TOR FOR SQUEAC Survey
|Location: Mataban and Beletweine
Subject: SQUEAC Survey
Deadline: 13th October-19 at 10:00AM.
Send documents To: CSS.LOGISTICS@savethechildren.org
The Community Based Management of Acute Malnutrition (CMAM) is a methodology for treating Acute malnutrition in young children using a case-finding and triage approach. Using the CMAM method, malnourished children receive treatment suited to their nutritional and medical needs. Most malnourished children can be rehabilitated at home with only a small number needing to travel for in-patient care. The CMAM model was developed by Valid International and has been endorsed by World Health Organization (WHO) and United Nation’s Children Fund (UNICEF). CMAM was originally designed for the emergency context, as an alternative to the traditional model of rehabilitating all severely malnourished children through in-patient care at Therapeutic Feeding Centers. However, it is increasingly being implemented in the context of long-term development programming, with several Ministries of Health including components of CMAM in their routine services. Through the CMAM program, children who are severely malnourished are managed through the outpatient therapeutic care (OTP), while children with complication are treated through the in-patient program (Stabilization Centers-SC). Coverage surveys (SQUEAC) are therefore an approach to identify the uptake of the program among the communities being served by the existing CMAM activities. This will inform the CMAM programming.
SCI in Hiiran has been implementing nutrition programs for the past 20 years and currently implementing CMAM activities in 20 sites inMataban districts and 16 sites in Beletweine district of Hiiran region.The CMAM activities comprise of OTP and TSFP integrated with IYCF /E activities. The nutrition program targets PLW and children under 5 with therapeutic and supplementary feeding. The current CMAM program in the two districts are majorly funded SC-UK, DFID-BRICs, SHF and WFP therefore in the coverage survey Save the children will assess the current CMAM Programme in the two districts.Last SQUEAC survey conducted in 2017 in Mataban, indicated coverage below the recommended 50% for Rural population in Mataban. During that time no SQUEAC survey has been conducted in Beletweine.
The assessment will be guided by the following specific objectives:
· To identify factors (boosters and barriers) affecting the access to the CMAM program in two districts.
· To develop specific recommendations to improve access and coverage of the program
· To enhance competencies of the nutrition program staff from SCI–Hiiranin the SQUEAC methodology.
The survey will use the SQUEAC (Semi-Quantitative Evaluation of Access and Coverage) methodologyto measure coverage for TSFP and OTP. SQUEAC is a low resource method that can be used on a regular basis to monitor program performance, identify barriers to service access and uptake and hence evaluate coverage. It is an investigation rather than a survey and uses a mix of quantitative (routine program data and small and wide area surveys) and qualitative data (anecdotal information from various relevant respondents). It equally, employs specific statistical analysis to provide an overall coverage estimate and show areas of poor coverage; and the methodology is action-oriented and practical, highlighting appropriate interventions needed to increase Coverage and access. The survey will adopt stages as follows:
Stage 1: Analyze routine data and other relevant available data to identify areas which suggest low or high coverage. Some of the information needed for this analysis includes program admissions over time, exits (cured, defaulters, non-response and deaths), listing and mapping of all settlements in the catchment area for the nutrition program, home locations of all beneficiaries and defaulters, home location and number of community volunteers. The Selected Districts Health Information System and routine program data shall be used to generate information on admission, default, and death rate in the nutrition program to develop trend of admission over time.
Stage 2: Collect information from the target communities, beneficiaries and health staff to explain and better inform the program data and build on the hypothesis of high or low coverage. This involves informal group discussions, household interviews where necessary, semi structured interviews and simple structured interviews with respondents such as caretakers, health workers and community health workers in the survey area. The information collected shall be used to triangulate the quantitative information collected in stage1. This stage also helps to identify factors promoting or hindering program coverage.
