Terms of Reference for Service Contracting

TERMS OF REFERENCE FOR SERVICE CONTRACTING

Assignment Independent Evaluation of the Infant and Young Child Feeding (IYCF) Programme in the Camp & Host Communities

Location Amman

Duration Four to five months

1. BACKGROUND AND CONTEXT

Nutrition during the first 1,000 days of life has the crucial, long-lasting impact on brain development and function. The period from birth to the age of two is important for child’s survival, optimal physical, mental, and cognitive growth and development.

Infant and Young Child Feeding (IYCF) practices in Jordan are relatively poor. According to the Jordan Population and Family Health Survey (2012), exclusive breastfeeding under six month of age is at 23 percent, a decrease from 27 percent in 2002. Socio-economic and cultural factors in southern governorates of Jordan appears to better support IYCF. At the same time, a lack of monitoring system or tool for the implementation of the Code of Marketing of Breast-milk Substitutes influences results negatively across Jordan.

Evidence shows preference for infant formula over breast milk among Syrian refugees1. Exclusive breastfeeding up to six months is less than half (46.4 percent) and just over a third (36 percent) in Za’atari refugee camp and host communities2 respectively, continued breastfeeding at one year is 24.2 percent and 39.5 percent for the camp and host communities, respectively, and the use of formula in infants below six months is at 9.8 percent and 16.1 percent for the camp and host communities, respectively3. Given the context, the ongoing crisis in Syria, the large influx of refugees into Jordan, poor IYCF indicators prior to the conflict, and a general lack of awareness of the need to protect and support optimal IYCF practices, the need for an IYCF programme was urgent.

In 2012, Save the Children Jordan (SC-J) started implementing an IYCF programme in Syrian refugee camps, funded initially by OCHA, SCUK, SC Germany, and by UNICEF from 2012 to date, targeting 40,000 pregnant and lactating women (PLWs) and children aged 0-59 months per year. SC-J’s administrative data from 2012 through July 2015 suggests improved feeding and care practices among pregnant and lactating women and caregivers of children aged 0-59 months in the target area, early detection and referral of children under the age of five with acute malnutrition, and provision of supplementary feeding.4

1 Interagency Technical Fact Sheet: Nutrition Situation – Syrian Refugees Response in Jordan. UNICEF, UNFPA, UNHCR, WHO, et al. (2014). 2 Host communities refer to communities in Jordan – outside of refugee camps - that host Syrian refugees. 3 Interagency Nutrition Survey on Syrian Refugees in Jordan. UNICEF, UNFPA, UNHCR and WHO. (2014). 4 SCJ claims that routine data on one-to-one counselling session shows improved breastfeeding practices among those who received IYCF services. Yet this information needs to be verified.

1 The IYCF programme aims to address the misconceptions surrounding breastfeeding by providing one-to- one counselling sessions including home visits, group education sessions, child maternal and child health and nutrition referral services (such as routine and supplementary immunization, antenatal and postnatal care), and providing regular follow-ups of PLWs and maternal nutrition advice. In addition, the programme also monitors and controls the prescription and dispensing of Ready to Use Infant Formula (RUIF). PLWs are screened for breastfeeding problems, and women with difficulties breastfeeding their infants are referred to the counsellors for one-on-one counselling sessions. Women attending the counselling sessions are provided with nutrient dense snacks for themselves and their children, and bottled water to ensure adequate fluids and nutrients to support breastfeeding. Breastfeeding shawls for privacy, baby bibs and bottle-cups, are also provided. Another key component of the programme has been the early detection and referral of children with malnutrition through MUAC screening. During the first year of implementation from August 2012 to July 2013, the IYCF programme was implemented in Za’atari, Azraq, and Emirati (EJC) camps, reaching 30,685 PLWs and caregivers and 32,758 under five children.

In August 2013, the programme expanded its services outside the camps to host communities, namely Amman, and the southern governorates of Jordan namely Aqaba, Ma’an and Karak as well as Jordan Valley (south, middle and north), targeting around 40,000 pregnant & lactating mothers & 65,000 under five children from both Syrian refugee and Jordanian populations.5 The design of the programme for host communities differs from the programmes in camps while the host community programme reaches out to both Syrian refugees and Jordanians through a common approach and provides exactly the same services. To maintain sustainable quality of IYCF services and institutionalization within existing health systems (public and private), SC-J has focused on building capacity of and diversifying partnerships with government and local partners such as the Ministry of Health (MOH), Ministry of Social Development (MOSD), around 40 Community-Based Organisations (CBOs), the private health sector hospitals and companies to support and improve the health and nutritional status of pregnant women, mothers and children. SCJ has applied integrated approach incorporating hygiene, immunization, diarrhoea prevention and management and early referral within their programme (IYCF+). The trainings go beyond the IYCF curriculum with now renewed focus on new-born and child care practices and are tailored to be context specific for partner and beneficiaries. For example, early marriage, new-born health and family planning are part of the training curriculum to ensure appropriate message delivery and counselling on the ground. In addition, strengthened outreach started, through a mobile caravan, staffed by an IYCF counsellor and an educator, providing outreach services to remote areas in the host communities. With the Ministry of Health (MoH), the programme has developed new, context appropriate IEC material and provides capacity building workshops for nurses and midwives working in primary health centers. To-date, the IYCF programme has trained more than 75 government health providers (nurses and midwives), 100 SC-J staff and 100 IYCF educators (Syrian refugees) in optimal IYCF practices, in counselling and education methods, and in implementation of code of marketing of Breast Milk Substitute (BMS). More details of the programme is described in Annex 1. While other agencies supports nutrition and food security interventions, the UNICEF-supported IYCF programme is known to be the only one that promotes breastfeeding in Jordan.

