Action Against Hunger | ACF International, a global humanitarian organization committed to ending world hunger, works to save the lives of malnourished children while providing communities with access to safe water and sustainable solutions to hunger.
Terms of Reference;
Consultant in Nigeria
Reference: ACF USA – LMIS and HIMS
Key dates of the consultancy
Planned starting date:
1st Dec 2016
Language of the consultancy
Required language for the consultancy:
Language of the report:
Back ground context
ACF has been operating in North Eastern Nigeria since 2010 supporting a number of development and humanitarian initiatives; employing a multi sectoral approach to addressing issues of maternal and child malnutrition, and food livelihood security.
There two major strands to addressing issues of child malnutrition: treatment of SAM and management of MAM children at the established SC and OTP sites; and training plus sensitization on recommended IYCF practices using Mother to Mother (MtM) support group model. Currently there 62 OTP and 04 SC sites spread across the six LGAs of Damaturu, Fune, Potiskum, Fika, Machina and Yunusari; and 397 MtM support groups – comprised of volunteer women of child bearing age group supported by AAH.
Building on existing capacities and national guidelines, the treatment component of the project aims to create commitment from local authorities to maintain quality CMAM services beyond the project period through capacity building, system strengthening, and integration into existing primary health care system plus advocacy.
AAH is currently implementing a wide range of projects (WINNN, Integrated Assistance for Persons Affected by the insecurity Situation, and Integrated Basic Nutrition Response to the Humanitarian Crisis) all funded by DFID and ECHO. The project aims to supports treatment and prevention of severely acute malnourished (SAM) U5 children via Community Management of Acute Malnutrition (CMAM) and Infant and Young Child Feeding (IYCF) practices. A number of trainings of Health Workers (HWs) and Community Volunteers (CVs) on CMAM and IYCF; and LGA, State MOH and SPHCMB officials on various aspects of health nutrition Management have been undertaken.
In addition, and as part of the minimum WASH in nutrition strategy implementation, WASH interventions are integrated into the nutrition interventions to avoid any cases of relapses attributed to poor hygiene and sanitation practices. Some of the WASH interventions include rehabilitation of WASH infrastructure at Health Facilities (HFs) and provision of hygiene kits to reduce treatment duration and relapses. All these interventions are delivered as an integrated package.
Previous initiatives on the HMIS and LMIS by ACF
Cognizant of the need to prudently manage nutrition data and supply of other nutrition essentials like RUFT and essential drugs; in the initial phase of the programme, ACF was hands-on supporting LGA staff at HF level collect and compile weekly and monthly data on the management of nutritional supplies and tracking OTP beneficiaries. ACF also actively involved in the supply chain management of the RUTF; ordering supplies to transporting the RUTF - from the State central level warehouse to LGAs and HFs, albeit on an ad hoc basis with little planning from the HF. It was then observed that it is essential for the State and LGA to take over the responsibility of these initiatives.
Thus, ACF in collaboration with the SMoH placed much effort to support the establishment of a system for nutrition related data collection and management. Trainings were conducted with the State Nutritionist and LGA NFP’s together with Health workers in the respective HFs. At LGA and State level, computers were procured and given to health facilities and SPHCMB; and basic computer trainings administered with the State Nutritionist and the LGA NFPs. On job mentoring and support was also given.
Since then, the State (at all levels) took an increased role in management of CMAM data, ordering and management of nutrition supplies. As a result of the above initiatives, there is some improvement at HFs, LGAs and the SPHCMB to manage nutrition data and RUTF supplies. Although the RUTF and other supplies are not delivered in a timely manner, however, there is a feeling of ownership by Health workers in general. Nutrition and other related data is collected monthly by HF staffs and shared with LGA NFPs during monthly coordination meetings. This data is then compiled by the NFP at the LGA and shared with the State Nutrition Officer (SNO).
Similarly, the in-charge at the HF is responsible for ordering the RUTF on a monthly basis and this is not released until the monthly report is received at the LGA.
Under the current nutrition projects funding initiatives, an assessment of HMIS and LMIS in the broader context of nutrition interventions is earmarked to gain more insights into, and identify any challenges and opportunities for delivering quality nutrition services in the LGAs and State at large.
Rationale for the assessment
According to WHO, Health Management Information Systems (HMIS) and its associated logistical requirements are one of the key six building blocks essential for health system strengthening. HMIS is a data collection system designed to support planning, management, and decision making in any effective health service delivery system. In essence, all information generated by design and implementation of health information systems must be action oriented - to serve the process of action taking at all levels: within communities, for case management, at HF for health unit management, for the LGA management, for State level health management, and for policy and planning at higher levels of the health system.
However, in Yobe State, there still gaps in ensuring consistency and timeliness in data collection and management, plus sharing with key stakeholders at various levels. Management of nutrition supplies (like RUTF, essential medicines etc.) is still very weak and adhoc in a manner - with frequent stock outs of essential nutrition supplies. Coupled to this, some nutrition indicators at SMoH and SPHCMB are not harmonized. All these issues need to be addressed without which timely delivery of quality nutrition health services will still be a challenge.
Objectives of assessment:
The objective of the assessment is to analyze and identify gaps and opportunities for improving HMIS and LMIS at all level of primary health service delivery; at the community, HF, LGA and state levels.
The assessment will help highlight areas of focus to improve quality of data collected and subsequent information available for decision making across all health system building block on selected health nutrition indicators of HMIS performance.
Scope and Duration of the Assessment
The assessment will be conducted in randomly selected health facilities – at least 1-2 from each of the 9 implementing local Government area of (Damaturu, Fune, Potiskum, Fika, Machina, Yunusari, Tarmuwa, Nangere and Gujba). The assessment will broadly look at the HMIS and LMIS at various levels of the State health service delivery system with a focus on primary health care service delivery.
Key informant interviews will be conducted by a lead consultant supported by AHH staff in collaboration with the nutrition teams in the respective LGAs. Key informant interviews will be conducted in selected health facilities, LGA NFP person and Director SPHCMB or his designate using a structured questionnaire. Observation methods will also be employed to gather real time information/status of HMIS and LMIS at the health facilities, LGA and possibly at SMoH.
The assessment (actual field data collection) is expected to take a minimum of 10 working days (1st to 10th Dec) of December 2016. The consultant is expected to share draft report 5 days after completing data collection - by end of December for input and final consideration.
Methodology for data collection by Source and nature of data
Nature of Data
In-depth individual interviews &
Key tasks and expected outcomes:
Some HMIS aspects to probe:
Qualifications of the consultant Resource person to lead this exercise should have the following minimum qualifications:
The ownership of the draft and final documentation belong to the agency and the funding donor exclusively. The document, or publication related to it, will not be shared with anybody except ACF before the delivery by ACF of the final document to the donor.
ACF is to be the main addressee of the evaluation and its results might impact on both operational and technical strategies. This being said, ACF is likely to share the results of the evaluation with the following groups:
Various co-ordination bodies
Intellectual Property Rights
All documentation related to the Assignment (whether or not in the course of the consultant’s duties) shall remain the sole and exclusive property of ACF.
Interested parties must submit their applications by email referenced under title;
LMIS and HMIS
Deadline for submission: 25TH November 2016 at 17.00 (GMT+3).
Consultants are requested to submit a proposal with a cover letter and must mention their expected total remuneration for this assignment.
Applications should include:
Only shortlisted applications will be contacted.
The final selection will be done by Action Against Hunger USA
For more information, prospective consultants may contact Monday to Friday between 9am and 5pm (GMT+3) at the following email address or by phone: