Nutrition SMART Survey Consultant (Please apply by 2/13)

Background and Context

The International Rescue Committee (IRC) responds to the world’s worst humanitarian crises and helps people to survive and rebuild their lives. Founded in 1933 at the request of Albert Einstein, the IRC offers life-saving care and life-changing assistance to refugees forced to flee from war or disaster. IRC has been working in Sudan and South Sudan for over 20 years. Currently IRC is implementing nutrition projects aimed at treating and preventing malnutrition. A      child with severe acute malnutrition is nearly 10 times likely to die than a well-nourished child. Hence there is need to address this condition so as to reduce mortality rates within South Sudan and providing life-saving basic health care services to the community.

Targeted Counties

1. Aweil South County in Northern Bar el Ghazal

Aweil South County is in the Northern Bahr el Ghazal State of South Sudan. It borders Aweil East to the north, Gogrial West County to the east, Wau County to the south and Aweil West County to the west. Aweil South is predominantly inhabited by the agro‐pastoralist Dinka (100%)  Panthou is the county capital located 35km from Aweil town state capital. The County consists of eight administrative payams: Ayai, Gakrol, Nyieth, Nyoch‐Awany, Panthou, Tarweng, Tiraliet and Wathmok. The population of the county is estimated to be 80,766 people with an average household size of 6.8 people.

Health: Health services are delivered by International Rescue Committee (IRC) and the county health department. The IRC is working in both the curative and prevention aspects of health services in six PHC’s of seven Payams since the beginning of the year. There are eleven functional health facilities within the county including one PHCC and ten PHCU. There are a total of 3 health professionals working in the health facilities and 460 trained CBDs working at community level throughout the county. The health facilities available are too few to cater for the community and the facilities are understaffed. The major diseases affecting the community include: malaria, upper respiratory tract infection (URTI), diarrhea and STI.

Nutrition status of the area: There are a number of nutrition activities in the county from difference INGOs, however gaps/breaks in implementation have been experienced resulting in the nutrition status of the community members worsening. Action Against Hunger (ACF USA) conducted a SMART pre-harvest survey in March 2012 and reported that GAM was 18.4% and SAM rates was 2.7%. Another pre-harvest survey conducted by the IRC in April 2014 showed a GAM of 26.1% and SAM of 5.9%. Comparing to the survey conducted in 2012 there has been an increase in malnutrition rates and this is as a result of numerous factors to include; hunger episodes due to the concurrent drought, floods, and the resent conflict.

2. Panyijar County in Unity State

Panyijar County is located in the southern part of Unity State and has an estimated population of 58,375. It has ten (10) official recognized payams, with Panyijar town being the county capital situated in Chuk payam. The geographical position continue to exposed the county to seasonal flooding since it is located in a low land area bordering on the east site with the river Nile. During the lean season, the communities mainly depend on wild food collection, fishing, selling grass, firewood and local poles and with support received from relatives and friends. Acute malnutrition levels were very high in the county according to a pre-harvest survey conducted in April 2014 by IRC with a GAM of 32.8% and a SAM of 10.8% which are both above the WHO emergency threshold.

Internally Displaced Persons (IDPs)

Following the December 2013 crisis people have been displaced from the county and the state as a whole. Between January 2012 and April 2013, Unity State received 15,198 returnees representing 18% of total returnees. On 15 February 2014, OCHA received reports that up to 45,000 IDPs were seeking refuge in Panyijar County; particularly in Ganyliel and Nyal towns and on numerous nearby islands that exist in the Sud (wetlands surrounding the White Nile). This influx has contributed to an increased strain on existing scarce resources within the community. The area is normally affected by high levels of food insecurity which has worsened over the last two years when flooding has destroyed crops and livelihoods.

To date, the conflict has not yet spread to Ganyliel and infrastructure is still intact. However Ganyliel has received an influx of IDPs who are mainly Nuer who had settled over the years in other locations but still have family residing there. Some IDPs came from places where they had been forced to flee because of fighting, such as Bentiu, Leer, Malakal, Bor, Rumbek and even Juba.

Rationale of conducting survey

IRC conducted pre-harvest survey in April 2014 in both locations; following the pre-harvest surveys there is need to monitor the post-harvest community nutritional status. This will assess impact on ongoing interventions in Panyijar and Aweil South counties. The survey is specifically to assess and monitor nutritional status in Panyijar and Aweil South Counties and the findings of the standard nutrition survey will be used to understand the overall nutrition, food security and health status across the county and give recommendations for planning and decision making from county to national level.

Objectives of the Nutrition SMART Survey

• To assess the prevalence of malnutrition in children aged 6-59 months as a proxy of the wider population.
• To estimate the mortality rates through a 90 days retrospective survey in the Counties.
• To determine the morbidity and health seeking behaviors in the Counties.
• To estimate Vitamin A supplementation rates and measles vaccination in the county
• To determine infant and young child feeding practices amongst the community in relation to malnutrition and morbidity.
• Analyze and identify some of other potential factors contributing to malnutrition such as water and sanitation and the broader food security and livelihoods situation.

Key Responsibilities

The consultants will, in coordination with the IRC team, undertakes the following activities:

• Develop the Survey Methodology to be presented to the nutrition information working group.
• Update, review and share the MOH/Nutrition Cluster already developed survey five modules tools for use in the SMART methodology Nutrition assessment survey. 
• Be responsible for preparation for the surveys, including review of population statistics, calculating the sample size, selecting clusters, developing an efficient survey schedule.
• Share the Survey full plan with the Nutrition Coordinator, ICCM Coordinator, Nutrition in ICCM Advisor and Nutrition and ICCM Managers in the specific County.
• Brief the SMOH on the survey Methodology, Survey objective and plan and result sharing plan.
• Share the training plan and conduct training for the enumerators and data entry clerks (including pre-testing questionnaire).
• Assume overall responsibility for implementation of the exercise including daily supervision of survey teams, daily data quality assurance.
• Supervise data entry and assure data entry quality. Ensure anthropometric data is entered each day and analyzed for errors. Feedback given to team on daily basis in order to ensure validity and reliability of results.
• Overseeing data cleaning and analysis using anthropometric software (ENA) for the core anthropometric and mortality data and others e.g EPINFO, SPSS on the other indicators.
• Presentation of the results in 2006 WHO growth standard and annex analysis with NCHS Growth Standards.
• Conduct a one day Preliminary result sharing with the SMOH and IRC teams.
• Prepare and submit a data set and preliminary results within 10 days on completion of the survey data collection.
• Write and submit full report within one week after validation of the preliminary report by the NIWG. Report should be as guided by the cluster guidance.

Expected Output

Comprehensive survey report with practical recommendations in addressing the situation in the counties.
The cleaned version of the raw data used to calculate the survey results.

Time Frame and Accountability

The consultancy period will last approximately 30 days, starting early January 2015 (this includes desk review, enumerators training, data collection, support to data entry/analysis and report writing). The consultant shall report directly to the Nutrition Coordinator. S/he will also liaise closely with Field Coordinators, Nutrition in ICCM Advisor and Nutrition and ICCM Manager.

The IRC’s responsibilities

• Guidance throughout the evaluation period.
• Data entry/analysis shall be joint venture between consultant and IRC staff.
• Logistic arrangements for all field travel
• Approval of all deliverables including final sign offs for the purpose of making payments.
• Accommodation will be provided by IRC in the program sites.
• The consultant will be covered for transport, accommodation and food in the field site. In Juba the consultant will provide for his/her own meals.