The programme has gained recognition by the global nutrition cluster for its achievements to date, and this IYCF model is considered for replication in other countries in the region. At the same time, the Health Sector Reform is underway in Jordan, and it is important for UNICEF to capitalize on this opportunity and consider institutionalization of IYCF to ensure sustainability of results achieved. This will also contribute to building resilience in Jordan. At the same time, there have been some anecdotes that the programme could be implemented at reduced cost. Given this and to independently assess the significance and worth of the programme, this evaluation has been planned. In the current context of donor fatigue in responding to the protracted impact of the Syria crisis and substantial reduction in funding situation across all sectors 5 It should also be noted that the programme in camps costs approximately 2/3 of the total programme cost.

2 in Jordan, it is also imperative for the programme to conduct a systematic and impartial examination of relevance, effectiveness, efficiency, impact and sustainability of the programme. Evidence on the results achieved, the nature and magnitude of gaps and scalability of the current design will also support future policy and advocacy efforts and facilitate the institutionalization of IYCF in the government health facilities and scaling up community-based IYCF services.

2. PURPOSE AND OBJECTIVE

As mentioned above, the purpose of the evaluation is to assess the significance and worth of the programme. The evaluation is expected to be used by UNICEF Jordan Country Office, Regional Office, the global nutrition cluster, the Ministry of Health, Save the Children Jordan and other partners, including donors, working in the nutrition sector in Jordan. The overall objective is to undertake an independent and critical assessment of the IYCF programme using evaluation criteria of relevance, effectiveness, efficiency6, sustainability and impact in the target communities (camp and host) in the areas where IYCF programme is being implemented, and collect evidence and lessons learnt to inform future programming, potential replication, as well as policy and advocacy efforts. More specifically, implementation of this evaluation will aim for the following key specific objectives:

A. To assess the relevance of the IYCF programme (emergency response and resilience components) in the current context in Jordan and its national priorities, including in the context of the health sector reform. To assess the relevance of IYCF programme design to achieve the expected results, taking into account the appropriateness for and social acceptability by children, PLWs, caretakers and communities. B. To assess the effectiveness of the IYCF programme and to measure to what extent the programme has achieved its set results, including behaviour change among PLWs in terms of initiation of breastfeeding, exclusive breastfeeding, continued feeding and introduction of safe and appropriate complementary foods from 6 months of age. C. To assess the efficiency of the IYCF programme and to what extent the programme has used resources (human, financial and others) in an efficient manner, and do the achieved results justify the resource? To assess the cost of the response per unit of aggregation as compared to the cost being incurred by other IYCF programme implemented in Jordan. Did UNICEF and partners seek options to achieve efficiency, e.g. integration with other relevant interventions (e.g. referrals for immunization, back to school campaigns)? D. To assess the impact of the IYCF programme, capturing changes (positive, negative, intended and unintended) and differences the programme may have brought. What has been the impact/effect of the programme on target beneficiaries and local networks and community based groups? E. To assess the sustainability of the IYCF programme and its results, considering the likelihood of programme sustenance in the absence or reduction of ongoing UNICEF and donor support. This is to be done by identifying the degree to which the IYCF programme has built on existing institutional and local capacities, and a potential exit strategy. F. To document lessons learnt and good practices that will inform future programming, replication in other countries in the region, and possible scale up of IYCF services in a more effective, efficient and sustainable way, suggesting different options for UNICEF and partner agencies.

3. SCOPE OF EVALUATION

The evaluation will cover the IYCF programme supported by UNICEF and implemented by SCJ, from the start of the programme (August 2012) up to 31 July 2015, in three camps (Zaatari, Azraq and EJC) and

6 This will include cost-effectiveness and cost-efficiency retrospectively.

3 selected host communities, namely Rabaa Alsarhan Transit Center (RSTC), Amman, Karak, Ma’an, and Aqaba. This means that the evaluation will cover the components of the programme implemented through SC-J’s CBO partners in the six IYCF caravans in Azraq, Zaatari & EJC camps, one in RSTC, the mobile IYCF caravan in host communities, including community mobilization and outreach.

Jordan Valley maybe considered partially and as appropriate, e.g. in assessing the relevance and sustainability of the programme. The implementation in Jordan Valley has been relatively shorter than other geographical locations, and sufficient evidence may not be available to assess effectiveness or impact. Nevertheless, it hosts beneficiaries who are mobile and have limited access to services, such as those who live in informal tented settlements. Jordan Valley implementation should be taken into account when assessing the programme design, relevance or effectiveness in reaching out to the hard to reach, among others..

As mentioned in the Background and Context section, the target population of the IYCF programme consists of pregnant and lactating women and children 0-59 months of age in three categories: Syrian refugees living in camps, Syrian refugees living in host communities and Jordanians in host communities. Differentiated analysis between camp and host communities will be essential for relevance, efficiency and sustainability criteria given the difference in the contexts and programme approach. Disaggregation among Syrian refugees in camps, those in host communities and Jordanians may be important and should be adequately taken into account because acceptance of the programme or feeding practices can be different.

