Title:

Semi Quantitative Evaluation of Access and Coverage (SQUEAC) Survey Consultancy

Location:

Elbarde and Kahda Districts in Bakool and Banadir regions in Somalia respectively.

 

Assessment timeline and duration

October –2021 (25 days in each District).

Key Working Contacts

Head of Medical and Nutrition Department.

Nutrition Specialist

Health specialist

Programme Development and Quality Coordinator

Monitoring and Evaluation coordinator.

Background

Action Against Hunger (ACF) has been a key humanitarian actor in Somalia since May 1992 providing an array of services in Nutrition, Health, Food Security and Livelihood, Water Sanitation and Hygiene across four Regions; Bakool, Nugaal, Banadir and Lower Shabelle. Our Health and Nutrition programme focuses primarily on prevention and treatment of Acute Malnutrition through static and mobile therapeutic centres (OTP and SFP) and Stabilization Centres as well as Primary Health care services through MCH and mobile outreach teams. Action against Hunger is also an active member of the Nutrition cluster Assessment and Information Management working Group (AIMWG).

Elbarde is a town in Bakool region in Southern Somalia, Majority of inhabitants are pastoralists.The last SQUEAC assessment done in the district in 2019 indicated an OTP programme coverage of 58.6% (51.3% – 65.5%).There is need to further examine the coverage after expansion of programme throught the district. Kahda district has a population consisting of mainly Internally Displaced Persons (IDPs) and residents. The district is the largest host for IDPs from three regions, namely Lower Shabelle, Bay and Bakool.

A SMART survey conducted by Action Against Hunger (AAH) in Elbarde in November 2020) indicated a Global Acute Malnutrition (GAM) by Weight for Height of 20.4% (16.1 – 25.5 95% CI) and Severe Acute Malnutrition (SAM) rate of 5.0% (2.7 – 8.8 95% CI) which is classified as critical based on WHO threshold. In Kahda district, findings from a SMART survey done in October 2020 shows Global Acute Malnutrition (GAM) rate of 9.0% (6.4 – 12.6 95% CI) and Severe Acute Malnutrition (SAM) of 1.3% (0.8 – 2.4 95% CI).

In Kahda District, Mogadishu, Action Against Hunger conducted integrated nutrition SMART survey in October 2020 among the IDPs to assess the nutrition status among children 6 – 59 months, and the women of child bearing age (15 – 49) years among other indicators. The findings indicated a Global Acute Malnutrition (GAM) by Weight for Height of 9.0% (6.4 – 12.6 95% CI) and Severe Acute Malnutrition (SAM) of 1.3% (0.8 – 2.4 95% CI). The combined GAM weight for height and MUAC indicated 13.6 % (10.6 – 17.2 95% C.I.). The findings indicate alert and improvement from the serious acute malnutrition, since September 2019, where GAM of 11.8 % (9.4 – 14.7 95% C.I.)1 was reported.

In an effort to strengthen Nutrition surveillance across Somalia and provide quality and timely nutrition data, Action against Hunger plans to engage a consultant to conduct a Semi quantitative Evaluation of Access and coverage (SQUEAC) assessment. The assessment is expected to dissect the relevant program and deeply analyse the coverage challenges/barriers and enablers/boosters through an interactive process that utilizes both secondary and primary data collection methods. This process should also incorporate both qualitative and quantitative data segregate by gender . The result will include an estimate of current project coverage for both severe acute Malnutrition (SAM) and Moderate acute Malnutrition (MAM), barriers and boosters to coverage and develop recommendation/action plan.

1. Purpose

The purpose of the SQUEAC assessment is to assess the coverage of the nutrition programme in two districts, investigate indicators related to coverage and programme quality. The assessment is expected to identify key factors affecting the uptake of Intergrated Management of Acute Malnutrition (IMAM) services in target areas of coverage on the basis of which specific recommendations are made.

2. Objectives of the coverage survey

The main objective of this assignment is to evaluate access and coverage of Integrated Management of Acute Malnutrition (IMAM) program using SQUEAC methodology in Elbarde and Kahda Districts.

Specific objectives

• To develop the skills of key nutrition staff in conducting access and coverage survey using Semi Qualitative Evaluation of Access and Coverage (SQUEAC) methodology.
• Conduct review of recommendations from previous coverage assessment conducted to examine the extent of implementation.
• Utilizing available routine program data, and other anecdotal data, identify areas of probable low and high coverage and reasons for coverage failure.
• Confirm the location of areas of high and low coverage and the factors affecting coverage failure identified.
• Map out program single Coverage estimate for the targeted areas.
• To conduct community assessment to understand dynamics and its impact on the access to care and the coverage of OTP/SC services in the targeted district.
• In collaboration with ACF Somalia team, develop specific recommendations to improve acceptance and coverage of Nutrition program.

• Activities

To achieve the above-mentioned objectives, the survey consultant will undertake the following:

• Design the survey protocol, develop comprehensive tools for data collection and present it to the Nutrition Cluster AIM working group for validation.
• Conduct training for ACF Somalia nutrition staff on SQUEAC methodology and thereafter guide and supervise them as they take part in the entire assessment.
• Organize adequate supervision and coordination of the survey teams in the field; the consultant should able to conduct field data collection.
• Analyse data and compile a comprehensive coverage survey report
• Present investigation results to ACF coordination team as well as the Assessment and Information Management Working Group (AIMWG) for validation

4. Duration of the Consultancy

The proposed consultancy will last for approximately 25 days in each district (Kahda and Elbarde) after validation by AIM WG, expected starting date as from 1^st October 2021; this is inclusive of all the processes of the investigations from the day the contract is signed to the report submission day.

NB: The Consultant should communicate any unforeseen delays, which might affect the completion date as stated above.

Expected Output

At the end of the assignment, the consultant should deliver:

• Validated SQUEAC protocol by AIM Working Group.
• A final report indicating how each of the above outputs has been achieved including reporting and capacity building of the staff.
• A PowerPoint presentation summarizing the key sections of the report and the recommendations.
• All the hard copy data collected (to be kept at ACF Field office) and copy of soft data collected and used for the report.
• A field report indicating the process, challenges faced for future improvement.

5. Desired Qualifications

Education (knowledge):

• Advanced degree in Nutrition, public health, social statistics, Epidemiology or related discipline

Experience:

• At least 5 years of international and field experience preferably in developing countries.
• Extensive Experience in Leading Nutrition surveys and surveillance systems as well as proven experience with the SQUEAC/SLEAC methodology. (Provide evidence of previous assessments undertaken)
• Experience conducting assessments in Somalia or similar challenging environment.

Skills and Abilities:

• Proven ability to organize and manage assessments in a cross-cultural setting.
• Ability to train team and ensure quality delivery of outputs within a limited period
• Excellent report writing, communication and presentation skills
• Understanding of Somalia context is desirable
• Consultant who can access the community is highly desirable.

6. Conditions of Work

The consultant(s) will be based in Elbarde and Kahda during the period of assessment. The Consultant will be responsible for initial preparations including development of assessment protocol, presentation of protocol to AIMWG, survey teams trainings and subsequent data collection for both small area and wide area surveys. In order to ensure quality in the process, data collected will be checked on daily basis and feedback given to the teams and ACF.

Administrative responsibilities are assigned below:

ACF:

· Airfare to and from Mission

· Entry visa to country of mission

· Domestic transportation

· Domestic Accommodation

The Consultant:

· Health Insurance for him/herself

· Equipment for use (Laptop etc.)

· Food/per diem