Moderate Acute Malnutrition Treatment Consultant at John Snow Inc - JSI

DESCRIPTION

According to the 2021 Joint Child Malnutrition Estimates, 45.4 million (6.7 percent) children under five globally are wasted. Of this number, 31.8 million children are MAM, representing 70 percent of all wasted children. Although MAM affects a larger number of children there is much less guidance on its treatment. In 2001, the Community-based Management of Acute Malnutrition (CMAM) approach was developed in an effort to reach more children with acute malnutrition. CMAM programs exist in more than 70 countries globally, making it one of the most common treatment approaches. Treatment of children diagnosed with MAM through targeted supplementary feeding programs (SFP) is one of the approach’s components. Much of the experience treating MAM as part of CMAM has been in emergency settings. Therefore, much of the guidance focuses on the use of supplementary food products such as ready-to-use supplementary food (RUSF) and fortified blended foods (FBF).

While there have been improvements in the number of children accessing treatment since the introduction of CMAM and targeted SFP programs supported by WFP and non-governmental organizations, still only one in three severely wasted children in need of treatment receive it. A common challenge driving this lack of access is an insufficient and/or unreliable supply of specialized supplementary food products, like RUSF, for children in need of treatment.

Practitioners have developed many innovative approaches to treat MAM using locally available foods in the permanent or temporary absence of these products. However, there is a lack of minimum standards for these approaches and insufficient global guidance on how these approaches should be designed and implemented—and if and how they should be utilized alongside targeted SFP that uses imported or locally produced, pre-packaged supplementary food products. Costing information on these local approaches is also limited, thereby limiting programmatic decisions about potential scale-up.

Practitioners and donors need to better understand the variety of local food-based approaches used across emergency and development settings, their appropriateness for treatment of MAM, and contextual considerations impacting success. In an effort to begin to document and generate evidence for these approaches, USAID Advancing Nutrition will be conducting case studies on approaches being implemented in Nigeria, Senegal, and Uganda. Specifically in Nigeria we will document the TOM Brown approach implemented by Catholic Relief Services (CRS), Save the Children, and Premiere Urgence Internationale (PUI) and the Porridge Mums approach implemented by Action Contre La Faim (ACF).

The objective of these case studies is to document how local food-based approaches to treating MAM are implemented in different contexts and understand the results of those efforts to inform the eventual development of programmatic guidance to ensure appropriate, high quality treatment for children in these alternate treatment programs. Based on the availability of records kept by the implementing entities and/or implementation sites, we will document the delivery of the program (e.g. service sites, client follow-up procedures), admission and discharge criteria, duration of stay in the program, the types of local foods used and their nutritional value, and program outcomes (e.g. cured, died, defaulted) in an effort to understand how these compare to standard SFP program protocols. We will also document contextual considerations for replicating the approach in new areas. To accompany this work, we will also undertake a cost analysis of each of the selected approaches.

RESPONSIBILITIES

The consultant will lead the following work, in coordination with the USAID Advancing Nutrition Emergency Nutrition Advisor and Activity Manager:
1. Facilitate in-country ethical approval (if required)

• Gather information on the ethical approval process (e.g. forms, fees, and timelines)
• Prepare the ethical approval package, including contextualization of the protocol and tools (as required)
• If key informant interview guides need to be translated to local languages, the consultant may be requested to support translation review.
• Follow up with the ethical committee, as required, until approval is obtained

2.Conduct outreach to CRS, Save the Children, PUI, and ACF to finalize data collection plan and gather secondary information

• Develop an interview and site visit plan, including contact details for interviewees, travel and data collection schedule
• Gather secondary data sources (e.g. protocols, guidance, reports, budget and costing information)

3.Complete primary data collection:

• Conduct key informant interviews to document the design and implementation of the selected approaches, and collect additional guidance or tools that is/are being used
• Conduct site visits to complete observational checklists and conduct site-level key informant interviews
• Collect costing data and enter it into a costing tool under the guidance of a costing consultant (data entry only, no analysis required)

4.Contribute to analysis and drafting of the case study report, as requested by the Activity Manager. Tasks may include:

• Drafting report sections
• Discussing analysis and interpretation of data with the USAID Advancing Nutrition team
• Commenting on the draft report
• Responding to USAID’s comments on the draft report

QUALIFICATIONS

• Bachelor’s degree (Master’s preferred) in Nutrition, Public Health Nutrition, or Humanitarian Response with a focus on nutrition
• Experience (2-5 years) implementing and/or evaluating acute malnutrition treatment programs
• Experience conducting qualitative research (e.g. conducting key informant interviews and observational site visits)
• Experience with in-country ethical approval processes a plus
• Experience in emergency settings a plus
• Excellent English skills (verbal and written)