Mozambique: Technical Assistance for Nutrition (TAN)-MOZ-01 – Short Term TA to support in-depth Mid-Term Review of the Multi-sectoral Plan of Action for the Reduc

Background

Technical Assistance for Nutrition (TAN) is a project led by the United Kingdom’s Department for International Development (DFID) which seeks to improve the capacity of countries who have joined the Scaling Up Nutrition (SUN) movement to design, deliver, and track the progress of nutrition programs and to generate, learn from and adopt knowledge of what works. Nutrition International is contributing to TAN by coordinating the provision of technical assistance to help national SUN Focal Points in select countries to overcome gaps in capacity for the design and delivery of multi-sectoral national nutrition plans, tapping into its global hub to source and deploy the expertise needed.

The national burden of malnutrition in Mozambique is significant, stunting and wasting affects 43% and 6% of children under five years old respectively^[1], anaemia affects 64% women of reproductive age and 54% of children under five^[2]. Mozambique is among the countries with greatest burden of malnutrition in the region and the world. Mozambique is among the 34 countries accounting for 90% of the stunting burden in the world. The prevalence of undernutrition and micronutrient deficiencies among children and women is not showing significant reductions over the years, with rates at critical levels indicating high public significance. Care and feeding practices among women and children remain sub-optimal. The problem of overweight and obesity are emerging and affect both children and adults. The cost of undernutrition in Mozambique is high, a total of 10.9% of Gross Domestic Product (equivalent to 1.8 Billion USD) lost every year as a result of the nutrition burden^[3]

From the time the Government of Mozambique (GOM) joined the SUN Movement in 2010, the national commitment to address malnutrition and food insecurity in the country has increased. The commitment was recently demonstrated in the Five-Year Plan of the Government of Mozambique (PQG 2015-2019), released in July 2015, which includes the reduction of chronic undernutrition as an indicator in the human and social development pillar. This commitment is further supported by key policy frameworks, such as the National Strategy for Food Security and Nutrition (ESAN II– 2008-2015) and the National Multi-Sectoral Plan of Action for the Reduction of Chronic Malnutrition (PAMRDC 2010-2015/2020).

The PAMRDC 2011-2015/2020 aims to reduce chronic undernutrition in children under five years of age from 44% in 2008 to 30% in 2015 and 20% in 2020. Two key features of the Plan are: (i) establishment of a package of interventions to complement the activities of other relevant plans and strategies already being implemented, which includes ESAN II and the Integrated Plan for the attainment of MDGs 4 and 5; and (ii) careful consideration of the limiting factors of implementing government institutions.

Complementary to the growing commitment and leadership in tackling malnutrition and food insecurity is the strengthening of governance structures and coordination mechanisms for nutrition and food security in the country. The Technical Secretariat for Food Security and Nutrition (SETSAN) chaired by the Ministry of Agriculture and Food Security convenes key ministries at the central level, coordinates the implementation of the PAMRDC at provincial level through working groups and is the SUN Movement Focal Point. The President of Mozambique is a member of the SUN Lead Group. At present, all of the SUN platforms including the UN Network, the Civil Society Platform and the Business network, have representation in the set-up and are working together toward accelerating progress in food security and nutrition. The Nutrition Partners Forum (NFP) created in 2011 serves as a coordination platform for development partners under the umbrella of the PAMRDC (UN Agencies, 2016). The UN Agenda for the Reduction of Chronic Undernutrition in Mozambique 2015-2019 recognizes that “explicit links have been made between key nutrition questions and national goals (GOM Quinquennial Plan Goals -PQG), international goals (SDGs), global priorities and standard”. Currently, the GOM is evaluating ESAN II and planning a review of the PAMRDC. A proposal to elevate SETSAN to a structure within the Council of Ministers is also underway with broad stakeholder support.

The GOM recently concluded that despite considerable investment in the last 6 years to improve nutrition, stunting prevalence remains the same. Various sources cited by the GOM’s report to Initiative of Food and Nutrition in Africa (IFNA) and to the SUN Global Coordinator shows the key reasons why malnutrition persists, including: persistent poverty, a weak agricultural extension system pitted against farming communities dispersed over a vast territory with low utilization of advanced technology, literacy among women hovering around fifty percent, deficiencies in primary health care coverage and water and sanitation facilities exacerbated by the economic crisis, recent drought and vulnerability to climate change and the historical serious gaps in human resources available to the sectors.

