Background

Over the last decade, Ethiopia has shown impressive progress in improving the nutritional status of children and tackling the main causes of morbidity and mortality. Part of the success is attributed to support being provided in improving the quality of care, especially at the service delivery point level and through the health extension programmer (HEP).

The HEP as the Government’s flagship program providing preventative and curative health and nutrition services at the community level throughout the country, therefore, warrants continued support. As one of the main interventions, the community-based management of acute malnutrition (CMAM) program to treat and manage severe acute malnutrition, is embedded within the HEP and is delivered through more than 18,000 health facilities nationwide. Again, the government has recently approved the acute malnutrition guidelines to align with the international standards that have been proven locally and elsewhere to improve the quality care and survival of children. The CMAM approach includes four components: Community Mobilization, outpatient therapeutic feeding program (OTP) where 90-95 % of all cases are managed through health posts or health centers at Kebele and woreda level; inpatient care for children with severe acute malnutrition suffering from complications, treated at stabilization centers (SC) at health centers or referral hospitals; and Targeted Supplementary Feeding Program (TSFP) to manage and treat moderate acute malnutrition among children under five years and pregnant and lactating women. While service ex pension is impressive across the country, in Developing Regional States (DRS) ensuring the quality of CMAM services remains a challenge, largely due to high staff turnover especially in remote/ hard to reach areas and requires continued attention and support. Also, service delivery challenges have been placed on the program due to climate change-induced displacements and displacements due to insecurity caused by inter-community strife. The internally displaced persons placed a burden on the already fragile service delivery program through the HEP across many areas in the regions. These circumstances provide a big challenge for the human resource needs for an optimal nutrition response to vulnerable children.

1. The contractor will recruit, in consultation with the RHB and UNICEF Hawassa Field office, One Emergency nutrition Officer (ENO) for  South West Ethiopia Region . The consultant will work closely with UNICEF regional office.
2. UNICEF Hawassa FO will assign the ENOs to emergency zones and the Enos will be stationed at respective ZHD offices.
3. Monitoring visits, on-the-job training, and other monthly activities should adhere to the agreed standard operating procedures which should be developed in consultation with the RHB and UNICEF regional office.
4. The ENOs will be responsible to ensure close liaison with the UNICEF Nutrition team in the region to enable a healthy nutrition supply pipeline.

Specific Tasks

Monitoring and field visit:

Conduct regular monitoring visits and assess the quality of nutrition services in HPs, HCs and Hospitals  (SAM treatment outcomes, Nutrition Screening, IYCF-E counseling and Micronutrient ). Each ENO is expected to visit on average, 24 HFs (Hospital, HCs & HPs) using the EUM/ODK and in case of special assignment given from Hawassa FO, a minimum of 15 HF is required.

1. Situation monitoring: The ENO is responsible to monitor emergency nutrition situation, through various methods and report to RHB and UNICEF Hawassa FO. If required, visit IDP sites, preferably with the woreda and kebele officials and health personnel as well as NGO counterparts, to assess needs and identify the best way to reach out to them for the provision of nutrition and health services (outreach activities in campaigns, establishment of additional facilities, or NGO operation of MHNT).
2. OJT: Provide mentoring and on-the-job training to HEWs on Nutritional Screening, IYCF counseling and adherence to SAM treatment protocols. Much more emphasis will be placed on supporting regular nutrition screening of IDP children and women for early detection of SAM as well as MAM.
3. Data: To improve nutrition data recording, reporting and utilization, including conducting data quality assurance. Data of interest are nutritional screening, and SAM admissions and performance.
4. For nutrition screening: ensure the data is compiled in a timely manner and is of quality by the woreda health office and support communicating the screening information with the woreda disaster risk management (DRM) to facilitate TSF allocation.
5. For SAM: ensure case management is as per the standard and quality Keep close communication with the NGO partners supporting the MHNT to ensure SAM program data through MHNT operations is captured.
6. CMAM Facility expansion: Identify and update the (1) health facilities operational/functional that can provide services to the community including IDPs in each kebele/woreda, (2) facilities with SAM treatment services, and (3) health personnel providing SAM treatment and training needs. Conduct capacity assessment and work closely with the woreda health office and NGO partners operating in the woreda in establishing new SAM treatment centers, considering all operating options such as static facility, and mobile outreach through MHNT.

Nutrition supplies:  Closely monitor supply needs, and gaps at the HF level, and alert the WoHo and ZHD immediately if there is any supply gap. Also, ensure a proper supply management system is in place (request, distribution, storage, and utilization) and misuse/abuse is not practiced at all levels. Train the health personnel on supply stock management and prepositioning at zonal, woreda, and facility levels. Ensure bin cards are kept for nutrition supplies, RUTF, routine drugs and therapeutic milk.

Coordination: To support and strengthen Nutrition sub-cluster coordination at the zonal level, regularly take minutes and share to Regional Nutrition Cluster (ENCU) and UNICEF Hawassa FO.

Build a close working relationship with the local line bureaus, UN and NGO partners supporting the region/zones/woredas to ensure the stakeholders keep themselves abreast of, and have the same understanding on, the latest situational updates and actions being undertaken.

Support region, zones and woredas for the successful conduct of nutrition review meetings and supportive supervisions.

Emergency-Development nexus: Support UNICEF-supported Nutrition Programme in targeted Woredas for its proper implementation of CINUS and multi-sectoral coordination/integration for sustainable reduction of under-nutrition (wasting and stunting).

Expected Deliverables

·         Monthly Travel Plans (the last week of each month for the next month). (It must be prepared in consultation with the respective ZHD Nutrition FP).

·         Submission of weekly (Every Wednesday COB) and monthly Sitrep (Each month from 25^th-28^th) to UNICEF Hawassa FO

·         Monthly activity and Progress Report (on nutrition screening, IYCF-E, and multi-sectoral coordination, and treatment outcomes for SAM management) to National Coordinator, and CC to Hawass FO.

·         Submission of monthly nutrition supply status in woredas of the assigned zone.

The ENO needs to have the following qualifications and experiences:

•  Minimum of BSC degree in either Medicine, Public Health, or Nutrition
• Proven track record of at least 5 years ‘ experience in emergency nutrition programming (CMAM)
• Experience in providing capacity building (training, mentoring, supervising)
• Experience in IYCF, Adolescent and Maternal Nutrition
•  Fluency in English (verbal and written).