As indicated in the evaluation questions listed below, it is also expected that the evaluation will assess whether and how IYCF+ (integration of hygiene, immunization, diarrhoea prevention and management and early referral within the IYCF programme, which started in 2013) may have influenced the relevance, efficiency, effectiveness, impact or sustainability of the programme.

As indicated in the objective, stakeholder participation is important for this evaluation, and their voices and views should be reflected through means such as interviews and focus group discussions. While all stakeholders are important, special emphasis will be placed on PLWs and children who are direct beneficiaries of the interventions. Other stakeholders whose participation will be important include care takers and parents (both mothers and fathers) of those children who are participating on response activities, Ministry of Health and health providers of MOH, CBO partners, local community leaders, frontline workers, staffs volunteers working with the response, mothers’ support groups, Health and Nutrition cluster partners and other INGOs/NGOs providing IYCF services will also be consulted.

The evaluation will be conducted, using the OECD-DAC criteria of relevance, efficiency, effectiveness, impact and sustainability. While the IYCF programme has also been responding to the impact of Syria Crisis and serving Syrian refugees in Jordan, this will not be an evaluation of humanitarian action. The evaluation should answer the following questions:

A. Relevance 1) Whether the IYCF programme and its expected results are aligned with the MOH National Strategy 2015-2017 and relevant in the context of Health Sector Reform in Jordan; Whether the IYCF programme and its expected results are aligned with the regional and national plans for the Syria response (namely National Resilience Plan 2014- 2016, Jordan Response Plan 2015, Regional Response Plan and Regional Resilience and Response Plan). Whether UNICEF’s support to the IYCF programme is in line with its organizational mandate.

4 2) Whether and to what extent the programme design, including activities and expected outputs is consistent with the intended results at the outcome and impact levels of IYCF/IYCF+?

3) Whether and to what extent the programme design is appropriate and accepted by the target community; to what extent the design took into account gender issues; how is the programme different from other approaches inside and outside of Jordan

4) Is the programme design relevant to achieve the most vulnerable, such as refugee mothers, informal and formal sector working mothers, to promote exclusive breastfeeding practices?

B. Effectiveness

1) To what extent the programme demonstrated expected results at all levels (i.e.: inputs/outputs level indicators, knowledge, behaviour change and coverage of programme)?

2) Did the programme identify and reach out to the most vulnerable? What was the difference in reach between those in camps and host communities, especially in the hard- to-reach areas? Whether and to what extent special attention has been made to reaching out to those beneficiaries who are hard-to-reach? Any difference between outreach (one- to-one) versus caravan (fixed-site provision of health education)?

3) Whether and how has the integrated approach, IYCF+ contributed to the expected results?

4) What are the major factors (internal and external, any issues related to gender) influencing the achievement or non-achievement of the results; whether and to what extent the technical support was provided to the implementation team to address issues and ensure achievement of results?

5) How has the quality of programme been ensured, especially with respect to the Global Operational Guidance on Infant Feeding in Emergencies and other standards?

6) Were there components of the programme that worked well or did not work well? Why so, and why not? What are the areas of strengths and weaknesses? Are there other approaches that will help overcome the weaknesses if any?

C. Efficiency

1) To what extent did the actual or expected results justify the costs incurred (considering the difference of approach and programme design for camps and host communities)? Whether and how has the integrated IYCF+ approach influenced the efficiency of the programme?

2) Have the resources been used and has the programme been implemented as efficiently as possible? (Resources here refer to those allocated for this programme, as well as any other external resources to enhance efficiency such as referral to other services) Did UNICEF and partners explored the possibility of integrating IYCF in other relevant interventions (e.g. immunization referral or back to school campaigns)? Are there areas of improvement?

5 3) Whether and to what extent the technical and other human resource capacity have been utilized and appropriate to achieve results? What have been the roles and contribution of volunteers in the results?

4) Were achievements made on time? If not, why not?

5) How have the IYCF program activities been coordinated with different stakeholders and their similar programmes, such as other UN agencies, INGOs, NGOs, CBOs, Ministries to achieve overall objective.

D. Impact

1) What are the key short term and long term (and lasting) changes produced by the programme (positive or negative, intended or unintended) as perceived by the stakeholders (PLW, front line workers, government, implementing partners including CBOs)? What are the key factors behind these changes?

2) Whether and to what extent the desired changes have been experienced by PLWs and children as a result of this programme. Did the integration of other components (as IYCF+) make any difference in those changes?

3) What were the degree and level of change in early initiation of breastfeeding, exclusive breast feeding and appropriate introduction of complementary feeding practices in the target communities versus non-intervention communities?

E. Sustainability

1) Whether measures have been in place to ensure the sustainability of achievements after the withdrawal of external support or in the context of the anticipated decrease in donor funding?

2) Whether and how the programme identified and built on existing national, local, civil society, government capacities? What new capacities within services or communities have been established or restored that can contribute to sustainability?

3) What are the possibilities for scale-up or replication?

