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Prise En Charge De La Malnutrition Aigüe Sévère Dans Au Moins

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Prise En Charge De La Malnutrition Aigüe Sévère Dans Au Moins Sep 28, 2021, 8:34:49 PM Call for Expression of Interest Prise en charge de la malnutrition aigüe sévère dans au moins 39 Zones de santé des Provinces du Kasai Central, Kasai Oriental, Lomami, Kasai, Sud Kivu, Ituri et Tanganyika, en République Démocratique du Congo CEF/COD/2021/080 1 Timeline Posted Apr 23, 2021 Clarification Request Deadline Apr 27, 2021 Application Deadline May 2, 2021 Notification of Results May 23, 2021 Start Date Jul 1, 2021 End Date Feb 28, 2022 2 Locations A Congo, Dem. Rep. a Tanganyika Province b South Kivu c Ituri Interim Administration d Kasaï-Central e Kasaï District f Kasai-Oriental g Lomami Province 3 Sector(s) and area(s) of specialization A Nutrition a Malnutrition prevention and treatment 4 Issuing Agency UNICEF 5 Project Background La République démocratique du Congo (RDC) est l'un des dix pays qui représentent 60% du fardeau mondial de l'émaciation chez les enfants de moins de 5 ans. Le pays a des taux élevés de malnutrition aiguë : 6,5 pour cent de malnutrition aiguë globale (MAG) et 2 pour cent de malnutrition aiguë sévère (MAS) selon la dernière MICS 2018. Deux des 26 provinces ont une prévalence de la MAS au-dessus du seuil critique et d'urgence de 5% (Ituri et Nord Ubangi). Douze des 26 provinces ont une prévalence de la MAS d'au moins 2%. Compte tenu du contexte COVID-19, le Cluster Nutrition a estimé en 2021 que les personnes dans le besoin s’élèvent à 3,8 millions d'enfants de moins de cinq ans touchés par la malnutrition aiguë dont 1,1 million souffrent de malnutrition aiguë sévère. La prévalence de la malnutrition chronique est restée très élevée et inchangée. Selon la dernière enquête MICS 2018, 41,8% des enfants de moins de cinq ans souffrent d'un retard de croissance (malnutrition chronique) en RDC. Le pays se classe au 8e rang mondial pour les taux de retard de croissance. On estime que plus de 7 millions d'enfants de moins de 5 ans souffrent d'un retard de croissance dans 25 des 26 provinces les plus touchées en RDC (prévalence > 30%, seuil critique selon l’OMS) et 3 provinces avec une prévalence supérieure à 50% (Kwango, Kasai Central et Sankuru). En 2019, la situation nutritionnelle est restée préoccupante dans onze territoires dont les enquêtes de nutrition et de mortalité menées dans dix-sept territoires dans 10 provinces (Sud-Kivu, Maniema, Kwango, Lomami, Sankuru, Kasai Oriental, Tanganiyka, Tshuapa, Mai Ndombe, Kwilu) ont montré des niveaux de malnutrition aiguë globale deux fois plus élevés que le seuil établi (5%). En effet, sur les dix-sept enquêtes nutritionnelles territoriales réalisées, onze ont révélé une forte prévalence de la malnutrition aiguë globale (MAG) allant de 16,5% à 10,1% ; et de 2,7% à 5% pour la prévalence de la malnutrition aiguë sévère (MAS). En 2020, selon les résultats des enquêtes SMART menées dans 27 Zones de santé dans 9 provinces l’Equateur (3), Haut Lomami (1), Nord Kivu (14), Sud Kivu (2), Kwango (1), Ituri (1), Mai Ndombe (2), Tanganyika (2), Kasai Oriental (2), 8 Zones de santé ont montré des niveaux de malnutrition aiguë globale, au-delà du seuil établi de 10% de l’OMS : Kamina dans la Province du Haut Lomami (SAM : 6,3%, GAM : 15,7%) ; Bikoro en Equateur (SAM : 4%, GAM : 17,4%) ; Mwenga au Sud Kivu (SAM : 3,4% et GAM : 14,3%) ; Boko au Kwango (SAM : 3%, GAM : 15.8%) ; Drodro en Ituri (SAM : 5.9%, GAM : 14.3%) ; Tandembelo au Mai Ndombe (SAM : 2,4% et GAM : 14%) ; Yumbi au Mai Ndombe (SAM : 3,6% et GAM : 14,4%) ; Nzaba au Kasai Oriental (SAM : 6.9% et GAM : 17.9%). Il est à noter qu’en 2020 peu d’enquêtes nutritionnelles ont été réalisée dans les Zones en alertes nutritionnelles faute de financement. L’analyse de la situation nutritionnelle en 2020 selon les 4 Bulletins trimestriels no 39, 40, 41 et 42 du système de surveillance nutritionnelle sécurité alimentaire et alerte précoce (SNSAP), appuyé par UNICEF/USAID Food for Peace, informe sur une augmentation de plus de 100% des alertes émises par les zones de santé par rapport aux mêmes périodes (Trimestre 4) en 2019. 