food security. • Good understanding of the Somalia context. • Experience of community health management structures such as District Health Boards, Village Health Committees. • Excellent reporting and communication skills, both written and verbal

SUPPORT SERVICES/LOGISTICS Trócaire will organize logistical arrangements for all work in Gedo/Mandera including transport, accommodation, briefings, translation and administration. Transport to Mandera and back will be arranged by Trócaire.

View the original article here