4. METHODOLOGY

The evaluation should use mixed methods and participatory approach. A specific and detailed evaluation design should be presented to UNICEF by the evaluation team based on the scope of the evaluation mentioned above. The key evaluation questions should be unpacked into sub-questions as appropriate, and should be answered, validated and triangulated through appropriate methods of data collection and analysis.

Available data include but not limited to Jordan Population and Family Health Survey 2012, Interagency Nutrition Survey on Syrian Refugees in Jordan (2012 and 2014), UNHCR HMIS in refugee camps, MOH- HMIS, project monthly service statistics and records (including SCJ-IYCF output trackers recording the number of beneficiaries on a daily basis), and financial records and cost and detailed statement of expenditure. SC-J has also been tracking PLWs who have received one-on-one counselling to assess

6 whether they apply what they learned through counselling. It should be noted that SC-J data for PLW tracking was paper-based and collected per woman up to the end of 2014 while the data covering January to July 2015 can be made available in a consolidated manner. Other than the routine monitoring data, there was no baseline data collected for the IYCF programme. These limitations should be duly taken into account when designing the methodology,.

The evaluation team should start with a review of available data, as well as programme and planning documents, such as UNICEF-GoJ Country Programme Action Plan, Regional Refugees Response Plans, Jordan National Resilience Plan 2014-2016, and Jordan Response Plan 2015, project proposals and results frameworks, quarterly reports submitted by SCJ to UNICEF, UNICEF weekly/bi-weekly situation reports, partner’ own assessments and review reports (for example, conducted by Save the Children UK), and NGO/INGO partner and international literature related to IYCF.

It is anticipated that the methodology could include but not limited to the following:

1) Desk review of relevant plans, strategies and documents, global standards, programme reports including donor reports. 2) Review and analysis of secondary data from the data sources mentioned above. 3) Primary data collection to supplement data gaps, i.e. s interviews with key informants, structured and semi-structured in-depth interviews, case studies, observations and/or focus group discussions as required with relevant stakeholders.

The evaluation team is expected to propose relevant methods for data collection and analysis to respond adequately to the evaluation questions listed in the “Scope” section. The availability of data (or lack thereof) should be adequately taken into account. This should be presented as an evaluation matrix. Specifically and given that there is no baseline data available, the evaluation team is expected to review the feasibility and propose appropriate methods to conduct the evaluation, particularly in assessing the impact criterion, or suggest alternative questions. Since the UNICEF-supported programme is the only IYCF programme that promotes breastfeeding in the country and there are geographical areas in host communities that are beyond the reach of IYCF programme, identification of a comparison group of villages and areas in host communities is possible.7

As part of methodology, it is essential to articulate how ethical considerations will be taken into account in the design of the evaluation and throughout the evaluation process.

UNICEF and SC-J will provide necessary information including all available data and reports, a list of CBO, MOH, and other partners and a list of key informants at the inception stage. PLWs, community members, and health professionals working in the field should be extensively consulted during the evaluation using different appropriate methods.

The evaluation team will also be provided with a mapping of all UNICEF supported IYCF programme. Additionally, the team will also receive copies of all the agreements, field visit reports, training manuals, guidelines, administrative project data, results from pre and post questionnaires (for trainings), monitoring data and case studies.

5. MANAGEMENT OF EVALUATION

To ensure independence, this evaluation will be co-managed by Chief of Health and Nutrition and Chief of Planning, M&E (PM&E) at UNICEF Jordan Country Office. A reference group will be formed, engaging subject matter experts from inside and outside of UNICEF, including the UNICEF Regional Office for Middle East and North Africa. Members of the reference group will be engaged and consulted at key milestones of the evaluation process such as review of the TORs, inception report, and draft reports.

7 While there are PLWs who may not be accessing the IYCF services in camps, identification of groups who are free from the influence of the programme would be difficult in a confined camp setting.

7 Selection of the evaluation team will be made through an open and competitive bidding process. Review of technical proposal will be done by at least three members. Chief of Health and Nutrition will be responsible for technical oversight in relation to the IYCF programing, support to the evaluation process by providing necessary background information, data, contact information, as well as management of contractual issues once the bidding process completes. Chief of PM&E will oversee and quality assure the evaluation, ensuring that it complies with the UNICEF global standards and norms. The evaluation team will report to Chief of Health and Nutrition and Chief of Planning, Monitoring and Evaluation at UNICEF Jordan Country Office who will serve as key contact points.

6. EXPECTED DELIVERABLES AND SCHEDULES

All deliverables should be made in English. The deliverables and reporting requirements will include the following:

