Standardized Expanded Nutrition Survey (SENS) Project 252 views4 applications

BACKGROUND

Kigoma Region is located in the north west of the Tanzania, Kigoma region is currently the only region hosting the refugee. The region is 45,066 km² and subdivided in to eight districts and 121 wards. There are three Refugee camps allocated in the region which include Nyarugusu Refugee camp, Nduta refugee camp and Mtendeli refugee camp. The region host a total of 283,168 refugees as of 1^st of April 2019.

Each Camp is located at the different district where Nyarugusu camp is located at Kasulu district, Nduta camp is located at Kibondo district while Mtendeli camp is located in Kakonko district council. Nyarugusu is the largest camp which is hosting mainly Congolese and Burundian with largest population of about 153,767, followed by Nduta camp which host Burundian refugee of about 92,075 and Mtendeli camp with Burundian population of about 36,808. Following a Tripartite Commission meeting in August 2017, the governments of Tanzania, Burundi, and UNHCR agreed to assist refugees who wish to voluntarily repatriate from Tanzania to Burundi. A subsequent meeting in March 2018 reaffirmed the commitment of both governments and UNHCR to uphold the principle of voluntariness, and noted that while some refugees may opt to return, others will continue to be in need of international protection. The March 2018 Tripartite meeting also produced a work plan entailing the repatriation of approximately 2,000 refugees per week from 5 April to 31 December 2018

Health care and nutrition activities are among the activities conducted in these refugee camps. The main health and nutrition partners includes Tanzania Red Cross society, MSF-CH, world vision and IRC with support from UN agencies i.e. UNHCR, WFP, UNICEF, WHO and UNFPA. Malnutrition is among the factor contribute mortality among the under five children. According to the HIS annual indicator for 2018 the total under five mortality reported were 434 cases where among these the total death occurred due to acute malnutrition were 23 cases across all the camps.

The last standardized expanded nutrition survey (SENS) was conducted in September 2018 and result showed the overall GAM prevalence of 2.3% across all the camps. The camp specific GAM result showed that Nyarugusu old population (mainly Congolese) GAM prevalence of 1.6% (0.7 – 3.7 C.I.), Nyarugusu new population (mainly Burundians) GAM prevalence of 2.5 % (1.6 – 4.0 C.I.), in Nduta camp the GAM prevalence of 2.3 % (1.3 – 3.9 C.I.) and in Mtendeli camp the GAM prevalence of 2.9 % (1.9 – 4.4 C.I.) respectively. Comparing to 2017 SENS results the GAM prevalence has reduced across all the camp especially for Nduta which has dropped from 6.1 in 2017 to 2.3% in 2018.

Anaemia prevalence in children (6 – 59 months) remains above the critical public health threshold of above 40%. In Nyarugusu, the Anaemia prevalence among the old caseload (Congolese) increased from 46.9% (39.1-54.7 C.I.) in 2017 SENS to 56.0% (49.5 – 62.5 C.I.) in 2018 SENS while in Mtendeli camp the Anaemia prevalence increased from 41.5% (37.3-45.8 C.I.) in 2017 to 49.9% (44.2-55.6 C.I.) in 2018. In spite of the ongoing interventions in place for the Congolese population in Nyarugusu and Burundian population in Mtendeli camp, Anaemia seems to be a major public health concern hence the need for an assessment to identify the course of high anaemia prevalence. However, the Aneamia prevalence amongst Burundian population in Nduta and Nyarugusu camp slight reduced in 2018. Amongst the Burundian population in Nyarugusu, the Anaemia prevalence reduced from 41.2% in 2017 to 35.3% in 2018, while in Nduta the Anaemia prevalence reduced from 41% in 2017 to 37.4% in 2018. For the past three years since 2016 Stunting continue to be the major Public health concern for Burundian Refugee across all the three camps above the WHO standard of 40%.

Stunting among children 6-59 months has consistently remains above the critical threshold, as well as prevalence of Anaemia in children 6-59 months. This could be contributed to high infectious disease burden, suboptimum sanitation and the hyper-endemic malaria situation especially to young children. According to the Community and Household Survey (CHS) conducted in Nyarugusu, Nduta and Mtendeli in August 2018 The findings showed that ration cut in 2017 and part of 2018 somehow resulted to a reduced number of meals and portion size of the meal as a coping strategy. With the cancellation of CBI program, dietary diversity remains a challenge which has resulted to negative coping mechanisms. Age disaggregation show younger age group 6-24 months are statistically significantly more anaemic compared to the older age group The health sector coordination working group has set some strategies for to assess the situation and develop appropriate interventions.

METHODOLOGY

The 2019 Nutrition survey will follow the SMART methodology https://smartmethodology.org/ and UNHCR Standardized Expanded Nutrition Survey (SENS) guidelines for Refugee Populations. All three camps (Nyarugusu, Nduta and Mtendeli) in Tanzania will be assessed and results generated for both Congolese and Burundian caseloads. The SENS Survey methodology, implementation plan, preliminary and final results reports will be reviewed by UNHCR Regional and HQ senior nutritionists and technical support and guidance will be provided.

OBJECTIVES

The consultant will conduct the UNHCR SENS with minimal supervision and produce updated Anthropometry, Health, Anemia, IYCF, Food Security, WASH, and Mosquito net coverage indicators in Nyarugusu, Nduta and Mtendeli camps as per the following objectives;

Primary objectives;

• To determine the prevalence of acute malnutrition among children aged 6-59
• To determine the prevalence of stunting in children aged 6-59 months.
• To determine the coverage of measles vaccination among children aged 9-59 months.
• To determine the coverage of vitamin A supplementation received during the last 6 months among children aged 6-59 months, and de-worming among children 6-59 month.
• To assess the two-week period prevalence of diarrhea among children aged 6- 59 months.
• To measure the prevalence of anaemia in children aged 6-59 months and in women of reproductive age between 15-49 years (non-pregnant)
• To investigate IYCF practices among children aged 0-23 months
• To determine the coverage of ration cards and the duration the general food ration lasts for recipient households.
• To determine the extent to which negative coping strategies are used by households.
• To assess household dietary diversity.
• To determine the population’s access to, and use of, improved water, sanitation and hygiene facilities.
• To determine the ownership of mosquito nets (all types and LLINs) in households.
• To determine the utilization of mosquito nets (all types and LLINs) by the total population, children 0-59 months and pregnant women
• To establish recommendations on actions to be taken to address the situation in the refuge population in the three camps.

Secondary objectives;**

• To determine the enrollment coverage of selective feeding programme (OTP/SC, BSFP, TSFP children 6-23 months and MNP children 24-59 months for children aged 6-59 months).
• To determine enrollment into Antenatal Care clinic and coverage of iron-folic acid supplementation in pregnant women.

DELIVERABLES

1. A final SENS assessment report complying UNHCR standards, including recommendations on actions to address the situation is to be submitted at the end of the Consultancy. Results of standardization tests, details of data cleaning and plausibility checks should be presented in the final report. The report must conform to the CRED survey completeness checklist (http://www.cedat.be/Field%20Resources).
2. Standardized tables as presented in the UNHCR SENS Guidelines for refugee populations (version 3, 2013, www.sens.unhcr.org) and should be used for presentation of the results.
3. The findings and major recommendations are to be presented to partners at the mission level (oral presentation and PowerPoint slides).
4. The final cleaned version of the data sets used to calculate the survey results is to be sent to the UNHCR Regional Service Centre (RSC) to [email protected], HQ [email protected] and to UNHCR Country Office.
5. Preliminary report to be shared by Mid-September and the final report to be shared by 30^th of September 2019.

REPORTING

The consultant will report on regular basis to the UNHCR Public health officer in Kigoma region who will have the overall responsibility of the survey.

TIME FRAME

The consultancy will last approximately 2.5 month, starting from August 1^st to October 15^th, 2019.

QUALIFICATIONS AND EXPERIENCE REQUIRED

The candidate should:

• Have a university degree or the equivalent, with advanced education in nutrition, with a specific competency in humanitarian emergencies.
• Have significant experience in undertaking nutrition surveys (design and methodologies, staff recruitment and training, field supervision and data analysis/write up).
• Be familiar with the SMART survey methodology and ENA for SMART, Epi/ENA or Epi Info software and UNHCR SENS
• Be fluent in English with excellent writing and presentation skills, French/Swahili/Kirundi will be an added advantage