Likelihood surveys shall be used to test hypothesis of spatial distribution of coverage. The likelihood surveys shall adopt active and adaptive methodology which involves looking for cases of both moderately and severely malnourished (those in program and those not in programs). Sampling approach for the villages to be visited shall be determined by the consultant.
Stage 4: Estimating Programme Coverage Using SQUEAC Calculator.
This should be guided by the following:
- The Prior building:The Prior is the expression of beliefs about coverage based on qualitative data (or quantitative data transformed into qualitative data) provided by the Mind Map exercise.
- Coverage estimation: Based on the Prior developed through mind mapping, a SQUEAC Bayes Coverage Estimator shall be used to estimate coverage.
Figure 1: Snap-Shot of the SQUEAC Methodology Stages
As part of the technical proposal, the consultant should clearly indicate the approaches and budget for this engagement. After receiving the inception report from the successful consultant/firm, SCI shall arrange all necessary logistical needs of the survey including travels, accommodation, allowances for Field Assistants and partners, transport to the field and other necessary items.
2.1Timeframe and Description of main Activities
This survey will last for one month i.e. November 2019. This period will cover all survey processes including: Pre-field preparation, compilation and analysis of routine program data, training of field assistants, field data collection, data analysis and reporting. Notably, field data collection shall cover but not limited to the following: seasonal calendars, labour calendar, food availability, disease patterns, and interviews with caregivers, health workers and small area surveys.
2.2 Team composition and Authority
The successful Consultant shall be under the Supervision of SCI’s MEAL team and nutrition technical specialists. SCI will recruit and allocate field assistants (enumerators) based on the agreement with the consultant. As part of capacity building and nurturing synergies, the surveys will have nutrition program partners participating including Ministry of Health (MOH), other nutrition Implementing Partners and other stakeholders as appropriate and applicable according to the geographical context.
3.0 Required Experience
The consultant should possess the following qualifications
- Extensive experience in nutrition research, SQUEAC surveys, monitoring and evaluation fieldwork (data collection, validation, entry and analysis)
- Experience in leading teams in field (training, field logistic management, human relations, teamwork)
- Prior experience with nutrition, health and food security programming.
- Excellent writing skills, with publication record (in any language) in one discipline related to assignment
- Good knowledge of Somalia and humanitarian operations in fragile contexts. Preferably Somalia national.
- Demonstrable ability and experience in working with communities in a survey setup.
- Demonstrable ability to facilitate capacity building sessions for people with different backgrounds.
- In addition, the consultant should be willing and able to work under a tight timeframe.
3.2 Expected Outputs from the Survey
During this engagement, the consultant shall be expected to deliver the following to the survey partners
- Prepare a pre-survey presentation for the methodology and delivered it to the AIM working group in Mogadishu.
- A well written survey report with clearly disaggregated findings by District, Category (SAM&MAM) and livelihood zones. Soft copy of raw data set for any quantitative data collected
- Soft copies of qualitative data collected (i.e. interview notes).
- Summary MS- PowerPoint presentation of the survey results –
3.3 Application criteria
Proposals for this consultancy should include the following information (at a minimum)
- Proposed technical approaches – this should clearly elaborate the methodology and logistics required
- Proposed timelines for each sub-activity
- Proposed budget – this should majorly focus on consultancy fees as logistics will be handled by SCI.
- Curriculum Vitae for two key team members intending to lead this investigation.
- Individual/Company Profile – Showing clear experience in facilitating SQUEAC and Coverage surveys. Please attach copies of scanned and stamped contracts.
- Relevant registration certificate for companies if applied through company.
Interested companies/ individuals to submit applications with the subject line of the email address” SQUEAC SURVEY to CSS.LOGISTICS@savethechildren.org
The deadline for the application is 13th October-2019 at 10:00AM
Mark Myatt, Daniel Jones, EphremEmru, Saul Guerrero, LionellaFieschi. SQUEAC & SLEAC: Low resource methods for evaluating access and coverage in selective feeding programs. http://www.brixtonhealth.com/SQUEAC.Article.pdf