1) A detailed inception report (10 to 15 pages) to be submitted within two weeks from an initial briefing / inception discussion with the evaluation managers and/or evaluation reference group). This report should be in line with UN standards for inception reports and outline the purpose; a theory of change; scope including evaluation criteria and questions; methodology including sampling, data collection and analysis methods and data sources; evaluation matrix; system to ensure ethics in evaluation; timeline for the evaluation and submission of deliverables; and final report outline as per the UNICEF Evaluation Report Standards. This report will be used as an initial point of agreement and understanding between the evaluation team and the evaluation managers. 2) Data collection tools, including protocols should be submitted for review after one week of the approval of the inception report. 3) Progress on the evaluation process should be reported at a frequency and method mutually agreed by the evaluation team and managers, i.e. once in two weeks over Skype or phone. 4) A briefing and debriefing with UNICEF should be conducted at the beginning and completion of the field data collection. Members of the Reference Group maybe invited. 5) A draft report in line with the outlines specified in the Inception Report as well as UNICEF Evaluation Report Standards should be submitted within three weeks after the completion of the data collection for review and comments by the Evaluation Reference Group. Based on the recommendation of the Evaluation Reference Group, the evaluation agency may be requested to submit a revised draft report for review prior to the submission of the final evaluation report. 6) Presentation of the draft report to stakeholders should be made to seek their feedback before the submission of the final report. For this, a maximum ten-slide PowerPoint presentation should be submitted, both in Arabic and English, one week prior to the presentation. The PowerPoint should visualize data and findings, highlight key findings and recommendations to brief a wide range of stakeholders such as government, non-governmental partners and donors 7) Final evaluation report (40 pages excluding annex) should be submitted within two weeks after the stakeholder presentation. It should contain an executive summary of no more than 5 pages, summarizing the object of evaluation, its context and background, purpose, findings, conclusions and recommendations. The final report will be reviewed by the evaluation reference group, as well as Regional Monitoring and Evaluation Advisor for clearance. This report should meet the criteria defined in the UNICEF Evaluation Report Standards. It should also be noted that all the reports of evaluation commissioned by UNICEF will be assessed as per the Global Evaluation Report Oversight System as per a predefined criteria and will receive a rating. The final evaluation report, regardless of the rating will be made available to the general public. 8) Anonymized raw data collected through this evaluation should also be submitted to UNCEF along with the final report.

8 A proposed time frame for the evaluation is provided below. The evaluation is expected to be completed within about four months.8 This might be subject to change depending on the prevailing situation on ground at the time of the evaluation and as per mutual agreement between the evaluation team and managers.

Activity Duration Tentative Date Inception meeting One day November Review of literature related to the IYCF programme (i.e. Two weeks 15 Novembeer list of reference materials; IYCF In consultation with MOH, UNICEF, SCJ team). Conduct initial review of available data to identify gaps and data collection needs. Develop an inception report. Review of inception report by UNICEF and Reference One week 22 November Group Developing data collection tools and protocols, testing Eight weeks 17 January and revision of the tools, data collection training as required, data collection, debriefing to UNICEF Data analysis and writing of first draft of the report in Three weeks 7 February English Review of first draft by UNICEF and Reference Group One week 14 February Incorporation of comments and produce second draft One week 21 February Prepare and deliver presentation to stakeholders One week 28 February Finalization and submission of the final report, along Two weeks on or before 13 with raw data March

7. OFFICIAL TRAVEL INVOLVED

Travel to Amman and field locations in Jordan should be anticipated as per the evaluation methodology and deliverables. All travel costs should be planned properly in the technical proposal and included in the financial proposal. UNICEF will not provide transport support or field travel arrangements, thus the estimated cost of travel should be included in the financial proposal. Please note that if selected, the contract can be a supporting document to obtain entry visa (if necessary). UNICEF will be unable to secure travel visas. All air travel will be reimbursed at economy class rates. Any applicable per diems should be included as part of the lump sum price proposal (see Section 11 below).

8. DESIRED QUALIFICATIONS, SPECIALIZED KNOWLEDGE OR EXPERIENCE

The evaluation shall be conducted by an evaluation team, selected through an open and competitive bidding process. Given the scope of evaluation, a multi-disciplinary team of national and international members is anticipated, including a team leader who is an evaluation specialist; two specialists or subject-matter experts such as nutrition specialist, health economists or experienced researcher with background in economic evaluation of health programmes; and others such as field researchers required to carry out the evaluation.

The team leader and specialists should have a Master’s degree in related field, such as social sciences, public health and nutrition or health economics, or statistics.

8 Consultants and interested institutions should indicate the expected time to complete the evaluation in their proposals.

9 This may be conducted by an institution or a group of individuals who meet qualifications. In case of a group of individual consultants who are not associated with one institution, UNICEF will sign the contract with the evaluation team leader who will be responsible to meet the agreement set forth in the contract.

Team leader and specialists should have the following qualifications:

The evaluation team leader:  At least 10 years of proven substantive experience at international level in designing and conducting evaluations and experience in leading evaluations of similar scope or a large scale health and/or nutrition programme; Submission of two most recent evaluations led by the proposed team leader is required.  Excellent experience and knowledge in global trends and standards associated with evaluation, use of quantitative and qualitative methods and participatory approach, and application of rigorous evaluation methodology relevant to a large scale health and nutrition programme;  Proven experience in leading a multi-disciplinary team, being able to identify the relevant capacities to deliver a quality evaluation, excellent skills in communicating complex issues to a diverse group of audience and bringing the group to a consensus, must have analytical thinking.  Understanding of broad issues that impact the lives of child health and nutrition, understanding of UNICEF programming and its mandate  Experience in the region and Jordan, as well as in the humanitarian context an asset.  Excellent spoken and written English is required; knowledge of Arabic an asset.

Nutrition/IYCF subject matter expert:  A minimum 8 years of experience in public health and/or nutrition programming, with background in research on behaviour change.  Knowledge of the latest guidelines, international literatures and issues related to IYCF, nutrition, and child health, and evidence-based strategies in nutrition in emergencies.  Previous experience in evaluating UNICEF’s programme as an asset

Health economist with extensive skills and experience of over 8 years in conducting economic evaluation (cost-effectiveness and cost-efficiency and costing) experiences in a large scale health and nutrition programmes.

Other members should have academic background, such as Master’s or Bachelor’s degree in social sciences, and/or experience in research or areas relevant to the roles and tasks assigned to them.

9. PERFORMANCE INDICATORS FOR EVALUATION OF RESULTS Proposed timelines for completion of activities are met and deliverables submitted on time with good quality and as per the standards described in the TORs as well as UNICEF/UNEG global standards. The evaluation team should conduct evaluation and develop deliverables in line with the UNEG Evaluation Standards and Norms, UNICEF Procedure on Ethics in Evidence Generation, UNEG Standards for Inception Report, and UNICEF UNICEF-Adapted UNEG Evaluation Reports Standards. Overall performance at the end of the contract will be evaluated against the following criteria: timeliness, responsibility, initiative, communication, and quality of the products delivered.

10. FREQUENCY OF PERFORMANCE REVIEWS Performance review will be conducted after completion of each deliverable. Bi-weekly meeting or meeting at a frequency mutually agreed will be held between the evaluation team and managers.

11. CALL FOR PROPOSALS

10 All requests for proposal will be weighed according to the technical (70%) and financial considerations (30%). Further, the technical part of the proposal will be weighted based a scoring system with 70 points. Proposal scoring 70% will be cleared for technical part of the submission. It will cover the following;

1. Overall Response (10 points): Responsiveness to Terms of Reference and call for proposals, elaborated and articulated understanding of the TORs and assignment, demonstrated knowledge on evaluation 2. Key personnel and company (25 points): Team members meet academic requirements; key team members especially the team leader meets the defined qualifications such as minimum years of proven and relevant experience; team has previously conducted similar work with evidence; the agency proposing a team with relevant and justified capacity and skillsets, company is properly registered and/or has required certifications, memberships, etc. 3. Proposed methodology and approach (35 points): Deliverables are addressed as per TOR; evaluation questions unpacked into sub-questions; proposed methodology and tools respond to the scope of evaluation and the nature of the evaluation questions; methodology is attentive to the availability of and limitations around the available data; proposed theory of change is sound and shows a results chain, ethics considerations made and built into the process; proposed timelines are met; and/or alternative proposal is made as per the sound understanding of the scope of the assignment and with reasonable justifications

Only those financial proposals will be opened which have been technically accepted according to the above criteria. Financial proposal will be weighted based on the clarity and appropriateness.

Each proposal should include the following:

a) Cover letter giving details of the applicants’ suitability for the consultancy b) Technical proposal that shows the evaluation team’s understanding of the TORs and outlines the purpose; a theory of change or results chain; scope including evaluation criteria and questions (key questions listed in the TORs unpacked into sub-questions); methodology including proposed sampling, data collection and analysis methods and data sources; evaluation matrix; plans to ensure ethics in evaluation; timeline for the evaluation and submission of deliverables c) Two most recent evaluations led by the proposed evaluation team leader. d) Budget proposal as listed above under “budgets and payments”, this should include estimated cost of field travel. Costs must include any additional administrative costs, as UNICEF will not provide reimbursement for visa fees, medical fees, insurance or daily travel allowances. e) Curriculum vitae for all team members in English, AND filled in UN Personal History Form (P11) in MS Word format including detailed work experience, education/degrees and current contact information (download P11 here) f) Any additional requirements needed to complete assignment or that might have an impact on cost or delivery of products g) The consultants would be required to use their own computers, printers, photocopier etc.

All interested institutions or group of consultants are requested to include in their submission detailed costs including:

All proposals should be sent to UNICEF MENARO Bids at [email protected] or hand delivered at: UNICEF Jordan Country Office, 15 Abdulqader al Abdul Street, Tla’a Al-Ali, Amman, 11811. Jordan. Technical and Financial proposals should be submitted in two separate sealed envelopes. All submissions with complete set of documents should reach UNICEF Jordan no later than 12:00 pm (local time) on October 26, 2015. A selection committee will review all applications as they arrive. All proposals must meet the minimum requirements described above, and those unable to meet these requirements will not be considered.

12. INDICATION OF HEALTH STATEMENT AND CERTIFICATE OF GOOD HEALTH HAS BEEN RECEIVED PRIOR TO SIGNING THE CONTRACT (for consultants/individual contractors traveling with UNICEF or working in UNICEF Office)

11 Above documents will be requested by UNICEF once contact with contractors is processed.

13. UNICEF RECOURSE IN CASE OF UNSATISFACTORY PERFORMANCE If the contractor for any reason did not deliver the work as agreed the contractor has to return any previous payment received. In case of unsatisfactory performance the contract will be terminated by notification letter sent 5 days prior to the termination date. In the meantime, UNICEF will initiate another selection process in order to identify an alternative candidate.

14. INDICATION THAT THE CONSULTANT/INDIVIDUAL CONTRACTOR HAS RECEIVED A COPY OF THIS DOCUMENT OR. ALTERNATIVELY, AN EXPERT OF RELEVANT PROVISIONS INCLUDING THOSE CONCERNING LEGAL STATUS, OBLIGATIONS AND TITLE RIGHTS.

15. CONDITIONS

- The contractor will work on its own computer(s) and use its own office resources and materials in the execution of this assignment. The contractor’s fee shall be inclusive of all office administrative costs - Flight costs will be covered at economy class rate as per UNICEF policies. - Any air tickets for travel will be authorized by and paid for by UNICEF directly, and will be for the attendance of meetings and workshops. - Please also see UNICEF’s Standard Terms and Conditions attached.

Enquiries:

Please direct any enquiries to: [email protected]

Proposals with all supporting documents should be addressed to:

UNICEF MENARO Bids [email protected]

12 ANNEX 1: IYCF Programme Description BACKGROUND “With Syria’s civil war outbreak in March 2011, an estimated 9 million Syrians have fled their homes taking refuge in neighbouring countries and within Syria itself. As of today, more than 628,000 Syrian refugees have registered with UNHCR in Jordan. The protracted emergency in Syria has had negative effects on maternal and child nutrition, exacerbating the already poor infant and young child feeing (IYCF) practices that existed pre-crisis. Suboptimal feeding practices are also common in Jordan.

In Syria, prior to the civil war, the nutrition situation of children less than five years of age was poor and IYCF practices were far from optimal. Only 46% of mothers initiating breastfeeding within the first hour of birth, 43% exclusive breastfeeding for the first 6 months, and 37% providing timely introduction of complementary food. In Jordan, according to the Jordan Population and Family Health Survey 2012, infant and young child feeding practices have worsened since 2002. Exclusive breastfeeding rates have decreased from 27 to 23 percent and use of a bottle with a nipple has increased from 40 to 65 percent. In addition, the percentage of breastfed children receiving timely and appropriate complementary food has decreased from 70 to 66 percent.

Suboptimal IYCF practices combined with maternal nutrition greatly affect an infant’s or young child’s vulnerability to malnutrition, illness, and death. Nutrition in the first 1,000 days of life (from pregnancy up to a child’s second birthday) is critical for physical and cognitive development, setting the stage for future growth, social ability, and productivity into adulthood (Alive and Thrive, 2012). On the other hand, optimal feeding practices as recommended by WHO increase survival rates and reduce a child’s vulnerability to illness. Breastfeeding is the single most effective nutrition intervention for saving lives and could prevent 1,000,000 deaths each year if practiced optimally (Save the Children, State of the World’s Mothers, 2012). Complementary feeding also features as one of the top three interventions for preventing deaths of children under 5 years by 6%, and early initiation of breastfeeding significantly reduces the risk of neonatal death (The Lancet, 2003 and Paediatrics, 2006). Therefore strong routine breastfeeding and complementary feeding programmes are linked to prevention of under nutrition and long-term resilience.

The Inter Agency Nutrition Survey Amongst Syrian Refugees in Jordan 2012-2014 (2014) highlighted the need to improve the already deteriorating IYCF practices and prioritize this intervention in the overall nutrition response.

ACHEIVEMENTS SO FAR In response to the crisis and deteriorating nutrition practices, Save the Children Jordan launched the IYCF programme in 2012 to improve the conditions of the most vulnerable in both refugee camps and host communities, including pregnant and lactating women (PLW), children under 5 years, and especially children under 2. The programme, aligned with Save the Children’s and UNICEF’s objectives and strategies, initially started in Za’atari Refugee Camp which expanded to cover the other two camps in Jordan (Azraq and EJC), as well as Rabaa Alsarhan, the new arrivals area along the Jordanian-Syrian border, and 4 governorates in the host communities of Amman, Karak , Ma’an, Aqaba and Jordan Valley.

Save the Children is the leading agency for IYCF in Jordan. To date the nutrition programme has reached more than 91,000 pregnant and lactating women and caregivers of children under 5 with skilled IYCF support. This includes (but is not limited to) one-to-one counselling and close follow-up of all cases, group education sessions, and empowerment of caregivers to sustain nutrition behaviors and even become agents of change in their own communities. With SCJ covering 100% of PLW and children under 5 in all of the refugee camps, GAM rates remain low, with just of 1.2% GAM inside Zaatari camp, for example, where beneficiaries receive daily nutritional support.

13 Under the IYCF umbrella Save the Children has expanded health and nutrition services to include management of moderate acute malnutrition (MAM) with current cure rates of 97% in Zaatari camp; oral rehydration therapy (ORT) corners in all 3 camps; and expanded programmes of immunization (EPI) in all current locations. Save the Children continue to improve immunization coverage rates through effective community mobilization that includes support to the MOH during immunization campaigns and close monitoring of child/caregiver vaccination appointments to ensure regular attendance. In addition, Save the Children has also developed a broad network of partners that include MOH, MOSD, MOE, and numerous CBOs to implement all current health and nutrition activities. In the Southern region partnership was established with 97 entities including MOE schools, CBO’s & health centers, moreover another 44 same entities were included in the middle region (Amman, Balqa & Zarqa governorates). To help building the capacity of the hospitals to respond to nutritional needs & challenges in the areas where the IYCF programme is being implemented partnerships were established with 5 public & 16 private hospitals all over the country.