While the country continues to demonstrate success in strengthening its governance structures for nutrition, key challenges remain. Chief of these challenges identified by GOM are as follows:

• Governance – There is limited coordination at highest level of decision-makers at central, provincial and district levels. The current Food Security and Nutrition coordination body (SETSAN) has limited authority to influence government and partners agendas, policies and strategies to ensure the multi-sectoral approach for nutrition, particularly given that: SETSAN is chaired by the Minister of Agriculture and Food Security and, therefore, is perceived as an agriculture institution and not a multi-sectoral structure; SETSAN focal points from ministries and provinces are not decision-makers; lack of formal FSN coordination structure at provincial and district levels and lack of a mapping and tracking mechanism of resources invested.
• Implementation Challenges – Despite substantial improvements in food availability, food access, utilization and stability remain inadequate in Mozambique, especially in the North and Central regions. While the current food security and nutrition strategies and programs are still valid and are updated, they are not well implemented. Among the main factors limiting the impact of those strategies and programs are: (a) Lack of program specificity to properly address regional or local community contexts; (b) lack of an efficient monitoring and evaluation system; and (c) unequal involvement of different sectors at all levels in terms of human, technical and financial resources.

The GOM has indicated the need to make strategic decisions to ensure a holistic multi-sectoral approach that will focus on prioritizing geographic areas with high population density, highest rates of stunting and targeting the most vulnerable. PAMRDC and ESAN II are national nutrition plans guiding multi-sectoral nutrition actions in Mozambique. Review of ESAN II is currently ongoing with support from several partners. To complete the picture and ensure informed strategic and technical decisions, an in-depth review of PAMRDC will also be essential.

SETSAN commissioned the first Mid-Term Review (MTR) in 2014 in order to review progress in PAMRDC implementation which came up with a set of policy, strategic and implementation level recommendations. In addition to evaluating implementation of the recommendations, the proposed in-depth review will complement what was highlighted in the previous PAMRDC review, while going into depth on selected issues (as detailed in the scope of work). Recommendations from the second mid-term review will either allow for adjustments to improve implementation over the remaining duration or even integrate interventions that are part of the PAMRDC into the new ESAN III. It is in this framework that the SUN Focal Point has requested Nutrition International TAN project to support in-depth mid-term review of PAMRDC.

Objectives

Overall objective

The overall purpose of this assignment is to provide complementary support to GOM to conduct in-depth review of the PAMRDC and provide recommendations to enhance implementation and integration for the remaining duration of the PAMRDC.

Specific objectives

1. Undertake in-depth strategic and technical review of the GOM’s PAMRDC
2. Provide recommendations for improved scope and implementation of PAMRDC until 2020
3. Provide recommendations on how the outcomes from the PAMRDC and ESAN II reviews will be linked to enhance integrated nutrition programming
4. Facilitate dissemination of the review findings through existing platforms and at the national, provincial and district levels

Expectations

This TA is expected to bring a significant contribution to the country efforts in evaluating and streamlining National Nutrition Plans (ESAN III) for improved nutrition actions.

The success of this TA will be measured by the attainment of the following success measures:

1. Systematic in-depth analysis and documentation of performance achieved against the PARMDC results framework
2. Clear recommendations for improved scope and implementation of PAMRDC until 2020 validated by various stakeholders
3. Dissemination of PMARDC recommendations implementation plan at the national and provincial levels
4. Enhanced integration of PAMRDC and ESAN plans

Scope of Work

Taking a consultative, participatory approach with leadership from SUN Focal Point, SETSAN and relevant stakeholders^[4], the consultant will undertake relevant tasks to produce the following deliverables:

1. Detailed methodology and work plan
2. Inception workshop with key stakeholders
3. Desk review and analysis of relevant materials and data
4. Interviews with selected stakeholders at national and provincial levels

5. Stakeholder interview report and table of contents for the main report. The report contents should include but not be limited to:

6. Key findings and lessons on scope, relevance, efficiency, effectiveness, sustainability and impact (including dimensions of equity and gender) of PAMRDC, systematically identified and analyzed

7. Documentation of emerging good practices from ongoing implementation of PAMRDC at the provincial level

8. Bottleneck analysis of the PAMRDC

9. The level and scope of implementation as well as facilitating factors and obstacles to effective and efficient implementation of planned interventions

10. Draft report, with clear recommendations. Recommendations should pertain to:

11. Alignment of PAMRDC with global evidence (Lancet Series, SDG agenda e.t.c) and innovations that have been proven to work, how to better prioritize the hard to reach and more vulnerable districts, and how to improve the coverage and quality of the PAMRDC interventions

12. Ways to strengthen integration of nutrition to other relevant sector programs

o The role of donors, UN, civil society and the private sector in the implementation of PAMRDC and how multi-sectoral coordination could be enhanced

• Ways in which the PAMRDC can systematically address the human resource and capacity building gaps especially at the national and provincial levels in the short, medium and long term
• Ways in which PAMRDC can be better implemented at the sub-national levels (recognizing heterogeneity of districts and communities and factoring the results of the Nutrient Gap Project)
• Potential provinces or set of districts to be prioritized as a way to ensure a shorter impact in stunting reduction and document lessons-learned for its scale up
• Ways in which the PAMRDC financing needs and prospects can be better planned, coordinated and tracked in a multi-sectoral environment at the national and provincial level
• Validation of the findings and draft report
• Finalization of the report (with way forward on the revision of PAMRDC and provision of input to ESAN III development process)
• Dissemination of the report at the national and provincial level

Duty Station/Location

The lead consultant and team will be based at the SETSAN for activities that require physical presence e.g stakeholder consultations and workshops. The team can work from home when not travelling to the sub-national level or presence at the SETSAN is not required. The consultants will also be expected to travel to selected provinces for an estimated 30 days.

Timeline

The consultancy will have a duration of 80-100 consultancy days from 1^st September 2017 to 30^th November 2017 (to be determined in consultation with SUN FP, SETSAN secretariat and Nutrition International).

Management and Reporting/Coordination mechanism

a. The lead consultant will report to the Executive Secretary of SETSAN or her designate.

1. Specific financial and administrative accountabilities are to the Nutritional International for all the deliverables of the assignment. Payment will be subject to performance and reaching deliverables as agreed upon at the moment of contract signing.

c. The SUN Focal Point will facilitate the operational linkages with SUN Networks, line ministries and other stakeholders under this TA. A task force including representatives from all SUN platforms and SETSAN will be constituted the SUN focal point to provide technical input and support the consultants.

1. Nutrition International will provide technical input into the assignment and is responsible for assuring the quality of the work being delivered by the consultant.
2. Nutrition International will review the consultant’s work and share with the SUN FP for feedback prior to sharing externally (as needed).

Profile/qualifications of consultant team

It is expected a team of up to consultants (3) may be required to be assembled with assortment of expertise required to complete all aspects of this mission.

Lead Consultant - Apart from possessing considerable experience in planning and evaluation of national food and nutrition security programs, the lead consultant should have proven leadership, negotiation, and organization and presentation skills.

Members (2) - Should be able to cover areas such as planning and budgeting, information systems, monitoring and evaluation, sub-national planning and implementation and technical expertise in nutrition, food security, and health and gender e.t.c. At least one member of the team should have nutrition background.

Education

Postgraduate level degree in Social sciences / Nutrition/ Food and Nutrition/ Community Nutrition/ Public Health Nutrition / Public Policy/ Program evaluation / Public Health or any other related field(s).

Language Skills

Fluency in written and spoken Portuguese and English is mandatory

Professional Experience and qualifications

· At least 10 years of relevant experience in reviewing and evaluation of plans and programs similar to PAMRDC

· Excellent knowledge of Mozambique context (policies, strategies, plans, coordination e.t.c)

· Experience in nutrition specific and sensitive programming in developing countries

· Technical expertise in nutrition will be essential (at least one member must be a nutritionist)

· Experience in providing strategic policy advice to national governments, and social planning and/or national/sub-national level policy and programmes development

· Expertise in undertaking evaluation and reviews of national programs and plans particularly in nutrition, food security and health. Knowledge of sectoral components and the manifold aspects of human resources, planning and budgeting, sub- national level programming, communication and mobilization for nutrition, working models will be an added advantage

· Experience in program design, financial planning and budget expenditure tracking

· Excellent analytical, research and writing skills

[1] Technical Secretariat for Food Security and Nutrition (SETSAN), 2013

[2] Malaria, HIV/AIDS Survey, 2015

[3] The Cost of Hunger in Africa (COHA) study, 2016

[4] GOM line ministries, donors, UN, civil society, private sector, academia and research among others.

Application Process

Interested consulting entities are invited to submit the following by email to TechnicalAssistance@NutritionIntl.org by 31^st July, 2017:

Up-to-date curriculum vitae (CVs)

Technical proposal: not exceeding five pages, describing the consultant’s understanding of the task, proposed methodology, responsibilities of key stakeholders and detailed work plan that breaks down activities and outputs.

Financial proposal: including daily fee rate, suggested number of trips/days in-country and any other expenses required to fulfill the terms of the consultancy (field trips, meetings, materials, etc.).

Submissions that will not include technical and financial proposals will not be processed.

Nutrition International is committed to the fundamental principles of equal employment opportunity. Women are encouraged to apply. Consultants are required to indicate how they will ensure that gender equality considerations are included in the provision of technical assistance.