Consultancy to support compiling a BCI strategy 131 views0 applications

TOR to support compiling a BCI strategy

1.0 Introduction

The Nutrition International (NI) formerly Micronutrient Initiative, is a global organization dedicated to delivery of proven nutrition interventions with a focus on pregnant women, new-born, infant, children under 5 years and adolescents. The vision of NI is a world where everyone, everywhere is free from malnutrition and able to reach their full potential. NI’s mission is to be a global leader in finding and scaling-up solutions to malnutrition through; Coverage: delivering low-cost high impact nutrition interventions, especially for women, adolescent girls and children in Africa and Asia; Leverage: Integrating nutrition across sectors to maximize impact and ensure there are no missed opportunities; and Influence: Utilizing research, technical assistance, advocacy, and partnerships with national and global nutrition actors to improve policies, programs, and resources for nutrition.

2.0 Background and Rationale

NI recognizes that behavior change is an important component for the success of nutrition interventions. In this regard, NI has continued to implement strong behavior change interventions informed by research and globally recognized best practices. NI uses the term BCI to define behavior change interventions that include distribution of micronutrient commodities and communications aimed at creating demand for these commodities and relevant services. BCI is therefore one of the key pillars of NI’s impact pathway model.

During the implementation of Right Start project (April 2017 to March 2020), NI supported implementation of demand creation strategies working with selected partners within communities. The strategies were intervention-specific and were based on formative assessment findings. The communication objective of the strategies was to improve knowledge, change attitudes and create self-efficacy among users on barriers to the desired nutrition behaviors, using the known behavior change theories. The strategies had some positive impact in creating overall community awareness as well as change in behaviors among users as evidenced through program progress reports.

Despite the success, some challenges were noted in this approach. First there was a lack of a standardized NI BCI approach within the different interventions. Intervention specific BCI strategies created duplication or too many uncoordinated messages targeting same communities, creating a potential for confusion among the beneficiaries and communities. For example, promotion of Iron and Folic Acid Supplementation (IFAS) for pregnant women and Weekly Iron and Folic Acid Supplementation (WIFAS) for adolescent girls led to communities questioning why pregnant mothers and adolescent girls were given similarly supplements. Thus, intervention specific strategies lacked synergy and were not well coordinated to provide comprehensive nutrition knowledge to the communities. As a response, NI developed a BCI toolkit to provide a standardized approach on BCI Strategy design and implementation of demand creation activities based on lessons learnt and best practices.

In current or just started Institution Support Grant (ISG) program, Nutrition International’s (NI) BCI strategies will focus on deepening gender and Behavior Change Interventions (BCI) by incorporating new innovative approaches for mainstreaming gender in programming. BCI objectives will be expanded beyond the knowledge, attitude and practice (KAP) domains to include social mobilization and community dialogue to create demand for commodities and services, as well as establishing a foundation of societal awareness and approval of desired behaviors.

To achieve this goal, NI BCI approaches seek to empower all levels of field staff with BCI skills to identify and resolve behavioral barriers through timely targeted information sharing and community dialogue among other approaches. BCI strategies also need to compliment knowledge, changing attitudes and practice approaches with empowerment of the target audience to make informed choices, community agenda setting, clarification and compensation/exchange of strong held cultural values through community dialogue. This approach will create stronger ownership of the achieved changes at individual and society levels and create sustainability in the resulting changes.

To address the challenge of duplication of efforts NI now plans to develop one comprehensive BCI country strategy covering for all four interventions which are:

1. Maternal Newborn Health and Nutrition (MNHN) – NI Tanzania supports the implementation of proven interventions that improve Maternal, Newborn Health and Nutrition by strengthening provision of nutrition education and services in both community and health facility levels. These include interventions which focus on the first “1000 Days” of a child; Early ANC booking by continuing providing support on availability and improved uptake of Iron and Folic Acid (IFA) supplementation, improved postnatal care, promoting early initiation, exclusive breastfeeding and improving complementary feeding.
2. Vitamin A Supplementation program (VAS) – NI Tanzania provides in-kind support of high quality Vitamin A capsules for all children aged 6 to 59 months country wide i.e. Mainland Tanzania and Zanzibar through Child Health and Nutrition Month (CHNM) campaigns and finalizing health system readiness assessment to support the government to safely strengthening VAS services from campaign to routine approach – six-month-contact-point.
3. Adolescents Nutrition Education and Counselling (Adolescents Nutrition) – NI Tanzania contributes to improved health and nutrition status by strengthening nutrition education and counselling to adolescent boys and girls and provide advice and guidance on Iron and Folic Acid Supplementation to adolescent girls as would be advised by the Ministry of Health.
4. Universal Salt Iodation (USI) – through “consolidation approach” (formation of producers’ or processors’ associations); NI Tanzania is working in salt producing regions of mainland Tanzania to create an enabled environment that will motivate salt producers and private investors to move towards consolidation in order to facilitate effective enforcement and increased technical and organizational capacity of salt producers in producing adequately iodated salt.
5. Upcoming Food Fortification program, NI Tanzania for the next five years will provide technical and financial support to strengthen national and subnational food fortification coordination, monitoring and enforcement mechanisms; and support capacity building of medium and small-scale maize flour processors to acquire proper skills and certification.

The comprehensive strategy will guide the programs by setting common approaches so that all communication activities, products and materials work in harmony to achieve the desired change. For MNHN, the new strategy will promote early clinic attendance and use of IFA by pregnant mothers. In Vitamin A supplementation, the strategy will promote VAS uptake among parents and caregivers of children under 5 yrs. In Adolescent nutrition, the strategy will promote a comprehensive approach on nutrition education and counselling targeting consumption of a balanced diet through the five food groups and where necessary provision of Weekly Iron and Folic Acid Supplementation as per WHO guidelines and for USI and Food fortification the strategy will promote the use of iodated salt and fortified flour (products) by the entire population especially women of reproductive age for the fight against under five mental retardation, neural tube defect and anaemia.

A comprehensive strategy will also enable stakeholders and partners to provide inputs and agree upon the best way forward so that actions are unified and contribute to the desired behaviors across different target audiences. With an agreed-upon communication strategy, staff and partners will have common reference point to guide the implementation of demand creation activities.

The strategy will have a common country background dovetailing into specific interventions on behavioral objectives, as described above, and later combining the community mobilization and demand creation approaches. In preparation to move this process forward, NI has conducted literature review on the different interventions to inform and update the existing baseline knowledge and behavioral barriers in each of the interventions .The next step will involve discussions to identify gaps (if any) in the existing approaches, communication objectives and gender issues for each intervention and making recommendations for addition on intervention specific and cross cutting issues.

3.0 Objective, activity and deliverables

NI is looking for an expert/editor with a good understanding and experience in behavior change communication strategy design and editing skills to support in compiling a comprehensive strategy following suggested recommendations and inputs. At the onset, the selected person will be expected to read through existing NI reports and strategies to gain an in-depth understanding of the programs’ background and goals. Then the expert/editor will participate in a review meeting with NI staff during which each intervention will be analyzed, and recommendations made. The expert/editor will compile a comprehensive BCI strategy based on recommendations and present it to NI for first round review and feedback on areas of improvement. The copy will incorporate diagrams and photo images of program activities where appropriate. The individual will use the recommendations and suggestion to improve the draft, then present the final edited and formatted version for approval. Once approved the individual will present 3 hard copies and one electronic version of the approved copy**

Scope of Work

Activity 1: Familiarize with NI existing BCI strategies and other materials provided by NI.

Activity 2: Participate in a one day strategy development process with NI staff

Activity 3: Compile one combined strategy based on agreed objectives and recommendations

Activity 4: Present the draft strategy to NI for discussions and inputs

Activity 5: Revise, edit and format the final copy

Activity 6: Present the final soft copy to NI for approval

Deliverables

One comprehensive BCI strategy for Tanzania in three spiral bound copies and one electronic version. The layout and sections will include a review on current situation by intervention, objectives, communication approaches and innovations, sample messages crosscutting issues focused on barriers to the desired behaviors of various target audiences approaches for monitoring. The format will be agreed upon between NI staff and the expert/editor during the first meeting.

Proposed timelines

This consultancy is expected to be delivered within 30 person-days.**

4.0 Required Competencies and Knowledge

§ Masters level of education

§ Grounded experience with SBCC/BCI

§ Hands on experience in the design of communication strategies/implementation of health communication programs

§ Document compiling and editing skills