At the global level SCJ has gained recognition and earned an excellent reputation for high quality IYCF programming in the Middle East region. Out of the Syrian crisis arose new contexts for infant feeding and nutrition programming, and key global nutrition groups (IFE Core Group, Global Nutrition Cluster) have looked to SCJ for programme examples and best practices that can be replicated in other areas of the region. These examples are also being used to revise international nutrition protocols for quality response (e.g., BMS programmeming guidance notes, joint statements, and updates to the Operational Guidance on Infant Feeding in Emergencies).

SCOPE OF WORK In the camps, Save the Children Jordan continues to provide quality nutrition services for pregnant and lactating women and caregivers of children under 5. IYCF+ skilled support is provided through a holistic approach of one-to-one counselling sessions, group education sessions, home visits, referrals to multiple services, and regular follow-ups of all cases to improve and sustain nutrition behaviour change & best child care practices of the affected population. Further, mothers are empowered and trained to become IYCF mother leaders, working in the camps and host communities as IYCF advocates for behaviour change. In the host community, SCJ targets remote areas with mobile caravans designed to extend to hard- to-reach areas in order to provide nutrition services for caregivers who are not able to easily access health centers and clinics.

The IYCF programme proved to be an entry point for other services with integration of sector activities and strong referral pathways established. An evidence-based package for newborns (home visits, counselling, and referrals) is integrated into current IYCF activities through the existing modality of home visits to mothers and newborns, including referral linkages with hospitals in the incidence of sick newborns. More can be done in this area based on MOH approval. Moderate acute malnutrition (MAM) is managed through Save the Children’s SFP programme and is detected through screenings during IYCF activities. Child Protection (CP) services are linked to IYCF counselling and home visits through a strong referral mechanism when a CP case is suspected. Early Childhood Development activities are integrated into the IYCF caravans to reach caregivers of young children with ‘positive discipline’ messages.

Along the Syrian border, SCJ works closely with the MOH to adhere to international protocols for BMS programming (The Code of Marketing of Breast Milk Substitutes and The Infant and Young Child Feeding in Emergencies Operational Guidance). GAM rates are continuously monitored and nutritional needs of PLWs and children under 5 are assessed to establish appropriate referrals to nutrition services upon transfer to the camps. Cases are followed up within 24 hours to streamline quality health and nutrition services.

14 PARTNERSHIPS AND CAPACITY BUILDING Save the Children Jordan (SCJ) is the leading agency in nutrition technical capacity at the national level, providing IYCF trainings to all stakeholders in Jordan. Currently, SCJ has established partnerships with the MOH, MOSD, various CBOs, the private health sector, and are building capacity of all to support and improve the health and nutritional status of pregnant women, mothers and children. The trainings go beyond the IYCF curriculum and are tailored to be context specific for partner and beneficiaries. For example, early marriage and family planning are part of the training curriculum to ensure appropriate message delivery and counselling on the ground.

Save the Children works with the Ministry of Health’s comprehensive healthcare centers, providing breastfeeding counselling in maternity wards. SCJ also work closely with the MOH to continuously advocate for improved BMS programming and monitoring in the host communities. Together with the Ministry of Social Development and their partner CBOs, Save the Children carry out group education and one-to-one counselling sessions for caregivers of children under 5 and provide technical workshops for community workers to deliver key health and nutrition services. Furthermore, SCJ has agreements with over 10 hospitals to carry out lactation counselling for mothers of newborns. Currently, plans are in development to build capacity of health staff in these hospitals, focusing on lactation and recommended MNCH practices.

Based on the successes with the MOH, cooperation and involvement of private hospitals, continuous demand for further trainings, and UNICEF’s interest to facilitate the Baby-friendly Hospital Initiative (BFHI) in Jordan, SCJ will utilize its technical strengths to support the initiative. Save the Children would like to collaborate with UNICEF and MOH by providing BFHI core trainings for selected hospitals that will support technical staff to implement the required actions to meet BFHI criteria.

CURRENT OPERATION (2015 July 1-2016 June) Save the Children Jordan is planning to expand health and nutrition services to Syrians, Jordanians, and other nationalities within the poverty pockets around the country. Expansion of geographical areas include: Tefeleh, Zarqa, Mafraq, and Irbid (Banikenanah). This expansion will also include UNICEF’s Makani programme that will offer multiple services in the host communities. Once the programme is established, Save the Children aims to integrate IYCF activities for a wider and more comprehensive reach to beneficiaries in need.

In addition to the expansion of services, Save the Children Jordan has been combating anemia throughout the country for 3 years and activities will soon become part of a comprehensive package of services for mother and children under the IYCF programme. SCJ will provide screening and Iron Folic Acid (IFA) supplementation for 25% of women of child bearing age (15-49) in all areas where Save the Children are working (both current areas and places of expansion). Due to budget limitations, this service will only be provided for mothers but not for children under 5 as it was initially agreed. Save the Children would continue the role to be the leading agency in IYCF capacity building. Due to numerous requests from partners SCJ will expand as the IYCF training hub and increase training sessions for various stakeholders that include the Ministry, CBOs, private hospitals, and other organizations, not only for Jordan but for the Middle East region . Future capacity building of the ministry and various hospitals is also part of a gradual exit strategy that builds empowerment of key actors in health and nutrition to ensure the sustainability of recommended health and nutrition practices in Jordan.