International Medical Corps is a global, humanitarian, nonprofit organization dedicated to saving lives and relieving suffering through health care training and relief and development programs. Established in 1984 by volunteer doctors and nurses, International Medical Corps is a private, voluntary, nonpolitical, nonsectarian organization. Its mission is to improve quality of life through interventions that build local capacity in underserved communities worldwide. Since 1991, International Medical Corps has worked in south-central Somalia and Somaliland to implement programs that build local capacity while serving the immediate health, nutrition and WASH needs of the most vulnerable. More than 2.1 million Somali women, men, girls and boys are internally displaced, with over one quarter of Somalia’s estimated 12.3 million populations in need of emergency healthcare services. Through our long-term presence on the ground, International Medical Corps has built strong relationships with communities throughout Somalia and Somaliland, making it possible to operate in highly unstable conditions. In addition to providing immediate relief, International Medical Corps builds a framework for program sustainability and long-term positive change, making Somali communities more self-reliant. Program background
International Medical Corps has been implementing Health and Nutrition interventions in Abduak, Balambal and Jowhar Districts of Galgaduud and Middle Shebelle region since mid-2014. Conflict, and associated displacement, has had a significant impact on food security and, consequentially, the prevalence of malnutrition. While famine was averted due to the scaled up humanitarian response, the situation still remains dire for Abduak, Balambal and Jowhar districts that have GAM rates of 20% and SAM rates of 4.6% according to the FSNAU 2017 post Gu assessments. In response to the emergency caused by the four failed consecutive rainy seasons resulting in the area being classified as IPC 4, IMC interventions have been contributing to the prevention and management of acute malnutrition among the most vulnerable groups: the under five children, pregnant and lactating mothers through therapeutic and supplementary feeding programs. In addition, IMCs health interventions have contributed to a reduction in maternal and child mortality and morbidity in the district through delivery of health and nutrition services aligned with the Somalia Essential Package of Health Services (EPHS) in Abduak and Balambal districts. Currently, IMC with financial and in-kind support from UNICEF, UNFPA, DFID (SNS+ IRF) and OFDA, International Medical Corps has been operating 1 referral health center (RHC) including a Stabilization center, 4 health centers (HCs), 15 primary health units (PHUs), and 4 mobile health and nutrition teams (MHNTs). Despite this interventions, International Medical Corps has observed that very slow progress has been made in sustainably impacting on the malnutrition status with significant gaps still being sustained.
IMC would therefore like to conduct a conduct a SMART survey in Abduak, Balambal and Jowhar District so as to assess and monitor the nutrition status of children 6-59 months of age, including other Health and WASH proxy indicators for the population of Abduak and Balambal districts as well as providing recommendations for planning and deciding on future nutrition programming in the area. This is because IMC relies on statistics from FSNAU which conducts surveys across regions and livelihoods making it difficult to establish the exact nutrition situation at district level. In addition to this IMC would like to build the capacity of the Program managers on SMART methodology.
The purpose of this TOR is to spell out the guidelines for the assignment that is aimed to carry out a SMART survey amongst the communities in Abduak and Balambal Districts. The main objective of the survey will be to estimate the prevalence of acute malnutrition amongst children aged 6-59 months and in women of reproductive age of 15-49 years in Abduak, Balambal and Jowhar Districts of Galgadud and Middle Shebelle Region of South Central Somalia, with the following specific objective
A cross sectional study utilizing a two-stage cluster sampling and the Standardized Monitoring of Relief and Transition (SMART) methodology will be used. A standardized integrated nutrition SMART survey tool will be used and uploaded electronically using ODK or KOBO. Emergency Nutrition Assessment (ENA) for SMART software, SPSS version 21 and will be used for analysis.
Main Tasks by the survey consultant
Be responsible for data cleaning and analysis using anthropometric software (ENA for SMART, SPSS and others as needed) for the core anthropometric and additional variables. Conduct some 2X2 tables to identify any associations or relationships between variables.
9. repare and present an overview of preliminary findings and share this with IMC technical team for comments and discussion.
10. Present the final survey findings with the AIM working group for validation
11. Write and submit a comprehensive Final nutrition survey report Submit the initial raw and final clean data sets in ENA- SMART
Deliverables under this assignment will include the following:
N/B: As with all population surveys it is imperative that the results are available to IMC as soon as possible. The report will be presented in English and will include at minimum: Introduction and details of the study population, study design (sampling frame, survey sites, sampling procedures, sample size, data collection methods, tools, training description, enumerator capacity, standardization test during training (procedure & results)), results), discussion, conclusions/recommendations, and references. The annex should contain but not necessary be limited to a map, final questionnaires, sampling frame indicating the clusters selected, actual survey schedule, teams & supervisors, plausibility test, TOR. As mentioned above the consultant will conduct debriefing meetings with IMC field team and Technical teams and other relevant stakeholders. Proposed Time Frame
Proposed # of Days
Development of the Survey Protocols, tools and secondary desk reviews
April 9th, 2018
Presentation of the survey protocols to AIMWG
April 12th, 2018
Training SMART methodology for managers
April 16th – 22nd, 2018
Training of Enumerators and pretesting of survey
April 21st – 23rd, 2018
April 24th, 2018
Data analysis and writing 1st draft
May 1st – 5th, 2018
Presentation and validating of the findings at the AIMWG
M ay 6th , 2018
PPT Dissemination presentations to staff, community members
May 6th 2018
Preparation of Final Report
May 7th - 13th, 2018
Responsibilities of International Medical Corps
Technical Proposal Format
The proposal should include the following at minimum: