TERMS OF REFERENCE Social Marketing of Micronutrient Powers in Somaliland and Puntland
Social Marketing of Micronutrient Powers in Somaliland and Puntland
| Somalia has one of the highest infant and under-five and maternal mortality rates in the world; at 137 per 1,000 live births the under-five mortality rate is the third highest in the world and at 732 per 100,000 live births, the maternal mortality ratio is the sixth highest.
Micronutrient deficiencies amongst young children and women of child bearing age are widespread. The prevalence of anemia, iron and Vitamin A deficiency are public health problems according to the World Health Organization (WHO) classification and thresholds. Iron deficiency stands at 59.3 per cent in children under-5 and at 73.7 in children under-2.(Somalia Micronutrient survey 2009)Anemia prevalence among children is 45.2 per cent and 56.4 per cent in Somaliland and Puntland respectively. Similarly, iron deficiency, at 59.6 per cent for both Somaliland and Puntland is high and prevalence of Vitamin A deficiency exceeds the 20 per cent WHO cut-off.
In response to these critical indicators, UNICEF in collaboration with its partners implemented interventions to combat micronutrient deficiencies and related-diseases. UNICEF promotes a holistic, life-cycle approach to nutrition service provision for women and children, ensuring the inclusion of treatment, promotion and prevention in one Basic Nutrition Services Package (BNSP) at both facility and community level. The BNSP includes, inter alia, the management of acute malnutrition; micronutrient support; and infant and young child nutrition.
Micronutrient powders (MNP), single-dose packets containing iron, Vitamin A and zinc in powder form that can be sprinkled onto any ready-to-eat semi-solid food, are recommended by WHO to reduce anaemia among children aged 6-59 months,. Micronutrient deficiencies are also exacerbated during pregnancy and are likely to influence maternal, fetal and newborn health.
MNPs and diarrhoea treatment kits (DTKs) were introduced in Somaliland in 2013 to help combat child morbidity and mortality-related to diarrhoeal diseases and micronutrient deficiencies through Fast Moving Consumer Goods (FMCG) channels and community-based distribution. Since then, a total of 1,048,035 sachets of MNPs and 429,326 DTKs have been distributed to children aged 6-59 months in Somaliland. UNICEF worked closely with one partner to strengthen efforts towards improvements in iron status, reduction in anemia and overall decrease in micronutrient deficiencies among children under five by distribution of MNPs (locally branded “Super Fariid”) through fast moving consumer goods (FMCG) channels (Bulshokaab chain of pharmacies) in Somaliland. Furthermore, DTKs (locally branded “Shuban-daweeye”) were distributed through FMCG channels to help combat child morbidity and mortality related to diarrhoeal diseases in children under five. A holistic campaign promoting product awareness and demand creation as well as key messaging around child health, infant feeding and diarrhoea prevention was sustained. Additionally, MMN tablets for PLW were introduced in the market to support product demand. The distribution of vouchers for MMN tablets was piloted for women attending interpersonal communication (IPC) sessions in seven towns, namely Hargeisa, Boroma, Burco, Berbera, Ceerigaabo, Odweyne and Wajaale. Vouchers were redeemed by PLW at identified and trained distribution outlets at subsidised costs. The model was also piloted in Puntland.
|UNICEF is requesting for proposals from a competent institution for the social marketing for micronutrient powders, multiple micronutrient tablets and diarrhea treatment kits to enhance maternal infant and young child nutrition.
The objectives include:
· Support the delivery of affordable nutritional services and products through the appropriate channels of social marketing
· To plan and implement social marketing and communication strategies and approaches at all levels to increase informed demand for nutritional services and improved knowledge and practices of key nutritionbehaviours among caretakers
· To build the capacity of relevant service providers (distributors, pharmacies providers, wholesalers, community based workers) on project interventions and products
 World Health Organization, Guideline: Use of Multiple Micronutrient Powders for Home Fortification of Foods Consumed by Infants and Children 6–23 Months of Age, WHO, Geneva, 2011,
 The Home Fortification Technical Advisory Group, Programmatic Guidance Brief on Use of Micronutrient Powders (MNP) For Home Fortification, HF-TAG, 20 Dec 2011.