238 alertes ont été déclaré pour 183 zones de santé en 2020 contre 178 durant les 4 trimestres de 2019, ce qui représente 33 % des alertes en plus sur toute l‘étendue du pays. Par ailleurs, 43 Zones de santé sont revenues 2 à 3 fois en alertes. Il est à noter que, les Provinces de l’Equateur (19%), Kasai Oriental (13%), Kasai Central (13%), Kwango (11%), Maniema (11%), Tshuapa (11%), et Kasai (8%) regorgent plus de 70% des alertes durant les 4 trimestres (T1, T2, T3 et T4) de 2020. L’UNICEF est l’organisme chef de file en matière de nutrition en RDC et le principal partenaire soutenant les efforts du gouvernement pour renforcer et mettre à échelle le programme de prise en charge des cas de malnutrition aiguë sévère en République Démocratique du Congo. Pour assurer la mise en œuvre sur le terrain, l'UNICEF travaille par l'intermédiaire des ONG partenaires d'exécution et de l'homologue gouvernemental par le biais des services de santé (PRONANUT - Programme national de nutrition et DPS - Divisions provinciales de la santé). L'UNICEF travaille également en étroite collaboration avec les ONG, les agences des Nations Unies (OMS, PAM) et le cluster de la nutrition pour assurer une complémentarité adéquate. En particulier sur le continuum des soins pour l'émaciation et sa prévention, l'UNICEF travaillera en étroite collaboration avec le PAM pour assurer la convergence interne entre le traitement de la MAM et de la MAS mais également avec les acteurs apportant des appuis relatifs aux soins de santé primaires existants (ASSR, PROSANI,…). 6 Expected Results La durée de la mise en œuvre des interventions est d’environ 10 mois maximum dans les Zones de santé et Provinces ciblées. Les résultats et principales activités de nutrition comprennent : Résultat 1 : 125 000 enfants âgés de 6 à 59 mois sont traités pour malnutrition aiguë sévère - Assurer la formation/recyclage des prestataires de soins et des agents de santé communautaires dans les zones de santé selon l'évaluation de capacités existantes ; - Identifier passivement les enfants souffrant de malnutrition aiguë sévère dans les centres de santé par les agents de santé ; - Approvisionner les structures de santé en intrants nutritionnels à l’aide des plans de distribution et plans de demandes et de commandes pour les centres de santé ; - Traiter les enfants souffrant de malnutrition aiguë sévère selon le protocole national de la PCIMA dans les unités nutritionnelles thérapeutiques ambulatoires (UNTA) pour les cas sans complications médicales et dans les unités nutritionnelles thérapeutiques intensives (UNTI) pour les cas avec complications médicales ; - Assurer une réhabilitation éventuelle de l'entrepôt et amélioration des conditions de stockage ; - Assurer le suivi de l'utilisation des intrants nutritionnels en occurrence les aliments thérapeutiques prêt à l’emploi (ATPE) dans les structures de santé et par les bénéficiaires - Faire le suivi de la vente des intrants nutritionnels sur les marchés locaux et rapporter sur les cas de fraude sur la gestion des intrants; - Renforcer la supervision et la qualité des services conjointement par PRONANUT, les autorités sanitaires locales et l'UNICEF. Résultat 2 : 90% des visites actives de recherche de cas et de référence à base communautaire y compris la Promotion de l’ANJE sont organisées. - Identifier activement les enfants souffrant de malnutrition aiguë sévère dans les aires de santé des zones de santé sélectionnées par les relais communautaires ; - Référer les enfants souffrant de malnutrition aiguë sévère dépistés vers les formations sanitaires (UNTA et UNTI) ; - Assurer la promotion de l'alimentation du nourrisson et du jeune enfant (ANJE) au niveau des établissements de santé mais aussi au niveau communautaire pour autonomiser la population afin de prévenir la malnutrition aiguë. Résultat 3 : Dans 2 zones de santé ciblées, les communautés et les ménages vulnérables ont la capacité de surveiller une croissance saine et une détection précoce de l'émaciation chez les enfants en utilisant le PB famille. L'approche `` famille MUAC '', également connue sous le nom de MUAC pour les mères ou mère-MUAC sera réalisée dans 2 Zones de santé. - Assurer la formation des mères à identifier les premiers signes de malnutrition chez leurs enfants et à les mesurer à l'aide d'un ruban MUAC ; - Assurer le suivi du référencement de cas détectés par les mères vers les relais communautaires pour vérification et transfert vers les centres de santé. 7 Indicative Budget - 8 Other Information - 9 Selection Criteria Name Description Weight Local experience and presence 1. Opérer dans les Provinces ciblées Weight of criteria: 15 15 2. Expérience prouvée dans la réalisation des activités de Nutrition en générale mais spécifiquement dans les nouvelles approches (PB Mères et/ou Approche simplifie de Sector expertise and experience traitement de la malnutrition aigüe et/ou PCIMA et/ou ANJE) Weight of criteria: 20 20 3. Capacités de gestion financière, comptable, logistique et de préfinancement Cost effectiveness (Meilleur cout/qualité) Weight of criteria: 20 20 4. Avoir une présence physique dans au moins une province de la RDC. Avoir la Other présence physique dans plusieurs provinces sera un atout ; Weight of criteria: 10 10 a) Description du contexte et analyse de la situation avec prévision du nombre de bénéficiaires du projet et des interventions à réaliser (dimensionnement) ======> 5 points b) Compréhension des résultats attendus et des activités à réaliser ======> 4 points c) Prise en compte des questions
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